Does the thickness of the resin cement affect the bond strength of a fiber post to the root dentin?

This study aimed to evaluate the influence of cement thickness on the bond strength of a fiber-reinforced composite (FRC) post system to the root dentin. Eighteen single-rooted human teeth were decoronated (length: 16 mm), the canals were prepared, and the specimens were randomly allocated to 2 groups (n = 9): group 1 (low cement thickness), in which size 3 FRC posts were cemented using adhesive plus resin cement; and group 2 (high cement thickness), in which size 1 FRC posts were cemented as in group 1. Specimens were sectioned, producing 5 samples (thickness: 1.5 mm). For cement thickness evaluation, photographs of the samples were taken using an optical microscope, and the images were analyzed. Each sample was tested in push-out, and data were statistically analyzed. Bond strengths of groups 1 and 2 did not show significant differences (P = .558), but the cement thicknesses for these groups were significantly different (P < .0001). The increase in cement thickness did not significantly affect the bond strength (r2 = 0.1389, P= .936). Increased cement thickness surrounding the FRC post did not impair the bond strength.     

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.     

Effect of different surface treatments on the composite–composite repair bond strength

The aim of this study was to investigate the effect of different mechanical and adhesive treatments on the bond strength between pre-existing composite and repair composite using two aging times of the composite to be repaired. Standardized cylinders were made of a microhybrid composite (Spectrum TPH) and stored in saline at 37°C for 24 h (n = 140) or 6 months (n = 140). Three types of mechanical roughening were selected: diamond-coated bur followed by phosphoric acid etching, mini sandblaster with 50-μm aluminum oxide powder, and 30-μm silica-coated aluminum oxide powder (CoJet Sand), respectively. Adhesive treatment was performed with the components of a multi-step bonding system (OptiBond FL) or with a one-bottle primer–adhesive (Excite). In the CoJet Sand group, the effect of a silane coupling agent (Monobond-S) was also investigated. The repair composite (Spectrum TPH) was applied into a mould in three layers of 1 mm, each separately light-cured for 40 s. Repair tensile bond strengths were determined after 24-h storage. Mechanical and adhesive treatment had significant effects on repair bond strength (P < 0.001). The age of the pre-existing composite had no significant effect (P = 0.955). With one exception (CoJet Sand/OptiBond FL Adhesive), adhesive treatments significantly increased repair bond strengths to 6-month-old composite when compared to the controls without adhesive. Adhesive treatment of the mechanically roughened composite is essential for achieving acceptable repair bond strengths. The more complicated use of silica-coated particles for sandblasting followed by a silane coupling agent had no advantage over common bonding 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.     

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.     

The effect of a ceramic coating on the cpTi–porcelain bond strength

ObjectivesTo investigate the bond strength between cpTi and low fusing porcelains after different treatments.Methods72 patterns were covered with a ceramic coating and invested with phosphate-bonded material (group A), another 72 were invested with magnesia material (group B) and all cast with cpTi. 31 solid castings were selected from each group. The castings of group B were ground and sandblasted, while the castings of group A were only sandblasted. Aluminum content of the metal surface was determined by EDS and castings were submitted to a 3-point bending test to determine the modulus of elasticity (E). The porcelains Duceratin Plus, Noritake Ti22 and Triceram were applied respectively and specimens were submitted to a 3-point bending test. The fracture mode and the remaining porcelain were determined by optical microscopy and SEM/EDS. Bond strength and fracture mode were calculated by two-way ANOVA.ResultsThe E of groups A and B was 98.3 GPa and 98.6 GPa respectively. The bond strength was 26 ± 3 MPa (Duceratin Plus), 28 ± 3 MPa (Noritake Ti22), 27 ± 2 MPa (Triceram) for group A and 24 ± 1 MPa, 29 ± 2 MPa, 27 ± 1 MPa for group B respectively. No significant differences were found for the same porcelain between the two groups (p < 0.05). A significant difference was found between Duceratin Plus and Noritake Ti22, for group B (p < 0.05). The mode of failure was mainly adhesive for all specimens. A significant reduction in aluminum was recorded in all subgroups.SignificanceThe special coating of patterns makes the Ti casting procedure inexpensive, without reducing the metal–ceramic bond strength.     

