Current scenario on adhesion to zirconia; surface pretreatments and resin cements: A systematic review.

Several methods have been proposed to increase bonding of zirconia with resin. However, we are still to find the Holy Grail. A systematic literature review was performed through PubMed on international literature from January 2000 to May 2021 with relevant Medical Subject Headings terms. 56 articles were found to be relevant. Of all the different methods proposed, mechanochemical pretreatment of zirconia surface with alumina oxide and use of 10-methacryloyloxydecyl dihydrogen phosphate were found to be most effective as per majority of studies. New methods that require further research also surfaced.

Effect of Sandblasting with Fluorapatite Glass-ceramic Powder and Chemical Primers/Adhesives on Shear Bond Strength of Indirect Repairing Composite to Zirconia.

OBJECTIVE: To investigate the effect of sandblasting with fluorapatite glass-ceramic (FGC) powder on zirconia surface roughness, crystallinity, and shear bond strength (SBS) of indirect repairing composite to zirconia using different primers/adhesives. METHODS: Zirconia blocks were treated as follows: no treatment (control group), blasting with 30-µm silica-coated alumina (CoJet group), and blasting with FGC powder (FGC group). The surface topography, silica content, roughness, and crystallinity of treated zirconia surfaces were analyzed by a scanning electron microscope (SEM), energy dispersive spectroscopy (EDS), an optical profilometer, and X-ray diffraction (XRD), respectively. Four primers/adhesives (Monobond Plus, Calibra Silane, Futurabond M+, and Scotchbond Universal) were compared to bond precured resin composite to zirconia groups using Multilink Automix resin cement. Bonded specimens were thermocycled for 10,000 cycles and tested in SBS and the modes of failure were recorded. The effect of different surface treatments and primers/adhesives on SBS results were statistically analyzed using two-way ANOVA and Bonferroni post-hoc tests (α=0.05). RESULTS: Both CoJet and FGC groups showed rough surfaces with a higher content of silica in FGC, but less monoclinic crystals, compared to the CoJet group. The highest mean SBS was found in the FGC group treated with Monobond Plus compared to CoJet and Control groups. Adhesive failure was predominant in control groups, while combined failure was found in the CoJet and FGC groups regardless of the primers/adhesives employed. CONCLUSION: Sandblasting zirconia with FGC powder increased SBS of resin composite to zirconia with lower monoclinic phase transformation compared to CoJet sand. Monobond Plus reported the highest means of SBS values compared to other primers/adhesives.

Disinfection of caries affected dentin using rose bengal, titanium sapphire laser; ammonium hexa-fluorosilicate, and ozonated water on resin dentin bond strength.

AIM: The present study intended to evaluate the shear bond strength (SBS) of resin cement bonded to caries affected dentin (CAD) after disinfection with rose Bengal (RB), Ti-Sapphire Laser, Ammonium Hexafluorosilicate (NH4)2[SiF6], and ozonated water (O3). MATERIAL AND METHODS: A total of 100 extracted human mandibular molars were acquired using caries severity code, 6 of the ICDAS criteria. To achieve homogeneity and prevent size-biased distributions, the average cavity preparation of all specimens had a depth of 2 mm and a breadth of 3 mm. Specimens were divided into five groups (n = 20) at random according to type of disinfection. Group 1: control group, Group 2: RB, Group 3: O3, Group 4: Ti-sapphire laser, and Group 5: (NH4)2[SiF6]. All specimens were etch and rinsed, bonding agent was applied and restored with resin cement. Estimation of SBS was performed by placing samples (10/group) in universal testing machine. Stereomicroscope under 40 × magnification was employed for failure mode analysis (FMA). Statistical analysis was executed using the ANOVA and the Tukey multiple test (p<0.05). RESULTS: The highest SBS was demonstrated in the control group when CAD bonded to resin cement without disinfection (18.22±1.14 MPa). Likewise, the lowest SBS values were unveiled by CAD disinfection with O3 (12.44±1.36 MPa). Similarly, CAD when disinfected with RB (16.25±1.01 MPa) and Ti-sapphire laser (16.25±1.22 MPa) bonded to resin cement exhibited comparable bond results (p>0.05). CONCLUSION: Caries affected dentin when treated with etch and rinse technique without the use of disinfectant displayed the highest SBS. However, it was seen that utilization of various disinfectants altered the adhesion capacity or bonding efficacy of caries-affected dentin.

