Resin-dentin Interface Research Articles

Different Concentrations of Ethanol as Dentin Pre-treatment to Bonding of an Etch-and-rinse Adhesive

Objective: to evaluate the bond strength (BS) to dentin pre-treated with ethanol in single application for 20 s after etching and before application of a two-step etch-and-rinse adhesive and to analyze the morphological features at the resin-dentin interface. Methods: twenty four third molars were collected and randomly assigned into four groups (n=5) according to the ethanol concentration: control (traditional water-wet technique), 50vol%, 70vol% and 100vol%. In experimental groups, ethanol was applied for 20 s and gently air-dried for 5 s. Bonding procedures were performed and resin composite was built up incrementally. Bonded teeth were sectioned into 0.8mm2 sticks on average. These specimens were submitted to microtensile bond strength test (μTBS). One-way ANOVA and post hoc Tukey’s test were applied to analyze statistical data (α=0 05). Light microscopy (LM) assisted by Masson’s trichrome staining was used to observe the features of resin/dentin interfaces. Results: control BS was not different from ethanol 50vol% (p>0.05). However, the pre-treatment using ethanol 70vol% and 100vol% showed increase on BS (p<0.001 and p=0.003 respectively) with no difference between these two groups. LM Showed a discrete decrease in denuded collagen fibrils to teeth treated with 70vol% and 100vol%. Conclusion: the pre-treatment of dentin using ethanol may increase the initial BS of resin/dentin interface when applied using 70vol% or 100vol% ethanol. Ethanol 70vol% is also able to decrease the thickness of the resin-sparse collagen fibrils.

Novel self-bonding composites: resin-dentin interfacial chemistry

Introduction: The biggest shortcoming of adhesive restorations is their susceptibility to bond degradation, when the substrate is dentin [1]. Since the quality of the resin-dentin interface relies mainly on its nanostructure [2], it is important to study the hybridization process in self-adhesive composites. Knowledge of the resin-dentin interface chemistry will provide insight into bonding, and possible susceptibility towards degradation [3]. Materials and methods: 9 primary teeth, obtained with informed consent from the Eastman Dental Hospital, previously approved by the EDI/EDH Joint Research & Ethics Committee were sectioned to obtain flat dentin surfaces, polished with 500 SiC grit paper and etched before material placement. The teeth were randomly divided (n = 3) between 3 materials - Activa ™ BioActive Restorative and 2 experimental composites. The experimental flowable composites had different levels of monocalcium phosphate (MCPM) and antibacterial polylysine (PLS) powders added to the filler phase. Restored teeth were stored in DI water for 24 h and vertically sectioned to obtain slabs perpendicular to the interface. Raman spectroscopy (Horiba Jobin Yvon, Paris, France) was used to research the chemistry of the resin-dentin interface. Three different lines were analysed in each sample to ensure reproducibility. Means corresponding to resin and dentin peaks were calculated and plotted using Microsoft Excel Tools (v15.30, Redmond, Washington, USA). FE-SEM (Phillip XL-30, Eindhoven, The Netherlands) was used to gather microstructural imaging of the interface. Results: Differences in chemical composition of the resin-dentin interface was found within interfacial regions ranging from 4 to 8 μm deep. Spectra obtained in mineralized dentin confirmed material diffusion and penetration in all cases. Doubling the hydrophilic additives in experimental composites, increased the resin infiltration depth by almost two-fold and affected the apatite to collagen ratio variation within the interface. SEM imaging confirmed resin tag formation, with all materials. Discussion and conclusions: No distinct hybrid layer was found at the interfaces, which is in accordance with previous studies [4,5]. However, resin infiltration was observable with all materials, providing evidence of envelopment and micromechanical interlocking. A gradual transition from dentin to pure material confirmed the presence of an interdiffusion zone [6] which was enhanced with increased hydrophilic additives. These results confirm micromechanical interlocking with dentin is achieved in both the experimental and commercial materials.

Influence of Er:YAG laser pulse duration on the long-term stability of organic matrix and resin-dentin interface.

