Do blood contamination and haemostatic agents affect microtensile bond strength of dual cured resin cement to dentin?

Objective:

The purpose of this study was to evaluate the effects of blood contamination and haemostatic agents such as Ankaferd Blood Stopper (ABS) and hydrogen peroxide (H₂O₂) on the microtensile bond strength between dual cured resin cement-dentin interface.

Material and Methods:

Twelve pressed lithium disilicate glass ceramics were luted to flat occlusal dentin surfaces with Panavia F under the following conditions: Control Group: no contamination, Group Blood: blood contamination, Group ABS: ABS contamination Group H₂O₂: H₂O₂ contamination. The specimens were sectioned to the beams and microtensile testing was carried out. Failure modes were classified under stereomicroscope. Two specimens were randomly selected from each group, and SEM analyses were performed.

Results:

There were significant differences in microtensile bond strengths (µTBS) between the control and blood-contaminated groups (p<0.05), whereas there were no significant differences found between the control and the other groups (p>0.05).

Conclusions:

Contamination by blood of dentin surface prior to bonding reduced the bond strength between resin cement and the dentin. Ankaferd Blood Stoper and H₂O₂ could be used safely as blood stopping agents during cementation of all-ceramics to dentin to prevent bond failure due to blood contamination.     

Do the origins of primary teeth affect the bond strength of a self-etching adhesive system to dentin?

The aim of this in vitro study was to evaluate the tensile bond strength of a self-etching adhesive system to three different dentinal substrates. Primary molar teeth that had been recently exfoliated (RE), with unknown time of exfoliation (UT), and extracted due to prolonged retention (PR) were used for this investigation. Ten primary molar teeth of each group were cut in the middle following the mesio-distal direction, creating a total of twenty specimens per group. The specimens were included in acrylic resin and had a flat dentin surface exposed. The self-etching adhesive system was applied to this surface and a 3-millimeter high cone with diameter of 2 mm in the adhesion area was constructed using composite resin. The specimens were stored in distilled water at 37oC for 24 hours. Fifteen specimens of each substrate were used for the tensile bond test (n = 15) and 5 had the interface analyzed by scanning electron microscopy (SEM). The data was examined by one-way ANOVA and presented no significant differences between groups (p = 0.5787). The mean values obtained for RE, UT and PR were 18.39 ± 9.70, 19.41 ± 7.80, and 23.30 ± 9.37 MPa, respectively. Any dentinal substrates of primary teeth studied are safe for tensile bond strength tests with adhesive systems.     

Does a reduction of polymerization time and bonding steps affect the bond strength of brackets?

High bond strengths are required in order to avoid bracket failure during treatment while brackets should be removable. In addition, chair time should be kept at a minimum. Therefore, the aim of this study was to investigate any differences in bracket's bond strength to enamel by reducing the polymerization time and the steps of bonding procedure. Five hundred teeth were randomly allocated into 20 groups. The groups were established considering the investigated curing units (quartz–tungsten–halogen (QTH) and light-emitting diode (LED), each with two different polymerization times) and the used bonding agents (Clearfil SE Bond, Transbond Plus, Ideal1, iBond, and Transbond XT Primer following acid etching). The brackets were debonded using a shear-peel load and used to calculate the bond strength. The location of adhesive failure was registered by using the modified adhesive remnant index (ARI). The influence of the parameters curing unit, curing time, and bonding agent as well as their interaction products on bond strength showed that the bonding agent influenced the bond strength most followed by curing time. The parameter curing unit as well as all the generated interaction products of it showed a lower impact. Regarding the ARI, the bonding agent exhibited also the highest influence. Using a LED resulted in comparable bond strengths as the QTH curing device also at shorter exposure times. Additionally, the two-component self-etching primers showed similar bond strengths compared to the acid-etching method. Chair time can be reduced by using two-component self-etching primers and LED without decrease of bond strength.     

Does application of phase-separated self-etching adhesives affect bond strength?

