The shear bond strength of bidirectional and random-oriented fibre-reinforced composite to tooth structure

OBJECTIVES: The objective of this study was to evaluate the bond strength and fracture pattern of fibre-reinforced composite (FRC) with two different fibre orientations and matrix compositions to dentine and enamel. MATERIALS AND METHODS: Extracted human molars were used as substrates (enamel and dentine) with a standard acid-etch technique. Light-polymerizable FRC with two different interpenetrating polymer network matrices and random or bidirectional fibre orientations was applied to the substrate, together with the adhesive resin. As a control, particulate filler composite resin was bonded to the substrates. The substrate-composite specimens (n=10) were either stored in water for 24h or additionally thermocycled for 6000 cycles. The shear bond strength of composite to substrate was measured and the fracture surfaces were evaluated visually and with SEM. RESULTS: Three-way factorial analysis of variance highlighted significant differences according to the substrate type, storage condition and composite material (p<0.05). Dentine specimens showed a significantly lower range of bond strength values (8.8-15.0 MPa), compared with enamel specimens (14.0-23.0 MPa). The highest mean bond strength in dentine was 15.0 MPa obtained with bidirectional FRC, whereas the highest bond strength in enamel was 23.0 MPa obtained with random-oriented FRC. Thermocycling did not identify a significant effect on the dentine bond strength, but did identify a significant decrease in enamel bond strength values (p<0.05). Several cohesive failures were observed in the tooth structure with the control material, whereas no cohesive bulk fracture of the tooth was observed when a thin layer of FRC was placed at the interface. CONCLUSIONS: The addition of bidirectional or random continuous fibres did not show any significant improvement in bond strength values compared to control of particulate filler. However, the difference in the fracture patterns observed may have implications for clinical applications.     

The effect of c-factor and flowable resin or fiber use at the interface on microtensile bond strength to dentin

PURPOSE: As polymerization shrinkage is compensated by flow of the composite, several attempts have been performed for relief of the contraction stresses. The aim of this in vitro study was to evaluate the effect of flowable composite or fiber use under composite restorations on microtensile bond strength of composite to dentin in Class I cavities or flat dentin surfaces. MATERIALS AND METHODS: Twenty-four sound extracted human first or second mandibular molars were randomly assigned to two groups (Class I cavities with a high c-factor or flattened dentin surfaces with a low c-factor). The dentin surfaces were treated with adhesive resin and restored with resin composite using four different techniques (bulk; with flowable composite; with a glass fiber (everStick NET); with a polyethylene fiber [Ribbond]). After 24 h storage at 37 degrees C in water, the specimens were thermocycled 600 times between 5 and 55 degrees C. Microtensile test specimens with a 0.9 x 0.9 (+/- 0.1) mm2 cross-sectional area were produced, and bond strength tests were carried out at a crosshead speed of 1 mm/min. Mean bond strengths were analyzed using two-way ANOVA and Bonferroni's test at a 95% significance level. RESULTS: Flowable composite decreased dentin bond strength in cavities with a high c-factor (p < 0.05). The group restored with everStick NET showed stable bond strengths regardless of the effect of c-factor. Ribbond THM used under composite restorations increased dentin bond strength in cavities with a high c-factor (p < 0.05). CONCLUSION: Flowable composite decreased dentin bond strength in cavities with a high c-factor; however, using a glass fiber in combination with flowable resin, stable bond strengths can be achieved in cavities with a high c-factor. Polyethylene fiber in combination with flowable resin increases the microtensile bond strength to the dentin floor in cavities with a high c-factor.     

The adhesion between prefabricated FRC posts and composite resin cores: microtensile bond strength with and without post-silanization.

