Fractured teeth bonded with dentin adhesives with and without unfilled resin

Fractured incisors were restored by reattaching the fragment to the remaining tooth structure. For this purpose, seven dentin adhesive systems were used with and without an unfilled resin (Heliobond^®) and the strength of the restored teeth was tested at a cross-head speed of either 1 or 500 mm/min. The hypothesis was that the strength of the reattachment would be higher when an unfilled resin was used. The dentin adhesive systems were Prime & Bond NT^® (PB), Exite^® (EX), One-Step^® (OS), PQ1^® (PQ), SingleBond^® (SB), Optibond Solo Plus^® (OS), and an experimental adhesive (GL). Statistical analysis revealed that with all adhesives except EX, a significantly greater mean fracture strength was achieved when the adhesives were used with the resin (Heliobond). Furthermore, with all adhesives except PB, there was a significantly lower mean fracture strength when tested at 500 mm/min than at 1 mm/min. All the tested adhesives except EX should be used with an unfilled resin when restoring fractured teeth by reattachment.     

Bracket bond strength comparison between new unfilled experimental self-etching primer adhesive and conventional filled adhesives

Objective:To determine if a new unfilled experimental self-etching primer (SEP) adhesive system (SBP-40TX + C&B Metabond) that incorporates a methyl methacrylate–based 4-META/TBB (4-methacryloxyethyl trimellitate anhydride tri-n-butyl borane) resin can provide adequate shear bond strength (SBS) when used for bonding orthodontic brackets.Methods and Materials:Forty-eight human maxillary premolars were randomly divided into three groups of 16 specimens each. Brackets were bonded with three bonding systems. A filled Bis-GMA/TEGDM (triethylene glycol dimethacrylate)–based SEP adhesive system (Transbond Plus) and an unfilled conventional etch-and-rinse adhesive system (C&B Metabond) were used for comparison. The SBS for each sample was examined with a universal testing machine, and the Adhesive Remnant Index score was calculated. Enamel surfaces after conditioning were examined using a scanning electron microscope. Data were compared by one-way analysis of variance and a χ² test.Results:The experimental SEP showed a milder etching pattern than Transbond Plus SEP. No statistically significant differences in the mean SBS were found between the specimens bonded with the unfilled experimental SEP adhesive system (10.0 MPa) and the filled SEP adhesive system (8.7 MPa). The unfilled experimental SEP adhesive system showed less residual adhesive than the filled SEP adhesive system.Conclusions:The unfilled experimental SEP adhesive system showed a clinically sufficient SBS that was equivalent to the filled SEP adhesive system.     

Enamel loss during orthodontic bonding and subsequent loss during removal of filled and unfilled adhesives.

1. The techniques required in the removal of highly filled composite adhesives at the end of orthodontic treatment on an average cause more loss of enamel than removal of an unfilled polymethylmethacrylate adhesive. 2. The amount of enamel lost during the removal of either adhesive may be of clinical significance because of the removal of a major part of the protective fluoride-rich layer of enamel. 3. The use of zirconium silicate on a rotating bristle brush may cause considerable abrasion of enamel.     

Flowable resin composites as filled adhesives: literature review and clinical recommendations.

There is increasing reliance on laboratory testing of new products. The clinical significance of many such studies can be questioned. To function clinically, bond strength must develop more quickly than the shrinkage stress. Oxygen inhibition of extremely thin resin layers prohibits establishment of the bond, perhaps particularly relevant for single-component dentin bonding agents. Use of thicker layers of radiolucent hydrophilic bonding materials can lead to difficulties during subsequent radiographic diagnosis and may contribute to degradation at enamel margins. Shrinkage stress is influenced significantly by many factors. The cavity geometry probably plays the most important role but cannot be controlled to any major extent by the operator. Shrinkage and modulus kinetics are also critical, involving variables such as content and type of monomers, the catalyst system, and the light intensity. In general, a high modulus of elasticity or more rapid polymerization leads to increased shrinkage stress. Combining a single-component adhesive as a dentin primer with a highly radiopaque flowable resin composite as a filled adhesive may help overcome these difficulties.     

