Durability of adhesive bonds to tooth structure involving the DEJ.

The importance of the Dentin Enamel Junction (DEJ) to the durability of adhesive bonds to tooth structure is unclear. In fact, no investigation has been reported on contributions of the DEJ to the fatigue resistance of the bonded interface. In this study, the durability of adhesive bonds to tooth structure involving the DEJ was quantified and compared to that of adhesive bonds to enamel only, not including the DEJ. Two different configurations of enamel bonding were considered, including when tensile stress is focused on the outer enamel (occlusal configuration) or the inner decussated enamel (decussated configuration). The resistance to failure for all bonded interfaces was assessed under both static and cyclic loading to failure. Results showed that the durability of the bonded interfaces was primarily a function of their resistance to crack initiation and growth. The bonded interface strength involving the DEJ was significantly (p ≤ 0.05) greater than that of bonds to enamel only with occlusal configuration, under both static and cyclic loading. While the fatigue strength of bonds involving the DEJ was approximately 20% greater than that for enamel bonds with occlusal configuration (7.7MPa) it was lower than that of enamel with the decussated configuration. The DEJ deterred cracks from extending readily into the dentin but it did not prevent fatigue failure. These results suggest that the durability of bonds to enamel are most dependent on the enamel rod decussation and that the DEJ plays a minor role.

Fatigue resistance of dentin bonds prepared with two- vs. three-step adhesives: Effect of carbodiimide.

The application of a cross-linker to demineralized dentin is reportedly effective at extending the durability of dentin bonds. OBJECTIVE: To compare the effect of a cross-linker pretreatment on the fatigue crack growth resistance of resin-dentin bonds prepared with a two- vs. three-step adhesive system. METHODS: Bonded interface Compact Tension (CT) specimens were prepared using commercial two- and three-step etch-and-rinse adhesives and compatible hybrid resin-composite. For the treated groups, adhesive bonding was preceded by a 1min application of an experimental carbodiimide (EDC) conditioner to the acid-etched dentin. The control groups received no such treatment. The fatigue crack growth resistance was examined after storage in artificial saliva at 37°C for 0, 3 and 6 months. RESULTS: There was no significant difference in the immediate fatigue crack growth resistance the control and EDC-treated groups at 0 months for either adhesive system. After 3 and 6 months of storage, the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the controls. Although the EDC treatment was equally effective in deterring degradation for both adhesives, bonds prepared with the three-step system exhibited the lowest resistance to fatigue crack growth overall. SIGNIFICANCE: An EDC treatment applied during dentin bonding could help maintain the durability of bonds prepared with two or three-step adhesive bonding systems.

Effect of carbodiimide on the fatigue crack growth resistance of resin-dentin bonds.

UNLABELLED: Recent studies have shown that ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) inactivates endogenous dentin proteases, thereby preventing collagen degradation and improving the durability of adhesive bonds to dentin. Bond durability is routinely assessed by monotonic microtensile testing, which does not consider the cyclic nature of mastication. OBJECTIVE: To characterize the effect of an EDC pretreatment on the fatigue crack growth behavior of resin-dentin bonds. METHODS: Bonded interface Compact Tension (CT) specimens were prepared using a three-step etch-and-rinse adhesive and hybrid resin-composite. Adhesive bonding of the treated groups included a 1 min application of an experimental EDC conditioner to the acid-etched dentin. The control groups did not receive EDC treatment. The fatigue crack growth resistance was examined after storage in artificial saliva for 0, 3 and 6 months. RESULTS: There was no significant difference in the immediate fatigue crack growth resistance of the EDC-treated and control groups at 0 months. However, after the 3 and 6 months storage periods the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the control specimens. SIGNIFICANCE: Although the EDC treatment maintained the fatigue crack growth resistance of the dentin bonds through 6 months of storage, additional studies are needed to assess its effectiveness over longer periods and in relation to other cross-linking agents.

Inhibition of matrix metalloproteinase activity in human dentin via novel antibacterial monomer.