OBJECTIVES: Aim of the study was to measure the adhesion between two types of translucent prefabricated FRC posts (FRC Postec, Ivoclar-Vivadent, FRC; Light-Post, RTD, LP), and two types of flowable composites used as core materials (UnifilFlow, GC, UF; Tetric Flow, Ivoclar-Vivadent, TF), with or without the application of a silane (Monobond-S, Ivoclar-Vivadent, S) on the post surface. METHODS: The experimental groups were: 1.1 FRC+UF; 1.2 FRC+S+UF; 1.3 FRC+TF; 1.4 FRC+S+TF: 2.1 LP+UF; 2.2 LP+S+UF; 2.3 LP+TF; 1.4 LP+S+TF. The bond strength at the interface between post and core was measured with the microtensile non-trimming technique. Thirty to thirty-five beam-shaped specimens per group were obtained from cylinders of core material, which had been built up around the post by progressively adding small increments of composite resin. Each specimen was loaded in tension until failure at either one of the two post-core interfaces present in each stick. The differences in interfacial bond strength among the groups were tested for statistical significance with the two-way ANOVA. RESULTS: The measured bond strengths in MPa were: [table: see text]. The statistical analysis revealed that post-silanization had a significant effect on adhesion (p<0.05). With any combination of post and core materials tested, the application of a silane onto the post surface prior to building up the core significantly increased the post-core bond strength. SIGNIFICANCE: For improved adhesion at the interface between prefabricated FRC posts and composite resin cores, post-silanization is advisable.     

Accelerated aging of adhesive-mediated fiber post-resin composite bonds: A modeling approach

OBJECTIVES: Although fiber posts luted in root canals are not directly exposed to oral fluids, water storage is considered as in vitro accelerated aging test for bonded interfaces. The aim of the study was to evaluate the influence of accelerated water aging on fiber post-resin composite adhesion. METHODS: Forty fiber posts (DT Light Post, RTD) were randomly divided into two main groups, according to the surface treatment performed. Group I: XPBond adhesive (Dentsply Caulk); Group II: sandblasting (Rocatec-Pre, 3M ESPE) and XPBond. Dual-cured resin cement (Calibra, Dentsply Caulk) and flowable composite (X-Flow, Dentsply Caulk) were applied on the posts to produce cylindrical specimens. The bond strength at the interface between post and cement/composite was measured with the microtensile test according to the non-trimming technique. Half of the sticks were tested immediately for bond strength, while in the other half testing was performed after 1 month of water storage at 37 degrees C. Post-cement/composite interfaces were evaluated under SEM prior and after water aging. Statistical analysis was performed using the Kruskal-Wallis ANOVA followed by Dunn's multiple range test (p<0.05). RESULTS: Immediate bond strength was higher on sandblasted posts. After water aging the two post surface treatments resulted comparable in bond strength. Resin cement achieved higher bond strength to fiber posts than flowable composite. Water aging significantly reduced bond strength. CONCLUSIONS: Sandblasting followed by adhesive coating may improve immediate post-resin bond strength in comparison to adhesive alone. However, fiber post-resin bond strength mediated by hydrophilic adhesive tends to decrease after water aging.     

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 degrees 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 degrees 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.     

Effects of filling techniques on the regional bond strength to lateral walls in Class I cavities

OBJECTIVES: Using the push-out technique, this study compared the influence of different composite insertion techniques in Class I cavities on the regional shear bond strength to lateral walls. MATERIALS AND METHOD: Standardized Class I cavities were prepared on the occlusal surface of 60 freshly extracted third molars, which were randomly assigned to one of five groups (n = 10). The cavities were bonded with the self-etch adhesive AdheSE and restored with Tetric Ceram resin composite by one of five techniques: G1, incremental technique (four oblique layers); G2, flowable composite as liner and bulk technique; G3, bulk technique and G4, light cone technique. The total-etch adhesive (Single Bond) and incremental technique were used as the control procedure. Each specimen was sectioned perpendicular to the long axis of the tooth in 1 mm-thick dentin slices. A push-out test was performed to measure regional bond strengths and identify the type of failure. Two additional teeth per group were prepared for the morphological interface study using scanning electron microscopy. RESULTS: Differences between the groups were tested by one-way ANOVA and Scheffé post hoc test (F = 29.635, p < 0.001). The highest shear bond strength values were obtained with the incremental technique, regardless of the adhesive used. Significant differences in bond strength to superficial and deep dentin were only found when a total-etch adhesive was used (Single Bond). CONCLUSIONS: Use of the incremental technique with total-etch or self-etch adhesives is the most effective method of inserting resin-based composites in large Class I cavities.     

