The effect of smear layer removal on marginal contraction gaps

The presence of the smear layer prevents direct contact between dentine and a dentine adhesive. The use of agents to remove the smear layer theoretically should improve the bonding of composite resins to dentine. This study examined the effect of smear layer removal on the effectiveness of a dentine bonding agent in reducing marginal contraction gaps. The agent used for smear layer removal in this study was ethylenediamine tetra-acetic acid (EDTA). Eighty cavities measuring 2mm in diameter and 1.5 mm in depth were prepared in dentine and randomly assigned to two equal groups. The control group was restored with Prisma Universal Bond 2 Adhesive and Prisma Fil Resin. The experimental group was similarly restored after pretreatment of dentine with 0.5% EDTA for 60s. All specimens were thermocycled and the marginal contraction gaps were assessed using a Nikon Measurescope. The mean contraction gap was expressed as a percentage of the cavity diameter. Results showed that the experimental group registered smaller contraction gaps (mean: 0.021%) than the control group (mean: 0.027%). No penetration of material into dentine was observed. Pretreatment with EDTA did not significantly improve the effectiveness of the dentine bonding agent used in terms of reduction of marginal contraction gaps.     

Effect of interchanging two composite resin system with a dentine adhesive

There is a tendency to interchange dentine adhesives and composite resins when using composite resins for restorations. This study used marginal contraction gaps to test the effect of changing composite resins with a dentine adhesive. Cylindrical butt-joint cavities were prepared entirely in dentine using extracted human teeth. Two groups of control cavities (30 cavities per group) were restored with Prisma-Bond/Prisma-Fil and Heliobond/Heliomolar respectively. Two groups of test cavities (30 cavities per group) were restored using the dentine adhesive. Prisma Universal Bond with Prisma-Fil on one group and Prisma Universal Bond and Heliomolar in the other. Following thermocycling the marginal contraction gaps were measured and assessed. The results showed a significant reduction in marginal contraction gaps when using either composite resin with Prisma Universal Bond. This indicates a compatibility of both resins with the adhesive in this instance.     

Dentin bond strength and marginal adaptation: direct composite resins vs ceramic inlays.

The aim of this in vitro study was to compare the dentin bond strength and marginal adaptation of directly and indirectly inserted restorations. A conically modified push-out test was designed to consider polymerization shrinkage and facilitate inlay placement. A total of 260 cavities were prepared into disks of freshly extracted human third molars and filled with direct composite resins or with adhesively luted ceramic inlays. Dentin adhesives of the third--(with self-etching primer: ART Bond, Syntac Classic), fourth--(with total etching: Scotchbond Multi-Purpose Plus), and fifth-generation (one-bottle adhesives: Syntac Single Component, Prime & Bond 2.1) were used in combination with one hybrid composite (Tetric) or luting composite (Variolink Low). Control groups did not use an adhesive. Polymerization of the bonding agent was carried out prior to insertion of the filling/inlay or afterwards simultaneously with the composite/luting composite. The thickness of the adhesive layer and luting composite was recorded, and after 7 days of storage and 24 hours of thermocycling (1150 cycles) replicas were made and extrusion testing performed. Fracture modes were determined and replicas were examined regarding marginal adaptation using SEM (X200 magnification). Precuring of the bonding resin increased dentin bond strength independent of the material combination or insertion mode (P < 0.05). In general, third- and fourth-generation dentin adhesives produced better results in bond strength and marginal adaptation than one-bottle systems (P < 0.05). In the third generation, ART Bond achieved significantly higher push-out values than Syntac (P < 0.05), but no better marginal adaptation. Cohesive fractures within the dentin were only observed in the inlay groups with precured resin. Precuring of the bonding resin is an important factor for both direct and indirect restorations. Nevertheless, precuring of the bonding resin prior to insertion of adhesive inlays cannot be recommended clinically, because the 120-micron luting spaces were too large. In simulated cavities, direct composite fillings with precuring achieved bond strengths similar to inlays without precuring. One-bottle adhesive systems performed poorly compared with multi-step adhesives of the third and fourth generation.     

