Shear bond strength of one 4th and two 7th generation bonding agents when used by operators with different bonding experience

PURPOSE: To test the hypothesis that simpler-to-use dentin adhesives (7th-generation adhesives) perform better when used by inexperienced operators than do the more complex 4th-generation adhesives. MATERIALS AND METHODS: Six operators with no previous experience regarding dental adhesives, three residents in pediatric dentistry, and three experienced dentists used one 4th-generation dentin adhesive (MA) and two 7th-generation adhesives (MB and MC). With each adhesive, each operator performed 6 bondings to enamel and 6 bondings to dentin. After 24 h of storage in water at 37 degrees C, the shear bond strength was determined. RESULTS: The pooled results showed that the bond strength to dentin was higher (p < 0.05) than that to enamel (dentin mean value = 14.0 MPa, SD = 9.1 MPa; enamel mean value = 11.9 MPa, SD = 7.1 MPa), and that adhesive MA performed better (p < 0.05) than adhesives MB and MC (inexperienced operators = 16.2 +/- 10.9 MPa; residents in pedodontics = 12.0 +/- 6.8 MPa, and experienced operators = 10.7 +/- 4.8 MPa). Of the two 7th-generation adhesives, one performed better on enamel than on dentin, while the other 7th-generation adhesive performed better on dentin than on enamel. Regarding operators, there were large individual variations. The inexperienced bonders performed as well as the residents (p > 0.05), while the experienced operators performed best (p < 0.05). CONCLUSION: In general, the tested 4th-generation adhesive performed better than the 7th-generation adhesives. Even inexperienced operators performed better with the more difficult-to-use 4th-generation adhesives than with the 7th-generation adhesives. Dentin adhesion was stronger than enamel adhesion.     

The microtensile bond strength of self-etching adhesives to ground enamel

It is uncertain whether single-phase self-etching adhesives form bonds to enamel as reliable as those of etch-and-rinse adhesives. This study compared the microtensile bond strengths to ground enamel of three self-etching adhesive systems, a self-etching primer system and an etchand-rinse adhesive system. Human enamel was ground flat with 320-grit silicone carbide paper. The self-etching adhesives iBond (Heraeus Kulzer), Prompt L-Pop (3M ESPE) and Xeno III (Caulk/Dentsply), the adhesive with a self-etching primer Clearfil SE Bond (Kuraray) and the etch-and-rinse adhesive Scotchbond Multipur-pose (3M/ESPE) were applied as directed, followed by a core of the same manufacturers' hybrid resin composite. A microtensile bond strength evaluation was performed after 48 hours of water storage, using untrimmed beams approximately 0.9 mm2 in cross-sectional area at a crosshead speed of 0.6 mm/minute. There were no pretest failures in any group, and failures were predominately adhesive or mixed. Adhesion to enamel of Clearfil SE was not significantly different from Scotchbond Multi-Purpose, while the three self-etching adhesive systems demonstrated significantly lower bond strengths (One-way ANOVA, Tukey-Kramer Multiple-Comparison Test, p < 0.00001).     

Microtensile dentin and enamel bond strengths of recent self-etching resins

In this study, the microtensile bond strengths of resin composites to dentin and enamel produced by recently introduced self-etching resins were determined. Included were two adhesives with self-etching primers, Clearfil SE (Kuraray) and Peak SE (Ultradent), four self-etching adhesives, Optibond All-In-One (Kerr), Clearfil S3 (Kuraray), Adper Prompt L-Pop (3M ESPE) and iBond (Heraeus Kulzer) and, as a positive control, PQ1 (Ultradent), an etch-and-rinse adhesive. Each product was evaluated using the same hybrid resin composite, Z250 (3M ESPE). Testing was performed after 48 hours using a "non-trimming" microtensile test at a crosshead speed of 0.6 mm/minute. Sample size was five teeth per group, with the value for each tooth calculated by averaging the bond strengths of seven beams derived from it. Mean values in MPa (SD) for dentin were: Clearfil SE 81.6 (3.5),a Peak SE 80.3 (9.9),a PQ1 73.4 (4.9),a,b Optibond All-In-One 64.4 (5.9),b Clearfil S3 62.5 (2.2),b,c iBond 51.0 (4.0)c and Prompt L-Pop 33.9 (6.4).d Mean values in MPa (SD) for enamel were: PQ1 55.6 (2.5),a Clearfil SE 54.1 (5.4),a Prompt L-Pop 54.0 (5.4),a Peak SE 51.8 (1.5),a,b Clearfil S3 44.3 (5.2),b,c Optibond All-In-One 40.1 (2.1)c,d and iBond 33.8 (3.3).d (Values for each substrate with the same letter were not significantly different, one-way ANOVA, Tukey-Kramer Multiple Comparison Test, p<0.05.) Compared to the positive control, PQ1, only adhesives with self-etching primers, Clearfil SE and Peak SE, were as effective in bonding to both enamel and dentin. With the exception of Prompt L-Pop, scanning electron micrographs of the etched enamel surface produced by self-etching products indicated far less surface topography than conventional etching, even for self-etching primer systems producing the same bond strengths as the etch-and-rinse adhesive.     

