Scanning electron microscope analysis of internal adaptation of materials used for pulp protection under composite resin restorations

Purpose: The aim of this study was to evaluate the interfacial microgap with different materials used for pulp protection. The null hypothesis tested was that the combination of calcium hydroxide, resin-modified glass ionomer, and dentin adhesive used as pulp protection in composite restorations would not result in a greater axial gap than that obtained with hybridization only. Materials and Methods: Standardized Class V preparations were performed in buccal and lingual surfaces of 60 caries-free, extracted human third molars. The prepared teeth were randomly assessed in six groups: (1) Single Bond (SB) (3M ESPE, St. Paul, MN, USA); (2) Life (LF) (Kerr Co., Romulus, MI, USA) + SB; (3) LF + Vitrebond (VT) (3M ESPE) + SB; (4) VT + SB; (5) SB + VT; (6) SB + VT + SB. They were restored with microhybrid composite resin Filtek Z250 (3M ESPE), according to the manufacturer's instructions. However, to groups 5 and 6, the dentin bonding adhesive was applied prior to the resin-modified glass ionomer. The specimens were then thermocycled, cross-sectioned through the center of the restoration, fixed, and processed for scanning electron microscopy. The specimens were mounted on stubs and sputter coated. The internal adaptation of the materials to the axial wall was analyzed under SEM with × 1,000 magnification. Results: The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, p ≤ .05). The null hypothesis was rejected. Calcium hydroxide and resin-modified glass ionomer applied alone or in conjunction with each other (p < .001) resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration. ©2005 BC Decker Inc.

The effect of adhesive systems on the pullout strength of a fiberglass-reinforced composite post system in bovine teeth

Purpose: To evaluate the pullout strength of a glass fiber-reinforced composite post (glass FRC) cemented with three different adhesive systems and one resin cement. The null hypothesis was that pullout strengths yielded by the adhesive systems are similar. Materials and Methods: Thirty bovine teeth were selected. The size of the specimens was standardized at 16 mm by sectioning off the coronal portion and part of the root. The specimens were divided into three groups, according to the adhesive system, which were applied following the manufacturers' instructions: G1, ScotchBond Multi-Purpose Plus; G2, Single Bond; G3, Tyrian SPE/One-Step Plus. The glass FRCs (Reforpost) were etched with 37% H3PO4 for 1 min and silanized (Porcelain Primer). Thereafter, they were cemented with the dual resin cement En-Force. The specimens were stored for 24 h, attached to an adapted device, and submitted to the pullout test in a universal testing machine (1 mm/min). The data were submitted to the one-way ANOVA and Tukey's test (α = 0.05). Results: G1 (30.2 ± 5.8 Kgf) displayed the highest pullout strength (p < 0.001) when compared to G2 (18.6 ± 5.8 Kgf) and G3 (14.3 ± 5.8 Kgf), which were statistically similar. Analysis of the specimens revealed that all failures occurred between the adhesive system and the root dentin (pullout of the post cement), regardless of group. Conclusion: The multiple-bottle, total-etch adhesive system provided higher pullout strength of the glass FRC when compared to the single-bottle, total-etch, and single-step self-etching adhesive systems. The null hypothesis was rejected (p < 0.001).

Effect of dentinal surface preparation on bond strength of self-etching adhesive systems

The aim of this study was to evaluate the effects of dentin surface treatments on the tensile bond strength (TBS) of the self-etching primer Clearfil SE Bond (CSE) and the one-step self-etching One-Up Bond F (OUB). The exposed flat dentin surfaces of twenty-four sound third molars were prepared with diamond bur at high-speed, carbide bur at low-speed or wet ground with #600 grit SiC paper. The adhesive systems were applied to the dentin surfaces and light-cured according to the manufacturers' instructions. A 6-mm high composite crown was incrementally built-up and each increment was light-cured for 40 seconds. After being stored in water (37°C/24 h), the samples were serially sectioned parallel to the long axis, forming beams (n = 20) with a cross-sectional area of approximately 0.8 mm 2. The specimens were tested in a Universal Testing Machine at 0.5 mm/min. The cross-sectional area was measured and the results (MPa) were analyzed by two-way ANOVA and Tukey Test (p < 0.05). Overall, the groups treated with CSE exhibited the highest TBS for all surface treatments. Dentin surfaces prepared with carbide bur at low speed reduced TBS in the CSE group; however, OUB was not affected by surface treatments. The effect of surface abrasive methods on TBS was material-dependent.

