Bond strength of composite to dentin: effect of acid etching and laser irradiation through an uncured self-etch adhesive system

This study evaluated the effect on micro-tensile bond strength (mu-TBS) of laser irradiation of etched/unetched dentin through an uncured self-etching adhesive. Dentinal surfaces were treated with Clearfil SE Bond Adhesive (CSE) either according to the manufacturer's instructions (CSE) or without applying the primer (CSE/NP). The dentin was irradiated through the uncured adhesive, using an Nd: YAG laser at 0.75 or 1 W power settings. The adhesive was cured, composite crowns were built up, and the teeth were sectioned into beams (0.49 mm(2)) to be stressed under tension. Data were analyzed using one-way ANOVA and Tukey statistics (alpha = 5%). Dentin of the fractured specimens and the interfaces of untested beams were observed under scanning electron microscopy (SEM). The results showed that non-etched irradiated surfaces presented higher mu-TBS than etched and irradiated surfaces (p < 0.05). Laser irradiation alone did not lead to differences in mu-TBS (p > 0.05). SEM showed solidification globules on the surfaces of the specimens. The interfaces were similar on irradiated and non-irradiated surfaces. Laser irradiation of dentin through the uncured adhesive did not lead to higher mu-TBS when compared to the suggested manufacturer's technique. However, this treatment brought benefits when performed on unetched dentin, since bond strengths were higher when compared to etched dentin.

Resin tag length of one-step and self-etching adhesives bonded to unground enamel

Length of resin tags yielded by utilization of an one-step conventional adhesive system and self-etching adhesive system on unground enamel was observed. In study Groups I and III, the enamel surface was etched for 60 seconds with 35% phosphoric acid gel and adhesive systems PQ1 (Ultradent Products, Inc) and Adper Prompt L Pop (3M/ESPE) were applied. Adper Prompt L Pop (3M/ESPE) was also applied in Group II in accordance with the manufacturer's recommendations. After application of these adhesive systems to dental enamel, specimens were prepared for light microscopy analysis to ascertain degree of penetration (x400). The results were submitted to an analysis of variance at the 5% level; whenever there was significance, the Tukey test was applied at the 5% level. It was found that acid etching prior to application of conventional and self-etching adhesive materials provided higher penetration of the adhesive into the unground enamel surface compared to that achieved solely by application of self-etching adhesive.

Cytotoxicity of adhesive systems of different hydrophilicities on cultured odontoblast-like cells

This study evaluated the cytotoxicity of experimental adhesive systems (EASs) on odontoblast-like cells. Paper discs (n=132) were impregnated with 10 μL of each EAS-R1, R2, R3, R4, and R5 (in an ascending order of hydrophilicity), followed by photoactivation. R1 and R2 are nonsolvated hydrophobic blends, R3 represents a simplified etch-and-rinse adhesive system, and R4 and R5 represent simplified self-etch adhesive systems. Discs were immersed in Dulbecco's modified Eagle's medium for 24 h to obtain eluates applied on MDPC-23 cell cultures. No material was applied on discs used as control (R0). Cell viability [3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay], total protein (TP) production, alkaline phosphatase (ALP) activity, type of cell death, and degree of monomer conversion Fourier transform infrared (%DC-FTIR) were evaluated. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Considering R0 (control) as having 100% of cell viability, R1, R2, R3, R4, and R5 reduced the metabolic activity of cells by 36.4, 3.1, 0.2, 21.5, and 65.7%, respectively, but only R1 and R5 differed from R0. Comparing with R0, lower TP production was observed for R1, R4, and R5, while ALP activity decreased for R1 and R5. Necrotic cell death was predominant for all EASs, but only R1, R4, and R5 differed from R0. Only R5 presented a different apoptotic cell death ratio from R0. R1 presented the lowest %DC (ca. 37%), whereas R4 and R5 presented the highest (ca. 56%). In conclusion, R2 and R3 were not toxic to the MDPC-23 cells, suggesting that the degree of hydrophilicity or %DC of the EASs alone were not responsible for their cytopathic effects. © 2013 Wiley Periodicals, Inc.

