NaOCl degradation of a HEMA-free all-in-one adhesive bonded to enamel and dentin following two air-blowing techniques

OBJECTIVE: Phase-separation within HEMA-free all-in-one dental adhesives may result in the entrapment of droplets within the adhesive resin. Strongly air-blowing prior to polymerization, can remove most of these droplets. The objective of this study was to evaluate the effect these droplets may have on the resistance of the adhesive-tooth interface to NaOCl degradation. METHODS: The micro-tensile bond strength (microTBS) to enamel and dentin was determined when a HEMA-free all-in-one adhesive was applied either following a mild or strong air-blowing technique. The bonds were also exposed to an aqueous sodium hypochlorite (NaOCl) solution for 1h, following a recently introduced methodology to mimic in vivo bond degradation. RESULTS: This study revealed that strong air-blowing of the adhesive only resulted in a significantly higher micro-tensile bond strength (microTBS) to dentin, but not to enamel. Likewise, NaOCl only reduced the microTBS to dentin for both the mild and strong air-blowing technique, but again not the microTBS to enamel. Failure analysis by SEM clearly revealed that strong air-blowing is less effective in droplet removal when the adhesive was applied in small and narrow class-I cavities, as compared to when it was applied to flat surfaces. CONCLUSIONS: NaOCl did preferentially dissolve the hybrid layer at dentin, and more for the mild than for the strong air-blowing technique. A strong air-blowing procedure resulted in a more NaOCl-resistant hybrid layer, so that it can be concluded that a HEMA-free one-step adhesive definitely benefits from a strong air-blowing technique.     

Clinical evaluation of non-carious cervical lesion restorations using a HEMA-free adhesive: three-year results

Background: The use of all‐in‐one resin‐based adhesives in clinical practice has continued to increase. The aim of this study was to evaluate retention and marginal staining of a HEMA‐free all‐in‐one adhesive Go! (SDI, Australia) and Ice resin composite in non‐carious cervical lesions (NCCLs). Methods: Forty‐one restorations were placed in 13 patients (age range 44–72 years). Human Ethics Committee approval from the University of Melbourne and Dental Health Services Victoria was obtained. Restorations were bonded and placed according to the manufacturer’s instructions. Enamel etching was performed on NCCL margins after cleaning with pumice and water. Patients were recalled at six months and one, two and three years. Restorations were evaluated for retention and marginal staining, and photographic records of restorations were obtained. Results: At three years, six patients were available for recall with 23 restoration sites reviewed. At the six‐month recall, three restorations had been lost, with a further two lost at two years. At three years, an overall cumulative retention rate of 85% was calculated using survival analysis. Fifteen of the 23 restorations showed slight marginal staining. Conclusions: At three years, the overall retention rate of 85% indicates a satisfactory result for this new adhesive. Marginal staining was regarded as minimal.     

In vivo degradation of resin-dentin bonds produced by a self-etch and an etch-and-rinse adhesive

Resin-dentin bonds are known to degrade in the relatively aggressive oral environment. In order to obtain greater insight into the interfacial degradation process, we examined, by using transmission electron microscopy (TEM), the interfacial ultrastructure of two adhesives bonded to dentin after 1 yr in vivo. Class V cavities were prepared on the buccal surfaces of 14 intact teeth of two monkeys and then restored by using either the two-step self-etch adhesive, Unifil Bond, or the two-step etch-and-rinse adhesive, Single Bond, in combination with the restorative microhybrid composite, Z250. After 1 yr, 10 other teeth were restored by using the same materials (controls). One day later, the monkeys were killed, following which the microtensile bond strength to dentin was determined and the interfacial ultrastructure was examined by TEM. Whereas no noticeable changes in the morphology of the resin-dentin interface were observed between the 1-d and 1-yr specimens for Unifil Bond, Single Bond exhibited signs of interfacial degradation, in particular at the bottom of the 3 microm-deep hybrid layer. In conclusion, the adhesive interface produced by the etch-and-rinse adhesive was less resistant to degradation than that produced by the self-etch system.     

