Dentin Conditioning Research Articles

Cross-sectional survey of resin-modified glass ionomer as dental restoration in Saudi Arabia

Introduction: Resin-modified glass ionomers (RMGI) were developed to improve the properties of glass ionomer cement. Aim: The objective is to assess the knowledge of dentists in Saudi Arabia about properties, uses, and manipulation of resin-modified glass ionomer (RMGI). Materials and Methods: An online questionnaire of 13 close-ended questions was disseminated on the internet. The survey investigated the preference for usage, cavity treatment, and both dentists' and patients' expectations. Results and Discussion: One hundred and thirty dentists have participated; and more than 99% are using RMGI occasionally with specific cases. The most common clinical use was found to be in cases of root caries and as a temporary filling material (84.6% and 61.5%, respectively). The most noticeable advantage was the fluoride release. However, the most undesirable disadvantage was the inferior esthetic compared to composite resin. It has also shown an average expectation regarding the retention, wear resistance, contouring, handling, and esthetics. Conclusion: Dentists had a good knowledge about the fluoride release ability of RMGI; however, most of the participating dentists were concerned about the esthetic and the handling of RMGI, and rarely use dentin conditioning and adhesive before RMGI placement.

Impact of Dentin Conditioning and Sealer Modification With Chitosan-Hydroxyapatite Nanocomplexes on the Antibacterial and Mechanical Characteristics of Root Dentin

IntroductionThis study aimed to characterize the effectiveness of dentin conditioning with bio-mineralizable chitosan-hydroxyapatite precursor (CS-HA) nanocomplexes alone or associated with tricalcium silicate sealer (TCS/CS-HA) on the mechanical property and antibiofilm efficacy in root dentin. MethodsFlow tests were performed following ISO6876:2012 specifications. Solubility was measured. Micromorphology was assessed using scanning electron microscopy (SEM). Nanohardness/elastic modulus were also determined. Fracture resistance was determined on lower premolars that were prepared, and randomly distributed among 7 groups (n = 8/group), including the control, CS-HA dentin-conditioning, and root canal–filled groups. Similar canal preparation/distribution procedure was followed to test the antibacterial effect on Enterococcus faecalis–infected roots. Descriptive statistics was used to report SEM findings. Flowability results were analyzed using paired t test. Multiple comparisons from solubility, fracture, and antibacterial assays were assessed by one-way analysis of variance–Tukey's tests. ResultsTCS/CS-HA showed optimal flow and no effect on solubility after immersion for 4 weeks (P > .05). TCS/CS-HA significantly increased nanohardness and elastic modulus (210 ± 11.3 MPa, 7.9 ± 0.9 GPa) compared with TCS (44.5 ± 7.8 MPa, 2.1 ± 0.3 GPa, P < .05). SEM revealed needle-shaped mineralized structures resulting in fewer voids and a well-adapted sealer-dentin interface in the TCS/CS-HA groups. NaOCl-EDTA irrigation resulted in reduced fracture resistance (444.34 N), whereas CS-HA dentin conditioning alone (928.28 N, P < .05) and CS-HA dentin-conditioning plus CS-HA/TCS resulted in higher fracture resistance (1134.06 N, P < .05). CS-HA dentin conditioning also reduced bacteria by 2.04 log (4.50 ± 0.43) from the initial bacterial load (6.54 ± 0.07, P < .05). There was further bacterial reduction when CS-HA–conditioned root canals were filled with TCS or TCS/CS-HA (0.00 to 0.98 ± 0.57, P > .05). ConclusionDentin modification with CS-HA increased the fracture resistance of root dentin, and decreased the residual bacterial burden. TCS/CS-HA potentiated the nanomechanical and physical properties of TCS.

Growth factor release and dental pulp stem cell attachment following dentine conditioning: An in vitro study.