The influence of hemostatic agents on dentin and enamel surfaces and dental bonding: A systematic review

Background.Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers investigated the effects of hemostatic agents on dentin and enamel surfaces and on bonding of adhesive systems and resin cements.Types of Studies Reviewed.The authors screened PubMed and Scopus databases for studies in English published from 1980 to 2013. They read the titles and abstracts to identify literature that fulfilled the inclusion criteria. The authors included studies in which researchers evaluated the hemostatic action on the dentin and enamel surfaces or its influence on the bond strength of adhesive systems or resin cements. They used cross-referencing to identify more articles.Results.Twenty in vitro studies met the inclusion criteria. Investigators in 12 of these studies evaluated the bond strength to contaminated dentin. Investigators in 10 of these studies reported a significant decrease in bond strength. Those in two studies evaluated the influence of a hemostatic agent on the dental enamel and reported decreases in bond strength. Researchers also reported significant increases in microleakage of self-etching adhesives on contaminated dentin. Scanning electron microscopy revealed partial removal of the smear layer or an etching effect of dentin as a result of the application of hemostatic agents on dentin.Practical Implications.Adhesive procedures may be affected adversely when performed on dentin and enamel contaminated by hemostatic agents. Hemostatic agents may induce changes in the dentin surface morphology. The results of this review indicate that the bond strength of self-etching adhesive systems is affected more negatively than is that of etch-and-rinse systems. The authors found that a 60-second application of ethylenediaminetetraacetic acid followed by a water spray restored the bond strength of a self-etching adhesive to dentin; use of phosphoric acid for 15 seconds followed by a water spray also was an effective cleaning method. Direct comparison of selected studies was not possible, however, mainly because of methodological differences hampering definitive conclusions.     

Influence of eugenol-containing temporary cement on bonding of self-etching adhesives to dentin

PURPOSE: To investigate the influence of eugenol-containing temporary cement on bonding of resin composite to dentin mediated by self-etching adhesives. MATERIALS AND METHODS: Flat dentin surfaces were produced by grinding of extracted human molars. The dentin surfaces were either used directly or after a one-week exposure to a zinc oxide-eugenol cement (IRM). A resin composite (Herculite XRV) was bonded to the dentin surfaces following treatment with 1 of 6 self-etching adhesives (AdheSE, Adper Prompt L-Pop, Clearfil SE Bond, iBond, OptiBond Solo Plus - Self-Etch Adhesive System, and Xeno III). An adhesive system containing 0.5 M EDTA as dentin conditioner (Gluma Classic) was included as negative control, and an etch-and-rinse adhesive system (OptiBond FL) was included as positive control. After storage in water at 37 degrees C for 1 week, the bonded specimens were fractured in shear (n = 8 in each group). RESULTS: Previous contact of dentin with zinc oxide-eugenol cement significantly decreased the bond strength mediated by the negative control and did not affect the bond strength mediated by the positive control. For the self-etching adhesives, no effect was found of previous contact with zinc oxide-eugenol cement. With and without previous contact with zinc oxide-eugenol cement, the etch-and-rinse adhesive system yielded a significantly higher bond strength than all other adhesive systems. CONCLUSION: Previous contact with zinc oxide-eugenol cement did not decrease the bond strength of resin composite to dentin mediated by self-etching adhesives. This finding suggests that eugenol-containing temporary cements may be safe to use in combination with self-etching adhesives.     

