Acid-etched Enamel Surfaces Research Articles

Building an aprismatic enamel-like layer on a demineralized enamel surface by using carboxymethyl chitosan and lysozyme-encapsulated amorphous calcium phosphate nanogels

ObjectivesThe purpose of this study was to prepare carboxymethyl chitosan (CMC) and lysozyme nanogels that could encapsulate amorphous calcium phosphate (ACP) for achieving its controlled delivery, thus forming an aprismatic enamel-like layer on the demineralized enamel surface. MethodsCMC/LYZ-ACP nanogels were developed, and the controlled delivery of ACP from the nanogels was induced by the presence of NaCl. The nanogel morphologies at various NaCl concentrations was measured by transmission electron microscopy (TEM). The particle sizes and zeta potentials (ζ-potential) of the samples were determined using a combined dynamic light scattering/particle electrophoresis instrument. Comparing the remineralization effect of the CMC/LYZ-ACP nanogels on the demineralized enamel surface with that of a fluoride treatment, the remineralization effect was examined by nanoindentation tests, X-ray diffraction (XRD), confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM). ResultsCMC/LYZ-ACP nanogels were negatively charged spherical structures with a particle size of approximately 300 nm. At high concentrations of NaCl (0.15 M), ACP was dissociated from the disassembled nanogels and transformed into hydroxyapatite (HAP). Groups treated with the CMC/LYZ-ACP nanogels showed the regeneration of an aprismatic enamel-like layer on an acid-etched enamel surface, which provided increased mechanical properties (P < 0.05) and a high impermeability (P < 0.01) compared to those of the fluoride-treated group. ConclusionsThis research provides a new idea for the stable and controllable delivery of ACP from CMC/LYZ-ACP nanogels, which can form an aprismatic enamel-like layer in situ on the surface of demineralized enamel. In regard to further clinical development, this material and method may be promising for treating early enamel caries.

Time-dependent effects after enamel fluoride application on an acid etching system in orthodontic bracket bonding.

This study investigated the effectiveness of acid etching and bond strength in an orthodontic bonding system in accordance with various time periods after 1.23% acidulated phosphate fluoride (APF) gel applications. APF gel was applied on the enamel surface of bovine teeth, which were assigned to group F0. The tooth specimens were then immersed in distilled water for 1 (F1), 7 (F7), 14 (F14), 21 (F21) and 28 (F28) days. A group without fluoride pretreatment was a control group. All groups were etched with 35% phosphoric acid and evaluated using a surface hardness tester and scanning electron microscope (SEM). A shear bond strength (SBS) test was performed using a universal testing machine, and the bond failure modes were also examined. After the 1.23% APF gel treatment, the hardness of the acid-etched enamel surface decreased as the immersion period increased. SEM images of the test groups showed etched patterns similar to control group as the immersion period increased. The SBS increased with increasing immersion period, whereas group F21 was not significantly different from the control group. Relatively high adhesive remnant index scores were identified as the ageing period increased. The present study indicated that in order to obtain suitable bond strength, it is recommended to use an acid etching-based bonding system for the fixation of orthodontic appliances on the enamel surface 21days after the use of APF gel. Fluoride pre-treatment interferes with the acid etching effects on enamel, causing a reduction in the bond strength with orthodontic brackets.

In vitro and in vivo evaluation of electrophoresis-aided casein phosphopeptide-amorphous calcium phosphate remineralisation system on pH-cycling and acid-etching demineralised enamel

Casein phosphate-amorphous calcium phosphate (CPP-ACP), as a remineralisation agent, is extensively used in managing demineralised enamel; however, its remineralisation kinetics is low. This study aimed to improve remineralisation kinetics of CPP-ACP by introducing a rapid remineralisation method with electrophoresis. In vitro, a pH-cycling enamel model was used to test remineralisation potentials of electrophoresis-aided CPP-ACP. For verifying remineralisation potentials of electrophoresis-aided CPP-ACP in vivo in a rabbit model, acid-etched enamel surface on rabbit maxillary incisors was remineralised by electrophoresis-aided CPP-ACP with 1.0 mA (group A) or 0.5 mA (group B). Both in vitro and in vivo, it was observed that electrophoresis was benefit to improve remineralisation kinetics of CPP-ACP, and the demineralised enamel was completely remineralised after 5 h. The Ca/P ratio in remineralised enamel consisted with that of hydroxyapatite, the microstructure in native enamel. Meanwhile, in vivo the micro-hardness of acid-etched enamel in group A (322.55 ± 31.90) and group B (322.55 ± 31.90) recovered up to the value of native enamel after 5 h remineralisation (p > 0.05). The Hematoxylin-eosin stain demonstrated that the electric field used in this study was safe on rabbit dental pulp. Therefore, this efficient and safe method has the potential to be applied in treating enamel deminerlisation.