Composite-to-composite microtensile bond strength in the repair of a microfilled hybrid resin: effect of surface treatment and oxygen inhibition

PURPOSE: To compare the 24-h microtensile bond strength of a microfilled hybrid composite to the same material after mechanical and/or chemical treatment and assess the effect of oxygen inhibition on the composite-composite bond. MATERIALS AND METHODS: Forty composite cylinders of Gradia Direct Anterior (GC) were prepared and stored 24 h prior to the following surface treatments: 50-microm aluminum oxide air abrasion and 37% phosphoric acid etching (group 1); hydrochloric acid and 6.9% hydrofluoric acid etching (group 2); diamond bur roughening and 37% phosphoric acid etching (group 3); diamond bur roughening (group 4). In all groups, Prime & Bond NT (Dentsply De Trey) was applied and light cured in air or under a nitrogen atmosphere, prior to layering a buildup of the repairing resin composite. Microtensile bond strength measurements were performed. Data were statistically analyzed with two-way ANOVA and Tukey's test (alpha = 0.05). RESULTS: The curing atmosphere did not significantly influence the interfacial strength (p < 0.05). Surface treatment significantly affected the composite-composite bond (p > 0.05). Air abrasion, regardless of curing atmosphere, resulted in the strongest bond (p < 0.05). The other treatments were comparable. CONCLUSION: Air abrasion and the application of a bonding agent offer satisfactory bond strengths for composite repair. The oxygen inhibition layer on a light-cured adhesive is not crucial to the success of the 24-h composite-composite bond.     

The use of flowable composites as filled adhesives.

OBJECTIVE: The effect of filled adhesives on bonding resin composites to dentin has not been fully understood. Due to their filler content, filled adhesives may act as stress breakers. The aim of this in vitro study was to evaluate the use of flowable composites of different viscosities on bonding to enamel and dentin without the use of an intermediate bonding resin. MATERIALS AND METHODS: Enamel and dentin bond strengths of OptiBond FL, Syntac Classic, and EBS Multi combined either with their proprietary bonding agent or a flowable resin composite (Ultraseal XT Plus or Revolution) were measured. The tests were carried out with a microtensile device at a crosshead speed of 1mm/min after 24h of storage at 37 degrees C in water. Mean bond strengths were analyzed using the Wilcoxon test and multiple comparisons according to the Mann-Whitney U-test. The micro-morphology of corresponding resin-dentin interfaces of the same teeth were analyzed using SEM and TEM. RESULTS: The control groups with adhesive systems used as per manufacturers' protocol showed bond strengths of 38.9-41.1 MPa to enamel and 28.8-33.4 MPa to dentin. With respect to bond strength to etched enamel, only Ultraseal XT Plus as bonding resin reached the level of the control groups. When used as bonding agents on dentin, both flowable composites produced lower microtensile bond strengths to etched and primed dentin than did the control groups. Micro-morphological analysis using SEM and TEM resulted in hybrid layer formation for both control and experimental groups. However, many areas of the resin-dentin interface showed insufficient penetration of the flowable composites at the top of the hybrid layer as well as numerous tubules obstructed by filler particles. CONCLUSIONS: The flowable composites tested in this study should not be used to replace bonding agents. Flowable composites of thinner viscosity, such as Ultraseal XT Plus, may bond to enamel adequately without the requirement of an intermediate bonding resin.     

Fracture strength of direct surface-retained fixed partial dentures: effect of fiber reinforcement versus the use of particulate filler composites only

This study compared the fracture strengths and analyzed the failure types of direct, surface-retained, anterior fixed-partial-dentures (FPD), reinforced with four types of fiber-reinforced composites (FRC) versus non-fiber-reinforced FPDs made of three particulate filler composites (PFC). To this end, surface-retained anterior FPDs (N = 70, 10 per group) were prepared and divided into seven experimental groups, where Group 1: FRC1 (everStick) + PFC1 (Clearfil Photo Posterior); Group 2: FRC2 (BR 100) + PFC1; Group 3: FRC3 (Interling) + PFC1; Group 4: FRC4 (Ribbond) + PFC1; Group 5: PFC1 only; Group 6: PFC2 only (Sinfony); and Group 7: PFC3 only (Estenia). Fracture strength test was performed after water storage at 37 degrees C for three days (universal testing machine, 1 mm/min). No significant differences were found among the four FRC types veneered with PFC1 (1490 +/- 548--1951 +/- 335 N) (p < 0.05) (ANOVA, Tukey's test). Among all the experimental groups, PFC1 presented a significantly higher mean value (2061 +/- 270 N) than PFC2 (1340 +/- 395 N) (p < 0.05) and all the other FRC-reinforced groups (p < 0.05). Complete pontic fracture was 100% and 70% for PFC2 and PFC3 respectively.     

