The importance of size-exclusion characteristics of type I collagen in bonding to dentin matrices

The mineral phase of dentin is located primarily within collagen fibrils. During development, bone or dentin collagen fibrils are formed first and then water within the fibril is replaced with apatite crystallites. Mineralized collagen contains very little water. During dentin bonding, acid-etching of mineralized dentin solubilizes the mineral crystallites and replaces them with water. During the infiltration phase of dentin bonding, adhesive comonomers are supposed to replace all of the collagen water with adhesive monomers that are then polymerized into copolymers. The authors of a recently published review suggested that dental monomers were too large to enter and displace water from collagen fibrils. If that were true, the endogenous proteases bound to dentin collagen could be responsible for unimpeded collagen degradation that is responsible for the poor durability of resin-dentin bonds. The current work studied the size-exclusion characteristics of dentin collagen, using a gel-filtration-like column chromatography technique, using dentin powder instead of Sephadex. The elution volumes of test molecules, including adhesive monomers, revealed that adhesive monomers smaller than ∼1000 Da can freely diffuse into collagen water, while molecules of 10,000 Da begin to be excluded, and bovine serum albumin (66,000 Da) was fully excluded. These results validate the concept that dental monomers can permeate between collagen molecules during infiltration by etch-and-rinse adhesives in water-saturated matrices. © 2013 Acta Materialia Inc.

Effectiveness of immediate bonding of etch-and-rinse adhesives to simplified ethanol-saturated dentin

This study examined the immediate bond strength of etch-and-rinse adhesives to demineralized dentin saturated with either water or absolute ethanol. The research hypothesis was that there would be no difference in bond strength to dentin between water or ethanol wet-bonding techniques. The medium dentin of 20 third molars was exposed (n = 5). The dentin surface was then acid-etched, left moist and randomly assigned to be saturated via either water wet-bonding (WBT) or absolute ethanol wet-bonding (EBT). The specimens were then treated with one of the following etch-and-rinse adhesive systems: a 3-step, water-based system (Adper Scotchbond Multipurpose, or SBMP) or a 2-step, ethanol/water-based system (Adper Single Bond 2, or SB). Resin composite build-ups were then incrementally constructed. After water storage for 24 h at 37 degrees C, the tensile strength of the specimens was tested in a universal testing machine (0.5 mm/min). Data were analyzed by two-way ANOVA and Tukey's test (alpha = 5%). The failure modes were verified using a stereomicroscope (40x). For both adhesives, no significant difference in bond strength was observed between WBT and EBT (p > 0.05). The highest bond strength was observed for SB, regardless of the bonding technique (p < 0.05). No significant interaction between adhesives and bonding techniques was noticed (p = 0.597). There was a predominance of adhesive failures for all tested groups. The EBT and WBT displayed similar immediate bond strength means for both adhesives. The SB adhesive exhibited higher means for all conditions tested. Further investigations are needed to evaluate long-term bonding to dentin mediated by commercial etch-and-rinse adhesives using the EBT approach.

Inhibitory Effects Of A Cured Antibacterial Bonding System On Viability And Metabolic Activity Of Oral Bacteria.

To evaluate the antimicrobial efficacy of Clearfil SE Protect (CP) and Clearfil SE Bond (CB) after curing and rinsed against five individual oral microorganisms as well as a mixture of bacterial culture prepared from the selected test organisms. Bacterial suspensions were prepared from single species of Streptococcus mutans, Streptococcus sobrinus, Streptococcus gordonii, Actinomyces viscosus and Lactobacillus lactis, as well as mixed bacterial suspensions from these organisms. Dentin bonding system discs (6 mm×2 mm) were prepared, cured, washed and placed on the bacterial suspension of single species or multispecies bacteria for 15, 30 and 60 min. MTT, Live/Dead bacterial viability (antibacterial effect), and XTT (metabolic activity) assays were used to test the two dentin system's antibacterial effect. All assays were done in triplicates and each experiment repeated at least three times. Data were submitted to ANOVA and Scheffe's f-test (5%). Greater than 40% bacteria killing was seen within 15 min, and the killing progressed with increasing time of incubation with CP discs. However, a longer (60 min) period of incubation was required by CP to achieve similar antimicrobial effect against mixed bacterial suspension. CB had no significant effect on the viability or metabolic activity of the test microorganisms when compared to the control bacterial culture. CP was significantly effective in reducing the viability and metabolic activity of the test organisms. The results demonstrated the antimicrobial efficacy of CP both on single and multispecies bacterial culture. CP may be beneficial in reducing bacterial infections in cavity preparations in clinical dentistry.