Effect of Air-Particle Abrasion Protocol and Primer on The Topography and Bond Strength of a High-Translucent Zirconia Ceramic.

PURPOSE: To evaluate effect of air-particle abrasion protocol and primer on surface topography and bond strength of resin cement to high-translucent zirconia ceramics. MATERIALS AND METHODS: Two hundred disk-shaped high-translucent zirconia specimens of 5Y-PSZ were prepared. The specimens were assigned to 5 groups in terms of particle type and air-particle abrasion pressure: (1) control, (2) alumina with 0.2 MPa-air pressure [AB-0.2], (3) alumina with 0.4 MPa-air pressure [AB-0.4], (4) glass beads with 0.2 MPa-air pressure [GB-0.2], and (5) glass beads with 0.4 MPa-air pressure [GB-0.4]. Two different primers 1% MDP (Experimental) and MDP-silane primer (Clearfil Ceramic Primer Plus) was also tested. Stainless steel rods were bonded to the 5Y-PSZ specimens with PANAVIA V5. For each group, the tensile bond strength (TBS) was measured after 24-hour water storage (n = 10) and after 5000 thermal-cycling (n = 10) at crosshead speed of 2 mm/min. The data were statistically analyzed using Weibull analysis. Surface roughness (Sa) was measured using a 3D-Laser Scanning Confocal Microscope (n = 5) and analyzed by t-test with Bonferroni correction. Surface topography using scanning electron microscopy (SEM) and surface elemental analysis using energy dispersion spectroscopy (EDX), and cross-section SEM at the interface with composite cement were also investigated. RESULTS: In MDP-silane groups, the highest TBS was observed in AB-0.4 after 24 hours and GB-0.4 after thermal-cycling (p < 0.05). In MDP groups, AB groups resulted in the significantly higher TBS than GB groups (p < 0.05). AB-0.4 group showed the highest Sa value compared to all groups (p < 0.005), meanwhile GB groups did not show different Sa compared to control (p > 0.005). CONCLUSION: Air-abrasion with different particle and blasting pressure can improve bonding to zirconia with proper primer selection. Particularly, glass beads abrasion followed by MDP-silane primer and alumina abrasion followed by MDP primer alone provided stable bond strength of resin cement to high-translucent zirconia after aging. High-translucent zirconia abraded with glass beads achieves a desirable bonding performance without creating surface microcracks which may hinder zirconia's mechanical properties.

Effect of surface treatment and aging on bond strength of composite resin onlays.

STATEMENT OF PROBLEM: Additional polymerization of indirect composite resins enhances their physical properties but lessens the potential for chemical bonding. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different surface treatments and 6-month water storage on the microtensile bond strength (µTBS) of composite resin onlays. MATERIAL AND METHODS: Composite resin onlays (Filtek Z250) randomly received 6 different surface treatments: (1) airborne-particle abrasion with 27-µm alumina particles+Adper Scotchbond 1XT adhesive application, (2) airborne-particle abrasion with alumina particles+silane application (ESPE SIL)+Adper Scotchbond 1XT, (3) airborne-particle abrasion with alumina particles+Scotchbond Universal adhesive, (4) tribochemical silica coating with 30-µm particles (CoJet Sand)+Adper Scotchbond 1XT adhesive, (5) tribochemical silica coating+silane application+Adper Scotchbond 1XT, and (6) tribochemical silica coating+Scotchbond Universal adhesive. Onlays were luted to fresh composite resin specimens with RelyX Ultimate resin cement. Bonded assemblies were stored in water for 24 hours or 6 months at 37°C and subjected to the µTBS test. Additional surface-treated composite resin onlays were analyzed with a contact profilometer to determine average roughness, and micromorphologic changes were analyzed with scanning electron microscopy. RESULTS: Airborne-particle abrasion with alumina followed by Adper Scotchbond 1XT or Scotchbond Universal adhesive application provided the highest bond strength values at 24 hours. Lower values were obtained after tribochemical silica coating. After 6 months of artificial aging, airborne-particle abrasion with alumina or silica-coated alumina particles followed by Scotchbond Universal application yielded the greatest bond strength results. Airborne-particle abrasion with alumina produced the highest roughness values and a more irregular surface. CONCLUSION: Adhesive selection seems to be relevant to the µTBS of luted composite resin onlays after 6 months of water aging, as specimens treated with Scotchbond Universal, after alumina airborne-particle abrasion or tribochemical silica coating, yielded the highest values and better aging stability.

