Fiber post cemented using different adhesive strategies to root canal dentin obturated with calcium silicate-based sealer.

BACKGROUND: Calcium silicate-based sealer has favorable properties for root canal filling, including hydroxyapatite formation during the setting process. However, this process can cause difficulty during post space preparation when the sealer is set. Additionally, the remaining sealer could interfere with the bond strength of fiber post to root canal dentin. The different adhesive strategies and fiber post cementation time may affect the bond strength of the fiber post. Thus, the objective of this study was to evaluate the effect of etching modes of Scotchbond™ Universal Plus adhesive and post cementation time on the push-out bond strength of a fiber post cemented in root canals obturated with calcium silicate-based sealer. METHODS: Fifty-four teeth were randomly allocated to 6 groups (n = 9) based on etching modes: self-etch (SE) or etch-and-rinse (ER); post space preparation and cementation time: immediate (Im) or 7-day delayed (De): Im-Im, Im-De, and De-De. The root canals were obturated with calcium silicate-based sealer and the post space preparation was performed. The fiber post was cemented using RelyX™ Universal resin cement according to each group's design. For the push-out bond strength test, 1-mm slices of the coronal, middle, and apical regions were tested using a universal testing machine. The failure mode analysis was determined using a stereomicroscope. The data was analyzed with three-way analysis of variance. RESULTS: No negative effects of etching modes, post space preparation or cementation time on push-out bond strength were detected (p > 0.05). Additionally, the root canal region also did not significantly affect the bond strength (p > 0.05). CONCLUSION: No significant differences were observed between the etching modes, post space preparation and cementation time and among root canal regions. CLINICAL RELEVANCE: The different etching modes of adhesive and post cementation time did not affect the bond strength of fiber post in calcium silicate filled-root canal.

Effects of NaF versus SDF treatment on microhardness of artificial radiation caries at cervical and root areas.

This study aimed to compare the effect of silver diamine fluoride (SDF) and fluoride varnish (NaF) on the Vickers microhardness (VHN) of enamel and dentin after radiotherapy and pH-cycling. Human premolars were cut longitudinally, embedded and serially polished. The VHN of enamel/dentin and irradiated enamel/dentin were evaluated. The irradiated specimens were treated with either NaF or SDF, subjected to pH-cycling then VHN test for 4 days. Consequently, they were subjected to energy-dispersive X-ray (EDX) analysis. Radiation adversely affect enamel VHN (p<0.05), whereas dentin VHN was not affected (p>0.05). After pH-cycling, a significant decrease in dentin VHN was observed on day 2 for all groups, whereas enamel VHN was significantly decreased in the control group on day 4. SDF-treated enamel demonstrated higher VHN than that of NaF on day 3. Caries prevention effect of SDF and NaF were observed on enamel, where SDF was proved to be superior to NaF.

Effect of Silver Diamine Fluoride on Bonding Performance and Ultra-morphological Characteristics to Sound Dentin.

OBJECTIVES: This study aimed to evaluate microtensile bond strength (µTBS) and ultra-morphological characteristic changes in sound dentin resulting from silver diamine fluoride (SDF) when using adhesives. METHODS: Ninety-six extracted human third molars were divided into the SDF-contaminated dentin group and the sound dentin group. In the SDF-contaminated dentin group, 38% SDF was agitated for 1 min, left undisturbed for 2 min, and rinsed with distilled water for 30 s. Then, each group was further subdivided into six subgroups (n = 8 / group) according to application modes: self-etch mode (SE) and etch-and-rinse mode (ER) followed by three adhesives: (1) Scothbond Universal Plus Adhesive (SUP); (2) G2-Bond Universal Adhesive (G2B); and (3) Clearfil Mega Bond 2 (MB2). All specimens were restored with resin composite and were stored in distilled water for 24 h before µTBS testing. Data from the µTBS test were analyzed using Three-way ANOVA and Duncan test (p < 0.05). The morphology of fractured surface and adhesive-dentin interfaces were evaluated by SEM, TEM, and STEM. Further elemental analysis was done by EDX. RESULTS: All SDF-contaminated dentin groups demonstrated significantly lower µTBS than sound dentin groups. All ER groups had higher µTBS than SE groups, except for G2B in the sound dentin group. STEM/EDX revealed an SDF-dentin-reacted layer in the SDF-contaminated dentin group. SIGNIFICANCE: SDF had an adverse effect on adhesives. Additionally, ER mode is preferable when bonded to SDF-contaminated dentin. A calcium and fluoride-contained layer was observed in all SDF-contaminated dentin.