Bonding durability of HEMA-free and HEMA-containing one-step adhesives to dentine surrounded by bonded enamel

OBJECTIVE: To evaluate the bonding durability of HEMA-free and HEMA-containing one-step adhesives to dentine surrounded by bonded enamel after 1-year storage in water. MATERIAL AND METHOD: Flat coronal dentine surfaces of extracted human molars were prepared, leaving the surrounding enamel. Two one-step self-etch adhesive systems: HEMA-containing Tri-S Bond (TSB; Kuraray Medical Inc., Tokyo, Japan) and HEMA-free G Bond (GB; GC Co., Tokyo, Japan), were applied to both dentine and the surrounding enamel surfaces according to manufacturers' instructions. Following resin composite crown (Clearfil AP-X, Kuraray Medical Inc., Tokyo, Japan) build-ups, the bonded specimens were stored in 37 degrees C water for 24h (control group), 3 months, 6 months and 1 year. After the designated periods of water storage, the specimens were serially sectioned perpendicular to the adhesive interface into 0.7 mm thick slabs, and then trimmed to form hour-glass configurations with a 1mm2 cross-sectional area. The micro-tensile bond strength (muTBS) test was carried out at a crosshead speed of 1.0mm/min. The muTBS data were statistically analyzed using two-way ANOVA, t test, and Tukey's HSD post hoc multiple comparison tests (alpha=0.05). RESULTS: After 1 year water of storage, the bond strength of TSB to dentine was significantly lower compared with the 1-day, 3-month and 6-month groups (p<0.05). On the other hand, the muTBS of GB decreased over time, but there was no significant difference between the experimental periods (p>0.05). CLINICAL SIGNIFICANCE: Bonded enamel margins may not maintain the integrity of the resin-dentine interface created by HEMA-free and HEMA-containing one-step adhesives.     

In vivo degradation of resin-dentin bonds produced by a self-etch vs. a total-etch adhesive system

The purpose of this study was to evaluate the long-term durability of in vivo bond strengths and the morphological changes of interfaces between dentin and two adhesive systems. Class V preparations were prepared on the facial surfaces of 14 intact teeth of two monkeys and restored with a combination of Unifil Bond/Z250 or Single Bond/Z250. One year later, 10 additional teeth were restored with the same materials and the monkeys were killed after 24 h. All of the restored teeth were subjected to microtensile bond strength ( micro TBS) testing. The debonded surfaces of the dentin sides were morphologically observed using Fe-scanning electron microscopy (SEM), as were the polished cross-sections of resin-dentin interfaces. For both Unifil Bond and Single Bond, the micro TBS at 24 h was significantly higher than that at 1 yr. Fe-SEM observations of polished cross-sectioned and fractured surfaces showed that porosity within the hybrid layers produced by Single Bond increased over time. However, the interface produced by Unifil Bond revealed no noticeable changes in morphology between 24-h and 1-yr specimens. It is concluded that even though the bond strengths of both adhesive systems declined over time, the bonding interface using self-etching primers was relatively stable over time compared to the wet bonding system.     

Hardness,elasticity and ultrastructure of primary tooth dentin bonded with a self-reinforcing one-step self-etch adhesive

Objective

This study evaluated the interfacial quality of sound and caries-affected primary tooth dentin bonded with a self-reinforcing one-step self-etch adhesive.

Methods

Non-carious, sound dentin was prepared with water-cooled high-speed diamond burs. Caries-infected dentin was removed with water-cooled low-speed round steel burs and hand instrument. Dentin was bonded with Bond Force (Tokuyama Dental). A nano-indentation tester was employed for determination of hardness (H) and Young's modulus (Y) of resin–dentin interface. Similar resin–dentin interfaces were examined with a SEM/EDX, and with a TEM using ammoniacal silver nitrate tracer for nanoleakage.

Results

In the comparison of the H and Y values between the interfacial dentin and the underlying mineralized dentin, no significant difference was seen in caries-affected dentin, however, the values of the interfacial dentin were significantly lower in sound dentin. The H value of the interfacial dentin of sound dentin was significantly lower than that of caries-affected dentin with significantly higher Ca content. No significant difference was observed in the Y values of the interfacial dentin of the two substrates. For both sound and caries-affected dentin, TEM revealed silver deposits in the interfacial dentin and adhesive layer, and smear layer remained within the resin–dentin interface. However, Ca and P contents of the adhesive layer at 10 μm above the dentin surface were the same as those present in the interfacial dentin.

Conclusions

Both for sound teeth and caries teeth, Bond Force does not prevent the nanoleakage along the resin–dentin interface.     