Biomimetic Enamel Regeneration Mediated by Leucine-Rich Amelogenin Peptide

We report here a novel biomimetic approach to the regeneration of human enamel. The approach combines the use of inorganic pyrophosphate (PPi) to control the onset and rate of enamel regeneration and the use of leucine-rich amelogenin peptide (LRAP), a nonphosphorylated 56–amino acid alternative splice product of amelogenin, to regulate the shape and orientation of growing enamel crystals. This study builds on our previous findings that show LRAP can effectively guide the formation of ordered arrays of needle-like hydroxyapatite (HA) crystals in vitro and on the known role mineralization inhibitors, like PPi, play in the regulation of mineralized tissue formation. Acid-etched enamel surfaces of extracted human molars, cut perpendicular or parallel to the direction of the enamel rods, were exposed to a PPi-stabilized supersaturated calcium phosphate (CaP) solution containing 0 to 0.06 mg/mL LRAP for 20 h. In the absence of LRAP, PPi inhibition was reversed by the presence of etched enamel surfaces and led to the formation of large, randomly distributed plate-like HA crystals that were weakly attached, regardless of rod orientation. In the presence of 0.04 mg/mL LRAP, however, densely packed mineral layers, comprising bundles of small needle-like HA crystals, formed on etched surfaces that were cut perpendicular to the enamel rods. These crystals were strongly attached, and their arrangement reflected to a significant degree the underlying enamel prism pattern. In contrast, under the same conditions with LRAP, little to no crystal formation was found on enamel surfaces that were cut parallel to the direction of the enamel rods. These results suggest that LRAP preferentially interacts with ab surfaces of mature enamel crystals, inhibiting their directional growth, thus selectively promoting linear growth along the c-axis of enamel crystals. The present findings demonstrate a potential for the development of a new approach to regenerate enamel structure and properties.

Oriented and Ordered Biomimetic Remineralization of the Surface of Demineralized Dental Enamel Using HAP@ACP Nanoparticles Guided by Glycine

Achieving oriented and ordered remineralization on the surface of demineralized dental enamel, thereby restoring the satisfactory mechanical properties approaching those of sound enamel, is still a challenge for dentists. To mimic the natural biomineralization approach for enamel remineralization, the biological process of enamel development proteins, such as amelogenin, was simulated in this study. In this work, carboxymethyl chitosan (CMC) conjugated with alendronate (ALN) was applied to stabilize amorphous calcium phosphate (ACP) to form CMC/ACP nanoparticles. Sodium hypochlorite (NaClO) functioned as the protease which decompose amelogenin in vivo to degrade the CMC-ALN matrix and generate HAP@ACP core-shell nanoparticles. Finally, when guided by 10 mM glycine (Gly), HAP@ACP nanoparticles can arrange orderly and subsequently transform from an amorphous phase to well-ordered rod-like apatite crystals to achieve oriented and ordered biomimetic remineralization on acid-etched enamel surfaces. This biomimetic remineralization process is achieved through the oriented attachment (OA) of nanoparticles based on non-classical crystallization theory. These results indicate that finding and developing analogues of natural proteins such as amelogenin involved in the biomineralization by natural macromolecular polymers and imitating the process of biomineralization would be an effective strategy for enamel remineralization. Furthermore, this method represents a promising method for the management of early caries in minimal invasive dentistry (MID).

