Multi-step adhesive cementation versus one-step adhesive cementation: push-out bond strength between fiber post and root dentin before and after mechanical cycling

This study evaluated the effects of mechanical cycling on resin push-out bond strength to root dentin, using two strategies for fiber post cementation. Forty bovine roots were embedded in acrylic resin after root canal preparation using a custom drill of the fiber post system. The fiber posts were cemented into root canals using two different strategies (N = 20): a conventional adhesive approach using a three-step etch-and-rinse adhesive system combined with a conventional resin cement (ScotchBond Multi Purpose Plus + RelyX ARC ), or a simplified adhesive approach using a self-adhesive resin cement (RelyX U100). The core was built up with composite resin and half of the specimens from each cementation strategy were submitted to mechanical cycling (45 degree angle; 37 degrees C; 88 N; 4 Hz; 700,000 cycles). Each specimen was cross-sectioned and the disk specimens were pushed-out. The means from every group (n = 10) were statistically analyzed using a two-way ANOVA and a Tukey test (P = 0.05). The cementation strategy affected the push-out results (P < 0.001), while mechanical cycling did not (P = 0.3716). The simplified approach (a self-adhesive resin cement) had better bond performance despite the conditioning. The self-adhesive resin cement appears to be a good option for post cementation. Further trials are needed to confirm these results.

Influência do sistema de cimentação e do modo de ativação na resistência ao push-out de pinos de fibra de vidro

O objetivo deste estudo foi avaliar a influência do tipo de sistema de cimentação (condicionamento ácido total ou autoadesivo), do modo de ativação (autoativado ou dual), do terço do conduto radicular (cervical, médio ou apical) e da espessura do filme de cimento sobre a resistência de união de pinos de fibra de vidro cimentados em dentes humanos. Quarenta raízes foram incluídas em resina epóxi, submetidas a tratamento endodôntico e obturadas com guta percha e cimento endodôntico sem eugenol. Decorridos sete dias, os condutos foram preparados a uma profundidade de 10mm com brocas padronizadas do sistema dos pinos de fibra (WhitePost DC #2) e aleatoriamente divididos em 4 grupos, conforme o sistema de cimentação e o modo de ativação: (G1) RelyX ARC/Adper Scotchbond Multi-Purpose Plus (condicionamento ácido total), ativação dual, (G2) RelyX ARC/Adper Scotchbond Multi-Purpose Plus, autoativado, (G3) RelyX U100 (autoadesivo), dual e (G4) RelyX U100, autoativado. Após uma semana, cada raiz foi seccionada em máquina de corte, originando 6 fatias de 1 mm de espessura (n=60). Antes do ensaio de push-out cada fatia foi fotografada em ambas as faces, para determinação do raio dos pinos e da espessura do filme de cimento. Após o ensaio mecânico, novas imagens foram capturadas para determinação do modo de falha. Para automatizar a determinação da espessura de cimento, foi desenvolvida uma macro no software KS 400. Os dados foram estatisticamente analisados com ANOVA 3 fatores (resistência de união) e teste de Kruskall-Wallis (espessura do cimento). Comparações múltiplas foram realizadas com o teste Student-Newman-Keuls. Análise de regressão, modelo linear, foi empregada para verificar a correlação entre espessura do cimento e resistência de união. Todos os testes foram aplicados com α = 0,05. O fator cimento exerceu influência significativa para a resistência de união (p = 0,0402): o RelyX U100 apresentou a maior média. A ativação dual elevou os valores de resistência de união em comparação ao modo quimicamente ativado (p < 0,0001). Houve diferenças significantes entre os grupos, sendo G1 (22,4 4,0 MPa) > G3 (20,4 3,6 MPa) > G4 (17,8 5,2 MPa) > G2 (13,5 4,3 MPa). O terço do conduto não exerceu influência significativa sobre a resistência adesiva (p = 0,4749). As espessuras dos filmes de cimento foram estatisticamente diferentes nos diferentes terços: cervical (102 45 m) > médio (75 29 m) > apical (52 28m). Não foi observada forte correlação entre os valores de espessura e os de resistência ao push-out (r = - 0,2016, p = 0,0033). O tipo de falha predominante foi a mista, exceto para o G2, que apresentou 74% das falhas na interface cimento-pino. Dessa forma, o cimento autoadesivo apresentou melhor desempenho que o convencional, e ambos os sistemas duais, sobretudo o RelyX ARC, apresentaram dependência da fotoativação para atingirem maiores valores de resistência de união.