Effects of additional and extended acid etching on bonding to caries-affected dentine

This study evaluated the effects of additional and extended acid etching on microtensile bond strength ( micro TBS) of two adhesive systems to sound (SD) and caries-affected dentine (CAD). Flat surfaces of CAD surrounded by SD of 36 extracted carious third molars were assigned to four treatments (i): self-etching adhesive system (Clearfil SE Bond) applied to dentine surfaces following manufacturer's instructions (MI); (ii) after additional etching for 15 s (35% phosphoric acid, PA); (iii) total-etch one-bottle adhesive (Single Bond) applied to dentine surfaces following MI; or (iv), after etching for 45 s with PA. Composite 'blocks' were built on bonded surfaces and restored teeth were vertically sectioned to obtain bonded slices of 0.7 mm thick. Slices were trimmed to create hourglass-shaped specimens (cross-sectional area of 1 mm(2)), which were tested under tension in a universal testing machine. Additional CAD and SD samples were prepared for scanning electron microscopy observations. Additional and extended etching significantly increased micro TBS to CAD; however, micro TBS of both adhesives to CAD were significantly lower than to SD. Additional and extended etching can improve bonding to CAD; however, adhesives applied on SD showed the best results for bonding.     

Duration of cleaning and priming of dentine and contraction gap formation

Objectives: The effects of the duration of cleaning and priming on the marginal adaptation of a light-activated resin composite in a cylindrical dentine cavity were examined by measuring the width of the wall-to-wall polymerization contraction gap.

Methods: The dentine cavity was cleaned with ethylene diamine tetra-acetic acid (EDTA) and primed 35 vol% hydroxyethyl methacrylate (HEMA) or glyceryl methacrylate (GM) solution for up to 60 s. The cavity was filled with a light-cured resin composite after the application of a dual-cured dentine bonding agent.

Results: The formation of a contraction gap by the composite appeared to be prevented completely, regardless of the duration of priming with GM solution, when the cavity was cleaned with EDTA for 60 s. When cleaning was limited to just 30 s, GM priming had to be prolonged to 60 s to obtain complete marginal integrity. A significantly wide contraction gap was observed without EDTA cleaning, even when the cavity wall was primed with GM solution for 60 s.

Conclusion: GM solution was a better dentine primer than HEMA solution, since HEMA priming did not prevent gap formation under any of the conditions tested.     

One-year clinical evaluation of an ethanol-based and a solvent-free dentin adhesive

PURPOSE: To analyze the clinical performance of adhesives with various solvents for restoration of non-carious cervical lesions. METHODS: The patient pool consisted of a total of 57 patients and 171 teeth (3 teeth per patient), with one non-carious cervical lesion per tooth. For each patient, one tooth was restored with a water-based, two-bottle adhesive (Scotchbond Multi-Purpose - SM), and another tooth with an ethanol-based, one-bottle adhesive (Single Bond - SB), and the other tooth with a solvent-free, one-bottle adhesive (One Coat Bond - OCB), all with resin-based composites (Silux Plus or Synergy). Restorations were assessed by retention, marginal integrity, margin discoloration and air sensitivity, according to modified USPHS criteria. The evaluations were performed at baseline, 6 months and 12 months after initial placement. RESULTS: The retention rates at 12 months were 98% for the SM adhesive, 91% for the SB adhesive, and 93% for the OCB adhesive. The differences in retention rates were not statistically significant, with 94% restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives. Overall, for the restorations still retained after 12 months, 80% had non/slightly detectable margins, 80% had no marginal discoloration and 90% had none/mild sensitivity. All three adhesives performed comparably with excellent outcomes after a 12-month period, with no significant differences between the water-based, ethanol-based and solvent-free adhesives, nor between the one-and two-bottle systems. Retention rate was high, air sensitivity was markedly reduced, and marginal integrity was good. Although superficial marginal discoloration was notable, no deep staining was evident. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure.     

