Polishing methods for composites restoration: the influence on human gingival fibroblasts behaviour.

BACKGROUND: Carious/Non-carious cervical lesions with gingival recessions may require both dental and periodontal reconstructive therapy, where flaps/grafts may be placed in contact with a dental filling material. Human Gingival Fibroblasts (HGF-1) response during the early phase of healing could vary according to the procedures employed to cure the dental composite. Moreover, oxygen diffusion into dental composite inhibits the polymerization reaction, creating an oxygen-inhibited layer (OIL) that presents residual unreacted monomers. The aim of this study was to assess the effect of different polishing techniques and OIL on HGF-1. METHODS: Composite discs polished with different techniques (diamond rubber, abrasive discs and tungsten carbide burr) were used. An additional not polished smooth group obtained with and without OIL was used as control. Samples were physically characterized through the analysis of their hydrophilicity and surface topography through contact angle measurement and SEM, respectively; afterwards the biologic response of HGF-1 when cultured on the different substrates was analyzed in terms of cytotoxicity and gene expression. RESULTS: The finishing systems caused alterations to the wettability, even if without a proportional relation towards the results of the proliferation essay, from which emerges a greater proliferation on surfaces polished with one-step diamond rubber and with abrasive discs as well as a direct effect of the glycerin layer, confirming that surface roughness can heavily influence the biological response of HGF-1. CONCLUSIONS: Surfaces wettability as well as cellular behavior seem to be affected by the selection of the finishing system used to lastly shape the restoration. Especially, the presence of OIL act as a negative factor in the regards of human gingival fibroblasts. The present study may provide the first clinical instruction regarding the best polishing system of composite material when the restoration is placed directly in contact with soft tissue cells. Understanding HGF-1 behavior can help identifying the polishing treatment for direct restoration of carious/non-carious cervical lesions associated with gingival recessions.

Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study.

BACKGROUND: It has been demonstrated that dental restorations with rough surfaces can have several disadvantages such as pigment retention or plaque accumulation, which can facilitate caries formation, color variation, loss of brightness, degradation of restoration, among others. The present study aimed to assess surface roughness in bulk fill and conventional nanohybrid resins with and without polishing, controlling the oxygen inhibited layer. METHODS: This in vitro and longitudinal experimental study consisted of 120 resin blocks of 6 mm diameter and 4 mm depth, divided into two groups: Bulk Fill (Tetric® N-Ceram Bulk-fill, Opus Bulk Fill APS, Filtek™ Bulk Fill) and conventional nanohybrid (Tetric® N-Ceram, Opallis EA2, Filtek™ Z250 XT). Each resin group was divided into two equal parts, placing glycerin only on one of them, in order to control the oxygen inhibited layer. Subsequently, the surface roughness was measured before and after the polishing procedure with Sof-Lex discs. The data were analyzed with the T-test for related measures, and for comparison between groups before and after polishing, the non-parametric Kruskal Wallis test with the Bonferroni post hoc was used, considering a significance level of p < 0.05. RESULTS: Before polishing, the resin composites with the lowest surface roughness were Opus Bulk Fill APS (0.383 ± 0.186 µm) and Opallis EA2 (0.430 ± 0. 177 µm) with and without oxygen inhibited layer control, respectively; while after polishing, those with the lowest surface roughness were Opus Bulk Fill APS (0.213 ± 0.214 µm) and Tetric N-Ceram (0.097 ± 0.099 µm), with and without oxygen inhibited layer control, respectively. Furthermore, before and after polishing, all resins significantly decreased their surface roughness (p < 0.05) except Opus Bulk Fill APS resin with oxygen inhibited layer control (p = 0.125). However, when comparing this decrease among all groups, no significant differences were observed (p < 0.05). CONCLUSION: The Opus Bulk Fill APS resin with oxygen inhibited layer control presented lower surface roughness both before and after polishing, being these values similar at both times. However, after polishing the other bulk fill and conventional nanohybrid resins with and without oxygen inhibited layer control, the surface roughness decreased significantly in all groups, being this decrease similar in all of them.

Effect of anaerobic cure of self-etch adhesive on degree of conversion and shear bond strength.

