Evaluation of the interaction of chlorhexidine and MDP and its effects on the durability of dentin bonding

ObjectiveThis study aimed to evaluate the potential interaction of chlorhexidine (CHX) and 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and its effects on the durability of dentin bonding.MethodsTwo commercial adhesives were tested: a MDP-free adhesive (Single Bond 2, SB2) and a MDP-containing adhesive (Single Bond Universal, SBU). Teeth were randomly assigned to six groups and tested for micro-tensile bond strength (μTBS): Ctr, direct bonding with SB2; CHX, CHX conditioning and SB2; MDP, MDP conditioning and SB2; CHX + MDP, combined CHX and MDP conditioning and SB2; SBU, direct bonding with SBU; CHX + SBU, CHX conditioning and SBU. The potential interaction of CHX and MDP was assessed by measuring nanoleakage, in situ zymography, and chemoanalytic characterization via Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and nuclear magnetic resonance (NMR). Specimens for μTBS and nanoleakage tests were first subjected to water storage for 24 h or 6 months.ResultsThe initial μTBS values of the Ctr and CHX groups were significantly lower than those of the other four groups (P < 0.05). Water storage for 6 months significantly weakened all groups (P < 0.05), with the Ctr group showing the lowest μTBS. This group also showed more obvious nanoleakage than the other five groups. In situ zymography revealed that the Ctr group showed the strongest fluorescence and that the CHX + MDP group showed greater fluorescence than either CHX or MDP group. FTIR, XPS, and NMR indicated that MDP can interact with hydroxyapatite. NMR detected no Ca²⁺ salt peak for MDP when it was combined with CHX.SignificanceThe application of either CHX or MDP alone can improve dentin bond durability. However, CHX may interfere with the formation of MDP–Ca salts.     

Fluoride-containing adhesive: Durability on dentin bonding

ObjectivesTo evaluate (1) the influence of fluoride-containing adhesive on microtensile bond strength (μTBS) and (2) in vitro secondary caries inhibition at the resin–dentin interface after 24 h and 3 months water-storage and (3) the degree of conversion of different adhesives after 24 h 1 month.MethodsFlat surfaces of human teeth were ground and randomly assigned to six groups: (SBMP-24) Scotchbond Multi-Purpose control [SBMP], 24 h; (SE-24) SBMP etch and primer + Clearfil SE Bond adhesive [SE], 24 h; (PB-24) SBMP etch and primer + Clearfil Protect Bond adhesive [PB], 24 h; (SBMP-3) SBMP, 3 months; (SE-3) SBMP + SE, 3 months; and (PB-3) SBMP + PB, 3 months. To evaluate the effect of the adhesive resin alone, all teeth were etched with 35% phosphoric acid and primed with SBMP primer prior to applying the adhesive resin. Bonded assemblies were prepared for μTBS and stored in distilled water at 37 °C for 24 h and 3 months. Sections of restored teeth of each group were exposed to an acid challenge. The specimens were sectioned, polished, and then observed with polarized light microscopy (PLM). Also, the degree of conversion (DC) of the adhesives was measured using Fourier Transform-Infrared spectroscopy (FTIR) at 24 h and 1 month, after polymerization.ResultsμTBS values obtained in MPa (24 h/3 m) were: (MP) 61.5 ± 10.5/52.9 ± 8.9, (SE) 55.5 ± 11.8/55.6 ± 13, and (PB) 50.3 ± 9.9/61.0 ± 13.6. For interface analysis by PLM, an inhibition zone (IZ) adjacent to the hybrid layer was created only when the fluoride-containing adhesive (PB) was used. The DC in percentage (24 h, 1 month) were: (MP) 60.5 ± 2.8/61.3 ± 0.6, (SE) 69.6 ± 1.3/70.7 ± 0.05, and (PB) 53.1 ± 0.4/58.3 ± 1.6.SignificanceThe fluoride-containing adhesive demonstrated significant increase of bond strength values after water-storage. This material was also able to create an acid inhibition zone in dentin. There was a significant increase of degree of conversion after 1 month only for PB.     