Effect of different post space irrigation procedures on the bond strength of a fiber post attached with a self-adhesive resin cement.

STATEMENT OF PROBLEM: The effects of different post space irrigation procedures on the bond strength of a self-adhesive resin cement to the root canal dentin are still unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effects of alternative post space irrigation procedures on the cement strengths of posts attached with a self-adhesive resin cement. MATERIAL AND METHODS: Forty single-rooted teeth were selected, and after root canal preparation and obturation, post spaces were prepared. The teeth were divided into 4 groups corresponding to the post space irrigation procedure and treated as follows: the distilled water (DW) group (control) received 15 mL of distilled water; the NaOCl+ethylenediaminetetraacetic acid (EDTA) group was treated with 5 mL of 5.25% NaOCl, 5 mL of 17% EDTA, and 5 mL of distilled water; the chlorhexidine (CHX) group was treated with 15 mL of 2% chlorhexidine solution; and the phosphoric acid (PA) group treatment consisted of etching the walls of the prepared post holes with 35% phosphoric acid. Fiber posts were attached with a self-adhesive resin cement, and specimens were cut horizontally for push-out testing. The statistical evaluation consisted of 1-way ANOVA with the post hoc Tukey honest significant differences test (α=.05). RESULTS: The NaOCl+EDTA treatment yielded a significantly higher bond strength than those used in the other 3 groups (P=.003). No statistically significant differences were found among any of the other groups, as different root regions showed similar bond strength values (P>.05). CONCLUSIONS: The results showed that EDTA in combination with NaOCl could be advantageous for post space irrigation when fiber posts are bonded with a self-adhesive resin cement.

Effect of EDTA conditioning on cervical restorations bonded with a self-etch adhesive: A randomized double-blind clinical trial.

OBJECTIVE: To compare the 18-month retention rates of composite restorations in non-carious cervical lesions [NCCLs] bonded with a self-etch adhesive with and without preliminary conditioning with EDTA. METHODS: Forty-eight patients with two similar-sized NCCL were selected and randomly allocated to one of two groups. Two calibrated operators placed 96 restorations with a one-step self-etch adhesive (Adper Easy One, 3M ESPE). Half of the restorations were placed according to the manufacturer's instructions while, for the other half, the surfaces of the lesions were conditioned with 17% EDTA for 2 min prior to adhesive application. Two blinded and independent examiners evaluated the restorations at baseline, 6, 12, and 18 months, according to the FDI criteria. The comparison between groups in each period was conducted with the Fisher's exact test, and the performance of each group at the different periods was evaluated by McNemar's test (α=0.05). RESULTS: After 18 months, significantly higher retention rates (95% CI) were observed for the EDTA group (95.5 [84.9-98.7]) than the control group (79.6% [65.5-88.9]) (p=0.02). Significant deterioration of the marginal adaptation and marginal discoloration were observed for both groups over the 18-month evaluation. CONCLUSIONS: The preliminary conditioning with EDTA before application of a one-step self-etch adhesive significantly improved the retention rates of composite restorations in cervical lesions. CLINICAL SIGNIFICANCE: Conditioning with EDTA is an alternative that improves the 18-month retention rate of cervical restorations bonded with a self-etch adhesive.

Effect of different matrix metalloproteinase inhibitors on microtensile bond strength of an etch-and-rinse and a self-etching adhesive to dentin.