AimThe aim of the study was to investigate the effect of dentine conditioning agents on growth factor liberation and settlement of dental pulp progenitor cells (DPSCs) on dentine surfaces.MethodologyThe agents used included ethylenediaminetetraacetic acid (EDTA; 10%, pH 7.2), phosphoric acid (37%, pH < 1), citric acid (10%, pH 1.5) and polyacrylic acid (25%, pH 3.9). Human dentine slices were conditioned for exaggerated conditioning times of 5 and 10 min, so that the growth factor liberation reached quantifiable levels above the limit of detection of the laboratory methods employed. Transforming growth factor beta‐1 (TGF‐β1) release and surface exposure were quantified by enzyme‐linked immunosorbent assay (ELISA) and immunogold labelling. Scanning electron microscopy (SEM) was used to assess the morphology of cells and coverage by DPSCs cultured on dentine surfaces for 8 days.ResultsAfter 5‐min conditioning of dentine slices, citric acid was the most effective agent for growth factor release into the aqueous environment as measured by ELISA (Mann–Whitney U with Bonferroni correction, p < .01 compared with phosphoric and polyacrylic acid). As well as this, dentine slices treated with phosphoric acid for the same period, displayed significantly less TGF‐β1 on the surface compared with the other agents used, as measured by immunogold labelling (MWU with Bonferroni correction, p < .05). After 8 days, widespread coverage by DPSCs on dentine surfaces conditioned with citric acid and EDTA were evident under SEM. On dentine surfaces conditioned with phosphoric and polyacrylic acid, respectively, less spread cells and inconsistent cell coverage were observed.ConclusionsBased on the findings of this in vitro study, a desirable biological growth factor‐mediated effect may be gained when conditioning dentine by milder acidic or chelating agents such as citric acid and EDTA. The results must be interpreted in the context that the potential of the applied materials inducing a desirable biological response in DPSCs is only one consideration amongst other important ones in a clinical setting. However, it is crucial to look beyond the mere physical effects of materials and move towards biologically based treatment approaches as far as the restorative management of teeth with viable dental pulps are concerned.

Attachment of human periodontal ligament fibroblasts to root dentin conditioned with different endodontic irrigants: An experimental study.

Background. Periradicular surgery is the last treatment option for teeth with persistent periradicular endodontic lesions. This study aimed to assess the adhesion of fibroblasts to root dentin conditioned with ethylenediaminetetraacetic acid (EDTA), MTAD, and QMix.Methods. Twelve dentin discs were fabricated of 6 human single-rooted teeth. Fibroblasts were isolated from the periodontal ligament (PDL) of a premolar tooth. The teeth were healthy and freshly extracted from the socket. The samples were divided into four groups for surface conditioning with (I) EDTA, (II) MTAD, (III) QMix, and the control group. Fibroblasts were cultured on conditioned dentin discs at 37°C, 95% air, and 5% CO2 for 4 hours and then rinsed with PBS three times to eliminate unattached cells from the surface. The mean counts of attached cells were calculated using a Neubauer chamber. Also, the attachment of fibroblasts was evaluated using scanning electron microscopy (SEM).Results. The mean counts of fibroblasts attached to root dentin in EDTA, QMix, MTAD, and control groups were 303±46, 243±41, 213±33, and 347±38, respectively. No significant difference was noted in the number of fibroblasts attached between MTAD, EDTA, and QMix and the control group (P>0.05). Under SEM, the fibroblasts were flat and spindle-shaped, with cytoplasmic processes covering the untreated dentin surface. In the experimental groups, the cells were rounder with fewer processes. All the three groups showed weaker adhesion to dentin compared to the control (untreated dentin) group.Conclusion. Under the limitations of this study, it was concluded that treating the dentin surface with EDTA, MTAD, or QMIX might not be an effective way to improve the adhesion of human PDL fibroblasts.

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review.

