Adhesion of tooth fragment after trauma: effect of adhesion strategy and storage in the rescue box.

This study aims to investigate the impact of storage conditions for crown fragments (specifically, whether they were stored within a tooth rescue box or in tap water) on their adhesion to fractured teeth when subjected to two different adhesive systems (namely, total etch and self etch). Sixty maxillary premolars were sectioned to obtain tooth fragments. These fragments were stored briefly (2 hours) and reattached in the following groups: Group 1 (fragments stored in tooth rescue box and reattached with etch and rinse (E&R) technique), Group 2 (fragments stored in tap water and reattached with E&R technique), Group 3 (fragments stored in tooth rescue box and reattached with self-etch (SE) technique), and Group 4 (fragments stored in tap water and reattached SE technique). After reattachment, the bonded tooth fragments underwent thermal cycling (500 cycles, 5-55 °C) and bond strength testing using a universal testing machine. Two-way Analysis of Variance (ANOVA) and Tukey's tests were used for bond strength comparison (p ≤ 0.05). A two-parameter Weibull distribution was conducted to evaluate the reliability of the storage medium and adhesion modality on bond strength. The results showed that measured shear bond values (MPa ± Standard deviation (SD); arranged in descending order) for each group were: Group 2 (Tap water/E&R = 6.5 ± 2.1), Group 1 (Rescue box/E&R = 6.0 ± 2.5), Group 4 (Tap water/E&R = 5.1 ± 2.8), and Group 3 (Rescue box/SE = 3.6 ± 3.2). Significant differences were found only between Groups 2 and 3 (p = 0.002). In conclusion, storing crown fragments in a tooth rescue box did not significantly affect the shear bond strength of the restored tooth. However, fragments reattached using the self-etch technique showed comparable shear bond strength but a higher rate of adhesive failures compared to the E&R technique.

Antibacterial effect, cytotoxicity, and bond strength of a modified dental adhesive containing silver nanoparticles.

This study aimed to evaluate the antibacterial effect, cytotoxicity, and microtensile bond strength of an adhesive system containing silver nanoparticles (NAg). NAg was synthesized and incorporated (500 and 1000 ppm) into Scotchbond Multi-Purpose (SBMP) primer and bond. A microtensile bond test (µTBS) was performed after 24 h and 1 year. The adhesive interface was characterized using a confocal Raman microscope. The antibacterial activity was assessed using agar diffusion and biofilm inhibition assays (S. mutans). MTT assay was used to assess the cytotoxicity of NAg-conditioned culture media on human dental pulp stem cells (hDPSCs). The results were statistically analyzed using analysis of variance and Tukey's tests (α = .01). Incorporating 500 and 1000 ppm of NAg in the SBMP did not affect the µTBS after 24 h (p > 0.05). However, in the 1 year evaluation, 500 ppm presented the highest µTBS values (p < 0.05). The addition of NAg at 500 and 1000 ppm in the primer and bond led to larger inhibition halos and colony-forming units than the control (p < 0.05). For the unpolymerized and polymerized groups, the combination of primer and bond presented the highest cytotoxic effects on hDPSCs (p < 0.05). In conclusion, incorporating 500 or 1000 ppm of NAg into an etch-and-rinse adhesive system led to an antibacterial effect without altering the cytotoxicity. SBMP at 500 ppm presented a higher µTBS at 1 year.

Formulating an altered dentin substrate to improve dentin bonding.

STATEMENT OF PROBLEM: Secondary caries is a major factor in the failure of dental restorations. However, studies on the fabrication of acid-resistant and antibacterial dentin to improve dentin bonding are sparse. PURPOSE: The purpose of this in vitro study was to compare the effects of 2 types of fluoride-containing etchants on dentin bonding and explore the feasibility of formulating an altered dentin substrate to improve dentin bonding. MATERIAL AND METHODS: NaF-containing and SnF2-containing etchants were developed by adding sodium fluoride and stannous fluoride to a 35% phosphoric acid aqueous solution. Two groups (N1 and N2) containing NaF, 10 and 30 mg/mL respectively, and 2 groups (S1 and S2) containing SnF2, 18.6 and 55.8 mg/mL respectively, were formulated. The etchant of the control group (C) was 35% phosphoric acid gel. Scanning electron microscopy (SEM), energy dispersive spectrometry (EDS), Fourier transform infrared spectroscopy (FTIR), microhardness, antierosion, and antibacterial tests were performed on the treated dentin. Moreover, the microtensile bond strength (µTBS) of each group was tested, and the fracture mode was determined after testing. Statistical analysis was performed with the 2-way ANOVA test (α=.05). RESULTS: The exposed collagen fiber was observed in group C, and minerals were formed on the dentin in the experimental groups. SEM, FTIR, and the microhardness test indicated more remineralization in the SnF2-containing etchant groups. The µTBS of S1 (77.5 ±10.36 MPa) was the highest in all groups, and group C (38.5 ±9.01 MPa) was the lowest. Moreover, the antierosion and antibacterial properties of the S2 group were the best among all groups (P<.05). CONCLUSIONS: Compared with NaF-containing etchant, SnF2-containing etchant could improve the dentin substrate, increase remineralization, improve bonding strength, and enhance antibacterial ability, especially by increasing resistance to acid erosion.