Bonding efficiency of contemporary adhesives to the dentinoenamel junction zone

The aim of this study was to investigate the bonding of dental adhesives to the dentinoenamel junction (DEJ) zone. Bonding of four adhesives [two etch-and-rinse adhesives (ERAs) and two self-etching adhesives (SEAs)] to enamel, dentin, and the DEJ zone was evaluated using a micro-shear test. Based on the measured bond strengths of dentin/enamel and on the area percentages of dentin in the DEJ zone, predicted bond strengths for the DEJ zone were calculated and compared with those measured. The DEJ zone was analyzed, using scanning electron microscopy, after conditioning, resin infiltration, and debonding. Regardless of the adhesive, bond strengths were significantly influenced by substrates, exhibiting the following order of bond strength (strongest to weakest): dentin >DEJ zone > enamel. The predicted values of the DEJ zone for the ERA groups were significantly higher than the measured values. Analysis of the ERA specimens using scanning electron microscopy showed distinct etching textures of enamel and dentin, which outlined the DEJ and increased the adhesive thickness at the enamel side of the DEJ. Those characteristics could not be detected in the SEA groups. The DEJ zone displayed bond properties that were stronger than enamel but weaker than dentin and therefore may be considered as transitional bond properties. Enamel/dentin within the DEJ zone might bond more weakly to ERAs than its counterpart of the bulk tissue. The presence of the DEJ in the bond area might compromise the bonding efficiency of ERAs.     

Microleakage of Class V resin composites placed using self-etching resins: effect of prior enamel etching.

OBJECTIVE: The purpose of this study was to compare the seal along dentin and enamel margins produced by 3 self-etching resin bonding systems to that of an etch-and-rinse adhesive system. Potential improvement in adaptation along enamel margins through the experimental use of conventional enamel etching prior to application of the self-etching adhesives was also evaluated. METHOD AND MATERIALS: Class V resin composite restorations were placed in prepared cavities in extracted third molars using 3 self-etching dentin adhesive systems: Adper Prompt L-Pop (3M Espe), iBond GI (Heraeus Kulzer), and Tyrian SPE (Bisco), and an etch-and rinse adhesive, Adper ScotchBond Multi-Purpose (3M Espe). A group of teeth also underwent conventional enamel etching prior to use of the self-etching products. The restored teeth were thermocycled, subjected to a dye challenge, and sectioned. The sections were scored using an ordinal leakage scale (n = 20). Ranked data were analyzed using a 2-way analysis of variance and Tukey multiple comparison. RESULTS: When used as directed, there were no significant differences along dentin margins for any of the adhesives, but Adper Prompt and iBond demonstrated significantly greater leakage than the etch-and-rinse product along enamel margins. The incidence of enamel margin leakage decreased significantly for the same 2 products when enamel etching preceded use of the resin. Enamel etching increased the leakage along dentin margins for all 3 self-etching products, but not significantly. CONCLUSION: Considerable improvement of all classes of dentin-adhesive resin systems is still needed. Practitioners should await further clinical trials before adopting use of self-etching resins, especially for large occlusal restorations.     

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.     

Effect of air abrasion and thermocycling on resin adaptation and shear bond strength to dentin for an etch-and-rinse and self-etch resin adhesive

This study examined the effect of air abrasion and thermocycling on the adaptation and shear bond strength, of composite resin bonded to dentin using etch-and-rinse and self-etch resin adhesives. Confocal microscopy showed both adhesives closely adapted to dentin and a significantly (p<0.001) greater number of resin tags were observed for the etch-and-rinse adhesive. Air abrasion significantly increased resin tag length (p<0.05) for the etch-and-rinse adhesive and significantly increased the number (p<0.001), length (p<0.001) and thickness (p<0.01) of tags for the self-etch adhesive. However, air abrasion resulted in defect formation within the hybrid layer and thermocycling caused separation of the hybrid layer from adjacent dentin containing resin tags. A significant (p<0.05) reduction in shear bond strength was observed for the etch-and-rinse adhesive following thermocycling. Both adhesive systems adapted well to dentin in vitro and shear bond strengths were similar. The area of tag penetration into dentin was significantly (p<0.0001) enhanced following air abrasion.     

