Exploring Zirconia Adhesion: Pre and Postsintering Physical Surface Treatment, Chemical Treatment, and Cement Interactions.

Background: Adhesion to zirconia remains a significant dental challenge. This study is aimed at assessing the bond strength of zirconia based on surface treatment with pre or postsintering sandblasting associated with different chemical treatments and resin cements. Methods: Zirconia blocks were divided into 12 experimental groups based on the surface treatment (presintering sandblasting or postsintering sandblasting/tribochemical abrasion treatment), chemical treatment (none, Single Bond Universal, or Signum Zirconia Bond), and choice of cement (Panavia F or RelyX™ U200). The bond strength was measured by shear tests using a universal testing machine. The fracture analysis was performed using stereomicroscopy. Data were analyzed using three-way ANOVA and Tukey's test (α = 5%). Results: Triple and double factor's interactions were not significant (p > 0.05). Regarding the surface treatment factor, the bond strength following postsintering sandblasting treatment associated with tribochemical abrasion (9.15 ± 3.62 MPa) was significantly higher than presintering sandblasting treatment (5.24 ± 3.53 MPa). Concerning the chemical treatment factor, bond strengths were ranked as follows: Signum Zirconia Bond > Single Bond Universal > no treatment. The bond strength of the resin cements did not differ among them. Most fractures (67%) were classified as adhesive, and 32% were categorized as mixed fractures. Conclusion: Surface treatment via postsintering sandblasting combined with tribochemical abrasion demonstrated superior efficacy than in presintering sandblasting. Additionally, chemical treatment with zirconia primer increased the bond strength of zirconia irrespective of the surface physical treatment.

Do the methods for cleaning the base of brackets used in indirect bonding interfere with adhesion to tooth enamel?

OBJECTIVE: The objective of this study was to evaluate the shear bond strength of metal brackets bonded with indirect bonding, under different surface treatment protocols. MATERIAL AND METHODS: 40 bovine teeth were randomly divided into four groups (n = 10), according to the type of surface treatment: G1 = 70% alcohol, G2 = air/water spray, G3 = 100-µm aluminum oxide blasting, G4 = direct boning. After drying, the standard Edgewise central incisor brackets were bonded with light-cured resin. The brackets were moved from the plaster models by means of a transfer tray made with condensation silicone, and bonded to the surface of the enamel with self-curing adhesive. The samples were submitted to shear tests by a universal test machine. Data were analyzed with SPSS 20.0 by the one-way ANOVA test and the Tukey post-test. RESULTS: No statistically significant difference (p=0.174) was observed between the mean forces measured between the group for shear strength values of the groups during the test: G1 (5.33 MPa), G2 (3.52 MPa) and G3 (4.58 MPa). CONCLUSION: The bracket surface treatment protocols presented similarities in shear bond strength test. However, alcohol 70% and oxide blasting presented higher absolute values of resistance than the water group.

Effects of lactic acid etching on immediate and aged bond strength of resin-dentin bonding interface.

To investigate the effects of lactic acid etching on the immediate and aged bond strength of the resin-dentin bonding interface, the resin-dentin bonding interface was evaluated 24 hours and 6 months later. A total of 42 isolated third molars were randomly divided into 6 experimental groups according to different lactate concentration (35%, 40%, 45%) and acid etching time (30 s, 45 s), with 37% phosphoric acid etching 15 s as a control. In each group, dentin samples were etched under different acidic conditions and bonded with Adper Single Bond 2 (3M ESPE) as directed. The immediate group was immediately stored in deionized water at 37 °C for 24 h, and the aging group was stored in artificial saliva at 37 °C for 6 months. Immediate and aged bond strengths were measured by a micro-tensile tester, and the specimen fracture surface was observed under a microscope. 14 isolated third molars were randomly divided into 7 groups, and each group was etched with acid. Collagen fibers morphology in dentin was examined after gradient dehydration with ethanol by scanning electron microscopy (SEM). Statistically, there was no difference between the resin-dentin immediate bonding strength of 35% lactic acid for 30 s and 37% phosphoric acid for 15 s, but the aged bond strength was greater than that of the phosphoric acid group. According to scanning electron microscope observations, the collagen fiber morphology in 35% and 40% lactate etching dentin 30 s groups was relatively intact compared with other groups. In conclusion, 35% lactic acid etching of dentin 30 s ensures both immediate and aged resin-dentin bond strength.

Effect of adding arginine at different concentrations to experimental orthodontic resins: an in vitro study.