The contribution of chemical bonding to the short- and long-term enamel bond strengths

ObjectivesMDP (10-methacryloyloxydecyl dihydrogenphosphate) has been proven to possess chemical bonding ability to tooth hard tissues, but its contribution to the enamel bond strength has not been recognized. The aim of this study was to investigate the contribution of chemical bonding to the short- and long-term bovine enamel micro-tensile bond strengths (μTBS). MethodsThe acid-etched enamel surfaces were treated without any primer (control) or with one of three MDP-containing primers (containing different ratio of MDP/HEMA/Bis-GMA, Kuraray Co.) for 5s, water-sprayed and air-dried. Subsequently, the pretreated enamel surfaces were applied with an etch-and-rinse adhesive Durafill Bond (Heraeus Kulzer) and placed with composite resin Durafill VS (Heraeus Kulzer). The specimens were prepared for μTBS tests after 24-h or 1-yr water storage. The etched enamel surfaces treated with or without MDP-containing primers were analyzed by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). ResultsThe acid-etched enamel treated with the MDP-primers for a very short time could produce the greater enamel μTBS than the control did (p<0.05), and change enamel micromorphology. No significant different μTBS were found between 24-h and 1-yr water storage (p>0.05). The chemical bonding of MDP on the enamel surfaces was re-confirmed by XPS. SignificanceThe additional chemical bonding of MDP around the enamel crystallites of the etched enamel substrate could significantly increase the short- and long-term enamel μTBS, and their μTBS surpass those of the etch-and-rinse adhesive alone.

Direct and indirect bonding of wire retainers to bovine enamel using three resin systems: shear bond strength comparisons

Objective: We compared the shear bond strength (SBS) of lingual retainers bonded to bovine enamel with three different resins using direct and indirect methods. Methods: Both ends of pre-fabricated twisted ligature wires were bonded to bovine enamel surfaces using Light-Core, Tetric N-Flow, or Transbond XT. Phosphoric acid-etched enamel surfaces were primed with One-Step prior to bonding with Light-Core or Tetric N-Flow. Transbond XT primer was used prior to bonding with Transbond XT. After 24 hours in water at 37 o C, we performed SBS tests on the samples. We also assigned adhesive remnant index (ARI) scores after debonding and predicted the clinical performance of materials and bonding techniques from Weibull analyses. Results: Direct bonding produced significantly higher SBS values than indirect bonding for all materials. The SBS for Light-Core was significantly higher than that for Tetric N-Flow, and there was no significant difference between the direct bonding SBS of Transbond XT and that of Light-Core. Weibull analysis indicated Light-Core performed better than other indirectly bonded resins. Conclusions: When the SBS of a wire retainer is of primary concern, direct bonding methods are superior to indirect bonding methods. Light-Core may perform better than Transbond XT or Tetric N-Flow when bonded indirectly.

Effects of CPP-ACP Paste on the Shear Bond Strength of Orthodontic Brackets

To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on shear bond strength and debonding failure modes of orthodontic brackets. Freshly extracted premolars were randomly divided into four groups (n =18) as follows: in groups 1 and 3, the enamel was treated with a solution of CPP-ACP dissolved in artificial saliva; groups 2 and 4 served as controls, and the enamel was treated with artificial saliva. After conventional acid etching, in groups 1 and 2, brackets were bonded using a light-cured bonding system (Blugloo); while in groups 3 and 4, brackets were bonded using a conventional bonding system (Unite Bonding Adhesive). Bonded specimens were subjected to thermal cycling for 1000 cycles before debonding procedures. After debonding, teeth and brackets were examined under a stereomicroscope at 10x magnification to determine whether any adhesive remained, in accordance with the adhesive remnant index. The acid-etched enamel surfaces were also observed using scanning electron microscopy after treatment with and without CPP-ACP paste. The shear bond strengths of group 1 were significantly higher than those seen in group 2 (P < .01). There was no significant difference in the shear bond strengths of groups 3 and 4 (P > .05). Scanning electron microscopic observation showed that the pretreated enamel surface was rougher than that of the control surface after acid etching. The use of CPP-ACP can be considered as an alternative prophylactic application in orthodontic practice since it did not compromise bracket bond strength.