Microtensile dentin bond strength of self-etching resins: effect of a hydrophobic layer

In this study, the microtensile bond strength of resin composites to dentin was determined when hydrophilic self-etching resins were used with and without an additional layer of a more hydrophobic adhesive. Included were three single-step self-etching adhesives, Adper Prompt L-Pop (3M ESPE), iBond GI (Heraeus Kulzer, Inc) and Xeno III (Caulk/Dentsply), and as a negative control, UniFil Bond (GC America), a self-etching primer with a separate adhesive. Each product was evaluated using a hybrid resin composite from its respective manufacturer, and each was used as directed and then used with an added layer of a more hydrophobic resin from its respective manufacturer. Testing was performed after 72 hours using a "non-trimming" microtensile test at a crosshead speed of 0.6 mm/minute. When the products were used according to manufacturers' directions, iBond had a significantly higher bond strength to dentin than the other three products (p<0.001), which were not significantly different from each other. For the three self-etching adhesive systems, the addition of a layer of a more hydrophobic resin produced significantly higher bond strengths to dentin (p<0.001), while no significant effect was found for the self-etching primer (p=0.40). A significant interaction was found between the variables product and adhesive treatment. The TEM evaluation of Prompt L-Pop and iBond demonstrated reduced nanoleakage with the additional resin layer.     

Bond strength of adhesives to dentin involving total and self-etch adhesives.

OBJECTIVE: Currently, the trend in dentin adhesion seems to be shifting from moist bonding systems to self-etching systems and from several application steps to single steps. However, recent studies have indicated that the performance of single-step adhesives was lower than the 2-step self-etch or total etch systems. In the present study, microtensile bond strength of a total etch, 2-step self-etch and single-step self-etch adhesives was comparatively evaluated. METHOD AND MATERIALS: The superficial occlusal dentin of 12 noncarious extracted human molars was exposed, finished with wet 600-grit silicon carbide paper, and a block of resin composite bonded with adhesives according to the manufacturers' instructions. The teeth were kept in tap water for 24 hours at 37 degrees C and sectioned to produce beams, with adhesive areas of +/- 0.9 mm2 (4 beams per tooth were obtained). The specimens were stressed at a crosshead speed of 1 mm per minute until the bonds ruptured. RESULTS: The mean bond strengths were calculated as MPa and compared by performing analysis of variance and Tukey tests to identify significant differences between the materials (P = 0.05). The mean bond strength of Clearfil SE Bond was significantly higher than that of OptiBond Solo Plus and iBond (P <.05). OptiBond Solo Plus gave significantly higher bond strengths than iBond (P <.05). CONCLUSIONS: The self-etching adhesive system Clearfil SE Bond (2 step) had higher bond strength than the 1-bottle self-etching adhesive iBond (single application) and the 2-step single-bottle system OptiBond Solo Plus (total etch). However, the 1-bottle adhesive system OptiBond Solo Plus (total etch system) had higher bond strength than the 1-bottle self-etching adhesive system iBond.     

The effect of thermocycling on the adhesion of self-etching adhesives on dental enamel and dentin

AIM: The aim of the present study was to investigate the effectiveness of one total-etch self-priming adhesive and two one-step self-etching adhesive systems on the adhesion of a resin composite to both dentin and enamel. The effect of thermocycling on the adhesion was also investigated. The null hypothesis tested was thermocycling would not affect bond strengths to enamel and dentin treated with self-etching adhesives or a total-etch adhesive. METHODS AND MATERIALS: Two single-step self-etching adhesives [Xeno III (XE3) and Prompt L-Pop (PP)] and one two-step total-etch adhesive system (Prime & Bond NT) (P&B NT) were used in this study. Thirty caries-free unrestored human third molars were used to make specimens of enamel and dentin. Different adhesives were applied on enamel and dentin surfaces according to the manufacturer's instructions then hybrid composite restorative material was condensed on the surface using a mold. The bonded specimens were stored in distilled water at 37 masculineC for 24 hours before being tested. Half of the bonded specimens were tested for shear bond strength without thermocycling. The other half of the test specimens were thermocycled using a thermocycling apparatus in water baths held at 5 masculineC and 55 masculineC with a dwell time of one minute each for 10,000 cycles prior to shear testing. The mean shear bond strength before and after thermocycling was calculated, and the results were subjected to two-way analysis of variance (ANOVA) and repeated measure design to show the interaction between different materials and different times. RESULTS: The results showed shear bond strength on both enamel and dentin of the total-etch adhesive and the self-etching adhesives decreased after the specimens were subjected to thermocycling. CONCLUSIONS: The null hypothesis tested "thermocycling would not affect bond strengths treated with self-etching adhesives" was rejected. Furthermore, the study revealed the following: 1. The shear bond strength to both enamel and dentin of the total-etch adhesive and the self-etching adhesives decreased after the specimens were subjected to thermocycling. 2. XE3 achieved the highest bond strength to both enamel and dentin (26.994+/-1.17 and 25.22+/-1.26, respectively). 3. XE3 showed even better bonding after thermocycling to enamel and dentin than the total-etching system or PP. 4. Although PP bonded to enamel showed lower shear bond strength value than XE3, it has durable bond strength even after thermocycling.     