Development of experimental HEMA-free three-step adhesive system

Objective

To evaluate the influence of Bis-EMA 30 on the resin-to-dentin microtensile bond strength (μTBS) and structural reliability of the experimental three-step etch-and-rinse adhesive systems.

Methods

Five experimental primers containing different dimethacrylate monomer concentrations (0, 10, 20, 40, 60 wt% of the Bis-EMA 30, P0.P60) added to acid monomer and solvents (ethanol/water), and a resin bond (Bis-GMA/TEGDMA, 50/50 wt%) were formulated. The adhesive system Scotchbond™ MultiPurpose (SBMP, 3M ESPE) was tested as commercial reference. Sixty bovine incisors were randomly separated into six groups, and their superficial coronal dentin was exposed. After acid etching and rinsing, the excess water was removed from the surface with absorbent paper. Each experimental primer was actively applied (30 s), followed by a mild air stream (10 s). The experimental adhesive resin was applied and light activated for 20 s. Resin composite restorations were incrementally built up. The restored teeth were stored in distilled water at 37 °C for 24 h, and then sectioned to obtain sticks with a cross-sectional area of approximately 0.5 mm², after which 24 specimens per group were subjected to the μTBS test. Data (MPa) were analyzed by One-way ANOVA, Tukey test (α = 0.05) and Weibull analysis.

Results

The P40 group showed μTBS means similar to those of the control (SBMP), whereas both had statistically higher values when compared with the other groups (p < 0.001). Moreover, P40 showed higher structural reliability, represented by the high Weibull modulus and characteristic strength values. The lowest μTBS was observed in the P0, P10 and P20 groups, which also had low structural reliability.

Significance

Bis-EMA 30 is a promising monomer to be considered as a substitute for HEMA in adhesive system compositions.     

Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions

Despite the fact that one-step adhesives are currently used routinely in clinical practice, long-term studies on their clinical performance are scarce. The objective of this randomized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch-and-rinse adhesive. Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite (Gradia Direct; GC). These restorations were bonded in random order either with the HEMA-free one-step adhesive G-Bond (GC) or with the 'gold-standard' (control) three-step adhesive Optibond FL (Kerr). The restorations were evaluated after 6, 12, 24, and 36 months of clinical service regarding retention, marginal adaptation, microleakage, caries occurrence, and sensitivity. After a medium-long period of 3 yr, similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive. However, the one-step adhesive exhibited significantly more incisal marginal defects and discolorations. Whereas marginal degradation appeared to arrest for the multistep etch-and-rinse adhesive after 12 months, the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate. These incisal marginal defects were, however, small and could easily be removed by polishing. For both adhesives, large and sclerosed lesions appeared to be at higher risk of retention loss.     

Five-year clinical performance of a HEMA-free one-step self-etch adhesive in noncarious cervical lesions

Objectives

The objective of this randomized controlled trial was to evaluate the clinical performance of a 2-hydroxyethyl methacrylate (HEMA)-free one-step adhesive.

Materials and methods

Two hundred sixty-seven cervical lesions in 52 patients were restored with the composite Gradia Direct (GC), bonded with either the one-step self-etch adhesive G-Bond (GC) or the three-step etch-and-rinse adhesive Optibond FL (Kerr) in a random order. The restorations were evaluated for retention, marginal integrity, marginal discoloration, and caries occurrence after 5 years. Specific statistics were used to account for the clustered data (multiple restorations per patient).

Results

The clinical success rate for G-Bond (87.4 %) was not significantly different from that of Optibond FL (90.9 %). Both adhesives showed progressive marginal deterioration, but G-Bond exhibited more small enamel defects and marginal discoloration, and unlike previous recalls, several restorations failed because of deep microleakage. Large sclerotic lesions were a significant risk factor for retention loss with G-Bond. Irrespective of the adhesive, almost all restorations with retention loss were located in the lower jaw.

Conclusion

After 5 years of clinical service, restorations bonded with the HEMA-free one-step adhesive did not need repair or replacement more often than those with the three-step etch-and-rinse adhesive, and both adhesives had a high retention rate (>90 %). There were indications that G-Bond did not (self-)etch enough in some clinical situations, as G-Bond exhibited more incisal defects and marginal discolorations, and sclerotic lesions were at higher risk of retention loss.