The purpose of this study was to explore the influence of Er:YAG laser irradiation with different pulse durations on the organic matrix, micromorphology of the hybrid layer (HL), and bond strength over time. Sixty caries-free human molars were cut to obtain flat dentin surfaces which were randomly divided into 4 groups: control (not irradiated-G1) and laser groups (80mJ/2Hz) with pulse duration ranging between 50 (G2), 300 (G3), and 600μs (G4). A self-etch adhesive system (Universal 3M ESPE) was applied on pre-treated dentin surfaces and cylinders of resin composite were built up and stressed in a universal testing machine (μSBS) at 24h and after12months (n = 12). In addition, 3 other dentin-bonded specimens were prepared as previously described for each group with the adhesive doped with 0.1wt% Rhodamine B to analyze hybrid layer morphology under Confocal Laser Microscope Scanning (CLMS). Organic matrix and collagen fibrils were analyzed by second harmonic generation (SGH). Two-way ANOVA and Tukey's test detected significantly higher μSBS values for the control group, whereas the lower values were observed in all laser groups at 24h (p < 0.05). Storage in artificial saliva did not reduce μSBS in all groups. The low signal emitted by SHG images below the irradiated area demonstrated thermal damage of the collagen matrix. CLMS images of laser groups exhibited thicker and irregular resin-dentin interfaces than the control group. Regardless of the pulse duration, Er:YAG laser pre-treatment altered the organic matrix and HL formation which resulted in low μSBS values at 24h. The alterations on dentin's organic structure did not jeopardize the μSBS after 1year of saliva storage.

Biological, mechanical and adhesive properties of universal adhesives containing zinc and copper nanoparticles

ObjectivesTo evaluate the effect of addition of zinc oxide and copper nanoparticles (ZnO/CuNp) into universal adhesives, on antimicrobial activity (AMA), cytotoxicity (CTX), water sorption (WS) and solubility (SO), microhardness (MH) and in vitro degree of conversion (DC), as well as resin-dentin microtensile bond strength (μTBS), nanoleakage (NL) and in situ DC. MethodsZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added in Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. For CTX, Saos-2 cell-line was used. For WS and SO, specimens were tested for 28d. For MH, specimens were tested after 24 h and 28d and for in vitro DC, specimens were evaluated after 24 h. After, the adhesives were applied to flat dentine surfaces, composite resin build-ups, specimens were sectioned to obtain resin–dentine sticks. It was evaluated in μTBS, NL and in situ DC after 24 h of water storage. ANOVA and Tukey’s test were applied (α = 0.05). ResultsThe addition of 5/0.2 ZnO/CuNp increase AMA and WS, but decrease the SO when compared to control (p < 0.05). The CTX and μTBS were maintaining with adhesive-containing ZnO/CuNp (p > 0.05). MH, in vitro DC and in situ DC was significant increase (AMB) or maintaining (PBA) with ZnO/CuNp addition. However, significantly lower NL was observed for ZnO/CuNp groups (p < 0.05). ConclusionsThe addition of ZnO/CuNp in the tested concentrations in universal adhesive systems may be an alternative to provide antimicrobial activity and improves the integrity of the hybrid layer, without jeopardizing biological, adhesives and mechanical properties. SignificanceThis is the first study that demonstrates that the addition of zinc oxide and copper nanoparticles in concentrations up to 5/0.2 wt% in two universal adhesive systems is a feasible approach and may be an alternative to adhesive interfaces with antimicrobial properties and less defects in the resin-dentin interface.

Resin-Dentin Bonding Interface: Mechanisms of Degradation and Strategies for Stabilization of the Hybrid Layer.