[Adhesive bonding on the endodontically treated tooth]. / Adhesieve hechting aan het endodontisch behandelde gebitselement.

Endodontic irrigants negatively influence the physical properties of dentine. The effect of sodium hypochlorite and ethylenediaminetetraacetic acid (EDTA) on the bond strength to dentine was investigated in a systematic review. Inclusion criteria were the following: a microtensile or microshear test, the irrigants sodium hypochlorite and/or EDTA, an irrigation time of ≥ 5 minutes of sodium hypochlorite, an irrigation protocol for endodontic treatment, human dentine, the presence of a control group and no post space preparation. Of the 188 eligible articles, 13 were suitable for inclusion. There was strong evidence that rinsing with sodium hypochlorite and also additional rinsing minutes with ethylenediaminetetraacetic acid leads to minimum bond strength to dentin for a two-step self-etching adhesive. For a two-step etch-and-rinse adhesive, the bond strength is approximately significant after rinsing with sodium hypochlorite (rinsing time: 10-60 minutes).

Physicochemical and biological properties of experimental dental adhesives doped with a guanidine-based polymer: an in vitro study.

OBJECTIVES: The objective of this study is to formulate experimental dental adhesives with different polyhexamethylene guanidine hydrochloride concentrations (PHMGH) and evaluate their physical, chemical, and biological properties. MATERIALS AND METHODS: The experimental adhesives were formulated with 0 (control, GCTRL), 0.5 (G0.5%), 1 (G1%), or 2 (G2%) wt.% into the adhesive. The adhesives were analyzed for degree of conversion (DC%), softening in solvent (ΔKHN%), ultimate tensile strength (UTS), microtensile bond strength (µTBS) immediately and after 1 year of aging, antibacterial activity, and cytotoxicity. RESULTS: There were no differences among groups for DC%, ΔKHN%, and UTS (p > 0.05%). There were no differences between each PHMGH-doped adhesive compared to GCTRL in the immediate µ-TBS (p > 0.05). Adhesives with at least 1 wt.% of PHMGH presented better stability of µ-TBS. PHMGH-doped adhesives showed improved longitudinal µ-TBS compared to GCTRL (p < 0.05). Lower Streptococcus mutans biofilm formation was observed for PHMGH-doped adhesives (p < 0.05). There was lower viability of planktonic S. mutans in the media in contact with the samples when at least 1 wt.% of PHGMGH was incorporated (p < 0.05). The formulated adhesives showed no cytotoxicity against pulp cells (p > 0.05). CONCLUSIONS: The adhesive with 2 wt.% of PHMGH showed the highest antibacterial activity, without affecting the physicochemical properties and cytotoxicity, besides conferring stability for the dental adhesion. CLINICAL RELEVANCE: PHMGH, a positively charged polymer, conveyed antibacterial activity to dental adhesives. Furthermore, it did not negatively affect the essential physicochemical and biocompatibility properties of the adhesives. More importantly, the incorporation of PHMGH provided stability for the µ-TBS compared to the control group without this additive.

Captopril inhibits matrix metalloproteinase activity and improves dentin bonding durability.