Effect of curing regime on the cytotoxicity of resin-modified glass-ionomer lining cements applied to an odontoblast-cell line

Objective: The aim of this in vitro study was to evaluate the cytotoxicity of resin-modified glass-ionomer lining cements submitted to different curing regimes and applied to an immortalized odontoblast-cell line (MDPC-23). Methods: Forty round-shaped specimens of each experimental material (Fuji Lining LC and Vitrebond) were prepared. They were light-cured for the manufacturers' recommended time (MRT = 30 s), under-cured (0.5 MRT = 15 s), over-cured (1.5 MRT = 45 s) or allowed to dark cure (0 MRT). Sterilized filter papers soaked with either 5 μL of PBS or HEMA were used as negative and positive control, respectively. After placing the specimens individually in wells of 24-well dishes, odontoblast-like cells MDPC-23 (30,000 cells/cm2) were plated in each well and incubated for 72 h in a humidified incubator at 37 °C with 5% CO2 and 95% air. The cytotoxicity was evaluated by the cell metabolism (MTT assay) and cell morphology (SEM). Results: Fuji Lining LC was less cytotoxic than Vitrebond (p < 0.05) in all the experimental conditions. However, the cytotoxicity of Fuji Lining LC was noticeably increased in the absence of light-curing while the same was not observed for Vitrebond. The length of light-curing (15, 30 or 45 s) did not influence the toxicity of both lining materials when they were applied on the odontoblast-cell line MDPC-23. Significance: The light-activation plays an important role in reducing the cytotoxicity of Fuji Lining LC. Following the manufacturer' recommendation regarding the light-curing regime may prevent toxic effect to the pulp cells. © 2005 Academy of Dental Materials.

Bond strength of adhesive systems to human tooth enamel

The purpose of this study was to evaluate in vitro three adhesive systems: a total etching single-component system (G1 Prime & Bond 2.1), a self-etching primer (G2 Clearfil SE Bond), and a self-etching adhesive (G3 One Up Bond F), through shear bond strength to enamel of human teeth, evaluating the type of fracture through stereomicroscopy, following the ISO guidance on adhesive testing. Thirty sound premolars were bisected mesiodistally and the buccal and lingual surfaces were embedded in acrylic resin, polished up to 600-grit sandpapers, and randomly assigned to three experimental groups (n = 20). Composite resin cylinders were added to the tested surfaces. The specimens were kept in distilled water (37°C/24 h), thermocycled for 500 cycles (5°C-55°C) and submitted to shear testing at a crosshead speed of 0.5 mm/min. The type of fracture was analyzed under stereomicroscopy and the data were submitted to Anova, Tukey and Chi-squared (5%) statistical analyses. The mean adhesive strengths were G1: 18.13 ± 6.49 MPa, (55% of resin cohesive fractures); G2: 17.12 ± 5.80 MPa (90% of adhesive fractures); and G3: 10.47 ± 3.14 MPa (85% of adhesive fractures). In terms of bond strength, there were no significant differences between G1 and G2, and G3 was significantly different from the other groups. G1 presented a different type of fracture from that of G2 and G3. In conclusion, although the total etching and self-etching systems presented similar shear bond strength values, the types of fracture presented by them were different, which can have clinical implications.

Tensile bond strength of self-etching versus total-etching adhesive systems under different dentinal substrate conditions

The use of acid etchants to produce surface demineralization and collagen network exposure, allowing adhesive monomers interdiffusion and consequently the formation of a hybrid layer, has been considered the most efficient mechanism of dentin bonding. The aim of this study was to compare the tensile bond strength to dentin of three adhesive systems, two self-etching ones (Clearfil SE Bond - CSEB and One Up Bond F - OUBF) and one total-etching one (Single Bond - SB), under three dentinal substrate conditions (wet, dry and re-wet). Ninety human, freshly extracted third molars were sectioned at the occlusal surface to remove enamel and to form a flat dentin wall. The specimens were restored with composite resin (Filtek Z250) and submitted to tensile bond strength testing (TBS) in an MTS 810. The data were submitted to two-way ANOVA and Tukey's test (p = 0.05). Wet dentin presented the highest TBS values for SB and CSEB. Dry dentin and re-wet produced significantly lower TBS values when using SB. OUBF was not affected by the different conditions of the dentin substrate, producing similar TBS values regardless of the surface pretreatments.