Ethanol Wet-bonding Challenges Current Anti-degradation Strategy

The long-term effectiveness of chlorhexidine as a matrix metalloproteinase (MMP) inhibitor may be compromised when water is incompletely removed during dentin bonding. This study challenged this anti-bond degradation strategy by testing the null hypothesis that wet-bonding with water or ethanol has no effect on the effectiveness of chlorhexidine in preventing hybrid layer degradation over an 18-month period. Acid-etched dentin was bonded under pulpal pressure simulation with Scotchbond MP and Single Bond 2, with water wet-bonding or with a hydrophobic adhesive with ethanol wet-bonding, with or without pre-treatment with chlorhexidine diacetate (CHD). Resin-dentin beams were prepared for bond strength and TEM evaluation after 24 hrs and after aging in artificial saliva for 9 and 18 mos. Bonds made to ethanol-saturated dentin did not change over time with preservation of hybrid layer integrity. Bonds made to CHD pre-treated acid-etched dentin with commercial adhesives with water wet-bonding were preserved after 9 mos but not after 18 mos, with severe hybrid layer degradation. The results led to rejection of the null hypothesis and highlight the concept of biomimetic water replacement from the collagen intrafibrillar compartments as the ultimate goal in extending the longevity of resin-dentin bonds.

Stability of wet versus dry bonding with different solvent-based adhesives

Objective. To evaluate the effects of surface moisture (wet or dry) and storage (24h or 3 months) on the microtensile bond strength (BS) of resin/dentin bonds mediated by two water/ethanol based adhesives Single Bond, 3M-ESPE, (SB) and Opti Bond Solo Plus, Kerr, (OB), and two acetone-based adhesives, One Step, Bisco, (OS) and Prime&Bond NT, Caulk/Dentsply, (PB). Materials and methods. Flat dentin surfaces were polished with 600-grit SiC paper, etched with 35% phosphoric acid for 15 s and rinsed for 20 s. Half the surface was maintained moist and the other half was air-dried for 30 s. Each adhesive was applied simultaneously to both halves, left undisturbed for 30 s and light-cured. Four-mm resin build-ups were constructed incrementally. After storage in water at 37 degrees C for 24h, slabs were produced by transversal sectioning and trimmed to an hourglass shape (0.8 mm 2). Half of the specimens were tested in tension at 0.6 mm/min immediately after trimming and the other half after 3 months of water storage. Data were analyzed by two-way ANOVA and SNK for each material. Results. Both moisture and storage affected BS to dentin, and was material- dependent. Dry, bonding affected mostly the acetone-based adhesives. Larger reductions in bond strength were associated with dry bonding after 3 months of water storage. Significance. Wet bonding resulted in more stable bonds over 3 months of water storage for most of the materials tested. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Pooling of dentin microtensile bond strength data improves clinical correlation.