The aim of this study was to assess the effect of adding arginine at different concentrations to commercial and experimental orthodontic resins on shear bond strength (SBS), as well as on the antimicrobial activity of arginine against S. mutans. Metal brackets were bonded onto the surface of 120 bovine incisors using Transbond, OrthoCem, and an experimental resin (ER), adding 0, 2.5, 5, and 7 wt.% of arginine. The SBS test was performed in deionized water at 37 ºC for 24 h, at 0.5 mm/min. SBS test results were subjected to two-way ANOVA and Tukey's test (α = 0.05). CFU/mL data (antimicrobial assessment) were assessed by Kruskal-Wallis and Dunn's tests (α = 0.05). No statistical difference between the resins was observed in untreated groups (p > 0.05). The addition of arginine at 2.5% (27.7 MPa) and 5% (29.0 MPa) increased the SBS of Transbond when compared (p < 0.05) to OrthoCem (18.5 and 15.6 MPa, respectively) and ER (16.3 and 18.1 MPa, respectively). Arginine at 7% improved the SBS of Transbond (24.1 MPa) and ER (21.0 MPa), which was statistically higher (p < 0.05) than OrthoCem (12.6 MPa). OrthoCem did not show a statistically significant difference at the three concentrations of arginine (p > 0.05). The addition of arginine to resins reduced the count of S. mutans (p < 0.05). As for ER, all concentrations of arginine significantly decreased CFU/mL (p < 0.05). Among commercial resins, only 7% of arginine significantly reduced CFU/mL. The addition of arginine did not interfere with the bond strength and demonstrated antibacterial activity against S. mutans.

Degree of conversion and interfacial adaptation of touch-cure resin cement polymerized by self-curing or dual-curing with reduced light.

OBJECTIVES: The first aim of this study was to determine whether there is a difference in degree of conversion (DC) of touch-cure cements polymerized by self-curing with adhesive or dual-curing under reduced light. The second aim was to compare interfacial adaptation of zirconia restoration cemented using touch-cure cements self-cured or dual-cured by reduced light. METHODS: The DC of touch-cure resin cements with adhesive was measured continuously using Fourier transform infrared spectrometry. Experimental groups differed depending on touch-cure cement. Each group had three subgroups of polymerization method. For subgroup 1, the DC was measured by self-curing. For subgroups 2 and 3, the DCs were measured by dual-curing with reduced light penetrating 3 mm and 1 mm zirconia blocks, respectively. For interfacial adaptation evaluation, Class I cavity was prepared on an extracted third molar, and zirconia restoration was fabricated. The restoration was cemented using the same cement. Groups and subgroups for interfacial adaptation were the same as those of the DC measurement. After thermo-cycling, interfacial adaptation at the tooth-restoration interface was evaluated using swept-source optical coherence tomography imaging. RESULTS: The DC of touch-cure cement differed depending on the measurement time, resin cement, and polymerization method (p < 0.05). Interfacial adaptation was different depending on the resin cement and polymerization method (p < 0.05). CONCLUSION: For touch-cure cement, light-curing with higher irradiance presented a higher DC and superior interfacial adaptation than light-curing with lower irradiance or self-curing. CLINICAL RELEVANCE: Although some adhesives accelerate the self-curing of touch-cure cement, light-curing for touch-cure cement is necessary for zirconia cementation.

Effect of time and photoactivated face on bond strength of brackets and on degree of monomer conversion.

OBJECTIVE: To evaluate the effect of four different photoactivation protocols (according to "photoactivated faces" - mesial/distal, cervical/incisal or center - and "photoactivation time" - 6-3 s) of a high-power photo activator (Valo Cordless®-Ultradent) on the shear bond strength (SBS) between metal brackets and dental enamel and on the degree of conversion (DC) of an orthodontic resin. MATERIALS AND METHODS: 40 bovine incisor crowns were randomly assigned to 4 groups (n = 10). The brackets were bonded with Transbond XT® resin using 4 protocols according to the "photoactivation protocol" factor (which was subdivided into photoactivated faces and photoactivation time): V3C = 3 s + center; V6C = 6 s + center; V3M3D = 3 s on mesial + 3 s on distal; V3C3I = 3 s on cervical + 3 s on incisal. All the samples were stored for 4 months (water,37ºC) and then subjected to a SBS test (100KgF,1 mm/min). 40 resin discs were made to evaluate the monomer degree of conversion. Data from the SBS and DC were assessed by One-way ANOVA and Tukey's test (5%). Bond failures were analyzed according to the Adhesive Remnant Index (ARI) and evaluated by the Kruskal-Wallis test (5%). RESULTS: There was a statistically significant difference (p = 0.008) in the One-way ANOVA result for SBS values between all groups, but the protocols showed statistically similar results (p ≥ 0.05-Tukey's tests) concerning the photoactivated faces (V6C, V3M3D and V3C3I) and photoactivation time (V3C and V6C) factors individually. There was no statistically significant difference (p ≥ 0.05) in the One-way ANOVA result for DC values. CONCLUSION: The SBS and DC values will vary depending on the protocol applied. CLINICAL RELEVANCE: It is possible to maintain the bracket fixation quality with the use of a high-power LED photo activator associated with a shorter photoactivation time. However, it is assumed that not all types of protocols that might be applied will provide quality bonding, such as V3C, V3M3D and V3C3I, which may - depending on the SBS and DC values - affect the final treatment time, due to brackets debonding, or increase of possibility of damage to dental enamel during bracket removal. Clinical studies are suggested to confirm the hypotheses of this research.

