Polymerization Kinetics, Shrinkage Stress, and Bond Strength to Dentin of Conventional and Self-adhesive Resin Cements.

PURPOSE: To evaluate the kinetics of polymerization and shrinkage stress of resin cements, as well as their bond strength to dentin after 24-h or one-year water storage. MATERIALS AND METHODS: Three conventional resin cements were evaluated: RelyX Ultimate (RUL), Panavia V5 (PNV), and Multilink N (MLN); and three self-adhesive resin cements: RelyX Unicem 2 (RUN), Panavia SA Cement Plus (PSA), and G-CEM LinkAce (GCL). Degree of conversion (DC), maximum polymerization rate (RPmax) and gel time values were obtained using Fourier-transform infrared spectroscopy (FTIR/ATR). Shrinkage stress values were determined with a tensiometer, using a universal testing machine (n=5). Indirect resin composite restorations (Solidex) were fabricated and cemented to the dentin surface using self-adhesive resin cements, or conventional resin cements with self-etching adhesive (n=5). Bonding performance was evaluated with the microtensile bond strength (µTBS) test after 24 h or one year of water storage. RESULTS: MLN exhibited a higher DC (76.7%), whereas the percentage of other materials differed slightly (ranging from 54% to 58.5%). The RPmax and shrinkage stress values differed significantly between the cements. PSA showed the longest gel time. Significantly higher µTBS were observed for conventional resin cements after 24-h and one-year storage; a decrease in µTBS was observed for MLN only. CONCLUSION: Self-adhesive resin cements may not perform as well as conventional resin cements. Although both categories of cements presented similar polymerization kinetics and shrinkage values, the self-adhesive resin cements showed lower µTBS compared to those of conventional resin cements. Nevertheless, storage time only affected the bonding performance of MLN.

Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation.

The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation

Abstract The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Assessment of Self-Adhesive Resin Composites: Nondestructive Imaging of Resin-Dentin Interfacial Adaptation and Shear Bond Strength.

Shear bond strength (SBS) and the interfacial adaptation (IA) of self-adhesive resin (SAR) composites to dentin were evaluated. Two SARs [Vertise Flow (VTF) and Fusio Liquid Dentin (FLD)] were evaluated and compared with a conventional restorative system [adhesive: OptiBond FL and composite: Herculite Précis (OBF/HP)]. Human third molars were used for SBS testing and IA imaging (n=7) using optical coherence tomography (OCT). Flattened dentin disks were prepared and the composites were applied into molds (2.4 mm diameter) that were positioned on dentin. Samples were subjected to SBS testing and OCT analysis, which considered an increase in signal intensity at the bonded interface as evidence of internal gaps. SBS data were analyzed by one-way analysis of variance and Tukey's test and IA data (% distribution of high brightness values) by Kruskal-Wallis and Dunn's test (p≤0.05). No statistically significant difference in SBS was observed between VTF (13.9±3.6 MPa) and FLD (11.3±3.2 MPa), whereas OBF/HP showed higher average strength (27.3±6.1 MPa). However, there was a statistically significant difference in IA when VTF (33.3%) was compared with FLD (1.2%) and OBF/HP (1.5%). The conventional restorative system exhibited superior SBS performance compared with SARs. However, the IA of FLD to dentin had values that were not significantly different from OBF/HP.

Assessment of current adhesives in class I cavity: Nondestructive imaging using optical coherence tomography and microtensile bond strength.

OBJECTIVES: To evaluate the sealing ability and the microtensile bond strength (MTBS) of different adhesive systems bonded to dentin in class I cavities. METHODS: Round tapered dentin cavities (3-mm diameter, 1.5-mm height) prepared in extracted human molars were restored using composite resin (Clearfil Majesty Posterior) with two-step etch-and-rinse adhesive system (Adper Single Bond 2: ASB2), two-step self-etch adhesive (Clearfil SE Bond: CSEB), all-in-one adhesives (G-Bond Plus: GBP; Tri-S Bond Plus: TSBP), or no adhesive (Control), or bonded using low-shrinkage composite with its proper adhesive (Filtek Silorane, Silorane Adhesive System: FSS). After 24-h water storage or 10,000 cycles of thermal stress, the specimens were immersed into a contrast agent. Two and three-dimensional images were obtained using optical coherence tomography (OCT). The mean percentage of high brightness (HB%) at the interfacial zone in cross-sectional images was calculated as an indicator of contrast agent or gap at the interface. The specimens were then sectioned into beams and the MTBS measured. RESULTS: The HB% (ASB2=TSBP=CSEBTSBP=GBP=FSS, ASB2>FSS) differed significantly among the adhesives. After aging, HB% increased for GBP and FSS specimens, and the MTBS decreased for FSS specimens (ANOVA, Tukey's post hoc, p<0.05). The HB% and MTBS were significantly and negatively correlated (p=0.002). Confocal laser scanning and scanning electron micrographs confirmed contrast agent infiltration within the gap. SIGNIFICANCE: There was a significant correlation between sealing performance and bond strength of the adhesives in the whole cavity. After aging, the two-step systems showed equal or superior performance to the all-in-one and Silorane systems.

Self-etch adhesive systems: a literature review.