Dental primer and adhesive containing a new antibacterial quaternary ammonium monomer dimethylaminododecyl methacrylate

ObjectivesThe main reason for restoration failure is secondary caries caused by biofilm acids. Replacing the failed restorations accounts for 50–70% of all operative work. The objectives of this study were to incorporate a new quaternary ammonium monomer (dimethylaminododecyl methacrylate, DMADDM) and nanoparticles of silver (NAg) into a primer and an adhesive, and to investigate their effects on antibacterial and dentin bonding properties.MethodsScotchbond Multi-Purpose (SBMP) served as control. DMADDM was synthesized and incorporated with NAg into primer/adhesive. A dental plaque microcosm biofilm model with human saliva was used to investigate metabolic activity, colony-forming units (CFU), and lactic acid. Dentin shear bond strengths were measured.ResultsMinimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the new DMADDM were orders of magnitude lower than those of a previous quaternary ammonium dimethacrylate (QADM). Uncured primer with DMADDM had much larger inhibition zones than QADM (p < 0.05). Cured primer/adhesive with DMADDM-NAg greatly reduced biofilm metabolic activity (p < 0.05). Combining DMADDM with NAg in primer/adhesive resulted in less CFU than DMADDM alone (p < 0.05). Lactic acid production by biofilms was reduced by 20-fold via DMADDM-NAg, compared to control. Incorporation of DMADDM and NAg into primer/adhesive did not adversely affect dentin bond strength.ConclusionsA new antibacterial monomer DMADDM was synthesized and incorporated into primer/adhesive for the first time. The bonding agents are promising to combat residual bacteria in tooth cavity and invading bacteria at tooth-restoration margins to inhibit caries. DMADDM and NAg are promising for use into a wide range of dental adhesive systems and restoratives.     

Effects of dual antibacterial agents MDPB and nano-silver in primer on microcosm biofilm,cytotoxicity and dentine bond properties

ObjectivesThe objective of this study was to investigate the effects of dentine primer containing dual antibacterial agents, namely, 12-methacryloyloxydodecylpyridinium bromide (MDPB) and nanoparticles of silver (NAg), on dentine bond strength, dental plaque microcosm biofilm response, and fibroblast cytotoxicity for the first time.MethodsScotchbond Multi-Purpose (SBMP) was used as the parent bonding agent. Four primers were tested: SBMP primer control (referred to as “P”), P + 5% MDPB, P + 0.05% NAg, and P + 5% MDPB + 0.05% NAg. Dentine shear bond strengths were measured using extracted human teeth. Biofilms from the mixed saliva of 10 donors were cultured to investigate metabolic activity, colony-forming units (CFU), and lactic acid production. Human fibroblast cytotoxicity of the four primers was tested in vitro.ResultsIncorporating MDPB and NAg into primer did not reduce dentine bond strength compared to control (p > 0.1). SEM revealed well-bonded adhesive–dentine interfaces with numerous resin tags. MDPB or NAg each greatly reduced biofilm viability and acid production, compared to control. Dual agents MDPB + NAg had a much stronger effect than either agent alone (p < 0.05), increasing inhibition zone size and reducing metabolic activity, CFU and lactic acid by an order of magnitude, compared to control. There was no difference in cytotoxicity between commercial control and antibacterial primers (p > 0.1).ConclusionsThe method of using dual agents MDPB + NAg in the primer yielded potent antibacterial properties. Hence, this method may be promising to combat residual bacteria in tooth cavity and invading bacteria at the margins. The dual agents MDPB + NAg may have wide applicability to other adhesives, composites, sealants and cements to inhibit biofilms and caries.     