Influence of luting strategies on dentin bond performance of self-adhesive resin luting cement in combination with a universal adhesive.

OBJECTIVES: This study aimed to evaluate the dentin bond performance of various resin luting cement (RLC) systems combined with universal adhesives in different luting strategies. MATERIALS AND METHODS: Three self-adhesive resin luting cements (SRLCs) were used with universal adhesives as primers. Twelve specimens per group were prepared to measure shear bond strength (SBS) under distinct luting strategies in etch-&-rinse and self-etch modes. Regarding luting strategies, the bonded specimens were categorized into four groups based on tooth primer application and the curing mode of the SRLC paste: (i) with light irradiation of the tooth primer (wL) + dual-cure mode (DC) of the SRLC paste, (ii) wL + self-cure mode (SC) of the SRLC paste, (iii) without light irradiation of the tooth primer (woL) + DC mode of the SRLC paste, and (iv) woL + SC mode of the SRLC paste. Specimens were also subjected to different storage conditions: 24 h in water (baseline condition) and 10,000 cycles of thermal cycling. RESULTS: Luting strategy, storage condition, and SRLC system type significantly influenced dentin SBS values in both etching modes. Notably, certain SRLCs exhibited significantly higher dentin SBS when the primer was light-irradiated compared with no primer irradiation. CONCLUSION: Most SRLCs demonstrated higher dentin bond strength with light-irradiated primers, suggesting potential enhancement of dentin bond performance via primer light irradiation.

Restoration-repair potential of resin-modified glass ionomer cement.

This in vitro study aimed to evaluate the repair bond strength of resin-modified glass ionomer cement using either the same material or a universal adhesive in the etch-and-rinse and self-etch modes plus resin composite. Twenty-four resin-modified glass ionomer cement blocks were stored in distilled water for 14 d and thermocycled. Sandpaper ground specimens were randomly assigned to three experimental groups according to the repair protocol: resin-modified glass ionomer cement (Riva Light Cure, SDI) and universal adhesive (Scotchbond Universal Adhesive, 3M Oral Care) in etch-and-rinse or self-etch modes and nanohybrid resin composite (Z350 XT, 3M Oral Care). After 24 h of water storage, the blocks were sectioned, and bonded sticks were subjected to the microtensile bond strength (µTBS) test. One-way ANOVA and Tukey's test were used to analyze the data. The failure mode was descriptively analyzed. The highest µTBS values were obtained when the resin-modified glass ionomer cement was repaired using the same material (p < 0.01). In addition, the mode of application of the universal adhesive system did not influence the repair bond strength of the resin-modified glass ionomer cement. Adhesive/mixed failures prevailed in all groups. Repair of resin-modified glass ionomers with the same material appears to be the preferred option to improve bond strength.

Comparison of various methods of restoring adhesion to recently bleached enamel.

AIM: This study compared the effectiveness of several techniques in restoring compromised bonding to recently bleached enamel. METHODS: Seventy-five healthy bovine incisors were divided into five groups (n = 15). Fifteen teeth (Group 1) remained intact, whereas 60 (Groups 2 to 5) underwent at-home bleaching with 16% carbamide peroxide. The bonding procedures were as follows: Group 1: Bonding of resin composite to unbleached enamel; Group 2: Bonding immediately after bleaching; Group 3: Application of a 10% sodium ascorbate solution for 10 min before bonding; Group 4: Enamel removal to the depth of 0.5 mm; and Group 5: Increased curing time of the bonding agent to 80 instead of 20 s. After 24 h, the specimens were subjected to micro-shear testing, and the failure mode was determined. RESULTS: ANOVA revealed a significant difference in bond strength among the groups (P < 0.001). The mean bond strength was significantly lower in group 2 than in other groups (P < 0.05), which showed comparable bond strength to each other (P > 0.05). Adhesive failure was the most predominant failure type in all groups. The mixed failure occurred with a frequency of 26.7% in groups 3 and 5. The Fisher's exact test revealed a significant difference in failure modes among the groups (P = 0.047). CONCLUSIONS: The three experimental procedures used in this study, including the application of 10% sodium ascorbate before bonding, enamel removal to the depth of 0.5 mm, and increasing the curing time of the bonding agent to 80 s, were effective in restoring the compromised bonding to recently bleached enamel.

Influence of provisional cementation on the stability of adhesively bonded resin-based composite crowns.

