Effect of Matrix Metalloproteinase-inhibiting Solutions and Aging Methods on Dentin Bond Strength.

PURPOSE: This study examined the effects of matrix metalloproteinase-inhibiting solutions and aging methods on the bond strength between resin composite and human dentin. MATERIALS AND METHODS: Crown segments of 105 human non-carious molars were bonded using simulated pulpal pressure at 20 cm water pressure. The teeth were randomly split into 5 groups according to the solution applied: CG (control, no solution), CHX (0.2% chlorhexidine), EPE (10% ethanolic propolis extract), APE (aqueous propolis extract), and E (70% ethanol). Each solution was left on the acid-etched dentin for 1 min. Adper Single Bond 2 and resin composite (Filtek Z350 XT) were applied to all specimens. The 5 groups were subdivided according to the aging method: SI (sectioned immediately); S (storage in artificial saliva for 6 months); and T (thermomechanical aging with 240,000 mechanical cycles and 1000 thermal cycles). Specimens were sectioned into sticks and subjected to microtensile testing. Bond strength data were analyzed by two-factor ANOVA followed by a post-hoc Tukey's test (α=0.05). RESULTS: For the factor "solution", there was no significant difference among the groups (p=0.32). For the factor "aging method", significant differences were found (p<0.001), with the following mean bond strengths (MPa): SI: 31.1; S: 24.4; T: 26.8. CONCLUSIONS: The use of matrix metalloproteinase-inhibiting solutions on dentin as an adjunct to the application of an etch-and-rinse adhesive does not prevent the loss of bond strength after aging. Nevertheless, these solutions have no adverse effect on adhesion to tooth structure.

A split-mouth randomized clinical trial of conventional and heavy flowable composites in class II restorations.

OBJECTIVE: The aim of this study was to evaluate the 2-year clinical performance of class II restorations made with a composite resin with two different viscosities. METHODS: 47 patients received two class II restorations (n=94), one made with GrandioSO (conventional viscosity - CV), and the other with GrandioSO Heavy Flow (flowable viscosity - FV), subjecting both materials to the same clinical conditions. The self-etching adhesive Futurabond M was used for all restorations. The composites were inserted using the incremental technique. The restorations were evaluated using the modified USPHS criteria according to the periods: baseline, 6 months, 1 year and 2 years after restorative procedures. RESULTS: After 24 months, 40 patients attended the recall and 78 restorations were evaluated. In all periods, no secondary caries was observed. After 6 months, there were slightly overall changes of scores for most parameters. After 24 months, the higher number of changes from score Alfa to Bravo was observed for marginal discolouration (32.5% - CV and 39.5% - FV) and colour match (15% - CV and 31.6% - FV), followed by proximal contact (25% - CV and 23.7% - FV) and marginal adaptation (20% - CV and 21.1% - FV). For wear, surface texture and postoperative sensitivity the changes were very small. Just two restorations were lost during the 24-month follow up. Less than 5% of all restorations showed postoperative sensitivity. Chi-square test showed no significant differences between the two materials for all parameters analysed. CONCLUSION: After 2 years of clinical service, no significant differences were observed between GrandioSO conventional and GrandioSO Heavy Flow for the parameters analysed. Both materials provided acceptable clinical behaviour in class II restorations. CLINICAL SIGNIFICANCE: This study presents the possibility of using a flowable composite with high filler content, for performing class II restorations.