PURPOSE: To investigate whether application of three all-in-one self-etching adhesives in a phase-separated stage has an adverse effect on bonding to enamel and dentin. MATERIALS AND METHODS: The shear bond strengths (SBSs) on ground enamel and dentin of the adhesives G-Bond, Hybrid Bond, and iBond, combined with Venus composite, were determined. The adhesives were dispensed in a dish and applied either 1) immediately, 2) after 2 min, or 3) after 5 min dark storage under ambient conditions. The adhesives were shortly stirred with a microbrush and applied. Prior to light activation, the adhesives were air dried for 10 s with a strong air blast. Composite cylinders were produced in a cylindrical mold clamped on the treated surface. SBSs (n = 8) were determined in a universal testing machine at 1 mm/min crosshead speed after 24 h storage in 37 degrees C water. Data were statistically analyzed with Kruskal-Wallis ANOVA and the Mann-Whitney U-Test (p < 0.05). The qualitative compositions of the separated phases were determined by FTIR spectroscopy. RESULTS: In the separated stage, the adhesives showed acidic monomer-rich phases, containing all components of the original adhesive composition, and water-rich phases with minor amounts of mainly functional monomers dissolved. The SBSs of the individual adhesives applied on enamel or dentin at the different times after dispensing were not significantly different. CONCLUSION: Application of the adhesives tested either as homogeneous solution or in a phase-separated stage has no adverse effect on bonding strength to enamel or dentin when applied under the present study conditions.     

Repair bond strength of restorative resin composite applied to fiber‐reinforced composite substrate

Delamination or fracture of composite veneers can occur as a result of improper design of the fiber‐reinforced composite (FRC) framework. This in vitro study tested the repair bond strength of restorative composite to aged FRC. The substrate was multiphase polymer matrix FRC (everStick) aged by boiling for 8 h and storing at 37°C in water for 6 weeks. The aged substrate surfaces were wet‐ground flat with 1200‐grit silicon carbide paper and subjected randomly to 5 different surface treatments: 1) An adhesion primer (Composite Activator) and resin (CA), 2) Silane (EspeSil) and resin (SIL‐MP), 3) Silane, adhesive primer, and resin (Clearfil Repair) (CF), 4) Air particle‐abrading (CoJet), silane, and resin (CJ‐SIL‐MP), 5) Resin (Scotchbond Multipurpose Resin) only as control (MP). Restorative composite resin (Z250) was added to the substrate in 2 mm layer increments and light‐cured. Subsequently, every surface treatment group was divided into 2 subgroups of 12 specimens each. The specimens were either 48 h water‐stored or thermocycled (6000 x 5–55°C). The shear bond strengths of composite resin to FRC were measured at a crosshead speed of 1.0 mm/min. The data were analyzed by ANOVA for factors ‘treatment type’ and ‘storage condition’; Tukey's post‐hoc tests and Weibull analysis were performed. ANOVA showed a significant difference as a function of surface treatment (P<0.05) and storage condition (P<0.05). The CJ‐SIL‐MP group showed highest bond strength and Weibull modulus after thermocycling. Repair of multiphase polymer matrix FRC may show reliable bond strength when silane treatment is used along with air‐particle abrading.     

Does the acidity of self-etching primers affect bond strength and surface morphology of enamel?

PURPOSE: This study examined the ultrastructure and microtensile bond strengths (TBS) of self-etching (with different acidity) and conventional adhesive systems bonded to unground enamel. MATERIALS AND METHODS: Resin composite (Filtek Z250) buildups were bonded to unground enamel surfaces of third molars after adhesive application with the following materials: Clearfil SE Bond (CSE); Optibond Solo Plus Self-Etch (OP); Tyrian Self Priming Etching (TY), and the controls Scotchbond Multi-Purpose Plus (SBMP) and Single Bond (SB). Six teeth were assigned to each material. After storage in waterfor 24 h at 37 degrees C, the bonded specimens were sectioned into beams of approximately 0.8 mm2 and subsequently subjected to microTBS testing at a crosshead speed of 0.5 mm/min. The average values were subjected to one-way ANOVA (alpha = 0.05). The effect of surface conditioning of each material was observed under scanning electron microscopy (SEM). RESULTS: The highest resin-enamel bond strength was observed for SBMP (22.7 +/- 5.2) and SB (26.7 +/- 5.2 MPa). The lowest mean bond strengths were 10.9 +/- 3.2 and 7.8 +/- 1.5 MPa for TY and OP, respectively. CSE showed an intermediate performance (18.7 +/- 4.6 MPa). An overall increase in porosity was evident along the entire enamel surface treated with the self-etching primers; however, no selective demineralization similar to that with 35% phosphoric acid was observed. CONCLUSION: The highest bond strength means and the more retentive etching pattern were observed for the two-step etch-and-rinse adhesives. Among the self-etching systems studied, Clearfil SE Bond should be preferred.     

