Does the bonding effectiveness of a fiber post/resin composite benefit from mechanical or chemical treatment? Seven methods for saliva-contaminated surfaces.

PURPOSE: This study examined four cleaning methods and three chemical treatments for artificial saliva-contaminated fiber posts in terms of bonding durability to resin composite core materials. METHODS: Non-contaminated fiber posts (Tokuyama FR Post, Tokuyama Dental) and those contaminated (GC Fiber Post, GC) with artificial saliva (Saliveht Aerosol, Teijin Pharma) were used. Washing and drying (WD), alcohol cleaning (AlC), H3PO4 etching (P/WD), alumina blasting (B/D) for decontamination and silanization (Clearfil Ceramic Primer Plus, Kuraray Noritake Dental, Si), resin priming (HC Primer, Shofu, MMA), and bonding resin application (Clearfil Universal Bond Quick, Kuraray Noritake Dental, BR) for chemical treatment were performed. The treated fiber post was planted inside a cylindrical tube and filled with resin composite (DC Core Automix ONE, Kuraray Noritake Dental). The specimen was sectioned, and a push-out test was performed after 24 h, 1 month, and 3 months. The fracture surface was observed using a scanning electron microscope (SEM). RESULTS: Adhesion between the non-contaminated fiber post and resin composite did not improve by silanization and decreased by alumina blasting. SEM observations revealed a fractured glass fiber by alumina blasting. Saliva contamination decreased the bond strength between the fiber post and resin composite; however, recovery was achieved by WD, Alc, P/WD, and B/D. Compared to Si, BR (P = 0.009) was effective in restraining the long-term durability of bonding, whereas MMA (P = 0.99) was not. CONCLUSION: The application of bonding resin after alcohol cleaning is the most convenient and effective clinical procedure for fiber post surface treatment.

Four-year clinical evaluation of CAD/CAM indirect resin composite premolar crowns using 3D digital data: Discovering the causes of debonding.

PURPOSE: To analyze the causes of debonding of computer-aided design/computer-aided manufacturing (CAD/CAM) indirect resin composite premolar crowns with a focus on the morphological factors of the crown and abutment teeth. METHODS: The clinical courses of 109 CAD/CAM indirect resin composite crowns were observed, and the patients' background characteristics, crown locations, luting methods, types of abutments, distal-most/non-distal-most molars, and types of resin blocks were confirmed. To investigate the influence of the morphology of the crown and abutment teeth, the 1) vertical dimension of the abutment teeth, 2) taper, and 3) thickness of the crown occlusal surface during events were measured from the three-dimensional digital data. The Kaplan-Meier method and multivariable Cox proportional hazard model were used for the statistical analyses. The nonlinearity of the effect of each comparison factor was included in the model. RESULTS: Complications included 21 debonding cases, two crown fractures, five root fractures, and two core debondings. The cumulative no-debonding and no-crown-fracture rate over 1423 days (3 years and 11 months) was 77.4%. The multivariable Cox regression analysis revealed that the abutment teeth type of tooth (first or second premolar) (P = 0.02) and luting materials (P < 0.01) significantly influenced the debonding frequency. All morphological factors (1-3) significantly influenced the debonding. The hazard ratios and nonlinear graph indicated that the crown thickness was less effective than the vertical dimension and taper. CONCLUSION: The combination analysis of clinical outcomes and 3D digital data revealed that preparation of the abutment is important for avoiding crown debonding.

MDP is effective for removing residual polycarboxylate temporary cement as an adhesion inhibitor.

The effect of cleaner containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) for removing temporary cement remnants on dentin surface was evaluated. Flat dentin surfaces were wet-polished (Co) and HY-BOND temporary cement hard (Shofu) was applied to the surface. This temporary cement was removed using an air-scaler (Sc), brush (Br), or phosphoric acid and NaOCl (NC). A prototype cleaner containing MDP (Kuraray Noritake Dental, Tokyo, Japan) was used with agitation mode (MC+AG). KATANA Avencia block (Kuraray Noritake Dental) was luted with SA Cement Plus Automix (Kuraray Noritake Dental). Co showed significantly higher bond strength than Sc or Br (p<0.001 each). Bond strengths with NC (p=0.99) and MC+AG (p=0.38) did not differ significantly from that with Co. Transmission electron microscopy revealed sufficient interaction of MC+AG. Cleaner containing MDP can effectively remove temporary cement by agitation, and can be expected to improve the chemical bonding ability by binding more MDP to dentin.

Adhesion procedures for CAD/CAM indirect resin composite block: A new resin primer versus a conventional silanizing agent.