OBJECTIVES: We investigated the inhibitory effects of captopril on matrix metalloproteinases (MMPs) and its effect as a primer on dentin bonding durability. MATERIALS AND METHODS: One hundred fifty human third molars were selected. Flat surfaces of the middle dentin were exposed, etched 15 s, and followed by pretreatment with a primer for 60 s, including distilled water (control, the negative control primer), 2% chlorhexidine digluconate (CHD, the positive control primer), and captopril solution. Inhibitory effects of primers on MMPs were evaluated by hydroxyproline and gelatinase activity tests. All primers were applied on dentin followed by bonding. Some of the samples were sliced into slabs, placed in a fluorescent solution containing gelatin, and incubated for in situ zymography. Some were cut into sticks, and after aging for 1 day, 12 months, or 24 months, microtensile bonding strength was tested. Some were cut into slabs, aged for 1 day, 12 months, or 24 months, and taken out for nanoleakage tests to reveal interface defects. RESULTS: Hydroxyproline and gelatinase activity analyses showed that captopril exerted better inhibitory effects on MMPs, relative to 2% CHD (p < 0.05). A 0.2% captopril aqueous solution (0.2% CapW) was chosen to apply to the dentin. In situ zymography showed that inhibitory effects of captopril on gelatinase were significantly higher compared to 2% CHD (p < 0.01). Microtensile strength revealed that the bonding effects of the 0.2% CapW group lasted longer, compared to the control and 2% CHD groups (p < 0.05). Interface defects, detected by nanoleakage, were significantly reduced in the 0.2% CapW group, compared to the control and 2% CHD groups (p < 0.05). CONCLUSIONS: Captopril inhibits dentin MMP activities and effectively improves dentin bonding durability. CLINICAL RELEVANCE: Captopril is a promising dentin bonding primer for improving bonding durability.

Effect of Nd:YAG laser irradiation, used as a desensitizing strategy, on bond strength to simulated hypersensitive dentin.

OBJECTIVES: To evaluate the effect of Nd:YAG laser irradiation as a prior desensitizing strategy on immediate and medium-term microtensile bond strength (µTBS) to simulated hypersensitive dentin. MATERIALS AND METHODS: Flat mid-coronal dentin was obtained from third molars and submitted to a 600-grit SiC paper (1 min; N: normal dentin) or subsequently challenged with citric acid (6%, 1 min; H: simulated hypersensitive dentin). Afterwards, dentin was or was not (C: control; HC, NC - each n = 7) irradiated with Nd:YAG laser (L: laser; 1.0 W/10 Hz/100 mJ/4 irradiations of 50-60 s; HL, NL - each n = 7). A 2-step self-etch adhesive (Clearfil SE Bond) was applied and composite (Filtek Z350) buildups were constructed. After 24-h (distilled water/37 °C) storage, specimens were sectioned into beams and tested (µTBS; 0.5 mm/min) immediately or after 6-month aging. Three-way ANOVA and Tukey tests were applied (α = 0.05). Qualitative evaluation of the adhesive interface (n = 1 extra tooth per group) was performed by Confocal Laser Scanning Microscopy. RESULTS: Substrate condition (p < 0.001), laser irradiation (p < 0.001), and aging (p = 0.002) influenced the results. Furthermore, there was interaction between substrate and irradiation (p < 0.001). Laser irradiation favored µTBS exclusively to hypersensitive dentin immediately and after aging. µTBS to hypersensitive dentin was higher than that to the normal substrate only when it was laser-irradiated. In any case, immediate µTBS was always higher than that after aging. CLSM revealed longer and more numerous resin tags for simulated hypersensitive dentin, and shorter and fewer resin tags for laser-irradiated dentin. No differences were observed in the hybrid layer itself. CONCLUSION: Nd:YAG laser irradiation prior to restoration favored the µTBS of a self-etch adhesive and resin composite to hypersensitive dentin. CLINICAL RELEVANCE: Desensitizing strategies are usually tried before performing restorative treatments in hypersensitive dentin; therefore, they may influence behavior of the adhesive interface established. However, instead of causing concern, Nd:YAG laser irradiation revealed a favorable effect on the aforementioned interface.

Influence of silver nanoparticles on the resin-dentin bond strength and antibacterial activity of a self-etch adhesive system.