The effect of fiber orientation on the polymerization shrinkage strain of fiber-reinforced composites.

OBJECTIVE: The aim of this study was to characterize the linear polymerization shrinkage strain of glass fiber-reinforced composite (FRC) according to the fiber orientation. METHODS: Test specimens (n=5) (10.0 x 10.0 x 1.5mm) were prepared from different brands of photopolymerizable resin-preimpregnated FRC; unidirectional continuous FRC, experimental random-oriented FRC, and bidirectional continuous FRC. As control materials, particulate filler composite resin and unfilled dimethacrylate monomer resin were used. Two uniaxial strain gages (gage length 2mm) were used to measure shrinkage strains in two directions: longitudinally and transversally to the fiber direction. The uncured composite or resin was placed on top of the strain gages, covered with a separating sheet and a glass plate, and irradiated for 40s with a light-curing unit. The shrinkage strain was monitored for 300 s. ANOVA and Tukey's posthoc test were used at a significance level of 0.05. RESULTS: ANOVA revealed that orientation of fiber and brand of material had a significant effect (P<0.05) on shrinkage strain. The unidirectional FRC revealed no shrinkage longitudinally to the fiber direction, whereas the shrinkage occurred transversally to the fiber direction. Particulate filler composite resin and unfilled resin revealed equal shrinkage strain in both of the measured directions. SIGNIFICANCE: Anisotropic nature of FRC exists with regard to polymerization shrinkage strain. The variation of polymerization shrinkage strains of FRC compared to those of particulate filler composites and unfilled resin might be important for future clinical applications.     

Shear Bond Strengths of Two Composite Core Materials After Using All-in-One and Single-Bottle Dentin Adhesives

PURPOSE: The purpose of this study was to compare the shear bond strengths of 2 composite core materials after using all-in-one and single-bottle dentin bonding materials. MATERIAL AND METHODS: The occlusal surfaces of 100 extracted, intact human third molars were ground to expose a flattened area of dentin and polished with 600-grit silicon carbide paper. Specimens were divided into 5 main groups (n= 20). Three all-in-one (AQ Bond, One-Up Bond, Xeno-CF Bond) and 2 single-bottle adhesives (Single Bond, One-Step Plus) were used. Each group was further divided into 2 subgroups. Ti-Core and Built-it F.R. core materials were applied using a translucent plastic ring (diameter: 3 mm, height: 5 mm). After storage in 37 degrees C water for 24 hours, shear bond strengths were measured using a Universal testing machine with a crosshead speed of 0.5 mm/min. Debonded dentin surfaces were examined with SEM. Two-way analysis of variance (ANOVA) and multiple comparison (Tukey) tests were used for statistical analysis of data. RESULTS: Two-way ANOVA revealed that the type of core material did not significantly influence the shear bond strength (p > 0.05), whereas there were significant differences in shear bond strength among the types of bonding agents (p < 0.0001). Shear bond strengths for single-bottle adhesive systems were significantly higher than those for all-in-one adhesive systems (p < 0.05). Furthermore, the interaction of these 2 parameters was not significant (p > 0.05). The fracture modes were predominantly adhesive for all-in-one adhesives and cohesive for single-bottle adhesives. CONCLUSION: Bonding of composite core materials with the newly developed all-in-one dentin adhesives produced lower shear bond strengths as compared with single-bottle adhesives.     

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.     