Microleakage with Gluma: effects of unfilled resin polymerization and storage time

An earlier study showed that the Gluma Bonding System permitted more microleakage than other dentin bonding agents. In that study, the unfilled resin was not polymerized prior to placement of the composite resin, as per manufacturer's instructions. The unfilled resin was cured in the other test groups. To evaluate the effect of unfilled resin polymerization on microleakage, Class V cavity preparations were made in sound extracted teeth. Composite resin restorations were placed using the Gluma Bonding System and a microfilled composite resin. In some samples, the unfilled resin was cured prior to placement of the composite. In others, the unfilled resin and composite were polymerized simultaneously. The samples were stored for either 24 hours or 30 days, then thermocycled. Microleakage was evaluated with a silver nitrate staining method. Specimens in which the unfilled resin had not been cured separately and which had been stored for 24 hours had the most leakage. Significantly less microleakage occurred when the unfilled resin was polymerized separately and/or when storage time was 30 days. To reduce microleakage with the Gluma Bonding System, the authors recommend polymerization of the unfilled resin before placement of the composite.     

Curing potential of experimental resin composites filled with bioactive glass: A comparison between Bis-EMA and UDMA based resin systems

ObjectivesTo evaluate the degree of conversion, light transmittance, and depth of cure of two experimental light-curable bioactive glass (BG)-containing composite series based on different resin systems.MethodsExperimental composite series based on either Bis-EMA or UDMA resin were prepared. Each series contained 0, 5, 10, 20, and 40 wt% of BG 45S5. Reinforcing fillers were added up to a total filler load of 70 wt%. The degree of conversion was evaluated using Raman spectroscopy, while light transmittance was measured using visible light spectroscopy. The depth of cure was estimated from the degree of conversion data and using the ISO 4049 scraping test.ResultsReplacement of reinforcing fillers with BG can diminish the degree of conversion, light transmittance, and depth of cure. The effect of BG on the aforementioned properties was highly variable between the experimental series. While in the Bis-EMA series, the degree of conversion was significantly impaired by BG, all of the composites in the UDMA series attained clinically acceptable degree of conversion values. The reduction of the degree of conversion in the Bis-EMA series occurred independently of the changes in light transmittance. The UDMA series showed better light transmittance and consequently higher depth of cure than the Bis-EMA series. The depth of cure for all composites in the UDMA series was above 2 mm.SignificanceWhile the Bis-EMA series demonstrated clinically acceptable curing potential only for 0–10 wt% of BG loading, an excellent curing potential in the UDMA series was observed for a wide range (0–40 wt%) of BG loadings.     

Effect of alcohol and unfilled resin in the incremental buildup of resin composite.

OBJECTIVE: The purpose of this in vitro study was to investigate the effect of isopropyl alcohol and unfilled resin on the flexural strength of incrementally layered resin-based composite beams. METHOD AND MATERIALS: Five groups of 30 composite beams were fabricated in a 2 3 2 3 24-mm Teflon split-mold: group 1 (control group), a homogeneous resin composite beam; group 2, 2 increments with an air-inhibited layer between the increments; group 3, 2 increments with a Mylar strip placed against the composite interface during polymerization of the first increment; group 4, 2 increments with the first increment contoured with an isopropyl alcohol (70%) lubricated instrument; and group 5, 2 increments with the first increment contoured with unfilled resin lubricating the application instrument. Each increment was polymerized for 40 seconds on both front and back surfaces. The flexural strength of the composite specimens was determined using 4-point bending in an Instron universal testing machine. RESULTS: The mean flexural strength in MPa and standard deviation were as follows: group 1: 142.5 (17.3); group 2: 98.2 (15.2); group 3: 105.9 (16.3); group 4: 103.4 (19.4); and group 5: 106.1 (21.3). One-way analysis of variance detected a statistically significant difference among the groups (P < .001). Tukey's HSD post hoc tests determined that only group 1 was significantly different from the other 4 groups. CONCLUSION: The use of isopropyl alcohol and unfilled resin as instrument lubricants for incremental composite buildup seems to have little effect on the flexural strength of light-cured composite.     

