The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities.

INTRODUCTION: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. MATERIAL AND METHOD: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. RESULTS: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). CONCLUSIONS: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

The effect of 2% chlorhexidine iontophoresis on dentin sealing ability of etch-and-rinse adhesive: An in vitro study.

Background/purpose: Iontophoresis could enhance the delivery of chlorhexidine into oral tissue. This study aimed to determine the effect of 2% chlorhexidine iontophoresis (CHI) on the sealing ability of etch-and-rinse adhesive in human dentin using hydraulic conductance (HD) measurement, scanning electron microscopy and energy dispersive x-ray spectroscopy (SEM-EDS). Materials and methods: Thirty-nine sound dentin specimens were prepared from 39 extracted intact third molars. Thirty specimens were used for HD measurement and randomly divided into 3 equal-sized groups; (1) No chlorhexidine treatment (control), (2) passive chlorhexidine treatment (CHT) and (3) CHI on acid-etched dentin. Each dentin surface was treated with etch-and-rinse adhesive. HD of each specimen was measured before treatment, after immediate bonding and after 14 days. The other 9 specimens were subjected to SEM-EDS analysis of the acid-etched dentin and the dentin treated with CHT and CHI. ANOVA test and Student-Newman-Keuls method were used for statistical analysis. Results: After bonding, there was no significant difference in percentage decrease of HD among the treatment groups (P > 0.05). After 14 days, CHI and CHT groups had greater percentage decrease of HD than the control (P < 0.001 and P = 0.009, respectively). Under SEM-EDS analysis, acid-etched dentin with CHI presented opened dentinal tubule orifices and more chlorhexidine precipitates on dentin than the dentin with CHT, which strongly related to a higher percentage of chloride ions on the CHI dentin surface (P < 0.001). Conclusion: The use of CHI on acid-etched dentin had a positive effect on dentin sealing ability of etch-and-rinse adhesive.

Aluminum zirconate nanoparticles in etch and rinse adhesive to caries affected dentine: An in-vitro scanning electron microscopy, elemental distribution, antibacterial, degree of conversion and micro-tensile bond strength assessment.

To incorporate different concentrations of Al2O9Zr3 (1%, 5%, and 10%) nanoparticles (NP) into the ER adhesive and subsequently assess the impact of this addition on the degree of conversion, µTBS, and antimicrobial efficacy. The current research involved a wide-ranging examination that merged various investigative techniques, including the application of scanning electron microscopy (SEM) for surface characterization of NP coupled with energy-dispersive x-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, µTBS testing, and microbial analysis. Teeth were divided into four groups based on the application of modified and unmodified three-step ER adhesive primer. Group 1 (0% Al2O9Zr3 NPs) Control, Group 2 (1% Al2O9Zr3 NPs), Group 3 (5% Al2O9Zr3 NPs), and Group 4 (10% Al2O9Zr3 NPs). EDX analysis of Al2O9Zr3 NPs was performed showing elemental distribution in synthesized NPs. Zirconium (Zr), Aluminum (Al), and Oxides (O2). After primer application, an assessment of the survival rate of Streptococcus mutans was completed. The FTIR spectra were analyzed to observe the characteristic peaks indicating the conversion of double bonds, both before and after the curing process, for the adhesive Etch and rinse containing 1,5,10 wt% Al2O9Zr3 NPs. µTBS and failure mode assessment were performed using a Universal Testing Machine (UTM) and stereomicroscope respectively. The µTBS and S.mutans survival rates comparison among different groups was performed using one-way ANOVA and Tukey post hoc (p = .05). Group 4 (10 wt% Al2O9Zr3 NPs + ER adhesive) specimens exhibited the minimum survival of S.mutans (0.11 ± 0.02 CFU/mL). Nonetheless, Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) displayed the maximum surviving S.mutans (0.52 ± 0.08 CFU/mL). Moreover, Group 2 (1 wt% Al2O9Zr3 NPs + ER adhesive) (21.22 ± 0.73 MPa) samples displayed highest µTBS. However, the bond strength was weakest in Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) (14.13 ± 0.32 MPa) study samples. The etch-and-rinse adhesive exhibited enhanced antibacterial activity and micro-tensile bond strength (µTBS) when 1% Al2O9Zr3 NPs was incorporated, as opposed to the control group. Nevertheless, the incorporation of Al2O9Zr3 NPs led to a decrease in DC. RESEARCH HIGHLIGHTS: 10 wt% Al2O9Zr3 NPs + ER adhesive specimens exhibited the minimum survival of S.mutans. 1 wt% Al2O9Zr3 NPs + ER adhesive samples displayed the most strong composite/CAD bond. The highest DC was observed in Group 1: 0 wt% Al2O9Zr3 NPs + ER adhesive.