Several studies have shown that the dentin-resin interface is unstable due to poor infiltration of resin monomers into the demineralized dentin matrix. This phenomenon is related to the incomplete infiltration of the adhesive system into the network of exposed collagen fibrils, mainly due to the difficulty of displacement and subsequent replacement of trapped water between interfibrillar spaces, avoiding adequate hybridization within the network of collagen fibrils. Thus, unprotected fibrils are exposed to undergo denaturation and are susceptible to cyclic fatigue rupture after being subjected to repetitive loads during function. The aqueous inclusions within the hybrid layer serve as a functional medium for the hydrolysis of the resin matrix, giving rise to the activity of esterases and collagenolytic enzymes, such as matrix metalloproteinases, which play a fundamental role in the degradation process of the hybrid layer. Achieving better interdiffusion of the adhesive system in the network of collagen fibrils and the substrate stability in the hybrid layer through different strategies are key events for the interfacial microstructure to adequately function. Hence, it is important to review the factors related to the mechanisms of degradation and stabilization of the hybrid layer to support the implementation of new materials and techniques in the future. The enzymatic degradation of collagen matrix, together with resin leaching, has led to seeking strategies that inhibit the endogenous proteases, cross-linking the denudated collagen fibrils and improving the adhesive penetration removing water from the interface. Some of dentin treatments have yielded promising results and require more research to be validated. A longer durability of adhesive restorations could resolve a variety of clinical problems, such as microleakage, recurrent caries, postoperative sensitivity, and restoration integrity.

Effects of Double Application of Contemporary Self-Etch Adhesives on Their Bonding Performance to Dentin with Clinically Relevant Smear Layers.

To evaluate the effects of double application of self-etch adhesives on their microtensile bond strength (μTBS) to dentin, as well as the hardness (H) of resin-dentin interfacial structures. Midcoronal dentin surfaces (n = 45) were polished with 180-grit SiC paper and randomly allocated to 9 groups based on three adhesives - Scotchbond Universal Adhesive (SB), G Premio Bond (GP), and Clearfil Megabond 2 (MB) - and three application modes: single application (S), double application with light curing after each application (DL), and double application with light curing only at the end (D). Following composite-resin build up and water storage (37°C; 24 h), μTBS were obtained. The hardness of adhesive, resin-dentin interface and dentin were evaluated by nanoindentation. The μTBS and H data were analyzed by two-way ANOVA to demonstrate the effects of adhesive and application mode as well as their interaction, followed by Tukey's test (α = 0.05). Fracture modes were determined using a stereomicroscope. μTBS and H were significantly affected by the adhesives and their application modes (p ˂ 0.001). Double application significantly increased the µTBS and H of adhesive and resin-dentin interface (p ˂ 0.05). SB and MB showed significantly higher µTBS than GP (p ˂ 0.05). Double applications during bonding of dentin having clinically relevant smear layers were beneficial for three contemporary self-etch adhesives. The improvement in bonding performance is believed to be the result of increased chemical interaction, better solvent removal, and improved resin infiltration, leading to improved mechanical properties of the resin-dentin interface or thicker adhesive layers providing improved stress distribution.

The effect of vitality and dentin depth on resin tags length of resin-dentin interface in dogs' teeth.

The aim of this study was to evaluate the effect of pulpal pressure and dentin depth on the quality of hybrid layer of bonded composite. Four healthy dogs, aged between 12 and 18 months, with intact dentitions were used for the experimental work. A total of 24 teeth were available for the study by using the six upper anterior teeth of each of the four dogs used in the study. The 24 teeth included in the study were divided according to presence or absence of pulpal pressure (P) into two groups with 12 teeth in each group. P1 teeth with positive pulpal pressure and P2 teeth with no pulpal pressure. Each of these two groups was further divided into two subgroups, according to the cavity depth (D) they received, where in D1 a class V cavity with depth of 1 mm was performed, while in D2 a class V cavity with depth of 2 mm was performed. The cavities were restored with micro hybrid composite restorative material and the samples were then left in the dogs’ mouth for 30 days. At the end of the experimental period, the dogs were euthanized by injecting an overdose of thiopental sodium. The anterior part of the upper jaw was sawed out of each dog’s mouth and the teeth were sectioned to evaluate the resin–dentin interface using Environmental Scanning Electronic Microscope. Results of the study showed that the mean resin tag length value was significantly affected by vitality and dentin depth. The presence of pulpal pressure together with depth of dentin could adversely affect the quality of hybridization.