Purpose: To evaluate whether the correlation between in vitro bond strength data and estimated clinical retention rates of cervical restorations after two years depends on pooled data obtained from multicenter studies or single-test data. Materials and Methods: Pooled mean data for six dentin adhesive systems (Adper Prompt L-Pop, Clearfil SE, OptiBond FL, Prime & Bond NT, Single Bond, and Scotchbond Multipurpose) and four laboratory methods (macroshear, microshear, macrotensile and microtensile bond strength test) (Scherrer et al, 2010) were correlated to estimated pooled two-year retention rates of Class V restorations using the same adhesive systems. For bond strength data from a single test institute, the literature search in SCOPUS revealed one study that tested all six adhesive systems (microtensile) and two that tested five of the six systems (microtensile, macroshear). The correlation was determined with a database designed to perform a meta-analysis on the clinical performance of cervical restorations (Heintze et al, 2010). The clinical data were pooled and adjusted in a linear mixed model, taking the study effect, dentin preparation, type of isolation and bevelling of enamel into account. A regression analysis was carried out to evaluate the correlation between clinical and laboratory findings. Results: The results of the regression analysis for the pooled data revealed that only the macrotensile (adjusted R2 = 0.86) and microtensile tests (adjusted R2 = 0.64), but not the shear and the microshear tests, correlated well with the clinical findings. As regards the data from a single-test institute, the correlation was not statistically significant. Conclusion: Macrotensile and microtensile bond strength tests showed an adequate correlation with the retention rate of cervical restorations after two years. Bond strength tests should be carried out by different operators and/or research institutes to determine the reliability and technique sensitivity of the material under investigation.

Effect of blood contamination on the shear bond strength at resin/dentin interface in primary teeth

Purpose: To assess in vitro the shear bond strength at the resin/dentin interface in primary teeth after contamination with fresh human blood. Methods: 75 crowns of primary molars were embedded in acrylic resin and mechanically ground to expose a flat dentin surface. The specimens were randomly assigned to five groups (n=15), according to the surface treatment. Group I (control) had no blood contamination. The other groups were blood-contaminated and subjected to different post-contamination protocols: in Group 2, the surfaces were rinsed with water; in Group 3, the surfaces were air-dried; in Group 4, the surfaces were rinsed and air-dried; and in Group 5, no post-contamination treatment was done. In all groups, a 3-mm dentin bonding site was demarcated, Single Bond adhesive system was applied and resin composite cylinders were bonded. After 24 hours in distilled water, shear bond strength was tested at a crosshead speed of 0.5 mm/minute. Results: Means (in MPa) were: Group 1: 7.1 (+/- 4.2); Group 2: 4.0 (+/- 1.8); Group 3: 0.9 (+/- 0.7); Group 4: 3.9 (+/- 2.2) and Group 5: 1.3 (+/- 1.5). Data were analyzed statistically by the Kruskal-Wallis test at 5% significance level. Groups 2 and 4 were similar to each other (P > 0.05) and both ware similar to Group 1 (P > 0.05). These groups (2, 3 and 4) had statistically significantly higher bond strengths than Groups 3 and 5 (P < 0.05). Blood contamination negatively affected the shear bond strength to primary tooth dentin. Among the blood-contaminated groups, water-rinsed specimens had higher bond strengths than those that were exclusively air-dried or not submitted to any post-contamination protocol before adhesive application.

Etch and rinse versus self-etching adhesives systems: Tridimensional micromechanical analysis of dentin/adhesive interface

The purpose of this study was to evaluate stress distribution in the hybrid layer produced by two adhesive systems using three-dimensional finite element analysis (FEA). Four FEA models (M) were developed: Mc, a representation of a dentin specimen (41 x 41 x 82 mu m) restored with composite resin, exhibiting the adhesive layer, hybrid layer (HL), resin tags, peritubular dentin, and intertubular dentin to simulate the etch-and-rinse adhesive system; Mr, similar to Mc, with lateral branches of the adhesive; Ma, similar to Mc, however without resin tags and obliterated tubule orifice, to simulate the environment for the self-etching adhesive system; Mat, similar to Ma, with tags. A numerical simulation was performed to obtain the maximum principal stress (sigma(max)). The highest sigma(max) in the HL was observed for the etch-and-rinse adhesive system. The lateral branches increased the sigma(max) in the HL. The resin tags had a little influence on stress distribution with the self-etching system. (C) 2012 Elsevier Ltd. All rights reserved.