STATEMENT OF PROBLEM: The influence of silver nanoparticles on adhesive properties of Single Bond Universal (3M ESPE) and the antibacterial activity of silver nanoparticles-modified adhesives against Streptococcus mutans is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of silver nanoparticles on the dentin bond strength of modified adhesives and the antibacterial activity against the cariogenic pathogen S. mutans. MATERIAL AND METHODS: Single Bond Universal adhesive was used as the control. Silver nanoparticles were added to adhesives at 0.05% and 0.1% (by weight) (experimental groups), and scanning electron microscopy was used to observe the uniformity of the modified adhesives. The Single Bond Universal adhesive and the modified adhesives were then used to prepare dentin-composite resin blocks. The microtensile bond strength and microleakage of the prepared dentin-composite resin blocks were determined with or without thermocycling. The colony-forming units (CFU) of S. mutans cultured with the adhesives were evaluated, and the microtensile bond strength and microleakage of each group were tested after treatment with S. mutans. The differences in the microtensile bond strength or CFU were analyzed by using the 2-way analysis of variance and independent sample t test. The differences in microleakage between the groups were evaluated by using the Mann-Whitney test (α=.05). RESULTS: Silver nanoparticle-modified adhesives exhibited uniform morphologies without agglomeration and exhibited a homogeneous adhesive layer in dentin-composite resin blocks. The microtensile bond strength and microleakage of the modified adhesives were similar to those of the control group, with or without thermocycling (P>.05). However, thermocycling reduced the bond strength significantly (P<.001). Self-etch adhesives incorporated with silver nanoparticles showed significant antibacterial activities after less than 6 months of aging treatment. The modified adhesives did not exhibit a decreased bond strength after S. mutans exposure (P>.05), while the control group exhibited a markedly decreased bond strength after S. mutans exposure (P<.05). CONCLUSIONS: Silver nanoparticle-modified adhesives showed excellent antibacterial activities against S. mutans and resisted the destruction of dentin bond strength caused by S. mutans while not compromising the bonding properties of Single Bond Universal self-etch adhesives.

Effect of high-concentration bleaching agents on dentin bonding: an in vitro study.

The aim of this in vitro study was to evaluate the effect of high-concentration hydrogen peroxide (HP) and carbamide peroxide (CP) bleaching solutions on the dentin-resin interface and the shear bond strength (SBS) of restorative materials. A total of 56 extracted human premolars were prepared with flat dentin windows and divided into groups according to the bleaching protocol: group A, bleached with 35% HP (n = 24); group B, bleached with 35% CP (n = 24); and group C, control, no bleaching (n = 8). Groups A and B were each divided into 3 subgroups according to the time of bonding: A0 or B0, bonded immediately after bleaching (n = 8); A1 or B1, bonded 1 week after bleaching (n = 8); and A2 or B2, bonded 2 weeks after bleaching (n = 8). The specimens in group C were bonded without prior bleaching. Scanning electron microscopic analysis was conducted to evaluate the length of the resin tags at the dentin-resin interface. For SBS testing, the specimens were loaded into a universal testing machine at a crosshead speed of 0.5 mm/min. The mean resin tag lengths of groups that were bonded immediately (A0 and B0) or after a 1-week delay (A1 and B1) were significantly shorter than that of group C (P < 0.001; Kruskal-Wallis test), but the differences between the 2-week delayed bonding groups (A2 and B2) and group C were not statistically significant. The SBS values of both the 35% HP and 35% CP groups increased significantly with delayed bonding time (P < 0.05; 1-way analysis of variance). When bonding was delayed until 2 weeks after bleaching, the mean SBSs of the bleaching and control groups were not significantly different (P > 0.05; Tukey test).

Effect of Dentin-Disinfection Chemicals on Shear Bond Strength and Microhardness of Resin-Infiltrated Human Dentin in Different Adhesive Protocols.

Background and Objectives: Bacteria and its remnants beneath the restorations predispose the tooth to secondary caries and pulpal pathology. Hence, various chemical antibacterial agents are suggested to disinfect the prepared tooth structure before the definitive restorative procedure. This study aimed to investigate the effects of chemical disinfectant solutions on the micro-shear bond strength (µSBS) and microhardness of total-etch and self-etch resin-infiltrated human dentin. Materials and Methods: 100 caries-free intact permanent third molar teeth were vertically sectioned into the buccal and lingual half. All these specimens were mounted on acrylic resin and underlying dentin surfaces were exposed by grinding. Samples were randomly divided into five groups [n = 20] following total-etch and self-etch adhesive protocol. Teeth samples were divided according to surface treatment, as Group I (Control-CNT), Group II (2% chlorhexidine-CHX), Group III (5.25% sodium hypochlorite-NaOCl), Group IV (17% ethylenediaminetetraacetate acid­EDTA) and Group V (10% povidone iodine-PVI). A randomly selected 10 samples from each subgroup were used for µSBS and microhardness tests. After surface treatment and bonding procedure, nono-hybrid composite cylinders with a 3-mm diameter and 2-mm height were directly cured over the dentin substrate. The samples for µSBS were subjected to 5000 thermocycles and tested using a universal testing machine. Microhardness was assessed using a micro-indenter instrument, data were statistically analyzed using a one-way analysis of variance and Tukey HSD tests at p < 0.05. Results: Amongst the chemical disinfectant assessed, 2% CHX did not affect µSBS and produced a marginal reduction in dentin microhardness compared to the control group. The 5.25% NaOCl and 17% EDTA significantly compromised the microhardness of the dentin substrate. Meanwhile, 10% PVI surface treatment resulted in a substantial reduction in µSBS between composite and dentin. Conclusions: CHX with preservation of bonding to dentin and insignificant negative effect on dentin microhardness is a safe option for tooth disinfection.