Degradation of Adhesive-Dentin Interfaces Created Using Different Bonding Strategies after Five-year Simulated Pulpal Pressure.

To compare after five-year simulated pulpal pressure (SPP) the degradation of adhesive-dentin interfaces created using two simplified adhesives applied with different bonding strategies. A two-step self-etch (CSE: Clearfil SE Bond) adhesive was used as a control multistep adhesive. The tested experimental materials were two simplified adhesives, a one-step self-etch (CS3: Clearfil S3 Bond) and a self-priming etch-and-rinse adhesive (SB2: Adper Single-Bond 2). Half of the bonded specimens were submitted to microtensile bond strength (µTBS) testing after 24 h. The other half submitted to SPP for five years before µTBS testing. Nonfractured sticks were evaluated using transmission electron microscopy (TEM). Scanning electron microscopy (SEM) was used to evaluate silver-nitrate nanoleakage within the interface. Data were statistically analyzed by two-way ANOVA and Tukey's test (p < 0.05). Prolonged SPP induced bond-strength reduction for both SB2 and CS3. All bonding approaches showed increased nanoleakage after aging. The two simplified adhesives showed severe degradation at the resin-dentin interface. TEM revealed that the main degradation patterns for the etch-and-rinse adhesive SB2 was collagen breakdown, while polymer hydrolysis along with filler debonding was mainly observed in CS3. Simplified adhesives applied in etch-and-rinse mode are mainly characterized by hydrolysis and collagen degradation. In self-etch mode, simplified adhesives may principally show hydrolysis of the polymeric matrix and/or at the interface of fillers and coupling agent. The use of multistep self-etching adhesives may guarantee greater dentin bond durability compared to simplified adhesives.

Comparative evaluation of effect of chlorhexidine, Azadirachta indica (neem), and Aloe barbadensis miller (Aloe vera) on resin-dentin bond stabilization using shear bond testing: An in vitro study.

Introduction:Cavity disinfectants help to remove the microbial remnants; hence, its use prior to any restoration is valuable, and a search for alternative to chlorhexidine (CHX) is required which may be more efficacious and can overcome the drawbacks of CHX.Objective:The aim of this study was to evaluate the effect of application of three different cavity disinfectants in a clinically relevant time period on the immediate and delayed shear bond strengths (SBSs) of an etch-and-rinse adhesive system to dentin.Materials and Methods:For SBS testing, flat coronal dentin surfaces were prepared in two hundred extracted human molars. Specimens were randomly assigned to four groups according to the disinfectant used: Group I: Control (no disinfectant), Group II: 2% CHX solution, Group III: Aloe barbadensis miller (Aloe vera) solution, and Group IV: Azadirachta indica (neem) solution. Specimens were bonded using Prime and Bond NT adhesive which was employed according to the manufacturer's instructions. Resin composite cylinder buildups were done in all the samples. The modes of failure were noted after visual examination using a binocular stereomicroscope. Samples were also analyzed under scanning electron microscope for observation of resin-dentin interface. SBS results were analyzed using one-way ANOVA followed by Tukey's post hoc test.Results:The results showed that CHX, Aloe vera, and neem had improved bond strengths as compared to the control group for both immediate and delayed SBSs.Conclusion:From the results of the study, the authors concluded that Aloe vera and neem can be used as alternative cavity disinfectants to CHX.