AIM: This study aimed to analyze the effect of different matrix metalloproteinase (MMP) inhibitors on the microtensile bond strength (microTBS) of an etch-and-rinse and a self-etching adhesive after 9 months of aging. METHODS AND MATERIALS: Flat human dentin surfaces were bonded either with an etch-and-rinse adhesive (Optibond FL) or a self-etching adhesive (Clearfil SE Bond). Dentin surfaces were left untreated or were pretreated with MMP inhibitors (2% chlorhexidine digluconate [CHX], 0.05% green tea extract, 1 mM ferrous sulfate, or 0.2 mM galardin) prior to application of the adhesive. Composite buildups were made incrementally. Pretreated groups were tested after 9 months of storage in artificial saliva (37°C) and compared with untreated groups, which were tested immediately (initial microTBS) and upon aging (9-month microTBS). Data were analyzed by linear mixed-model regression. Failure mode analysis was performed microscopically and statistically analyzed by repeated-measures analysis of variance (p<0.05). RESULTS: MicroTBS of the etch-and-rinse adhesive but not of the self-etching adhesive was significantly decreased by aging. For Optibond FL, pretreatment with 2% CHX, 0.05% green tea extract, and 0.2 mM galardin revealed bond strength values (MPa) similar to the initial microTBS (32.1±14.8) and significantly higher compared with the microTBS (20.3±13.6) of aged untreated dentin. No significant differences were observed between groups bonded with Clearfil SE Bond (initial microTBS: 28.3±12.4; 9-month microTBS: 25.3±11.8). Application of the MMP inhibitors decreased the number of adhesive failures compared with untreated controls after 9 months of aging, but this effect was not significant. CONCLUSION: The MMP inhibitors prevented the decrease in microTBS upon aging of the etch-and-rinse but not of the self-etching adhesive.

Initial sliding wear kinetics of two types of glass ionomer cement: a tribological study.

The aim of this work was to characterize the initial wear kinetics of two different types of glass ionomer cement used in dentistry (the conventional glass ionomer cement and the resin-modified glass ionomer cement) under sliding friction after 28-day storing in distilled water or Ringer's solution. Sliding friction was applied through a pin-on-disk tribometer, in sphere-on-plane contact conditions, under 5 N normal load and 120 rotations per minute. The test lasted 7500 cycles and replicas were performed at 2500, 5000 and 7500 cycles. A profilometer was used to evaluate the wear volume. Data were analysed using Student's t-test at a significant level of 5%. There is no statistical significant difference between the results obtained for a given material with the maturation media (P > 0.05). However, for a given maturation medium, there are significant statistical differences between the data obtained for the two materials at each measurement (P < 0.0001). The wear rates of both materials decrease continuously during the running-in period between 0 and 2500 cycles. After 2500 cycles, the wear rate becomes constant and equal for both materials. The resin matrix contained in the resin-modified glass ionomer cement weakens the tribological behaviour of this material.

Bacterial leakage in root canals filled with AH Plus and dentine bonding agents.

OBJECTIVE: The aim of this study was to compare the efficacy of different dentine adhesives in delaying the coronal bacterial leakage of Enterococcus faecalis in filled root canals. Materials and methods. Ninety-five lower incisors of patients >65 years of age were instrumented using the ProTaper system and were irrigated with 1 mL of 2.5% sodium hypochlorite (NaOCl) alternated with 1 mL 17% EDTA between each file change. Final irrigation was performed with 5 mL of 17% EDTA and then flushed with 5 mL of distilled water. The teeth were randomly divided into five experimental groups (n = 15/group) and one of the following dentine adhesives was applied: (1) AdheSE; (2) Excite DSC; (3) Clearfil Protect Bond; (4) One Coat 7.0; or (5) Control group without adhesive. After filling the root canals, the samples were mounted on a double chamber device to evaluate the bacterial filtration of E. faecalis during a period of 240 days. The results underwent non-parametric Kaplan-Meier survival analysis and comparisons among groups were done using the Log-Rank test. RESULTS: At 240 days, E. faecalis was detected in samples of all groups in the lower chamber. The highest survival value was obtained by One Coat 7.0, giving statistically significant differences from the other groups, whereas Clearfil Protect Bond, AdheSE and Excite DSC showed similar behaviours, likewise similar to the Control group. CONCLUSIONS: One Coat 7.0 adhesive system provides the longest survival value to delay E. faecalis coronal leakage in filled root canals.

Effect of Er:YAG laser pulse duration on shear bond strength of metal brackets bonded to a porcelain surface.

