Micromorphology of Resin-Dentin Interfaces Using One-Bottle Etch&Rinse and Self-Etching Adhesive Systems on Laser-Treated Dentin Surfaces: A Confocal Laser Scanning Microscope Analysis

Background and Objectives: This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters. Study Design: Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S3 Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface. Results: Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. ""Stretch mark""-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections. Conclusion: Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study. Lasers Surg. Med. 42:662-670, 2010. (C) 2010 Wiley-Liss, Inc.

Micro-shear bond strength of Er : YAG-laser-treated dentin

This study tested if dentin adhesion is affected by Er:YAG laser. Ninety dentin disks were divided in groups (n=10): G1, control; G2, Er:YAG laser 150 mJ, 90 degrees contact, 38.8 J/cm(2); G3, Er:YAG laser 70 mJ, 90 degrees contact, 18.1 J/cm(2); G4, Er:YAG laser 150 mJ, 90 degrees non-contact, 1.44 J/cm(2); G5, Er:YAG laser 70 mJ, 90 degrees non-contact, 0.67 J/cm(2); G6, Er:YAG laser 150 mJ, 45 degrees contact, 37.5 J/cm(2); G7, Er:YAG laser 70 mJ, 45 degrees contact, 17.5 J/cm(2); G8, Er:YAG laser 150 mJ, 45 degrees non-contact, 1.55 J/cm(2); and G9, Er:YAG laser 70 mJ, 45 degrees non-contact, 0.72 J/cm(2). Bonding procedures were carried out and the micro-shear-bond strength (MSBS) test was performed. The adhesive surfaces were analyzed under SEM. Two-way ANOVA and multiple comparison tests revealed that MSBS was significantly influenced by the laser irradiation (p < 0.05). Mean values (MPa) of the MSBS test were: G1 (44.97 +/- 6.36), G2 (23.83 +/- 2.46), G3 (30.26 +/- 2.57), G4 (35.29 +/- 3.74), G5 (41.90 +/- 4.95), G6 (27.48 +/- 2.11), G7 (34.61 +/- 2.91), G8 (37.16 +/- 1.96), and G9 (41.74 +/- 1.60). It was concluded that the Er:YAG laser can constitute an alternative tool for dentin treatment before bonding procedures.

Bond strength of adhesive restorations to Er : YAG laser-treated dentin

Background and Objective: evaluate the adhesion of adhesive restorations with and without a base of resin-modified glass-ionomer cement (RMGIC) to dentin irradiated with Er:YAG laser.Study Design/Materials and Methods: Twenty-four human molar teeth were divided into 6 groups (n=4): G1) 37% Phosphoric acid (PA) + Adhesive system (Ad) + Composite resin (CR); G2) RMGIC + CR; G3) Laser (60mJ-5Hz-20s) + PA + Ad + CR; G4) Laser (60 mJ-5 Hz-20 s) + RMGIC + CR; G5) Laser (100mJ-5Hz-20s) + PA + Ad + CR; G6) Laser (100mJ-5Hz-20s) + RMGIC + CR. Teeth were prepared, restored and cut into specimens, according to the treatment proposed and to methodology for microtensile test. Data were submitted to ANOVA and Tukey statistical tests (alpha=5%).Results:. The mean values for adhesion (MPa) and standard deviation (+/- SD) were: G1) 26.30(+/- 4.50), G2) 5.34(+/- 2.87), G3) 21.16(+/- 6.01), G4) 5.22(+/- 1.52), G5) 22.23(+/- 4.98), G6) 5.25(+/- 3.08).Conclusion: the use of Er:YAG laser did not influence on the restorations adhesion.

Micromorphology and adhesive performance of Er:YAG laser-treated dentin of primary teeth