Predictable diastema reduction with filled resin: diagnostic wax-up

A method for predictably altering anterior esthetics with composite resins is presented. The diagnostic wax-up is the key element. It is used to make a patient presentation cast and to customize resin forms. The resin forms are used to reproduce the predicted tooth form in the mouth quickly and accurately. The method should alert the dentist to the technical feasibility of the planned treatment and the difficulties that may be encountered. In addition, it should alleviate potential misunderstanding and disappointment of the patient. Finally, diagnostic waxing is time saving and simplifies the chairside procedure.     

Enamel bond strengths of pairs of adhesives from the same manufacturer

Most manufacturers of dental adhesives have both a total-etch adhesive and a simplified self-etching adhesive available on the market. This study measured the enamel microtensile bond strengths of five pairs of enamel adhesives as a function of enamel roughness. The proximal surfaces of 25 extracted mandibular molars were sectioned with a diamond saw to obtain 50 enamel rectangles with an area of 8x4 mm2. The enamel rectangles were divided in two equal parts via a groove to obtain 4x4 mm2 squared bonding surfaces. One half was roughened with a coarse diamond bur under water for five seconds, while the other half was kept intact. The enamel surfaces were randomly assigned to 10 enamel adhesives grouped into five pairs. Each pair included one self-etch adhesive and one total-etch adhesive from the same manufacturer: Adper Prompt and Adper Single Bond (PLP and SB, 3M ESPE); AdheSE and Excite (ADH and EXC, Ivoclar Vivadent); OptiBond Solo Plus SE and OptiBond Solo Plus (OPTSE and OPT, Kerr); Tyrian SPE/One-Step Plus and One-Step (TYR and OST, BISCO, Inc); Xeno III and Prime&Bond NT (XEN and PBNT, Dentsply). The adhesives were applied according to the manufacturers' instructions. Buildups were constructed with Filtek Z250 (3M ESPE). The specimens were sectioned in sticks with a cross section of 0.8+/-0.2 mm2 and tested to failure in tension at a crosshead speed of 1 mm/minute. Two-way ANOVA followed by Duncan's post-hoc test at p<0.05 was computed. The highest mean bond strengths were obtained with total-etch adhesives. For "roughened enamel," three pairs of materials had statistically different means in which the total-etch adhesive resulted in statistically higher bond strengths (MPa) than the corresponding self-etch adhesive: EXC (36.6) > ADH (23.0) at p<0.026; OPT (34.5) > OPTSE (25.3) at p<0.028; PBNT (36.6) > XEN (19.5) at p<0.0001. For "intact enamel," four pairs of materials resulted in statistically different means: SB (31.7) > PLP (20.9) at p<0.049; EXC (37.9) > ADH (16.3) at p<0.0001; OST (30.1) > TYR (18.0); PBNT (43.8) > XEN (16.0) at p<0.0001. When the same adhesive was compared on intact vs roughened enamel, all the self-etch materials resulted in lower bond strengths on intact enamel, but this difference was only significant for TYR (p<0.042) and ADH (p<0.050). For total-etch materials, only OPT resulted in statistically lower bond strengths when applied on intact enamel p<0.011).     

The shear bond strength between human enamel and composite resin placed with cured or uncured unfilled resin.

The shear bond strength between enamel and composite resin placed with an unfilled resin layer was tested under several conditions: The unfilled resin layer was either blown thin or left unthinned, and pre-cured alone or cured with the composite resin. Shear testing showed that the bond to enamel was slightly enhanced for Pekalux and was significantly enhanced for Durafill VS when the unfilled resin was not pre-cured. Thinning of unfilled resin slightly increased the bond strength of Pekalux and decreased the bond strength of Durafill VS. A majority of the specimens fractured at the composite resin-unfilled resin interface, and more than half of all interface failures occurred in specimens in which the unfilled resin had been pre-cured. The results indicated that the link between composite resin and the unfilled resin layer was enhanced by simultaneous curing.     