The effects of ethylenediaminetetraacetic acid (EDTA) on regenerative endodontic procedures (REPs) are controversial, because, despite releasing growth factors from dentine, some studies show negative effects on cell behaviour. The aim of the study was to investigate the influence of the use of EDTA in REP on the growth factors' release, cell behaviour and tissue regeneration. A systematic search was conducted (PubMed/Medline, Scopus, Cochrane Library, Web of Science, Embase, OpenGrey and reference lists) up to February 2021. Only in vivo and in vitro studies evaluating the effects of EDTA on the biological factors of dentine, pulp/periapical tissues and cell behaviour were eligible. Studies without a control group or available full text were excluded. The growth factors' release was the primary outcome. Risk of bias in the in vitro and in vivo studies was performed according to Joanna Briggs Institute's Checklist and SYRCLE's RoB tool, respectively. Of the 1848 articles retrieved, 36 were selected. Amongst these, 32 were in vitro, three animal studies and one with both models. The EDTA concentrations ranged from 3% to 15%, at different times. Regarding growth factors' release (17 studies), 15 studies found significant transforming growth factor (TGF)-β release after dentine conditioning with EDTA, and most found no influence on vascular endothelial growth factor release. Regarding cell behaviour (26 studies), eight studies showed no influence of EDTA-treated dentine on cell viability, whereas, five, nine and six studies showed higher cell migration, adhesion and differentiation respectively. No influence of EDTA conditioning was observed in animal studies. In vitro studies had a low risk of bias, whereas animal studies had high risk of bias. Meta-analysis was unfeasible. This review found that EDTA increased TGF-β release and improved cell activity. However, well-designed histological analyses using immature teeth models are needed. High-quality in vitro evidence suggests that EDTA-treated dentine positively influences TGF-β release, cell migration, attachment and differentiation; further research to evaluate its influence on tissue regeneration is necessary due to low methodological quality of the animal studies.

Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro

BackgroundTo compare the mean mineral density (MMD) and examine the remineralization of carious dentin after cavity disinfection with chlorhexidine gluconate (CHX) and restoration with high viscosity glass ionomer cement (H-GIC) in vitro.MethodsSelective caries removal to leathery dentin was performed in 40 extracted primary molars. The samples were scanned using micro-computed tomography (micro-CT) to determine the MMD baseline and randomly divided into 4 groups (n = 10): Equia™ group, applied dentin conditioner and restored with H-GIC (Equia Forte™), CHX-Equia™ group, disinfected the cavity with 2% CHX before applying dentin conditioner and restored with H-GIC (Equia Forte™), Ketac™ group, restored with H-GIC (Ketac Universal™) and CHX-Ketac™ group, disinfected the cavity with 2% CHX before restored with H-GIC (Ketac Universal™). The samples underwent micro-CT scanning post-restoration and post-pH-cycling to determine their respective MMDs. One sample from each group was randomly selected to analyze by scanning electron microscopy (SEM).ResultsThe MMD gain in the 4 groups post-restoration was significantly different between the Equia™ and CHX-Ketac™ groups (oneway ANOVA with Post hoc (Tukey) test, P = 0.045). There was a significant difference in MMD gain post-restoration between the Equia™ and CHX-Equia™ groups (Independent t-test, P = 0.046). However, the Ketac™ and CHX-Ketac™ group’s MMD were similar. The SEM images revealed that the CHX-Ketac™ group had the smallest dentinal tubule orifices and the thickest intertubular dentin among the groups. However, the CHX-Equia™ group had thicker intertubular dentin than the Equia™ group.ConclusionApplying 2% CHX on demineralized dentin enhances the remineralization of the dentin beneath the restoration.

Bonding of Glass-Ionomer Cement and Adhesives to Silver Diamine Fluoride-treated Dentin: An Updated Systematic Review and Meta-Analysis.

To evaluate through a systematic review and meta-analysis the bonding performance of adhesive materials to silver diamine fluoride (SDF)-treated dentin. Studies located in PubMed, Web of Science, LILACS, and Scopus up to September 2020, which compared the bond strength of adhesives (AD) or glass-ionomer cement (GIC) to SDF-treated and untreated (control) dentin were included. Mean differences were estimated separately by material and dentin condition (sound or caries-affected), with a random-effects model, at a 5% significance level. Twenty-two studies, including 11 new studies not included in our previous systematic review, met the eligibility criteria, and 21 studies were considered in the meta-analyses. SDF dentin pretreatment did not influence the bonding of GIC (Z = 0.53; p = 0.60), independent of dentin condition. SDF treatment significantly impaired the bonding of AD (Z = 2.43; p = 0.01). A rinsing step after SDF eliminated this effect in sound dentin (Z = 1.82; p = 0.07) and increased the bond strength to caries-affected dentin (Z = 2.14; p = 0.03). SDF pretreatment does not influence the bond strength of GIC. A rinsing step after SDF application can improve the bond strength of AD to caries-affected dentin.

