Evaluation of pretreatments on intra-radicular dentin bond strength of self-adhesive resin cements.

OBJECTIVES: To evaluate the influence of dentin pretreatments on the push-out bond strength (POBS) of self-adhesive resin cements (SARCs) to radicular dentin. MATERIALS AND METHODS: Two experimental pretreatments (2.5% titanium tetrafluoride (TiF4 ) and 26% polyacrylic acid (PA)) and two SARCs: Maxcem Elite (MAX) and Calibra Universal (CAL) were used. For each cement, a control group was applied as indicated by the manufacturer. Sixty bovine incisors were restored (n = 10) and subjected to POBS evaluation. Failure mode, adhesive interface and surface morphology were analyzed by a Scanning Electron Microscopy (SEM) and resin infiltration was performed by confocal laser scanning microscopy (CLSM). Data for POBS and CLSM were analyzed by three-way ANOVA and Bonferroni post-hoc (α = 0.05). RESULTS: For MAX, both experimental pretreatments resulted in increased POBS in the cervical third, and for CAL, only the PA resulted in higher POBS in the cervical third. The most failures occurred between the dentin and the resin cement, except when TiF4 was applied. For PA, analysis of surface morphology showed open dentinal tubules, while TiF4 presented particle agglomerates. SEM and CLSM images confirmed presence of resin tags for both pretreatments. CONCLUSION: Pretreating radicular dentin with PA and TiF4 solutions improves the bond strength of SARCs.

Effects of a relined fiberglass post with conventional and self-adhesive resin cement.

Objectives: This study was conducted to evaluate the mechanical properties of relined and non-relined fiberglass posts when cemented to root canal dentin using a conventional dual-cure resin cement or a self-adhesive resin cement. Materials and Methods: Two types of resin cements were utilized: conventional and self-adhesive. Additionally, 2 cementation protocols were employed, involving relined and non-relined fiberglass posts. In total, 72 bovine incisors were cemented and subjected to push-out bond strength testing (n = 10) followed by failure mode analysis. The cross-sectional microhardness (n = 5) was assessed along the root canal, and interface analyses (n = 3) were conducted using scanning electron microscopy (SEM). Data from the push-out bond strength and cross-sectional microhardness tests were analyzed via 3-way analysis of variance and the Bonferroni post-hoc test (α = 0.05). Results: For non-relined fiberglass posts, conventional resin cement exhibited higher push-out bond strength than self-adhesive cement. Relined fiberglass posts yielded comparable results between the resin cements. Type II failure was the most common failure mode for both resin cements, regardless of cementation protocol. The use of relined fiberglass posts improved the cross-sectional microhardness values for both cements. SEM images revealed voids and bubbles in the incisors with non-relined fiberglass posts. Conclusions: Mechanical properties were impacted by the cementation protocol. Relined fiberglass posts presented the highest push-out bond strength and cross-sectional microhardness values, regardless of the resin cement used (conventional dual-cure or self-adhesive). Conversely, for non-relined fiberglass posts, the conventional dual-cure resin cement yielded superior results to the self-adhesive resin cement.

Using a fiber-reinforced composite fixed partial denture to restore a missing posterior tooth: a case report.

With the advent of new adhesive technologies, fiber-reinforced composite fixed partial dentures (FRC-FPDs) have become an inexpensive, esthetic and useful restorative option for patients missing a single tooth. This article describes a case involving an inlay-retained FRC-FPD with a prefabricated fiber-reinforced pontic substructure. In addition, a 6-year follow-up is presented. The FRC-FPD fully restored the single missing molar with simple and conservative intracoronal preparations in the proximal teeth and was deemed clinically acceptable after the evaluation period. The clinical procedures to build a FRC-FPD with a prefabricated fiber-reinforced pontic substructure typically are finished by the clinician in 1 or 2 visits without laboratory assistance, making it a viable alternative for patients who cannot afford implant-based treatment or a conventional metal-ceramic FPD.

A complete esthetic approach with multiple diastemata in anterior teeth: 1-year follow-up.