PURPOSE: To investigate the influence of temporary cementation and subsequent bonding on the durability during in-vitro aging-simulation and fracture force of resin-based composite crowns. METHODS: Identical molar crowns (n=48, n=8 per group) were milled from resin-based composites and temporarily cemented and finally bonded to human molars. To simulate temporary application, crowns were cemented either with zinc-oxide-eugenol-cement (Tempbond) or with eugenol free zinc-oxide-cement (Tempbond NE). For a first simulation of a long-term provisional clinical application, thermal cycling, and mechanical loading (TCML 2 x 600 x 5°C-55°C, 2 minutes each cycle, distilled water, 240,000 cycles at 50N) was performed. After TCML all crowns were removed, cleaned, and luted either by using etch-and-rinse technique (Vococid, Futurabond U, Bifix QM) or a self-adhesive (Bifix SE) cementation system. A second thermal cycling and mechanical loading (TCML 2 x3,000 x 5°C/55°C, 2 minutes each cycle, distilled water, 1.2 x 106 at 50N) was accomplished to simulate 5 years of clinical application. To assess the survival of the crowns, the failure rates during TCML were documented. As controls, crowns were included without prior provisional cementation. After TCML all crowns were loaded to failure. Failure was categorized as fracture of the crown and partial loosening of the crown. RESULTS: All crowns survived both TCML procedures without any failures. The fracture values after TCML varied between 3,538.0 ± 1,041.2 N and 4,612.0 ± 801.5 N without significant (P= 0.146) differences between the individual groups. No correlation was found between fracture force and type of provisional cementation (zinc-oxide-eugenol vs. zinc-oxide: Pearson: -0.063/P= 0.672) or type of bonding (adhesive vs. self-adhesive: Pearson: -0.151/ P= 0.307). No different failure pattern was observed between the tested systems. CLINICAL SIGNIFICANCE: Regardless of the type of temporary cementation, there was no effect on the in-vitro performance or strength of the final permanently bonded crowns. Resin-based crowns might be bonded with adhesive or self-adhesive systems even after previous temporary cementation.

Microhardness, diametral tensile strength and color stability of heated resin composites used for luting ceramic veneers.

PURPOSE: To evaluate color change in ceramic veneers luted to enamel with light-cured, dual-cured resin luting agents, or heated resin composites, as well as to evaluate microhardness and diametral tensile strength of these luting agents. METHODS: For color analysis, 0.5 mm-thick leucite-reinforced glass ceramic veneers (IPS Empress CAD) were cemented onto 40 bovine dental blocks (n= 10) using RelyX Ultimate (RU) or RelyX Veneer (RV) resin-based luting agents, or Gradia Direct (GD) and Palfique Lx5 (P) heated resin composites. After luting, the specimens were subjected to thermocycling (10,000 cycles). Color analysis was performed before and after thermocycling (L*, a*, b*, ΔEab, ΔE00). For the microhardness (Knoop) and diametral tensile strength tests, specimens (Ø 6 x 2 mm) were made (RU, RV, GD, and P). The specimens were subdivided into eight groups (n=10) and light-cured through different ceramic sheets (thicknesses of 0.5 mm or 1.5 mm). Knoop microhardness was performed on the top surface in a microhardness tester, and diametral tensile strength on a universal testing machine. Data were submitted to statistical analysis, using two-way ANOVA, Tukey, and Kruskal-Wallis tests (α= 0.05). RESULTS: For the general color alteration, there was no statistically significant difference between the luting materials (ΔEab, P= 0.57; ΔE00, P= 0.50). There was no interaction between luting agent and thermocycling, for L* (P= 0.87), a* (P= 0.97) and b* (P= 0.95) values. Thermocycling significantly affected only the L* values (P= 0.047), which increased after the cycles. For microhardness, there was a statistically significant difference considering luting agents and ceramic thickness (P< 0.001). GD heated resin composite presented significantly lower microhardness values than all other materials, at both ceramic thicknesses. At a thickness of 1.5 mm, RU cement had higher microhardness values than RV and P materials. Diametral tensile strength was significantly influenced by luting agent (P= 0.01), but not by ceramic thickness (P= 0.55). Diametral tensile strength of GD resin composite was higher than that of the RU, but neither of these two materials differed from RV and P. CLINICAL SIGNIFICANCE: Heated resin composite, used as luting agents, showed similar color stability to light-cured and dual-cure resin cements, however its microhardness was affected by ceramic thickness.

Influence of Different Application Modes of a Universal Adhesive System on the Bond Strength of Bulk-Fill Composite Resin to Enamel and Dentin in Primary Teeth.