Adhesion of multimode adhesives to enamel and dentin after one year of water storage

Objectives

This study aimed to evaluate the ultramorphological characteristics of tooth–resin interfaces and the bond strength (BS) of multimode adhesive systems to enamel and dentin.

Methods

Multimode adhesives (Scotchbond Universal (SBU) and All-Bond Universal) were tested in both self-etch and etch-and-rinse modes and compared to control groups (Optibond FL and Clearfil SE Bond (CSB)). Adhesives were applied to human molars and composite blocks were incrementally built up. Teeth were sectioned to obtain specimens for microtensile BS and TEM analysis. Specimens were tested after storage for either 24 h or 1 year. SEM analyses were performed to classify the failure pattern of beam specimens after BS testing.

Results

Etching increased the enamel BS of multimode adhesives; however, BS decreased after storage for 1 year. No significant differences in dentin BS were noted between multimode and control in either evaluation period. Storage for 1 year only reduced the dentin BS for SBU in self-etch mode. TEM analysis identified hybridization and interaction zones in dentin and enamel for all adhesives. Silver impregnation was detected on dentin–resin interfaces after storage of specimens for 1 year only with the SBU and CSB.

Conclusions

Storage for 1 year reduced enamel BS when adhesives are applied on etched surface; however, BS of multimode adhesives did not differ from those of the control group. In dentin, no significant difference was noted between the multimode and control group adhesives, regardless of etching mode.

Clinical relevance

In general, multimode adhesives showed similar behavior when compared to traditional adhesive techniques. Multimode adhesives are one-step self-etching adhesives that can also be used after enamel/dentin phosphoric acid etching, but each product may work better in specific conditions.

     

Fiber post placement with core build-up materials or resin cements—An evaluation of different adhesive approaches

Abstract

Objective. To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin. Materials and methods. Forty maxillary first incisors were decoronated and endodontically treated. Specimens were randomly distributed into five groups (n = 8) and fiber-posts (DentinPost coated, Komet) were inserted using five different luting materials: etch-and-rinse adhesive systems and corresponding core-and-post material in groups 1 (DentinBond/DentinBuild, Komet) and 2 (XP Bond + SCA/Core-X flow, Densply), self-adhesive resin cements in groups 3 (RelyX Unicem, 3M Espe) and 4 (SmartCem 2, Dentsply) and a self-etch adhesive/resin cement in group 5 (ED-Primer II/Panavia F 2.0, Kuraray). The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated. Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05. The failure modes were analyzed using Chi square test. Results. The bond strength [MPa] (mean/min–max) for groups 3 (12.35/3.60–32.44), 4 (13.52/4.48–30.69) and 2 (11.15/5.23–35.58) were significantly higher (p < 0.001) compared to groups 1 (6.66/2.34–24.89) and 5 (7.41/0.28–34.18). Adhesive failure between dentin and luting agent was the most frequent failure mode. Conclusions. Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used. One (group 2) of the tested core-and-post materials/etch-and-rinse adhesive achieved comparable bond strength values.     

Fatigue of enamel bonds with self-etch adhesives

ObjectiveFatigue testing of adhesive bonds to tooth structures in conjunction with bond strength testing can provide more useful information for examining the effectiveness of dental adhesives. The purpose of this study was to determine the shear bond strength (SBS) and shear fatigue limit (SFL) of composite to enamel bonds using modern adhesive systems.MethodsTwelve specimens each were used to determine 24-h resin composite (Z100-3M ESPE) to enamel shear bond strengths with an etch-and-rinse system (ERA), Adper Single Bond Plus (SB), and four self-etch adhesives (SEA)—Adper Prompt-L-Pop (PLP), Clearfil SE (CSE), Clearfil S³ (CS3) and Xeno IV (X4). A staircase method of fatigue testing was used in a four-station fatigue cycler to determine the SFL of composite to enamel bonds with the adhesives (16–20 specimens for each adhesive) at 0.25 Hz for 40,000 cycles. ANOVA and Tukey's post hoc test were used for the SBS data and a modified t-test with Bonferroni correction was used for comparisons of the SFL.ResultsThe SBS and SFL of the etch-and-rinse system were significantly greater (p < 0.05) than those of the four self-etch adhesives. The SBS and SFL of CSE were also significantly greater than for the other three self-etch systems. The ratio of SFL to SBS was highest with the etch-and-rinse system and the ratio became increasing smaller in the same order that the values for SBS decreased with the self-etch systems.SignificanceThe lower fatigue limits for composite to enamel bonds obtained with the self-etch adhesive systems may indicate that greater enamel margin breakdown will occur with restorations where these systems are used for bonding.     