In vivo preservation of the hybrid layer by chlorhexidine

Host-derived proteases have been reported to degrade the collagen matrix of incompletely-resin-infiltrated dentin. This study tested the hypothesis that interfacial degradation of resin-dentin bonds may be prevented or delayed by the application of chlorhexidine (CHX), a matrix metalloproteinase inhibitor, to dentin after phosphoric acid-etching. Contralateral pairs of resin-bonded Class I restorations in non-carious third molars were kept under intra-oral function for 14 months. Preservation of resin-dentin bonds was assessed by microtensile bond strength tests and TEM examination. In vivo bond strength remained stable in the CHX-treated specimens, while bond strength decreased significantly in control teeth. Resin-infiltrated dentin in CHX-treated specimens exhibited normal structural integrity of the collagen network. Conversely, progressive disintegration of the fibrillar network was identified in control specimens. Auto-degradation of collagen matrices can occur in resin-infiltrated dentin, but may be prevented by the application of a synthetic protease inhibitor, such as chlorhexidine.

Surface conditioning of a composite used for inlay/onlay restorations: Effect on μTBS to resin cement

Purpose: To assess the effect of the composite surface conditioning on the microtensile bond strength of a resin cement to a composite used for inlay/onlay restorations. Materials and Methods: Forty-two blocks (6 × 6 × 4 mm) of a microfilled composite (Vita VMLC) were produced and divided into 3 groups (N = 14) by composite surface conditioning methods: Gr1 - etching with 37% phosphoric acid, washing, drying, silanization; Gr2 - air abrasion with 50-l̀m Al2O3 particles, silanization; Gr3 - chairside tribochemical silica coating (CoJet System), silanization. Single-Bond (one-step adhesive) was applied on the conditioned surfaces and the two resin blocks treated with the same method were cemented using RelyX ARC (dual-curing resin cement). The specimens were stored for 7 days in water at 37°C and then sectioned to produce nontrimmed beam samples, which were submitted to microtensile bond strength testing (μTBS). For statistical analysis (one-way ANOVA and Tukey's test, · = 0.05), the means of the beam samples from each luted specimen were calculated (n = 7). Results: μTBS values (MPa) of Gr2 (62.0 ± 3.9a) and Gr3 (60.5 ± 7.9a) were statistically similar to each other and higher than Gr1 (38.2 ± 8.9b). The analysis of the fractured surfaces revealed that all failures occurred at the adhesive zone. Conclusion: Conditioning methods with 50-l̀m Al2O3 or tribochemical silica coating allowed bonding between resin and composite that was statistically similar and stronger than conditioning with acid etching.

Influence of surface sealants on microleakage of composite resin restorations

Purpose: The purpose of this study was to verify the influence of surface sealants and dentin adhesive systems on the microleakage of composite restorations. Methods: Class V cavities were made on the buccal faces of 100 permanent third molars and restored with Z250. After 24 hours, they were submitted to polishing and finishing processes. The teeth were divided into groups according to the sealant agent: group 1 - Single Bond; group 2 - Opti Bond Solo Plus; group 3 - Fortify; group 4 - Fortify Plus; and group 5 - control without sealant. The analysis of immediate microleakage was performed in 10 restorations from each group, soon after the sealing. The other 10 specimens from each group were submitted to tooth-brushing and thermal cycles. The teeth were isolated and immersed in 2% methylene blue solution, washed in tap water, and sectioned in the buccolingual direction. The percentage of marginal leakage was calculated using an image analysis program, and results were submitted to analysis of variance and Tukey's test. Results: All the sealed groups demonstrated lower microleakage values compared to the control group. Group 3, sealed with Fortify, presented the lowest mean microleakage values. Conclusion: The application of surface sealants effectively decreased the microleakage in composite resin restorations.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching.

PURPOSE: To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant. MATERIALS AND METHODS: The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification. RESULTS: The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive. CLINICAL SIGNIFICANCE: When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.

Influência da contaminação da dentina por cimentos temporários na resistência da união de sistemas adesivos