Degree of conversion of Filtek Silorane Adhesive System and Clearfil SE Bond within the hybrid and adhesive layer: An in situ Raman analysis

ObjectivesTo examine the degree of conversion (DC) of the adhesive interfaces created by Filtek Silorane Adhesive and Clearfil SE Bond using micro-Raman spectroscopy.MethodsThe adhesives were applied on human dentin in accordance with manufacturer's instructions. Specimens were cut to expose the bonded interfaces to the micro-Raman beam (Ranishaw InVia; laser wl 785 nm). Raman spectra were collected along the dentin/self-etching primer/adhesive interface at 1 μm intervals. The relative intensities of bands associated with mineral (P–O functional group at 960 cm^?1) and adhesive (C–C–O group at 605 cm^?1) components within the bonded interface were used to detect monomer penetration into the dentin matrix and to calculate the degree of conversion (CC at 1640 cm^?1 as reaction peak, C–C–O at 605 cm^?1 as reference peak). Data were statistically analyzed with two-way ANOVA.ResultsDC of Filtek Silorane Adhesive was 69 ± 7% in the adhesive layer, increasing (p < 0.05) to 93 ± 5% in the primer and 92 ± 9% in the hybrid layer. Clearfil SE Bond showed a DC of 83 ± 3% in the hybrid and 85 ± 3% in the adhesive layer. Thus, Filtek Silorane Adhesive showed a higher DC than Clearfil SE Bond in the hybrid layer (p < 0.05), but a lower DC in the adhesive (p < 0.05).SignificanceAs high DC is a fundamental pre-requisite for the stability of the bond over time, this study supports the hypothesis that optimal stability of Filtek Silorane Adhesive can be obtained. However, further research is needed to investigate the mechanical properties of the hybrid layer created by Filtek Silorane Adhesive and its long-term stability.     

Antibacterial activity and ion release of bonding agent containing amorphous calcium phosphate nanoparticles

ObjectiveRecurrent caries at the margins is a primary reason for restoration failure. The objectives of this study were to develop bonding agent with the double benefits of antibacterial and remineralizing capabilities, to investigate the effects of NACP filler level and solution pH on Ca and P ion release from adhesive, and to examine the antibacterial and dentin bond properties.MethodsNanoparticles of amorphous calcium phosphate (NACP) and a quaternary ammonium monomer (dimethylaminododecyl methacrylate, DMADDM) were synthesized. Scotchbond Multi-Purpose (SBMP) primer and adhesive served as control. DMADDM was incorporated into primer and adhesive at 5% by mass. NACP was incorporated into adhesive at filler mass fractions of 10%, 20%, 30% and 40%. A dental plaque microcosm biofilm model was used to test the antibacterial bonding agents. Calcium (Ca) and phosphate (P) ion releases from the cured adhesive samples were measured vs. filler level and solution pH of 7, 5.5 and 4.ResultsAdding 5% DMADDM and 10–40% NACP into bonding agent, and water-aging for 28 days, did not affect dentin bond strength, compared to SBMP control at 1 day (p > 0.1). Adding DMADDM into bonding agent substantially decreased the biofilm metabolic activity and lactic acid production. Total microorganisms, total streptococci, and mutans streptococci were greatly reduced for bonding agents containing DMADDM. Increasing NACP filler level from 10% to 40% in adhesive increased the Ca and P ion release by an order of magnitude. Decreasing solution pH from 7 to 4 increased the ion release from adhesive by 6–10 folds.SignificanceBonding agents containing antibacterial DMADDM and remineralizer NACP were formulated to have Ca and P ion release, which increased with NACP filler level from 10% to 40% in adhesive. NACP adhesive was “smart” and dramatically increased the ion release at cariogenic pH 4, when these ions would be most-needed to inhibit caries. Therefore, bonding agent containing DMADDM and NACP may be promising to inhibit biofilms and remineralize tooth lesions thereby increasing the restoration longevity.     

