The influence of a selected desensitizer on marginal microleakage of a class V composite restoration subjected to thermocycles: an in vitro study.

INTRODUCTION: Dentin hypersensitivity is a painful clinical condition. The frequency of its occurrence varies from 8 to 57%, depending on tested group and different methods of investigations. Recommended desensitizing agents have different mechanism of action and effectiveness. We are still looking for solutions that will improve their effectiveness and simultaneously allow for wider use of e.g. as a base material, counteracting postoperative hypersensitivity, reducing marginal microleakage. The aim of the study was to assess the effect of a selected desensitizing agent occluding dentin tubules with calcium hydroxyapatite on marginal microleakage formation of a class V composite restorations subjected to thermocycles. MATERIALS AND METHODS: In study it was used 40 molars and premolars, which were alternately assigned into two groups. In both groups standardized cavities were prepared. In the study group (study group - SG) before application of bonding agent Teethmate Desensitizer (f. Kuraray, Noritake Dental Inc., Okayama, Japan) was used. In the control group (control group - CG) OptiBond All-in-one (f. Kerr, Bioggio, Switzerland) bonding agent was used and cavities were filled using composite material Gradia Direct (f. GC Europe N.V., Leuven, Belgium). After storage in saline, teeth were subjected to 600 thermocycles, passive dye penetration test was done, teeth were cut in the area of filling, according to its long axis. Under light microscope magnification value of microleakage was measured and marginal microleakage rate (M) was counted. The results of the tests were statistically analyzed using the package STATISTICA 12.0 (StatSoft, USA). RESULTS: The average value of M for the SG group was 0.46 (min 0.05, max 0.76, SD 0.226) and for CG was 0.22 (min 0, max 0.74, SD 0.235). The differences between M values were statistically significant (p = 0.0094). CONCLUSION: A reduction in the number of retention sites for the bonding system, facilitates the formation of microleakage in the experimental conditions and reduces the degree of adhesion of the composite material to the hard tissues of the tooth.

Effect of a one-step self-etch adhesive on endogenous dentin matrix metalloproteinases.

Degradation of the hybrid layer created in dentin by dentin adhesives is caused by enzyme activities present within the dentin matrix that destroy unprotected collagen fibrils. The aim of the present study was to evaluate the effect of a one-step self-etch adhesive system on dentinal matrix metalloproteinases 2 and 4 (MMP-2 and MMP-9, respectively) using in situ zymography and an enzymatic activity assay. The null hypothesis tested was that there are no differences in the activities of dentinal MMPs before and after treatment with a one-step adhesive system. The MMP-2 and MMP-9 activities in dentin treated with the one-step adhesive, Adper Easy Bond, were quantified using an enzymatic activity assay system. The MMP activities within the hybrid layer created by the one-step adhesive tested were also evaluated using in situ zymography. The enzymatic assay revealed an increase in MMP-2 and MMP-9 activities after treatment with adhesive. In situ zymography indicated that gelatinolytic activity is present within the hybrid layer created with the one-step self-etch adhesive. The host-derived gelatinases were localized within the hybrid layer and remained active after the bonding procedure. It is concluded that the one-step self-etch adhesive investigated activates endogenous MMP-2 and MMP-9 with the dentin matrix, which may cause collagen degradation over time.

Comparison of Marginal Gap and Microleakage in Copy-Milled and Cad-Milled Zirconia Copings Bonded Using Light Cure and Chemical Cure Resin Bonding Systems.