The influence of water storage and C-factor on the dentin-resin composite microtensile bond strength and debond pathway utilizing a filled and unfilled adhesive resin.

OBJECTIVE: To test the elastic wall concept utilizing adhesive resins of varying stiffness in a low- and high-C-factor cavity design after short- and long-term water storage. METHODS: A flat and box-shaped cavity was restored on occlusal dentin with a resin composite using a filled and unfilled adhesive resin from which microtensile specimens with a 0.5mm(2) cross-sectional area were formed. After storage for 30- and 150-days the microtensile bond strength (muTBS) was determined in a Zwick materials testing machine and the subsequent debond pathway was examined under scanning electron microscopy. Fisher's exact test was used to determine differences in joint and substrate failure modes and a Weibull regression model with gamma frailties was used to test for differences between failure distributions. Tests for three-way and two-way interactions were also completed for storage time, C-factor and adhesive. All tests were at 95% confidence levels. RESULTS: The characteristic strength (TBS degrees ) for the Optibond FL adhesive applied on a flat cavity was 47.57 and 20.90MPa and a box-shaped cavity was 49.26 and 17.49MPa for short- and long-term storage, respectively, while the corresponding TBS degrees for the unfilled Optibond adhesive on the flat cavity design was 36.93 and 32.68MPa and in a box-shaped cavity was 32.84 and 15.46MPa. Combining all groups according to storage time revealed a three-fold increase in the debond pathway including the bottom of the hybrid layer. SIGNIFICANCE: Evidence suggests that the durability of the bonded joint is threatened by hydrolysis and the most susceptible region is the bottom half of the hybrid layer and in low C-factor cavity designs a more flexible adhesive resin liner was more durable.     

Restoration of Class IV and VI defects in anterior teeth with an unfilled resin

The etched resin technique with unfilled acrylic resin has been successful for Class IV and VI defects on anterior incisor teeth and has proven more useful than alternatives in the immediate treatment of traumatized teeth. The advantages of this approach are ease of operation, excellent retention, conservative tooth preparation, excellent esthetics, lower cost to patient, reduced additional insult to recently traumatized teeth in stabilizing them, stable color, and lack of trauma to opposing teeth (Fig. 10).     

Effect of composite resin placement and use of an unfilled resin on the microleakage of two dentin bonding agents

The purpose of this study was to assess, in vitro, the microleakage of Class V restorations using two third generations dentin bonding agents, with a hybrid light polymerized composite resin. One of the bonding agents was of the NPG-PMDM type and the other was a polyhexanide. Restorations were placed in cavities prepared in extracted human premolars using either a bulk or incremental packing technique. The NPG-PMDM-based agent was used with and without an intermediary unfilled resin. The teeth were stored for 1 week at 37 degrees C, thermocycled for 1500 cycles between 55 degrees C, 37 degrees C and 5 degrees C and the restorations examined for leakage using methylene blue dye. The teeth were sectioned through the restorations and the degree of microleakage assessed visually. All groups of restorations showed some degree of leakage at the gingival margin. Statistical analysis showed that there were significant differences in the amounts of leakage (P less than 0.001). There was no difference in leakage between any of the groups that had been restored using the NPG-PMDM system (P greater than 0.05). There was, however, less leakage of the incrementally filled group compared with the bulk-packed group with the polyhexanide agent (P less than 0.05). When the two bonding agents were compared, there was no significant difference in leakage (P greater than 0.05) except for the incrementally-packed polyhexanide and the incrementally-packed NPG-PMDM with unfilled resin (P less than 0.05). Only one specimen in any of the groups leaked at the enamel margin.