This study evaluated (1) the micromorphology by scanning electron microscopy (SEM) and (2) the adhesive performance by microtensile bond strength (μTBS) of diamond bur-treated dentin compared to Er:YAG laser-treated dentin of human primary teeth. (1) For qualitative SEM evaluation, dentin of 18 second primary molars (n = 3/method) was treated with either diamond bur as a control (group 1a: 40 μm diamond bur only (clinical situation); group 1b: grinding + 40 μm diamond bur) or with Er:YAG laser (group 2a (clinical situation, manufacturer's settings): 200 mJ/25 Hz (5 W) + 100 mJ/35 Hz (3.5 W) laser only; group 2b (experimental setting "high"): grinding + 400 mJ/20 Hz (8 W); group 2c (manufacturer's setting "finishing"): grinding + 100 mJ/35 Hz (3.5 W); group 2d (experimental setting "low"): grinding + 50 mJ/35 Hz (1.75 W)). (2) For evaluation of adhesive performance, 64 second primary molars were divided into four groups and treated as described for group 1b and groups 2b/c/d (n = 16/method), and μTBS of Clearfil SE/Clearfil Majesty Esthetic to dentin was measured. The SEM micrographs were qualitatively analyzed. The μTBS values were compared with a Kruskal-Wallis test. The significance level was set at α = 0.05. SEM micrographs showed the typical micromorphologies with a smear layer for the diamond bur groups and open dentin tubules for all laser-treated groups. However, in group 2d, the laser beam had insufficiently irradiated the dentin area, rendering the underlying ground surface partly visible. There were no statistically significant differences between μTBS values of the four groups (p = 0.394). This suggests that Er:YAG laser treatment of dentin of primary molars provides bond strengths similar to those obtained following diamond bur treatment.

Relationship Between Surface Topography and Energy Density Distribution of Er,Cr:YSGG Beam on Irradiated Dentin: An Atomic Force Microscopy Study

Objective: The aim of this study was to assess by atomic force microscopy (AFM) the effect of Er,Cr:YSGG laser application on the surface microtopography of radicular dentin. Background: Lasers have been used for various purposes in dentistry, where they are clinically effective when used in an appropriate manner. The Er, Cr: YSGG laser can be used for caries prevention when settings are below the ablation threshold. Materials and Methods: Four specimens of bovine dentin were irradiated using an Er, Cr:YSGG laser (lambda = 2.78 mu m), at a repetition rate of 20 Hz, with a 750-mu m-diameter sapphire tip and energy density of 2.8 J/cm(2) (12.5 mJ/pulse). After irradiation, surface topography was analyzed by AFM using a Si probe in tapping mode. Quantitative and qualitative information concerning the arithmetic average roughness (Ra) and power spectral density analyses were obtained from central, intermediate, and peripheral areas of laser pulses and compared with data from nonirradiated samples. Results: Dentin Ra for different areas were as follows: central, 261.26 (+/- 21.65) nm; intermediate, 83.48 (+/- 6.34) nm; peripheral, 45.8 (+/- 13.47) nm; and nonirradiated, 35.18 (+/- 2.9) nm. The central region of laser pulses presented higher ablation of intertubular dentin, with about 340-760 nm height, while intermediate, peripheral, and nonirradiated regions presented no difference in height of peritubular and interperitubular dentin. Conclusion: According to these results, we can assume that even when used at a low-energy density parameter, Er, Cr: YSGG laser can significantly alter the microtopography of radicular dentin, which is an important characteristic to be considered when laser is used for clinical applications.

Long-term stability of dentin matrix following treatment with various natural collagen cross-linkers

Objectives: Collagen disorganization is one of the main degradation patterns found in unsuccessful adhesive restorations. The hypothesis of this study was that pretreatment using natural collagen cross-linking agents rich in proanthocyanidin (PA) would improve mechanical properties and stability over time of the dentin collagen and, thus, confer a more resistant and lasting substrate for adhesive restorations. Methods: PA-based extracts, from grape seed (GSE), cocoa seed (CSE), cranberry (CRE), cinnamon (CNE) and acai berry (ACE) were applied over the demineralized dentin. The apparent elastic modulus (E) of the treated dentin collagen was analyzed over a 12 month period. Specimens were immersed in the respective solution and E values were obtained by a micro-flexural test at baseline, 10, 30, 60, 120 and 240 min. Samples were stored in artificial saliva and re-tested after 3, 6 and 12 months. Data was analyzed using ANOVA and Tukey test. Results: GSE and CSE extracts showed a time-dependent effect and were able to improve [240 min (MPa): GSE = 108.96 +/- 56.08: CSE = 59.21 +/- 24.87] and stabilize the E of the organic matrix [12 months (MPa): GSE = 40.91 +/- 19.69; CSE = 42.11 +/- 13.46]. CRE and CNE extracts were able to maintain the E of collagen matrices constant over 12 months [CRE = 11.17 +/- 7.22; CNE = 9.96 +/- 6.11; MPa]. ACE (2.64 +/- 1.22 MPa) and control groups immersed in neat distilled water (1.37 +/- 0.69 MPa) and ethanol-water (0.95 +/- 0.33 MPa) showed no effect over dentin organic matrix and enable their degradation and reduction of mechanical properties. Significance: Some PA-based extracts were capable of improving and stabilizing collagen matrices through exogenous cross-links induction. (C) 2011 Elsevier Ltd. All rights reserved.