OBJECTIVES: The objective of this study was to assess how the application mode of a universal adhesive system affects the microshear bond strength (µSBS) of bulk-fill and conventional composite resins to enamel and dentin in primary teeth. METHODS: A total of 80 caries-free primary second molars were randomly assigned to eight experimental groups (n = 10) based on the bonding substrate (enamel or dentin), the application mode of the universal adhesive system (etch and rinse [E&R], or self-etch [SE]), and the type of composite resin used (bulk-fill or conventional). After bonding the composite resin to enamel or dentin, the µSBS of the bonded composite resins was measured. RESULTS: The mean µSBS value of bulk-fill composite resin was significantly higher than that of conventional composite resin for both enamel and dentin substrates, regardless of the application mode (p < 0.001). An interaction effect between the bonding substrate and the application mode of the adhesive system was observed, indicating a significant relationship (p < 0.001). The highest µSBS values for primary teeth enamel were achieved using the E&R mode with bulk-fill composite resin, while for dentin specimens, the SE mode with bulk-fill composite resin yielded the highest µSBS values. The µSBS of the E&R group was significantly higher than that of the SE group for enamel specimens (p < 0.001), whereas the µSBS of the SE group was significantly higher than that of the E&R group for dentin specimens (p < 0.001). CONCLUSION: Bulk-fill composite resin demonstrated higher µSBS in comparison to conventional composite resin. The universal adhesive system exhibited superior performance in the SE mode compared to the E&R mode on primary dentin. Pre-etching the enamel before the application of the universal adhesive enhanced the µSBS to primary teeth enamel, highlighting the importance of selectively acid etching the enamel of primary teeth.

Stability of the Dentin-Bonded Interface Using Self-Etching Adhesive Containing Diacrylamide after Bacterial Challenge.

Purpose/Aim: Acrylamides are hydrolytically stable at pH lower than 2, and were shown to preserve bonded interface integrity with two-step, total etch adhesives. The objective of this study was to leverage those two characteristics in self-etching primers containing the acidic monomer 10-MDP and test the microtensile bond strength before and after incubation with S. mutans incubation. Materials and Methods: Acidic primers (10 wt % 10-methacryloyloxydecyl dihydrogen phosphate─10-MDP; 45 wt % N,N-diethyl-1,3-bis(acrylamido)propane─DEBAAP, or 2-hydroxyethyl methacrylate─HEMA; 45 wt %, glycerol-dimethacrylate─GDMA) and adhesives (DEBAAP or HEMA/10-MDP/UDMA 45/10/45 wt %) were made polymerizable by the addition of 0.2 wt % camphorquinone, 0.8 wt % ethyl-4-dimethylaminobenzoate, 0.4 wt % diphenyliodonium hexafluorophosphate, and 0.1 wt % butylhydroxytoluene. Nonsolvated materials were characterized for flexural strength (FS), modulus (E), toughness, water sorption/solubility (WS/SL), contact angle, and vinyl conversion (DC). Viscosity was evaluated after adding 20 and 40 vol % ethanol to the primer and adhesive, respectively. The experimental materials or Clearfil SE Bond (CC─commercial control) were used to bond a commercial composite (Filtek Supreme) to the flat surface of human dentin. Microtensile bond strength (MTBS) was tested in 1 mm2 sticks for the 5 primer/bond combinations: CC (Clearfil Bond Primer and Bond), HH (HEMA/HEMA), DD (DEBAAP/DEBAAP), HD (HEMA/DEBAAP), and DH (DEBAAP/HEMA). Prior to testing, sticks were stored in water or biofilm-inducing culture medium with S. mutans for 1 week. Confocal images and FTIR-ATR evaluation evaluated the hybrid layer of the adhesives. Results were analyzed using Student's t-test (WS, SL, DC, contact angle, FS, E, toughness), one-way ANOVA/Tukey's test for viscosity, and two-way ANOVA/Tukey's test for MTBS (95%). Results: HEMA-based materials had lower contact angle (p = 0.004), higher WS (p < 0.001), and similar SL values compared to DEBAAP (p = 0.126). FS (p = 0.171) and E (p = 0.065) dry values were similar, but after one week of water storage, FS/E dropped more significantly for HEMA materials. Dry and wet toughness was greater for DEBAAP (p < 0.001), but it also had the greatest drop (46%). Clearfil bonds had the highest viscosity, followed by DEBAAP and HEMA, respectively (p = 0.002). For the primers, HEMA had the lowest viscosity (p = 0.003). As far as MTBS, all groups tested in water were statistically different when compared with HH (p < 0.001). After storage in biofilm, DH had the highest MTBS value, being statistically different from HH (p = 0.002), CC (p = 0.015), and DD (p = 0.027). Conclusions: The addition of a diacrylamide and its association with HEMA in self-etching adhesive systems provided greater bonding stability after bacterial challenge.