OBJECTIVE: The main aim was to evaluate the effect of postponing the curing of the adhesive layer until the first layer of composite resin is applied-hereby oxygen-inhibited layer (OIL) formation and its detrimental effect on the degree of conversion (DC) of self-etch adhesives should be prevented. For this purpose, the degree of conversion and shear bond strength of four current market self-etch adhesives were evaluated, assessing the effect of curing the adhesives anaerobically and then under two different thicknesses of composite resin, and compare this to the samples cured alone and in air. MATERIALS AND METHODS: The degrees of conversion were obtained by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, after the samples were prepared on a glass slide. The samples were either light-cured in air or anaerobically under a clear matrix strip alone, under 2 mm of cured composite resin or under 4 mm of cured composite resin. To determine the shear bond strength (SBS), extracted molars were halved and set in acrylic. Prefabricated cured cylinders of composite resin (TPH 3, 2.4 mm in diameter) of two different lengths are placed over the adhesives under the following conditions: light-cured conventionally (2-mm-long cylinder) and light-cured anaerobically under the uncured end of the piece of composite resin (using both 2- and 4-mm-long cylinders as separate treatments). After another incubation for 24 h at 37 °C, the samples were subjected to shearing using the Bisco Shear Bond Strength Tester. RESULTS: The degree of conversion of the one-step self-etch adhesives was not statistically different when cured anaerobically under a clear matrix strip or cured anaerobically under 2 mm of composite resin. These results were greater than those cured under 4 mm. Shear bond strength between samples cured in air and anaerobically were similar under 2 mm of composite resin tubes, while those cured anaerobically under 4 mm of resin showed lower shear bond strength. CONCLUSION: When cured anaerobically, one-step self-etch adhesives show a greater degree of conversion and no significant difference in degree of conversion and shear bond strength when compared to those cured in air under the same thickness of composite resin. CLINICAL RELEVANCE: The results obtained from DC and SBS analysis show promise in placing the uncured adhesive under the composite resin and curing both the adhesive and restoration material simultaneously.

Influence of an oxygen-inhibited layer on enamel bonding of dental adhesive systems: surface free-energy perspectives.

The influence of an oxygen-inhibited layer (OIL) on the shear bond strength (SBS) to enamel and surface free-energy (SFE) of adhesive systems was investigated. The adhesive systems tested were Scotchbond Multipurpose (SM), Clearfil SE Bond (CS), and Scotchbond Universal (SU). Resin composite was bonded to bovine enamel surfaces to determine the SBS, with and without an OIL, of adhesives. The SFE of cured adhesives with and without an OIL were determined by measuring the contact angles of three test liquids. There were no significant differences in the mean SBS of SM and CS specimens with or without an OIL; however, the mean SBS of SU specimens with an OIL was significantly higher than that of SU specimens without an OIL. For all three systems, the mean total SFE (γS), polarity force (γSp), and hydrogen bonding force (γSh) values of cured adhesives with an OIL were significantly higher than those of cured adhesives without an OIL. The results of this study indicate that the presence of an OIL promotes higher SBS of a single-step self-etch adhesive system, but not of a three-step or a two-step self-etch primer system. The SFE values of cured adhesives with an OIL were significantly higher than those without an OIL. The SFE characteristics of the OIL of adhesives differed depending on the type of adhesive.

Influence of oxygen-inhibited layer on dentin bond strength of chemical-cured resin composite.

This study evaluated the influence of an oxygen-inhibited layer on the surface free energies of three single-step self-etch adhesives and on the bond strength of chemical-cured resin. Adhesives were applied to bovine dentin and light irradiated, and the oxygen-inhibited layer was either retained or removed. Surface free energies were determined by measuring the contact angles of test liquids placed on the cured adhesives. Dentin bond strengths of chemical-cured resin with and without the oxygen-inhibited layer were measured. Ultrastructural observation of the restorative-dentin interface was made by scanning electron microscopy. For all surfaces, values of the estimated surface tension component, Lifshitz-Van der Waals force (γS(LW)), were relatively constant. Values for the Lewis acid (γS(+)) component increased slightly when the oxygen-inhibited layer was removed, whereas those of the Lewis base (γS(-)) component decreased significantly. The bond strength of the chemical-cured resin composite was significantly higher in specimens without an oxygen-inhibited layer (7.6-8.0 MPa) than in those with an oxygen-inhibited layer (4.8-5.2 MPa). Small gaps between adhesive and resin composite were found for the group with an oxygen-inhibited layer. These results indicate that the absence of an oxygen-inhibited layer in single-step self-etch adhesives promotes higher dentin bond strength of the chemical-cured resin.

Degree of Conversion and Oxygen-Inhibited Layer Effect of Three Dental Adhesives.

This study investigated the effect of the oxygen-inhibited layer on the degree of conversion (DC) of three dental adhesives, comparing two different protocols. Quartz-tungsten-halogen (QTH) light curing and light-emitting diode (LED) were used to cure three adhesives: OptiBond All in One (OAIO), Adper Easy Bond (AEB) and ExciteF (EXF). The DC was calculated utilizing Fourier Transform infrared spectroscopy (FTIR) (n = 12). The two protocols used were as follows: (i) prevent the oxygen-inhibited layer using a Mylar plastic strip pushed onto each bonding adhesive; and (ii) polymerize samples without a plastic strip. The data was analyzed statistically by a three-way ANOVA, and Tukey Test (a = 0.05). The presence of an oxygen-inhibited layer reduced the DC of the adhesives by 64% for EXF, 46% for AEB and 32% for OAIO. This study suggests that there are differences among the oxygen-inhibited layers present for the adhesives tested.