Bonding of restorative resins to dentine: status of dentine adhesives and impact on cavity design and filling techniques

In conjunction with the acid etch technique for bonding of restorative resins to enamel, an effective bonding to dentine would eliminate the need for retentive undercuts and ensure a tight marginal seal. Bonding to dentine can be achieved through dentine adhesives. These may be divided into Ca2+-bonding and collagen-bonding types. Several Ca2+-bonding adhesives are based on phosphate methacrylates. Adhesives of this type mediate a bond strength to dentine not exceeding 10 MPa. In contrast, Bowen's bonding system and the Gluma system yield bond strengths higher than 10 MPa. The two latter systems have recently been conceived in simplified versions. In general, the higher the bond strength to dentine mediated by an adhesive, the smaller are the marginal gaps formed by a composite resin polymerizing in a dentine cavity treated by the adhesive. The size and the shape of the cavity influence the width of the marginal gaps. A cavity having a V-shape gives rise to smaller gaps than box-shaped cavities. A filling technique with two 'inclining' layers reduces the width of marginal gaps. Combination of certain Ca2+-bonding and collagen-bonding adhesives results in increased bond strength and smaller marginal gaps.     

Self-etch vs etch-and-rinse adhesives: effect of thermo-mechanical fatigue loading on marginal quality of bonded resin composite restorations.

OBJECTIVE: This study evaluated the marginal integrity of dentine adhesives bonded to enamel and dentine, before and after thermo-mechanical loading (TML). METHODS: MO cavities with proximal boxes beneath the CEJ were prepared in extracted human third molars. Direct resin composite restorations (Tetric Ceram) were bonded with 3-step etch-and-rinse (Syntac Classic, Solobond Plus, OptiBond FL), 2-step etch-and-rinse (Admira Bond, Single Bond), 2-step self-etch (AdheSE, Clearfil SE Bond), and 1-step self-etch (all-in-one) adhesives (Adper Prompt, Xeno III, iBond). Marginal gaps were analyzed using SEM of epoxy resin replicas. Bonded interfaces before TML were examined with TEM to identify pre-existing attributes for subsequent marginal disintegration. RESULTS: In enamel, high percentages of gap-free margins were initially identified for all adhesives. After TML, etch-and-rinse adhesives exhibited significantly higher percentages of gap-free margins (approximately 90%) compared with two-step self-etch (approximately 75%) and all-in-one (approximately 55%) adhesives (p<0.05). iBond did not completely etch through the enamel smear layer. In dentine, 89-100% gap-free margins were initially observed. After TML, there were no statistical differences among etch-and-rinse (62-70%) and two-step self-etch (62-63%) adhesives (p>0.05). The all-in-one adhesives exhibited significantly less gap-free margins (<40%) in dentine (p<0.05), with iBond showing the worst marginal integrity (15%). The presence of pre-existing water channels within the adhesives probably expedited water sorption when restorations were under functional stresses. CONCLUSION: Enamel bonding was more effective with phosphoric acid-etching. Etch-and-rinse and 2-step self-etch adhesives showed promising marginal adaptation to dentine and may have a better clinical prognosis than the all-in-one bonding approach.     

Quantitative evaluation of microleakage in Class V cavities using one-bottle and self-etching adhesive systems

The aim of this in vitro study was to evaluate quantitatively the microleakage in Class V cavities restored with one-bottle and self-etching adhesive systems with and without previous acid etching. Two one-bottle adhesive systems (Single Bond and Prime & Bond 2.1) and one self-etching adhesive system (Clearfil Mega Bond) were used in this study. One hundred and twenty sound human premolar teeth were randomly divided into 6 groups, and 20 Class V restorations were prepared in the root dentin to test each bonding system. Each bonding system was used with and without acid etching. Specimens were prepared, dyed with 2% methylene blue, sectioned, triturated, and evaluated with an absorbance spectrophotometer test in order to quantify the infiltrated dye. Results were statistically evaluated by ANOVA and Tukey-Kramer test. No statistically significant differences were found among the adhesive systems when no etching agent was used. However, the Single Bond adhesive system showed statistically significant lower microleakage means than Clearfil Mega Bond and Prime & Bond 2.1 when 37% phosphoric acid was used. Single Bond and Clearfil Mega Bond adhesive systems presented similar behavior when the manufacturers' instructions were followed.     