Bonding performance of glass ionomer cement to carious dentin treated with different surface treatment protocols using silver diamine fluoride.

This study investigated the influence of silver diamine fluoride (SDF) on the shear bond strength (SBS) to artificial carious dentin and GIC restorations with various SDF application protocols. Artificial caries were prepared on human dentin discs using bacteria model. These samples were randomly allocated to five groups (n = 10/group) according to the following treatment: (1) control group (CD): no treatment (2) CSR: dentin conditioner, SDF, and rinsing (3) CS: dentin conditioner and SDF (4) SRC: SDF, rinsing and dentin conditioner, and (5) SC: SDF and dentin conditioner. The treated-dentin surface was bonded with GIC and subjected to SBS test. Mean SBS was analyzed using one-way ANOVA. Surface morphology and elemental contents after surface treatment were examined (n = 3/group) by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX). There was no significant difference in the mean SBS among CD (2.45 ± 0.99 MPa), CSR (1.76 ± 0.65 MPa), and SRC (2.64 ± 0.95 MPa). Meanwhile, the mean SBS of CS (0.35 ± 0.21 MPa) was significantly lower than the control and SRC group. SEM/EDX demonstrated deeper silver penetration in CSR and CS groups when compared to SRC and SC groups. SDF-modified GIC restorations resulted in significantly lower bond strength in CS and SC groups. The findings suggested treating the carious dentin surface with CSR and SRC protocol. SDF-treated carious dentin should be rinsed off prior to restore with GIC.

Digital fabrication of customized intraoral appliances for head and neck radiotherapy.

Introduction: The radiotherapy received by head and neck cancer patients commonly has adverse effects on oral tissue and the muscles of mastication. This short communication describes the digital fabrication of intraoral appliances for radiotherapy and muscle exercises. Methods: Three patients diagnosed with tongue squamous carcinoma were treatment-planned for radiotherapy using different radiation techniques. The patients were referred for oral scanning and digital bite records, and the appliance was collaboratively designed by a radiation oncologist, dentist, and laboratory technician. The appliance covered the occlusal surface of the remaining teeth with a 1-mm engagement. The lingual plate was 2-mm below the occlusal plane, and extended 4-mm distally, and the jaws were opened by 20-mm. The appliances were printed overnight using a rigid and biocompatible 3D printing material. Results: Requiring minimal chair-time, the appliance was easily inserted and adjusted to comfortably fit in the mouth. The patients were trained to insert it themselves. The tongue was at a pre-determined position during daily radiotherapy, and the healthy tissues were separated from the radiation field. The patients had mild adverse effects on their oral mucosa. Additionally, the appliances were used for muscle exercises after the radiation courses to prevent trismus. Conclusions: The interprofessional collaboration to fabricate customized intraoral appliances using digital workflow to maximize patients' benefits is feasible. Clinical significance: The use of intraoral appliances is potentially increased when the fabrication process is facilitated. Using an intraoral appliance precisely targets the tumor are for better treatment outcomes, and the healthy adjacent tissues will be preserved to maintain the patient's quality of life.

Bond Strengths of Universal Adhesives to Dentin Contaminated with a Hemostatic Agent.