Effect of conditioning and 1 year aging on the bond strength and interfacial morphology of glass-ionomer cement bonded to dentin

ObjectiveThe purpose of this study was to determine the bond stability and the change in interfacial ultra-structure of a conventional glass-ionomer cement bonded to dentin, with and without pre-treatment using a polyalkenoic acid conditioner.MethodsThe occlusal dentin surfaces of six teeth were ground flat. Glass-ionomer cement was bonded to the surfaces either with or without polyalkenoic acid conditioning. The teeth were sectioned into 1-mm² stick-shaped specimens. The specimens obtained were randomly assigned to two groups with different periods of storage in water: 1 week and 1 year. The micro-tensile bond strength (μTBS) was determined for each storage time. Additional specimens were prepared for Transmission Electron Microscopy (TEM); they were produced with or without prior polyalkenoic acid conditioning in the same way as in the μTBS test.ResultsThere was no significant difference in μTBS to conditioned dentin and non-conditioned dentin (p > 0.05). The failures appeared to be of a mixed nature, although aging caused more areas of cohesive than adhesive failure in both groups. The TEM observation showed an intermediate layer, a matrix-rich layer and a partially demineralized layer in the polyalkenoic acid conditioned group.SignificanceAging did not reduce the bond strength of the conventional glass-ionomer cement to dentin with or without the use of a polyalkenoic acid conditioner.     

Effect of sonic application mode on the resin–dentin bond strength and nanoleakage of simplified self-etch adhesive

Objectives

This study aims to evaluate the effect of different application modes on the immediate and 6-month resin–dentin bond strength (μTBS) and nanoleakage in the hybrid and adhesive layers.

Materials and methods

Three 1-step self-etch adhesives (One Coat 7.0 (OC), Clearfil S³ Bond (CS), and FuturaBond NR (FB)) were applied on a flat superficial dentin surface of 30 human molars under manual mode or sonic vibration at a frequency of 170 Hz (SV). Composite build-ups were constructed incrementally; specimens were sectioned to obtain resin–dentin sticks with cross-sectional area of 0.8 mm² and tested in tension (0.5 mm/min) immediately (IM) or after 6 months (6M) of water storage. Two bonded sticks, from each tooth at each storage time, were immersed in a silver nitrate solution, photo-developed, and analyzed under scanning electron microscopy. The amount of nanoleakage was measured using the ImageTool 3.0 software. Data, from each adhesive, were analyzed by two-way ANOVA and Tukey’s test (α?=?0.05).

Results

OC and CS showed higher μTBS and lower nanoleakage in the IM period when applied with SV groups. For FB, no significant difference was observed between the two modes of application. All materials showed lower nanoleakage in the SV groups. Higher nanoleakage was observed after 6M for OC and FB.

Conclusions

The sonic application mode at an oscillating frequency of 170 Hz can improve the resin–dentin μTBS, reduce the nanoleakage, and retard the degradation of the resin–dentin μTBS of Clearfil S³ Bond and One Coat 7.0 adhesives.

Clinical significance

Sonic application mode at an oscillating frequency of 170 Hz can be helpful and easy to use in dental practice to guaranty long-lasting restorations.     

Does tin pre-treatment enhance the bond strength of adhesive systems to enamel?

Objectives

The study investigated the modification of composite-to-enamel bond strength by pre-treatment of enamel with a concentrated, acidic SnCl₂-solution.