Internal Adaptation of Composite Fillings Made Using Universal Adhesives-A Micro-Computed Tomography Analysis.

This study aimed to evaluate internal tooth-filling interfaces of composite fillings made using universal adhesives using micro-computed tomography (µCT). Sixty class V cavities were randomly assigned into six groups: Peak Universal etch and rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch and rinse (AER), and Adhese Universal self-etch (ASE). Two further adhesives considered gold standards were used as control groups: OptiBond FL (OER) for the etch and rinse technique and Clearfil SE for the self-etch technique (CSE). All teeth were subjected to thermomechanical loading and four-year water storage. Next, they were analyzed using µCT to investigate the internal tooth-filling interfaces. The proportions between the gap volume (GV) at the tooth-filling interface and the volume of applied composite filling (FV), between the gap and cavity volumes (CV), and between the gap volumes at the tooth-filling interface of the external (EGV) and internal (IGV) parts were calculated. Adhese Universal achieved the significantly lowest gap-to-filling- and gap-to-cavity-volume ratios for both types of etching techniques comparing to those of the Peak Universal and control groups. Significant differences between the gaps in external and internal parts of the tooth-filling interface were only noted in the control groups. Internal gap formation and development at the tooth-filling interface depend on the material as well as the type of its application.

The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity-An In Vitro Study.

The increasing demand for orthodontic treatments due to the high prevalence of malocclusion has inspired clinicians and material scientists to investigate innovative, more effective, and precise bonding methods with reduced chairside time. This study aimed at comparing the shear bond strength (SBS) of metal and ceramic brackets bonded to enamel using the indirect bonding technique (IDB). Victory Series metal brackets (Metal-OPC, Metal-APC) and Clarity™ Advanced ceramic brackets (Ceramic-OPC) (3M Unitek, Monrovia, CA, USA) were bonded indirectly to extracted human premolars through the etch-and-rinse technique. A qualitative assessment of the enamel surface using microscopic methods was performed, and the amount of residual adhesive was reported as per the adhesive remnant index (ARI). Moreover, the bracket surface was evaluated with SEM-EDS. The highest SBS mean values were observed in the Ceramic-OPC group (16.33 ± 2.01 MPa), while the lowest ones were obtained with the Metal-OPC group (11.51 ± 1.40 MPa). The differences between the Metal-AOPC vs. Metal-APC groups (p = 0.0002) and the Metal-OPC vs. Ceramic-OPC groups (p = 0.0000) were statistically significant. Although the Ceramic-OPC brackets bonded indirectly to the enamel surface achieved the highest SBS, the enamel damage was significantly higher compared to that of the other groups. Thus, considering the relatively high bond SBS and favourable debonding pattern, Metal-APC brackets bonded indirectly may represent the best choice.

The effects of dental adhesives total etch; self-etch and selective etch application procedures on microleakage in class II composite restorations.

