"Enamel layering" using double-layered enamel-shade resin composites: The strategy to simulate the optical characteristics of human enamel.

OBJECTIVE: To evaluate the optical match between enamel and resin composites fabricated using mono-layered and double-layered techniques. MATERIALS AND METHODS: Enamel slabs were prepared from human upper incisors and canines. Mono-layered composite replicas were prepared from seven Filtek Z350XT and Estelite Sigma shades using silicone molds prepared from the respective enamel surfaces. Translucent and enamel shades (A2 or A3) of the two materials were produced from incisor molds for double-layered replicas, and the groups with the best results underwent accelerated aging. Spectrophotometric evaluation was performed using CIE color system. The differences in translucency (ΔTP) and color (ΔE00 ) between the enamel and paired composite replicas were calculated and analyzed using parametric statistics (α = 0.05). RESULTS: For the mono-layered composites, white enamel and translucent shades of Filtek yielded the lowest ΔTP for canines (4.6) and incisors (8.9), respectively. The ΔE00 of mono-layered replicas ranged from 5.1 to 11.8. Double-layered Filtek replicas displayed a better 1-day optical match with the lowest ΔTP (3.4-4.0) and ΔE00 (4.2-4.6), irrespective of each layer's thickness. CONCLUSIONS: For canines, the lowest ΔTP of Filtek white enamel was close to the acceptable threshold (4.43). For incisors, the thicker translucent double-layered Filtek composites demonstrated the greatest optical match before and after aging. CLINICAL SIGNIFICANCE: Upper incisors and canines have distinct enamel optical properties. Enamel layering using specific double-layered resin composites could achieve a better optical match with upper incisor enamel.

Bond Durability of a Repaired Resin Composite Using a Universal Adhesive and Different Surface Treatments.

PURPOSE: To evaluate the long-term effect of different surface treatments on the repair microtensile bond strength (µTBS) of resin composite using a universal adhesive. MATERIALS AND METHODS: Thirty-six resin composite blocks were fabricated and aged in 37°C distilled water for 1 month. The blocks were randomly assigned to different surface treatments: no treatment (control); diamond bur grinding (D); diamond bur + phosphoric acid cleaning (DP); diamond bur + silane application (DSi); diamond bur + phosphoric acid + silane (DPSi); and grit blasting with 50 µm H3PO4 particles + phosphoric acid + silane (APSi). Thereafter, Single Bond Universal adhesive was applied and repaired with the same composite. Composite-composite stick-shaped specimens were fabricated and subjected to the µTBS test either after 37°C water storage for 24 h or thermocycling for 10,000 cycles. Roughness of different surface-prepared specimens was measured by profilometer. Data were analysed using ANOVA and Duncan's post-hoc test (α = 0.05). Failure mode and micromorphology of different surface-prepared specimens were observed with SEM and EDS analysis. RESULTS: The highest µTBS was found in DPSi group at 24 h, and was significantly higher than others. The bond strengths in all thermocycled groups were significantly lower than those measured at 24 h. The highest µTBS was also found in the DPSi group, but this did not significantly differ from the DSi group. CONCLUSION: Thermocycling significantly reduced the repair bond strength. Diamond bur roughening with application of silane and universal adhesive yielded the highest repair bond strength for the aged resin composite.

The influence of a local anesthetic containing vasoconstrictor on microtensile bond strengths of two adhesive systems to human dentin in situ.

PURPOSE: To evaluate the bond strengths of an etch-and-rinse adhesive and a self-etching adhesive to human dentin in vitro and under two in situ conditions: non-anesthetization and anesthetization of the teeth with a local anesthetic containing vasoconstrictor. MATERIALS AND METHODS: An in situ study was performed on 49 maxillary premolars scheduled for extraction due to orthodontic reasons. For the bond strength test, occlusal cavities were prepared either with or without a local anesthetic containing vasoconstrictor. The cavities were bonded with Adper Single Bond or Clearfil SE Bond and filled with a resin composite, Filtek Z250. The teeth were then extracted, sectioned, trimmed, and tested for microtensile bond strength. For the observation of dentin surfaces, 20 premolars were used. The impressions of the cavity floors in the anesthetized and non-anesthetized groups were taken before and after acid etching. The replicas were observed under a scanning electron microscope. In vitro, the bond strength test and the SEM observation were also carried out on 24 extracted premolars with the same procedures used in the in situ study. RESULTS: The bond strengths of the two adhesives bonded to dentin in situ were significantly lower than those in vitro. When both adhesives were tested under in situ conditions, there were no significant differences between the bond strengths to dentin of anesthetized and non-anesthetized groups (p > 0.05). No fluid droplets were found on dentin on the cavity floor prepared in vitro, either before or after acid-etching. For the unetched dentin prepared in situ, fluid droplets were found and covered on the smear layer in anesthetized and non-anesthetized groups, but the droplets were slightly larger in the non-anesthetized group. In the non-anesthetized, acid-etched group, dentin surfaces were covered with coalescent dentinal fluid in most specimens. However, in the anesthetized, acid-etched group, patent tubules and some dentinal fluid were observed on the surfaces. CONCLUSION: It was concluded that in situ, dentinal fluid had a detrimental effect on the dentin bond strengths of an etch-and-rinse adhesive and a self-etching adhesive. However, reduction in dentinal fluid due to the effect of a local anesthetic containing vasoconstrictor did not improve the bond strengths in either adhesives.