Microleakage of adhesively bonded cervical amalgam restorations

Purpose: To evaluate dye penetration in adhesively bonded cervical amalgam restorations. Materials and Methods: the specimens were randomly divided into four groups and the adhesives Prime & Bond 2. 1, Prime & Bond 2.1 Dual Cure, Scotchbond Multi Purpose Plus and Amalgambond Plus were tested. After being restored and polished, the teeth were thermocycled 1,000 times at temperatures varying between 5degreesC +/- 2degreesC and 55degreesC +/- 2degreesC. Statistical analysis was carried out using the Kruskal-Wallis test and multiple comparisons. Results: Scotchbond Multi-Purpose Plus demonstrated lower levels of microleakage in enamel and dentin. The dual adhesives were more effective than the one bottle adhesive.

Human pulpal response to direct pulp capping with an adhesive system

Purpose: To evaluate clinically and microscopically the human pulp response when directly capped with an adhesive system or calcium hydroxide over short (9-12 days) and long (53-204 days) experimental periods. Materials and Methods: Fifty-one sound human premolars scheduled for orthodontic extraction, had their pulp horns gently exposed with a diamond point. Debris in the pulp wound was washed out with a sterile saline solution. The pulps were then capped with either an adhesive system (Scotchbond Multi-Purpose Plus) or calcium hydroxide. All teeth were subsequently restored with resin-based composite (Z-100) according to the manufacturer's instructions. After the experimental periods, the teeth were extracted and processed for light microscopic examination. Results: Short-term: the pulp tissue capped with SBMP-P exhibited dilated and congested blood vessels associated with a mo;derate inflammatory response and blanching of pulp cell nuclei. Long-term: no evidence of healing and bridge formation was observed. A persistent mild inflammatory pulp response was present. Micro-abscesses were detected in three cases associated with bacterial infiltration. Calcium hydroxide stimulated early pulp repair and dentin bridging which extended into the longest period.

Shear Bond Strength of Different Repair Systems to Titanium After Water Aging

This study evaluated the shear bond strength (SBS) and stability of commercially pure titanium (CP Ti)/repair material interfaces promoted by different repair systems. One hundred CP Ti cast discs were divided into five repair system groups: 1) Epricord (EP); 2) Bistite 11 DC (BT); 3) Cojet (CJ); 4) Scotchbond Multi-Purpose Plus (SB) (control group); and 5) Cojet Sand plus Scotchbond Multi-Purpose Plus (CJSB). The specimens were stored in distilled water for 24 hours at 37 degrees C, thermal cycled (5000 cycles, 5 degrees-55 degrees C) and stored under the same conditions for either 24 hours or six months (n=10). SBS was tested and the data were analyzed by two-way analysis of variance (ANOVA) and Tukey test (alpha=.05). Failure mode was determined with a stereomicroscope (20x). The repair system, storage time, and their interaction significantly affected the SBS (p<0.001). At 24 hours, CJSB exhibited the highest SBS value, followed by CJ. At six months, these two groups had similar mean SBS (p>0.05) and higher means in comparison to the other groups. For both storage times, BT presented the lowest SBS, while the EP and SB groups did not differ significantly from one another (p>0.05). There were no significant differences in SBS between the storage times for the groups EP and CJ (p>0.05). The groups BT, SB, and CJSB showed 100% adhesive failure, irrespective of storage time. The CJSB group showed the highest SBS at both storage times. At six months, the CJ group exhibited a similar SBS mean value when compared to the CJSB group. Water storage adversely affected the groups BT, SB (control group), and CJSB. Considering SBS values, stability, and the failure mode simultaneously, the CJ group showed the best CP Ti repair performance.