OBJECTIVE: The aim of this study was to compare the effect of different Er:YAG laser pulse durations on the shear bond strength (SBS) of metal brackets bonded to porcelain with two different adhesive systems. BACKGROUND DATA: Orthodontic brackets do not bond well to feldspathic porcelain surfaces, using resin cement. Various treatment methods have been suggested for the porcelain surface to improve bond strength. Thus far, no orthodontic study has evaluated the effect of different Er-YAG laser pulse durations on porcelain surfaces with or without sandblasting. METHODS: In the present study, 150 porcelain crowns were assigned to 10 groups differing in adhesive system and surface treatment. In five groups, the adhesive system was RelyX(™) U 200 and in the other five, Transbond XT was used. For each adhesive system, the porcelain surfaces were treated in one of five different ways: sandblasted, Er:YAG laser short pulse (SP), Er:YAG laser super short pulse (SSP), sandblasted+SP, or sandblasted+SSP. The sandblasted group with Transbond XT served as the control. SBS test was conducted for each group. Samples were examined by scanning electron microscopy. ANOVA and independent t test were used for statistical analysis. RESULTS: The control group had increased roughness and the highest SBS. Er:YAG laser application to the sandblasted porcelain flattened the roughness, and the effects of SP and SSP were similar. CONCLUSIONS: Er:YAG laser application did not allow for elimination of the hydrofluoric acid step. RelyX U 200 is a viable alternative to Transbond XT on sandblasted porcelain.

Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements

The aim of this study was to evaluate the effect of treating intraradicular dentin with irrigating solutions on the retention of glass-fiber posts luted with self-adhesive resin cement. Bovine incisors were endodontically treated, and 9-mm-deep postholes were prepared. Before inserting the cement, the root canals were irrigated with various solutions: 11.5% polyacrylic acid for 30 s, 17% EDTA for 60 s, or 5% NaOCl for 60 s, respectively. Irrigation with distilled water was used in the control group. After all specimens had been rinsed with distilled water, the excess moisture was removed and the posts were luted using either BisCem (Bisco) or RelyX Unicem clicker (3M ESPE). Seven days after luting, the specimens were sectioned transversally into 1-mm-thick slices, which were submitted to push-out testing on a mechanical testing machine. Bond strength data (n = 6 per group) were analyzed by two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). For Unicem, EDTA showed lower bond strength than the other solutions, which had similar results. For BisCem, EDTA showed higher bond strength than the other treatments, while application of NaOCl yielded higher bond strength than polyacrylic acid whereas the control group had intermediate results. In conclusion, irrigating root canals before insertion of self-adhesive resin cements, especially EDTA, might interfere with retention of the fiber posts.

Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements.

The aim of this study was to evaluate the effect of treating intraradicular dentin with irrigating solutions on the retention of glass-fiber posts luted with self-adhesive resin cement. Bovine incisors were endodontically treated, and 9-mm-deep postholes were prepared. Before inserting the cement, the root canals were irrigated with various solutions: 11.5% polyacrylic acid for 30 s, 17% EDTA for 60 s, or 5% NaOCl for 60 s, respectively. Irrigation with distilled water was used in the control group. After all specimens had been rinsed with distilled water, the excess moisture was removed and the posts were luted using either BisCem (Bisco) or RelyX Unicem clicker (3M ESPE). Seven days after luting, the specimens were sectioned transversally into 1-mm-thick slices, which were submitted to push-out testing on a mechanical testing machine. Bond strength data (n = 6 per group) were analyzed by two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). For Unicem, EDTA showed lower bond strength than the other solutions, which had similar results. For BisCem, EDTA showed higher bond strength than the other treatments, while application of NaOCl yielded higher bond strength than polyacrylic acid whereas the control group had intermediate results. In conclusion, irrigating root canals before insertion of self-adhesive resin cements, especially EDTA, might interfere with retention of the fiber posts.

Ability of barrier coat S-PRG coating to arrest artificial enamel lesions in primary teeth.

PURPOSE: To evaluate the effects of a surface pre-reacted glass-ionomer (S-PRG) filled coating material to arrest artificial enamel lesions in primary teeth. METHODS: Buccal and lingual enamel was demineralized in 0.1 M lactic acid buffer solution (pH 4.75) for 5 days and then divided in the PRG-applied and non-PRG areas. Proximal surfaces were used as a control area without demineralization and coating application. Teeth were divided into three groups (n = 4) according to the 1-week immersion in different solutions: Group 1 (distilled water), Group 2 (demineralizing solution) and Group 3 (artificial saliva). Hardness and Young's modulus by nano-indentation test, and elemental contents and ultrastructure by SEM/EDX analysis were obtained. Data were statistically analyzed using ANOVA and Fisher's PLSD at alpha = 0.05. RESULTS: Only for the non-PRG area in Group 1, the hardness and Young's modulus of the demineralized surface enamel were significantly lower than those of the enamel 30-60 microm beneath the surface. Demineralized enamel of non-PRG and PRG-applied areas showed similar SEM views. Only for the non-PRG area in Group 2 and control area in Group 3, the Ca/P of the surface enamel was significantly higher than that of the enamel 5-10 microm beneath the surface. There was no significant difference of the Ca/P among the measuring points from the surface to 10 microm depth of enamel for the PRG applied area in Group 2.