Purpose: The aim of this study is to evaluate the amount of microleakage resulting from the application of self-etch, selective etch, etch-and-rinse of adhesive systems in class II cavities. Materials and methods: Four adhesive systems with etch-and-rinse, selective etch and self etch methods were used on the extracted teeth. All groups were restored with G-aenial A'CHORD (Nanohybrid) (GC, Tokyo, Japan) A2 composite. After 1000 thermal cycles were applied to the teeth after restoration, the samples were kept in 0.5% basic fuchsin for 24 hours. Microleakage values formed after dye penetration with basic fuchsin were determined quantitatively by scoring method on sections taken from each sample in the mesiodistal direction. One-way Analysis of Variance (ANOVA) and Tukey test were used for statistical analysis of the data (p<0.05). Results: While there was no statistically significant difference between the etch-and-rinse and selective etch applications of adhesive systems (G2-Bond Universal, Clearfil Tri-S Bond Universal Prime&Bond Universal and Tokuyama Bond Force II) (p>0.05), there was a statistically significant difference in self-etch application (p<0.05). As a result of Prime&Bond Universal's self-etch application, it showed statistically more microleakage than the other three adhesive systems (p<0.05). Conclusion: It has been observed that additional etching of enamel and/or dentin with phosphoric acid reduces the amount of microleakage.

Shear Bond Strength of Metal and Ceramic Brackets Depending on Etching Protocol in Direct Bonding Technique.

Successful orthodontic therapy, apart from a proper treatment plan, depends on optimal bracket-enamel adhesion. Among numerous factors affecting adhesion, the type of bracket and preparation of the tooth's surface are crucial. The aim of this study was to compare the shear bond strength (SBS) of metal and ceramic brackets to the enamel's surface using direct bonding. Forty extracted human premolars were divided into four groups according to the etching method (etch-and-rinse and self-etch) and bracket type. The SBS and adhesive remnant index (ARI) were determined. The ceramic brackets achieved the highest SBS values both in the self-etch (SE) and etch-and-rinse (ER) protocols. Higher SBS values for ceramic and metallic brackets were found in the ER protocol. In all tested groups, the achieved SBS value was satisfactory to withstand orthodontic and occlusal forces. There was no significant difference in the ARI score between study groups (p = 0.71). The fracture occurred between the bracket base and adhesive material in both types of brackets, which decreased the risk of enamel damage during debonding.

Effect of Modified Triple-Layer Application on the Bond Strength of Different Dental Adhesive Systems to Dentin.

The goal of this article was to assess the effect of modified triple-layer application (MTLA) in conjunction with the active bonding technique on the bond strength of four adhesive systems to dentinal substrate. The adhesives tested were Prime&Bond Universal (PBU), OptiBond Universal (OBU), OptiBond FL (OBFL), and Clearfil SE (CSE). The adhesives were applied according to the following strategies: single active application (A) and triple adhesive layer application including Active-Passive-Passive (APP); AAP; and AAA. The micro-tensile bond strength test was evaluated following 24 h or 6 months of storage. The composite-dentin interface morphology was investigated using scanning electron microscopy. The data were statistically analyzed with a significance level of α = 0.05. At 24 h of aging, all of the factors tested were not significant (p > 0.05) for CSE. For OBFL, OBU, and PBU, statistically higher values were observed for the A technique (p < 0.05). Plus, there were no significant variances between the APP, AAP, and AAA techniques (p > 0.05) for OBFL and PBU. However, for OBU, there were no significant differences between the A and AAA techniques (p > 0.05). After 6 months of aging, the A technique showed statistically higher values when compared to the other techniques (p < 0.01), except for OBFL, where the A and AAA techniques showed promising outcomes. When comparing the bond strength values of 24 h and 6 months, only for PBU, all of the techniques used resulted in bond strength stability over time (p > 0.05). Thicker adhesive layers were observed when MTLA was applied. Only the OBFL adhesive showed the formation of resin tags in all of the modalities tested. The bonding performances of the different application techniques used were material-dependent.

The Effect of Bonding Strategy and Aging on Adhesion to Primary Enamel: An In-Vitro Study.