A novel dry-bonding approach to reduce collagen degradation and optimize resin-dentin interfaces

In dentistry, the wet-bonding approach relies on water to maintain demineralized collagen expanded for proper resin infiltration; nevertheless, hydrolytic instability of the resin-dentin interface is inevitable with current bonding techniques. Considering dimethyl sulfoxide’s (DMSO) ability to “biomodify” collagen and precipitate enzymes, the aim was to test whether the use of DMSO would permit adequate resin bonding to H3PO4-etched dehydrated dentin and assess its impact on collagen degradation by host-derived enzymes. Etched dentin surfaces from extracted sound human molars were randomly bonded in wet or dry conditions using aqueous or ethanolic DMSO solutions as pretreatments and bonding resins with or without DMSO. Bonded teeth were sectioned into resin-dentin slabs for confocal in situ zymography and beams for microtensile bond strength test. Demineralized powdered dentin was incubated in the tested DMSO -media and a hydroxyproline assay evaluated dissolution of collagen peptides. Zymography was performed on protein extracts obtained from dry and wet H3PO4-ecthed dentin powder treated with the DMSO- media. The correlative biochemical analysis demonstrated that reduction of water content during dentin hybridization by the innovative dry-bonding approaches with DMSO is effective to inactivate host-derived MMP-2 and MMP-9 and thus reduce collagen degradation while simultaneously optimizing resin-dentin bonding.

Isocyanate-terminated urethane-based dental adhesive bridges dentinal matrix collagen with adhesive resin

Commercially available dental adhesives fail to chemically unite the demineralized collagen matrix with resinous materials within the resin-dentin interface. Sub-micron separations between the collagen fibrils and polymerized resin provide the backdrop for bond deterioration. Here, novel isocyanate-terminated urethane methacrylate precursors (UMP) were synthesized with the capacity to bond chemically to dentin collagen via covalent and hydrogen bonds. Collagen grafted with UMP also copolymerized with other methacrylate resin monomers, thereby producing a monoblock of chemically-linked biocomposite. The viscosity, degree of conversion and biocompatibility of UMP are comparable with commercially available resin monomers. An experimental adhesive containing 40% UMP demonstrated co-polymerization capability, good infiltration capacity and achieved higher immediate bond strength to dentin than the control commercially available adhesive. Improvement of dentin bonding by incorporation of UMP into dentin adhesives justifies future evaluation of the potential of these UMP-based adhesives in extending the longevity of resin-dentin bonds. Statement of SignificanceComposite-adhesive restorations have become an indispensable treatment modality in contemporary restorative dentistry. While the inability of these adhesives to bond chemically with collagen undermines the bond quality. This study describes a novel isocyanate-terminated urethane multi methacrylate precursors (UMP) which can bridge dentinal matrix collagen with adhesive resin by covalent and hydrogen bonds. Furthermore, an experimental UMP-based adhesive shows better co-polymerization capability, good infiltration capacity and higher immediate bond strength than the putatively effective adhesive Single Bond 2. The new chemical bonding mechanism based on UMP would theoretically produce more stable bonding interface that are more resistant to degradation.

Benefits of Nonthermal Atmospheric Plasma Treatment on Dentin Adhesion.