Effects of different concentrations of sodium hypochlorite on dentine adhesion and the recovery application of sodium erythorbate. / ä¸åŒæµ“åº¦æ¬¡æ°¯é ¸é’ å¤„ç†å¯¹ç‰™æœ¬è´¨ç²˜æŽ¥çš„å½±å“åŠå¼‚æŠ—åè¡€é ¸é’ çš„æ¢å¤ä½œç”¨.

OBJECTIVES: Root canal therapy is the most effective and common method for pulpitis and periapical periodontitis. During the root canal preparation, chemical irrigation plays a key role. However, sodium hypochlorite (NaOCl), the widely used irrigation fluid, may impact the bonding strength between dentin and restorative material meanwhile sterilization and dissolving. Therefore, it's important to explore the influence of NaOCl on the adhesion between dentin and restoration materials to ensure clinical efficacy. This study aims to explore the effect of NaOCl on dentine adhesion and evaluate the effect of dentine adhesion induced by sodium erythorbate (ERY), and to provide clinical guidance on dentin bonding after root canal therapy. METHODS: Seventy freshly complete extracted human third molars aged 18-33 years old, without caries and restorations were selected. A diamond saw was used under running water to achieve dentine fragments which were divided into 10 groups with 14 fragments in each group: 2 control [deionized water (DW)±10% ERY] and 8 experimental groups (0.5%, 1%, 2.5%, and 5.25% NaOCl±10% ERY). The dentine specimens in the control group (treated with DW) and the experimental groups (treated with 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl) were immersed for 20 min using corresponding solutions which were renewed every 5 min. The other 5 groups were immersed in 10% ERY for 5 min after an initial washing with DW for 1 min. Then, we selected 4 dentine fragments from all 14 fragments in each group and the numbers and diameters of opening dentinal tubules were observed under scanning electron microscope (SEM). The other 10 dentine fragments from each group were used to make adhesive samples by using self-etch adhesive wand composite resin. All the above adhesive samples were sectioned perpendicular to the bonded interface into 20 slabs with a cross-sectional area of 1 mm×1 mm using a diamond saw under the cooling water, and then the morphology of 10 slabs in each group's bonding interface was observed from aspects of formation of resin tags, depth of tags in dentin, and formation of hybrid layer under SEM. The other 10 slabs of each group's microtensile bond strength and failure modes were also analyzed. RESULTS: Among the 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl groups, the number and diameter of patent dentinal tubules gradually increased with the rise of concentration of NaOCl solution (all P<0.05). Among the DW, 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl groups, the number and diameter of patent dentinal tubules increased after using ERY, but without significant difference (all P>0.05). Among the DW, 0.5% NaOCl, 1% NaOCl, and 2.5% NaOCl groups, the scores of formation of resin tags under SEM gradually increased with the increase of concentration of NaOCl solution, while the score in the 5.25% NaOCl group decreased significantly compared with the score of the 2.5% NaOCl group (P<0.05). There was no significant difference between using 10% ERY groups and without using 10% ERY groups (all P>0.05). The scores of length of the tags under SEM in the 5.25% NaOCl group was significantly higher than the scores of DW, 0.5% NaOCl, and 1% NaOCl groups (all P<0.05), and it was also higher than the score of the 2.5% NaOCl group, but without significant difference (P>0.05). There was no significant difference between using 10% ERY groups and without using 10% ERY groups (P>0.05). The scores of formation of hybrid layer under SEM in the 2.5% NaOCl and 5.25% NaOCl groups significantly decreased compared with the score of the DW group (all P<0.05). There were significant differences between the 2.5% NaOCl±10% ERY groups and between the 5.25% NaOCl±10% ERY groups (all P<0.05). Microtensile bond strength was greater in the 0.5% NaOCl, 1% NaOCl, and 2.5% NaOCl groups, but lower in the 5.25% NaOCl group than that in the DW group (all P<0.05). There were significant differences between the 2.5% NaOCl±10% ERY groups and between the 5.25% NaOCl±10% ERY groups (all P<0.05). The incidence of type "Adhesive" of failure modes in the 5.25% NaOCl group was significantly higher than that in other groups (all P<0.05), while the incidence of type "Adhesive" in the 5.25% NaOCl+10% ERY group was lower than that in the 5.25% NaOCl group (P<0.05). CONCLUSIONS: The bonding strength to dentine increases with the increase of NaOCl concentration when the concentration lower than 2.5%; whereas it is decreased at a higher concentration (such as 5.25%). 10% ERY has a definite recovery effect on attenuated bonding strength to 5.25% NaOCl-treated dentine.