OBJECTIVE: Dentin-composite bond failure is caused by factors including hybrid layer degradation, which in turn can be caused by hydrolysis and enzymatic degradation of the exposed collagen in the dentin. The objectives of this study were to investigate a new antibacterial monomer (dimethylaminododecyl methacrylate, DMADDM) as an inhibitor for matrix metalloproteinases (MMPs), and to determine the effects of DMADDM on both soluble recombinant human MMPs (rhMMPs) and dentin matrix-bound endogenous MMPs. METHODS: Inhibitory effects of DMADDM at six mass% (0.1% to 10%) on soluble rhMMP-8 and rhMMP-9 were measured using a colorimetic assay. Matrix-bound endogenous MMP activity was evaluated in demineralized human dentin. Dentin beams were divided into four groups (n=10) and incubated in calcium- and zinc-containing media (control medium); or control medium+0.2% chlorhexidine (CHX); 5% 12-methacryloyloxydodecylpyridinium bromide (MDPB); or 5% DMADDM. Dissolution of dentin collagen peptides was evaluated by mechanical testing in three-point flexure, loss of dentin mass, and a hydroxyproline assay. RESULTS: Use of 0.1% to 10% DMADDM exhibited a strong concentration-dependent anti-MMP effect, reaching 90% of inhibition on rhMMP-8 and rhMMP-9 at 5% DMADDM concentration. Dentin beams in medium with 5% DMADDM showed 34% decrease in elastic modulus (vs. 73% decrease for control), 3% loss of dry dentin mass (vs. 28% loss for control), and significantly less solubilized hydroxyproline when compared with control (p<0.05). SIGNIFICANCE: The new antibacterial monomer DMADDM was effective in inhibiting both soluble rhMMPs and matrix-bound human dentin MMPs. These results, together with previous studies showing that adhesives containing DMADDM inhibited biofilms without compromising dentin bond strength, suggest that DMADDM is promising for use in adhesives to prevent collagen degradation in hybrid layer and protect the resin-dentin bond.

On the Mechanics of Fatigue and Fracture in Teeth.

Tooth fracture is a major concern in the field of restorative dentistry. However, knowledge of the causes for tooth fracture has developed from contributions that are largely based within the field of mechanics. The present manuscript presents a technical review of advances in understanding the fracture of teeth and the fatigue and fracture behavior of their hard tissues (i.e., dentin and enamel). The importance of evaluating the fracture resistance of these materials, and the role of applied mechanics in developing this knowledge will be reviewed. In addition, the complex microstructures of tooth tissues, their roles in resisting tooth fracture, and the importance of hydration and aging on the fracture resistance of tooth tissues will be discussed. Studies in this area are essential for increasing the success of current treatments in dentistry, as well as in facilitating the development of novel bio-inspired restorative materials for the future.

Fatigue of the resin-dentin interface: a new approach for evaluating the durability of dentin bonds.

UNLABELLED: There are concerns regarding the longevity of resin composite restorations and the clinical relevance of in vitro bond strength testing to the durability of dentin bonds in vivo. OBJECTIVE: The objectives of this investigation were to: (1) develop a new method of experimental evaluation for quantifying the durability of dentin bonds, (2) apply this method to characterize the interfacial strength of a selected commercial system under both monotonic and cyclic loading, and (3) distinguish mechanisms contributing to the interface degradation and failure. METHODS: A new method for fatigue testing the resin-dentin interface was developed based on a four-point flexure arrangement that includes two identical bonded interfaces. Cyclic loading of specimens comprised of coronal dentin bonded to a commercial resin composite and controls of resin composite was performed to failure within a hydrated environment. Scanning electron microscopy and nanoscopic dynamic mechanical analysis were used to evaluate failure mechanisms. RESULTS: The fatigue strength of the resin-dentin interface was significantly lower (p≤0.0001) than that of the resin composite and reported for dentin over the entire finite life regime. Defined at 1×10(7) cycles, the apparent endurance limit of the resin-dentin interface was 13MPa, in comparison to 48MPa and 44MPa for the resin composite and dentin, respectively. The ratio of fully reversed endurance limit to ultimate strength of the interface (0.26) was the lowest of the three materials. SIGNIFICANCE: The proposed approach for characterizing the fatigue strength of resin-dentin bonds may offer new insights concerning durability of the bonded interface.