Correlations Between AFM and SEM Imaging of Acid-Etched Tooth Enamel

Enamel bond strength is an important factor in restorative dentistry and crucially depends on the enamel roughness. To increase roughness, different etching procedures are employed and profilometric estimations, with probe profilometers, including atomic force microscopy (AFM), have been made. However, no correlation between roughness and bond strength has been found. To search for a possible error source leading to the underestimation of enamel roughness when utilizing probe profilometers, the authors compared scanning electron microscopy and AFM images of acid-etched tooth enamel. The results showed that AFM imaging cannot correctly depict the acid-etched enamel surface, because of the high steepness of the enamel crystallites and the generation of convolute images. This leads to a large underestimation of the profilometric parameters measured with AFM, or other profilometers, on acid-etched tooth enamel surfaces.

Antibacterial Activity and Shear Bond Strength of 4-Methacryloxyethyl Trimellitate Anhydride/Methyl Methacrylate-Tri-n-butyl Borane Resin Containing an Antibacterial Agent

To produce an antibacterial adhesive for orthodontic bonding without compromising the mechanical property. We added benzalkonium chloride (BAC) to the Superbond C&B (4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane [4-META/MMA-TBB]), a resin that exhibits a strong bonding strength between enamel and bracket. BAC concentrations in the BAC composites were 0.25%, 0.75%, 1.25%, 1.75%, 2.5%, and 5% (wt/wt). Antibacterial activity of the BAC composite was measured by the disk diffusion method. BAC-composite discs were placed on the surface of the agar inoculated with Streptococcus mutans and Streptococcus sobrinus, and the plates were incubated at 37 degrees C. After 48 hours of incubation, the inhibition zone around each sample was measured and recorded. The BAC-modified composite was used to bond metal brackets to the phosphoric acid-etched enamel surface of human premolars. The shear bond strengths were measured after immersion in water at 37 degrees C for 24 hours. The BAC-composite samples showed significant (P < .0001) antibacterial activity compared with the control. Measurable zones of bacterial inhibition increased as the BAC content in test samples increased. The shear bond strength declined with the increase in BAC concentration in the composite. A significant difference was found between the control composite and composites containing 1.25%, 1.75%, 2.5%, and 5% BAC (P < .05). No significant difference was found between the control composite and composites containing 0.25% and 0.75% BAC. However, shear bond strengths of the modified composites ranged from 10.12 MPa to 20.94 MPa. These results confirmed that BAC-modified 4-META/MMA-TBB resin has a possibility for clinical application as an orthodontic bonding adhesive.

Bonding durability of using self-etching primer with 4-META/ MMA-TBB resin cement to bond orthodontic brackets.

This study determines the bonding durability when a self-etching primer is used with Superbond C&B (a 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane resin) to bond orthodontic brackets to enamel. Thermocycling test was used to assess bonding durability. Metal brackets were bonded to the phosphoric acid-etched or Megabond self-etching primer-treated enamel surface of human premolars using Superbond C&B. The shear bond strengths were measured after immersion in water at 37 degrees C for 24 hours or after 2000 or 5000 cycles of thermocycling between 5 degrees C and 55 degrees C. Data were analyzed using 2-way analysis of variance and Fisher's protected least significant difference test for multiple comparisons. There was no significant difference in shear bond strength between phosphoric acid and Megabond self-etching primer treatment before the thermocycling test. After 2000 and 5000 thermal cycles, significant decreases in shear bond strength were observed with phosphoric acid etching. On the contrary, no significant differences in shear bond strength were observed after 2000 and 5000 thermal cycles with Megabond self-etching primer. The adhesive remnant indices were not significantly different between phosphoric acid etching and Megabond self-etching primer treatment either before or after thermal cycles. This study suggested that when used with Superbond C&B in bonding orthodontic brackets, Megabond self-etching primer is superior to phosphoric acid as an enamel preparation agent in providing durable bond strength.

Evidence of chemisorption of maleic acid to enamel and hydroxyapatite.