Fracture resistance of fragmented incisal edges restored with fiber-reinforced composite

PURPOSE: The aim of this study was to determine the static load-bearing capacity of fractured incisors restored with the conventional adhesive-composite technique or by using fiber-reinforced composites (FRC). MATERIALS AND METHODS: Twelve extracted sound maxillary incisors per group were prepared by cutting the incisal (one-third) part of the crown horizontally. Restorations were made using three techniques. Group A (control group) was restored by reattaching the original incisal edge to the tooth. Group B was restored using particulate filler composite (PFC). Group C was restored with PFC and FRC by adding a thin layer of FRC on the palatal surface of tooth. The bonding system used was the conventional etch system with primer and adhesive. All restored teeth were stored in water at room temperature for 24 h before they were statically loaded until fracture in a universal testing machine. Data were analyzed using ANOVA (p = 0.05). Failure modes were visually examined. RESULTS: Group A (reattaching fractured incisal edge) revealed the lowest load-bearing values, whereas preparation of the new incisal part with PFC revealed 148% higher load-bearing values compared to Group A. Group C (teeth restored with FRC) revealed a 254% higher load-bearing capacity than the control group. ANOVA revealed that the restoration technique significantly affected load-bearing capacity (p < 0.001). The failure mode in Groups A and B was debonding of the restoration from the adhesive interface, while in group C, 50% of the teeth fractured below the cementoenamel junction. CONCLUSION: These results suggest that an incisally fractured tooth restored with a combination of PFC and FRC provide the highest load-bearing capacity.     

Effect of acid etching time and a self-etching adhesive on the shear bond strength of composite resin to porcelain

PURPOSE The purpose of this study was to evaluate the effect of different acid etching times with 9.6% hydrofluoric acid gel and two adhesive systems on shear bond strengths of resin composite to porcelain. MATERIALS AND METHODS: Ninety-eight 7 x 7 x 2 mm feldspathic porcelain blocks (VMK 95, Vita) were prepared. The specimens were divided into 7 groups: 1 control (no surface treatment) and 6 groups acid etched with 9.6% hydrofluoric acid gel for different etching times, including 30 s, 30+30 s, 60 s, 60+60 s, 120 s, and 180 s. Each of the etching time groups was divided into two bonding agent (Single Bond, AdheSE) subgroups (n = 7). Microhybrid composite (Filtek Z250) was condensed using a teflon mold and light polymerized for 20 s on the porcelain specimens. The prepared specimens were then stored in distilled water at 37 degrees C for 24 h before mechanical testing. Shear testing of all groups was performed on a universal testing machine (Lloyd LRX) at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with two-way ANOVA. The means were compared using the Tukey HSD test (alpha = 0.05). RESULTS: Acid etching time and bonding agent statistically significantly influenced bond strength (p < 0.05). In the Single Bond group, the bond strengths between group 0 (10.48 MPa) and Group 30 (11.17 MPa) did not differ significantly, with these groups exhibiting the lowest bond strength values. The highest bond strength in Single Bond group was observed in group 120 (15.07 MPa) and group 60+60 (15.42 MPa), which did not differ significantly from each other. In the AdheSE group, the bond strengths of group 0 (9.33 MPa) and group 30 (9.49 MPa) did not differ significantly, and these groups exhibited the lowest bond strength values. The highest bond strengths in the AdheSE subgroup were observed in group 120 (14.84 MPa) and group 60+60 (14.96 MPa), which were not significantly different. Comparing the two different adhesive systems, Single Bond exhibited higher bond strength values than did the self-etching adhesive AdheSE. CONCLUSIONS: Acid etching of porcelain with 9.6% hydrofluoric acid gel for 120 s provided adequate bond strength for composite repair with a microhybrid composite. When a porcelain restoration is repaired with composite, Single Bond adhesive should be preferred to the AdheSE self-etching adhesive system.     

Bonding of lithium-disilicate ceramic to enamel and dentin using orthotropic fiber-reinforced composite at the interface

