Resin-dentine interfacial morphology following CPP-ACP treatment.

OBJECTIVES: To evaluate the quality of bonded resin-dentine interfaces produced by two self-etching primer adhesives after casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatment, in comparison to untreated dentine. METHODS: Thirty-four adult molar teeth were sectioned to obtain dentine with tubule orientations parallel/oblique or perpendicular to the surface. The specimens were divided into 'smear layer' (1A, 1B) and 'no smear layer' groups, after treatment with 15% EDTA (2A, 2B). The specimens were then left either untreated (1A, 2A) or treated (1B, 2B) with CPP-ACP paste (Tooth Mousse, GC Corp.) for 60 min x 7 days. Each treatment group was divided into three subgroups and specimens etched/conditioned (no conditioning; 30-40% phosphoric acid (H(3)PO(4)); 20% polyacrylic acid) and bonded with either a 2-step self-etching primer adhesive (Clearfil SE Bond, Kuraray Medical) or an 'all-in-one' adhesive (G-Bond, GC Corp.) and a hybrid resin composite. After 24-h water storage, the bonded specimens were sectioned, polished up to 4000-grit abrasive silicon carbide paper and 0.25-microm diamond paste, prepared for FE-SEM using the acid-base technique, critical point-dried, gold-coated and examined. Bonded and fractured dentine interfaces were also prepared and examined. RESULTS: The 2-step adhesive produced a similar appearance of bonded resin-dentine interface irrespective of smear layer group, treatment or etching/conditioning. After polyacrylic acid conditioning, the 'all-in-one' adhesive exhibited more areas with bond failures. The bond failures were within the hybrid layer and more pronounced following CPP-ACP treatment. CONCLUSION: The quality of the bonded resin-dentine interface produced after CPP-ACP treatment may depend on the adhesive system used.

An SEM evaluation of conditioned and bonded enamel following carbamide peroxide bleaching and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatment.

OBJECTIVES: The study aimed to evaluate, (a) the surface morphology of acid etched/conditioned enamel following carbamide peroxide bleaching with/without casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (Tooth Mousse (MI Paste); GC Corp., Tokyo, Japan) treatment; and b) the nature of the bonded resin-enamel interfaces formed with a self-etching primer adhesive. METHODS: Twenty-four human adult molars were each sectioned into four, the specimens divided and treated according to four experimental groups: 1, no treatment; 2, 16% carbamide peroxide bleaching; 3, CPP-ACP paste; 4, bleaching and CPP-ACP paste. A self-etching primer adhesive (Clearfil SE Bond, CSE) was used. The specimens were further divided into four subgroups for etching/conditioning: A, CSE Primer only; B, 30-40% phosphoric acid and CSE primer; C, 15% EDTA and CSE primer; D, 20% polyacrylic acid and CSE primer. Bonded specimens were also prepared. The morphology of the etched/conditioned enamel surfaces and polished resin-enamel interfaces of the bonded specimens were observed by field-emission scanning electron microscopy (FE-SEM). RESULTS: Treatment with CPP-ACP did not inhibit phosphoric acid etching of enamel. Poorly defined enamel etch patterns were observed with the other conditioners in all the groups. The morphology of the bonded resin-enamel interfaces observed on FE-SEM for each acid etching/conditioning subgroup was similar in all the experimental groups, except after bleaching. Resin infiltration into enamel was observed with prior phosphoric acid etching and polyacrylic acid conditioning and was unaffected by experimental group treatments. CONCLUSIONS: The use of a CPP-ACP paste with or without prior bleaching did not inhibit enamel etching. Enamel etching/conditioning may help improve bonding efficiency of the self-etching primer adhesive after CPP-ACP treatment.

Dentine bonding after CPP-ACP paste treatment with and without conditioning.

OBJECTIVES: To evaluate microshear bond strength (MSBS) to dentine following application of a casein phosphopeptide amorphous calcium phosphate paste (Tooth Mousse (TM)), and the effect of smear layer removal before paste application and preconditioning. METHODS: Specimens of polished human dentine were divided into two groups: 1, smear layer retained; 2, smear layer removed using 15% EDTA for 90 s. In each group, half the specimens were left untreated and half treated with TM for 60 min daily x 7 days. Each subgroup was divided into three further subgroups for conditioning (Primer only; 30-40% phosphoric acid (PA)+primer; 20% polyacrylic acid (CC)+primer). Two self-etching/priming adhesives (Clearfil SE Bond (CSE) and G-Bond (GB)) were used for bonding resin composite to superficial/deep dentine and after 24h, stressed in shear until failure. Maximum loads at failure and bond failure modes were recorded. Group means were compared using one-way ANOVA and Tukey's post hoc test at alpha=0.05. RESULTS: TM did not significantly affect MSBS in group 1. In group 2, there was a statistically significant increase in MSBS for CSE on deep dentine (P=0.002) and a reduction for GB (P=0.013) on superficial dentine. PA conditioning did not significantly affect MSBS for CSE and GB while CC significantly reduced MSBS for GB. CONCLUSIONS: TM application did not reduce MSBS for CSE but significantly reduced MSBS for GB when the smear layer was removed before paste treatment. Preconditioning did not improve or worsen dentine MSBS for CSE or GB with/without TM, except when CC was used with GB.

Effects of conditioners on microshear bond strength to enamel after carbamide peroxide bleaching and/or casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatment.

OBJECTIVES: To evaluate (a) the enamel microshear bond strength (MSBS) of a universal adhesive and (b) the effects of conditioning with a self-etching primer adhesive with/without prior bleaching and/or casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application. METHODS: Thirty-five molars were cut into four sections, assigned randomly to four groups (no treatment; 16% carbamide peroxide bleaching; CPP-ACP-containing paste (Tooth Mousse, TM); bleaching and TM) and treated accordingly. Specimens were divided into two for bonding with either a self-etching primer (Clearfil SE Bond, CSE) or a total-etch adhesive (Single Bond, SB). Specimens for CSE bonding were subdivided for one of four preconditioning treatments (no conditioning; 30-40% phosphoric acid (PA); 15% EDTA; 20% polyacrylic acid conditioner (Cavity conditioner, CC) and treated. The adhesives were applied and resin composite bonded to the enamel using microtubes (internal diameter 0.75mm). Bonds were stressed in shear until failure, mean MSBS calculated and data analysed using ANOVA with Tukey's HSD test (alpha=0.05). The modes of bond failure were assessed and classified. RESULTS: Two-way ANOVA revealed significant differences between treatments (P<0.0001), conditioners (P<0.0001) and a significant interaction between treatments and conditioners (P=0.001). One-way ANOVA revealed no significant differences in MSBS following any of the treatments for SB; following TM application for CSE without preconditioning; and significant differences in MSBS following bleaching with and without TM application for CSE. With preconditioning, applying PA before CSE post-bleaching and either PA or CC before CSE post-TM application, resulted in significant differences in MSBS (P<0.05). CONCLUSIONS: The use of conditioners prior to bonding with the self-etching primer adhesive system on treated enamel may significantly improve bond strengths.