PURPOSE: To evaluate the microtensile bond strength (µTBS) of three universal adhesives to dentin contaminated with a hemostatic agent. MATERIALS AND METHODS: Ninety-six human premolars were cut to expose mid-coronal dentin. The teeth were randomly divided into a control group (uncontaminated dentin) and an experimental group in which a hemostatic agent was applied (contaminated dentin). Each group was further divided into 6 subgroups according to universal adhesives - SBU (Single Bond Universal), OPU (OptiBond Universal), CBQ (Clearfil Universal Bond Quick) - and etching mode, either etch-and-rinse (ER) or self-etch (SE). Following adhesive application, composite was placed in two increments and light cured. The specimens were stored in distilled water at 37°C for 24 h. The µTBS test was performed using a universal testing machine. Failure mode was assessed using a light microscope. The data were statistically analyzed using three-way ANOVA followed by Scheffe's test (p < 0.05). The resin-dentin interface was observed using scanning electron microscopy. RESULTS: Significantly lower bond strength was observed when the universal adhesives were bonded to contaminated dentin in SE mode (p < 0.05). In contrast, the µTBS of the universal adhesives in ER mode was not affected by contamination (p > 0.05). The µTBS of CBQ to contaminated dentin was significantly lower than that of the other adhesives. Observation of the resin-dentin interface revealed limited resin penetration when the universal adhesive was applied in SE mode on contaminated dentin. CONCLUSION: Contaminating the dentin with a hemostatic agent significantly reduced the µTBS of the universal adhesives in SE mode. However, this adverse effect was not found when the universal adhesives were used in ER mode.

Cause-Effect Relationship of Varying Bonding Thicknesses in Dentin Adhesion of Universal Adhesives.

PURPOSE: To evaluate whether varying thicknesses of universal adhesives utilizing the additional coating strategy would affect their microtensile bond strength (µTBS) to dentin, hardness, and elastic modulus (mechanical properties). MATERIALS AND METHODS: Ninety-nine human maxillary premolars were cut to expose coronal dentin, ground with regular-grit diamond burs, and randomly distributed into 9 groups based on 1. adhesive: Scotchbond Universal Adhesive (SB; universal), G Premio Bond (GP; universal) and Clearfil Megabond 2 (MB; two-step self-etch; control); and 2. application strategy (one, two or three coats; each coat light cured). After adhesive application and resin composite buildup, the bonded teeth were stored in distilled water (37°C; 24 h). Resin-dentin sticks from eight premolars per group (each premolar yielded 3 sticks; n = 24 sticks altogether) were prepared for the µTBS test, followed by measurement of the adhesive thicknesses at their fractured ends using SEM. The mechanical properties of the adhesive layers produced by different coats were evaluated on separate resin-dentin slices (n = 3 teeth per group). RESULTS: Two coats significantly increased the µTBS (p < 0.001) of all the adhesives. The correlation between adhesive thickness and bond strength was positive for GP but negative for SB. MB did not show any correlation. Additional coating significantly increased the mechanical properties of GP (p < 0.05) but did not affect SB and MB (p < 0.05). CONCLUSION: An additional adhesive coating over the manufacturers' recommendations improved the bond strength of all the adhesives tested. However, the increased mechanical properties of the adhesives with additional curing was material dependent.

Delayed light activation of resin composite affects the bond strength of adhesives under dynamic simulated pulpal pressure.

OBJECTIVE: To evaluate the effect of a time delay before the light activation of resin composite on the microtensile bond strength (µTBS) of self-etch adhesives under dynamic simulated pulpal pressure. MATERIALS AND METHODS: One hundred twenty crown segments were prepared from human third molars. Dentin surfaces were prepared with coarse diamond burs and connected to a dynamic pulpal pressure device. The self-etch adhesives used were Clearfil SE Bond (CSE), G2-Bond Universal (G2B), Clearfil Universal Bond Quick (CBQ), and G-Premio Bond (GPB). Each adhesive was divided into 3 subgroups: immediate light activation of resin composite (T0), delayed light activation for 150 s (T1), and 300 s (T2). The µTBS data were obtained after 24-h water storage. Scanning electron microscopy was used to evaluate the nanoleakage at the resin-dentin surface. The µTBS data were analyzed using two-way ANOVA and Duncan's multiple comparisons. RESULTS: All adhesives demonstrated a significant reduction in µTBS at T2, except for CBQ where the bond strength was not affected by the delayed light activation times. The two-step self-etch adhesives (CSE and G2B) demonstrated higher bond strength than the one-step adhesives at all conditions. Nanoleakage was observed in all adhesives at T2; however, nanoleakage was detected only in CBQ and GPB at T1. CONCLUSIONS: Delayed light activation of resin composite adversely affected the dentin bond strength of self-etch adhesives. Two-step self-etch adhesives had better bonding performance than one-step self-etch adhesives. CLINICAL RELEVANCE: After adhesive application, resin composite should be adapted and cured as soon as possible.