Adhesives bonded to erbium:yttrium-aluminum-garnet laser-irradiated dentin: transmission electron microscopy, scanning electron microscopy and tensile bond strength analyses

The aim of this in vitro study was to investigate the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation on dentinal collagen by transmission electron microscopy and to analyze the resin-dentin interface by scanning electron microscopy. A tensile bond strength test was also applied. Specimens from 69 sound human third molars were randomly divided into three groups: control (no laser), and two irradiated groups, laser 250 (250 mJ/2 Hz) and laser 400 (400 mJ/4 Hz). Then, specimens were restored with two adhesive systems, an etch-and-rinse or a self-etch system. Although ultrastructural examination showed a modified surface in the irradiated dentin, there was no statistical difference in bond strength values between the laser groups and controls (P < 0.05). In conclusion, the use of Er:YAG laser for ablating human dentin did not alter the main adhesion parameters when compared with those obtained by conventional methods, thus reinforcing its use in restorative dentistry.

INFLUENCE of DIFFERENT SURFACE CONDITIONING PROTOCOLS on MICROTENSILE BOND STRENGTH of SELF-ADHESIVE RESIN CEMENTS TO DENTIN

Statement of problem. According to manufacturers, bonding with self-adhesive resin cements can be achieved without any pretreatment steps such as etching, priming, or bonding. However, the benefit of saving time with these simplified luting systems may be realized at the expense of compromising the bonding capacity.Purpose. The purpose of this study was to assess whether different dentin conditioning protocols influence the bond performance of self-adhesive resin cements to dentin.Material and methods. Flat dentin surfaces from 48 human molars were divided into 4 groups (n=12): 1) control, no conditioning; 2) H(3)PO(4), etching with 37% H(3)PO(4) for 15 seconds; 3) SEBond, bonding with self-etching primer adhesive (Clearfil SE Bond); and 4) EDTA, etching with 0.1M EDTA for 60 seconds. The specimens from each dentin pre-treatment were bonded using the self-adhesive cements RelyX Unicem, Maxcem or Multilink Sprint (n=4). The resin-cement-dentin specimens were stored in water at 37 degrees C for 7 days, and serially sectioned to produce beam specimens of 1.0 mm(2) cross-sectional area. Microtensile bond strength (mu TBS) testing was performed at 1.0 mm/min. Data (MPa) were analyzed by 2-way ANOVA and Tukey multiple comparisons test (alpha=.05). Fractured specimens were examined with a stereomicroscope (x40) and classified as adhesive, mixed, or cohesive. Additional bonded interfaces were evaluated under a scanning electron microscope (SEM).Results. Cement-dentin mu TBS was affected by the dentin conditioning approach (P <.001). RelyX Unicem attained statistically similar bond strengths to all pre-treated dentin surfaces. H(3)PO(4)-etching prior to the application of Maxcem resulted in bond strength values that were significantly higher than the other groups. The lowest mu TBS were attained when luting Multilink Sprint per manufacturers' recommendations, while H(3)PO(4)-etching produced the highest values followed by Clearfil SE bonding and EDTA. SEM observations disclosed an enhanced potential of the self-adhesive cements to form a hybrid layer when applied following manufacturer's instructions.Conclusions. When evaluated self-adhesive resin cements are used, selectively etching dentin with H(3)PO(4) prior to luting results in the most effective bonding. (J Prosthet Dent 2011;105:227-235)

Effect of Cement Shade and Light-curing Unit on Bond Strength of a Ceramic Cemented to Dentin

Purpose: To evaluate the effect of cement shade, light-curing unit, and water storage on tensile bond strength (a) of a feldspathic ceramic resin bonded to dentin.Materials and Methods: The dentin surface of 40 molars was exposed and etched with 37% phosphoric acid, then an adhesive system was applied. Forty blocks of feldspathic ceramic (Vita VM7) were produced. The ceramic surface was etched with 10% hydrofluoric acid for 60 s, followed by the application of a silane agent and a dual-curing resin cement (Variolink II). Ceramic blocks were cemented to the treated dentin using either A3 or transparent (Tr) shade cement that was activated using either halogen or LED light for 40 s. All blocks were stored in 37 degrees C distilled water for 24 h before cutting to obtain non-trimmed bar-shaped specimens (adhesive area = 1 mm(2) +/- 0.1) for the microtensile bond strength test. The specimens were randomly grouped according to the storage time: no storage or stored for 150 days in 37 degrees C distilled water. Eight experimental groups were obtained (n = 30). The specimens were submitted to the tensile bond strength test using a universal testing machine at a crosshead speed of 1 mm/min. The data were statistically analyzed using ANOVA and Tukey's post-hoc tests (alpha = 0.05).Results: The mean bond strength values were significantly lower for the corresponding water stored groups, except for the specimens using A3 resin cement activated by halogen light. There was no significance difference in mean bond strength values among all groups after water storage.Conclusion: Water storage had a detrimental effect under most experimental conditions. For both cement shades investigated (Tr and A3) under the same storage condition, the light-curing units (QTH and LED) did not affect the mean microtensile bond strengths of resin-cemented ceramic to dentin.