Evaluation of adhesive properties and enzymatic activity at the hybrid layer of a simplified adhesive loaded with 0.2 % Cu and 5 % ZnO nanoparticles: A Randomized Clinical Trial and ex vivo analysis.

OBJECTIVE: The aim of this study was to evaluate the effect of an adhesive loaded with 0.2 % copper (Cu) and 5 % zinc oxide (ZnO) nanoparticles (Nps) on its adhesive properties and enzymatic activity at the hybrid layer ex vivo in a randomized clinical model. METHODS: Fifteen patients participated in this study, and a total of 30 third molars were used. Occlusal cavities (4 × 4 × 2 mm) were made in each tooth, and randomly divided into 2 groups: (i) Experimental group: commercial adhesive loaded with 0.2wt % CuNps and 5wt % ZnONps; and (ii) Control Group: non-loaded commercial adhesive. Teeth were restored with resin composite. Thirty days later, extractions were performed. Extracted teeth were longitudinally sectioned. Nps in powder were characterized by field emission scanning electron microscope (FE-SEM) and energy dispersive X-ray (EDX) analysis. Microtensile bond strength (µTBS), degree of conversion (DC), and nanoleakeage (NL) tests were executed. In situ zymography (Zym) was performed to evaluate the gelatinolytic activity at the hybrid layer. Student's t-test (α = 0.05) was applied for all tests. RESULTS: µTBS and DC did not show significant differences (p > 0.05) between both groups. However, NL and gelatinolytic activity at the hybrid layer showed significant values (p < 0.05) for experimental group in comparison with control group. CONCLUSION: The addition of 0.2 % CuNps and 5 % ZnONps to a universal adhesive decreases NL and gelatinolytic activity at the hybrid layer, without jeopardizing its adhesive properties. SIGNIFICANCE: This randomized clinical trial with ex vivo analysis demonstrate that a commercial adhesive modified with 0.2wt % Cu and 5wt % ZnO Nps that does not affect its adhesive properties, reducing gelatinolytic activity and nanoleakage at the hybrid layer, which should contribute to an improvement of long term bonding-dentine clinical performance.

The effect of ascorbic acid, QMix and other conditioning solutions on the bond strength of adhesively luted glass fiber-reinforced composite posts to root dentin, a laboratory study.

PURPOSE: This study was designed to investigate the effect of post space conditioning with different solutions on the bond strength of glass FRC posts and evaluate the mode of resin failure. METHODS: Sixty extracted human single rooted teeth were root filled using a resin sealer and suitable gutta-percha cones. Post spaces were prepared, and the teeth randomly allocated into 5 groups according to their irrigation regimens which included the following solutions: 17 % EDTA, 2 % CHX, 3 % NaOCl, 10 % ascorbic acid and QMix solutions. Post spaces were irrigated with 5 ml of the solution for 15 s and subsequently washed with distilled water and dried with paper points. Glass FRC posts were cemented into their spaces using a self-adhesive resin cement. The specimens were mounted in plexiglass molds using autopolymerizing acrylic resin. A universal testing machine was used to measure post retention at a crosshead speed of 2 mm/min. The results were analyzed by one-way ANOVA followed by Tukey HSD test (α = 0.05). Dislodged posts and post spaces were examined microscopically to evaluate retention failure. RESULTS: The Ascorbic acid group exhibited the highest mean retentive strength value at 229 N, followed by QMix at 198 N, NaOCl at 186 N, CHX at 170 N, and EDTA at 124 N. The mean value of the ascorbic acid group was significantly higher than EDTA group, p = 0.012. The failure category was primarily mixed. CONCLUSIONS: Rinsing post spaces with ascorbic acid exhibited significantly superior bond strength. The failure mode was mixed. CLINICAL SIGNIFICANCE: Irrigating post spaces with ascorbic acid solution before luting FRC posts significantly improves their bond strength compared to irrigation with EDTA solution. Irrigation with QMix solution produced the second highest retentive strength but showed no statistical significance when compared to using ascorbic acid, NaOCl, CHX, or EDTA solutions.

Modified Hybrid Hydroxyapatite-Silver Nanoparticles Activated via a Blue Light Source in Various Concentrations in Two-Step Self-Etch Adhesive to Caries-Affected Primary Dentin.