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.     

Does the application of an adhesive layer improve the bond strength of etched and silanized glass-ceramics to resin-based materials? A systematic review and meta-analysis

Statement of problemA consensus on whether to use an adhesive layer on glass-ceramics after etching with hydrofluoric acid and applying a silane-coupling agent is lacking.PurposeThe purpose of this systematic review and meta-analysis was to determine whether adhesive layer application after etching and silanization influences the bond strength values of glass-ceramics to resin-based materials.Material and methodsPubMed, ISI Web of Science, and Scopus electronic databases were searched to select in vitro studies comparing bond strength values of etched and silanized glass-ceramics bonded with or without an adhesive layer. No publication year or language restriction was applied. Data sets were extracted, and the mean differences were applied by using the Rev Man 5.3 program. The association between bond strength (shear/microshear or tensile/microtensile) and an adhesive layer application on nonaged and aged specimens was analyzed.ResultsOf 4727 potentially eligible studies, 54 were selected for full-text analysis, and 15 were included for qualitative synthesis; of these, 14 were used in the meta-analysis. A total of 2 meta-analyses were performed with heterogeneity varying from high to moderate among study specimens. For shear/microshear studies, both nonaged (MD, 1.36 [95% CI: -0.18, 2.90], P=.080, I²=79%) and aged (MD, 0.89 [95% CI: -1.04, 2.82], P=.370, I²=80%) specimens presented no statistically significant difference between groups bonded with or without an adhesive layer application. For microtensile studies, both nonaged (MD, -1.49 [95% CI: -2.48, -0.50], P=.003, I²=88%) and aged (MD, -3.87 [95% CI: -5.63, -2.11], P<.001, I²=97%) specimens exhibited higher values without an adhesive application.ConclusionsRegardless of the bond strength test used, an adhesive layer application did not improve the bond strength of etched and silanized glass-ceramics to resin-based materials. The influence of this adhesive layer application should be evaluated under clinical conditions.     

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 1—host-derived immunological parameters

The purpose of this study was to assess host-derived parameters around dental zirconia and titanium implants and natural teeth during the occurrence of mucositis. After 4 weeks of perfect oral hygiene, 16 clinically profiled patients were asked to refrain from oral hygiene for 2 weeks, resulting in experimental plaque accumulation. This was followed by 4 weeks of perfect oral hygiene to reverse the inflammation. Immunological samples were analyzed for interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-α), and interleukin 1β (IL-1β). Immunological parameters were measured each week, starting at week 4 (session 2) and ending at week 10 (session 8). There were significant differences in IL-6 between the groups (zirconia vs. tooth and titanium vs. tooth), with unfavourable values for the tooth unit (P < 0.05). After reinstitution of oral hygiene, there was a significant increase in TNF-α values for the tooth but not for the zirconia and titanium implants. There were significant differences in IL-1β between the groups (zirconia vs. titanium and titanium vs. tooth), with higher IL-1β levels around titanium implants (P < 0.05). The soft tissue around titanium implants developed a stronger inflammatory response to experimental plaque accumulation in terms of IL-1β values, whereas the teeth presented an increase in IL-6 and TNF-α values.     

Do different implant surfaces exposed in the oral cavity of humans show different biofilm compositions and activities?

Osseointegrated dental implants play an important role in restorative dentistry. However, plaque accumulation may cause inflammatory reactions around the implants, sometimes leading to implant failure. In this in vivo study the influence of two physical hard coatings on bacterial adhesion was examined in comparison with a pure titanium surface. Thin glass sheets coated with titanium nitride (TiN), zirconium nitride (ZrN) or pure titanium were mounted on removable intraoral splints in two adults. After 60 h of intraoral exposure, the biofilms were analyzed to determine the number of bacteria, the types of bacteria [by applying single-strand conformation polymorphism (SSCP analysis) of 16S rRNA genes], and whether or not the bacteria were active (by SSCP analysis of 16S rRNA). The results showed that bacterial cell counts were higher on the pure titanium-coated glass sheets than on the glass sheets coated with TiN or ZrN. The lowest number of bacterial cells was present on theZrN-coated glass. However, the metabolic activity (RNA fingerprints) of bacteria on TiN- and ZrN-coated glass sheets seemed to be lower than the activity of bacteria on the titanium-coated surfaces, whereas SSCP fingerprints based on 16S rDNA revealed that the major 16S bands are common to all of the fingerprints, independently of the surface coating.     