Evaluation of marginal microleakage in Class II cavities: Effect of microhylolrid, flowable, and compactable resins

Objective: the goal of the present study was to evaluate the microleakage on the cementum/dentin and enamel surfaces in Class 11 restorations, using different kinds of resin composite (microhybrid, flowable, and compactable). Method and materials: Forty human caries-free molars were extracted and selected. Eighty Class 11 standardized cavities were made in the cervical wall at the cementoenamel junction (CEJ) and at the mesial and distal surfaces. The teeth were divided into four groups: G1 - adhesive system + microhybrid resin composite Z100; G2 - adhesive system + compactable resin composite Prodigy Condensable; G3 - adhesive system + flowable resin composite Revolution + Z1 00 resin composite; G4 - adhesive system + Revolution fluid resin + compactable resin composite Prodigy Condensable. The adhesive system used in this study was Scotchbond Multi-Purpose Plus. The specimens were thermocycled in baths of 5degreesC and 55degreesC for 1,000 cycles and immersed in 50% silver nitrate solution. The specimens then were sectioned and evaluated on degree of dye penetration. Results: the results were evaluated using the nonparametric Kruskall-Wallis test, which showed a statistically significant difference between groups G1 and G4, G2 and G4, and G3 and G4. Conclusions: None of the materials was able to eliminate the marginal microleakage at the cervical wall; the application of a low-viscosity resin composite combined with a compactable resin composite significantly decreased the microleakage.

Does Adhesive Resin Application Contribute to Resin Bond Durability on Etched and Silanized Feldspathic Ceramic?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dentin bond strength: Influence of laser irradiation, acid etching, and hypermineralization

Objective: the purpose of the present study was to investigate the effects of ND:YLF laser irradiation (1.31 J/cm(2); 250 mJ per pulse), acid etching, and hypermineralization on the shear bond strength (SBS) of the Scotchbond Multi-Purpose Plus (3M Dental Products) bonding system. Summary Background Data: Previous studies had shown that the pretreatment of the dentin substrate with laser irradiation can influence the SBS, Methods: Sixty bovine incisors were selected and stored at -18 degrees C, Dentinal buccal surface was exposed and radiographs were taken to control dentin thickness, the specimens were separated into 2 groups: (1) the control, which was kept in distilled water at 4 degrees C; (2) the hypermineralized, which was kept in hypermineralizing solution at 4 degrees C for 14 days, Each group was divided into 3 subgroups according to the type of dentin pretreatment used: M (acid etching + primer + bond); AL (acid etching + primer + bond + laser); and LA (laser + acid etching + primer + bond). A standard composite resin cylinder (Z100-3M) was bonded to the dentinal surface and the SBS performed on an Instron machine (500 Kg load cell at 0.5 mm/min), followed by scanning electron microscopy (SEM) and x-ray diffraction analysis. Results: Analysis of variance (ANOVA) determined that the pretreatments influenced the SBS values (p < 0.05): AL (9.96 MPa), M (7.28 MPa), and LA (4.87 MPa), the interaction between the group and pretreatment factors also influenced the SBS (p < 0.05). The highest values were obtained for the interaction control/AL (11.64 MPa), Conclusion: the results suggested that dentin treatment with laser after the application of the adhesive system is efficient in achieving higher bond strength and is promising as a possible new adhesive substrate.