Efecto del grabado de la dentina radicular con ácido dietilenoaminotetra acético (EDTA) en la resistencia de unión de cementos autoadhesivos y autograbantes / Effect of engraving dietilenoaminotetra acetic acid (EDTA) root dentin in the resistance of cemented joints stickers and etching

Fue evaluado el efecto del grabado de la dentina radicular con EDTA en la resistencia de unión (RU) inmediata (IM) y después de termociclaje (TM) de un cemento autoadhesivo (AA) y uno auto grabador (AG) para la cementación de postes de fibra de vidrio. Fueron utilizadas 40 raíces de premolares humanos divididas en 4 grupos según tipo de cementación (n=10) G1 RelyX U100 (UC) según indicaciones del fabricante(IF); G2 grabado con EDTA 24% por 60 s antes de la aplicación del UC ; G3 Para Post Para Core Automix (PC) (IF)G4 - grabado con EDTA 24% por 60 s antes de la aplicación del (PC).Las raíces fueron cortadas en discos de 1 mm (dos discos por tercio radicular), la mitad de los discos fueron sometidos a ensayo expulsión IM (0,5mm/min) y la otra mitad después de TM (5º C e 55º C).los datos fueron analizados en test de ANOVA y Tukey (?=0,05).dando como resultado que el grabado con EDTA altero negativamente los valores de RU solo del tercio cervical en los dos cementos. Cuando fue comparado TM con IM con o sin aplicación de EDTA no se encontraron diferencias estadísticas significativas. Para todos los grupos testados.El cemento PC obtuvo mayores valores de RU (19,59 MPa) comparado con el UC (15,80 MPa).concluyéndose que el tratamiento con EDTA afecto la RU solo para el tercio cervical tanto en IM como TM en los dos cementos. El TM con o sin EDTA no afecto los valores de RU cuando comparado con IM

The effect of post-space treatment whit EDTA on the bond strength (BS) of fiber posts in different root regions was evaluated using two different type of resin cements Rely X U100 (UC) and Para Post Para Core automix (PC) . Fourty extracted premolars root canals were assigned to four groups of 10 roots each. G1 RelyX U100 (UC) according to manufacturer's instructions (MI), G2 etching whit EDTA 24% for 60 s before application of UC; G3 Para Post Para Core Automix (PC) MI; G4 Etching whit EDTA 24% for 60s before application off PC. After cementation the roots were sectioned in 6 slices 1mm each (two slides for root region) and randomly divided into two subgroups, depending on testing time immediate (IM) vs. after termocicling(TM) ), for expulsion test. Statistical analysis was performed with ANOVA and Tukey test (?=.05) No differences in BS was found among the groups whit and whit out EDTA 24 %. Etching whit EDTA adversely alter the BS values of the cervical third in the two cements. When TM was compared with IM with or without application of EDTA there was no statistically significant difference. For all groups tested, PC show higher values of BS (19.59 MPa) was compared with UC (15.80 MPa). Concluded that treatment with EDTA affected the BS only on the cervical third in both IM and TM in the two cements. The TM with or without EDTA did not affect the values of BS when compared with IM

Análise da força de tração necessária para a remoção de cimento resinoso fixado em raízes preparadas com diferentes substâncias químicas / Analysis of the force required to remove resin cement from roots prepared with different chemicals