Bond Strength of Two-Step Etch-and-Rinse Adhesive Systems to the Dentin of Primary and Permanent Teeth

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Chlorhexidine increases the longevity of in vivo resin-dentin bonds

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Current status of pulp capping with dentin adhesive systems: a review

Several studies have assessed the morphology and thickness of hybrid layer, the dentin bend strengths as well as sealing ability of dentin adhesive systems. However, few in vivo studies have evaluated the biocompatibility of the adhesive systems following application to deep dentin or directly to the pulp of human teeth. Many studies performed in non-human primate teeth or teeth of rats have reported pulp healing and dentin bridging following pulp capping with bonding agents. In addition, a few clinical and radiographical reports of the success of resin pulp capping have been described in the dental literature.Objectives: the aim of this review was to evaluate the literature on pulp responses following total acid etching and application of adhesive resins on deep cavities or pulp exposures. In addition, the clinical/radiographical evidence for the apparent success of vital pulp therapy and results obtained from animal and human studies were compared and discussed.Significance and conclusions: the self-etching adhesive systems may be useful and safe when applied on dentin, In contrast, persistent inflammatory reactions as well as delay in pulpal healing and failure of dentin bridging were seen in human pulps capped with bonding agents. The results observed in animal teeth cannot be directly extrapolated to human clinical conditions. Consequently, vital pulp therapy using acidic agents and adhesive resins seems to be contraindicated. (C) 2000 Academy of Dental Materials. Published by Elsevier B.V. Ltd. All rights reserved.

Interfacial fracture of dentin adhesively bonded to quartz-fiber reinforced composite

The paper presents the results of an experimental study of interfacial failure in a multilayered structure consisting of a dentin/resin cement/quartz-fiber reinforced composite (FRC). Slices of dentin close to the pulp chamber were sandwiched by two half-circle discs made of a quartz-fiber reinforced composite, bonded with bonding agent (All-bond 2, BISCO, Schaumburg) and resin cement (Duo-link. BISCO, Schaumburg) to make Brazil-nut sandwich specimens for interfacial toughness testing. Interfacial fracture toughness (strain energy release rate, G) was measured as a function of mode mixity by changing loading angles from 0 degrees to 15 degrees. The interfacial fracture surfaces were then examined using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX) to determine the failure modes when loading angles changed. A computational model was also developed to calculate the driving forces, stress intensity factors and mode mixities. Interfacial toughness increased from approximate to 1.5 to 3.2 J/m(2) when the loading angle increases from approximate to 0, 0 to 15 degrees. The hybridized dentin/cement interface appeared to be tougher than the resin cement/quartz-fiber reinforced epoxy. The Brazil-nut sandwich specimen was a suitable method to investigate the mechanical integrity of dentin/cement/FRC interfaces. (C) 2011 Elsevier B.V. All rights reserved.

Effect of Biomimetic Remineralization on the Dynamic Nanomechanical Properties of Dentin Hybrid Layers

The mineral and organic phases of mineralized dentin contribute co-operatively to its strength and toughness. This study tested the null hypothesis that there is no difference in nano-dynamic mechanical behavior (complex modulus-E*; loss modulus-E ''; storage modulus-E'; in GPa) of dentin hybrid layers (baseline: E*, 3.86 +/- 0.24; E '', 0.23 +/- 0.05; E', 3.85 +/- 0.24) created by an etch-and-rinse adhesive in the presence or absence of biomimetic remineralization after in vitro aging. Using scanning probe microscopy and nano-dynamic mechanical analysis, we demonstrated that biomimetic remineralization restored the nano-dynamic mechanical behavior of heavily remineralized, resin-sparse regions of dentin hybrid layers (E*, 19.73 +/- 3.85; E '', 8.75 +/- 3.97; E', 16.02 +/- 2.58) to those of the mineralized dentin base (E*, 19.20 +/- 2.42; E '', 6.57 +/- 1.96; E', 17.39 +/- 2.0) [p > 0.05]. Conversely, those resin-sparse, water-rich regions degraded in the absence of biomimetic remineralization, with significant decline [p < 0.05] in their complex and storage moduli (E*, 0.83 +/- 0.35; E '', 0.88 +/- 0.24; E', 0.62 +/- 0.32). Intrafibrillar apatite deposition preserves the integrity of resin-sparse regions of hybrid layers by restoring their nanomechanical properties to those exhibited by mineralized dentin.