Maleic acid has been used as an etchant or non-rinse conditioner in adhesive dentistry. However, the inherent mechanisms of the interaction of maleic acid with hydroxyapatite/enamel have never been fully elucidated. The purpose of this study was to provide evidence for the chemisorption of maleic acid onto hydroxyapatite/enamel, and to identify the reaction products obtained following the interaction of maleic acid with hydroxyapatite. Hydroxyapatite particles were dissolved in a 15% (w/v) aqueous solution of maleic acid (pH = 0.98). Half of the solution was dried to obtain a desiccated mixture. This mixture, hydroxyapatite, maleic acid and self-prepared calcium maleate were analysed by X-ray diffraction (XRD). Acetone was added to the other half of the solution to obtain a precipitate. This precipitate, hydroxyapatite, maleic acid, unetched enamel and maleic acid-etched enamel were analysed by X-ray photoelectron spectroscopy (XPS). The precipitate was also analysed by (1)H NMR. A new binding energy, indicating carboxylate groups, was detected by XPS on the precipitate and maleic acid-etched enamel surface. XRD data indicated the formation of calcium maleate and calcium hydrogen phosphate after the reaction. NMR data revealed that one carboxylic group of maleic acid reacted with hydroxyapatite. Hence, maleic acid can chemisorb to hydroxyapatite and enamel via ionic interactions.

Evaluation of shear bond strength with different enamel pre-treatments.

The purpose of this study was to investigate the shear bond strengths of two adhesives, Panavia-21 and a composite resin (Transbond XT), with different enamel pre-treatments, acid etching (37 per cent phosphoric acid) and grit blasting (50 microm aluminium oxide particles). The mode of bond failure was also assessed using the modified adhesive remnant index (ARI). Ninety freshly extracted non-carious human premolar teeth were randomly divided into the following groups: (1) Transbond XT, acid-etched enamel surface; (2) Panavia-21, acid-etched enamel surface; (3) Transbond XT, grit-blasted enamel surface; (4) Panavia-21, grit-blasted enamel surface; (5) Transbond XT, acid-etched enamel surface with grit-blasted brackets; (6) Panavia-21, acid-etched enamel surface with grit-blasted brackets. All groups had stainless steel brackets bonded to the buccal surface of each tooth. An Instron universal testing machine was used to determine the shear bond strengths at a crosshead speed of 0.5 mm/second. Statistical analysis was undertaken using analysis of variance and the Tukey test. The mean bond strength values were as follows: group 1, 135.7 +/- 23.0 N; group 2, 181.5 +/- 18.4 N; group 3, 38.4 +/- 27.5 N; group 4, 59.1 +/- 24.1 N; group 5, 106.7 +/- 21.5 N; group 6, 165.3 +/- 21.4 N. Panavia-21 with the acid-etched enamel surface had a significantly higher shear bond strength than the other groups (P < 0.001). This was followed by the composite group with the acid-etched enamel surface. This group differed significantly from the composite and Panavia-21 groups with the grit-blasted tooth surface (P < 0.001) and from the composite and Panavia-21 groups with the acid-etched enamel surface and grit-blasted brackets (P < 0.01). The current findings indicate that Panavia-21 is an excellent adhesive and produces a bond strength that is clinically useful. Enamel surface preparation using grit blasting alone results in a significantly lower bond strength and should not be advocated for clinical use.

In vitro permeability and scanning electron microscopy study of acid-etched and ground enamel surfaces protected with dental adhesive coating.

Clinical procedures, such as acid etching and reshaping of the teeth supporting removable partial dentures by grinding off some enamel surface, increase the permeability of dental enamel. Teeth take several months in vivo to partially recover from such damage. In the meantime, the tooth is more susceptible to carious decay. To prevent this the ground or etched enamel should be effectively protected. Using electron paramagnetic resonance (EPR) and a two-chamber diffusion cell the authors studied the influence of adhesive resin applied to the ground and acid-etched enamel surfaces on the diffusion of spin label TMAPO (2,2,6-6 tetramethyl-4-acetamido-piperidine-1-oxyl) molecules through the enamel. The enamel permeability was measured in samples exposed to 1-min etching with 37% phosphoric acid, in samples etched for 5 min, and in samples ground with a diamond bur. Next, all the treated enamel surfaces were coated with Scotchbond Multi-Purpose Plus(R) dental adhesive system and the permeability measurements repeated. Scanning electron microscopy (SEM) was used to study the porosity of enamel surfaces. The adhesive resin film covering the etched or ground enamel surfaces was found to decrease significantly the diffusion through dental enamel. This finding confirms the clinical value of dental adhesives used to protect ground or accidentally acid-etched enamel surfaces. SEM analysis showed that adhesive resin covers the porous surface of the acid-etched and ground enamel tightly.