This study aimed to evaluate the influence of two nonthermal atmospheric plasma (NTAP) application times and two storage times on the microtensile bond strength (μTBS) to dentin. The influence of NTAP on the mechanical properties of the dentin-resin interface was studied by analyzing nanohardness (NH) and Young's modulus (YM). Water contact angles of pretreated dentin and hydroxyapatite blocks were also measured to assess possible alterations in the surface hydrophilicity upon NTAP. Forty-eight human molars were used in a split-tooth design (n=8). Midcoronal exposed dentin was flattened by a 600-grit SiC paper. One-half of each dentin surface received phosphoric acid conditioning, while the other half was covered with a metallic barrier and remained unetched. Afterward, NTAP was applied on the entire dentin surface (etched or not) for 10 or 30 seconds. The control groups did not receive NTAP treatment. Scotchbond Universal (SBU; 3M ESPE) and a resin-based composite were applied to dentin following the manufacturer's instructions. After 24 hours of water storage at 37°C, the specimens were sectioned perpendicular to the interface to obtain approximately six specimens or bonded beams (approximately 0.9 mm2 in cross-sectional area) representing the etch-and-rinse (ER) approach and another six specimens representing the self-etch (SE) approach. Half of the μTBS specimens were immediately loaded until failure, while the other half were first stored in deionized water for two years. Three other bonded teeth were selected from each group (n=3) for NH and YM evaluation. Water contact-angle analysis was conducted using a CAM200 (KSV Nima) goniometer. Droplet images of dentin and hydroxyapatite surfaces with or without 10 or 30 seconds of plasma treatment were captured at different water-deposition times (5 to 55 seconds). Two-way analysis of variance revealed significant differences in μTBS of SBU to dentin after two years of water storage in the SE approach, without differences among treatments. After two years of water aging, the ER control and ER NTAP 10-second groups showed lower μTBS means compared with the ER NTAP 30-second treated group. Nonthermal atmospheric plasma resulted in higher NH and YM for the hybrid layer. The influence of plasma treatment in hydrophilicity was more evident in the hydroxyapatite samples. Dentin hydrophilicity increased slightly after 10 seconds of NTAP, but the difference was higher when the plasma was used for 30 seconds. Dentin NTAP treatment for 30 seconds contributed to higher μTBS after two years of water storage in the ER approach, while no difference was observed among treatments in the SE evaluation. This result might be correlated to the increase in nanohardness and Young's modulus of the hybrid layer and to better adhesive infiltration, since dentin hydrophilicity was also improved. Although some effects were observed using NTAP for 10 seconds, the results suggest that 30 seconds is the most indicated treatment time.

Dentin pretreatment with 45S5 and niobophosphate bioactive glass: Effects on pH, antibacterial, mechanical properties of the interface and microtensile bond strength

ObjectivesThe aim of the study was to evaluate the effect of bioactive glass (45S5 and NbG) suspensions on bond strength (µTBS), hardness, modulus of elasticity, pH and antibacterial activity of the resin-dentin interfaces after 3 months. MethodsGroups with different concentrations (5% and 20%) of two types of glass (45S5 and NbG), and a control group (distilled water) were studied. Twenty-five extracted human third molars were etched with phosphoric acid. The data from µTBS, hardness and modulus of elasticity data were submitted to two-way ANOVA (suspension vs. time) and Holm-Sidak tests (=0.05). The antimicrobial activity data were analyzed by the Kruskal-Wallis test (α = 5%). ResultsThe interactions were significant among groups for µTBS (p = 0.033). Significant reductions in µTBS were observed after 3 months storage in PBS for the Control and 5% NbG Groups. Suspensions with 5% and 20% 45S5 glass and 20% NbG resulted in stable µTBS values and increased hardness after 3 months. Both 20% suspensions (45S5 and NbG) increased the elastic modulus. A significant greater reduction in bacterial growth was observed with the use of 20% 45S5. ConclusionRewetting dentin with the suspension of 20% 45S5 glass prevented the reduction in bond strength; increased hardness; modulus of elasticity of the resin-dentin interface, and demonstrated antibacterial activity against Streptococcus mutans.

Interfacial microscopic examination and chemical analysis of resin-dentin interface of self-adhering flowable resin composite.

Background: The newly introduced self-adhering flowable resin-composites decrease the required time for application by incorporation of an acidic adhesive monomer, thus reducing the number of steps, but its bonding is still uncertain. The aim of this study was to evaluate the interfacial microscopic examination and chemical analysis at the resin-dentin interface of a self-adhering flowable resin composite (Vertise™Flow Self-Adhering Flowable Composite, Kerr Dental, USA) versus a total-etch (Te-Econom Plus) resin composite, using an etching agent (Eco-Etch gel) and bonding agent (Single Bond Universal). Methods: Sixteen freshly extracted sound human posterior teeth were used. The teeth were randomly divided into two groups: 8 specimens per type of composite. Standard-shaped class V cavities were prepared on the buccal surface. One group was restored by Te-Econom Plus resin composite by total-etch technique using Eco-Etch gel, which was applied to dentine for 15 seconds, followed by rinsing, drying and bonding agent application (Single Bond Universal). The other group restored directly with self-adhering resin composite (Vertise-Flow) without application of etch or bond. Curing was done for 20 seconds using a light emitting diode light curing unit. Evaluation of the resin-dentin interface was done microscopically by examination of marginal gap distance in μm using scanning electron microscope (SEM), and chemical analysis of silver particles was observed using SEM with energy-dispersive X-ray spectrometry after 24 hours of specimen storage in ammoniacal silver nitrate. Results: Regarding marginal gap distance (µm) and silver atomic % mean values, teeth restored with self-adhering resin composite (Vertise-Flow) showed significantly higher mean values than the multi-step etch and rinse resin composite group (5.2 vs 0; 12.2 vs 8.2, respectively). Conclusions: Resin-dentin bonding using total-etch resin composite technique was more effective than self-adhering flowable resin composite (Vertise-Flow) regarding marginal gap formation and penetration of silver particles. Further studies for bond strength could be performed.