Adhesive systems: important aspects related to their composition and clinical use

This literature review article addresses the types and the main components of different etch-and-rinse and self-etch adhesive systems available in the market, and relates them to their function, possible chemical interactions and influence of handling characteristics. Scanning electron microscopy (SEM) images are presented to characterize the interface between adhesives and dentin. Adhesive systems have been recently classifed according to their adhesion approaches in etch-and-rinse, self-etch and glass ionomer. The etch-and-rinse systems require a specifc acid-etch procedure and may be performed in two or three steps. Self-etch systems employ acidic monomers that demineralize and impregnate dental substrates almost at the same time. These systems are separated in one or two steps. Some advantages and defciencies were noted for etch-and-rinse and self-etch approaches, mainly for the simplifed ones due to some chemical associations and interactions. The SEM micrographs illustrate different relationships between adhesive systems and dental structures, particularly dentin. The knowledge of composition, characteristics and mechanisms of adhesion of each adhesive system is of fundamental importance to permit the adoption of ideal bonding strategies under clinical conditions.

Grander system: A new technology to reduce surface tension of adhesive systems in dentistry

Background. Reduced surface tension of liquids results in higher surface wetting ability and diffusivity by the substrate. Objectives. The objective of this study was to evaluate the influence of the Grander Technology in reducing the surface tension of adhesive systems. Methods. Two adhesive systems (self-etch and total-etch) were modified by physical contact with the Grander system Flexible unit to revitalize water, for 48 h. Surface tension of adhesive systems and water in normal and grander-modified conditions was measured with a goniometer. Results. The results showed a reduction of surface tension for all conditions grander-modified between 3-15%. Conclusions. Grander Technology was effective in reducing the surface tension of the Single Bond and Clearfil SE Bond adhesive systems. Clinical significance. Grander technology was employed to restructure the molecular structure of water-based adhesive systems, which can increase their wetness capacity and therefore ensure a greater diffusibility.

Responses of dental pulp cells to a less invasive bleaching technique applied to adhesive restored teeth

To assess the cytotoxicity of 35% hydrogen peroxide (HP) bleaching gel applied for 15 min to sound or restored teeth with two-step self-etching adhesive systems and composite resin. Materials and Methods: Sound and restored enamel/dentin disks were stored in water for 24 h or 6 months + thermocycling. The disks were adapted to artificial pulp chambers and placed in compartments containing culture medium. Immediately after bleaching, the culture medium in contact with dentin was applied for 1 h to previously cultured odontoblast-like MDPC-23 cells. Thereafter, cell viability (MTT assay) and morphology (SEM) were assessed. Data were analyzed by two-way ANOVA and Tukey's test (a = 5%). Results: In comparison to the negative control group (no treatment), no significant cell viability reduction occurred in those groups in which sound teeth were bleached. However, a significant decrease in cell viability was observed in the adhesive-restored bleached groups compared to negative control. No significant difference among bleached groups was observed with respect to the presence of restoration and storage time. Conclusion: The application of 35% HP bleaching gel to sound teeth for 15 min does not cause toxic effects in pulp cells. When this bleaching protocol was performed in adhesive-restored teeth, a significant toxic effect occurred.

Clinical performance of cervical restorations: a meta-analysis.

OBJECTIVES: To carry out a meta-analysis in order to assess the influencing factors on retention loss and marginal discoloration of cervical restorations made of composites and glass ionomer (derivates). METHODS: The literature was searched for prospective clinical studies on cervical restorations with an observation period of at least 18 months. RESULTS: Fifty clinical studies involving 40 adhesive systems matched the inclusion criteria. On average, 10% of the cervical fillings were lost and 24% exhibited marginal discoloration after 3 years. The variability ranged from 0% to 50% for retention loss and from 0% to 74% for marginal discoloration. Hardly any secondary caries was detected. When linear mixed models with a study and experiment effect were used, the analysis revealed that the adhesive/restorative class had the most significant influence, with 2-step self-etching adhesive systems performing best and 1-step self-etching adhesive systems performing worst; 3-step etch-and-rinse systems, glass ionomers/resin-modified glass ionomers, 2-step etch-and-rinse systems and polyacid-modified resin composites were ranked in between. Restorations placed in teeth whose dentin/enamel had been prepared/roughened showed a statistically significant higher retention rate than those placed in teeth with unprepared dentin (p<0.05). Beveling of the enamel and the type of isolation used (rubberdam/cotton rolls) had no significant influence. SIGNIFICANCE: The clinical performance of cervical restorations is significantly influenced by the type of adhesive system used and/or the adhesive class to which the system belonged and whether the dentin/enamel is prepared or not. 2-Step self-etching- and 3-step etch&rinse systems shall be chosen over 1-step self-etching systems and glass ionomer derivates. The dentin (and enamel) surface shall be roughened before placement of the restoration.

