Dentin Treatment Research Articles

Effect of Laser Treatment of Root Dentine on Retention of Dental Fiber Post in Endodontically Treated Teeth: An In Vitro Study.

Introduction: The most common causes of fiber post-failure are inadequate restorations and dislodgement. This study aimed to evaluate fiber post-bond strength to dentin following Er,Cr:YSGG laser irradiation. Methods: A total of 65 human mandibular premolars with single roots were included. The 14 mm root length was instrumented with the rotary system using the crown-down technique. Gutta-percha was used for obturation, followed by conventional post space preparation. The samples were divided into two major groups: control (A) and Er,Cr:YSGG (2780 nm) laser group (B). The laser group was subdivided into (B1) 1.25 W, (B2) 1.5 W, and (B3) 1.75 W. All laser groups were set at 20 Hz, 10% and 30% water/air ratio. Fiber posts were cemented with selfadhesive cement. Each sample was divided horizontally into two slices, coronal and apical. The universal testing equipment was used to conduct a push-out test. All groups were examined by SEM and temperature changes. The statistical analysis was performed by using one-way ANOVA and Tukey HSD tests. Results: SEM images of all laser groups revealed the elimination of the smear layer and opened dentinal tubules, which was particularly noticeable in the apical region with no thermal risk to the periodontal tissue. In the push-out test, all laser groups had highly significant (P<0.001) increases in the bond strength of fiber post to dentin. The failure mode of the control group was a predominantly adhesive failure, whereas the laser groups were a predominantly mixed type. Conclusion: The three laser protocols can be used safely in the surface treatment of the fiber post space of endodontically treated teeth. Laser help to increase the bond strength of fiber post to dentin, especially in the apical area.

Comparison of microtensile bond strength of prepared teeth treated with proanthocyanidin, Camellia sinensis - Polyphenols, and metal crowns luted with resin-modified glass ionomer cement: An in vitro study.

The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC). This was an in vitro study. Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated. The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD. Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin. C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.

Assessment of Nanosilver Fluoride Application on the Microtensile Bond Strength of Glass Ionomer Cement and Resin-modified Glass Ionomer Cement on Primary Carious Dentin: An In Vitro Study.

Nanosilver sodium fluoride (NSF) has recently gained popularity in dentistry as an alternative to silver diamine fluoride (SDF) due to its drawbacks of staining the tooth black and possibly causing soft tissue injury, which has been eliminated in NSF due to the nanoparticle size of silver. This study aims to assess the microtensile bond strength of glass ionomer cement (GIC) and resin-modified glass ionomer cement (RMGIC) with pretreatment of NSF on extracted primary carious teeth. Teeth were stored in 10% formalin. The roots were severed, and the pulp chambers were cleaned. The occlusal enamel was ground, reducing the dentin thickness by 1 mm. The specimens were covered with nail varnish, leaving only the area of flat dentin exposed. Caries were induced microbiologically by inoculating Streptococcus mutans. Group I-NSF with GIC restoration, group II-NSF with RMGIC restoration, group III-restoration with GIC, and group IV-restoration with RMGIC. After different surface treatments of the carious dentin were performed, each specimen was placed in the testing jig of a universal testing machine and stressed in tension at a crosshead speed of 1 mm/minute until bond failure was observed. They were air-dried and placed under a scanning electron microscope. The failure modes-adhesive, cohesive, and mixed failure were recorded for statistical evaluation. Maximum results of microtensile bond strength were seen in the pretreatment group with NSF sealant, followed by RMGIC restoration, and the least results were observed in the conventional GIC restoration group. Of all the types of failures in our study, adhesive was the maximum type. The microtensile bond strength of pretreatment with NSF showed higher values when compared to conventional restorations of GIC and RMGIC. The failure modes in each group were not significantly varied. Pretreatment with NSF will prevent secondary caries formation, and the restorations will also be stronger. Das A, Ramamurthy N, Srinivasan I, et al. Assessment of Nanosilver Fluoride Application on the Microtensile Bond Strength of Glass Ionomer Cement and Resin-modified Glass Ionomer Cement on Primary Carious Dentin: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(5):565-569.

Evaluation of the Dentinal Shear Bond Strength and Resin Interface in Primary Molars after Pre-Treatment with Various Dentin Bio-Modifiers: An In Vitro Study.