Aims: To evaluate hydroxyapatite-silver (HA-Ag) hybrid nanoparticles (NPs), as an antibacterial agent when integrated in self-etch (SE) adhesive. Blue light activated HA-Ag hybrid NP incorporation on mechanical properties, degree of conversion (DC), and microtensile bond strength (µTBS). Method: Eighty primary molar teeth have carious lesions reaching the dentin but not involving the pulp. The infected dentin was removed and carious-affected dentin (CAD) was preserved. Forty samples were inoculated with Streptococcus mutans. All primary teeth (n = 80) were allocated into four groups based on the incorporation of HA-Ag hybrid NPs in different concentrations (0%, 1%, 5%, and 10%). Group 1: 0% HA-Ag hybrid NPs + Clearfil SE bond primer, group 2: 1% HA-Ag hybrid NPs + Clearfil SE bond primer, group 3: 5 wt% HA-Ag NPs + Clearfil SE bond primer, and group 4: 10 wt% HA-Ag NPs + Clearfil SE bond primer. The survival rate assessment of S. mutans was conducted on 40 inoculated samples. On the remaining primary teeth (n = 40), Clearfil SE bonding agent was applied uniformly via a blue light source. The composite buildup was performed on the samples and µTBS and failure analysis assessed. Fourier transform infrared spectroscopy was performed to assess DC. Survival rates of S. mutans and µTBS among the tested groups were compared using ANOVA and Tukey post hoc analysis. Results: 10 wt % HA-Ag NPs + Clearfil SE bond primer exhibited the highest level of antibacterial efficacy (0.14 ± 0.02 CFU/mL) against S. mutans. The highest µTBS (18.38 ± 0.78 MPa) at the composite/CAD interface was in group 2 (1 wt % HA-Ag NPs + Clearfil SE bond primer + Clearfil SE bonding agent + activation with a blue light source). The highest DC was observed in the control group with Clearfil SE bond primer + Clearfil SE bonding agent + activation with a blue light source. Conclusion: 1 wt% HA-Ag hybrid NPs showed enhanced antibacterial effectiveness, DC, and bond strength of the SE adhesive to the primary CAD.

The influence of neutral MDP-Na salt on dentin bond performance and remineralization potential of etch-&-rinse adhesive.

OBJECTIVES: To investigate the effect of neutral 10-methacryloyloxydecyl dihydrogen phosphate salt (MDP-Na) on the dentin bond strength and remineralization potential of etch-&-rinse adhesive. METHODS: Two experimental etch-&-rinse adhesives were formulated by incorporating 0 wt% (E0) or 20 wt% (E20) neutral MDP-Na into a basic primer. A commercial adhesive, Adper Single Bond 2 (SB, 3 M ESPE), served as the control. Sixty prepared teeth were randomly allocated into three groups (n = 20) and bonded using either one of the experimental adhesives or SB. Following 24 h of water storage, the bonded specimens were sectioned into resin-dentin sticks, with four resin-dentin sticks obtained from each tooth for microtensile bond strength (MTBS) test. Half of the sticks from each group were immediately subjected to tensile loading using a microtensile tester at a crosshead speed of 1 mm/min, while the other half underwent tensile loading after 6-month incubation in artificial saliva (AS). The degree of conversion (DC) of both the control and experimental adhesives (n = 6 in each group) and the adsorption properties of MDP-Na on the dentin organic matrix (n = 5 in each group) were determined using Fourier-transform infrared spectrometry. Furthermore, the effectiveness of neutral MDP-Na in promoting the mineralization of two-dimensional collagen fibrils and the adhesive-dentin interface was explored using transmission electron microscopy and selected-area electron diffraction. Two- and one-way ANOVA was employed to assess the impact of adhesive type and water storage on dentin bond strength and the DC (α = 0.05). RESULTS: The addition of MDP-Na into the primer increased both the short- and long-term MTBS of the experimental adhesives (p = 0.00). No difference was noted in the DC between the control, E0 and E20 groups (p = 0.366). The MDP-Na remained absorbed on the demineralized dentin even after thorough rinsing. The intra- and extra-fibrillar mineralization of the two-dimensional collagen fibril and dentin bond hybrid layer was confirmed by transmission electron microscopy and selected-area electron diffraction when the primer was added with MDP-Na. CONCLUSIONS: The use of neutral MDP-Na results in high-quality hybrid layer that increase the dentin bond strength of etch-&-rinse adhesive and provides the adhesive with remineralizing capability. This approach may represent a suitable bonding strategy for improving the dentin bond strength and durability of etch-&-rinse adhesive.

Effects of Artificial Aging of Direct Resin Nano-Hybrid Composite on Mean Bond Strength Values for Veneer Ceramic Samples.