Clinical relevance

The clinical performance of the HEMA-free one-step adhesive was clinically acceptable after 5 years.     

A 6-year prospective evaluation of a one-step HEMA-free self-etching adhesive in Class II restorations

Objective

The aim of this study was to evaluate the clinical effectiveness of a one-step HEMA-free self-etching adhesive (SEA) placed with a micro-fine hybrid resin composite in Class II restorations. The restorations were compared intraindividually with 2-step HEMA containing SEA-giomer restorations.

Material and methods

Fifty-four patients with at least one pair of two similar Class II cavities participated (30 men, 24 women; mean age 57.1 yrs). A total of 115 Class II composite restorations were placed with (1) a one step HEMA-free adhesive and a micro-fine hybrid resin composite (Gbond/Gradia Direct: 60; GG) and (2) a 2-step HEMA-containing SEA and a giomer (FL Bond/Beautifil: 55; FB). Each participant received in a randomized way at least one restoration with each of the experimental materials. The restorations were evaluated at baseline and yearly during a 6 year followup using modified USPHS criteria.

Results

During the 6 years, 111 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Fourteen failed restorations (12.6%) were observed during the follow up, 5 GG (8.5%; 4 premolar and 1 molar teeth) and 9 FB (17.7%; 1 premolar and 8 molar teeth) (p < 0.05). Annual failure rate at 6 years were 1.4% for GB and 3.0% for FB. Main reasons of failure were bulk fracture of resin composite for FB and tooth fracture for GB.

Significance

The HEMA-free SEA-hybrid RC restorations showed good clinical durability in Class II cavities after 6 years. The HEMA-containing SEA-giomer restorations showed a rather high failure frequency.     

Influence of enamel border and regional variability on durability of resin-dentin bonds

OBJECTIVES: To evaluate the influence of enamel border on regional resin-dentin microtensile bond strength (muTBS) over time. METHODS: Thirty human third molars had a flat dentine surface exposed. Two adhesive systems (Single Bond [SB] and ScotchBond Multi Purpose Plus [SBMP]) were applied and composite resin crowns (Filtek Z250) were constructed. Teeth were divided into three groups (n=5). Group A, specimens were sectioned to obtain sticks to be tested in tension (0.5mm/min) immediately. Group B specimens were stored without outer enamel in water for 6 months, before sectioning and testing. Group C, specimens were stored with outer enamel in water for 6 months, before sectioning and testing. In all groups, the origin of the sticks, periphery and inner regions was controlled. The data for each adhesive were subjected to a two-way repeated measure ANOVA (location versus storage conditions) and Tukey's test. RESULTS: No significant degradation in muTBS was observed for SBMU in all conditions. For SB, a significant reduction on muTBS was observed in the specimens without enamel border (group B). The degradation was more pronounced in the specimens from the periphery. CONCLUSIONS: The three-step etch-and-rinse system is less susceptible to water degradation effects; stable resin-dentin bonds can be achieved with two-step etch-and-rinse systems as long as there is a bonded enamel border.     

Effect of air-drying and solvent evaporation on the strength of HEMA-rich versus HEMA-free one-step adhesives

OBJECTIVES: The objectives of this study were (1) to clarify the relationship between the duration of air-drying of one-step self-etch adhesives (1-SEAs) and the evaporation degree (ED) of solvents, and (2) to evaluate the effect of ED on the ultimate micro-tensile strength (muTS) of the adhesives. METHODS: The ED of one HEMA-rich 1-SEA, Clearfil S(3) Bond (Kuraray), and two HEMA-free 1-SEAs, iBond (Heraeus-Kulzer) and G-Bond (GC), was determined without air-drying and after, respectively, 5- and 10-s air-drying using a gravimetric method. Next, the muTS of the adhesives at ED equivalent to 0-, 5- and 10-s air-drying was measured. RESULTS: The ED increased with extension of air-drying time. Among the adhesives tested, iBond showed the largest ED, followed by G-Bond and Clearfil S(3) Bond in this order. A longer air-drying time for 10-s resulted in a statistically significantly higher muTS for the HEMA-rich Clearfil S(3) Bond. The muTS of the latter was higher than that of the other two HEMA-free adhesives for each air-drying time. SIGNIFICANCE: Air-drying of 1-SEAs had a significant effect on the degree of solvent evaporation (ED) and also on the mechanical properties (muTS) of the 1-SEAs upon setting. It is therefore beneficial to remove solvents of the 1-SEAs as much as possible by thorough, strong air-drying in order to achieve a strong adhesive layer at the interface.     