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength.

Effect of sodium perborate treatment on Bond Strength of two resin-based composite systems to pulpal dentine

Objectives: The aim of this study was to assess the effect of treatment with sodium perborate on the shear bond strength of two resin-based composite systems to pulpal dentine. Materials and Methods: Sixty extracted maxillary anterior teeth were divided into six groups (n=10) according to the type of restorative system: etch and rinse adhesive (Adper Single bond 2) with Filtek Z250 or self-etch adhesive (Silorane system Adhesive) with Filtek P90 and bonding protocol (bonding with no sodium perborate, immediate and late bonding). Bond strength was tested in a universal testing machine, and data were analyzed using two-way analysis of variance with independent samples t-test and one-way analysis of variance with Tukey’s HSD post-hoc (p≤0.05). Results: Treatment with sodium perborate significantly lowered the shear bond strength between both composite systems and pulpal dentine, (p&lt;0.001). The mean shear bond strength values were significantly higher in the late bonding compared to the immediate bonding groups for both composites, (p&lt;0.001). Conclusions: Treatment of the pulpal dentine with sodium perborate significantly reduced the immediate shear bond strength between the dentine and composites. The shear bond strength can be returned to nearly normal values if the final bonded restoration is delayed for two weeks after treatment.

Effects of immersion in 4-methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane resin-activated liquid on microtensile bond strength of root canal dentin

Background/purpose4-methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin is used for indirect restorations. We aimed to evaluate effects of immersion in 4-META/MMA-TBB-activated liquid on the bond strength of root canal dentin. Materials and methodsWe used freshly extracted single-rooted human teeth. After decoronation, each root was vertically sectioned into halves; their dentin walls were polished and flattened. The control group underwent dentin treatment with Green Activator. The immersion group was treated with Green Activator and Teeth Primer and immersed in 4-META/MMA-TBB-activated liquid. After bonding the resin blocks with Super-Bond, microtensile bond strength (μTBS) tests were performed (n = 6), and fracture surfaces were analyzed. Before surface treatment, dentin was immersed in a sodium fluorescein solution for 3 h, and resin blocks were bonded with Super-Bond with rhodamine B as in the bond strength test. The bonded cross section was observed using confocal laser scanning microscopy (CLSM). ResultsμTBS was significantly higher in the immersion group than in the control group (61.5 [51.3–66.7] vs. 33.0 [20.4–57.8] MPa; P < 0.05). Fracture mode analysis showed that, compared with the control group, the immersion group had a significantly lower rate of adhesive failure at the dentin interface and a significantly higher rate of cohesive failure in Super-Bond (P < 0.01). CLSM showed a water droplet-like accumulation of fluorescein dye above the hybrid layer in the control group, not in the immersion group. ConclusionImmersion in a 4-META/MMA-TBB-activated liquid inhibited water exudation from the root canal dentin and improved the bond strength.

Bond strength to dentin of a Polymer-infiltrate ceramic-network material cemented with dual resin cements submitted to different adhesive strategies

The purpose of the present in vitro study is to assess the immediate and long-term bond strength of a self-adhesive and conventional resin luting agents with a new hybrid restorative material to dentin. Blocks of a polymer-infiltrated ceramic-network (PICN) material (VITA Enamic) were cemented to a flat exposed dentin surface through different protocols. The groups were divided considering the combination of resin luting agent and ceramic surface treatment (U200 – Relyx U200 with silane; Ult + Sil – Relyx Ultimate with silane; Ult + SBU – Relyx Ultimate with Scotchbond Universal) and dentin treatment (NT – no dentin treatment; ER – etch-and-rinse with 35 % phosphoric acid) (n = 6). Beam-shaped specimens were obtained by cutting the cemented restorations. Specimens were submitted to microtensile bond strength in a universal testing machine (EMIC). Half of the specimens were tested 24 h after cementation, and the other half were tested after 12 months of water storage. ANOVA revealed one significant interaction between “time” and “dentin treatment” factors, as ER strategy was associated with bond strength decreases after 12 months. All resin luting agents (u200, Ult + Sil, and Ult + SBU) presented higher immediate μTBS with ER adhesive strategy. As the groups Ult + Sil, with both ER and SE adhesive strategies, and (Ult + SBU), with ER adhesive strategy, showed higher μTBS values after 12 months. It was concluded that conventional dual resin cement, combined with ER strategy produced better bond strength to dentin when cementing indirect PICN restoration.

