Effect of 35% Sodium Ascorbate Treatment on Microtensile Bond Strength after Nonvital Bleaching

The purpose of this study was to analyze the influence of 10% sodium ascorbate (SA) on the hybrid layer, resin tag length, and bond strength to dentin after bleaching. Six groups were tested: G C, control; G SA, sodium ascorbate (SA) + restoration; G CP, bleaching with carbamide peroxide (CP) + restoration; G CP+SA, bleaching with CP + SA+ restoration; G HP, bleaching with 35% hydrogen peroxide (HP) + restoration; and G HP+SA, HP + SA + restoration. After dental bleaching, the dentin was exposed and the antioxidant solution was applied to groups G SA, G CP+SA, and G HP+SA, before bonding procedures. The teeth were sectioned in the mesiodistal direction. One section was decalcified, and the specimens were embedded in paraffin and sectioned in the longitudinal direction with a thickness of 6 μm. Fifteen slices of each specimen were selected according to a systematic sample of slices with an interval proportional to the total number of slices obtained for each tooth. The specimens were stained using the Brown & Brenn method, and an optic microscope was used to analyze the hybrid layer thickness and resin tag length. The remaining tooth segment was sectioned into stick-shaped specimens and used for microtensile bond strength testing (0.5 mm/min). Statistical analysis was performed using two-way analysis of variance and Fisher test. The results for hybrid layer + tag formation (in micrometers) were G C, 13.27 Aa; G SA, 11.85 Ba; G CP, 6.84 Bb; G CP+SA, 9.02 Ab; G HP, 7.28 Bb; and G HP+SA, 9.22 Ab; bond strength results (in MPa) were G C, 49.5 Aa; G SA, 51.7 Aa; G CP, 37.16 Bb; G CP+SA, 47.69 Aa; G HP, 32.39 Ab; and G HP+SA, 39.67 Ab. Tooth bleaching with CP or HP impairs the formation of the hybrid layer and resin tags and reduces the microtensile bond strength. Statistically, the use of SA significantly increases the hybrid layer thickness and resin tag length. The microtensile bond strength values for carbamide peroxide increased, but the microtensile bond strength for hydrogen peroxide was not affected.

The aim of this study is to assess the effect of 35% sodium ascorbate on microtensile bond strength of dentin immediately after bleaching with 35% hydrogen peroxide. A total of 25 sound human 3rd molars were collected. Teeth were randomly divided into five groups for different treatments: Group I [bleaching + immediate bonding (i.e., restoration)], group II (bleaching + delayed bonding), group III(bleaching + sodium ascorbate + immediate bonding), group IV (bleaching + sodium ascorbate + delayed bonding), and group V (bonding only). After bleaching, but before bonding, groups II and IVwere stored for 1 week in deionized water at 37°C. All samples were bonded using OptiBoned FL (Kerr) and Filtek Supreme (3M/ESPE). Teeth were sectioned into 1 × 1 mm 2 bars, and microtensile bond strength was tested with a universal testing machine (Instron 8841) at a cross-head speed of 0.5 mm/minute. Microtensile bond strength differed significantly across the five groups, with a significant reduction in microtensile bond strength observed for samples in group I relative to samples in any of the other treatment groups (p < 0.05). The application of a high concentration of sodium ascorbate for a shorter time reversed the negative effect of 35% hydrogen peroxide bleaching on composite bonding strength to dentin. The negative effects of bleaching on composite bonding can be neutralized by the application of the reversing agent sodium ascorbate thus, increasing the efficiency of clinic chair time. This is clinically relevant for those patients requiring restorative treatment immediately after in-office bleaching.