In vivo degradation of resin-dentin bonds in humans over 1 to 3 years

The longevity of resin restorations is currently an area of great interest in adhesive dentistry. However, no work has been conducted to investigate the durability of resin-dentin bond structures using human substrate in vivo. The purpose of this study was to investigate the degradation of the resin-dentin bond structures aged in an oral environment for 1, 2, or 3 years. Cavities were prepared in primary molars, and an adhesive resin system (Scotchbond Multi-Purpose) was applied to the cavity. After 1 to 3 years, following the eruption of the succedaneous permanent teeth, the resin-restored teeth were extracted. Immediately after extraction, those teeth were sectioned perpendicular to the adhesive interface and trimmed to produce an hourglass-shaped specimen. Then, a micro-tensile test was performed at a crosshead speed of 1.0 mm/min. The mean bond strengths were statistically compared with one-way ANOVA and Fisher's PLSD test (p < 0.05). Further, all fractured surfaces were observed by SEM, and the area fraction of failure mode was calculated by means of a digital analyzer on SEM photomicrographs. There were significant differences in tensile-bond strength among all 3 groups (p < 0.05), with mean values ranging from 28.3 +/- 11.3 MPa (control), to 15.2 +/- 4.4 MPa (1 to 2 years), to 9.1 +/- 5.1 MPa (2 to 3 years). Moreover, under fractographic analysis, the proportion of demineralized dentin at the fractured surface in specimens aged in an oral environment was greater than that in control specimens. Furthermore, degradation of resin composite and the depletion of collagen fibrils was observed among the specimens aged in an oral environment. Analysis of the results of this study indicated that the degradation of resin-dentin bond structures occurs after aging in the oral cavity.     

A randomized controlled clinical trial of a HEMA-free all-in-one adhesive in non-carious cervical lesions at 1 year

OBJECTIVES: One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard). METHODS: Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the 'all-in-one' adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient). RESULTS: The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond. CONCLUSIONS: After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects.     

Evaporating solvents with a warm air-stream: effects on adhesive layer properties and resin-dentin bond strengths

OBJECTIVES: This study evaluated the effect of a warm or cold air-dry stream for solvent evaporation on the microtensile resin-dentin bond strength (muTBS), nanoleakage pattern (SEM), degree of conversion (DC) and solvent evaporation rates (SE) of an ethanol/water- (Adper Single Bond, [SB] 3MESPE) and an acetone-based (Prime & Bond 2.1, [PB] Dentsply), two-step etch-and-rinse adhesive system. MATERIALS AND METHODS: Adhesives were applied on demineralized dentin surfaces. For SE, a warm or cold air-dry stream (10 s) was applied prior to light-activation (10 s). Bonded sticks (0.8mm2) were tested in tension (0.5 mm/min). Two bonded sticks from each tooth were immersed in a 50% (w/v) solution of silver nitrate (24 h), photodeveloped (8 h) and analyzed by SEM. The DC and solvent evaporation rate of the adhesives were evaluated under FTIR and analytical balance, respectively. Data were analyzed by two-way ANOVA and Tukey test (alpha=0.05). RESULTS: Higher muTBS and lower nanoleakage were observed when the SE step was performed with warm air-dry stream. However, the DC of the adhesives was not altered by the use of a warm air-dry. CONCLUSIONS: The use of a warm air-dry stream seems to be a clinical tool to improve the bond strength and the quality of the hybrid layer (less nanoleakage infiltration), since it might reduce the number of pores within the adhesive layer.     

The effect of warm air-blowing on the microtensile bond strength of one-step self-etch adhesives to root canal dentin

Purpose

The use of warm air-blowing to evaporate solvents of one-step self-etch adhesive systems (1-SEAs) has been reported to be a useful method. The purpose of this study was to evaluate the effect of warm air-blowing on root canal dentin.