Fatigue of the resin-enamel bonded interface and the mechanisms of failure.

The durability of adhesive bonds to enamel and dentin and the mechanisms of degradation caused by cyclic loading are important to the survival of composite restorations. In this study a novel method of evaluation was used to determine the strength of resin-enamel bonded interfaces under oth static and cyclic loading, and to identify the mechanisms of failure. Specimens with twin interfaces of enamel bonded to commercial resin composite were loaded in monotonic and cyclic 4-point flexure to failure within a hydrated environment. Results for the resin-enamel interface were compared with those for the resin composite (control) and values reported for resin-dentin adhesive bonds. Under both modes of loading the strength of the resin-enamel interface was significantly (p≤0.0001) lower than that of the resin composite and the resin-dentin bonded interface. Fatigue failure of the interface occurred predominantly by fracture of enamel, adjacent to the interface, and not due to adhesive failures. In the absence of water aging or acid production of biofilms, the durability of adhesive bonds to enamel is lower than that achieved in dentin bonding.

On the fatigue behavior of resin-dentin bonds after degradation by biofilm.

The durability of resin-dentin bonds is a growing concern in the placement of composite restorations. Most reported evaluations concerning the mechanical behavior of the bonded interface are conducted using static loading to failure only. They also do not account for the acid production of biofilms, which is one of the most common contributors to interfacial failures in vivo. In this investigation resin-dentin bonded interface specimens were exposed to S. mutans for 14 days and then subjected to quasi-static or cyclic four-point flexure to failure. Control specimens (without biofilm) were evaluated after aging for one and fourteen days. While no significant difference in flexure strength resulted from the duration of water aging (66.2 MPa vs. 56.9 MPa), biofilm exposure caused a significant reduction in strength (29.3 MPa; p ≤ 0.000). After water aging for one and fourteen days the apparent endurance limits were 13.0 MPa and 13.1 MPa, respectively. Biofilm treatment caused a significant (p ≤ 0.001) reduction in fatigue resistance of the interface, and the endurance limit was reduced to 9.9 MPa. Fatigue failure of the control specimens initiated within the resin composite adjacent to the interface, whereas failure of the biofilm treated specimens initiated within the hybrid layer and appeared attributed to the localized demineralization of dentin. Biofilm degradation is an important consideration in assessing the durability of resin-dentin bonds.

Contributions of aging to the fatigue crack growth resistance of human dentin.

An evaluation of the fatigue crack resistance of human dentin was conducted to identify the degree of degradation that arises with aging and the dependency on tubule orientation. Fatigue crack growth was achieved in specimens of coronal dentin through application of Mode I cyclic loading and over clinically relevant lengths (0 ≤ a ≤ 2 mm). The study considered two directions of cyclic crack growth in which the crack was either in-plane (0°) or perpendicular (90°) to the dentin tubules. Results showed that regardless of tubule orientation, aging of dentin is accompanied by a significant reduction in the resistance to the initiation of fatigue crack growth, as well as a significant increase in the rate of incremental extension. Perpendicular to the tubules, the fatigue crack exponent increased significantly (from m=14.2 ± 1.5 to 24.1 ± 5.0), suggesting an increase in brittleness of the tissue with age. For cracks extending in-plane with the tubules, the fatigue crack growth exponent does not change significantly with patient age (from m=25.4 ± 3.03 to 22.9 ± 5.3), but there is a significant increase in the incremental crack growth rate. Regardless of age, coronal dentin exhibits the lowest resistance to fatigue crack growth perpendicular to the tubules. While there are changes in the cyclic crack growth rate and mechanisms of cyclic extension with aging, this tissue maintains its anisotropy.