PURPOSE: Resin composites are commonly used in pediatric dentistry, but there is limited evidence on adhesion to primary teeth, especially primary enamel. In this study, three bonding strategies were assessed - one-step self-etch (1-SE), two-step self-etch (2-SE), and three-step etch-and-rinse (3-ER) - by measuring the immediate and aged microshear bond strength (µSBS) to sound primary enamel. MATERIALS AND METHODS: 120 extracted human primary molars with sound buccal surfaces were used for µSBS testing. Six adhesive protocols (two per bonding strategy) were selected and µSBS was measured either after 24 h or 10,000 thermal cycles (n = 10). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were used to determine failure modes. Furthermore, 18 primary molars were etched using the different adhesive protocols (n = 3) for the measurement of surface roughness (Sa) using CLSM and morphological analysis using SEM. RESULTS: After 24 h, there was no significant difference in µSBS between 1-SE and 2-SE strategies (p = 0.96), but the 2-SE strategy yielded significantly higher µSBS after thermocycling (p < 0.001). The highest µSBS was obtained using the 3-ER strategy regardless of aging (p < 0.001). The 3-ER strategy clearly exposed enamel prisms and resulted in the highest Sa (p < 0.001). In contrast, if SE strategies were used, enamel prisms were barely recognizable, and Sa was not significantly different from baseline (p > 0.95). CONCLUSION: The 3-ER strategy is optimal for bonding to primary enamel. The etching effect of SE strategies is weaker, resulting in lower µSBS. Thermocycling revealed that the bonding durability of the 1-SE strategy is inferior to that of to multi-step strategies.

The Classification and Selection of Adhesive Agents; an Overview for the General Dentist.

Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords "adhesive agents", "classification", "dentin", "enamel", "universal", "self-etch", "etch-and-rinse", and "bonding". The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or "multi-mode" according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.

Adhesion to enamel and dentine: an update.

With the continuous development of adhesive technology leading to a wide variety of bonding systems in the market, clinicians are often faced with a vast number of systems to choose from. Although research and manufacture of bonding systems is constantly progressing, the focus has generally been on simplifying the bonding process by reducing the number of clinical steps, with little emphasis on evidence-based performance. This article draws attention to the current strategies of common commercially available products to guide clinicians during bonding system selection and application.

A Three-step Etch-and-Rinse vs a Universal Adhesive in Nanohybrid Composite Anterior Restorations: A Retrospective Clinical Evaluation.

PURPOSE: To retrospectively evaluate the clinical behavior of direct anterior composite restorations performed with a universal adhesive or with a three-step etch-and-rinse (E&R) adhesive. MATERIAL AND METHODS: Patients were randomly treated with a three-step E&R adhesive (Optibond FL, Kerr) or a universal adhesive (Clearfil Universal Bond Quick, Kuraray Noritake) applied in E&R mode. All restorations were performed with a nanohybrid composite (ClearFil Majesty ES-2, Kuraray Noritake) by the same experienced operator. Two calibrated examiners evaluated the restorations using a dental mirror and explorer, in accordance with modified United States Public Health Service (USPHS) procedures. Clinical events were registered and classified as either failure (F), survival (SR), or success (S). RESULTS: 168 restorations were evaluated in 90 patients with an average follow-up period of 37.9 (± 22.9) months. A total of 132 restorations were performed on vital teeth, and 36 were performed on endodontically treated teeth (ETT). A total of 128 Class-IV and 40 Class-III restorations were performed. In 89 restorations, a three-step E&R adhesive was applied (14 Class-III and 75 Class-IV), while in 79, a universal adhesive was used (26 Class-III and 53 Class-IV, p = 0.0091). A Cox regression analysis was performed (p < 0.05) to analyze which factors were involved in the failure of the restorations, considering failure (F) as restorations that needed re-intervention at the follow-up period of 37.9 (± 22.9) months. No statistically significant differences were observed when considering parameters directly involved with the adhesives tested. Endodontically treated teeth were more prone to fractures (p = 0.0006) compared to vital teeth. Restorations made with universal adhesives failed by fracturing significantly more frequently (p = 0.0234), while restorations made on endodontically treated teeth had a significantly worse outcome (p = 0.0001). Restorations made on canines also failed significantly more frequently (HR = 3.8, 95% CI = 1.4-10.1, p = 0.0062). CONCLUSIONS: Based on the obtained results, both the universal adhesive and the three-step E&R adhesive proved to be good treatment choices for direct anterior restorations after 37.9 (± 22.9) months of follow-up. Tooth vitality seems fundamental for the prognosis of a direct anterior composite restoration over time.