Effect of methacrylated chitosan incorporated in experimental composite and adhesive on mechanical properties and biofilm formation.

The lifespan of a resin-based restoration is limited, with the main reason for failure being secondary caries. Biofilm formation at the tooth-material interface is a necessary etiological agent for caries development. Dental materials with antimicrobial properties may reduce formation of biofilm and thus increase the longevity of restorations. This study aimed to investigate the effect of methacrylated chitosan (CH-MA), incorporated into the polymeric network of an experimental dental composite and adhesive, on biofilm growth of Streptococcus mutans and to assess the mechanical properties of the modified materials. The methacrylation of low-molecular-weight chitosan was achieved and biofilm studies confirmed the antibacterial effect of the modified polymer in solution. Methacrylated chitosan was incorporated into an experimental composite and adhesive, and the modified materials reduced the formation of S. mutans biofilm. The incorporation of CH-MA did not alter the bond strength of the adhesives. However, the amount of CH-MA in composite that is required to elicit an antibacterial response challenges the mechanical properties of the material. The hardness and flexural strength of the composite decreased with increasing amounts of CH-MA. However, flexural strength values still met the requirement in the ISO standard.

The recovery effect of proanthocyanidin on microtensile bond strength to sodium hypochlorite-treated dentine.

AIM: To evaluate the recovery effect of proanthocyanidin (PA) on microtensile bond strength (µTBS) to sodium hypochlorite (NaOCl)-treated dentine. METHODOLOGY: Fifty-five freshly extracted third molars with intact dental crowns, no caries or restorations were sectioned to expose a sound middle layer of dentine and were randomly divided into 11 groups. In the blank control group, dentine surfaces were immersed in deionized water for 20 min. In the negative control group, dental surfaces were immersed in 5.25% NaOCl for 20 min. In the other nine experimental groups, after immersion for 20 min in 5.25% NaOCl, followed by PA (5%, 10%, or 15%) treatment for 1, 5 min or 10 min. The NaOCl solution was renewed every 5 min. Then dentine surfaces were bonded using SE bond. Bonded samples were sectioned into dentine-resin sticks (n = 45) for microtensile bond strength testing (MPa). Failure modes were observed and classified into three types with a stereomicroscope. Microtensile bond strength data were analysed using one-way anova. The confidence interval test was performed to analyse the recovery effect of PA on bond strength to NaOCl-treated dentine. The chi-squared test was used to analyse failure mode distribution. RESULTS: After use of 5.25% NaOCl for 20 min, microtensile bond strength in the negative control group decreased significantly compared with that of the untreated group (P < 0.05). After a recovery treatment of 10% PA for 10 min or 15% PA for more than 5 min, the bond strength was restored to at least 90% of baseline (P < 0.05). No recovery effect on bond strength was detected after the application of 5% PA for 1 min (P > 0.05). Adhesive fracture was found to be the most common failure mode in the NaOCl-treated group. After the recovery application of PA, the proportion of mixed failures increased significantly (P < 0.05). CONCLUSIONS: Microtensile bond strength to NaOCl-treated dentine recovered after the application of either 5% PA for more than 5 min or 10% or 15% PA for more than 1 min. The application of PA before an adhesive procedure may immediately restore the compromised bond strength of NaOCl-treated dentine.

Effect of silver diamine fluoride and potassium iodide on bonding to demineralized dentin.