The extent of enamel surface fractures. A quantitative comparison of thermally debonded ceramic and mechanically debonded metal brackets by energy dispersive micro-and image-analysis

This clinical study investigated the practical value of two methods for debonding brackets attached by the adhesive Concise to acid-etched enamel surfaces. Forty-two Ultratrimm Standard metal brackets and 42 Fascination ceramic brackets were collected from juvenile patients undergoing orthodontic treatment. All metal brackets were mechanically debonded by a conventional bracket removal plier, whereas the ceramic brackets were thermally debonded by a commercial Dentaurum ceramic debonding unit. All brackets were evaluated by scanning electron microscopy for the morphology of their adhesive fracture surfaces and for the occurrence of mineral-like particles attached to the adhesive fracture surfaces. These particles were analysed by an energy dispersive X-ray microprobe for their Ca/P ratios and by image analysis of scanning electron micrographs for measurement of their areas. The scanning electron micrographs showed 4 types of debonding fractures. The most frequent fracture was type 1 (between adhesive and bracket base) and type 2 (between adhesive and enamel surface). In the group of mechanically debonded metal brackets type 1 (38 per cent) and type 2 (45 per cent) showed a similar fequency, whereas thermally debonded ceramic brackets predominantly showed fracture type 1(79 per cent) and only a minor percentage of type 2(11 per cent). A statistical evaluation was applied to estimate the range of reproducibility of fracture types with a 95 per cent confidence interval (level of significance α=5 per cent). In both groups the microprobe analysis of fracture surfaces lying completely or partly between adhesive and enamel surface identified the mineral-like particles as enamel mineral. They occurred partly as single particles (range of thickness: 5–25 μm, mean area: 3500 μm 2 ) and partly as a coherent covering with a total area of 1.9–5.8 mm 2 . It is concluded that the thermodebonding technique is superior to conventional mechanical debonding, because the frequent occurrence of fracture type 1 after thermodebonding affords a protection for the enamel surface, whereas mechanical debonding entails a comparatively high risk of enamel fractures.

The effect on the tensile bond strength of orthodontic brackets of titanium tetrafluoride (TiF 4) application after acid etching

Titanium tetrafluoride (TiF 4) was applied to acid-etched enamel surfaces to study the effect on surface structure and tensile bond strength of orthodontic brackets. Three groups of 20 premolars each were compared in debonding tests. Group l received a 1% and Group ll received a 4% topical TiF 4 treatment after acid etching. Group lIl served as control, that is, no fluoride solution was applied to the enamel after acid etching. Each treatment lasted 60 seconds followed by a thorough rinsing with water for 30 seconds. Brackets were bonded on all teeth with the same procedure. All premolars were then placed in a water bath at 37° C. Ten teeth from each group were debonded after 24 hours, and the remaining teeth were debonded after 6 months. Results indicated that the application of 1% and 4% TiF 4 solutions on etched enamel surfaces did not alter the tensile bond strength significantly after 24 hours and 6 months. The scanning electron microscope (SEM) examination of the surface structure demonstrated the presence of extensive reaction products, which covered enamel surfaces and appeared to interfere with etch patterns. It was concluded that the application of TiF 4 solutions to etched enamel surfaces before bonding will not have an adverse effect on the tensile strength of orthodontic attachments. (A M J O RTHOD D ENTOFAC O RTHOP 1995;108:256-61.)

In vitro fatigue testing of a dental bonding system on enamel.