OBJECTIVE: To evaluate the effect of orthotropic fiber-reinforced composite (FRC) at the interface on bonding of lithium-disilicate ceramic to dentin and enamel using different adhesive systems. MATERIAL AND METHODS: Dentin and enamel surfaces were ground occlusally on human molar teeth. Ceramic blocks of IPS Empress 2 (Ivoclar-Vivadent) were fabricated. Following acid etching and silane treatment of the ceramics, the teeth were divided into two groups (dentin and enamel). Ceramic blocks were bonded to the tooth substance with or without a layer of FRC and dual-polymerizing composite cement (Duolink). Total-etching (etchant (Etch 37) with adhesive (One Step Plus)) and self-etching (self-priming etchant (Tyrian SPE) with adhesive (One Step Plus)) systems were used, with five test specimens in each group. The cement was polymerized with a LED curing unit (Elipar Freelight LED 2) with standard mode of 40 s. The specimens were thermocycled for 6000 cycles and tested with the microtensile tester at a rate of 5 mm/min. Fracture mode analyses were done by light microscope and with SEM. The data were analyzed using three-way analysis of variance (ANOVA). RESULTS: ANOVA showed that enamel had statistically significant (p<0.001) higher bond strength values than dentin. Bond strength values were significantly higher (p=0.012) with the total-etching system than with the self-etching system. The existence of FRC also had a minor effect on bond strength values (p=0.013). CONCLUSIONS: The enamel and total-etching system provided more reliable bonding than dentin and the self-etching system. Use of an FRC layer at the interface did not improve bond strength values, but instead changed fracture pattern behavior.     

Shear Bond Strength of Self-etching Adhesive Systems with Different pH Values to Bleached and/or CPP-ACP-treated Enamel

Purpose: To compare shear bond strengths of three different self-etching adhesive systems of different pH values to enamel bleached with carbamide peroxide, treated with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), or treated with CPP-ACP subsequent to bleaching with carbamide peroxide. Materials and Methods: Thirty-six human third molars were cut into 4 sections and randomly assigned to 4 groups (n = 36): group I: no treatment; group II: bleaching; group III: CPP-ACP; group IV: bleaching and CPP-ACP. After surface treatments, the samples of each group were further divided into three subgroups (n = 12) based on the adhesive used. The adhesives Clearfil SE Bond (CSE), AdhesE (ADE), and Adper SE Plus (ADP) were applied, and resin composite cylinders with a diameter of 2 mm and a height of 4 mm were bonded to the enamel. Then the specimens were subjected to shear bond strength testing. Two-way ANOVA and a post-hoc Tukey's test were used for statistical analysis (α = 0.05). Results: There were significant differences between the adhesive systems (p < 0.001) and surface treatments (p < 0.001), but no significant interactions were observed between these variables (p = 0.78). The CSE adhesive system showed the highest bond strength, and the bleaching procedure reduced bond strengths (p = 0.001). Furthermore, there were no significant differences in shear bond strength values between the control and CPP groups. However, the differences between other groups were statistically significant (p < 0.05). Conclusion: Bleaching reduced shear bond strength to enamel, but CPP-ACP application did not affect the bond strength to intact and previously bleached enamel. The bond strength of adhesives with different pH values to enamel was material dependant.     

Composite-composite repair bond strength: effect of different adhesion primers

Objectives. Recently, new products have been introduced to repair composite restorations that may be used as ‘one-step’ primers or monomers and silane compounds which are used separately as ‘multi-step’ primers. The aim of this study was to compare the shear bond strength of the new composite resin to aged composite, by using different adhesion primers.

Methods. The substrates were particulate filler composite (Z250, 3M-ESPE), which was aged by boiling for 8 h and storing at 37 °C in water for 3 weeks. The aged substrate surfaces were wet-ground flat with 320-grit silicon carbide paper and subjected randomly (n=8) to either one-step adhesion primer: Compoconnect (CC) (Heraus Kulzer), or multi-step: Clearfil Repair (CF) (Kuraray) or an intermediate resin: Scothchbond Multi-purpose adhesive resin (3M-ESPE) according to the manufacturers' recommendations. Specimens with no surface treatment were used as control (C). New composite resin (Z250) was added to the substrate using 2 mm layer increments and light cured. The specimens were either water stored for 48 h or water stored for 24 h and then thermocycled for 6000 cycles. The shear bond strengths were measured with a crosshead speed of 1.0 mm/min using a universal testing machine. Data were analysed by two-way ANOVA and Tukey's post-hoc tests (p=0.05).

Results. All surface treatment methods showed significant difference compared to control (p<0.05). CF showed higher bond strength than CC and MP (p<0.05). Storage condition did not show a significant difference (p>0.05) in bond strength values.