PURPOSE: To evaluate the microtensile bond strength (MTBS) of resin composite to demineralized dentin treated with SDF or SDF-KI. METHODS: Occlusal enamel of 30 caries-free extracted human molars was removed to expose flat dentin surfaces. Specimens were immersed in demineralizing solution (pH 4.5) for 7 days. A standard smear layer was created using 600-grit silicon carbide paper. Specimens were distributed into three groups (n=10). Control: Dentin rinsed with deionized water; SDF: Dentin treated with 38% SDF; and SDF-KI: Dentin treated with SDF and KI. Specimens were bonded with composite using Scotchbond Universal in etch-and-rinse mode. MTBS beams were prepared from each specimen after 24 hours and tested. Data was analyzed by one-way ANOVA with Tukey HSD post-hoc test. RESULTS: MTBS test results ranged from 0 to 40 MPa. The highest values were obtained in the Control and lowest in SDF-KI, where pre-test failures were frequently observed. One-way ANOVA showed a significant difference among groups (P< 0.005); post-hoc analysis suggested no statistical difference between Control and SDF, but both groups showed higher MTBS compared with SDF-KI. CLINICAL SIGNIFICANCE: Silver diamine fluoride can be applied precisely and regionally on demineralized dentin before bonding without compromising the bond strength of a universal adhesive used with phosphoric acid etching. Addition of potassium iodide to reduce discoloration will dramatically weaken the bond.

Flow Cytometry Analysis of Antibacterial Effects of Universal Dentin Bonding Agents on Streptococcus mutans.

There is no consensus on the antibacterial activity of dentin bonding systems (DBS). Many study models have been used to evaluate the antimicrobial activity of dental materials. In this study, a novel detection method, flow cytometry, was introduced. It allows for evaluation of the antibacterial activity of DBS, based on assessment of the disruption of the bacterial physical membrane induced by DBS. The aim of the study was to evaluate the antibacterial properties of selected dentin bonding systems against Streptococcus mutans. The highest antibacterial activity against S. mutans was observed for Adhese Universal (99.68% dead cells) and was comparable to that of Prime&Bond Universal, OptiBond Universal, or Clearfil Universal Bond Quick (p > 0.05). The lowest activity of all tested systems was displayed by the multi-mode adhesive, Universal Bond (12.68% dead bacteria cells), followed by the self-etch adhesive, OptiBond FL (15.58% dead bacteria cells). The present study showed that in the case of two-component DBS, the primer exhibited higher antimicrobial activity than the adhesive (or bond) itself.

Influence of fluoride varnish on shear bond strength of a universal adhesive on intact and demineralized enamel.

The aim was to evaluate the effect of fluoride varnish on the shear bond strength (SBS) on polished and non-polished intact and demineralized enamel. Bovine incisors (half demineralized) were used. Bifluorid 12™ was applied. Bonding was made with Futurabond®M + and GrandioSO, 24 h and 7 days after varnishing. In some groups, varnish was removed by polishing before bonding. SBS was measured. Fracture type was determined by stereomicroscopy and scanning electron microscope (SEM) observations of the enamel surface were made. Between-group differences were determined by one-way ANOVA and the Tukey test. Associations between study factors and fracture modes were analysed using contingency tables and Pearson's chi-squared test. For intact enamel, SBS on varnished enamel at 24 h was significantly less than in the other groups. SBS recovered 7 days after varnishing. Varnish elimination after 24 h significantly increased the SBS. However, removal at 7 days did not modify SBS. SBS on demineralized enamel groups was significantly less than in intact enamel, except for demineralized enamel varnished and removed at 7 days. Demineralized enamel was associated with cohesive enamel fractures and intact enamel with cohesive fractures of the composite and adhesive fractures. SEM of varnish surfaces showed a homogenous layer scattered with amorphous precipitate. In conclusion, on intact enamel fluoride varnish had a negative effect on SBS at 24 h, which disappeared after 7 days. On demineralized enamel, varnish did not reduce SBS at either time. Polishing the varnished enamel surface showed a similar SBS to intact enamel after 7 days.

The effect of endodontic irrigants on the microtensile bond strength of different dentin adhesives.