Smear Layer-Deproteinization: Improving the Adhesion of Self-Etch Adhesive Systems to Caries-Affected Dentin

This paper reviews a new method of dentin surface modification, smear layer-deproteinization for self-etch adhesive systems, particularly in relation to improving the adhesion to caries-affected dentin. Remnants of smear debris, which forms hybridized smear layer with self-etch adhesives, can prevent monomer infiltration and interfere with the chemical interaction of adhesive monomers and the underlying dentin. The hybridized smear layer weakens the physical and chemical properties of the resin-dentin hybridized complex both immediately and over time. Smear layer-deproteinization with NaOCl and HOCl solutions can improve the quality of resin-dentin interface of self-etch adhesives through elimination of the hybridized smear layer, development of monomer infiltration, and enhancement of the chemical interaction of adhesive monomers with hydroxyapatite due to an increase in the mineral/organic ratio on the dentin surface. These positive effects are influenced by the types of oxidizing solution and their application time and also depend upon the adhesive materials used because compromising effects of residual oxidized-byproducts at the dentin surface on the polymerization behavior of the adhesives are different between the materials. However, applying antioxidant/reducing agents can eliminate this problem. Smear layer-deproteinization is more effective for improving the bonding efficacy of self-etch adhesives to caries-affected dentin than normal dentin because caries-affected dentin produces a thicker organic-rich smear layer. Smear layer-deproteinization with HOCl solution, which has a rapid and broad-spectrum antimicrobial activity with less irritating and sensitizing properties, along with the subsequent application of antioxidant/reducing agents could enhance the longevity of composite restoration with self-etch adhesives.

Evaluation of The Role of Different Adhesive Systems in Durability of Endodontically Treated Teeth After Thermocycling

Background: The main reason suggested for the failure of endodontically treated teeth after a long period of time of intraoral performance is the lack of perfect coronal seal together with the presence of nanoleakage. Therefore, this study was conducted to evaluate to what extent the difference between adhesive systems may affect the seal achieved between pulp chamber dentin and the overlying coronal restoration together with nanoleakage evaluation. Materials and methods: Two groups of root canal treated teeth were bonded with two types of adhesive systems (Total-etch and Self-Etch) and restored with nano-hybrid resin composite. All teeth were thermocycled (2,500 cycles, 5°C to 55°C, 20 seconds dwell time, and 5 seconds resting time). After thermocycling, teeth were sectioned into sticks of 1 mm2 (15 sticks obtained from each group) for microtensile bond strength testing (mTBS). From each group, a slab of 1 mm2 was obtained for micromorphological analysis to observe the quality of the resin-dentin interface by scanning electron microscope and to evaluate nanoleakage pattern through silver tracing as well. The collected data were expressed in MPa and analyzed by independent sample t-test.Results: Regarding bond strength testing, highly significant difference was recorded between both adhesive systems (p<0.05). Total etch adhesive group showed higher results compared to the Self Etch one. Besides, SEM observations showed that all specimens showed different patterns of nanoleakage regardless of the type of adhesive system used.Conclusions: Total etch adhesive system showed better results than self-etch adhesive one in achieving good seal to pulp chamber dentin in endodontically treated teeth after thermocycling.