Dentin conditioned with a metal salt-based conditioner

ObjectivesUniversal adhesives (UAs) can optionally be applied in either an etch-and-rinse (E&R) or self-etch (SE) bonding mode. As the preferred bonding mode differs for enamel versus dentin, a universal conditioner for both enamel and dentin in replacement of the relatively aggressive phosphoric-acid etchant remains desirable. This study aimed to test if a metal salt-based etchant (ZrO(NO3)2) provides as durable bonding to dentin as a classic E&R or SE bonding mode MethodsBefore applying the UA Adhese Universal (‘AdU’; Ivoclar Vivadent) to bur-cut dentin of 24 teeth (n = 8), dentin was conditioned with either (1) an experimental metal salt-based conditioner (‘ZON’; Ivoclar Vivadent) or (2) 37% phosphoric acid (Total Etch gel, Ivoclar Vivadent), representing a classic ‘E&R′ mode; (3) a third experimental group involved AdU applied in SE mode. Bonding effectiveness was determined in terms of immediate (‘1w’) and aged (‘50k’ TC) micro-tensile bond strength (μTBS) to bur-cut dentin. Adhesive-conditioned dentin interfacial interactions were characterized by S/TEM. ResultsLinear mixed-effects modeling revealed significantly higher immediate μTBS to dentin of ZON_AdU than E&R_AdU, while ZON_AdU performed not significantly different from SE_AdU. No significant differences were found between the three experimental groups after 50k TC (aged μTBS). S/TEM disclosed less exposure of dentinal collagen fibrils when AdU was bonded upon ZON etching than when applied in E&R mode. Moreover, ZON resulted in more hydroxyapatite (HAp) crystals remaining at the bottom of the hybrid layer, while dentinal tubule orifices remained nearly fully closed, by which hardly any resin tags were formed. SignificanceThe alternative metal salt-based conditioner revealed at dentin a more HAp-protected hybrid layer with less exposure of collagen fibrils, while a comparable bond strength was obtained to that with a phosphoric-acid E&R as well as with an SE (no conditioner) bonding mode. These findings confirm that the metal salt-based conditioner can be considered as a suitable alternative (enamel/)dentin conditioner to classic phosphoric acid employed in an E&R bonding mode.

Marginal microleakage and modified microtensile bond strength of Activa Bioactive, in comparison with conventional restorative materials.

This study aimed to assess the enamel and dentin marginal microleakage and dentin microtensile bond strength (μTBS) of ACTIVA BioACTIVE Restorative with and without a bonding agent compared with conventional restorative materials. For enamel and dentin microleakage, Class II boxes were prepared in the mesial (1 mm under the cementoenamel junction) and distal (1 mm above the cementoenamel junction) surfaces of 90 extracted human third molars. The teeth were randomly divided into five groups (n = 18): Group Z (G-Premio Bond + Filtek Z250 XT), Group X (G-Premio Bond + X-tra fil bulk-fill), Group AA (G-Premio Bond + Activa Bioactive restorative), Group A (Activa Bioactive restorative), and Group G (dentin conditioner + Fuji II LC Improve). The teeth were thermocycled, and their microleakage was quantified using the dye penetration test under a stereomicroscope. For dentin μTBS measurement, 12 specimens were fabricated in metal molds (1 × 1 × 12 mm³) for each group mentioned above, and a universal testing machine measured their μTBS. Data were analyzed using one-way analysis of variance (ANOVA), the Kruskal-Wallis test, and multiple comparisons tests. Significant differences were noted among the groups in marginal microleakage and μTBS (p < .001). The highest mean microleakage scores at the enamel and dentin margins were noted in Group A, which had significant differences with other groups (p < .001). The highest μTBS was found in Group X, with significant differences with Group G and Group A (p < .05). The lowest µTBS was noted in Group A, with significant differences with Groups X, Group AA, and Group Z (p < .001). Activa Bioactive without a bonding agent showed significantly lower µTBS to dentin, and higher microleakage at the enamel and dentin margins. Application of adhesive resin with Activa Bioactive provided a dentine bond strength and marginal seal comparable to other restorative materials.