Anterior diastemata and discolored teeth may interfere with the harmony of a person's smile. This article presents a case involving multidisciplinary intervention for esthetic treatment utilizing integrated microabrasion, dental bleaching, and restorative solutions. The relevant aspects of etiology and treatment planning are discussed.

Influence of Surface Treatment on the Physical Properties and Biofilm Formation of Zirconia- Reinforced Lithium Silicate Ceramics: In Vitro Trial.

PURPOSE: To evaluate the performance of fully crystallized zirconia-reinforced lithium silicate (Celtra Duo, ZLS-CD), partially crystallized zirconia-reinforced lithium silicate (Vita Suprinity, ZLS-VS), and partially sintered lithium disilicate-based (IPS e.max CAD, LD) glass-ceramics submitted to polishing, glazing, or no surface treatment after aging. MATERIAL AND METHODS: Samples of each glass-ceramic material were subjected to polishing with rubber cups (POL), glazing (GL), or no treatment (control: unpolished) and afterward aged with 18,000 thermal cycles (5.C to 55.C). The average roughness, 2D and 3D morphology, contact angle, multispecies biofilm formation (Streptococcus mutans and Candida albicans), and mechanical strength were evaluated with atomic force microscopy (AFM, n = 5), sessile-drop goniometry (n = 5), spectrophotometry (n = 5), and the flexural strength test (n = 10), respectively. Data were analyzed using two-way ANOVA and Tukey test (α = 5%). RESULTS: POL produced lower surface roughness than GL, and ZLS-CD presented higher roughness than LD (P < .05). Surfaces without polishing displayed higher roughness than the POL group (P < .001), greater contact angle (P < .001), and significant morphologic changes, regardless of the glass-ceramic material. Irrespective of the treatment, the contact angle was higher in the ZLS-CD group, and regardless of the material, there was higher biofilm formation and lower flexural strength of the unpolished compared to the POL or GL ceramics. CONCLUSIONS: POL promoted lower roughness and minor morphologic surface alterations, but biofilm formation and flexural strength were similar to the GL group. In general, ZLS-CD and ZLS-VS showed more similar behavior than LD, which makes ZLS glass-ceramic a good option for indirect restorations.

Effect of curing unit and adhesive system on marginal adaptation of composite restorations.

This study sought to evaluate how a curing unit and adhesive system affected the marginal adaptation of resin composite restorations. Class V cavities were prepared in bovine teeth with a gingival margin in dentin and an incisal margin in enamel. The cavities were restored with a micro-hybrid resin composite using one of four adhesives: Single Bond 2, Prime & Bond NT, Clearfil SE Bond, Xeno IV. The light-activations were performed using a quartz-tungsten-halogen (QTH) lamp or a second-generation light-emitting diode (LED). Restorations were finished and polished and epoxy replicas were prepared. Marginal adaptation was analyzed by using scanning electronic microscopy (magnification 500X). The widest gaps in each margin were recorded, and data were submitted to Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests (α = 0.05). Differences between the adhesives were observed only when the dentin margins were evaluated: Clearfil SE Bond demonstrated better marginal adaptation than Prime & Bond NT or Single Bond 2 (which demonstrated the widest gaps in the dentin margin). The type of curing unit only affected the results for Xeno IV when the enamel margin was analyzed; the LED lamp promoted smaller gaps than the QTH lamp.

Influence of inorganic composition and filler particle morphology on the mechanical properties of self-adhesive resin cements.