Effect of proanthocyanidins and photo-initiators on photo-polymerization of a dental adhesive

ObjectivesTo evaluate the effects of proanthocyanidins (PA) and photoinitiator type on the degree of conversion (DC) and polymerization rate (PR) of a model dental adhesive.MethodsThree types of photo-initiation systems were introduced into the Bis-GMA/HEMA co-monomer mixture, resulting in four resin formulations including CQ/A (0.5 wt% CQ and EDMAB), CQ/A/I-1 (0.5 wt% CQ, EDMAB and DPIHP), CQ/A/I-2 (1.0 wt% CQ, EDMAB and DPIHP), and TPO (2.1 wt% TPO). For each resin formulation, adhesives containing 0%, 2.5%, 5% and 10% of PA with respect to the weight of resin were produced after mixing the resin with various amount of PA/ethanol solution. When light-cured, the RP and DC of each adhesive was determined using ATR-FTIR spectroscopy.ResultsAcross and within the initiator groups, the DC followed the general trend of CQ/A < CQ/A/I-1 < CQ/A/I-2 < TPO and 0-PA > 2.5-PA > 5-PA > 10-PA, respectively. The change of PR with respect to photo-initiation systems and PA content was in a similar but less pronounced pattern.ConclusionPA hampered the polymerization of all adhesives regardless of photoinitiators used. The initiator formulations CQ/A/I-2 and TPO are better fit for PA-containing adhesives, both leading to >65% DC in the presence of 5% PA.Clinical significanceThe inclusion of PA in dental adhesives has been limited by its interference with the light-curing of adhesive resins. This study found photo-initiation formulations that could maintain a satisfactory degree of monomer conversion while a significant amount of PA is incorporated.     

Impact of shelf-life simulation on bonding performance of universal adhesive systems

ObjectivesTo evaluate the micro-tensile bond strength to dentin (μTBS), the degree of conversion (DC) and nanoleakage expression (NL) of eight dental adhesives considering their expiry date (as-received, half-life and or end of shelf-life) after shelf-life simulation.MethodsFive universal adhesives (Single Bond Universal, SBU; Tetric Bond Universal, TBU; OneCoat Universal, OCU; OptiBond Universal, OBU; and Prime&Bond Elect, P&B), two two-step self-etch adhesives (Clearfil SE, CSE; and AdheSE, ASE) and one two-step etch-and-rinse adhesive (Adper Singlebond 2, ASB) were evaluated. Shelf-life was simulated by storing the materials in an acclimatization chamber for different periods of time. The μTBS was tested in accordance with ISO/TS 11,405. DC was evaluated by means of FTIR spectroscopy. NL was evaluated after ammoniacal silver challenge. The significance level of α = 0.05 was used for all statistical analyses.ResultsThe μTBS to dentin of TBU, P&B, ASE, and ASB adhesive systems remained stable throughout the shelf-life periods evaluated, while for SBU, OCU, OBU, and CSE, decreased significantly after evaluation in the ‘half-life’ or ‘end of shelf-life’ condition (p < 0.05). Except for P&B, ASE and OBU, the degree of conversion significantly decreased after the shelf-life simulation (p < 0.05). OCU, ASE, and CSE showed significantly increased percentage of silver deposition within the adhesive layer (p < 0.05).SignificanceStoring conditions and progressively longer storage time affect the performance of universal adhesives systems.     

Effect of pulpal pressure on the microtensile bond strength of luting resin cements to human dentin