Bond strengths of nine current dentine adhesive systems to primary and permanent teeth

The aim of this study was to compare the shear bond strength (SBS) of nine dentine bonding systems (DBS) of different classes to human primary and permanent dentine. Flat dentine occlusal surfaces were produced on human molars (100 primary, 100 permanent) by wet grinding on a 800-grit SiC paper. Nine DBS were applied following the manufacturers' instructions: One total etch multi-step system: Scotchbond Multipurpose Plus (3M/ESPE); Four total etch one-bottle system: Prime &Bond 2.1 (Dentsply), One Step (Bisco), Scotchbond 1 (3M/ESPE), and OptibondSolo Plus (Kerr); Three two-step self-etching primer systems: Clearfil Liner Bond 2 (Kuraray), Clearfil SE Bond (Kuraray), and Prime &Bond NT with NRC (Dentsply); An 'all-in-one' self-etching system: Prompt L-Pop (3M/ESPE). Composite (Z100; 3M/ESPE) cylinders (2 mm diameter, 3 mm high) were polymerized on the treated dentine surfaces and the specimens were stored at 37 degrees C for 24 h prior to testing. Twenty experimental groups were produced and tested. Statistical analysis revealed both a substrate and a bonding system effect. Two adhesive systems (One Step, Prime &Bond NT) had significantly higher bond strengths on permanent than on primary dentine. There was an effect of dentine bonding system on the mode of fracture. Although eight of the 10 DBS tested exhibited higher median SBS values on permanent dentine than on primary dentine, the dependent pairwise comparison identified a significant difference only for two groups. The use of simplified bonding systems does not necessarily result in improved bond strength to primary or to permanent dentine.     

Influence of enamel wetness on resin composite restorations using various dentine bonding agents: part I-effects on marginal quality and enamel microcrack formation

OBJECTIVES: To investigate the influence of enamel wetness on marginal quality and enamel microcrack formation using various dentine bonding adhesives; and to determine the changes of marginal quality and enamel microcracks over time. METHODS: Forty extracted molars were each prepared with a cylindrical cavity and divided into five groups. Groups 1-4 were acid-etched and treated separately with either an ethanol-based adhesive (Single Bond) or an acetone-based adhesive (Prime&Bond NT) on either dry or wet enamel. Teeth in Group 5 were treated with a self-etching adhesive (Clearfil SE Bond). Epoxy replicas of different stages were taken after cavity preparation, after restoration, after 24 h storage, and after thermocycling test. These replicas were examined under a scanning electron microscope for their restorative marginal quality and enamel microcrack. Quantitative measurement was performed to measure the length ratio of different margin patterns, and enamel microcracks. RESULTS: There was no difference in the marginal quality when ethanol-base adhesive was applied on dry or wet dentin. The group using acetone-based adhesive on the dry enamel presented higher intact margin ratio than the group on wet enamel did only after restoration. Using self-etching primer led to higher open margin ratio at all stages. Enamel microcracks were found in all five groups and were higher in groups using acetone-based adhesives. CONCLUSION: Enamel wetness did not show a significantly adverse effect on the marginal quality of the restorations using either acetone- or ethanol-based adhesive. Using self-etching adhesive may lead to high incidence of margin deterioration.     

The effect of thermal cycling on the bovine dentine shear bond strength of current adhesive systems