Interaction of zirconium oxide nanoparticle infiltrated resin adhesive with dentin conditioned by phosphoric acid and Er, Cr: YSGG laser.

The aim was to prepare experimental adhesive (EA) with ZrO2 nanoparticles (ZEA) and without it; and its interaction with dentin conditioned with photodynamic therapy (PDT), etch and rinse, and Er, Cr: YSGG laser (ECL). Methods consisted of the scanning electron microscope (SEM), energy dispersive X-ray (EDX), shear bond strength (SBS) failure mode, and rheological property analysis. The methods were employed to assess bond integrity; the shape of ZrO2 NPs and interfacial dentin and adhesive interaction. Ninety premolar teeth were collected and pre-bonding, conditioning of dentin was performed utilizing phosphoric acid (H3PO4), photodynamic therapy (PDT), and ER-CR-YSGG laser (ECL). The teeth were set to form bonded specimens using two adhesives EA and ZEA. The microscopic imagery of ZrO2 revealed irregular-shaped, non-edged particles. EDX analysis revealed Zr to be 75.7% whereas, O2 by weight was 25.3%. The highest SBS was demonstrated in dentin conditioned with etch and rinse and ZEA (19.05 ± 0.13 MPa). Whereas, the lowest SBS was observed in dentin surface treated with PDT and EA (12.25 ± 0.14 MPa). Most of the reported failure modes were adhesive. Rheological analysis revealed that with increasing frequencies the viscosities of adhesives were reduced. The presence of 10% ZrO by weight in adhesive improves SBS of restoration and this improvement in bond values is statistically significant compared to EA. Bond values may be influenced by surface treatment of dentin.

Biomimetic strategy of a hybrid biointerface creation between native human dental tissue and dental composite

The aim of the studyis the peculiarities of the molecular composition of the biointerface between the native human dental tissue and the dental composite, created in an alkaline environment, based on synchrotron chemical infrared micro-mapping. When creating a biomimetic interface under alkaline conditions, we used an original bioprimer, dentin conditioner, nanofilled universal adhesive, and a light-curing compomer based on BIS-GMA. Biointerface analysis was carried out on the basis of chemical infrared micro-mapping, implemented using the equipment of the Australian Synchrotron, and subsequent multivariate cluster analysis of the collected spectral data array. It was shown that the use of a primer modified with a set of polar amino acids additionally facilitated the opening of dentinal tubules and the penetration of the bioprimer components into the dentin with the formation of a deeper transitional hybrid layer. At the same time, modification of the Bis-GMA adhesive using nanocrystalline carbonate-substituted hydroxyapatite, which has a structural and morphological organization similar to natural dental tissue apatite, led to an increase in the degree of conversion of the used adhesive material during polymerization. Using a biomimetic strategy and nanocrystals of carbonate-substituted hydroxyapatite as a filler of a universal adhesive, the necessary conjugation at the interface with dentin can be achieved without disrupting the polymerization processes, as well as preserving the natural structural complexity of the intact tissue, which makes it possible to take into account the individual characteristics of the patient.

19 - Root Dentin Conditioning with Self-Etch Primers Incorporated with Nanochitosan

19 - Root Dentin Conditioning with Self-Etch Primers Incorporated with Nanochitosan

Influence of dentin moisture conditions on the wetting action of different endodontic sealers using Rame-Hart goniometer: An in vitro study