Microleakage of hydrophilic adhesive systems in Class V composite restorations

Purpose: To investigate the microleakage of four hydrophilic adhesive systems: one multiple-bottles (Scotchbond Multi-Purpose Plus); two one-bottle (Single Bond, Stae); and one self-etching (Etch & Prime 3.0). Materials and Methods: 120 bovine incisor teeth were divided into four groups (n = 30) and Class V cavities were prepared at the cemento-enamel junction. The cavities were restored with the adhesive systems and with Z100 composite. The teeth were thermocycled 1,000 times between 5 +/- 2 degreesC and 55 +/- 2 degreesC with a dwell time of 1 min, and then placed in a 2% methylene blue dye (pH 7.0) for 4 hrs, washed and sectioned vertically through the center of the restorations. The qualitative evaluation was made by three examiners who distributed pre-established scores (0-4) for each tooth using a stereomicroscope at x30 magnification. Results: In enamel margins little microleakage was observed and the Kruskal-Wallis analysis did not show differences. In dentin margins the KruskaI-Wallis and multiple comparison analyses were applied: microleakage was significantly greater with Stae (median 3) and Scotchbond MP Plus (median 4). Single Bond (median 1) and Etch & Prime 3.0 (median 2) showed the best results in dentin margins, and the statistical analysis did not demonstrate differences in microleakage among these groups.

An In Vitro Comparison of Different Cementation Strategies on the Pull-out Strength of a Glass Fiber Post

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Microleakage in primary teeth restored by conventional or bonded amalgam technique.

The aim of this in vitro study was to evaluate marginal leakage in class V restorations in primary teeth restored with amalgam, using three different techniques. Thirty maxillary anterior primary teeth, clinically sound and naturally exfoliated, were used. In group 1 (n = 10), two thin layers of a copal varnish (Cavitine) were applied. In group 2 (n = 10), Scotchbond Multi-Purpose Plus, a dual adhesive system, was used according to manufacturer instructions. In group 3 (n = 10), One-Step adhesive system in combination with a low-viscosity resin (Resinomer) were used according to manufacturer instructions. All samples were restored with a high-copper dental amalgam alloy (GS 80, SDI). After restoration, the samples were stored in normal saline at 37 degrees C for 72 h. The specimens were polished, thermocycled (500 cycles, 5 degrees and 55 degrees C, 30-s dwell time) and impermeabilized with fingernail polish to within 1.0 mm of the restoration margins. The teeth were then placed in 0.5% methylene blue for 4 h. Finally, the samples were sectioned and evaluated for marginal leakage. The Kruskal-Wallis test showed that the filled adhesive resin (group 3) had the least microleakage. There was no significant difference between groups 1 and 2.

Evaluation of marginal microleakage in Class II cavities: Effect of microhybrid, flowable, and compactable resins

Objective: The goal of the present study was to evaluate the microleakage on the cementum/dentin and enamel surfaces in Class II restorations, using different kinds of resin composite (microhybrid, flowable, and compactable). Method and materials: Forty human caries-free molars were extracted and selected. Eighty Class II standardized cavities were made in the cervical wall at the cementoenamel junction (CEJ) and at the mesial and distal surfaces. The teeth were divided into four groups: G1 - adhesive system + microhybrid resin composite Z100; G2 - adhesive system + compactable resin composite Prodigy Condensable; G3 - adhesive system + flowable resin composite Revolution + Z100 resin composite; G4 - adhesive system + Revolution fluid resin + compactable resin composite Prodigy Condensable. The adhesive system used in this study was Scotchbond Multi-Purpose Plus. The specimens were thermocycled in baths of 5°C and 55°C for 1,000 cycles and immersed in 50% silver nitrate solution. The specimens then were sectioned and evaluated on degree of dye penetration. Results: The results were evaluated using the nonparametric Kruskall-Wallis test, which showed a statistically significant difference between groups G1 and G4, G2 and G4, and G3 and G4. Conclusions: None of the materials was able to eliminate the marginal microleakage at the cervical wall; the application of a low-viscosity resin composite combined with a compactable resin composite significantly decreased the microleakage.

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).