Nano silver fluoride versus silver diamine fluoride with potassium iodide on carious dentine of primary teeth

Background Dental caries is one of the most prevalent diseases, and treating carious lesions remains a major concern, especially in pediatric dentistry. Minimally invasive interventions have been proposed as a promising treatment modality for caries control. Aim This study evaluated nano silver fluoride versus silver diamine fluoride with potassium iodide for the treatment of carious dentine in primary teeth. Material and methods This in vivo study was performed on 30 children presented with 60 primary molars with soft dentinal lesions. Carious teeth were assigned into two equal groups: group I received silver diamine fluoride with potassium iodide, while group II received nano silver fluoride. Teeth were diagnosed and treated at the baseline visit and followed up for clinical evaluation at 3, 6, and 9 months. Also, dentine samples were obtained from the initial carious teeth and after 9 months of applying the treatments for microbiological evaluation. Results Both groups had comparable clinical values at 3, 6, and 9 months, with no statistically significant difference. While after 9 months, there was a highly significant increase in the number of teeth showing dentine color change in group I compared with group II. Microbiological results showed no significant difference in the reduction of Lactobacillus count between both groups. While there was a significant difference between both groups in terms of Streptococcus mutans count. Conclusion Silver diamine fluoride with potassium iodide and nano silver fluoride provides simple and effective dentinal caries management.

Effect of Dentine Conditioning with Silver Diamine Fluoride on Wettability of Root Canal Sealers.

To test the null hypothesis that dentine treatment with silver diamine fluoride (SDF), a potent antimicrobial agent, following use of proteolytic and chelating agents does not influence the wettability of an epoxy resin (AH Plus, Dentsply Sirona, Charlotte, NC, USA) and a tricalcium silicate sealer (BioRoot RCS, Septodont, Saint-Maur-des-Fossés, France). Seventy-two intraradicular dentine specimens were divided into six groups based on the final irrigation solutions used: 2.5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) (NaOCl-EDTA) (group 1); NaOCl-EDTA-NaOCl (group 2); NaOCl-EDTA followed by 3.8% SDF, NaOCl-EDTA-SDF (group 3); NaOCl-EDTA-NaOCl-SDF (group 4); SDF (group 5) and saline (group 6). After irrigation, the specimens were divided into subgroups according to the sealer used, AH Plus or BioRoot RCS. Contact angles were measured using a contact angle analyser. The data were analysed using an independent t test, one-way analysis of variance (ANOVA) and Tamhane T2 post hoc test, with the level of significance set at P < 0.05. In the epoxy resin sealer group, dentine surfaces treated with only SDF showed the lowest contact angle. This was significantly less than the groups in which NaOCl was used as the final irrigant (P < 0.05). In the tricalcium silicate-based sealer group, the groups treated with SDF showed significantly greater contact angles when compared to the control group (P < 0.05). It was concluded that SDF conditioning of dentine favours the wettability of epoxy resin sealer but is detrimental to the wettability of tricalcium silicate sealer.

Analysis of the adhesive interface of dentine treated with carbodiimide and chitosan before cementation of fiberglass posts with different resin cements.

The objective of this study is to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) and chitosan (CHI) on the adhesive interface of resin cements to root dentine. Forty-five upper canines were sectioned, endodontically treated, prepared and divided into three groups according to dentine treatment (distilled water-DW, CHI 0.2% and EDC 0.5) and in three subgroups according to resin cement: RelyX ARC, Panavia F 2.0 or RelyX U200. Slices were obtained, with five slices of each third submitted to the analysis of the adaptation of the adhesive interface through scores and the perimeter with gaps in confocal laser scanning microscopy and one slice of each third later evaluated qualitatively in scanning electron microscopy. The results were analyzed using with Kruskal-Wallis and Spearman correlation tests. There was no difference in adaptation for the different resin cements (p = .438). EDC presented better adaptation when compared to the groups treated with DW and CHI (p < .001), while the CHI and DW presented similar adaptation values (p = .365). No difference was observed in the perimeter referring to the gap areas for the different resin cements (p = .510). EDC showed a lower percentage of perimeters with gaps when compared to CHI (p < .001), with the percentage of perimeter with gaps of teeth treated with CHI being lower than DW (p < .001). A positive correlation coefficient equal to 0.763 was obtained between the perimeter with gaps and the adaptation data of the adhesive interface (p < .001). EDC resulted in better adaptation of the adhesive interface and a lower percentage of perimeters with gaps compared to chitosan.