OBJECTIVES: The aim of this study was to determine the influence of irrigants on bond strength of adhesive systems. MATERIALS AND METHODS: Superficial dentin surfaces of 60 extracted molars were divided into 15 groups, according to irrigants and adhesives. In the control groups, surfaces were irrigated with distilled water. In experimental groups, sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA) + NaOCl, chlorhexidine (CHX), and NaOCl + sodium ascorbate were used as irrigants. Resin composites were then built up using Single Bond, Clearfil SE Bond, and Xeno 3 as adhesives. The microtensile bond strength of groups was determined. Data were statistically analyzed by two-way analysis of variance (ANOVA), one-way ANOVA, and the Bonferroni test. RESULTS: NaOCl reduced bond strength of Single Bond and Clearfil SE Bond (P < 0.01). For all adhesive systems, EDTA + NaOCl-treated groups exhibited lower bond strength than control groups (P < 0.01). CHX decreased bond strength of Single Bond (P < 0.01). Application of sodium ascorbate improved compromised bond strength to NaOCl-treated dentin (P < 0.01). CONCLUSION: Different irrigants had several effects on bonding of different adhesives. Sodium ascorbate after NaOCl could restore compromised bond strengths.

Antibacterial Effect of Surface Pretreatment Techniques against Streptococcus Mutans.

OBJECTIVE: The aim of this study was to evaluate the antibacterial surface pretreatment methods against Streptococcus mutans within the infected dentin surface using a tooth cavity model. MATERIAL AND METHODS: Seventy-two cavities were prepared on caries-free third molars (n = 8). After sterilization, teeth were inoculated with S. mutans for 48 h. One cavity of each tooth was used to evaluate the infection. Following inoculation, infected cavity surfaces were treated either with (1) Er:YAG Laser (1W; 5x5s, Smart 2940D Plus, Deka Laser), (2) Ozone (80s; HealOzone, Kavo), (3) ErYAG-Ozone combination, (4) Er:YAG-Ozone-CHX combination, (5) Chlorhexidine (CHX), (6) Clearfil Protect Bond (PB), (7) potassium-titanyl-phosphate (KTP) Laser (1W; 60 s, SMARTLITE D, Deka Laser), (8) KTP-Ozone combination, and (9) KTP-Ozone-CHX. Standardized amounts of dentin chips were obtained from the cavity walls, and the number of bacteria recovered was counted. Kruskal-Wallis test was used for statistical analyzes. RESULTS: Both sole antibacterial materials, CHX or Protect Bond application, exhibited the most effective antibacterial activity with 125 and 156 CFU is an acronym of "colony forming unit" usullay mentioned by acronym. (CFU/ml), respectively, among the groups evaluated (P < 0.05). Er:YAG laser irradiation and its combinations with other antibacterial surface pretreatment applications also inhibited the bacterial growth with, respectively, 1444, 406, and 294 CFU/ml bacterial recovery being more efficient than KTP laser irradiation and ozone combinations. CONCLUSIONS: As an alternative device with photodynamic effects, Er:YAG and KTP laser irradiations and their further combinations during the cavity pretreatment procedure with chlorhexidine and ozone treatments exerted antibacterial effect against S. mutans, whereas chlorhexidine and antibacterial dentin bonding application solely have the highest antibacterial effects.

Minimal Gap Size and Dentin Wall Lesion Development Next to Resin Composite in a Microcosm Biofilm Model.

This in vitro study investigated the development of dentin wall lesions next to resin composite containing very small gap sizes using an in vitro biofilm model, and evaluated whether a relevant threshold for the gap size could be established. Microcosm biofilms were grown for 14 days within small interfacial gaps between dentin-resin composite discs under intermittent cariogenic challenge. The factor under study was gap size: samples were either restored with composite resin without adhesive procedure (no intentional gap; no bonding [NB] group) or with intentional gaps of 30, 60, or 90 µm, or with complete adhesive procedure (no gap; bonding [B] group). Secondary caries wall lesion progression was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography at 3 locations: outer surface lesion and wall lesions at 200 and 500 µm distance from gap entrance. Results from linear regression analysis showed that the presence of an intentional gap (30, 60, and 90 µm) affected the secondary caries progression at 200 µm from the gap entrance (p ≤ 0.013). The NB group did not show significant wall lesion development (ML and LD, p ≥ 0.529). At 500 µm distance almost no wall caries development was observed. In conclusion, dentin wall lesions developed in minimal gap sizes, and the threshold for secondary wall lesion development was a gap of around 30 µm in this microcosm biofilm model.

Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO2 9.3 µm short-pulsed laser for dental restorative procedures.

The objective of this study was to evaluate the influence of CO2 9.3 µm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO2 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).