Introduction. Dental bleaching is the first choice to improve smile esthetics, but, in some cases, it needs to be associated with resin composite restoration to obtain a satisfactory result. Unfortunately, the bonding of resin-based materials can be impaired due to residual oxygen molecules, which can decrease the durability of the restoration. Objectives. To evaluate the effect of the antioxidant application on the bond strength of bleached enamel after 24 hr and 3 years of water storage. Methods. In total, 84 bovine teeth were used in this study. Of these, 77 were bleached with 35% hydrogen peroxide in a single session for three cycles of 15 min. Then, the specimens were divided into groups (n = 7 each): control (without bleaching), without antioxidant (WA) use; application of 10% sodium ascorbate (SA) gel, grape seed (GS) extract, and aloe vera (AV). The restorative procedure was performed immediately after bleaching, 7 and 14 days after bleaching. Specimens were sectioned and evaluated using microtensile bond strength (μTBS). Half of the resin-enamel sticks were tested after 24 hr, and the remaining half after 3 years of water storage. µTBS data were analyzed using a three-way analysis of variance, Tukey’s test, and Dunnett’s test. Results. The lowest µTBS values were observed when the restoration was performed immediately after bleaching in the AV, GS, and WA groups when compared with the SA group ( p &lt; 0.005 ). However, no significant differences were observed among all groups after 3 years of water storage ( p &lt; 0.001 ). Conclusions. SA at 10% was the most effective antioxidant agent for improving the immediate bond strength. However, independent of the antioxidant agent used, the bond strength values were maintained or recovered after 3 years of water storage. SA at 10% could be used to avoid delayed bonding procedures after in-office whitening without compromising bond strength over time. Clinical Significance. The use of antioxidants after dental bleaching can be effective in improving the bonding durability of the adhesive restorations.

To evaluate the effect of mechanical loading on the microtensile bond strength (MTBS) of five adhesive systems to dentin. Flat dentin surfaces from human molars were divided into five groups and bonded with total-etch self-priming adhesives (Single Bond, Prime&Bond NT and Prime&Bond XP), two-step self-etching primer (Clearfil SE Bond) and an all-in-one adhesive (Etch&Prime 3.0), according to the manufacturers' instructions. Composite build-ups were constructed incrementally with Tetric Ceram. After 24 hours of water storage, half the specimens were load cycled (5000 cycles, 90 N). The teeth were then sectioned into beams of 1.0 mm2 cross-sectional area. Each beam was tested in tension in an Instron machine at 0.5 mm/minute. Data were analyzed by two-way ANOVA and Student Newman Keuls multiple comparisons tests (p<0.05). Clearfil SE Bond and Single Bond attained higher MTBS than the other three adhesives. Prime&Bond NT and Prime&Bond XP performed equally, and Etch&Prime 3.0 resulted in the lowest MTBS. After mechanical loading, MTBS decreased in all groups except Prime&Bond XP. Clearfil SE Bond, Single Bond and Prime&Bond XP obtained higher MTBS than Prime&Bond NT. Specimens bonded with Etch&Prime 3.0 resulted in premature failures and MTBS could not be measured. When using Etch&Prime 3.0, bond structures did not withstand mechanical loading, which may have an influence on the long-term success of restorations. If dentin is acid-etched, alcohol-based adhesive systems showed higher bond strength after mechanical loading.

We investigated the effect of sodium ascorbate (SA) on the microtensile bond strengths (MTBSs) of different composites to bovine enamel after vital bleaching with hydrogen peroxide (HP) or carbamide peroxide (CP). Thirty bovine incisors were randomly divided into five groups and treated with no bleaching application (control), 35% HP alone, 35% HP+10% SA for 10 minutes (HP+SA), 16% CP alone, or 16% CP+10% SA for 10 minutes (CP+SA). Specimens were restored with Silorane adhesive and Filtek Silorane composite (designated as S/group) or with Clearfil SE bond and Filtek Supreme XT (designated as F/group). Composite build-up was created on the enamel. Sectioned specimens (n=10 per group; 1 mm2; cross-sectional area) were created and stressed in a universal testing machine at 1 mm/min crosshead speed. The application of 10% SA immediately after bleaching with 16% CP or 35% HP increased the enamel MTBS, regardless of the adhesive/composite resin used. The resulting MTBS values were similar to those of the control groups. Use of 16% CP and 35% HP alone decreased the enamel MTBS, regardless of the adhesive/composite resin used, with F/CP+SA=F/HP+SA=F/CP=S/CP+SA=S/HP+SA=S/C>S/CP=S/HP=F/CP=F/HP (p<0.05). We concluded that the application of SA for 10 minutes immediately after vital bleaching increases the enamel BS for dimethacrylate- and silorane-based composites.