Objectives: This study aimed to evaluate the influence of inorganic composition and filler particle morphology on the mechanical properties of different self-adhesive resin cements (SARCs). Materials and Methods: Three SARCs including RelyX Unicem-2 (RUN), Maxcem Elite (MAX), and Calibra Universal (CAL) were tested. Rectangular bar-shaped specimens were prepared for flexural strength (FS) and flexural modulus (FM) and determined by a 3-point bending test. The Knoop microhardness (KHN) and top/bottom microhardness ratio (%KHN) were conducted on the top and bottom faces of disc-shaped samples. Sorption (Wsp) and solubility (Wsl) were evaluated after 24 hours of water immersion. Filler morphology was analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (EDS). FS, FM, %KHN, Wsp, Wsl, and EDS results were submitted to 1-way analysis of variance and Tukey's post-hoc test, and KHN also to paired t-test (α = 0.05). Results: SARC-CAL presented the highest FS value, and SARC-RUN presented the highest FM. SARC-MAX and RUN showed the lowest Wsp and Wsl values. KHN values decreased from top to bottom and the SARCs did not differ statistically. Also, all resin cements presented carbon, aluminum, and silica in their composition. SARC-MAX and RUN showed irregular and splintered particles while CAL presented small and regular size particles. Conclusions: A higher mechanical strength can be achieved by a reduced spread in grit size and the filler morphology can influence the KHN, as well as photoinitiators in the composition. Wsp and Wsl can be correlated with ions diffusion of inorganic particles.

Fracture resistance of composite resin cores with or without prefabricated posts over different substrates.

The fracture resistance of endodontically treated teeth has been an obstacle to the durability of the remaining teeth and restorations. The aim of this study was to evaluate the fracture resistance of endodontically treated bovine and human teeth that were restored with either prefabricated metal posts, glass fiber posts, or composite resin cores. Statistical analysis revealed significant difference between different substrates, but there was no statistically significant difference between different types of intraradicular posts or in the interaction between substrate and post types. The intraradicular posts do not increase the fracture resistance of endodontically treated teeth. The metal posts presented more unfavorable fracture modes when compared to glass fiber posts and composite resin cores.

Assessment of a novel bleaching agent formula containing 35% hydrogen peroxide and titanium tetrafluoride: an in vitro study.

This study developed experimental gels containing titanium tetrafluoride (TiF4) combined with commercial 35% hydrogen peroxide (HP), and evaluated bleaching efficacy and pH of the gels, and mineral content and morphology of enamel submitted to these treatments. In phase-1, different stock gels mixed with TiF4 were combined with HP. In phase-2, the selected gels were tested on enamel/dentin specimens (n=8): HP; HP and Natrosol+TiF4 (HPnT); HP and Natrosol+Chemygel+TiF4 (HPncT); HP and Aristoflex+TiF4 (HPaT). Bleaching was performed in four sessions (3x15min-application/session). Color (CIEL*a*b*) and whiteness index (WID) were measured after each session, whereas whiteness index differences (ΔWID), color alteration (CIELab-ΔE, CIEDE2000-ΔE00), enamel morphology and pH, at end of bleaching therapy. The change in Knoop microhardness (ΔKHN) was compared before and after bleaching. Data were analyzed by two-way repeated measures ANOVA and Bonferroni (CIEL*, a*, b*), one-way ANOVA and Tukey (ΔWID, ΔE, ΔE00), and LSD (ΔKHN) tests (α=5%). SEM and pH measurements were submitted to descriptive analysis. No differences were observed in lightness (L*) or WID among the groups (p > 0.05), but HP exhibited lower b* values (p<0.05), higher ΔWID than HPnT, and the highest ΔE among the groups (p < 0.05). No differences in ΔE00 were observed between HP and HPncT (p > 0.05), and HPncT showed higher ΔKHN than HP (p < 0.05). HP presented pH values closer to neutral (6.9), whereas experimental agents showed acidic pH values (2.3-3.9). No morphological changes were observed in HP or HPncT groups. HPncT was able to bleach the enamel and maintain enamel microhardness and surface integrity, even at low pH.

Microtensile Bond Strength, Bonding Interface Morphology, Adhesive Resin Infiltration, and Marginal Adaptation of Bulk-fill Composites Placed Using Different Adhesives.