Conclusion. It was concluded that multi-step adhesion primer yielded higher bond strength compared to one-step primer or intermediate resin.     

Effect of physicochemical aging conditions on the composite-composite repair bond strength

PURPOSE: This study evaluated the effect of different physicochemical aging methods and surface conditioning techniques on the repair bond strength of composite. It was hypothesized that the aging conditions would decrease the repair bond strength and surface conditioning methods would perform similarly for the repair of resin composites. MATERIALS AND METHODS: Disk-shaped resin composite specimens (Clearfil Photo Bright, Kuraray) were randomly assigned to one of the three aging conditions (N=120, n = 12/per group): (1) immersion in deionized water (37 degrees C, 1 week), (2) immersion in citric acid (pH: 3.0, 1 week), (3) boiling in water (8 h), (4) thermocycling (5000 times, 5 degrees C to 55 degreesC), (5) immersion in water (37 degrees C, 2 months). After aging procedures, the specimens were subjected to one of the following surface conditioning methods: (1) chairside silica coating (30-microm SiOx) (CoJet, 3M ESPE) + silane (ESPE-Sil) (SC method), (2) silane (Clearfil SE Bond Primer and Clearfil Porcelain Bond Activator) + bonding agent (Clearfil SE Bond) (SB method). The fresh and aged composite surfaces were also examined using SEM (n=6, 1/group). Resin composite (Quadrant Anterior Shine) was bonded to the conditioned substrates using polyethylene molds and then light polymerized. Shear force was applied to the adhesive interface in a universal testing machine (1 mm/min). The failure types were categorized as: (A) cohesive in the substrate, (B) adhesive at the interface, or C) cohesive in the adherend. Bond strength values were statistically analyzed using two-way ANOVA and Tukey's test (alpha < 0.05). RESULTS: A significant influence of the conditioning method (p < 0.0001) and aging method was observed (p < 0.01) (two-way ANOVA, Tukey-Kramer). The SC method showed significantly higher bond values (7.8 +/- 1.2 to 11.6 +/- 5 MPa) than those of SB method (4.6 +/- 2.3 to 7.6 +/- 3.9 MPa) in all groups (p < 0.0001). While the SC method showed 96% cohesive (A type), the SB method demonstrated 92% adhesive failures (B type). SEM images showed distinct pattern of microcracks in the boiled specimens and filler dissolution with disorganized matrix resin in the other aged specimens. Aging the composite substrates through water storage for 2 months produced significantly lower bond strengths than those of water or acid storage for 1 week (p = 0.011). CONCLUSION: Chairside silica coating and silanization provided the highest bond strength values with almost exclusively cohesive failures on aged composites. Aging methods showed significant differences on the composite-composite repair strength.     

Effects of dentin bonding agents on bonding durability of a flowable composite to dentin

The present study evaluated the bonding durability of a flowable composite on bovine dentin using dentin bonding agents with different numbers of application steps: Scotchbond Multipurpose (three steps), Prime & Bond NT and One-Step (two steps), AQ Bond and Prompt L-Pop (one step). Shear bond strength tests were performed, and resin-dentin interface and fracture mode were observed. There were no significant differences in bond strength among the specimens within 37 degrees C storage group (p > 0.05) and post-thermocycling group, except between Prompt L-Pop and Scotchbond Multipurpose (p < 0.05) in the post-thermocycling group. Further, Scotchbond Multipurpose and One-Step showed significantly lower bond strengths after thermocycling (p < 0.05). It was thus shown that the use of simplified bonding agents did not necessarily improve the bonding strength of flowable composites.     

Shear bond strength of new self-adhesive flowable composite resins

Recently, new self-adhesive flowable composite resin systems have been introduced to the market. These new composite resin systems reportedly bond to dentin and enamel without the application of an adhesive bonding agent. The purpose of this study was to evaluate the shear bond strength to enamel of two new self-adhesive flowable composites with and without the use of an etch-and-rinse bonding agent. The new self-adhesive flowable composites had significantly lower bond strengths to enamel compared to a traditional adhesively bonded flowable composite. Both self-adhesive flowable composites had a significant increase in bond strength to enamel with the use of a phosphoric acid-etch and adhesive bonding agent.