Clinical effectiveness of direct class II restorations: a meta-analysis.

Purpose: More than five hundred million direct dental restorations are placed each year worldwide. In about 55% of the cases, resin composites or compomers are used, and in 45% amalgam. The longevity of posterior resin restorations is well documented. However, data on resin composites that are placed without enamel/dentin conditioning and resin composites placed with self-etching adhesive systems are missing. Material and Methods: The database SCOPUS was searched for clinical trials on posterior resin composites without restricting the search to the year of publication. The inclusion criteria were: (1) prospective clinical trial with at least 2 years of observation; (2) minimum number of restorations at last recall = 20; (3) report on dropout rate; (4) report of operative technique and materials used; (5) utilization of Ryge or modified Ryge evaluation criteria. For amalgam, only those studies were included that directly compared composite resin restorations with amalgam. For the statistical analysis, a linear mixed model was used with random effects to account for the heterogeneity between the studies. P-values under 0.05 were considered significant. Results: Of the 373 clinical trials, 59 studies met the inclusion criteria. In 70% of the studies, Class II and Class I restorations had been placed. The overall success rate of composite resin restorations was about 90% after 10 years, which was not different from that of amalgam. Restorations with compomers had a significantly lower longevity. The main reason for replacement were bulk fractures and caries adjacent to restorations. Both of these incidents were infrequent in most studies and accounted only for about 6% of all replaced restorations after 10 years. Restorations with macrofilled composites and compomer suffered significantly more loss of anatomical form than restorations with other types of material. Restorations that were placed without enamel acid etching and a dentin bonding agent showed significantly more marginal staining and detectable margins compared to those restorations placed using the enamel-etch or etch-and-rinse technique; restorations with self-etching systems were between the other groups. Restorations with compomer suffered significantly more chippings (repairable fracture) than restorations with other materials, which did not statistically differ among each other. Restorations that were placed with a rubber-dam showed significantly fewer material fractures that needed replacement, and this also had a significant effect on the overall longevity. Conclusion: Restorations with hybrid and microfilled composites that were placed with the enamel-etching technique and rubber-dam showed the best overall performance; the longevity of these restorations was similar to amalgam restorations. Compomer restorations, restorations placed with macrofilled composites, and resin restorations with no-etching or self-etching adhesives demonstrated significant shortcomings and shorter longevity.

Meta-analysis of the influence of bonding parameters on the clinical outcome of tooth-colored cervical restorations