Aim: To evaluate the influence of different dentin moisture conditions on the wetting action of different classes of endodontic sealers, that is, Bioceramic based sealer – Smart Paste Bio, Resin based sealer - AH Plus and Zinc oxide eugenol based sealer – Tubliseal. Materials and Methods: The present research is an in vitro comparative study in which the samples were selected by random sample method. A total of 54 dentin samples were prepared by longitudinally sectioning 27 freshly extracted single rooted mandibular first premolars. 54 samples were then allocated into three groups of 18 each based on the sealer used. Irrigation of the dentin samples were done with 5.25% sodium hypochlorite followed by 17% EDTA and a final rinse with distilled water.18 samples in each sealer group were further divided into separate subgroups of six each on the wide variety of dentin moisture conditions subjected to dry, moist and wet conditions. 0.1ml of sealer was deposited on flat dentin surface and contact angles were measured. Statistical evaluation was done using Analysis of variance and Post-hoc Tukey test at 95% confidence interval and P value <0.05 was considered statistical significant. Results: One way ANOVA was done to analyse the statistical significant difference between the wetting ability of three different sealers under different moisture condition the P Value was <0.001 which was considered statistically significant. Post hoc Tukeys test was done to analyze the contact angle between the two groups in dry, moist and wet condition with P value =0.001 which is <0.05 hence there is a statistical significant difference among all the subgroups. Conclusion: Within the limitation of this in vitro study it can be concluded that the wetting behavior of Resin based sealer - AH Plus was significantly better than Bioceramic sealer - Smart Paste Bio and Zinc oxide eugenol sealer - Tubliseal during dry and moist dentin conditions.

Effect of conditioning and 3-year aging on the bond strength and interfacial morphology of glass-ionomer cement bonded to dentin

Background/purposeGlass-ionomer cement (GIC) is bioactive and independent. Bioactivity, which is a big trend in restorative dentistry. When they actively stimulate with microbiological species besides their primary function of restoring tooth structure then restorative materials should called “bioactive” materials. The purpose of this study was to determine the bond stability and the change in interfacial ultra-structure of a conventional glass-ionomer cement bonded to dentin, with and without pre-treatment using a polyalkenoic acid conditioner. Material and methodsThe occlusal dentin surfaces of six teeth were ground flat. Glass-ionomer cement was bonded to the surfaces either with or without polyalkenoic acid conditioning. The teeth were sectioned into 1-mm2 stick-shaped specimens. The specimens obtained were randomly assigned to two groups with different periods of storage in water: 1-week and 3-year. The micro-tensile bond strength (μTBS) was determined for each storage time. Additional specimens were prepared for interfacial analysis by using Scanning Electron Microscopy (SEM); they were produced with or without prior polyalkenoic acid conditioning in the same way as in the μTBS test. ResultsThere was no significant difference in μTBS to conditioned dentin and non-conditioned dentin (p > 0.05). The failures appeared to be of a mixed nature, although aging caused more areas of cohesive than adhesive failure in both groups. ConclusionAging did not reduce the bond strength of the conventional glass-ionomer cement to dentin with or without the use of a polyalkenoic acid conditioner. Remineralized dentin layer were observed in both conditioned and unconditioned 3-years specimens.

Dentin surface and hybrid layer morphological analysis after use of a copaiba oil- based dentin biomodifier

This study evaluated dentin surface and hybrid layer’s morphology, using copaíba (CO) emulsion as dentin biomodifier before traditional and self-etching adhesive, by environmental scanning electron microscopy (ESEM). Ninety-six third sound molars were divided into 16 groups, according to the dentin substrate, tested substances, and the adhesive system used. The conditioned dentin surface treated with clorexidina (CHX) 2% showed phosphate salts on two dentin substrates as well as the sound conditioned or not surface treated with calcium hydroxide solution (CHS), where the mineral precipitate deposition obstructs the tubules lumen. A significant difference (p &lt;0.0001) in dentin surface morphology was observed at the CHS group on conditioned and not conditioned sound dentin. The CO emulsion produced a regular and homogenous hybrid layer with many resin tags on both dentin surfaces, irrespective of the adhesive system used, with better performance than CHS and CHX 2% (p =0.0007) on caries-affected dentin at the self-etching group. CO emulsion showed no morphological changes on sound and caries-affected dentin and presented a regular hybrid layer, regardless of the adhesive system used.&#x0D; Keywords: Copaiba oleoresin; Emulsions; Dentin-bonding agents; Phytotherapy.