PURPOSE: This study evaluated dentin bond strength, failure mode, interface morphology, adhesive infiltration into dentin, and marginal adaptation of bulk-fill composites used with different adhesives. MATERIALS AND METHODS: Third molars received occlusal class I cavities (4 mm x 4 mm x 4 mm) that were bulk-filled with Admira Fusion x-tra (Voco) or SonicFill 2 (Kerr) using four adhesives (Scotchbond Multipurpose, 3M Oral Care; Clearfil SE Bond, Kuraray Noritake; OptiBond All-In-One, Kerr; Futurabond U, Voco). Scotchbond was used with acid-etching, while the remaining adhesives were applied in self-etch mode. Sixty-four teeth were selected for the microtensile bond strength test (n = 8). Failure modes were analyzed with scanning electron microscopy (SEM). Interface morphology and adhesive infiltration (n = 3) were investigated using confocal laser scanning microscopy (CLSM). Marginal adaptation (n = 3) was also evaluated using SEM. Bond strength, failure mode, and adhesive infiltration data were analyzed for distribution and homocedasticity, followed by appropriate statistical analyses (α = 0.05). RESULTS: Regarding bond strength, no differences were found among adhesives for SonicFill; Clearfil showed a significantly lower mean value than did Scotchbond (p ≤ 0.05) for Admira; the two composites did not differ. Adhesive and mixed failures were observed for all groups. Scotchbond led to thicker hybrid layers with deeper adhesive infiltration as opposed to Futurabond. The groups Admira+Futurabond, SonicFill+Clearfil, and SonicFill+Futurabond presented the highest marginal discontinuity. CONCLUSION: The tested bulk-fill composites did not affect dentin bonding. Scotchbond and Clearfil seem to be reliable for bonding SonicFill 2 to dentin. The performance of Futurabond was questionable, given its poor-quality interface and higher percentages of marginal gaps.

Activation mode effects on the shear bond strength of dual-cured resin cements.

OBJECTIVES: This study evaluated the immediate (10-minute) and delayed (24-hour) bond strength of dual-cured resin cements that are light-activated either immediately or delayed (after five minutes) or chemically-activated only. MATERIALS AND METHODS: Three dual-cured resin cements were evaluated: RelyX ARC, Panavia F and Enforce. Cylinders of resin cement were built up over resin composite blocks following the manufacturers' instructions for each luting agent. The cements were mixed, inserted into the molds and light-activated either immediately or after five minutes (delayed light activation). When no light activation was performed, the materials were protected from light exposure until testing. Half of the samples were tested at 10 minutes; the remaining samples were stored at 100% relative humidity for 24 hours when they were then tested (n = 10). Data were submitted to three-way ANOVA and post-hoc Tukey's tests (alpha = 0.05). The failure mode was evaluated under SEM. RESULTS: RelyX ARC presented the highest values of shear bond strength, followed by Enforce. Panavia F showed the lowest values. Both immediate and delayed light activation caused the cements to present the highest means of shear bond strength. There was an improvement in bond strength after 24 hours of storage. CONCLUSIONS: RelyX ARC produced the highest bond strength, which was improved by light activation and storage for 24 hours.

Evaluation of bonded orthodontics brackets using different adhesive systems after a cariogenic challenge.

AIM: The aims of this study were to evaluate the prevention of enamel demineralization and the shear bond strength (SBS) of orthodontic brackets bonded with fluoride and no fluoride conventional and self-etching adhesives and to analyze the characteristics of enamel near the bond area using a polarized light microscope (PLM) following demineralization and remineralization cycling (Des Re). METHODS AND MATERIALS: Fifty bovine incisors were selected and divided into five groups according to the adhesive system used during the bonding process: G1, Transbond XT Adhesive; G2, Single Bond 2 Adhesive; G3, Optibond Solo Plus; G4, Clearfil SE Bond; and G5, Clearfil Protect Bond. Transbond XT was used to fix the brackets to the teeth in all groups. After bonding, the groups were separated into cycling and control subgroups. The specimens were submitted to SBS testing and evaluated under a PLM. The results were submitted to ANOVA and Tukey's post hoc tests (p<.05). RESULTS: There were no significant differences for SBS after Des-Re cycling. The Clearfil Protect Bond showed the SBS to be statistically lower than the other adhesives used for the control groups. After a cariogenic challenge, the Single Bond adhesive showed an SBS significantly lower than Transbond XT. The Des-Re cycling increased the enamel demineralization induced after the cariogenic challenge. CONCLUSIONS: The cariogenic challenge did not reduce the SBS. Optibond Solo Plus and Transbond XT adhesives presented the highest SBS while Clearfil Protect Bond had the lowest. The PLM showed that the cariogenic challenge increased the enamel demineralization for all adhesives evaluated, independent of the presence of fluoride. CLINICAL SIGNIFICANCE: An alternative material with the ability to prevent enamel demineralization should be used in orthodontic patients due to the higher accumulation of plaque around orthodontic brackets.