Bond Durability of a Repaired Resin Composite Using a Universal Adhesive and Different Surface Treatments.

PURPOSE: To evaluate the long-term effect of different surface treatments on the repair microtensile bond strength (µTBS) of resin composite using a universal adhesive. MATERIALS AND METHODS: Thirty-six resin composite blocks were fabricated and aged in 37°C distilled water for 1 month. The blocks were randomly assigned to different surface treatments: no treatment (control); diamond bur grinding (D); diamond bur + phosphoric acid cleaning (DP); diamond bur + silane application (DSi); diamond bur + phosphoric acid + silane (DPSi); and grit blasting with 50 µm H3PO4 particles + phosphoric acid + silane (APSi). Thereafter, Single Bond Universal adhesive was applied and repaired with the same composite. Composite-composite stick-shaped specimens were fabricated and subjected to the µTBS test either after 37°C water storage for 24 h or thermocycling for 10,000 cycles. Roughness of different surface-prepared specimens was measured by profilometer. Data were analysed using ANOVA and Duncan's post-hoc test (α = 0.05). Failure mode and micromorphology of different surface-prepared specimens were observed with SEM and EDS analysis. RESULTS: The highest µTBS was found in DPSi group at 24 h, and was significantly higher than others. The bond strengths in all thermocycled groups were significantly lower than those measured at 24 h. The highest µTBS was also found in the DPSi group, but this did not significantly differ from the DSi group. CONCLUSION: Thermocycling significantly reduced the repair bond strength. Diamond bur roughening with application of silane and universal adhesive yielded the highest repair bond strength for the aged resin composite.

Effects of dentin surface preparations on bonding of self-etching adhesives under simulated pulpal pressure.

Objectives: This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure. Materials and Methods: Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH2O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests. Results: Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives. Conclusions: Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

Role of the smear layer in adhesive dentistry and the clinical applications to improve bonding performance.

Currently, dental adhesives can be divided into two systems; a smear layer-removal approach with etch-and-rinse adhesives or a smear layer-modified approach with self-etching adhesives. After phosphoric acid etching, the smear layer is completely removed. More attention is, however, required when using self-etching adhesives. The smear layer is partially demineralized by the weak acidic monomer and subsequently incorporated into the hybrid layer. Therefore, the characteristics of the smear layer play an important role on the bonding performance of self-etching adhesives. Such characteristics, for instance, smear layer thickness and smear layer density, are influenced by many factors, e.g., instruments used for dentin surface preparation, cutting speed, and the abrasive particle size of the cutting instruments. This review discusses the contributing factors that affect the smear layer characteristics, and the influence of the smear layer on the bonding performance of dental adhesives. Also, the application techniques regarding how to improve the bonding performance of self-etching adhesives - the smear layer removal by using chemical agents, or the modification of the adhesive application procedures - are provided.

Effects of Color Modifier on Degree of Monomer Conversion, Biaxial Flexural Strength, Surface Microhardness, and Water Sorption/Solubility of Resin Composites.

Color modifiers can be mixed with resin composites to mimic the shade of severely discolored tooth. The aim of this study was to assess the effects of a color modifier on the physical and mechanical properties of a resin composite. The composite was mixed with a color modifier at 0 wt% (group 1), 1 wt% (group 2), 2.5 wt% (group 3), or 5 wt% (group 4). The degree of monomer conversion (DC) was examined after light curing for 20 or 40 s. Biaxial flexural strength (BFS)/modulus (BFM), surface microhardness (SH), and water sorption (Wsp)/solubility (Wsl) were also tested. The DC of group 1 was significantly higher than that of groups 3 and 4. The increase in curing time from 20 to 40 s increased the DC by ~10%. The BFS, BFM, Wsp, and Wsl of all the groups were comparable. A negative correlation was detected between the concentration of color modifier and the BFS and DC, while a positive correlation was observed with Wsp. In conclusion, the color modifier reduced the DC of composites, but the conversion was improved by extending the curing time. The increase in color modifier concentration also correlated with a reduction in strength and the increase in the water sorption of the composites.

Bonding Performance of Self-etching Adhesives to Bur-cut Dentin with Active Application Mode.