Self-etch adhesives for the bonding of orthodontic brackets: faster, stronger, safer?

Objectives

This study aimed to evaluate the performance of accelerating procedures for bonding of orthodontic brackets in vitro by comparing different adhesives (etch-and-rinse, self-etch) and polymerization procedures (curing devices, time). The performance was characterized by three parameters: (1) the bond strength achieved, (2) the incidence of enamel damage, and (3) the extent of residual composite on the tooth.

Materials and methods

Bracket bonding was performed on 500 extracted human teeth after application of either an etch-and-rinse adhesive or a one-step self-etch adhesive. Two different two-component self-etch adhesives (Clearfil SE and Transbond Plus) and two single-component self-etch adhesives (Ideal and iBond) were investigated after using different polymerization procedures (light-emitting diode for 10 or 20 s or plasma arc curing device for 3 or 6 s). The bond strength, incidence of enamel damage, and extent of residual composite on the tooth were measured.

Results

Single-component self-etch adhesives gave the lowest bond strengths. No significant difference in bond strength could be detected between the two-component self-etch adhesives and the etch-and-rinse method. There was a 70.3 % risk for enamel damage at bond strengths above 12 MPa, but only 5 % risk below 12 MPa and no risk below 8.2 MPa. The risk of enamel damage increased by an odds ratio increment of 1.3 for each additional MPa above 8.2 MPa.

Conclusion

Single-component self-etch adhesives showed the lowest bond strengths, caused limited enamel damage, and generally left less residual composite on the tooth.

Clinical relevance

The nature of the adhesive greatly influences the resultant bond strength, the risk of enamel damage, and the extent of residual composite on the teeth.     

Bonding to enamel and dentin using self-etching adhesive systems.

OBJECTIVES: This study investigated the effectiveness of three different dentin adhesive systems on the adhesion of resin composite to both dentin and enamel. METHOD AND MATERIALS: The flat dentin and enamel surfaces of 60 extracted human molar teeth were exposed by wet grinding with 600-grit silicon carbide paper. One total-etch self-priming adhesive system (Prime & Bond NT), one two-step self-etching primer adhesive system (Clearfil SE Bond), and one "all-in-one" self-etching adhesive system (Prompt L-Pop) were evaluated. Each bonding system was applied according to the manufacturer's instructions and followed by composite (TPH Spectrum) application. Twenty-four hours after bonding, the teeth were subjected to shear testing. There were 10 replicates for each group. RESULTS: Prompt L-Pop exhibited significantly higher bond strength values to enamel (27 +/- 4.2 MPa) than all other groups. There were no statistically significant differences for shear bond strength to dentin among adhesives. Prompt L-Pop showed the statistically significantly higher bond strength to enamel than dentin. There were no statistically significant differences between the enamel and dentin bond strengths of Clearfil SE Bond and Prime & Bond NT. CONCLUSIONS: The self-etching adhesive systems produced high bond strengths to human coronal dentin and ground enamel surfaces. These materials seem to be very promising for further clinical applications, and the results are very encouraging for the clinical success of these simplified adhesive systems. The self-etching adhesive systems produced even better bond strengths to both enamel and dentin than conventional total-etch systems, especially the "all-in-one" system, which produced the highest bond strength to enamel.     