The purpose of this study was to evaluate the effect of vitamin C containing sodium ascorbate prepared solution on dentin bond strength of resin composite to non-vital bleached tooth and on fracture resistance of restored non-vital bleached tooth. Sixty (30 pairs, left and right) extracted sound human maxillary premolar teeth were collected from 30 patients. All teeth were endodontically treated and each pair was randomized assigned into microtensile bond strength and fracture resistance tests. The teeth were divided into 3 groups for each test which were 1) non-bleach tooth, 2) bleached with 35% hydrogen peroxide and immediately restored with resin composite, and 3) bleached with 35% hydrogen peroxide, followed by application of 10% vitamin C prepared solution and immediately restored with resin composite. Samples of microtensile bond strength test were cut to obtain stick-shaped specimens and tested with a universal testing machine. Samples of fracture resistance test were embedded in acrylic resin with simulated periodontal ligament before subjecting to an axial compression test in the universal testing machine. Results showed that the bleached tooth followed by 10% vitamin C solution application group had the highest microtensile bond strength (55.566 ± 3.514 MPa) while the bleached group had the significant lowest bond strength (36.571± 2.609 MPa). The non-bleached group showed the highest fracture strength (1053.44 ± 183.65 N) and the bleached group had significant less strength (616.98 ± 97.07 N). There was no significant difference between the non-bleached group and vitamin C solution application group in both microtensile bond strength and fracture strength tests (p&gt;0.05). The most failure mode in the microtensile bond strength test for all groups was adhesive failure and was favorable failure in the fracture resistance test. The microtensile bond strength was positively correlated to the fracture resistance (r=0.639, p&lt;0.001). In conclusion, the use of 10% vitamin C containing sodium ascorbate prepared solution could increase the microtensile bond strength and fracture strength of non–vital bleached tooth comparable to non-bleached tooth.

AimThis study evaluated the effect of sodium ascorbate (SA) on the proteolytic activity of matrix metalloproteinases (MMPs) and investigated the related effects on the bond strength of bleached dentin.Materials and methodsEighty freshly extracted human third molars were randomly divided according to treatment (bleaching or SA application), type of analysis (microshear or measuring MMP activity), and post-bleaching time to assess bond strength (24 hrs or 30 days). Data from both analyses were subjected to one-way analysis of variance to detect differences among groups, followed by Tukey’s multiple comparison test (p≤0.05).ResultsDental bleaching significantly reduced bond strength values when the adhesive strategy was performed after 24 hrs (despite the SA treatment) or 30 days after the bleaching procedure. However, after 30 days, the bond strength values of the groups who received bleaching or SA application were similar to those of the unbleached group. Dental bleaching caused the activation of MMPs, and SA did not influence this activity.ConclusionIt was concluded that SA does not affect the activity of MMPs or the bond strength in bleached dentin immediately after the bleaching treatment.

Objectives:The objective was to assess the shear bond strength (SBS) of composite resins on stainless steel brackets immediately bonded to previously bleached teeth with 35% hydrogen peroxide and to compare the neutralization effect of various antioxidant agents on the bond strength after bleaching.Materials and Methods:One hundred sound human maxillary premolars were used for the study. Teeth were divided into 5 groups (n = 20); Group 1 (control), Group 2 (bleach treatment), Group 3 (sodium ascorbate treatment), Group 4 (tocopherol acetate treatment), and Group 5 (retinol acetate treatment). Teeth in Group 3, 4, and 5 were treated as in Group 2, but after that and before bleaching received treatment with sodium ascorbate, tocopherol acetate, and retinol acetate, respectively. Subsequently, teeth were bonded with stainless steel brackets (Ormco) using 3M Transbond XT. After 24 h, each specimen was loaded into a universal testing machine to determine the SBS at debonding. The data were exposed to the analysis of variance, Bonferroni, and Weibull Analysis.Result:There significant SBS difference (P = 0.000, F = 32.125) between various groups. Group 1 had the highest SBS (12.182 ± 1.41 MPa) and Group 2 the least SBS (6.182 ± 1.49 MPa). Significant SBS differences observed between Group 1 and 2; Group 2 and 3; Group 2 and 4; and Group 2 and 5 (P = 0.000). There was no significant SBS difference between Group 1 and 3; Group 1 and 4; and Group 3 and 4 (P = 1.000). Bonferroni results also indicated that there was a significant difference between Group 1 and 5 (P = 0.002); Group 3 and 5 (P = 0.144); and between Group 4 and 5 (P = 0.008). Weibull analysis indicated that bond strength for a 90% probability of failure, which was highest for Group 1 (13.99 MPa) and lowest for Group 2 (8.49 MPa).Conclusion:The in-vitro study showed that bleaching with 35% hydrogen peroxide reduced the SBS significantly and this could be effectively reversed by the application of 10% sodium ascorbate, 10% tocopherol acetate, or 10% retinol acetate. Thus, treatment of bleached teeth with antioxidants can be a good clinical option for bonding immediately after bleaching.