Intracanal bonding with therapeutic adhesives and new dentin conditioners

The EDTMP (ethylenediamine-tetra-methylene phosphonate) is a molecule similar to EDTA (ethylenediamine-tetra-acetic acid), but with phosphonates, thereby presenting efficient chelating action and binding adequately to proteins, such as collagen. The objective of this study was to evaluate EDTMP as new etching solution to aid ion-releasing adhesive containing beta-tri-calcium phosphate (β-TCP) fillers used for intrarradicular dentin bonding. Thirty extracted single-rooted human teeth were prepared, and glass-fiber posts were adhesively luted with Scotchbond Multipurpose (SBMP, 3 M) adhesive after etching with 37% phosphoric acid for 15s, 15% EDTA or 15% EDTMP for 120s, and SBMP adhesive incorporated or not with β-TCP. RelyX ARC (3 M) was used as resin cement. The restored roots were cut horizontally in 1 mm-thick slabs and submitted to push-out bond strength test after 24h and 6 months of water storage. Interfacial silver nanoleakage was investigated in scanning electron microscopy. Micro-Raman spectroscopy was employed to track mineralization at the hybrid layer. Data were submitted to two-way ANOVA and Tukey’s test (p<0.05). EDTMP without β-TCP achieved the overall highest bond strength in both storage times. The addition of β-TCP impaired the improvements of EDTMP. The presence of carbonated apatite (peak at 1090 cm -1 ) was found in EDTMP without β-TCP, thereby suggesting remineralization. Little silver impregnation was observed in general across groups. Conclusion : EDTMP could be an optimal alternative as root dentin etchant for luting glass-fiber posts with improvements in dentin bond stability.

CHX Stabilizes the Resin/demineralized Dentin Interface.

The aim of this study was to evaluate the effect of 2% chlorhexidine digluconate (CHX) on microtensile bond strength (µTBS) between an adhesive system and under 3 dentin conditions. For that, this study evaluated the adhesive interface at initial, after 6 months and 1 year of storage. Forty-eight human third molars were prepared and randomly divided into 3 groups, according to dentin substrates: sound dentin (Sd), caries-infected dentin (Ci) and caries-affected dentin (Ca). The groups were subdivided into two according to the dentin pre-treatment: application of 2% CHX or without pre-treatment (control). The dentin surfaces were etched with 35% phosphoric acid gel and bonded with Adper Single Bond 2 (3M ESPE) adhesive system according to manufacturer's instructions. Subsequently, the specimens were stored in deionized water at 37°C for 24h, 6 months and 1 year. Two additional teeth were used to analyze the bonding interfaces by SEM. Data was submitted to three-way ANOVA in a split plot design and Tukey's test (α = 0.05). The results showed that Ci decreased µTBS values when compared to Ca and Sd, regardless storages time or treatment. Stored samples for 6 months and 1 year decreased the µTBS for the control group, but no difference was found between storages time for the CHX group. As a conclusion, the 2% CHX application after etching showed improved dentin bond strength in the storage time, regardless of the substrates evaluated.

Using Proanthocyanidin as a Root Dentin Conditioner for GIC Restorations

Glass ionomer cements (GICs) are considered the material of choice for restoration of root carious lesions (RCLs). When bonding to demineralized dentin, the collapse of dentinal collagen during restorative treatment may pose challenges. Considering its acidic nature and collagen biomodification effects, proanthocyanidin (PAC) could be potentially used as a dentin conditioner to remove the smear layer while simultaneously acting to biomodify the dentinal collagen involved in the bonding interface. In this study, 6.5% w/v PAC was used as a conditioner for sound (SD) and laboratory demineralized (DD) root dentin before bonding to resin-modified GIC (FII), casein phosphopeptide–amorphous calcium phosphate (CPP-ACP)–modified GIC (FVII), or a high-viscosity GIC (FIX). Root dentin conditioned with deionized distilled water (DDW) or polyacrylic acid (PAA) served as controls. Results indicated FII showed higher shear bond strength (SBS) on SD than the other 2 GICs, especially in PAA-conditioned samples; FIX showed significantly higher SBS than FII and FVII on PAA- or PAC-conditioned DD. In each category of GIC, PAA and PAC did not have a significant influence on SBS in most cases compared to DDW except for a significant decrease in PAC-conditioned SD bonded to FII and a significant increase in PAA-conditioned DD bonded to FIX. The bonding interface between GIC and SD was generally more resistant to the acid-base challenge than DD. Although the alterations in failure modes indicated a compromised interfacial interaction between GICs and PAC-treated root dentin, biomodification effects of PAC on dentin were observed from Raman microspectroscopy analysis in terms of the changes in mineral-to-matrix ratio and hydroxyproline-to-proline ratio of dentin adjacent to the bonding interface, especially of DD. Results from this study also indicated the possibility of using in situ characterization such as Raman microspectroscopy as a complementary approach to SBS test to investigate the integrity of the bonding interface.