Adhesives with different pHs: Effect on the MTBS of chemically activated and light-activated composites to human dentin

Purpose: To evaluate the bond strength between human dentin and composites, using two light-activated single-bottle total-etch adhesive systems with different pHs combined with chemically activated and light-activated-composites. The tested hypothesis was that the dentin bond strength is not influenced by an adhesive system of low pH, combined with chemically activated or light-activated composites. Material and Method: Flat dentin surfaces of twenty-eight human third molars were allocated in 4 groups (n=7), depending on the adhesive system: (One Step Plus-OS and Prime & Bond NT-PB) and composite (light-activated Filtek Z-100 [Z100] and chemically activated Bisfil 2B [B2B]). Each adhesive system was applied on acid-etched dentin and then one of the composites was added to form a 5 mm-high resin block. The specimens were stored in tap water (37 degrees C/24 h) and sectioned into two axes, x and y. This was done with a diamond disk under coolant irrigation to obtain beams with a cross-section area of approximately 0.8 mm(2). Each specimen was then attached to a custom-made device and submitted to the microtensile test (1 mm.min(-1)). Data were analyzed using two-way ANOVA and Tukey's tests (p<0.05). Results: the anticipated hypothesis was not confirmed (p<0.0001). The bond strengths (MPa) were not statistically different between the two adhesive systems when light-activated composite was used (OS+Z100 = 24.7 +/- 7.1(a); PB+Z100 = 23.8 +/- 5.7(a)). However, with use of the chemically activated composite (B2B), PB (7.8 +/- 3.6(b) MPa) showed significantly lower dentin bond strengths than OS (32.2 +/- 7.6(a)). Conclusion: the low pH of the adhesive system can affect the bond of chemically activated composite to dentin. on the other hand, under the present conditions, the low pH did not seem to affect the bond of light-activated composites to dentin significantly.

Localized mechanics of dentin self-etching adhesive system

The bond strength of composite resins (CRs) to dentin is influenced by the interfacial microstructure of the hybrid layer (HL) and the resin tags (TAG). The contemporary self-etching primer adhesive systems overcame the inconvenient of the etch-and-rinse protocol. Studies, however, have demonstrated that HL thickness and TAG length vary according to the wetting time and additional use of acid-etching prior to self-etching primers. This study investigated the localized stress distribution in the HL and the dentin/adhesive interface. Two HL thicknesses (3 or 6 mu m), two TAG lengths (13 or 17 mu m) and two loading conditions (perpendicular and oblique-25 degrees) were investigated by the finite element (FE) analysis. Five two-dimensional FE models (M) of a dentin specimen restored with CR (38 x 64 mu m) were constructed: M1 - no HL and no TAG; M2 - 3 mu m of HL and 13 mu m of TAG; M3 - 3 mu m of HL and 17 mu m of TAG; M4 - 6 mu m of HL and 13 mu m of TAG; and M5 - 6 mu m of HL and 17 mu m of TAG. Two distributed loadings (L) (20N) were applied on CR surface: L1 - perpendicular, and L2 - oblique (25 degrees). Fixed interfacial conditions were assigned on the border of the dentin specimen. Ansys 10.0 (Ansys (R), Houston, PA, USA) software was used to calculate the stress fields. The peak of von Mises (sigma(vM)) and maximum principal stress (sigma(max)) was higher in L2 than in L1. Microstructures (HL and TAG) had no effect on local stresses for L1. Decreasing HL decreased sigma(vM) and sigma(max) in all structures for L2, but the TAG length had influence only on the peributular dentin. The thickness of HL had more influence on the sigma(vM) and sigma(max) than TAG length. The peritubular dentin and its adjacent structures showed the highest sigma(vM) and sigma(max), mainly in the oblique loading.