The elastic moduli across various types of resin/dentin interfaces.

OBJECTIVE: The purpose of this study was to evaluate the elastic moduli of an unfilled adhesive resin (Adper Single Bond) and a filled adhesive resin (Adper Single Bond 2) used with and without a low-viscosity resin (LVR) (Filtek Flow) as an elastic cavity wall in class V composite restorations, restored with a hybrid resin composite (Z250). METHODS: Buccal class V cavities were prepared on extracted premolars and lined with (1) the unfilled adhesive resin, (2) the filled adhesive resin, (3) the unfilled adhesive resin and the flowable composite, and (4) the filled adhesive resin and the flowable composite. All cavities were restored with the hybrid resin composite. The specimens were cut bucco-lingually, embedded in epoxy resin and polished. The polished specimens were evaluated for the elastic modulus with nano-indentation test at the layer of dentin, hybrid layer, adhesive resin, low-viscosity resin and resin composite. RESULTS: The elastic moduli were 25,111 MPa for dentin, 12,243 MPa for hybrid layer of Adper Single Bond, 11,765 MPa for hybrid layer of Adper Single Bond 2, 7595 MPa for Adper Single Bond, 8430 MPa for Adper Single Bond 2, 13,543 MPa for Filtek Flow and 24,494 MPa for Filtek Z250 resin composite. The statistical analysis demonstrated that the elastic moduli were significantly different among layers (p<0.05) except between hybrid layers of unfilled and filled adhesives (p=1.0). CONCLUSION: The application of filled adhesive did not increase the elastic modulus of hybrid layer when compared with the unfilled adhesive resin. The modulus of filled adhesive resin was significantly higher than that of unfilled adhesive resin.

Effect of elastic cavity wall and occlusal loading on microleakage and dentin bond strength.

OBJECTIVE: This study evaluated the effect of an unfilled-adhesive resin (Adper Single Bond) and a filled-adhesive resin (Adper Single Bond 2) with and without a low viscosity resin (Filtek Flow) as an elastic cavity wall on marginal leakage and dentin microtensile bond strength in Class V composite restorations under unloaded and loaded conditions. METHODS: V-shaped cavities were prepared on the buccal surfaces of 56 premolars lined with unfilled (Groups 1 and 3) or filled (Groups 2 and 4) adhesives with (Groups 3 and 4) and without (Groups 1 and 2) a low viscosity resin and restored with a resin composite. The restored teeth in each group were divided into two sub-groups for unloaded and loaded conditions with 50N loading force for 250,000 cycles parallel to the long-axis of the tooth. Five specimens from each group were cut bucco-lingually 0.7 mm thick and subjected to a dye leakage test for four hours using 2% methylene blue dye. The tested specimens were then trimmed into dumbbell shapes at the gingival margin and subjected to microtensile testing. The remaining two specimens were cut, embedded and observed for resin/dentin interfaces under a scanning electron microscope. RESULTS: For the microleakage test, there were no significant differences in microleakage among the groups on both the enamel and dentin margin. No statistically significant differences were found between microleakage of the loaded and unloaded groups on enamel margins for all materials. There were statistically significant differences between microleakage of the loaded and unloaded groups on the dentin margin for Groups 3 and 4. For the microtensile test, the significant difference was found between Groups 1 and 4 for the unloaded groups. For the loaded groups, there were no significant differences between Groups 1 and 2 and Groups 3 and 4. There were no statistically significant differences in microtensile bond strength between the loaded and unloaded groups except for Group 2. CONCLUSION: The application of filled adhesive or low viscosity resin had no influence on marginal leakage at both the enamel and dentin margin but it had an influence on the microtensile bond strength to dentin of Class V restorations. Occlusal loading significantly increased the degree of marginal leakage at the dentin margin when low viscosity was applied in combination with either unfilled or filled-adhesives, but it decreased dentin bond strength in the group treated with only filled adhesive.

Bond strengths of two adhesive systems to dentin contaminated with a hemostatic agent.

This study evaluated the bond strength of a total-etch and a self-etch adhesive to dentin contaminated with a hemostatic agent containing aluminum chloride (AlCl3). Eighteen occlusal dentin discs were prepared from human molars. Each disc was ground and sectioned into two halves, one for normal dentin and the other for contaminated dentin. The specimens of both normal and contaminated dentin were randomly divided into three groups and treated with the following materials: (1) Excite (EX); (2) Clearfil SE Bond with 20-second primer application time (CB 20) and (3) Clearfil SE Bond with 40-second primer application time (CB 40). The microshear bond strength specimens were prepared using the resin composite Clearfil APX. The bond strengths were evaluated on a universal testing machine. Statistical analysis was performed at alpha = 0.05. The surface micromorphology and aluminum content of the different dentin conditions were also examined. In EX, no significant difference was found between the bond strengths of normal dentin and contaminated dentin. The bond strength of CB20 to contaminated dentin was significantly lower than that to normal dentin. The extension of primer application time from 20 to 40 seconds significantly increased the bond strength of CB to contaminated dentin.