Microrotary fatigue resistance of a HEMA-free all-in-one adhesive bonded to dentin

PURPOSE: To determine the effect of thorough air drying on the static and dynamic bonding effectiveness of a HEMA-free all-in-one adhesive bonded to Class-1 cavity-bottom dentin. MATERIALS AND METHODS: G-Bond (GC, Japan) was applied to standard occlusal Class I cavities following either a gentle (1 bar) or strong (4 bar) air-drying technique. After restoring the cavity using a composite resin (Gradia Anterior, GC), microspecimens were prepared that were loaded until failure or inserted in a microrotary fatigue testing device. RESULTS: Strong air drying had no effect on the static (39.1 vs. 38.4 MPa) or the dynamic (19.0 vs. 18.6 MPa) strength of the interface complex. CONCLUSION: Strong air drying did not improve the static or the dynamic bonding effectiveness, although a very thorough (4 bar) and long air-drying procedure was employed. SEM analysis revealed that even when the adhesive was strongly air dried, droplets originating from phase separations could still be observed, albeit to a reduced extent. Ineffective drying and pooling of the adhesive in a narrow cavity diminished the effect of strong air drying of the all-in-one adhesive.     

The role of HEMA in one-step self-etch adhesives

In spite of its high allergenic potential, 2-hydroxyethyl methacrylate (HEMA), a low-molecular-weight monomer, is frequently used in adhesives for its positive influence on the bond strength. In addition, the presence of HEMA in one-component one-step adhesives can prevent phase separation. OBJECTIVES: In search of improved bonding effectiveness, the 24-h bond strength of four experimental one-step self-etch adhesives with different concentrations of HEMA to bur-cut enamel and dentin was determined using a micro-tensile bond strength protocol. METHODS: The tested experimental adhesives (Exp-0, Exp-10, Exp-19 and Exp-36) only differed in their concentration of HEMA, which was 0, 10, 19 and 36%, respectively. With an increasing concentration of HEMA, the concentration of acetone was decreased. Besides bond strength, the adhesives were also examined by light-microscopy for phase separation. The interface was investigated by SEM and TEM. RESULTS: Regarding bond strength, Exp-10 performed best. Even though Exp-36 was the only adhesive formulation that did not exhibit phase separation on a glass plate, it yielded the lowest bond strength. Accordingly, droplets could be observed by SEM and TEM in the adhesive layers of all adhesives, except for Exp-36 on enamel. CONCLUSION: A small amount of HEMA (10%) improved the bond strength of a one-step self-etch adhesive. When added in higher concentrations, this beneficial effect of HEMA on the bond strength is lost due to increased osmosis, which resulted in many droplets; due to reduced polymerization conversion; and sub-optimal physico-mechanical properties of the resultant poly-HEMA containing adhesive interface.     

Adhesive performance of a multi-mode adhesive system: 1-Year in vitro study

Objectives

The aim of this study was to investigate the adhesive stability over time of a multi-mode one-step adhesive applied using different bonding techniques on human coronal dentine. The hypotheses tested were that microtensile bond strength (μTBS), interfacial nanoleakage expression and matrix metalloproteinases (MMPs) activation are not affected by the adhesive application mode (following the use of self-etch technique or with the etch-and-rinse technique on dry or wet dentine) or by ageing for 24 h, 6 months and 1 year in artificial saliva.

Methods

Human molars were cut to expose middle/deep dentine and assigned to one of the following bonding systems (N = 15): (1) Scotchbond Universal (3M ESPE) self-etch mode, (2) Scotchbond Universal etch-and-rinse technique on wet dentine, (3) Scotchbond Universal etch-and-rinse technique on dry dentine, and (4) Prime&Bond NT (Dentsply De Trey) etch-and-rinse technique on wet dentine (control). Specimens were processed for μTBS test in accordance with the non-trimming technique and stressed to failure after 24 h, 6 months or 1 year. Additional specimens were processed and examined to assay interfacial nanoleakage and MMP expression.

Results

At baseline, no differences between groups were found. After 1 year of storage, Scotchbond Universal applied in the self-etch mode and Prime&Bond NT showed higher μTBS compared to the other groups. The lowest nanoleakage expression was found for Scotchbond Universal applied in the self-etch mode, both at baseline and after storage. MMPs activation was found after application of each tested adhesive.

Conclusions

The results of this study support the use of the self-etch approach for bonding the tested multi-mode adhesive system to dentine due to improved stability over time.

Clinical significance

Improved bonding effectiveness of the tested universal adhesive system on dentine may be obtained if the adhesive is applied with the self-etch approach.