OBJETIVO: Avaliar in vitro, a influência das substâncias químicas utilizadas durante o preparo endodôntico na força de tração do cimento resinoso Rely-X (3M, Sumaré, Brasil) na dentina radicular bovina. MÉTODOS: Utilizou-se 72 dentes bovinos que tiveram suas coroas seccionadas e raízes padronizadas. A seguir, os espécimes foram incluídos em blocos de resina e receberam tratamento químico por 10 minutos com hipoclorito de sódio nas concentrações de 0,5 por cento, 1 por cento, 2,5 por cento, 5,25 por cento ou gel de clorexidina a 2 por cento, além do grupo-controle que recebeu água destilada. Em seguida os espécimes foram imersos em solução de EDTA a 17 por cento por 3 minutos. Dois espécimes de cada grupo foram submetidos à microscopia eletrônica de varredura para avaliação da superfície. Os espécimes para o ensaio de teste de tração receberam condicionamento com ácido fosfórico a 37 por cento por 15 segundos, sistema adesivo Single-Bond (3M, Sumaré, Brasil) e sobre este aplicado o cimento resinoso Rely-X (3M, Sumaré, Brasil). RESULTADOS: Os resultados em Kgf foram: GClorex (2,26); GNaOCl-0,5 por cento (7,92); GNaOCl-1 por cento (9,70); GNaOCl-2,5 por cento (9,05); GNaOCl-5,25 por cento (8,91); GA (0,61). CONCLUSÃO: O hipoclorito de sódio nas concentrações testadas aumentou a força de adesão do cimento resinoso na dentina de forma significativa frente água destilada e gel de clorexidina a 2 por cento. A observação na microscopia eletrônica de varredura mostrou que a estrutura de dentina radicular que fora tratada com hipoclorito de sódio apresentava túbulos dentinários com diâmetros aumentados, menor quantidade de dentina intertubular, além de áreas de depressões, diferentemente dos grupos-controle e gel de clorexidina a 2 por cento.

OBJECTIVE: This study assessed in vitro how the chemicals used in the preparation of root canals affected the force required to remove the resin cement Rely-X (3M, Sumaré, Brazil) from bovine root dentin. METHODS: The crowns of 72 bovine teeth were sectioned and the roots were standardized. The specimens were then placed in resin blocks and treated for 10 minutes with sodium hypochlorite at 0.5 percent, 1 percent, 2.5 percent or 5.25 percent or chlorhexidine gel at 2 percent. The control group was treated with distilled water. Next, the specimens were soaked in 17 percent EDTA for 3 minutes. The surfaces of two specimens from each group were assessed by electron scanning microscopy. The tested specimens were then treated with 37 percent phosphoric acid for 15 minutes, adhesive system Single-Bond (3M, Sumaré, Brazil) and the resin cement Rely-X (3M, Sumaré, Brazil) was applied over it. RESULTS: The results in Kgf were: GChlorhex (2.26); GNaOCl-0.5 percent (7.92); GNaOCl-1 percent (9.70); GNaOCl-2.5 percent (9.05); GNaOCl-5.25 percent (8.91); GA (0.61). CONCLUSION: Sodium hypochlorite in the tested concentrations increased the adhesion of the resin cement to the dentin significantly when compared with water and 2 percent chlorhexidine. Electron scanning microscopy showed that the structure of the root dentin treated with sodium hypochlorite presented widened dentinal tubules, less intertubular dentin and depression areas, all of which were not observed in the roots treated with water and 2 percent chlorhexidine gel.

Microtensile bond strength of resin cement to a feldspathic ceramic.

OBJECTIVE: The purpose of this study was to evaluate the microtensile bond strength of resin cement to a feldspathic ceramic after treating the surface with (a) hydrofluoric (HF) acid, (b) air abrasion, (c) Er:YAG laser irradiation, (d) Nd:YAG laser irradiation, and (e) HF acid etching after either air abrasion or laser irradiation. BACKGROUND DATA: It is unknown whether the laser application or its combination with another treatment method can be used as a tool to roughen the surface of a feldspathic ceramic in order to increase the bond strength between the resin cement and ceramic surface. MATERIALS AND METHODS: Forty feldspathic ceramic blocks (Ceramco(TM)) were prepared and divided into eight equal groups (n = 5) according to the following surface treatments: no treatment; etching with 9.5% HF acid; air abrasion with 50 µm Al(2)O(3); Er:YAG laser irradiation; Nd:YAG laser irradiation; air abrasion plus acid etching; Er:YAG laser plus acid etching; and Nd:YAG laser plus acid etching. After surface treatment, a silane-coupling agent and resin cement (Panavia F(TM)) were applied to each block. After storing for 24 h at 37°C and thermocycling between 5°C and 55°C for 1000 cycles, the microtensile bond strength of each specimen was measured. RESULTS: The highest bond strength was obtained from HF acid etching. HF acid etching after each laser irradiation significantly increased the bond strength (p < 0.05). However, HF acid etching after air abrasion decreased bond strength when compared to air abrasion alone. CONCLUSIONS: HF acid etching is the most effective surface treatment method for a feldspathic ceramic. However, laser irradiation with either the Er:YAG or Nd:YAG laser is not an adequate method for improving the bond strength of Panavia F. The laser application should be combined with HF acid etching.