Objective: The aim of this study was to assess the bond strength of adhesive systems to dentin contaminated by temporary cements with or without eugenol. Method: Flat dentin surfaces were obtained from twenty-four human third molars. With exception of the control group (n=8), the surfaces were covered with Interim Restorative Material (Caulk Dentsplay, Milford, DE, USA) or Cavit (3M ESPE, St. Paul, MN, USA) and kept in an oven at 37°C for seven days. After removing the cements, the adhesive systems Adper Single Bond (3M ESPE, St. Paul, MN, USA) or Clearfil SE Bond (Kuraray Co. Ltd., Osaka, Japan) were applied in accordance with the manufacturers' recommendations, and then the crowns were constructed in of resin composite. The teeth were sectioned into specimens with a cross-sectional bond area of 0.81mm2, which were submitted to microtensile testing in a mechanical test machine at an actuator speed of 0.5mm/min. The data were analyzed by t- and ANOVA tests, complemented by Tukey tests (α=0.05). Results: For Adper Single Bond (3M ESPE, St. Paul, MN, USA), bond strength did not differ statistically (p>0.05) for all the experimental conditions. For Clearfil SE Bond (Kuraray Co. Ltd., Osaka, Japan), only the Interim Restorative Material (Caulk Dentsplay, Milford, DE, USA) Group showed significantly lower bond strength (30.1 ± 13.8 MPa) in comparison with the other groups; control (38.9 ± 13.5 MPa) and Cavit (3M ESPE, St. Paul, MN, USA) (42.1 ± 11.0 MPa), which showed no significant difference between them. Conclusion: It was concluded that the previous covering of dentin with temporary cement containing eugenol had a deleterious effect on the adhesive performance of the self-etching system only.

Influence of voids in the hybrid layer based on self-etching adhesive systems: a 3-D FE analysis

The presence of porosities at the dentin/adhesive interface has been observed with the use of new generation dentin bonding systems. These porosities tend to contradict the concept that etching and hybridization processes occur equally and simultaneously. Therefore, the aim of this study was to evaluate the micromechanical behavior of the hybrid layer (HL) with voids based on a self-etching adhesive system using 3-D finite element (FE) analysis. Three FE models (Mr) were built: Mr, dentin specimen (41x41x82 μm) with a regular and perfect (i.e. pore-free) HL based on a self-etching adhesive system, restored with composite resin; Mp, similar to M, but containing 25% (v/v) voids in the HL; Mpp, similar to Mr, but containing 50% (v/v) voids in the HL. A tensile load (0.03N) was applied on top of the composite resin. The stress field was obtained by using Ansys Workbench 10.0. The nodes of the base of the specimen were constrained in the x, y and z axes. The maximum principal stress (σmax) was obtained for all structures at the dentin/adhesive interface. The Mpp showed the highest peak of σmax in the HL (32.2 MPa), followed by Mp (30 MPa) and Mr (28.4 MPa). The stress concentration in the peritubular dentin was high in all models (120 MPa). All other structures positioned far from voids showed similar increase of stress. Voids incorporated into the HL raised the σmax in this region by 13.5%. This behavior might be responsible for lower bond strengths of self-etching and single-bottle adhesives, as reported in the literature.

Influence of cutting instruments and adhesive systems on hybrid layer formation.

Influence of cutting instruments and The aim of this study was to analyze the hybrid layer in noncarious dentin prepared by different cutting instruments and restored with composite resin. The cavities were randomly prepared in 40 specimens using a high-speed diamond bur (KG Sorensen 1013) and an ultrasonic tip (CVDentus C22). The cavities were restored with composite resin by varying the adhesive system between the Adper™ Single Bond (2 x 1 system, primer+adhesive) and the Prompt L-Pop™ (3 x 1 system, self-etching). The restorations were hemisected longitudinally and analyzed in the SEM (Scanning electron microscopy) in order to evaluate the hybrid layer and resinous tags characteristics, using scores ranging from 1 to 6. The Pearson test revealed a high correlation coefficient and good significance levels for both intra- and inter-raters values (r=0.90). The data were statistically analyzed using the Mann-Whitney test (P≤0.05). A larger proportion of regular hybrid layers with numerous tags were observed in the dentin prepared using the high-speed diamond burs and restored with a 2 × 1 adhesive system. Alternatively, the 3 × 1 adhesive system promoted the generation of a thin hybrid layer with few tags. After preparation using an ultrasonic tip revealed few or no tags after the preparation and 2 × 1 or 3 × 1 adhesive system application. The high-speed diamond burs produced a dentin surface that was more favorable to restorative material adhesion than the ultrasonic tips, regardless of the adhesive system used.

Using the self-etch adhesives in anterior restoration

With the arrival of self-etch adhesives systems, there has been a rise in interest among clinicians, making it imperative for health professionals to have knowledge of the properties, characteristics, the association as well as the dental structures of these materials, in order to select them and use them correctly. The self-etch adhesive systems show good values of bond strength, microleakage and performance, and have therefore become an option in direct adhesive restorations. In the regard, this case study aims to describe the technique involving the use of selfetch adhesives system for direct restoration of anterior teeth.

Tempo de condicionamento da dentina hígida e afetada por cárie de dentes decíduos e permanentes: efeito na desmineralização do substrato, na produção e na resistência da união resina-dentina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)