Oyster shell-derived nano-hydroxyapatite and proanthocyanidin pretreatment on dentinal tubule occlusion and permeability before and after acid challenge—an in vitro study

This in vitro study evaluated the dentinal tubule occlusion (TO), depth of penetration (DoP), and dentin permeability (DP) of oyster shell-derived nanohydroxyapatite (os-nHAp) with and without 15% proanthocyanidin (PA) pretreatment. os-nHAp was synthesized via the precipitation method and it was characterized. The morphology and particle size of os-nHAp were analyzed using a high-resolution transmission electron microscope (HRTEM). Cytotoxicity of os-nHAp, PA/os-nHAp, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) was assessed by (3-(4,5-dimethythiazol-2-yl) 2,5-diphenyl tetrazolium bromide (MTT) assay using human osteosarcoma (MG-63) cell line. One hundred and ninety-seven dentin discs of 3 mm thickness were prepared from the crown portion of extracted human teeth. The dentinal surfaces of the discs were etched for 2 min with 6% citric acid to simulate dentin hypersensitivity. Five discs were randomly selected and the patency of dentinal tubules was confirmed using a scanning electron microscope (SEM). The remaining 192 discs were divided into four groups (n = 48) depending on the type of remineralization as follows: group 1: os-nHAp, group 2: PA/os-nHAp, group 3: CPP-ACP, and group 4: no treatment. The remineralization protocol was followed for 21 days. Out of the 48 dentin discs in each group, 32 discs were used to evaluate dentinal tubule occlusion (TO) and depth of penetration (DoP) using SEM. The remaining 16 discs were subjected to an assessment of dentin permeability (DP) using a hydraulic conductance model. TO, DoP and DP were evaluated after remineralization and acid challenge. Characterization studies confirmed the presence of pure phase apatite. HRTEM confirmed the nanometric particle size of os-nHAp. MTT assay results showed that all the tested materials exhibited >80% cell viability when tested up to a concentration of 100 µg/mL. The results demonstrated a significantly higher mean percentage of TO, DoP, and lesser mean DP after remineralization in groups 1, 2, and 3 (p < 0.05). After the acid challenge, group 3 showed a significant reduction in TO and DoP, and increased DP (p < 0.05). However, no such changes were observed in groups 1 and 2. Within the limitations of this study, it can be concluded that os-nHAp and PA/os-nHAp could serve as potential and durable therapeutic agents in the treatment of dentin hypersensitivity.Graphical

Evaluation of different remineralization agents in the treatment of natural caries-affected dentin in permanent teeth.

In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS2) (Code3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5%NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.

Can Carbodiimide (EDC) and Chitosan Cross-linking Agents Effect the Longevity of Fiberglass Posts Luted with Different Types of Composite Cements to Root Dentin?

To evaluate the effect of carbodiimide (EDC) and chitosan (CHI) on the enzymatic activity (EA) and bond strength (BS) of different composite cements to root dentin. Ninety (90) maxillary canines were sectioned, standardizing the length of the roots. The roots were endodontically treated, prepared, divided into 3 groups according to dentin treatment (distilled water [DW], CHI 0.2 wt%, or EDC 0.5M), and further subdivided into 3 subgroups according to composite cement (RelyX ARC [3M Oral Care], Panavia F 2.0 [Kuraray Noritaki], or RelyX U200 [3M Oral Care]). Of the slices obtained by sectioning, the most cervical of each third were subjected to a push-out test and the most apical were subjected to in-situ zymography. Half of the slices were analyzed immediately, and the other half after 6 months. The results were analyzed with ANOVA or the chi-squared test. RelyX ARC showed higher BS associated with CHI, while RelyX U200 showed higher BS associated with EDC (p = 0.044). For Panavia F 2.0, the treatment did not influence BS (p > 0.05). For the cervical and middle thirds, no differences were observed between the cements, while the apical third revealed higher BS for RelyX U200 (p < 0.001). The highest percentage of adhesive-to-dentin failures was observed for Panavia F 2.0. EDC showed the lowest percentage of adhesive-to-dentin failures. According to zymographic analysis, DW and CHI showed greater fluorescence for RelyX ARC, while EDC exhibited the lowest fluorescence of all cements (p > 0.05). The different mechanisms of action of solutions for pre-treatment of intraradicular dentin yielded different results depending on the adhesive used. EDC resulted in higher bond strength and higher enzyme inhibition for RelyX U200, while the treatment with chitosan resulted in higher bond strength and lower enzymatic activity for RelyX ARC. Although EDC and chitosan treatments did not influence the bond strength for Panavia F 2.0, both resulted in higher enzyme inhibition for this composite cement.