PURPOSE: The purpose of this study was to evaluate the effectiveness of both a resin primer containing methyl methacrylate (MMA) and a silanizing agent on bonding to indirect resin composite blocks, using two types of build-up hybrid resin composites. METHODS: SHOFU BLOCK HC (Shofu) specimens were blasted with alumina, after which one of two surface treatments was applied: CERA RESIN BOND (Shofu, the Silane group) or HC primer (Shofu, the MMA group). Resin composites made using either Solidex Hardura (SDH, Shofu) or Ceramage Duo (CMD, Shofu) were built up and micro-tensile bond strength (µTBS) values were measured after storage in water for either 24h or 6 months (n=24 per group). The fracture surfaces after µTBS measurements and the resin block/build-up resin interfaces were observed by scanning electron microscopy (SEM). RESULTS: The bond strength of the Silane/SDH group significantly decreased after 6 months (p<0.001), whereas in the MMA group there was no significant loss after 24h or 6 months (p=0.99). In the CMD group, the bond strength after 6 months was significantly lowered in both the Silane group (p<0.001) and the MMA group (p<0.001), but the latter still showed greater adhesion. SEM images demonstrated that the matrix resin was partially destroyed at the fracture surfaces of the MMA group and fracture surface unevenness was observed. CONCLUSIONS: A primer containing MMA produced stronger bonding to CAD/CAM resin even after long-term aging compared to a silane treatment.

Effectiveness of pretreatment with phosphoric acid, sodium hypochlorite and sulfinic acid sodium salt on root canal dentin resin bonding.

PURPOSE: The purpose of this study was to evaluate the effect of pretreatment using phosphoric acid, sodium hypochlorite and sulfinic acid sodium salt on the bonding of one-step self-etching adhesives to root canal dentin. METHODS: Thirty-six single-rooted sound human premolars were randomly assigned into three groups before applying the one-step self-etching adhesive. These comprised a control group with no pretreatment, an NC group that received phosphoric acid and subsequent sodium hypochlorite gel pretreatments, and an NC+AC group that received an additional treatment with sulfinic acid sodium salt following the same pretreatment applied to the NC group. Microtensile bond strength measurements, bonding interface observations by scanning electron microscopy (SEM), elemental analyses by X-ray photoelectron spectroscopy (XPS) and degree of polymerization (DOP) analyses by Raman spectroscopy were subsequently performed. RESULTS: The bond strength was significantly higher in the NC+AC group than in the other two groups (Control: P=000.1 and NC: P=0.004). SEM observations showed that resin tags were present in the dentinal tubules in the NC and NC+AC groups. Compared to the control group, the adhesive resin layer had a lower DOP in the NC group, while the DOP for the NC+AC group was higher than that of the NC specimens. CONCLUSIONS: Bonding to root canal dentin was improved by applying sulfinic acid sodium salt in addition to treatment with phosphoric acid followed by sodium hypochlorite. The DOP of the adhesive resin was reduced by sodium hypochlorite and subsequently restored by applying sulfinic acid sodium salt.

Effects of three drying methods of post space dentin bonding used in a direct resin composite core build-up method.

PURPOSE: The purpose of this study was to evaluate drying methods for post space dentin bonding in a direct resin composite core build-up method. METHODS: Experiment 1: Four root canal plastic models, having diameters of 1.0 or 1.8mm and parallel or tapered shapes, were prepared. After drying each post space using three drying methods (air drying, paper-point drying, or ethanol drying, which involves filling the space with 99.5 vol% ethanol followed by air drying), the residual liquid in the models was weighed. Experiment 2: Thirty endodontically treated single-root teeth were dried using the above-described drying methods and filled with dual-cure resin composite. The bonded specimens were sectioned into square beams of approximately 1mm2 for microtensile bond strength (µTBS) testing. Nine teeth were observed through transmission electron microscopy (TEM) and micro computed tomography (µCT). The weight of residual liquid and µTBS were analyzed using Scheffé multiple comparison. RESULTS: Experiment 1: The results of air drying were significantly different from those of paper-point drying (p<0.001) and ethanol drying (p<0.001), and no significant difference was observed between paper-point drying and ethanol drying. Experiment 2: The µTBS significantly decreased in the order of ethanol drying, paper-point drying, and air drying (air drying/ethanol drying: p<0.001, air drying/paper-point drying: p=0.048, ethanol drying/paper-point drying: p=0.032). TEM and µCT observation revealed a sufficient dentin/adhesive interface in the ethanol drying group. CONCLUSIONS: Ethanol drying was found to be more effective for post space dentin bonding, as compared with air drying and paper-point drying.

Effectiveness of sodium hypochlorite and sulfinic acid sodium salt treatment on dentin-resin bonding: Long-term durability of one-step self-etching adhesive.