PURPOSE: To meta-analyze the literature on the clinical performance of Class V restorations to assess the factors that influence retention, marginal integrity, and marginal discoloration of cervical lesions restored with composite resins, glass-ionomer-cement-based materials [glass-ionomer cement (GIC) and resin-modified glass ionomers (RMGICs)], and polyacid-modified resin composites (PMRC). MATERIALS AND METHODS: The English literature was searched (MEDLINE and SCOPUS) for prospective clinical trials on cervical restorations with an observation period of at least 18 months. The studies had to report about retention, marginal discoloration, marginal integrity, and marginal caries and include a description of the operative technique (beveling of enamel, roughening of dentin, type of isolation). Eighty-one studies involving 185 experiments for 47 adhesives matched the inclusion criteria. The statistical analysis was carried out by using the following linear mixed model: log (-log (Y /100)) = β + α log(T ) + error with β = log(λ), where β is a summary measure of the non-linear deterioration occurring in each experiment, including a random study effect. RESULTS: On average, 12.3% of the cervical restorations were lost, 27.9% exhibited marginal discoloration, and 34.6% exhibited deterioration of marginal integrity after 5 years. The calculation of the clinical index was 17.4% of failures after 5 years and 32.3% after 8 years. A higher variability was found for retention loss and marginal discoloration. Hardly any secondary caries lesions were detected, even in the experiments with a follow-up time longer than 8 years. Restorations placed using rubber-dam in teeth whose dentin was roughened showed a statistically significantly higher retention rate than those placed in teeth with unprepared dentin or without rubber-dam (p < 0.05). However, enamel beveling had no influence on any of the examined variables. Significant differences were found between pairs of adhesive systems and also between pairs of classes of adhesive systems. One-step self-etching had a significantly worse clinically index than two-step self-etching and three-step etch-and-rinse (p = 0.026 and p = 0.002, respectively). CONCLUSION: The clinical performance is significantly influenced by the type of adhesive system and/or the adhesive class to which the system belongs. Whether the dentin/enamel is roughened or not and whether rubberdam isolation is used or not also significantly influenced the clinical performance. Composite resin restorations placed with two-step self-etching and three-step etch-and-rinse adhesive systems should be preferred over onestep self-etching adhesive systems, GIC-based materials, and PMRCs.

Bond Strength of Two Resin Cements on Dentin Using Different Cementation Strategies

Purpose:This study evaluated the microtensile bond strength of two resin cements to dentin either with their corresponding self-etching adhesives or employing the three-step etch-and-rinse technique. The null hypothesis was that the etch-and-rinse adhesive system would generate higher bond strengths than the self-etching adhesives.Materials and Methods:Thirty-two human molars were randomly divided into four groups (N = 32, n = 8/per group): G1) ED Primer self-etching adhesive + Panavia F; G2) All-Bond 2 etch-and-rinse adhesive + Panavia F; G3) Multilink primer A/B self-etching adhesive + Multilink resin cement; G4) All-Bond 2 + Multilink. After cementation of composite resin blocks (5 x 5 x 4 mm), the specimens were stored in water (37 degrees C, 24 hours), and sectioned to obtain beams (+/- 1 mm2 of adhesive area) to be submitted to microtensile test. The data were analyzed using 2-way analysis of variance and Tukey's test (alpha = 0.05).Results:Although the cement type did not significantly affect the results (p = 0.35), a significant effect of the adhesive system (p = 0.0001) was found on the bond strength results. Interaction terms were not significant (p = 0.88751). The etch-and-rinse adhesive provided significantly higher bond strength values (MPa) with both resin cements (G2: 34.4 +/- 10.6; G4: 33.0 +/- 8.9) compared to the self-etching adhesive systems (G1: 19.8 +/- 6.6; G3: 17.8 +/- 7.2) (p < 0.0001). Pretest failures were more frequent in the groups where self-etching systems were used.Conclusion:Although the cement type did not affect the results, there was a significant effect of changing the bonding strategy. The use of the three-step etch-and-rinse adhesive resulted in significantly higher bond strength for both resin cements on dentin.CLINICAL SIGNIFICANCEDual polymerized resin cements tested could deliver higher bond strength to dentin in combination with etch-and-rinse adhesive systems as opposed to their use in combination with self-etching adhesives.(J Esthet Restor Dent 22:262-269, 2010).

Influência do tipo de preparo e sistema adesivo na resistência de união à dentina bovina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito da inibição de metaloproteinases da matriz dentinária na produção e estabilidade mecânica da união resina-dentina afetada por cárie

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise clínica e clínica/digital de restaurações de lesões cervicais não cariosas: efeitos dos sistemas adesivos e tempos de análise

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

Análise in vitro da resistência de união da resina composta à dentina tratada com diferentes sistemas adesivos

Pós-graduação em Ciências Odontológicas - FOAR

Análise in vitro da resistência de união ao cisalhamento de uma resina composta à dentina humana e à bovina, tratadas com diferentes adesivos

Pós-graduação em Ciências Odontológicas - FOAR