PURPOSE: This study evaluated whether active application of self-etching adhesives would influence their microtensile bond strength (µTBS) to dentin cut with burs of different grit sizes. MATERIALS AND METHODS: Eighty-four human premolars were divided into 12 groups according to 1) two dentin surface preparations with either superfine- or regular-grit diamond burs; 2) three adhesives - Clearfil SE Bond 2 (SE2), Scotchbond Universal (SBU, 3M Oral Care) and G-Premio Bond (GPB, GC); and 3) two application modes of each adhesive (active or passive). Six bonded teeth per group were sectioned into sticks for µTBS testing. Statistical analyses were performed using 3-way ANOVA followed by Duncan's test (p < 0.05). Additional teeth were prepared to observe the interaction between the dentin smear layer obtained from each bur with adhesives under different application modes using transmission electron microscopy (TEM). RESULTS: Active application significantly increased the dentin bond strength of SE2, irrespective of the kind of bur used (p < 0.05). The highest bond strength of SBU was observed when bonded to superfine-grit diamond bur-cut dentin with the active application. There was, however, no influence of the tested factors on GPB group (p > 0.05). TEM observation showed that active application promoted dentin smear layer dissolution in all adhesive groups. CONCLUSIONS: Bond strengths of self-etching adhesives to dentin are influenced by bur-cut smear layers and mainly by application mode of adhesive materials. Active application improves µTBS of self-etching adhesives by enhancing smear layer modification and resin penetration into bur-cut dentin.

Characterization of an Experimental Two-Step Self-Etch Adhesive's Bonding Performance and Resin-Dentin Interfacial Properties.

This study evaluated an experimental two-step self-etch adhesive (BZF-29, BZF) by comparing it with a reference two-step self-etch adhesive (Clearfil Megabond 2, MB) and a universal adhesive (G-Premio Bond, GP) for microtensile bond strength (µTBS) and resin-dentin interfacial characteristics. Twenty-four human third molars were used for the µTBS test. Bonded peripheral dentin slices were separated to observe the resin-dentin interface and measure the adhesive layer thickness with SEM. µTBS data of the central beams were obtained after 24 h and 6 months of water storage. Fracture modes were determined using a stereomicroscope and SEM. Nine additional third molars were used to determine the elastic modulus (E) employing an ultra microhardness tester. Water storage did not affect µTBS of the tested adhesives (p > 0.05). µTBS of BZF and MB were similar but significantly higher than GP (p < 0.05). BZF achieved the highest adhesive layer thickness, while GP the lowest. E of BZF and MB were comparable but significantly lower than GP (p < 0.05). Except for GP, the predominant fracture mode was nonadhesive. The superior bonding performance of BZF and MB could be attributed to their better mechanical property and increased adhesive thickness imparting better stress relief at the interface.

Effects of Double Application of a Resin Cement Primer and Different Diamond Burs on Cement-Dentin Bond Strength.

PURPOSE: To evaluate the effects of double application of resin cement primers to dentin prepared with different diamond burs on the cement-dentin bond strengths. MATERIALS AND METHODS: Sixty flat dentin surfaces were prepared and divided into 12 groups (n = 5) according to three experimental factors: 1. resin cements: RelyX Ultimate (RU), Multilink Automix (ML), and Panavia V5 (PV); 2. resin cement primer application: single or double; 3. dentin surface preparation with regular or superfine diamond burs. Cement-dentin sticks (1 mm2) were prepared for and underwent microtensile bond strength testing (µTBS). Statistical analysis was performed using three-way ANOVA and Duncan's test (α = 0.05). Fractured surfaces and cement-dentin interfaces were observed using SEM. Additional teeth were used to observe the demineralization effect of resin cement primers with SEM and transmission electron microscopy (TEM). RESULTS: All tested factors demonstrated significant effects on µTBS (p < 0.001). The combination of PV with superfine-grit bur and double application yielded the highest bond strengths. Surfaces prepared with superfine-grit burs demonstrated higher µTBS than did the regular-grit group, but a significant effect was not observed for all groups. The double application of primer significantly increased the bond strength for most combinations, except for PV with superfine-grit bur-prepared dentin. CONCLUSIONS: PV showed higher bond strengths than other resin cements. Double application of primer improved the bond strength of all cements to dentin. Bond strengths were higher when dentin was prepared with a superfine-grit bur.