This study aimed to evaluate the effect of sulfinic acid sodium salt interposition after acid and sodium hypochlorite treatment (NC treatment) on dentin bonding durability using a mild type one-step self-etching adhesive. Fifteen human third molars were randomly assigned into three experimental groups according to dentin pretreatment before applying the one-step self-etching adhesive: Cont group, without pretreatment; NC group, pretreatment with phosphoric acid and sodium hypochlorite gel; and NC+AC group, additional treatment with sulfinic acid sodium salt followed by the same pretreatment of the NC group. Microtensile bond strength was measured and the pre-treated dentin surface, fracture modes, and bonding interface were observed. The bond strength of the NC+AC group was significantly higher than that of the other groups (p<0.001). The dentin-adhesive interface was degraded after 1 year only in the Cont group. Our results demonstrated NC treatment improves bonding durability and application of sodium sulfinic acid salt after NC treatment improves bonding effectiveness.

Bonding effectiveness and multi-interfacial characterization of two direct buildup resin core systems bonded to post-space dentin.

OBJECTIVES: The aim of the present study was to evaluate the bonding effectiveness of two resin core buildup systems using conventional methods in the field of adhesive dentistry and a new non-destructive method. MATERIALS AND METHODS: Twenty-four single-rooted human teeth were built up with dual-cure one-step self-etch adhesive and composite systems (SY1: Clearfil DC bond and Clearfil DC core automix, SY2: Clearfil bond SE one and Clearfil DC core automix one). The prepared samples were sectioned into approximately 1 × 1-mm-thick beams and subjected to micro-tensile bond strength (µTBS) testing (n = 24). The fractured beams after µTBS testing were analyzed by SEM and energy-dispersive X-ray (EDX) spectrometry. The three teeth filled with each resin core system were sectioned and embedded in epoxy resin to observe the dentin-bonding interface under TEM (n = 6). Moreover, three of each resin core-filled teeth without any processing were examined using µCT (n = 6). RESULTS: Two-way ANOVA revealed that the two factors "root region" (p < 0.001, F = 15.22) and "system" (SY1 < SY2; p < 0.001, F = 22.52) had a significant influence. The µTBS gradually decreased from the coronal side to the apical side of the root canal. Morphological evaluation revealed that SY2 was superior in terms of resin curing at the apical side. µCT non-destructive evaluation clearly revealed gap formation in SY1. CONCLUSION: SY2, which included a new light-independent catalyst, showed better bonding effectiveness and adhesive interface to dentin compared to that of SY1. CLINICAL RELEVANCE: The new catalyst, which is activated by contact with adhesive and resin composite, can be used for resin core buildup restorations.

Surgical Intervention for Masticatory Muscle Tendon-Aponeurosis Hyperplasia Based on the Diagnosis Using the Four-Dimensional Muscle Model.

OBJECTIVES: The surgical target of Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is the masseter or temporal muscle. In our clinic, the 4-dimentional muscle model (4DMM) has been used to decide if we should approach to the masseter or temporal muscle. The aim of this study is validate the clinical usefulness of 4DMM on the basis of the surgical results. METHODS: The 4DMM was constructed from the digital data of 3D-CT and 4-dimentional mandibular movements of the patients. It made us to able to visually observe the expansion rate of masticatory muscles at maximum mouth opening comparing to their length at closed mouth position. Fifteen patients were applied the 4DMM before the surgical treatment and 2 healthy volunteers were enrolled as control group. RESULTS: The expansion rate of temporal muscle at the maximum mouth opening in the patient group was significantly less than that in the control group (P < 0.05). On the other hand, the masseter muscles of all patients were expanded as same as the control group. Therefore the main cause of limitation of mouth-opening was suggested to be a contracture of the temporal muscle. Consequently, we performed successful bilateral coronoidectomy with no surgical intervention to the masseter muscles in all patients. CONCLUSION: The present 4DMM would be valuable modality to decide the target muscle of surgical treatment for patients with MMTAH. In this pathology, contracture of the temporal muscle seems to be main cause of limited mouth opening.

Nondestructive observation of teeth post core space using optical coherence tomography: a pilot study.

Coronal tooth lesions, such as caries, enamel cracking, and composite resin restoration cavities, have been observed by optical coherence tomography (OCT). This pilot study was performed to verify whether OCT could reveal details of root canals filled with resin core build-up. A dual-cure, one-step, self-etch adhesive system-bonding agent (Clearfil Bond SE ONE, Kuraray Noritake Dental) and dual-cure resin composite core material (Clearfil DC Core Automix ONE, Kuraray Noritake Dental) were used according to the manufacturer's instructions in root canals. OCT was performed at three stages of the core build-up: after the post space preparation, after bonding application, and after resin core fabrication. The cementum was removed in the cementum absent group and the root was left untreated in the cementum present group. Bubbles were observed in the resin cores and gaps formed between the resin core and dentin. In the cementum absent group, the internal structure of the root could be visualized clearly compared with the cementum present group. The root internal structure could be observed by OCT and the image became clearer when cementum was removed.