Influence of ER-CR-YSGG Laser and Photodynamic Therapy on the Dentin Bond Integrity of Nano-Hydroxyapatite Containing Resin Dentin Adhesive: SEM-EDX, Micro-Raman, Micro-Tensile, and FTIR Evaluation.

The study aimed to analyze the effect of the addition of nano-hydroxyapatite (nano-HA) particles on the mechanical properties of experimental adhesive (EA). Furthermore, dentin interaction of EA (without nano-HA) and EA with nano-HA (hereon referred to as HA-10%) were also investigated and equated. Methods consisting of scanning electron microscopy (SEM)–energy-dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy, micro-tensile bond strength (µTBS) test, and Fourier transform infrared (FTIR) spectroscopy were employed to study nano-HA particles shape, dentin bond strength, degree of conversion (DC), and adhesive–dentin interaction. Ninety teeth (N = 90) were collected, and pre-bonding, conditioning of dentin was performed utilizing phosphoric acid (H3PO4) etching, photodynamic therapy (PDT), and ER-CR-YSGG (ECY) laser. The teeth were set to form bonded specimens using two adhesives. Nano-HA particles were spherical-shaped, and EDX confirmed the presence of oxygen, calcium, and phosphorus. Micro-Raman spectroscopy revealed distinct phosphate and carbonate peaks for nano-HA. The µTBS test demonstrated highest values for HA-10% group on the H3PO4 conditioned dentin. The greatest DC was observed for the EA group. The addition of nano-HA-10 wt.% particles in dentin adhesive resulted in improved bond strength. The incorporation also demonstrated acceptable DC (although lower than EA group), suitable dentin interaction, and resin tag formation.

Bonding to dentin using an experimental zirconium oxynitrate etchant

ObjectiveTo investigate, by means of microtensile bond strength test (μTBS), nanoleakage expression analysis (NL), gelatin zymography and in situ zymography, the effects of an experimental metal salt-based zirconium oxynitrate etchant [ZrO(NO3)2,] – ZON with two simplified adhesives on long-term bond strength and endogenous enzymatic activities. MethodsMiddle/deep coronal dentin surfaces (N = 32) were conditioned either with a traditional 37 % H3PO4 etchant (TE) or with ZON. Further, a single-component etch-and-rinse adhesive (EF) or a universal adhesive (AU) were applied and μTBS and NL tests were performed. Additional freshly extracted teeth were processed for gelatin zymography and in situ zymography evaluation. The tests were performed at baseline and (T0) and after 1-year-aging (T12). Bond strength and in situ zymography results were analyzed using analysis of variance (ANOVA) (three-way and one-way, respectively), while Chi-squared test was used for the NL results. Statistical significance was preset at α = 0.05. ResultsAll the investigated factors (adhesive system, dentin conditioner and aging) significantly influenced μTBS, with the AU and ZON performing better compared to EF and TE, respectively, and with lower bond strength values after aging (p < 0.05). Incremented silver nitrate deposits were observed at the adhesive interfaces after aging, especially for the TE groups (p < 0.05). Further, the experimental groups treated with ZON had significantly lower levels of enzymatic activity compared to TE, as shown by gelatin and in situ zymography (p < 0.05). ConclusionsThe experimental etchant demonstrated promising results in hybrid-layer preservation over time when used with simplified bonding systems, and could therefore be recommended in the clinical practice.