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Self-Etch Adhesive Systems: A Literature Review

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Este artigo apresenta o estado da arte de sistemas adesivos autocondicionantes. Quatro temas são apresentados nesta revisão: o histórico desta categoria de agentes de união, o mecanismo de adesão, as características/propriedades, e a formação da zona ácido-base resistente nas interfaces esmalte/dentina-adesivo. Além disso, as vantagens relativas aos sistemas de condicionamento total ( etch-and-rinse ) e as classificações dos sistemas adesivos autocondicionantes de acordo com o número de passos e acidez são abordados. Por fim, são discutidas questões como a durabilidade potencial e a importância clínica. Sistemas adesivos autocondicionantes são materiais promissores porque são fáceis de usar, unem-se quimicamente à estrutura do dente e preservam a hidroxiapatita dentinária, o que é importante para a durabilidade da ligação.

Non-destructive 3D imaging of composite restorations using optical coherence tomography: marginal adaptation of self-etch adhesives.

OBJECTIVES: To investigate the potential use of swept-source optical coherence tomography (SS-OCT) as a new tool to evaluate marginal adaptation of composite restorations in class I cavities. METHODS: Round-shaped class I cavities (3mm diameter × 1.5mm depth) were prepared on buccal enamel of bovine teeth with cavity floor located in dentine. The cavities were restored with a flowable resin composite (Clearfil Majesty LV) using two-step self-etch adhesive (SE Bond), all-in-one self-etch adhesive (G-Bond) or no adhesive (Control). The specimens were subjected to water storage (37 °C, 24 h) or thermal stress challenge (5000 cycles, 5 °C and 55 °C). 3D scans (4 mm×4 mm×2.6 mm obtained in 4 s) of the restoration were obtained using SS-OCT before and after immersion into a contrast agent. 2D images obtained from the 3D scans (n=30/group) were analysed to evaluate marginal adaptation. Area fraction of pixels with high brightness values at the interfacial zone was calculated using a digital image analysis software. The results were statistically compared with statistical significance defined as p≤0.05. RESULTS: Wilcoxon signed ranks test showed that there was no statistically significant difference in the results of SS-OCT before and after infiltration of the contrast agent when a ranking transformation was applied on to the data (p>0.05). A significant positive linear correlation was found between the two SS-OCT images. Confocal laser scanning photomicrographs of samples cut after silver infiltration confirmed the presence of gap. CONCLUSIONS: 3D imaging by SS-OCT can be considered as a non-invasive technique for fast detection of gaps at the restoration interface.

The role of functional monomers in bonding to enamel: acid-base resistant zone and bonding performance.

OBJECTIVES: To investigate the effects of two functional monomers on caries-inhibition potential and bond strength of two-step self-etching adhesive systems to enamel. METHODS: Clearfil SE Bond and similar experimental formulations different in the functional monomer were used. Four combinations of primer and bonding agents were evaluated: (1) Clearfil SE Bond which contains MDP in both primer and bonding (M-M); (2) Clearfil SE Bond primer and Phenyl-P in bonding (M-P); (3) Phenyl-P in primer and Clearfil SE Bond bonding (P-M); (4) Phenyl-P in primer and bonding (P-P). Ground buccal enamel surfaces of human sound premolars were treated with one of the systems and the bonded interface was exposed to an artificial demineralising solution (pH 4.5) for 4.5 h, and then 5% NaOCl with ultrasonication for 30 min. After argon-ion etching, the interfacial ultrastructure was observed using SEM. Micro-shear bond strength to enamel was measured for all groups and results were analysed using one-way ANOVA and Turkey's HSD, while failure modes were analysed by chi-square test. RESULTS: An acid-base resistant zone (ABRZ) was found with all adhesive systems containing MDP either in primer or bond; however, ultramorphology and crystallite arrangement in the ABRZ were different among groups. P-P was the only group devoid of this protective zone. Micro-shear bond strength in M-M was significantly higher than those in M-P, P-M and P-P, while the latter three were not different from each other. Failure modes were significantly different (p<0.05). CONCLUSIONS: Functional monomers in two-step self-etching systems influence both the bonding performance and the formation of ABRZ on enamel.

Nanoleakage expression and microshear bond strength in the resin cement/dentin interface.

PURPOSE: The aim of this study was to evaluate dentin sealing ability and microshear bond strength of two different resin cements. MATERIALS AND METHODS: Resin composite overlays (Estenia C&B) were fabricated and cemented to mid-dentin surfaces with either a self-adhesive resin cement (RelyX Unicem) or a resin cement with a self-etching primer (Panavia F2.0). After 24 h storage in water, the specimens were sectioned, placed into 50% (w/v) ammoniacal silver nitrate solution for 24 h, exposed to photodeveloping solution and observed using FE-SEM and EDS. Percentage distribution of metallic silver particles in the resin cement/dentin interface was calculated using digital image analysis software. In addition, small resin overlay cylinders were also bonded to dentin using either of the resin cements, and their bonding performance was evaluated with the microshear bond strength test. The statistical significance was defined as p ≤ 0.05. RESULTS: No statistically significant difference was detected in the microshear bond strength between RelyX Unicem and Panavia F2.0 (24.9 ± 4.8 and 26.1 ± 5.3 MPa, respectively, p > 0.05). However, a significant difference was detected in silver particle penetration percentage between RelyX Unicem and Panavia F2.0 (7.4 ± 4.6 and 18.7 ± 8.7 MPa, respectively). The Kruskal-Wallis mean ranks for nanoleakage were 6.8 and 14.2, respectively (p < 0.05). CONCLUSION: While the bond strengths of the two materials were comparable, the self-adhesive resin cement may provide better dentin sealing compared to the self-etching primer resin cement.