Methods

Six groups of flat human enamel specimens (n = 44 per group) were treated as follows: OB-H: H₃PO₄ etching, Optibond FL application (primer + adhesive; manufacturer's instructions); OB-S: SnCl₂ pre-treatment, Optibond FL application (primer + adhesive); OB-HS: H₃PO₄ etching + SnCl₂ pre-treatment, Optibond FL application (primer + adhesive); CF-N: Clearfil SE application (primer + bond; manufacturer's instructions); CF-H: H₃PO₄ etching, Clearfil SE application (primer + bond); CF-S: SnCl₂ pre-treatment, Clearfil SE application (primer + bond). Enamel specimens were then built up with resin composite (Clearfil Majesty Esthetic) and stored (100% humidity, 37 °C, 1 week). μTBS-measurement and failure mode analysis of one-half of the specimens were performed immediately after storage, while the other half was analysed after a thermocycling procedure (8500 cycles; 5 °C and 55 °C; dwell time 30 s). Additional specimens were prepared for SEM- and EDX-analysis.

Results

Highest values were measured for OB-H before and after thermocycling, lowest values for CF-N. Compared to OB-H treatment, OB-S treatment reduced μTBS before/after thermocycling by 23%/28% and OB-HS treatment by 8%/24% (except for OB-SH before (n.s.), all p ≤ 0.001 compared to OB-H). In the Clearfil SE treated groups pre-treatment increased μTBS significantly compared to CF-N (before/after: CF-H: +46%/+70%; CF-S: +51%/42%; all p ≤ 0.001).

Conclusion

Pre-treatment with H₃PO₄ or SnCl₂ markedly increased the μTBS of Clearfil SE to enamel. However, thermocycling partly reduced the gain in μTBS obtained by SnCl₂ pre-treatment.

Clinical significance

The application of an acidic and highly concentrated SnCl₂ solution is a good option to increase the μTBS between enamel and a resin composite mediated by an adhesive system containing the multifunctional monomer MDP.     

Do chlorhexidine and ethanol improve bond strength and durability of adhesion of fiber posts inside the root canal?

Objectives

The aim was to investigate the effects of chlorhexidine and ethanol pretreatment of the root canal on push-out bond strengths and durability of adhesion of fiber posts luted with two different adhesive strategies.

Materials and methods

One hundred twenty human anterior teeth were endodontically treated. After post space preparation, the root canals were irrigated using 1 % sodium hypochlorite (NaOCl) applied with passive ultrasonic irrigation followed by distilled water (control). In pretreatment (PT) group, chlorhexidine (CHX) root canals were irrigated using 2 % chlorhexidine; and in the PT group, 99 % ethanol was used prior application of the luting agent. Two different post-and-luting systems with an etch-and-rinse (CX) adhesive approach (n?=?60) and a self-adhesive resin cement (RX; n?=?60) were inserted into the root canals. Bond strengths were evaluated initially and after thermocycling and storage for 6 months using push-out tests.

Results

Bond strength was significantly affected by the adhesive strategy (p?<?0.0005), the pretreatment (p?<?0.0005) and the location inside the root canal (p?<?0.0005; repeated measurement ANOVA). Ethanol significantly increased bond strengths irrespective of the luting agent used compared to the control and CHX group (p?<?0.05; Tukey's B).

Conclusion

Ethanol significantly increased bond strength of the CX and the RX system inside the root canal and could be recommended as a final rinse for luting fiber posts using an ethanol-based etch-and-rinse adhesive system or self-adhesive resin cement.

Clinical relevance

PT of the root canal using ethanol seems to facilitate adhesive luting of fiber posts with the tested adhesive system and luting cements.     

Does hybridization of intraradicular dentin really improve fiber post retention in endodontically treated teeth?

This study tested the hypothesis that hybridization of intraradicular dentin eliminates interfacial gaps, thereby improving the coronal seal and retention of teeth restored with fiber posts. Post spaces were bonded with two types of fiber posts, using the corresponding etch-and-rinse adhesives and dual-cured resin cements. Longitudinal sections of the interfaces were examined for dentin hybridization in the coronal- and middle-thirds of the root canals. Resin replicas of these sections were evaluated for interfacial gap formation. Although intraradicular dentin hybridization was not compromised irrespective of whether the adhesives were light-cured before cementation, the universal occurrence of interfacial gaps along the hybrid layer surface or the post-cement interface reflects the challenge in bonding to post spaces with low compliance and high C-factors. The clinical success associated with bonded fiber posts is probably due predominantly to frictional retention.     