Does Silver Diamine Fluoride Affect the Adaptation of High-Viscosity Resin-Modified Glass Ionomer to Dentin? An In Vitro Study

Background: The aim of this study was to evaluate the adaptation of a resin-modified glass ionomer to the internal walls of dentin with different conditioning systems, with or without the application of silver diamine fluoride (SDF) and potassium iodide (KI). Methods: Cervical standardized cavities were prepared on the buccal and lingual sides of 15 extracted molars. Molars were then sectioned longitudinally in a buccolingual direction, obtaining two samples from each tooth with two cavities each (60 samples). Samples were randomly divided into three groups (n = 20). Each group was divided into two subgroups. One subgroup did not receive dentin conditioning, one was conditioned with 25% polyacrylic acid—10 s (PA), and one with 37% orthophosphoric acid—5 s (OPA). In the other subgroup, dentine was treated with SDF/KI and not conditioned or conditioned with PA or OPA. All cavities were filled with Riva Light Cure® (RLC). The adaptation of the RLC to the cavity walls was evaluated by SEM at 100× magnification. The area of maximum interfacial gap was magnified at 1000× to measure its size. Kruskal–Wallis and Mann–Whitney U test were used for comparison. A significance level of α = 0.05 was used. Results: No significant differences in the percentage of well-adapted samples were found in subgroups when SDF/KI was used, regardless of whether conditioner was used or not and whether PA or OPA was used (p &gt; 0.05). Regardless of the gap size, dentin treatment with SDF/KI did not negatively influence ionomer adaptation to dentin walls significantly (p &gt; 0.05), except for the subgroup conditioned with OPA (p &lt; 0.05). Furthermore, it improved the adaptation in the axial wall of the subgroup without dentin conditioning (p &lt; 0.05). Conclusion: According to the results of the present in vitro study, the use of SDF/KI did not affect RLC adaptation to the cavity walls. Subsequent use of a conditioner worsens the adaptation of the material to the cavity walls.

Bonding strategy of a universal adhesive system containing chitosan: influence on dentin permeability, and effect on adhesive layer micromorphology.

This study evaluated the influence of chitosan added to a universal adhesive system used in totaletch (TE) or self-etch (SE) mode on dentin permeability, and on the micromorphology of the adhesive layer. Dentin discs were obtained from human third molars and randomly distributed according to bonding strategy (TE or SE), and to whether or not 1% chitosan (C) was added to a universal adhesive system (Single Bond Universal/3M ESPE), to create the following groups (n=10): TE, TEC, SE, and SEC. Dentin permeability was measured at baseline and after application of dentin treatments. The surface of the adhesive layer (AL) and the dentin adjacent to the AL were examined under a scanning electron microscope. There were no significant differences in permeability percentage between the groups with and without C (TE and SE versus TEC and SEC) (p>0.05; Mann Whitney test). Dentin permeability was lower when the adhesive system was applied in the SE mode, regardless of the addition of C. The micromorphology of the AL surface showed irregularities, and a greater degree of porosity, when the adhesive system was applied in the SE mode, regardless of chitosan addition. There was a greater depth of penetration of the adhesives into the dentin adjacent to the AL in both the TE and TEC groups. Chitosan added to the adhesive system did not influence dentin permeability. The self-etch strategy led to lower dentin permeability, and to more irregularities on the surface of the adhesive layer.