The aim of this study was to evaluate the effect of thermal cycling on shear bond strength to bovine dentine of four current adhesive systems. Forty bovine incisors were ground flat with #600-grit silicon carbide paper to obtain superficial coronal dentine surfaces. Three one-bottle (etch and rinse) adhesive systems (Single Bond, Bond 1, One Step), and one self-etching primer adhesive system (Clearfil Liner Bond 2V) were evaluated. Dentine was conditioned and bonded with the adhesive systems tested according to the manufacturers' instructions. A cylindrical teflon mould (3 x 4 mm) was placed over the bonded area (to eliminate the bonded surface) and filled with composite resin. For each adhesive system the filling composite used was from the same manufacturer. Ten specimens were prepared for each material and all specimens were conditioned at 37 degrees C for 24 h. Five specimens of each material (half of the specimens) were thermocycled at 5000 cycles (at 5, 37, 55 and 37 degrees C) with a dwell time of 15 s and bonds were stressed in shear at a rate of 0.5 mm min(-1) until failure. Data were analysed by one-way anova and Student-Newman-Keuls rank test (alpha=0.05). Statistical analysis revealed that thermal cycling significantly (P < 0.05) reduced the bond strengths of all adhesive systems. Bond strengths prior to thermocycling were not significantly different (P > 0.05), except for One Step which revealed the lowest bond strength, and varied from 22.5 +/- 3.34 to 10.98 +/-0.87 MPa. After thermal cycling, the bond strengths ranged from 9.35 +/- 1.13 to 6.06 +/- 1.77 MPa. Failures after testing and prior to thermal cycle were most commonly adhesive failures between the bonding resin and dentine associated with partial cohesive failures in the adhesive resin (type 2). Adhesive failures between bonding resin and dentin (type 1) after thermocycling were most commonly seen.     

Evaluation of the modern self-etching adhesives efficacy

The durability of bonding efficacy of composites with hard tissues of a tooth was investigated at application of one-bottle adhesive with total etching and five self-etching adhesives. The efficiency of etching by 36% orthophosphoric acid and acid components of self-etching adhesives was estimated. The adhesion between substrate and composite was measured by method of microtensile bond strength (mTBS). The control of efficiency of etching and depth of the penetration was carried out with the confocal laser scanning microscopy. It was established, that self-etching adhesives are capable to guarantee bonding of composites with enamel and dentine at a level compared with adhesives of the 5th generation. Deep adhesives penetration in dentine tubules is not the key factor for creation of reliable bonding.     

Effect of two-step adhesive systems on inhibition of secondary caries around fluoride-releasing resin composite restorations in root dentine

OBJECTIVE: The purpose of this study was to investigate the effect of two-step adhesive systems on secondary caries inhibition around fluoride-releasing materials in vitro. METHODS: Two self-etching primer systems, Clearfil SE Bond (SE) and UniFil Bond (UB), and two one-bottle systems with a total-etch wet-bonding technique, Single Bond (SB) and One-Step (OS), were used prior to placement of resin composites either with (Reactmer) or without (Z100) fluoride release. Class V cavities prepared in extracted human premolars were restored with various combinations of materials: Reactmer/SE, Reactmer/UB, Reactmer/SB, Reactmer/OS, Z100/SE, Z100/UB, Z100/SB and Z100/OS. After storage for 14 days, the restored teeth were incubated in bacterial medium containing sucrose with Streptoccus mutans for 2 weeks. Water sorption and desorption of the adhesives and fluoride release from the resins either coated with adhesive or uncoated were also determined. RESULTS: The one-bottle groups showed higher water sorption and desorption than the self-etching primer groups. Although fluoride release from the Reactmer specimens was suppressed by the adhesive coating, the one-bottle groups allowed significantly higher fluoride release than the self-etching primer groups. On microradiographs, the radio-opaque layers adjacent to the Reactmer restorations were thick and clear, while the layers adjacent to the Z100 restorations were thin and unclear. For the Reactmer restorations, the radio-opaque layers associated with the one-bottle groups were significantly thicker than for the self-etching primer groups. CONCLUSIONS: These results indicated that the use of one-bottle wet-bonding systems for bonding of fluoride-releasing resin composites to dentine may contribute to inhibit secondary caries compared to self-etching primer systems.     