Flowable and Regular Bulk-Fill Composites: A Comprehensive Report on Restorative Treatment.

This article reports a comprehensive restorative treatment using bulk-fill composites and discusses their properties and clinical performance. A 20-year-old man sought dental treatment due to the dark shade of his smile and multiple old amalgam fillings. Based on clinical and radiographic findings, and the patient's demand for tooth-colored fillings, treatment comprised enamel microabrasion and in-office dental bleaching, followed by the replacement of amalgam fillings by bulk-fill composites. Bulk-fill composites exhibit modifications in the filler size and shape or in the chemistry of monomers that allow them to be applied in thicker layers (4 to 5 mm), creating opportunities for simpler, faster, and more-efficient clinical procedures, as seen in the present report.

Characterization of low-cost Brazilian resin composites submitted to tooth brushing.

This in vitro study aimed to evaluate surface microhardness, roughness, color, gloss and topography of low-cost Brazilian resin composites, compared with an international one. All 120 samples (8mm ø x 2mm height) were prepared and divided into 5 groups: Ultrafill (Biodinâmica), Llis (FGM), Fill Magic (Coltene), Applic (Makira), and Filtek Z250XT (3M Oral Care). Surface microhardness (KHN) (n=10) was analyzed at two time periods: before and after simulated tooth brushing (STB). Other standardized samples of each group (n=10) were analyzed for surface roughness (Ra), color (ΔL, Δa, Δb, ΔE, ΔE00) and gloss unit (GU) at the same two periods. The topography of non-brushed and brushed samples of each group (n=4) was evaluated by scanning electron microscopy. Data were analyzed statistically by two-way repeated measures ANOVA with Bonferroni post-hoc test (KHN, Ra, GU), and one-way ANOVA with Tukey post-hoc test (ΔL, Δa, Δb, ΔE, ΔE00) (α=0.05). Topographic images were submitted to descriptive analysis. The low-cost Brazilian resin composites investigated were compared with the international one and revealed: lower KHN, regardless of before or after STB; statistically similar Ra before STB, except Ultrafill, which presented higher values; lower Ra after STB, except Ultrafill, which presented statistically similar values; statistically similar color change in ΔL, Δa, Δb parameters; statistically similar color change in ΔE, ΔE00 parameters, except Fill Magic, which presented lower values; lower gloss before STB; lower gloss after STB, except Ultrafill, which presented statistically similar values. In a situation of scarce resources, low-cost Brazilian composites might be an acceptable cost-effective restorative alternative.

Two-dimensional FEA of dowels of different compositions and external surface configurations.

PURPOSE: The degree of stress generated in the endodontically treated and restored tooth can be influenced by the composition and configuration of the dowels used for the restoration. Using two-dimensional (2D) finite element analysis (FEA), this study tested the hypothesis that the characterization of the stress distribution can be influenced by which evaluation method is employed: protrusion loading and 4-point flexural strength test or varying the type of material (carbon and glass fiber) or the external configuration of the dowel (smooth and serrated). MATERIALS AND METHODS: For simulation of the protrusion load test, models were generated with Mechanical-AutoCAD V6 software from an image of an anatomical plate, one maxillary central incisor, and two dowels and exported to Ansys 9.0. The bone region model was fixed, and a tangential load of 1 N with a 135 degrees inclination to the tooth longitudinal axis was applied at the level of the palatal surface of the crown. In the simulation of a 4-point flexural strength test, a 1 N perpendicular load was applied in two points to the dowel. The dental materials and structures were considered elastic, isotropic, homogeneous, and linear, with the exception of the dowel, which was assumed to exhibit orthotropic behavior. Mechanical properties were defined based on a review of the literature, and the model was meshed with an eight node tetrahedral element. RESULTS: The stress results from both tests were analyzed according to von Mises criteria and principal stresses (Sx). Data from the 4-point flexural strength test simulation showed that, for the serrated dowels, a higher stress concentration was found; however, no difference in the occlusal load for material or dowel configuration was found. CONCLUSIONS: These results suggest that although the external configuration of the dowel influences direct loading, when the dowel is integrated to the tooth and setting material, the influence on biomechanical behavior disappears.