Chlorhexidine and proanthocyanidin enhance the long-term bond strength of resin-based endodontic sealer.

The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.

Effect of fluoride-resistant strains of Streptococcus mutans on the bonding strength of dental resin composite

The aim of this study was to determine the influence of fluoride-resistant strains of S. mutans on the bonding strength of dental resin composite. Standardized specimens of resin composite (Z350), and self-etch adhesives (Single bond Universal, 3M) were incubated with S. mutans UA159, fluoride-resistant strains of S. mutans UA159 (UA159-FR) or uninoculated culture medium (Control) or PBS for up to 14 days. Resin-dentin bonded disks were subjected to push-out test. Fractured surface analysis of the specimens was performed by scanning electron microscopy(SEM). SPSS18.0 software package was used for statistical analysis. UA159-FR and UA159 were shown to decrease the bond strengths in levels comparable with those found in the control groups (P<0.05). SEM confirmed the increased degradation of all materials with UA159-FR and UA159, compared with control and PBS. The results suggest that resin-dentin interface can be compromised by oral bacteria that contribute to the progress of secondary caries. Fluoride-resistant strains of S. mutans and its parental strains both decrease bonding strengths in a short time, but no significant difference in the extent of damage.

Three-dimensional diagnosis of dentin caries beneath composite restorations using swept-source optical coherence tomography.

The aims of this study were to assess the diagnostic accuracy of swept-source optical coherence tomography (SS-OCT) for detection of caries beneath composite restorations and to compare the results with those obtained by radiography. Flat dentin surfaces with and without natural caries were bonded with 1- or 2-mm thick composite restorations. SS-OCT scanning was performed over the composite restorations to construct three-dimensional (3D) images of the resin-dentin interface. Images were chosen from the 3D constructions to detect caries beneath the restorations. The sensitivity, specificity, false positive and negative predictive values for caries detection, and Az values from receiver-operating characteristic analysis were calculated and compared with those of digital dental radiography at a significance level of α=0.05. Intraexaminer and interexaminer reproducibility was compared between SSOCT and radiography. SS-OCT could detect caries, which appeared as a bright zone beneath composite up to 2-mm thick. SS-OCT provided greater diagnostic accuracy than radiography.

Effects of different Er,Cr:YSGG laser parameters on dentin shear bond strength and interface morphology: an in vitro study

The aim of this in vitro study is to evaluate the effect of Er,Cr:YSGG laser parameters, specifically power (Watt) and frequency (Hertz), throughout both, shear bond strength (SBS) and dentin-composite interface morphology, when using laser etch as an alternative to acid etching with a “two-step” total etch adhesive. Thirty-six human sound molars were mounted on acrylic blocks, randomly divided into six groups, six teeth into each group, where five teeth were selected for the SBS test, and one sectioned for the scanning electron microscope (SEM) analysis. Teeth were sliced occlusally to expose a flattened dentin surface, then grouped according to various treatments: control group, only treated with phosphoric acid etchant; and groups 1–5, only treated with Er,Cr,:YSGG laser irradiating at 3 W/25 Hz, 3 W/50 Hz, 4 W/25 Hz, 4 W/50 Hz, and 5 W/75 Hz respectively. The adhesive was applied followed by composite build up. SBS test was carried out using a universal testing machine. The resin-dentin interface was analyzed utilizing a SEM. The control group showed the highest SBS values (11.38 ± 2.03 Mpa). Group 5 (5 W/75 Hz) was the second highest (8.46 ± 1.82 Mpa), yet the highest among the entire laser-irradiated groups, showing a marginal/borderline significance with the control group (P = 0.044). Group 3 (4 W/25 Hz) came second through the laser samples (7.41 ± 0.97 Mpa). SEM analysis manifested premier retentive composite dentin interface among the control group and groups 5 and 3. When applying Er,Cr,:YSGG laser solely for dentin etching, adjusting the settings to a power of 5 W and frequency at 75 Hz will lead to optimum results regarding both SBS and interface morphology.