BACKGROUND This study investigates the effect of artificial aging of direct resin nanohybrid composites on mean bond strength values for veneer ceramic samples. MATERIAL AND METHODS Ninety direct nanohybrid composite resin (Tetric N-Ceram) cylindrical discs were divided into 5 groups (n=18 each) based on aging cycles (thermocycling), as follows: TC=no aging (control), T1=850, T3=2500, T6=5000, and T12=10000 cycles, representing 1, 3, 6, and 12 months of clinical usage, respectively. Lithium disilicate glass ceramic (IPS e.max Press) cylindrical discs were cemented to resin discs using resin cement (Variolink N) after surface treatments (ceramic etching, silaning, composite abrasion). Differences in means between subgroups were calculated using one-way ANOVA, followed by the Tukey honestly significant differences post hoc test. Differences were considered statistically significant with a P value ≤0.05. RESULTS The highest SBS between ceramic and aged composite was observed at 1 month (m=20.35) but did not differ significantly from the control group (m=20.97). For all other subgroups (3, 6, 12 months) SBS was significantly less than that of the control (P≤0.05). At 1 and 3 months, cohesive failures were more common, whereas adhesive failures were more common in 6- and 12-month-old composites. CONCLUSIONS SBS of aged composites was less than that of non-aged composites, with SBS decreasing proportionally as the resin aged. When cementing a ceramic restoration over existing composite restorations, those older than 1 month should be removed and replaced with new ones.

Marginal integrity of prototype bioactive glass-doped resin composites in class II cavities.

OBJECTIVES: This in vitro study examined the marginal integrity of experimental composite materials doped with bioactive glass (BG). MATERIALS AND METHODS: Class-II MOD cavities were prepared and restored with one of the following composite materials: a commercial composite material as a reference (Filtek Supreme XTE), an experimental composite doped with BG 45S5 (C-20), and an experimental composite doped with a fluoride-containing BG (F-20). Six experimental groups (n = 8) were used, as each of the three composites was applied with (+) or without (-) a universal adhesive (Adper Scotchbond Multipurpose). All specimens were subjected to thermocycling (10,000 x, 5-55 °C) and then additionally stored in artificial saliva for eight weeks. Scanning electron micrographs of the mesial and the distal box were taken at three time points (initial, after thermocycling, and after eight weeks of storage in artificial saliva). The margins were classified as "continuous" and "non-continuous" and the percentage of continuous margins (PCM) was statistically analyzed (α = 0.05). RESULTS: In most experimental groups, thermocycling led to a significant decrease in PCM, while the additional 8-week aging had no significant effect. F-20 + performed significantly better (p = 0.005) after 8 weeks storage in artificial saliva than the reference material with adhesive, while no statistically significant differences were observed at the other two time points. C-20 + exhibited significantly better PCM than the reference material with adhesive after thermocycling (p = 0.026) and after 8 weeks (p = 0.003). CONCLUSIONS: Overall, the experimental composites with BG showed at least as good marginal adaptation as the commercial reference, with an indication of possible re-sealing of marginal gaps. CLINICAL RELEVANCE: Maintaining or improving the marginal integrity of composite restorations is important to prevent microleakage and its likely consequences such as pulp irritation and secondary caries.

Ion release of the glass ionomer restoration with silver diamine fluoride dentin pretreatment.

OBJECTIVE: To assess the fluoride and silver ion release of glass ionomer cement (GIC) restorations, including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations, with 38 % silver diamine fluoride (SDF) solution dentin pretreatment. METHODS: Eighty dentin blocks were allocated into 4 groups and restored with SDF+CGIC, CGIC, SDF+RMGIC and RMGIC, respectively. Each block was stored in deionized water at 37 °C for 2 years. Fluoride and silver ion concentration in storage solution was measured using ion-selective electrode and inductively coupled plasma-optical emission spectrometry for up to 2 years. The cross-sectional surfaces of restored dentin blocks were assessed by X-Ray diffraction analysis (XRD), scanning electron microscope (SEM) with energy-dispersive X-ray spectroscopy (EDS) after 1 week and 2 years, respectively. RESULTS: The mean ± standard deviation (SD) of accumulative fluoride releasing in SDF+CGIC, CGIC, SDF+RMGIC and RMGIC for 2 years were 0.13±0.005 mg, 0.09±0.006 mg, 0.15±0.008 mg and 0.05±0.003 mg, respectively (Groups SDF+RMGIC > SDF+CGIC > CGIC >RMGIC, p < 0.05). The mean ± SD of accumulative silver releasing in SDF+CGIC, CGIC, SDF+RMGIC and RMGIC for 2 years were 0.03±0.009 mg, 0.00±0.00 mg, 0.01±0.003 mg, and 0.00±0.00 mg, respectively (Groups SDF+CGIC > SDF+RMGIC > CGIC&RMGIC, p < 0.05). Groups SDF+CGIC and SDF+RMGIC showed sustainably higher fluoride and silver releasing compared to Groups CGIC and RMGIC (p < 0.05). XRD analysis indicated the fluorapatite and silver chloride were observed only in Groups SDF+CGIC and SDF+RMGIC, but not in Groups CGIC and RMGIC. SEM images of the cross-sectional view of the dentin blocks showed silver crystals within dentinal tubules 1 week and 2-year in Groups with SDF pretreatment. CONCLUSION: The 38 % SDF dentin pretreatment sustainably increased the fluoride and silver release of GIC and RMGIC restorations for up to 2 years.