ObjectivesThe objectives of this study were to examine the effect of pulpal pressure on the microtensile bond strength (mTBS) of luting resin cements to human dentin and the permeability of dentin surfaces pre-treated with an adhesive and a self-etching primer.MethodsCylindrical composite blocks were luted with resin cements (RelyX ARC, 3M ESPE: ARC; Panavia F, Kuraray Medical Inc.: PF; RelyX Unicem, 3M ESPE: UN) in the absence or presence of simulated pulpal pressure. The application of Adper Single Bond 2 (3M ESPE) and ED primer 2.0 (Kuraray) was performed under 0 cm H₂O. After each resin cement was applied, the pulpal pressure group was subjected to 20 cm H₂O of hydrostatic pressure for 10 min during the initial setting period. Testing for mTBS was performed on 0.9 mm × 0.9 mm sectioned beams after 24 h water-storage. Scanning electron microscopy was performed to investigate the fractured surfaces after mTBS testing and additional dentin surfaces that were treated by an etchant, ED primer 2.0 and UN. Fluid permeability was measured on dentin surfaces that were applied with Adper Single Bond 2 and ED primer 2.0.ResultsApplication of pulpal pressure reduced mTBS significantly in groups ARC and PF. Porous bonding interfaces due to water permeability through the cured adhesive were observed on fractured surfaces. Dentin surfaces that were applied with the adhesive and the primer were more permeable than smear layer-covered dentin. The mTBS of UN was significantly lower than ARC and PF regardless of the absence/presence of pulpal pressure.SignificanceFluid permeation during the initial setting period deteriorated the bonding quality of resin cements.     

Peel bond strength between 3D printing tray materials and elastomeric impression/adhesive systems: A laboratory study

ObjectivesThe present study aimed to evaluate the bonding between three 3D printed custom tray materials and three elastomeric impression/adhesive systems using the peel test.MethodsTest blocks were 3D printed by three different technologies using Dental LT, FREEPRINT tray, and polylactide (PLA) tray materials. The reference test blocks were conventionally fabricated with Zeta Tray LC, a light-curing resin. The surface topographies of the four tray materials were investigated by scanning electron microscopy (SEM) analyses and roughness measurements. The peel bond strength between the four tray materials and three impression/adhesive systems, vinylsiloxanether (VSXE), vinyl polysiloxane (VPS), and polyether (PE), was measured (n = 12 per group). The peeling failure modes and rupture sites were identified microscopically.ResultsThe four tray materials featured different surface topographies. The peel bond strength was not significantly different with VSXE and PE, but PLA and the reference showed higher peel bond strength with VPS than the Dental LT and FREEPRINT tray (p < 0.05). The rupture site of adhesive failure in all groups was partly at the adhesive-impression material interface and partly within the adhesive but never at the adhesive-tray material interface.SignificanceThe 3D printed tray materials can achieve satisfactory chemical compatibility with the adhesives of VSXE, VPS, and PE. Surface topographies generated by the 3D printing technologies may affect bonding. Generally, 3D printed tray materials can provide clinically adequate bond strength with the elastomeric impression/adhesive systems. PLA is recommended for bonding with VPS when severe impression removal resistance is detected.     

Effectiveness of pretreatment with phosphoric acid,sodium hypochlorite and sulfinic acid sodium salt on root canal dentin resin bonding

PurposeThe purpose of this study was to evaluate the effect of pretreatment using phosphoric acid, sodium hypochlorite and sulfinic acid sodium salt on the bonding of one-step self-etching adhesives to root canal dentin.MethodsThirty-six single-rooted sound human premolars were randomly assigned into three groups before applying the one-step self-etching adhesive. These comprised a control group with no pretreatment, an NC group that received phosphoric acid and subsequent sodium hypochlorite gel pretreatments, and an NC + AC group that received an additional treatment with sulfinic acid sodium salt following the same pretreatment applied to the NC group. Microtensile bond strength measurements, bonding interface observations by scanning electron microscopy (SEM), elemental analyses by X-ray photoelectron spectroscopy (XPS) and degree of polymerization (DOP) analyses by Raman spectroscopy were subsequently performed.ResultsThe bond strength was significantly higher in the NC + AC group than in the other two groups (Control: P = 000.1 and NC: P = 0.004). SEM observations showed that resin tags were present in the dentinal tubules in the NC and NC + AC groups. Compared to the control group, the adhesive resin layer had a lower DOP in the NC group, while the DOP for the NC + AC group was higher than that of the NC specimens.ConclusionsBonding to root canal dentin was improved by applying sulfinic acid sodium salt in addition to treatment with phosphoric acid followed by sodium hypochlorite. The DOP of the adhesive resin was reduced by sodium hypochlorite and subsequently restored by applying sulfinic acid sodium salt.     