The effect of individualization of fiberglass posts using bulk-fill resin-based composites on cementation: an in vitro study.

OBJECTIVES: This study evaluated the bond strength of various fiberglass post cementation techniques using different resin-based composites. MATERIALS AND METHODS: The roots from a total of 100 bovine incisors were randomly assigned to 5 treatment groups: G1, post + Scotchbond Multi-Purpose (SBMP) + RelyX ARC luting agent; G2, relined post (Filtek Z250) + SBMP + RelyX ARC; G3, individualized post (Filtek Z250) + SBMP; G4, individualized post (Filtek Bulk-Fill) + SBMP; G5, individualized post (Filtek Bulk-Fill Flow) + SBMP. The samples were subjected to the push-out (n = 10) and pull-out (n = 10) bond strength tests. Data from the push-out bond strength test were analyzed using 2-way analysis of variance (ANOVA) with the Bonferroni post hoc test, and data from the pull-out bond strength test were analyzed using 1-way ANOVA. RESULTS: The data for push-out bond strength presented higher values for G2 and G5, mainly in the cervical and middle thirds, and the data from the apical third showed a lower mean push-out bond strength in all groups. No significant difference was noted for pull-out bond strength among all groups. The most frequent failure modes observed were adhesive failure between dentine and resin and mixed failure. CONCLUSIONS: Fiberglass post cementation using restorative and flowable bulk-fill composites with the individualization technique may be a promising alternative to existing methods of post cementation.

Biomechanical behaviour of bulk-fill resin composites in class II restorations.

The aim of this study was to evaluate the biomechanical properties expressed by shrinkage stress, cuspal strain, fracture strength and failure mode in molars with large class II mesio-occlusal-distal restorations. Sixty-four human caries-free third molars were selected and distributed randomly into four groups: Z100 restorative material (Z100), Tetric N-Ceram Bulk-Fill (TNC), Filtek Bulk-Fill (FBF) and Aura Ultra Universal (ABF). The bulk-fill materials were inserted in one singular bulk increment and the conventional composite resin in three ones. Polymerisation shrinkage stress was evaluated by optical Fibre Bragg Gratings (FBG) sensors (n = 6). The cuspal deformation was measured using an extensometer during three moments: restorative procedure, axial compressive loading and at fracture (n = 10). The fracture strength was evaluated on a universal machine. The failure mode was analysed by Scanning Electron Microscopy (SEM). Data were analysed using one-way ANOVA tests with Tukey's posthoc test (α = 5%). Data of the failure mode were submitted to a likelihood ratio chi-square test. Z100 presented the highest mean value for the shrinkage stress (p < 0.05) by FBG evaluation, whereas bulk-fill resin groups presented low polymerisation stress mean value, especially the TNC (p < 0.05). The cuspal deformation test showed that Z100 presented a significant difference mean value compared to the other groups (p < 0.01) during the restoration and compressive axial force; however, load until the fracture presented a difference only between TNC and FBF (p < 0.05). The fracture strength of TNC was statistically different from Z100 (p < 0.01). The failure mode was not statistically different in all the groups (p > 0.05). Bulk-fill composites promoted less polymerisation shrinkage stress than conventional microhybrid composite during and after the light curing process in class II posterior resin composite restorations.

Evaluation of the cervical integrity during occlusal loading of Class II restorations.