Bond strength of different adhesive systems to dental hard tissues

This study compared the shear bond strengths of different adhesive systems to enamel and dentin of different depths. The adhesive systems used were: Single Bond one-bottle total-etch; AQ Bond one-step self-etching, Clearfil SE Bond two-step self-etching and Tyrian SPE/One-step Plus two-step self-etching. Eighty extracted non-carious human mandibular molars were mounted in self-curing resin and the occlusal surfaces were ground with a mechanical grinder to obtain flat occlusal enamel surfaces. After applying the adhesive systems, a plastic tube was attached to the enamel surfaces. The tube was filled with a universal hybrid resin composite, which was then polymerized. The specimens were stored in water at 37 degrees C for 24 hours. Shear bond testing was carried out using an Instron Universal testing machine with a crosshead speed of 1 mm/minute. The occlusal enamel of the 80 teeth was removed to determine the bond strengths of the adhesives to superficial dentin. To obtain deep dentin, the same teeth were ground deep towards the pulp, with the remaining dentin thickness approximately 0.7 mm. The adhesives and restorative material were then applied to the prepared dentin surfaces following the methodology described above. For occlusal enamel surfaces, the bond strength of Single Bond was significantly higher than the other adhesives. Single Bond, Clearfil SE Bond and Tyrian SPE/One-step Plus performed equally when bonded to superficial dentin; the lowest bond strength was obtained with AQ Bond. On deep dentin, the highest bond strengths were obtained with Clearfil SE Bond. For each adhesive system, shear bond strength to enamel was statistically higher than it was to either superficial or deep dentin. There were no significant differences between shear bond strengths to superficial versus deep dentin, regardless of adhesive.     

Influence of caries infiltrant contamination on shear bond strength of different adhesives to dentin

Objectives

To analyze whether the contamination with a caries infiltrant system impairs the adhesive performance of etch-and-rinse and self-etching adhesives on dentin.

Materials and methods

Dentin contamination with the caries infiltrant system (Icon, DMG) was simulated by applying either hydrochloric acid (15 % HCl, Icon Etch, 15 s), the resin infiltrant (Icon infiltrant, 4 min), or both prior to the application of the respective adhesives (each group n?=?10). In the control groups, the etch-and-rinse adhesive (Optibond FL, Kerr) and the self-etching adhesive (iBOND Self Etch, Hereaus) were applied without former contamination with the infiltrant system. Additionally, the adhesive performance of the resin infiltrant alone was tested. Shear bond strength of a nano-hybrid composite was analyzed after thermocycling (5,000×, 5–55°C) of the specimens and analyzed by ANOVA/Scheffé post hoc tests (p?<?0.05) and Weibull statistics. Failure mode was inspected under a stereomicroscope at?×?25 magnification.

Results

Contamination with the resin infiltrant alone did not impair shear bond strength, while contamination with hydrochloric acid or with hydrochloric acid and the resin infiltrant reduced shear bond strength (MPa) of the adhesives (Optibond FL: 20.5?±?3.6, iBOND Self Etch: 17.9?±?2.6) significantly. Hydrochloric acid contamination increased the number of adhesive failures. The adhesive performance of the caries infiltrant system alone was insufficient.

Conclusion

The contamination with the caries infiltrant system impaired the shear bond strength of conventional dental adhesives.

Clinical relevance

Contamination of the caries infiltrant system on dentin should be avoided due to the detrimental effect of hydrochloric acid etching.     

Effect of carbodiimide (EDC) on the bond stability of etch-and-rinse adhesive systems

Objective

Recent studies supported the use of protein cross-linking agents during bonding procedures to inactivate endogenous dentin proteases, preventing dentin collagen degradation thus improving bond durability. The aim of this study was to evaluate the effect of a 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)-containing conditioner on the stability of the adhesive interface created by two etch-and-rinse adhesives.

Methods

Human dentin was etched with 35% phosphoric acid, treated with 0.3 M EDC-containing conditioner followed by a three-step or a two-step etch-and-rinse adhesive. Adhesives were applied to control specimens without EDC pre-treatment. Specimens were subjected to microtensile bond strength test and pulled to failure after 24 h or 1 year of storage and interfacial nanoleakage expression was evaluated and quantified by light microscopy. Additionally, to investigate endogenous dentin matrix metalloproteinase activity a zymographic assay was performed on protein extracts obtained from phosphoric-acid-etched dentin powder with or without EDC treatment.

Results

The use of the EDC-containing conditioner did not affect immediate bond strength to dentin but contributed to preserve the bond strength after 1 year (p < 0.05) for both tested adhesives. No difference was found in the interfacial nanoleakage expression that increased after aging irrespective from the treatment. EDC pre-treatment inhibited dentin endogenous MMPs as assayed with the zymography.

Significance

In conclusion, the results of the study provide proof that EDC can produce long-term inactivation of MMPs in acid-etched dentin matrices contributing to bond strength preservation over time. Future studies are needed to support the use of EDC in vivo.