Bonding strategies to deal with caries-affected dentin using cross-linking agents: Grape seed extract, green tea extract, and glutaraldehyde - An in vitro study.

Aim: This study evaluated the effect of three collagen cross-linking agents - proanthocyanidins (grape seed extract [GSE] and green tea extract [GTE]) and glutaraldehyde [GA] on microshear bond strength (µSBS) of caries-affected dentin (CAD)-resin complex. Materials and Methods: Freshly extracted 96 teeth with caries up to the middle third of dentin were sectioned through the deepest part of the occlusal fissure, perpendicular to the long axis of the crown. Caries was excavated with large round bur until firm dentin was obtained, confirmed by visual inspection and tactile examination. Flat occlusal dentin surfaces were treated as follows: Group-1 - 6.5% GSE (n = 30), Group-2 - 2% GTE (n = 30), Group-3 - 5% Glutaraldehyde (n = 30), Group-4 - control group (no agents) (n = 6). Each group was further divided into Subgroup A - Etch-N-Rinse 15s, Subgroup B - Etch-N-Rinse 45s, and Subgroup C - Self-etch. Two increments of 1.5-mm thick composite (Tetric-N-Ceram - Ivoclar Vivadent) with a 1-mm diameter were built-up. Each sample was subjected to µSBS test in Universal Testing Machine. Student's t-test was done for intragroup comparison and one-way ANOVA for intergroup comparison. Results: Statistically significant difference was present in mean µSBS, with Group 1B showing the best results and Group 4C, the least. Conclusions: Thus, the application of these collagen cross-linkers, to CAD, increases µSBS and promises a new approach to improve dentin bond strength.

Are universal adhesives in etch-and-rinse mode better than old 2-step etch-and-rinse adhesives? One-year evaluation of bonding properties to dentin.

OBJECTIVES: This study compared the bonding properties of dentin of three 2-step etch-and-rinse adhesives (2-ERAs) to those of three universal adhesives (UAs) applied with an etch-and-rinse strategy (ER), immediately and after 1 year of water storage. METHODS: Sixty caries-free molars were divided into 6 groups according to the adhesive systems used (n = 10). The 2-ERA systems included were: 1) Adper Single Bond 2 (SB), 2) Tetric N-Bond (TB), and 3) Ambar (AM); and the UAs systems were: 4) Single Bond Universal (SBU) 5) Tetric N-Bond Universal (TBU), and 6) Ambar Universal (AMU). The occlusal third of each tooth was removed and the adhesives were applied. After the composite build-up, specimens were sectioned and tested for microtensile bond strength (µTBS) and nanoleakage (NL) immediately and after 1 year of water storage. In situ degree of conversion (DC) was only evaluated in the immediate time. For water sorption (WS), solubility (SO), and mass change (MC) tests, 48 disk-shaped specimens were prepared (n = 8) and assessed according to ISO 4049:2009. RESULTS: UAs showed higher µTBS and lower NL values than 2-ERAs did after 1 year of water storage (p = 0.001). Regarding DC, 2-ERAs showed higher DC values than UAs (p = 0.001). Regarding WS, 2-ERAs showed higher WS values than those of UAs (p = 0.00001), except for AM and AMU. Lower WS was observed for AM than for other 2-ERAs (p = 0.00001). CONCLUSION: The use of UAs applied with the ER strategy seems to be a more effective technique for maintaining adhesion to dentin substrate than 2-ERAS. CLINICAL SIGNIFICANCE: This study may support clinicians in selecting the most adequate adhesive system to be used in ER strategy in dentin, demonstrating that UAs were more effective, considering the longevity of the resin restorations.

Effect of using different component combinations for orthodontic bracket bonding with self-etch primers.