Er:YAG-Laser and Sodium Hypochlorite Influence on Bond to Dentin

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

Effect of Salivary Contamination and Decontamination on Bond Strength of Two One-Step Self-Etching Adhesives to Dentin of Primary and Permanent Teeth

Purpose: To evaluate the effects of human saliva contamination and two decontamination procedures at different stages of the bonding procedure on the bond strength of two one-step self-etching adhesives to primary and permanent dentin. Materials and Methods: Extracted human primary and permanent molars (210 of each) were ground to mid-coronal dentin. The dentin specimens were randomly divided into 7 groups (n = 15/group/molar type) for each adhesive (Xeno V+ and Scotchbond Universal): no saliva contamination (control); saliva contamination before or after light curing of the adhesives followed by air drying, rinsing with water spray/air drying, or by rinsing with water spray/air drying/reapplication of the adhesives. Resin composite (Filtek Z250) was applied on the treated dentin surfaces. The specimens were stored at 37°C and 100% humidity for 24 h. After storage, shear bond strength (SBS) was measured and data analyzed with nonparametric ANOVA followed by exact Wilcoxon rank sum tests. Results: Xeno V+ generated significantly higher SBS than Scotchbond Universal when no saliva contamination occurred. Saliva contamination reduced SBS of Xeno V+, with the reduction being more pronounced when contamination occurred before light curing than after. In both situations, decontamination involving reapplication of the adhesive restored SBS. Saliva contamination had no significant effect on Scotchbond Universal. There were no differences in SBS between primary and permanent teeth. Conclusion: Rinsing with water and air drying followed by reapplication of the adhesive restored bond strength to saliva-contaminated dentin.

Airborne-particle Abrasion Is a Minimally Invasive Method to Pre-Treat Sclerotic, Non-Carious Cervical Dentin

Objectives: To investigate substance loss and bond strength capacity of sclerotic, non-carious cervical dentin after airborne-particle abrasion or diamond bur preparation. Methods: Fifteen non-sclerotic dentin specimens were made from crowns of extracted human incisors of which the labial surfaces had been ground with silicon carbide papers (non-sclerotic control; Group 1). Forty-five sclerotic dentin specimens (n=15/group) were made from the labial, non-carious cervical root part of extracted human incisors and underwent either no pre-treatment (sclerotic control; Group 2), pre-treatment with airborne-particle abrasion (CoJet Prep [3M ESPE] and 50 µm aluminium oxide; Group 3), or with diamond bur preparation (40 µm grit size; Group 4). Substance loss after pre-treatment was measured in Groups 3 and 4. Subsequently, Scotchbond Universal (3M ESPE) and resin composite (CeramX [DENTSPLY DeTrey]) were applied on the treated dentin surfaces. The specimens were stored at 37°C and 100% humidity for 24 h. After storage, shear bond strength (SBS) was measured and data analyzed with nonparametric ANOVA followed by Wilcoxon rank sum tests. Results: Substance loss (medians) was 19 µm in Group 3 and 113 µm in Group 4. SBS-values (MPa; medians) in Group 2 (9.24) were significantly lower than in Group 1 (13.15; p=0.0069), Group 3 (13.05; p=0.01), and Group 4 (13.02; p=0.0142). There were no significant differences in SBS between Groups 1, 3, and 4 (p≥0.8063). Conclusion: Airborne-particle abrasion and diamond bur preparation restored bond strength of Scotchbond Universal to sclerotic dentin to the level of non-sclerotic dentin, with airborne-particle abrasion being less invasive than diamond bur preparation.

Bond Strength of Resin Composite to Dentin with Different Adhesive Systems: Influence of Relative Humidity and Application Time.