A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives

BACKGROUND: The authors conducted an in vivo investigation to compare the clinical performance of two commercial one-bottle adhesives and a two-bottle adhesive for restoration of noncarious cervical lesions (NCCLs). METHOD: The patient pool consisted of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. Each patient received three resin-based composite restorations, each with a different adhesive: one tooth with a two-bottle, water-based adhesive as the control; another tooth with a one-bottle, ethanol-based adhesive; and a third tooth with a one-bottle, solvent-free adhesive. The authors assessed restorations in terms of retention, marginal integrity, margin discoloration and air sensitivity at baseline, six months, one year, two years and three years after initial placement. RESULTS: The retention rates at 36 months were 88 percent for the first adhesive, 81 percent for the second adhesive and 90 percent for the third adhesive. No statistically significant differences in retention rates could be shown, with 86 percent of restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives (P > .05). CONCLUSIONS: All three adhesives performed with acceptable outcomes after a 36-month period, with small differences between the one- and two-bottle systems and between the various solvents. Retention rate was moderately high and air sensitivity was markedly reduced; however, superficial marginal discoloration and marginal degradation was notable. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure. CLINICAL IMPLICATIONS: The type of solvent may not be a major factor in retention of Class V restorations in NCCLs. Both single-bottle adhesives and conventional two-bottle adhesives performed acceptably.     

Effects of regional enamel and prism orientation on resin bonding

Human enamel, with its prismatic, rod-like apatitic morphology, is an anisotropic material. Because of this structural anisotropy, variation in enamel bonding sites might influence the bonding ability of current adhesive systems. This study investigated the effects of regional enamel and the direction of enamel sectioning on the bonding ability of two commercially available resin adhesives: a self-etching primer system (Clearfil SE Bond) and a one-bottle adhesive system intended for use with a total-etch wet bonding technique (Single Bond). Two regions of enamel, cuspal and mid-coronal enamel, were chosen, then sectioned in three different directions, horizontally, axially and tangentially. Slices of the sectioned enamel were then bonded with each adhesive system and submitted to a micro-shear bond test. The results of a micro-shear bond testing showed that the bonding of a one-bottle adhesive system (Single Bond) to enamel was high at the surface perpendicular to the enamel prisms (40 MPa to 51 MPa) and low at the surface parallel to the enamel prisms (24 MPa to 27 MPa). In the case of a self-etching primer system (Clearfil SE Bond), 35 MPa to 45 MPa bond strengths were obtained from all surfaces. The bond strengths of the two adhesive systems were significantly influenced by the anisotropic structure of enamel (p < 0.05). However, the effect of a self-etching primer system was less influenced by the orientation of the prismatic structure of enamel than that of a one-bottle adhesive system (p < 0.05). SEM and CLSM microphotographs showed that the self-etching primer effectively modified the smear layer without being excessively destructive to the enamel.     

Comparative clinical evaluation of different treatment approaches using a microfilled resin composite and a compomer in Class III cavities: two-year results

This study evaluated the 24-month clinical performance of a microfilled composite using a one-bottle bonding system and a compomer that uses one-bottle bonding systems, which include a non-rinse conditioner or 36% phosphoric acid gel in Class III cavities. Each patient received three restorations due to primary caries of the anterior teeth, resulting in a total of 96 restorations. Three types of restoration/adhesive combinations were used: a microfilled resin composite (Filtek A110) with a one-bottle bonding system (Single Bond); a polyacid-modified resin composite (compomer) (Dyract AP) with a filled one-bottle bonding system (Prime & Bond NT) using 36% phosphoric acid pretreatment and a polyacid-modified resin composite (compomer) (Dyract AP) with a filled one-bottle bonding system (Prime & Bond NT) using a non-rinse conditioner (NRC) and a self-priming pretreatment. At baseline and one- and two-year recalls, color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation and surface texture of the restorations were evaluated by two experienced, calibrated examiners using the modified Ryge criteria. After two years, one restoration from each group had a rating of Charlie (C) for both color match and marginal discoloration and needed to be replaced. Therefore, the failure rate was 3.6% (success rate: 96.4%) for each group at the end of two years. Statistical analysis showed no significant differences among the three groups in color match, marginal discoloration, wear or loss of anatomical form, marginal adaptation and surface texture after two years. Also, no statistically significant differences were determined for each group with respect to color match, marginal discoloration, wear or loss of anatomical form, marginal adaptation and surface texture at the end of two years.     