There are many concerns regarding the clinical behavior of packable composite restorations in Class II cavities, particularly when those restorations are subjected to axial mechanical loads. This study evaluated microleakage in vitro in proximal vertical "slot"-type cavities with walls located in enamel and dentin, filled with packable composite, associated or not associated with a flowable composite, a reinforced light-curing glass-ionomer or a compomer, after being submitted to occlusal load cycling. These preparations were subjected to either occlusal load cycling or no occlusal load cycling. Eighty human molars with enamel and dentin margins were treated with standardized cavity preparations (proximal vertical "slot" preparations). After completing the filling process using a packable composite (Filtek P60) with or without a cervical increment of flowable composite (Filtek flow), light-curing glass-ionomer (Vitremer) or compomer (Dyract AP), the molars were separated into two groups: control (without occlusal loading) and test, in which 4,000 one-second cycles of 150 N occlusal loading were applied. All 80 teeth were submitted to a microleakage test, then evaluated utilizing silver nitrate dye penetration. Significant statistical differences (Wilcoxon test, p<0.05) in the amount of leakage in enamel and dentin were found in both the control and test groups. After a paired comparison of the control and test groups, a significant statistical difference was found at the enamel level (Mann-Whitney test, p<0.05). In dentin, the only statistically significant difference found was the relation to the flow material. The Kruskal-Wallis test did not detect any statistically significant difference in the amount of leakage among the four materials studied, with a 5% level of significance for both enamel and dentin. Based on this data, it was concluded that restorations with margins located in dentin had greater microleakage than those restorations with margins located in enamel. When the samples were submitted to occlusal loading, they were negatively influenced, which increased microleakage values in enamel and dentin. There was no statistically significant difference among the four tested materials, when comparing their performance.

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.

Optimization of the etch-and-rinse technique: New perspectives to improve resin-dentin bonding and hybrid layer integrity by reducing residual water using dimethyl sulfoxide pretreatments.

OBJECTIVE: To determine whether bonding effectiveness and hybrid layer integrity on acid-etched dehydrated dentin would be comparable to the conventional wet-bonding technique through new dentin biomodification approaches using dimethyl sulfoxide (DMSO). METHODS: Etched dentin surfaces from extracted sound molars were randomly bonded in wet or dry conditions (30s air drying) with DMSO/ethanol or DMSO/H2O as pretreatments using a simplified (Scotchbond Universal Adhesive, 3M ESPE: SU) and a multi-step (Adper Scotchbond Multi-Purpose, 3M ESPE: SBMP) etch-and-rinse adhesives. Untreated dentin surfaces served as control. Bonded teeth (n=8) were stored in distilled water for 24h and sectioned into resin-dentin beams (0.8mm2) for microtensile bond strength test and quantitative interfacial nanoleakage analysis (n=8) under SEM. Additional teeth (n=2) were prepared for micropermeability assessment by CFLSM under simulated pulpar pressure (20cm H2O) using 5mM fluorescein as a tracer. Microtensile data was analyzed by 3-way ANOVA followed by Tukey Test and nanoleakage by Kruskal-Wallis and Dunn-Bonferroni multiple comparison test (α=0.05). RESULTS: While dry-bonding of SBMP produced significantly lower bond strengths than wet-bonding (p<0.05), DMSO/H2O and DMSO/ethanol produced significantly higher bond strengths for SBMP irrespective of dentin condition (p<0.05). SU presented significantly higher nanoleakage levels (p<0.05) and micropermeability than SBMP. Improvement in hybrid layer integrity occurred for SBMP and SU for both pretreatments, albeit most pronouncedly for DMSO/ethanol regardless of dentin moisture. CONCLUSION: DMSO pretreatments may be used as a new suitable strategy to improve bonding of water-based adhesives to demineralized air-dried dentin beyond conventional wet-bonding. Less porous resin-dentin interfaces with higher bond strengths on air-dried etched dentin were achieved; nonetheless, overall efficiency varied according to DMSO's co-solvent and adhesive type. CLINICAL SIGNIFICANCE: DMSO pretreatments permit etched dentin to be air-dried before hybridization facilitating residual water removal and thus improving bonding effectiveness. This challenges the current paradigm of wet-bonding requirement for the etch-and-rinse approach creating new possibilities to enhance the clinical longevity of resin-dentin interfaces.