Shear Bond Strength of Two Self-Etching Adhesives to Air-Abraded Dentin: An in Vitro Study

Background: The aim of this research was to study the effect of air-abrasive treatment of dentin on the chemical composition of its surface and the adhesion strength of 2 self-etching adhesive systems (AS). Methods and Results: Powders based on aluminum oxide (Al2O3) (27µm) (KaVo, Biberach, Germany), sodium bicarbonate (NaHCO3) (40µm) (AIR-FlOW Classic Comfort, EMS, Nyon, Switzerland), and erythritol (14µm) (AIR-FLOW Plus, EMS, Nyon, Switzerland) were used for the air-abrasive treatment of adhesive surfaces. Bonding steps were carried out with Single Bond Universal (SBU) (3M ESPE, USA) and Bond Force 2 (BF2) (Toquyama, Japan). The adhesion strength of composite to dentin was evaluated on 80 samples prepared in accordance with the Ultradent Shear Bond Strength test. All samples were divided into 4 groups depending on the method of dentin surface processing. In the samples of Group 1 (n=20), aluminum oxide was used for the air-abrasive treatment of dentin. In Group 2 (n=20) and Group 3 (n=20), samples were treated using powders based on sodium bicarbonate and erythritol, respectively. Group 4 (control, n=20) included tooth samples in which the dentin surface was not air-abraded after preparation with carbide burs. Then, each group was divided into 2 subgroups (Sub-A and Sub-B) depending on the type of adhesive system used. Adhesive resin was applied and polymerized in accordance with the manufacturer’s instructions. Single Bond Universal (SBU) was used for the samples of Sub-A, and Bond Force 2 (BF2) (Toquyama, Japan) was used for the samples of Sub-B. Scanning electron microscopy and determining the surface elemental composition of samples were carried out on an SEM-EVO MA 10 (Carl Zeiss) and energy dispersive X-ray spectrometer with EDS Aztec Energy Advanced X-Act (Oxford Instruments). It was concluded that air-abrasive treatment of the dentin surface does not enhance the adhesion strength of composite material when using self-etch AS. Also, it was noted that the pH level of self-etch AS is not a crucial feature in determining the strength of the filling-tooth interface. The resulting variations in the elemental composition of dentin surface after air-abrasion with various mixtures and their effect on the efficacy of the different AS require further in vitro studies.

Effect of adhesive strategy on resin cement bonding to dentin.

The cement bonding strategy and the polymerization mode can influence the prognosis of indirect restorations. The microtensile bond strength (μTBS) and dentin endogenous enzymatic activity of a dual-cure resin cement (PV5) used in combination with two dentin surface conditioners (accelerator-enhancer primer, TP or universal adhesive, UA) were evaluated. PV5 was used to lute composite overlays after dentin treatment with TP or UA. The resin cement was self-cured, SC (1 h at 37 °C) or dual-cured, DC (20 s light-cure followed by 15 min self-cure at 37°C). The μTBS test, fractographic analysis, and the in situ zymography evaluations were performed after 24 h (T0 ) or 1 yr (T12 ) of artificial storage. Data were statistically analyzed (α=0.05). TP/DC obtained the highest adhesive strengths (45 ± 9 and 36.6 ± 8), while UA/SC (17 ± 8 and 11 ± 4) the lowest, both at T0 and T12 , respectively. DC resulted in superior bonding values than the SC, independent of the dentin surface treatment (p < 0.05). The type of adhesive, curing mode and aging influenced the gelatinolytic activity (p < 0.05). The dual-cure resin cement used in combination with its accelerator-enhancer primer showed superior bonding performances with respect to universal adhesive. Dual-curing the resin cement was determinant to enhance bonding capability over time, independent of the adhesive strategy. Clinicians must be aware to faithfully follow manufacturer's recommendation regarding the adhesive strategy suggested with the resin cement used.