In vitro comparison of self versus professionally applied remineralizing materials.

OBJECTIVE: To compare the effect of 4 remineralizing materials on the incipient artificial carious lesion and its proximal sound enamel when used with fluoride dentifrice. STUDY DESIGN: Models mimicking proximal contact were made, each of which was placed with an artificial carious specimen in contact with a sound enamel specimen. Each carious specimen was treated with one of four materials: glass ionomer cement (GIC), resin modified glass ionomer cement (RMGIC), 5000 ppm sodium fluoride (F-gel), and casein phosphopeptide amorphous calcium phosphate (CPP-ACP). The GIC and RMGIC specimens were thermocycled. Then all specimens were pH-cycled for 5 days with twice a day soaking in 1,000 ppm NaF dentifrice solution. Specimens were examined by polarized light microscopy and lesion area quantified by image analysis. RESULTS: RMGIC significantly yielded smaller areas of lesion than CPP-ACP and GIC (p < 0.05). F-gel reduced more area of lesion than CPP-ACP significantly (p < 0.05). In the associated contact, RMGIC significantly reduced the area of lesion better than CPP-ACP (p < 0.05). CONCLUSIONS: The most effective remineralizing material in reducing the carious lesion areas was RMGIC followed by F-gel, GIC and CPP-ACR The demineralization inhibitory effects on the associated sound contact enamel followed the same trend.

Effect of Er,Cr:YSGG laser irradiation on the apical sealing ability of AH Plus/gutta-percha and Hybrid Root Seal/Resilon Combinations.

OBJECTIVE: The objective of this study was to evaluate the sealing ability of 2 different resin-based endodontic filling systems after smear layer removal with 2 different techniques. STUDY DESIGN: Extracted human single-rooted teeth (n = 74) were instrumented using HERO Shaper rotary instruments and irrigated with 1 mL of 2.5% NaOCl between each instrument. Additionally, the canals received either an extra 3-minute rinse with 2 mL of 17% EDTA or a 40-second Er,Cr:YSGG laser treatment. The root canals were filled with either Hybrid Root Seal/Resilon combination or AH Plus/gutta-percha combination using lateral condensation technique (n = 11). Apical leakage quantity was measured with the computerized fluid filtration meter at 1 and 4 weeks. One root from each group, which was not submitted to the fluid filtration test, was selected for scanning electron microscopy (SEM) analysis. Statistical analysis was performed using 3-way ANOVA and the post hoc Tukey HSD test (α = 0.05). RESULTS: A significant decrease was observed in the microleakage values of all the experimental groups tested with time (P < .0001). EDTA + AH Plus/gutta-percha combination exhibited the least microleakage, whereas laser irradiation + Hybrid Root Seal/Resilon combination showed the greatest microleakage at each of the 2 time periods. Each experimental combination exhibited architecture in SEM that seemed to correlate with its sealing performance. CONCLUSION: Er,Cr:YSGG laser treatment does not enhance the sealing ability of the sealers compared with EDTA application. The root canal adaptation and sealing ability of the Hybrid Root Seal/Resilon combination is not superior to that of the AH Plus/gutta-percha combination.

Preclinical effectiveness of a novel pulp capping material.

INTRODUCTION: The purpose of this study was to evaluate the direct pulp capping response to a novel resin-based calcium phosphate cement (RCPC). METHODS: The RCPC was placed in contact with the exposed healthy pulps of dog teeth and in a follow-up study on the healthy or inflamed pulps of ferret teeth. The inflamed ferret teeth had reversible pulpitis induced with Salmonella typhimurium lipopolysaccharides. After direct pulp capping with RCPC or visible light-curing resin-modified calcium hydroxide material (VLCCH) as a control, the restorations were bonded using a composite resin. The pulp responses and dentin repair were evaluated histologically in dog teeth after 7, 28, or 90 days and in ferret teeth after 45 days. RESULTS: Most of the RCPC-treated healthy pulps and 75% of the RCPC-treated inflamed ferret teeth had dentin healing and repair, whereas those teeth treated with VLCCH had minimal healing and dentin repair. CONCLUSIONS: The direct pulp capping of ferret and dog teeth with RCPC was associated with superior healing in comparison to VLCCH.