Follow-up study to investigate symmetry and stability of cranioplasty in craniosynostosis – Introduction of new pathology-specific parameters and a comparison to the norm population

PurposeCranioplasty and modulation of frontoorbital advancement (FOA) in children with craniosynostosis aims to achieve an attractive aesthetic and functional rehabilitation of the forehead area, comparable to that in unaffected children. Based on a three-dimensional surface scan, a cephalometric data evaluation with new parameters for the quantification of physiological and pathological cranial morphologies, and objective evaluation of postoperative follow-up in comparison to an age-equivalent standard population, were performed.Materials and methodsIn a prospective study, 80 children were operated on with non-syndromic craniosynostosis (trigonocephalus, n = 30; plagiocephalus, n = 10; scaphocephalus, n = 38; brachycephalus, n = 2) and pre- and 3, 6, 12, 18 and 30 months postoperative three-dimensional surface scans were obtained (3DShape, Erlangen, Germany) and morphometrically measured (Onyx Ceph, Image Instruments, Chemnitz, Germany). In addition, 49 healthy children who were not operated on were measured at equivalent ages (n = 25 [6 months]; n = 20 [9 months]; n = 4 [12 months]).ResultsAll patient groups showed stable long-term results with regard to shaping of the forehead. Cranioplasty in patients with scaphocephalus resulted in a significant widening of the anterior (73.9 ± 3.5 mm; p < 0.001) and posterior (132.2 ± 5.2 mm; p < 0.001) cranial width, with no significant difference from the norm population 1 year after surgery (p = 0.6597). As parameters for the correction of trigonocephaly, the frontal angle showed significant improvement (145.9 ± 3.7°; p < 0.001). While the parietal angle 12 months after surgery showed similar values as the norm population, the frontal angle was about 10° smaller than in healthy children (p = 0.0055), despite a clinically inconspicuous physiognomy. As part of the correction of plagiocephaly, the patients tended to relapse in the postoperative course, although there was no statistically significant difference in the frontal angle compared to that in the norm population (153.3 ± 3.9°; p = 0.06). While 6 months after surgery all patients showed a normal cranial volume development compared to healthy children of the same age, the volumes of brachycephalic patients remained below the norm (1244.2 ± 153.2 cm³; p = 0.0244). Overall, the analysis of the norm population showed a growing dispersion of measurement values with increasing age, which was observed to be more concentrated in the operated cranial morphologies.ConclusionThe determination of new pathology-specific morphometric parameters on the three-dimensional surface scan enables an objective quantification of physiological and pathological cranial morphologies of children. A comparison of operated children with a healthy, age-appropriate comparison group showed that preoperative and statistically significant deviations of the new measuring parameters in long-term follow-up could be normalized through surgical intervention, although this does not apply without limitations to children with coronary suture synostosis.     

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2—clinical and microbiological parameters

The aim of this study was to assess the clinical and microbiological parameters around dental zirconia and titanium implants compared with natural teeth during experimental plaque accumulation. Clinical parameters were evaluated (gingival index, plaque index, bleeding on probing, and probing pocket depth). Microbiological samples were analyzed for total bacterial cell counts, as well as Tannerella forsythia and Prevotella intermedia counts. A statistically significant difference over time was observed in the groups in terms of the gingival index (P < 0.001), plaque index (P < 0.001), and bleeding on probing (P = 0.039). The lowest mean total number of bacterial cells was measured around the teeth, followed by the zirconia implants; the highest values were found around the titanium implants. T. forsythia and P. intermedia values showed significant changes over time and sessions around the titanium implants. Compared to the soft tissues around zirconia implants and the teeth, those around titanium implants developed a stronger inflammatory response to experimental plaque accumulation in terms of the total number of bacterial cells and T. forsythia and P. intermedia values.     

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.