Resin bonding to root canal dentin: Effect of the application of an experimental hydrophobic resin coating after an all-in-one adhesive

Aim: Based on the hypothesis the application of a low-viscosity hydrophobic resin coating improves the bond of all-in-one adhesive, the purpose of the study was to evaluate the bond strength of four adhesive systems to bovine root dentin using the push-out test method. Methods and Materials: The root canals of 32 bovine roots (16 mm) were prepared to a length of 12 mm using a FRC Postec Plus preparation drill. The specimens were allocated into four groups according to the adhesive system used: (Group 1) All-in-one Xeno III; (Group 2) All-in-one Xeno III+ScotchBond Multi-Purpose Plus Adhesive; (Group 3) Simplified Etch & Rinse One Step Plus; and (Group 4) Multi-Bottle Etch & Rinse All-Bond 2. A fiber-reinforced composite retention post was reproduced using an additional silicon impression and fabricated with DuoLink resin cement. The root specimens were treated with the selected adhesive systems, and the resin posts were luted in the canals with DuoLink resin cement. Each root specimen was cross sectioned into four samples (±1.8 mm in thickness), and the post sections were pushed-out to determine the bond strength to dentin. Results: Group 2 (2.9±1.2) was statistically higher than Group 1 (1.1±0.5) and Group 3 (1.1±0.5). Groups 1 and 3 showed no statistically significant difference while Group 4 (2.0±0.7) presented similar values (p>0.05) to Groups 1, 2, and 3 [(one-way analysis of variance (ANOVA)] and Tukey test, α=0.05). Conclusion: The hypothesis was accepted since the application of the additional layer of a low-viscosity bonding resin improved the bond of the all-in-one adhesive. Further studies must be conducted to evaluate the long-term bond.

Durability of Adhesion between Feldspathic Ceramic and Resin Cements: Effect of Adhesive Resin, Polymerization Mode of Resin Cement, and Aging

Purpose: Adhesive cementation is an important step for restorations made of feldspathic ceramic as it increases the strength of such materials. Incorrect selection of the adhesive resin and the resin cement to adhere to the ceramic surface and their durability against aging can affect the adhesion between these materials and the clinical performance. This study evaluated the effect of adhesive resins with different pHs, resin cements with different polymerization modes, and aging on the bond strength to feldspathic ceramic. Materials and Methods: One surface of feldspathic ceramic blocks (VM7) (N = 90) (6.4 × 6.4 × 4.8 mm3) was conditioned with 10% hydrofluoric acid for 20 seconds, washed/dried, and silanized. Three adhesive resins (Scotchbond Multi-Purpose Plus [SBMP], pH: 5.6; Single Bond [SB], pH: 3.4; and Prime&Bond NT [NT], pH: 1.7) were applied on the ceramic surfaces (n = 30 per adhesive). For each adhesive group, three resin cements with different polymerization modes were applied (n = 10 per cement): photo-polymerized (Variolink II base), dual polymerized (Variolink II base + catalyst), and chemically polymerized (C&B). The bonded ceramic blocks were stored in water (37°C) for 24 hours and sectioned to produce beam specimens (cross-sectional bonded area: 1 ± 0.1 mm2). The beams of each block were randomly divided into two conditions: Dry, microtensile test immediately after cutting; TC, test was performed after thermocycling (12,000×, 5°C to 55°C) and water storage at 37°C for 150 days. Considering the three factors of the study (adhesive [3 levels], resin cement [3 levels], aging [2 levels]), 18 groups were studied. The microtensile bond strength data were analyzed using 3-way ANOVA and Tukey's post hoc test (α= 0.05). Results: Adhesive resin type (p < 0.001) and the resin cement affected the mean bond strength (p= 0.0003) (3-way ANOVA). The NT adhesive associated with the chemically polymerized resin cement in both dry (8.8 ± 6.8 MPa) and aged conditions (6.9 ± 5.9 MPa) presented statistically lower bond strength results, while the SBMP adhesive resin, regardless of the resin cement type, presented the highest results (15.4 to 18.5 and 14.3 to 18.9 MPa) in both dry and aged conditions, respectively (Tukey's test). Conclusion: Application of a low-pH adhesive resin onto a hydrofluoric acid etched and silanized feldspathic ceramic surface in combination with chemically polymerized resin cement did not deliver favorable results. The use of adhesive resin with high pH could be clinically advised for the photo-, dual-, and chemically polymerized resin cements tested. © 2012 by the American College of Prosthodontists.