Do intact collagen fibers increase dentin bond strength?

The purpose of the present study was to evaluate surface morphology and shear bond strength of All Bond 2 bonded to dentin surfaces, that were treated progressively to remove collagen fibers. For the study of surface morphology, fifteen teeth were divided in to five groups. Dentin surfaces in groups 1-4 were etched either with 24% EDTA for 30 seconds or 32% phosphoric acid for 15 seconds with and without subsequent treatment with 10% NaOCl for 60 seconds. Group 5 received no treatment and served as control. Evaluation was performed using scanning electron microscopy. Thirty teeth were used for the shear bond strength test. Two experimental surfaces were prepared on each tooth and cylindrical copper matrixes were attached to the surfaces. Experimental surfaces were divided into four groups and treated in the same way as group 1-4 in the morphology part of the study. Dentin was bonded with All Bond 2, after which a flowable composite was inserted and light cured. Shear strength test was performed at a crosshead speed of 1 mm/minute until the composite debonded. Results showed that etching followed by treatment with NaOCl removed all collagen fibers from the dentin surfaces, while treatment with EDTA alone denuded the fiber structures. Shear strength was significantly decreased when surfaces were treated with NaOCl. The highest shear strength values were obtained in the EDTA etched group. The results from the present study indicate that exposed dentin associated collagen fibers increases adhesion of All Bond 2 to dentin.     

Correlation between degree of conversion,resin–dentin bond strength and nanoleakage of simplified etch-and-rinse adhesives

Objectives

The aim of this study was to correlate the degree of conversion measured inside the hybrid layer (DC) with the microtensile resin–dentin bond strength (μTBS) and silver nitrate uptake or nanoleakage (SNU) for five simplified etch-and-rinse adhesive systems.

Methods

Fifty-five caries free extracted molars were used in this study. Thirty teeth were used for μTBS/SNU [n = 6] and 25 teeth for DC [n = 5]. The dentin surfaces were bonded with the following adhesives: Adper Single Bond 2 (SB), Ambar (AB), XP Bond (XP), Tetric N-Bond (TE) and Stae (ST) followed by composite resin build-ups. For μTBS and SNU test, bonded teeth were sectioned in order to obtain stick-shaped specimens (0.8 mm²), which were tested under tensile stress (0.5 mm/min). Three bonded sticks, from each tooth, were not tested in tensile stress and they were immersed in 50% silver nitrate, photo-developed and analyzed by scanning electron microscopy. Longitudinal 1-mm thick sections were prepared for the teeth assigned for DC measurement and evaluated by micro-Raman spectroscopy.

Results

ST showed lowest DC, μTBS, and higher SNU (p < 0.05). All other adhesives showed similar DC, μTBS, and SNU (p > 0.05), except for TE which showed an intermediate SNU level. The DC was positively correlated with μTBS and negatively correlated with SNU (p < 0.05). SNU was also negatively correlated with μTBS (p < 0.05).

Significance

The measurement of DC inside the hybrid layer can provide some information about bonding performance of adhesive systems since this property showed a good correlation with resin–dentin bond strength and SNU values.     

Selective masking for thin indirect restorations: can the use of opaque resin affect the dentine bond strength of immediately sealed preparations?

Purpose

Evaluate the dentine bond strength using different methods of application of opaque resins to mask dentine discoloration.

Materials and methods

Dentine was exposed on 21 extracted molars which were assigned to 3 groups: G1: immediate dentine sealing (IDS). G2: IDS + opaque. G3: IDS with adhesive resin mixed with opaque. After 1 week, teeth were restored and beams were fabricated for microtensile testing. Optical microscopy was used to analyse the failure mode.

Results

Bond strength mean values were statistically different: G1 55.20 MPa > G2 45.79 MPa > G3 18.96 MPa. Failure modes were mostly adhesive for G1 and G3. G2 presented mostly mixed failures.

Conclusion

The use of opaque resin to mask discoloured dentine results in a decrease of bond strength.