Etch-mineralizing treatment to improve dentin bonding

Objectives This study aimed to investigate the effect of etch-mineralizing solution as a dentin treatment agent on dentin bonding.Methods This study designed four kinds of etch-mineralizing solutions (EMs) by adding sodium fluoride in 35% phosphoric acid aqueous solution with four different concentrations (5, 10, 20, and 30 mg/ml), and named F1, F2, F3 and F4, respectively. 35% phosphoric acid gel treatment was the control group. SEM, EDS, FTIR and microhardness tests were performed on the treated dentin. Shear bond strength was measured before and after aging. Nanoleakage was also evaluated. Fracture mode was researched after SBS testing. The antibacterial properties of treated dentin were also investigated through live/dead staining of biofilms.Results The smear layer was removed and mineralization substances were observed on the dentin surface and tubule, and no obvious collagen fibers were observed compared with the control group. FTIR spectrums showed that the ratios of phosphate/collagen on EMs treated dentin surfaces were significantly increased (P < 0.05). F2 group had the highest bonding strength (32.14 ± 7.33 MPa) and microhardness (66.08 ± 10.58), while the control group had the lowest bonding strength (21.81 ± 4.03 MPa) and microhardness (42.34 ± 7.08) (p < 0.05), and excellent bonding strength caused more cohesive fracture. Experimental groups showed less nanoleakage than group C (P < 0.05). Moreover, experimental groups had better antiaging performance and antibacterial properties than the control group (p < 0.05).Conclusion EMs treatment not only improved dentin bonding and antibacterial ability, but also remineralized dentin with autologous mineral elements.Clinical significance The treatment provides a novel therapeutic strategy for obtaining ideal dentin bonding strength and prolonging the longevity of the restoration.

Fast Construction of Biomimetic Organic-Inorganic Interface by Crosslinking of Calcium Phosphate Oligomers: A Strategy for Instant Regeneration of Hard Tissue.

The organic-inorganic structure in biological hard tissues ensures their marvelous characteristics but these hybrids are easily destroyed by the demineralization of inorganic components, e.g., the damage of dentin. Current clinical materials for hard tissue regeneration commonly act as "fillers" and their therapeutic effect is limited by the failures of biological-linked organic-inorganic interface reconstruction. Herein, a fast in situ crosslinking of calcium phosphate oligomers (CPOs) on collagen matrixes for efficient organic-inorganic interface re-construction, which can result in a biomimetic hybrid, is demonstrated. By using damaged dentin as an example, the inorganic ionic crosslinking can instantly infiltrate into the dentin matrix to rebuild a dense and continuous calcium phosphate-collagen hybrid within only 5min, where the structurally integrated organic-inorganic interface is identical to natural dentin. As a result, the damaged dentin can be fully recovered to a healthy one, which is superior to any current dentin treatments. The fast construction of biomimetic hybrid by inorganic ionic crosslinking provides a promising strategy for hard tissue repair and follows great potentials of CPOs as advanced biomedical materials in future.

Development and characterization of ion-releasing fiber-reinforced flowable composite

ObjectiveThis study aimed to develop and characterize an ion-releasing experimental fiber-reinforced flowable composite (Bio-SFRC) and dentin treatment solution made of poly(acrylic acid) (PAA) with a high molecular weight. In addition we also evaluated the interface structure and mineralization potential between the Bio-SFRC and dentin. MethodsSome mechanical properties (flexural properties and fracture toughness) of Bio-SFRC in comparison with commercial inert (G-aenial Flo X) and ion-releasing materials (ACTIVA-BioActive Base/Liner and Fuji II LC) were assessed (n = 8/group). Calcium-release at different time-points was measured during the first six weeks by using a calcium-ion selective electrode. Surface analysis of composites after being stored in simulated body fluid (SBF) was investigated by using SEM/EDS. Dentin disks (n = 50) were prepared from extracted sound teeth and demineralization was simulated by acid etching. SEM/EDS was used to evaluate the microstructure of dentin on the top surface and at interface with composites after being stored in SBF. ResultsBio-SFRC showed higher fracture toughness (1.6 MPa m1/2) (p < 0.05) compared to Flo X (1.2 MPa m1/2), ACTIVA (1 MPa m1/2) and Fuji II LC (0.8 MPa m1/2). Accumulative calcium release after six weeks from Bio-SFRC (15 mg/l) was higher than other tested ion-releasing materials (≈ 6 mg/l). Mineralization was clearly seen at the interface between treated dentin and Bio-SFRC. None of the commercial tested materials showed signs of mineralization at the interface and dentinal tubules remained open.Significance.Developing such reinforced ion-releasing flowable composite and PAA solution might offer the potential for mineralization at the interface and inside the organic matrix of demineralized dentin.