This study examined the effects of different application times of sodium ascorbate (SA) on the bond strength of composite resin to bleached dentin. Specimens with an exposed dentin surface were divided into 3 groups according to the type of bleaching agent used: Group A, mixture of sodium perborate (SP) and distilled water (DW); Group B, mixture of SP and hydrogen peroxide (HP); control group, no bleaching. Each group was classified into 10 subgroups. Subgroups IB and DB underwent immediate bonding and delayed bonding, respectively. 10% SA was applied to 3, 5, 10, and 30 minutes and 1, 24, 48, and 72 hours, respectively. Microtensile bond strength (μTBS) was measured after restoration, and the data was analyzed by one-way ANOVA and Scheffé's test. Before restoration, the dentin surfaces were examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). SEM showed that most dentin surfaces were filled with crystals when SA was applied to more than 24 hours. EDS revealed peaks of calcium, carbon, oxygen, and sodium. The application of SA for 5 minutes to 48 hours or for 30 minutes to 24 hours is suggested when a mixture of SP and DW or HP is used, respectively.

To evaluate the effect of an in vitro challenge (NaOCl immersion) on microtensile bond strength (MTBS) of five adhesive systems to dentin. Flat dentin surfaces from 40 molars were bonded with three total-etch adhesives (Single Bond, Prime&Bond NT and the experimental Prime&Bond XP), and two self-etching agents (Clearfil SE Bond and Etch&Prime 3.0). Composite build-ups were constructed with Tetric Ceram. Teeth were then sectioned into beams of 1.0 mm2 cross-sectional area. Half of the beams were immersed in 10% NaOCl aqueous solution for 5 h. Each beam was tested in tension in an Instron machine at 0.5 mm/min. Data were analyzed by 2-way ANOVA and multiple comparisons tests (p < 0.05). Clearfil SE Bond and Single Bond attained higher MTBS than the other three adhesives. Prime&Bond NT and Prime&Bond XP performed equally, and Etch&Prime resulted in the lowest MTBS. After NaOCl immersion, MTBS decreased in all groups. The highest MTBS values were obtained for Clearfil SE Bond and Prime&Bond XP. Scaning electron microscopy observation of debonded sticks evidenced dissolution and microstructural alterations of intertubular dentin, except when Clearfil SE Bond was used. Resin-dentin bonds are prone to chemical degradation. The extent of the resin degradation is adhesive system specific. Chemical degradation of the nonresin infiltrated collagen fibers does also exist in total-etch adhesives. Both processes may reduce long-term resin-dentin bond strength.

This study aimed to evaluate the effect of antioxidant solutions on fracture strength and bonding performance in non-vital and bleached (38% hydrogen peroxide) teeth. One hundred and eighty dentin specimens were obtained, 60 for each test: fracture strength, hybrid layer thickness, and bond strength. The groups (n=10) were randomly composed according to post-bleaching protocol: REST - restoration, without bleaching; BL - bleaching + restoration; SA - bleaching, 10% sodium ascorbate solution, and restoration; AT - bleaching, 10% α-tocopherol solution, and restoration; CRAN - bleaching, 5% cranberry solution, and restoration; CAP - bleaching, 0.0025% capsaicin solution, and restoration. Data were analyzed with ANOVA, Kruskal-Wallis, Dunn, and Qui-Square tests (α=0.05). The highest fracture strength values were observed in REST (1508.96 ±148.15 N), without significant difference for the bleached groups (p>0.05), regardless of the antioxidant use. The hybrid layer thickness in the group that was not subjected to bleaching (REST) was significantly higher than in any other group. The bond strength in the bleached and antioxidants-treated groups (SA, AT, CRAN, CAP) has no differences with the bleached group without antioxidants (BL). Adhesive failures were predominant in the groups that did not receive the antioxidant application. In conclusion, the evaluated antioxidants did not show an effect on the fracture strength, hybrid layer thickness, or bond strength of dentin bleached after endodontic treatment. The application of 10% sodium ascorbate, 10% alpha-tocopherol, 5% cranberry, or 0.0025% capsaicin solutions is not an effective step and should not be considered for the restorative protocols after non-vital bleaching.