Bond strength of self-etch adhesives to pre-etched enamel

ObjectiveBond strengths of composite resin to enamel using four self-etch adhesive (SEA) systems were compared with the bond strength of an etch-and-rinse adhesive (ERA) system, for both polished enamel and enamel pre-etched with phosphoric acid. The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to match the ERA system.MethodsTen specimens were used for each adhesive to determine 24-h resin composite to enamel shear bond strengths (SBS) to polished (4000 grit) human enamel and this was repeated for the SEA systems for enamel that was pre-etched with phosphoric acid for 15 s. SEM analysis was made to assess the degree of etching and resin penetration into enamel for each of the adhesive systems. Data were analyzed by a two factor ANOVA with a Tukey HSD post hoc test.ResultsThe SBS to polished enamel for all four SEA systems were statistically significantly lower (p < 0.05) than the ERA control, but with pre-etched enamel there were no statistically significant differences (p > 0.05) between any of the adhesive systems. All four of the SEA systems demonstrated statistically significant increases in bond strength between bonding to polished and pre-etched enamel, ranging from 27% to 86%. The results of SEM analysis showed no differences in the resin penetration patterns of any of the adhesives for enamel that was etched with phosphoric acid.SignificancePre-etching enamel may enhance the bond strength of SEA systems to values comparable with those found with ERA adhesive systems, which may improve their overall performance in clinical use.     

Clinical effectiveness of contemporary adhesives for the restoration of non-carious cervical lesions. A systematic review

ObjectivesThe aim of this systematic review was to evaluate the clinical effectiveness of contemporary adhesives for the restoration of non-carious cervical lesions (NCCLs) in terms of restoration retention as a function of time.MethodsMedline Ovid and IADR abstracts were reviewed for NCCLs clinical trials from 1950 to 2013. The reference list of all eligible trials and relevant review articles was checked to find additional studies. The review did not have any language restrictions. Only randomized controlled clinical trials that evaluated at least two adhesives for a follow-up period of at least 18 months were included. Materials with adhesive potential were categorized into 6 main classes: 3-step etch&rinse adhesives (3E&Ra's), 2-step etch&rinse adhesives (2E&Ra's), 2-step self-etch adhesives (2SEa's), 1-step self-etch adhesives (1SEa's), glass-ionomers (GI's) and self-adhesive composites (SAC's). The first four can bond restorative composite to tooth tissue. Both 2SEa and 1SEa were further sub-divided in ‘mild’ and ‘intermediately strong (1/2SEa_m), with a pH ≥ 1.5, and ‘strong’ (1/2SEa_s), with a pH < 1.5. From the restoration retention rates as a function of time the average annual failure rate (AFR) per adhesive and adhesive class was calculated.ResultsThe lowest AFR scores [mean (SD)] were recorded for GI [2.0 (1.4)] shortly followed by 2SEa_m [2.5 (1.5)], 3E&Ra [3.1 (2)] and 1SEa_m [3.6 (4.3)] (Tukey Contrasts: p > 0.05). Significantly higher AFR scores were recorded for 1SEa_s [5.4 (4.8)], 2E&R [5.8 (4.9)], and 2SEa_s [8.4 (7.9)] (p > 0.05). In addition, significant differences in AFR were noticed between adhesives of the same class (Kruskal–Wallis sum test: p > 0.05), except for GI (p = 0.7) and 2SEa_m (p = 0.1). Finally, selective enamel etching did not significantly influence the retention rate of SEa (AFR SEa_etch = 0.43 (0.49), AFR SEa_non-etch = 1.43 (1.77).SignificanceThe adhesive approach significantly influences the clinical effectiveness of adhesives in NCCLs. Within each class, except for GI, there was a wide variation in clinical bonding effectiveness.     

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.     