Clinical evaluation of two one-bottle dentin adhesives at three years

BACKGROUND: The method currently used to adhere resin to dentin involves etching, priming and bonding. Many commercial adhesives now combine priming and bonding functions in a single solution, and these are frequently called one-bottle adhesives. The purpose of this study was to compare the 36-month clinical performance of two commercial one-bottle adhesives. METHODS: The authors enrolled 33 patients with noncarious cervical lesions in the study. A total of 101 lesions were restored with either a filled, ethanol-based adhesive (OptiBond Solo, SDS Kerr) or an unfilled, acetone-based adhesive (Prime & Bond 2.1, Dentsply Caulk) and a hybrid resin-based composite. Enamel margins were not beveled, and no mechanical retention was placed. The restorations were evaluated at baseline and six months, 18 months and 36 months after placement using modified Cvar/Ryge criteria. RESULTS: The retention rates at 36 months were 93.3 percent for the ethanol-based adhesive and 89.4 percent for the acetone-based adhesive. The difference in retention rates was not statistically significant. In both groups, 12 percent of the retained restorations had marginal staining, but no recurrent caries was detected around any restoration. Other restoration characteristics such as marginal adaptation and color match remained excellent three years after placement. CONCLUSIONS: The performance of both adhesives was excellent during this 36-month clinical trial. At the most recent recall evaluation (that is, 36 months), the filled, ethanol-based adhesive exhibited slightly better bond durability, but the difference between the two materials was not statistically significant. CLINICAL IMPLICATIONS: The one-bottle adhesives evaluated in this study provided excellent clinical retention of Class V restorations without mechanical retention. When the materials are used properly, restorations are retained at a high rate during at least three years of clinical service.     

Physiochemical interactions at the interfaces between self-etch adhesive systems and dentine

OBJECTIVES: The purpose of this study is to provide direct and comprehensive information regarding morphology, quality and chemistry of the interfaces between three self-etching primers/adhesives and dentine. MATERIALS AND METHODS: The occlusal one-third of the crown was removed from 18 unerupted human third molars. The prepared dentine surfaces were randomly selected for treatment with one of three commercial self-etching bonding agents according to manufacturers' instructions. One two-step self-etching adhesive (Clearfil SE Bond) and two one-step self-etching adhesives (One-Up Bond F and Prompt L-Pop) were selected. Five-micron-thick sections of adhesive/dentine interface specimens were cut and stained with Goldner's trichrome for light microscopy. Companion slabs were analysed with micro-Raman spectroscopy and scanning electron microscopy (SEM). RESULTS: It was shown that the difference in aggressiveness of these three contemporary self-etching systems produced different thickness of hybrid layer. Staining technique showed a distinct coloured line/zone at the adhesive/dentine interfaces for all three bonding systems. The width of this line varied, and was approximately 1, 1-2, 2-3 microm for Clearfil SE Bond, One-Up Bond F and Prompt L-Pop, respectively. The colour differences in the stained interface sections, which is reflected by the extent to which the adhesive encapsulates the demineralised dentine matrix, indicated that collagen fibrils at the interfaces were not totally encased in all three self-etching adhesives. Raman results showed that Prompt L-Pop is the most aggressive systems in this study. It almost totally demineralised the 2-microm deep subsurface dentine, while Clearfil SE is mild, only partially demineralised the first micron deep dentine. CONCLUSIONS: The complementary techniques, i.e. SEM, staining and micro-Raman spectroscopy, hold considerable promise for comprehensive physicochemical characterisation of self-etching adhesive/dentine interfaces. In comparison with two-step self-etching system, the aggressive one-step system produces more complex interfaces.     

Shear Bond Strengths of One-Bottle Adhesives to Moist Enamel

Abstract: Purpose: This study evaluated bond strengths of six one-bottle bonding agents and a control (primer plus unfilled resin) to moist enamel.
Materials and Methods: One-hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts).
Results: Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives.
CLINICAL SIGNIFICANCE: The results of this study suggest that all of the one-bottle systems tested should provide clinically acceptable bonding to moist enamel.