PURPOSE To investigate the influence of relative humidity and application time on bond strength to dentin of different classes of adhesive systems. MATERIALS AND METHODS A total of 360 extracted human molars were ground to mid-coronal dentin. The dentin specimens were treated with one of six adhesive systems (Syntac Classic, OptiBond FL, Clearfil SE Bond, AdheSE, Xeno Select, or Scotchbond Universal), and resin composite (Filtek Z250) was applied to the treated dentin surface under four experimental conditions (45% relative humidity/application time according to manufacturers' instructions; 45% relative humidity/reduced application time; 85% relative humidity/application time according to manufacturers' instructions; 85% relative humidity/reduced application time). After storage (37°C, 100% humidity, 24 h), shear bond strength (SBS) was measured and data analyzed with nonparametric ANOVA followed by Kruskal-Wallis tests and Mann-Whitney U-tests with Bonferroni-Holm correction for multiple testing (level of significance: α = 0.05). RESULTS Increased relative humidity and reduced application time had no effect on SBS for Clearfil SE Bond and Scotchbond Universal (p = 1.00). For Syntac Classic, OptiBond FL, AdheSE, and Xeno Select there was no effect on SBS of reduced application time of the adhesive system (p ≥ 0.403). However, increased relative humidity significantly reduced SBS for Syntac Classic, OptiBond FL, and Xeno Select irrespective of application time (p ≤ 0.003), whereas for AdheSE, increased relative humidity significantly reduced SBS at recommended application time only (p = 0.002). CONCLUSION Generally, increased relative humidity had a detrimental effect on SBS to dentin, but reduced application time had no effect.

Influência da densidade tubular em diferentes profundidades dentinárias na estabilidade de união de cimentos de iônomero de vidro

O objetivo do estudo foi avaliar a influência da densidade tubular em diferentes profundidades dentinárias na estabilidade de união de dois cimentos de ionômero de vidro (CIV) de alta viscosidade. Vinte terceiros molares foram alocados em 6 grupos experimentais, de acordo com a profundidade da dentina - proximal, oclusal superficial ou oclusal profunda, e os CIVs - Fuji IX (GC Corp.) e Ketac(TM) Molar Easy Mix (3M/ESPE). Inicialmente os dentes foram cortados a fim de se obter fatias de aproximadamente 1 mm de espessura de dentina proximal, oclusal superficial e profunda. Em seguida, foi realizado uma análise topográfica das secções das diferentes superfícies e profundidades em microscopia confocal a laser (100X) para obtenção das médias da densidade tubular em cada profundidade. Cânulas de polietileno foram então posicionadas sobre as secções de dentina pré-tratadas e preenchidas pelos CIVs. Os espécimes foram armazenados em água destilada por 24 h e 12 meses a 37°C, em seguida foram submetidos ao ensaio de microcisalhamento (0,5 mm/min). Após o ensaio, foi realizada a análise do padrão de fratura em estereomicroscópio (400X). Os dados obtidos foram submetidos à Análise de Variância para dados repetidos, seguido do teste de Tukey (?=5%). Verificamos que a densidade dos túbulos dentinários, em diferentes profundidades de molares permanentes, é inversamente proporcional a resistência de união de cimentos de ionômero de vidro de alta viscosidade. Foi ainda observado em todos os grupos que a resistência de união após 24 horas é maior do que em 12 meses, indicando degradação da interface adesiva ao longo do tempo.

Adhesion of Epiphany and AH Plus sealers to human root dentin treated with different solutions

This study evaluated comparatively the adhesion of Epiphany and AH Plus endodontic sealers to human root dentin treated with 1% NaOCl and 1% NaOCl+17% EDTA, using the push-out test. Sixty root cylinders obtained from maxillary canines had the canals prepared and were randomly assigned to 3 groups (n=20), according to root dentin treatment: GI - distilled water (control), GII - 1% NaOCl and GIII - 1% NaOCl+17% EDTA. Each group was divided into 2 subgroups (n=10) filled with either Epiphany or AH Plus. Bond strength push-out test data (kN) were obtained and analyzed statistically by ANOVA and Tukey's post-hoc test. There was statistically significant difference between sealers (AH Plus: 0.78 ± 0.13; Epiphany: 0.61 ± 0.19; p<0.01) and among root dentin treatments (distilled water: 0.58 ± 0.19; 1% NaOCl: 0.71 ± 0.12; 1% NaOCl+17% EDTA: 0.80 ± 0.17; p<0.05). In conclusion, AH Plus sealer presented greater adhesion to dentin than Epiphany, regardless of the treatment of root canal walls.