Epigallocatechin-3-gallate (EGCG) enhances the therapeutic activity of a dental adhesive

ObjectivesThe purpose of this study was to evaluate the antibacterial potential and physicochemical properties of a dental adhesive incorporated with epigallocatechin-3-gallate (EGCG) in different concentration over time.MethodsEGCG was incorporated at a ratio of 100, 200, and 300 μg/ml into a dental adhesive. The effects of the cured adhesives on the growth of Streptococcus mutans were determined by direct contact test immediately or one month later and by scanning electron microscopy (SEM), respectively. Microtensile bond strength (μTBS) test was used to test the mechanical property of the adhesives immediately or six months later. The degree of conversion (DC) of the adhesives was evaluated by Fourier Transform Infrared Spectroscopy (FTIR).ResultsCompared with negative control, the 200 μg/ml and 300 μg/ml EGCG-incorporated dental adhesive were found to exhibit inhibitory effect on the growth of S. mutans. The μTBS of the EGCG-incorporated dental adhesive was higher than the control. The DC of the adhesive system was not affected by the addition of EGCG.Conclusions200 μg/ml EGCG incorporated dental adhesives could accomplish therapeutic goals that play in antimicrobial function whilst keeping the durability of resin–dentine bond.     

The role of etching in bonding to enamel: A comparison of self-etching and etch-and-rinse adhesive systems

ObjectiveEtch and resin infiltration morphologies were compared for three self-etch adhesive (SEA) systems and eleven model etch-and-rinse (ERA) systems using various phosphoric acid (PA) concentrations with Adper Single Bond Plus (SB) adhesive. Matches for the morphologies were made between each SEA system and one of the PA/SB systems and bond strength measurements were made for all the systems. The hypothesis was that similar morphology would result in similar bond strength assuming micro-mechanical bonding is the mechanism of adhesion.MethodsThree specimens were prepared on polished (4000 grit) human enamel for each adhesive system to examine etch and resin infiltration morphology by SEM. For the latter, the adhesive systems were bonded using recommended methods and the enamel was dissolved in acid to reveal the resin. The etch patterns for the SEA systems were determined by rinsing off the material with water and acetone. Polished (4000 grit) human enamel was used with each adhesive system to determine 24-h resin composite to enamel shear bond strengths (SBS). A minimum of 10 specimens were used for each group. Data were analyzed by a one factor ANOVA and Fisher's PLSD post hoc test.ResultsThe SBS to polished enamel for two of the three SEA systems were statistically significantly greater (p < 0.05) than the PA/SB matched systems, indicating that chemical bonding might be partly responsible for the measured bond strength. All three SEA systems provided statistically lower (p < 0.05) SBS values than the PA/SB systems with PA concentrations between 2.5% and 40%.SignificanceAlthough chemical bonding may be present for some SEA systems it does not provide enough increase in bond strength to compete with the bond produced by ERA systems using phosphoric acid etching of enamel.     

Influence of chlorhexidine on the degree of conversion and E-modulus of experimental adhesive blends

ObjectivesThis study examined the effect of chlorhexidine (CHX) content on degree of conversion (DC) and E-modulus of experimental adhesive blends. The hypothesis tested was that increasing concentrations of CHX result in decreased DC and E-modulus in relation to adhesive hydrophilicity.MethodsExperimental adhesive blends with increasing hydrophilicity R2 (70% bisGMA, 28.75% TEGDMA); R3 (70% BisGMA, 28.75% HEMA); R4 (40% BisGMA, 30% TCDM, 28.75% TEGDMA); R5 (40% BisGMA, 30% BisMP, 28.75% HEMA) and different CHX concentrations (1 and 5%) were analyzed. 5% CHX could not be dissolved in R2. A differential scanning calorimeter was used to measure the DC of resin blends. Photopolymerized disks of the experimental comonomer mixtures (n = 10/gp) were used to measure the E-modulus of each specimen using a biaxial flexure test. Data were analyzed with two-way ANOVA (resin type and CHX concentration) and Tukey's post hoc test.ResultsThe addition of 1% CHX did not significantly alter the DC of R2 and R3. Significant decrease in R3 DC values was observed when 5% CHX was added. CHX significantly increased the DC of R4 and R5. 1% CHX reduced the E-modulus of all resins (p < 0.05) except for R2, in which the E-modulus was significantly increased (p < 0.05). 5% CHX significantly reduced the E-modulus of resins R3 to R5 (p < 0.05).SignificanceIn conclusion, increasing concentrations of CHX dissolved in resin blends had little adverse effect on DC but decreased the E-modulus 27–48% compared to controls. Solvation of CHX in ethanol prior to incorporation of CHX into R2 may permit higher CHX concentrations without lower polymer stiffness.     