The aim of this study was to investigate the in vitro fatigue behavior of a dental bonding system [ScotchBond Multi Purpose (SBMP)] by using a cyclic shear loading test. Cylinders of a light-cured hybrid composite resin (Z100) were formed on, and bonded with SBMP to, the flattened, acid-etched enamel surface of human teeth. Thirty-two samples (eight per group) were used to determine the 1-h, 1-day, 7-day, and 30-day shear bond strengths. For the shear fatigue test, the stress was cycled, at a rate of 1 Hz, between 0 and a present value in the 12-28 MPa range (from -3 SD to +1 SD around the 24-MPa mean bond strength of the 1-h specimens). The applied stress and the number of cycles to failure were recorded for each of the 75 samples tested (15 samples per set-stress). Three stress versus number of cycles curves (low, median, and high S-N curves) were obtained and an approximate endurance limit of 10 MPa was identified for the SBMP bonding system. The data obtained explain, in part, the discrepancy between in vitro and in vivo results and underline the difficulty of predicting the in vivo behavior based on results of in vitro bond strength tests alone. Shear fatigue test data, however, could provide a better insight into the long-term in vivo behavior of a dental bonding system.

Load dependency and reliability of microhardness measurements on acid-etched enamel surfaces

The load dependency of hardness measurements was investigated on sound and demineralized enamel samples. For all samples investigated, the Knoop hardness number (KHN) varied as a function of the applied load. Higher loads enhanced indenter penetration into the test surface. The variation in KHN values observed in demineralized enamel, both surface-softened and surface-etched, was explained by a decrease in porosity as a function of depth. The reading error for indentations made on surface enamel etched with 37% phosphoric acid gel for 30 s was found to be slightly elevated compared to indentations made on a polished sound enamel surface. It was concluded that the surface microhardness technique can be used for the longitudinal investigation of etched surface enamel.

Acid-etched enamel surfaces after 24 h exposure to calcifying media in vitro and in vivo

The remineralization of acid-etched enamel lesions is investigated in this study both in vitro and in vivo over periods of 24 h. In an initial study, samples of etched bovine enamel were subjected in vitro to treatment with synthetic calcifying solutions, or were exposed to saliva by means of an intraoral appliance. Alterations in hardness of the enamel surface were measured by indentation techniques. In a second study the suitability of an impression technique for investigating the surface relief induced by an acid-etch procedure was investigated. Extracted human incisors were used to make SEM observations of eteched areas and corresponding sections of impressions. Subsequently, six subjects were selected for a clinical evaluation of the impression technique. Although a significant decrease in indentation length (increase in hardness) was observed for etched enamel lesions treated with calcifying solutions in vitro, no evidence for any such change was observed in samples exposed to the influence of saliva when investigated by the indentation and impression techniques.

Orthodontic bonding to porcelain—Bond strength and refinishing

Glazed porcelain surfaces are not amenable to resin penetration for orthodontic bonding. The aims of this study were to evaluate (1) the bond strengths of two orthodontic composite materials to treated porcelain surfaces, (2) the effect of thermocycling, and (3) the porcelain surfaces after refinishing. Sixty glazed poocelain disks were assigned to three surface treatment groups: Silane (S), roughening and silane (RS), and roughening (R). The acid-etched enamel surfaces of 20 extracted teeth served as a control group. Ten specimens in each group were bonded with either Concise or System 1. They were stored in water at 37° C or thermocycled 8° to 45° C. Shear bond strength was tested with an Instron testing machine (0.05 cm/min). Analysis of variance showed that the four surface treatment groups and the two composite materials produced significantly different bond strengths ( P < 0.01 and P < 0.05, respectively). The effect of thermocycling was not significant ( P > 0.05). Acid-etched enamel/Concise produced the highest mean bond strength (17.4 MN/m 2). This was significantly greater ( P < 0.05) than the mean bond strengths of S/Concise (11.1), RS/System 1 (8.6), RS/Concise (8.1), and enamel/System 1 (7.8). The latter four mean bond strengths in turn were significantly greater ( P < 0.05) than S/System 1 (2.5), R/Concise (2.1), and R/System 1 (1.8). Of the four refinishing systems evaluated, all produced smooth surfaces but were unable to reproduce a glazed appearance. Roughening of porcelain and the silane treatment achieve bond strengths that should be clinically successful. With appropriate composite material selection, the silane procedure alone may be adequate. Surface roughening without silane treatment may not produce clinically acceptable bond strengths.