PURPOSE: To evaluate bonding quality for orthodontic bracket bonding with different component combinations of self-etch primers in vitro. METHODS: Metallic brackets were bonded to bovine lower incisors and assigned to groups. Group 1: comparison of self-etch (Transbond™ Plus, 3M™ Unitek, Neuss, Germany, n = 30; BrackFix® primer SE, VOCO®, Cuxhaven, Germany, n = 20) and etch-and-rinse bonding systems (Transbond™ XT, n = 20; BrackFix®, n = 20); group 2: comparison of different self-etch primer (Transbond™ Plus; BrackFix® primer SE) and adhesive (Transbond™ XT, n = 20; BrackFix®, n = 20) product combinations; group 3: testing cyclic fatigue bond strength of self-etch bonding systems (Transbond™ Plus, n = 20; BrackFix® primer SE, n = 20). All teeth were tested for shear bond strength according to the DIN-13990 standard, the adhesive remnant index (ARI) and enamel fractures were determined microscopically (10 נmagnification). RESULTS: The mean shear bond strength of the self-etch (Transbond™ Plus: 16.38 ± 3.68 MPa; BrackFix® primer SE: 16.24 ± 1.73 MPa) and etch-and-rinse bonding systems (Transbond™ XT: 18.45 ± 2.56 MPa; BrackFix®: 17 ± 5.2 MPa) were of a clinically adequate order of magnitude (≥ 6-10 MPa) and were not statistically different. The component combination BrackFix® primer SE/Transbond™ XT adhesive led to a significantly lower shear bond strength (11.99 ± 3.68 MPa). There were no significant differences between static and fatigue shear bond strengths of self-etch bonding systems. Mean ARI scores mostly ranged between 4 and 5. The combination of the self-etch primer Transbond™ Plus with the BrackFix® adhesive led to a significantly increased enamel fracture rate. CONCLUSIONS: Based on the present findings bond strength of self-etch primers was equal to etch-and-rinse primers for bracket bonding. Combining different self-etch bonding systems might alter the clinical performance.

Influence of three different types of desensitizing agents on bond strength of etch-and-rinse and self-etch adhesive system on dentin: An in vitro study.

Aim: To determine the effect of three different dentin hypersensitivity treatment procedures on the microtensile bond strength of etch and rinse and self-etch adhesive system. Materials and Methods: Eighty extracted intact human permanent lower premolars were decoronated, and dentin was exposed on the buccal surface. The teeth were randomly assigned to two experimental groups of 40 teeth each: etch and rinse system or self-etch system. The 40 samples assigned were further randomly assigned to four desensitizing treatment subgroups: Control, Gluma, NovaMin, and GC tooth Mousse with 10 samples per subgroup. Desensitizing treatment was performed two times each day for 2 weeks respectively. The exposed dentin was subjected to etch and rinse or self-etch adhesive system bonding agent as per the group and restored using composite to 4-mm thickness. Samples were then subjected to universal testing machine for microtensile bond strength. Results: The bond strength to the dentin obtained with etch and rinse adhesive system group where significantly higher (P < 0.05) when compared to self-etch adhesive system. However, there was no significant effect of the desensitizing agent on the microtensile bond strength in its own. Scanning electron microscope imaging reviled tubular occlusion in all specimens treated with desensitizer. Conclusion: The bond strength was majorly impacted by the type of adhesive system used. While the desensitizing agents used in the study had little or no adverse effect on the bond strength of composites to dentin surface.

Biomimetic Mineralized Hydrophilic Polyurethane Primers for Inducing Dentin Tubule Fillings.

This experiment aimed to synthesize a biomimetic mineralized hydrophilic polyurethane dentin primer containing DDDEEKC peptide (DDDEEKC-PU) to fill dentin tubules and induce mineralization. The degree of conversion (DC) was tested. Dentin samples were acid-etched and treated with DDDEEKC-PU. They were immersed in stimulated human fluid (SBF) for 7, 14 and 28 days. Dentin permeability, X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) and Vickers hardness were measured. After 28 days, regenerated minerals were deposited on resin tags which were confirmed to be hydroxyapatite (HAp). The minerals reduced the dentin permeability and improved the microhardness. DDDEEKC-PU was able to fill dental tubules immediately and induce mineralization simultaneously.

Assessment of Caries-Affected Dentin Adhesive Interface Treated with Contemporary Conditioning Techniques.