Immediate bonding properties of universal adhesives to dentine

ObjectivesTo evaluate the dentine microtensile bond strength (μTBS), nanoleakage (NL), degree of conversion (DC) within the hybrid layer for etch-and-rinse and self-etch strategies of universal simplified adhesive systems.Methodsforty caries free extracted third molars were divided into 8 groups for μTBS (n = 5), according to the adhesive and etching strategy: Clearfil SE Bond [CSE] and Adper Single Bond 2 [SB], as controls; Peak Universal Adhesive System, self-etch [PkSe] and etch-and-rinse [PkEr]; Scotchbond Universal Adhesive, self-etch [ScSe] and etch-and-rinse [ScEr]; All Bond Universal, self-etch [AlSe] and etch-and-rinse [AlEr]. After restorations were constructed, specimens were stored in water (37 °C/24 h) and then resin–dentine sticks were prepared (0.8 mm²). The sticks were tested under tension at 0.5 mm/min. Some sticks from each tooth group were used for DC determination by micro-Raman spectroscopy or nanoleakage evaluation (NL). The pH for each solution was evaluated using a pH metre. Data were analyzed with one-way ANOVA and Tukey's test (α = 0.05).ResultsFor μTBS, only PkSe and PkEr were similar to the respective control groups (p > 0.05). AlSe showed the lowest μTBS mean (p < 0.05). For NL, ScEr, ScSe, AlSe, and AlEr showed the lowest NL similar to control groups (p < 0.05). For DC, only ScSe showed lower DC than the other materials (p < 0.05).ConclusionsPerformance of universal adhesives was shown to be material-dependent. The results indicate that this new category of universal adhesives used on dentine as either etch-and-rinse or self-etch strategies were inferior as regards at least one of the properties evaluated (μTBS, NL and DC) in comparison with the control adhesives (CSE for self-etch and SB for etch-and-rinse).     

Optimization of the etch-and-rinse technique: New perspectives to improve resin–dentin bonding and hybrid layer integrity by reducing residual water using dimethyl sulfoxide pretreatments

Objective

To determine whether bonding effectiveness and hybrid layer integrity on acid-etched dehydrated dentin would be comparable to the conventional wet-bonding technique through new dentin biomodification approaches using dimethyl sulfoxide (DMSO).

3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions

ObjectivesDespite representing an important component of current dental adhesives, HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel. The aim of this randomised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives.MethodsThirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two examiners at baseline, 6, 12, 24 and 36 months regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. The data were statistically analysed with GEE and McNemar tests (p < 0.05).ResultsThe recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p = 0.14). A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated, irrespective of the recall (p > 0.05). After 3 years, both adhesives presented an increase in the percentage of clinically acceptable marginal discoloration (C3S: 32.9% and GB: 26.8%) normally associated to clinically acceptable marginal defects (C3S: 35.8% and GB: 26.5%). Only 1 dentine margin of a GB restoration presented a severe marginal defect (1.2%) and 1 C3S restoration presented caries recurrence. The overall 3-year clinical success rate was 92.6% for C3S and 97.6% for GB (p = 0.16).ConclusionBoth one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years.Clinical significanceHEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity. However, this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex. In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a HEMA-rich and HEMA-free one-step adhesive.