Ultra-morphological characteristics of dentin surfaces after different preparations and treatments.

Using transmission electron microscopy (TEM), this study investigated the characteristics of smear layers after preparation of dentin surfaces using different methods. In addition, this study analyzed, using scanning electron microscopy (SEM), the interactions of smear layers with the various acidic agents used subsequently to treat the dentin surface. Mid-coronal dentin surfaces were prepared according to one of five instrumentation methods: fracture; grinding with carbide bur; grinding with regular-grit diamond bur; grinding with superfine-grit diamond bur; or grinding with 600-grit silicon carbide (SiC) abrasive paper. Then, each prepared dentin surface was further divided into control (no further treatment) or treatment with one of the following agents: phosphoric acid solution (PAS); phosphoric acid gel (PAG); Clearfil SE Bond 2 Primer (SE2); or Scotchbond Universal Adhesive (SBU). Longitudinal ultra-thin sections were made for TEM observations. Dentin discs, representing each surface preparation and treatment method described above, were created, and the morphology was examined by SEM. The TEM results revealed differences in thickness and denseness of the smear layer, according to the different methods of instrumentation used to prepare the dentin surface. The two forms of phosphoric acid completely removed the smear layer in all groups. Agglomerated silica particles were observed on the top of the collagen layer after etching with PAG. For all dentin surfaces, except for that prepared with SiC, SE2 demonstrated better etching efficacy on different smear layers, whereas SBU provided only superficial interaction.

Size- and Morphology-Controlled Preparation of Surface-Modified Water-Dispersible Fullerene Nanoparticles for Bioapplications.

In this study, we investigated water-dispersible surface modification for size- and shape-controlled fullerene nanoparticles (C60P) based on a condensation reaction with di-amino alkane. This modification provided for water dispersibility of C60P and the capability for secondary modification as well. The resultant C60P particles have several useful physical properties: water-dispersibility for ease of injection; fluorescence for detection and quantification; and a characteristic morphology to assist identification. These properties will widely extend the applications of these particles, especially into the biological fields of bioimaging and drug delivery.

The microtensile bond strength test: Its historical background and application to bond testing.

Microtensile bond strength (µTBS) test was introduced in 1994. Since then, it has been utilized profoundly across many bond strength testing laboratories, making it currently one of the most standard and versatile bond strength test. Although it is a static and strength-based method, together with the morphological and spectroscopic investigations, it has been contributing immensely in the advancement of dentin adhesive systems. µTBS test has a greater discriminative capability than the traditional macro-shear bond test. During the early stage of its development, the authors predicted that this testing method would enable evaluation of the adhesive performances of resins to excavated carious or sclerotic dentin and the regional bond strengths of various portions of the cavity. In addition, they also stated the possibility of comparing the long-term stability of resin adhesion at various portions of the cavity walls on teeth extracted at various times after insertion of bonded restorations. In this review, we discussed the historical background, inception and the application of the µTBS test and proposed directions for further improvement of this testing method.

Gradual dehydration affects the mechanical properties and bonding outcome of adhesives to dentin.

This study evaluated the effects of dehydration on the mechanical properties of adhesive resins and dentin, and on the microtensile bond strength (µTBS) of adhesives. Third molars were randomly bonded with Clearfil Mega Bond (MB) or Clearfil SE Bond 2 (SE). After water-storage (37°C; 24 h), µTBS was obtained in 'wet' (tested after 5 min of removal from storage) and 'dehydrated' (tested after 10, 15 min and 24 h) conditions by a universal tester (crosshead speed: 1 mm/min). Data were analyzed by two-way ANOVA and Duncan's test. Hardness (H), Elastic modulus (E) and weight-loss of dentin beams and adhesive-resin discs were also monitored over time and analyzed by one-way repeated measures ANOVA and Bonferroni's test (α=0.05). Significant differences in bond strength were observed for adhesives and for conditions. Except for dentin's E, dehydration caused significant gradual changes in the H, E and weight of adhesive resins and dentin (p<0.05).

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

PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.