To evaluate the effects of the elapsed time (ET) after nonvital bleaching (NVB) and sodium ascorbate application (10%) (SAA) on the shear bond strength of dentin to ceramic. Bovine incisors were selected, internally bleached (35% carbamide peroxide) for 9 days and submitted to the following treatments (n = 10): G1, G2, G3-luting after 1, 7, and 14 days; G4, G5, and G6-luting after SAA, 1, 7, and 14 days, respectively. G7 and G8 were not bleached: G7-luting 24 hours after access cavity sealing; G8-luting 24 hours after access cavity sealing after SAA. After NVB, the vestibular dentin was exposed and flattened. The SAA was applied to the dentin (G4, G5, G6, G8) for 10 minutes, and it was then washed and dried. The dentin was etched (37% phosphoric acid), and an adhesive system (Single Bond 2) was applied. Feldspathic ceramic discs (VM7; 4-mm diameter, 3-mm thick) were luted with a dual-resin agent (RelyX ARC, 3M ESPE Dental Products, St. Paul, MN). After 24 hours, specimens were submitted to shear test on a universal testing machine. The data (MPa) were submitted to ANOVA and Dunnet's test (5%). The means (+/- SD) obtained were (MPa): G1 (14 +/- 4.5), G2 (14.6 +/- 3.1), G3 (14 +/- 3.7), G4 (15.5 +/- 4.6), G5 (19.87 +/- 4.5), G6 (16.5 +/- 3.7), G7 (22.8 +/- 6.2), and G8 (18.9 +/- 5.4). SAA had a significant effect on bond strength (p= 0.0054). The effect of ET was not significant (p= 0.1519). G5 and G6 presented higher values than the other bleached groups (p < 0.05) and similar to G7 and G8 (p > 0.05). After NVB, adhesive luting to dentin is recommended after 7 days if sodium ascorbate has been applied prior to dentin hybridization.

Reduction in bond strength when bonding was done immediately after intracoronal bleaching procedure has been recognized. The purpose of this study is to assess the effect of antioxidants (10% sodium ascorbate (SA), 0.1M thiourea and7% sodium bicarbonate (SB)) on reversing bonding strength of composite resin to bleached dentin. Materials and method: Sixty upper 1st premolar teeth, were selected, the crowns of the teeth were embedded in acrylic resin blocks exposing a flat dentin from the buccal surface, then divided into 6 groups (10 samples each). Bleaching for the experimental groups was performed using 35% hydrogen peroxide bleaching gel (pola-office).Group A (Negative control group; dentin samples immediately bonded with composite without bleaching)Group B (Positive control group; dentin samples bleached and immediately bonded with composite). Group C (Dentin samples bleached and stored for 14 days in DDW then bonded with composite). Group D (Dentin samples bleached and treated with 10% (SA) then immediately bonded with composite). Group E (Dentin samples bleached and treated with 0.1M thiourea then immediately bonded with composite). Group F (Dentin samples bleached and treated with 7% SB then immediately bonded with composite).The shear bond strength was determine using instron testing machine. Results: Bleaching the dentin with 35 % hydrogen peroxide gel for 24 minutes resulted in reduction in bond strength of the bleached teeth when bonding was performed immediately after bleaching. Delayed bonding of composite to the bleached dentin for 14 days will result in a highly significant increase in the shear bond strength. Conclusion: Treating the bleached dentin with 10% (SA) in water base showed a highly significant increase in the shear bond strength of the composite to dentin and reversing the bond strength value to the level of the unbleached dentin. Treating the bleached dentin with 0.1M thiourea significantly increased the shear bond strength of the composite to dentin.

Introduction: In non-vital tooth bleaching, dentin is in direct contact with the bleaching agent, 1 to 3-week delay is needed to eliminate free radicals from tooth structure. The present study aimed to evaluate the effect of irradiation of Er: YAG laser on immediate microtensile bond strength of bleached dentin to composite. Methods: Sixty sounds human teeth were collected and randomly divided into 4 groups (n=15): no bleaching (NB), opalescence endo hydrogen peroxide (HP) gel bleaching, sodium perborate (SP) bleaching and laser bleaching with heydent gel (LB). The groups were divided into 3 subgroups (n=5): no surface treatment, Er: YAG laser irradiation and 10% sodium ascorbate (SA). All samples were restored and underwent microtensile bond strength testing. Statistical analysis was carried out using one-way and two-way ANOVA. Results: Bond strength in NB-SA group had a significant difference with the NB group (P<0.05) while no significant difference was noted between NB and NB-Er groups (P=0.55). Application of SA and Er: YAG laser after bleaching with SP did not enhance the bond strength (P=0.07). Conclusion: Application of SA and Er: YAG laser after HP gel bleaching significantly enhanced the bond strength. Application of Er: YAG laser after internal bleaching with HP gel could enhance the bond strength.

Influence of different surface conditioning protocols on microtensile bond strength of self-adhesive resin cements to dentin