Objective: The aim of this study was to assess shear bond strength (SBS) and failure analysis of adhesion of composite resin (CR) to caries-affected dentin (CAD) pretreated with the Er,Cr:YSGG (ECY) laser, photodynamic therapy (PDT), and etch and rinse (ER) used for cavity disinfection. Materials and methods: Methods used in this study included scanning electron microscopy (SEM), SBS analysis, failure analysis, and digital microscopy. The methods were adopted to assess bond integrity, CAD interface, smear layer, and hybridization. Thirty human third molars assessed clinically and having scores of 4 and 5 based on International Caries Detection and Assessment System (ICDAS) criteria were inspected. Infected dentin was removed. Dentin that was hard and stained pink was categorized as CAD. Ten samples were used in each group for pretreatment of CAD. Ten samples of healthy dentin [sound dentin (SD)] were collected separately and taken as controls. Samples were divided into the following groups: group 1: SD+ER; group 2: CAD+ER; group 3: CAD+ECY; and group 4: CAD+PDT after the pretreatment bonding agent was applied and the restorative procedure was performed using CR. Results: CAD conditioned with PDT before bonding to CR demonstrated the lowest SBS values (11.22 ± 0.77 MPa), whereas the highest SBS values were observed in the SD surface treated with ER (18.25 ± 1.22 MPa). In CAD and SD pretreated with ER, majority of failure modes were cohesive failure and admixed failure, whereas in CAD pretreated with PDT and the ECY laser, the adhesive failure mode was pertinent. Conclusions: The use of the ECY laser and PDT on CAD for cavity disinfection does not have potential for application in clinical settings as it decreases bond integrity of CR. Moreover, the ER pretreatment method for CAD and SD remains the gold standard.

Evaluation of the efficacy of a 2-step etch-and-rinse, 2-step self-etch and 1-step self-etch adhesive systems, in class II primary molars restorations. An one year prospective, randomized clinical trial.

PURPOSE: To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. METHODS: This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4-8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- ClearfilTMS3Bond Plus (CSB); GII- ClearfilTMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). RESULTS: The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). CONCLUSIONS: After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. TRIAL REGISTRATION NUMBER: ISRCTN11458186.

Clinical Performance of a "No Wait" Universal Adhesive in Noncarious Cervical Lesions: A Two-year Randomized Controlled Clinical Trial.

PURPOSE: To evaluate the 24-month clinical performance of a "no wait" universal adhesive with different application modes in comparison with an etch-and-rinsew and two-step self-etch adhesive in non-carious cervical lesions (NCCLs). MATERIALS AND METHODS: A total of 234 non-carious cervical lesions in 34 patients were restored following 5 different adhesive approaches: 1. Clearfil Universal Bond Quick, self-etch mode (CUQ-SE); 2. Clearfil Universal Bond Quick, selective etch mode (CUQ-SLE); 3. Clearfil Universal Bond Quick, etch-and-rinse mode (CUQ-ER); 4. Clearfil SE Bond (self-etch adhesive) (CSEB); 5. Tetric N-Bond Universal, etch-and-rinse mode (TBU-ER). All NCCLs were restored with a nanohybrid composite (Tetric N-Ceram). The restorations were evaluated at baseline, 6, 12, and 24months of clinical service regarding retention, marginal adaptation, marginal discoloration, secondary caries, post-operative sensitivity, color match, surface texture using modified United States Public Health Service (USPHS) criteria. RESULTS: The patient recall rate at 24 months was 73.5%. Eleven restorations, 6 of the CUQ-SE group, 4 of the CSEB group and 1 of the TBU-ER group, were clinically unacceptable due to retention loss. Regarding marginal adaptation and discoloration, CUQ-SE and CSEB groups exhibited higher bravo scores than other groups after 24 months (p < 0.05). At the end of 24-month examinations, no significant differences were detected among the groups regarding secondary caries, post-operative sensitivity, color match and surface texture. CONCLUSION: The clinical survival rates of the "no wait" universal adhesive at self-etch mode after 24 months were not acceptable. The "no wait" universal adhesive showed clinically acceptable performance in selective-etch and etch-and-rinse mode according to the evaluated USPHS criteria.