This in vitro study assessed the marginal gap and marginal microleakage in zirconia copings fabricated using two computer aided techniques- CAD milling and Copy milling and cemented to respective tooth preparations using two resin bonding systems, light cure and self-cure resin bonding systems. 32 extracted premolars were prepared to receive zirconia copings fabricated using CAD/CAM and Copy milling techniques. Once the copings were fabricated, the samples were evaluated for marginal fit prior to cementation through microscopic observation. Evaluation of marginal gap was done again after cementation, in order to incorporate the influence of the resin bonding system on the marginal microgap. The specimens were evaluated under the stereomicroscope for micro-leakage using commercial software. A comparative statistical analysis was done following data collection using Mann-Whitney U test, Wilcoxon test and chi-square test. The data collected regarding marginal gap was well within 120 µ, which is in accordance with previous studies. However, Copy milled specimens showed statistically lesser marginal gap when compared to CAD milled specimens. While comparing microleakage, it was observed that the microleakage in Copy milled specimens bonded with light cure resin bonded cement was statistically lesser than that of specimens cemented with chemical cure resin cement.(P = 0.003). This in vitro study concluded that Copy milling technique fabricated zirconia restorations with lesser marginal gap and microleakage score in comparison to CAD milled samples. Light cure resin bonding system also proved to be more effective option compared to self cure resin bonding systems. However, the limitations of this study should be taken into concern and further research should be aimed at a larger sample size to validate the results.

Current antibacterial agents in dental bonding systems: a comprehensive overview.

Dental caries is mainly caused by oral biofilm acid, and the most common dental restoration treatment is composite dental restorations. The main cause of failure is secondary caries adjacent to the restoration. Long-term survival of dental materials is improved by the presence of antibacterial agents, which selectively inhibit bacterial growth or survival. Chemical, natural and biomaterials have been studied for their antimicrobial activities and antibacterial bonding agents have been improved. Their usage has been increased to inhibit the growth of invading and residual bacteria in the oral cavity, as biofilm accumulation increases the risk of treatment failure. In this article, the success and applications of antibacterial agents are discussed in dental bonding systems.

Dental Adhesives-Surface Modifications of Dentin Structure for Stable Bonding.

The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

High-Strength and Injectable Supramolecular Hydrogel Self-Assembled by Monomeric Nucleoside for Tooth-Extraction Wound Healing.

Hydrogels with high mechanical strength and injectability have attracted extensive attention in biomedical and tissue engineering. However, endowing a hydrogel with both properties is challenging because they are generally inversely related. In this work, by constructing a multi-hydrogen-bonding system, a high-strength and injectable supramolecular hydrogel is successfully fabricated. It is constructed by the self-assembly of a monomeric nucleoside molecular gelator (2-amino-2'-fluoro-2'-deoxyadenosine (2-FA)) with distilled water/phosphate buffered saline as solvent. Its storage modulus reaches 1 MPa at a concentration of 5.0 wt%, which is the strongest supramolecular hydrogel comprising an ultralow-molecular-weight (MW < 300) gelator. Furthermore, it exhibits excellent shear-thinning injectability, and completes the sol-gel transition in seconds after injection at 37 °C. The multi-hydrogen-bonding system is essentially based on the synergistic interactions between the double NH2 groups, water molecules, and 2'-F atoms. Furthermore, the 2-FA hydrogel exhibits excellent biocompatibility and antibacterial activity. When applied to rat molar extraction sockets, compared to natural healing and the commercial hemorrhage agent gelatin sponge, the 2-FA hydrogel exhibits faster degradation and induces less osteoclastic activity and inflammatory infiltration, resulting in more complete bone healing. In summary, this study provides ideas for proposing a multifunctional, high-strength, and injectable supramolecular hydrogel for various biomedical engineering applications.

Performance of MDP-based system in eroded and carious dentin associated with proteolytic inhibitors: 18-Month exploratory study.

The aim of this study was to explore the impact of the interaction between an MDP-based universal adhesive system in etch-and-rinse mode and two proteolytic inhibitors on the longevity of restorations bonded to artificially-affected-dentin substrates. 90 sound human third molars were randomly distributed into three groups according to the substrate: N-no challenges-control (stored in artificial saliva), ACD-artificial caries dentin (6 h DE + 18 h-RE/5 days + 48 h RE) and ERO-artificial erosion dentin (3 × 5 min/5 days with orange juice). They were further redistributed according to dentin pretreatment: W- water (control), CHX-2% digluconate chlorhexidine and E64- 5 µM E64-Trans-Epoxysuccinyl-L-Leucylamido-(4-guanidino) butane, which resulted in the following 9 groups (n = 10): N-W, N-CHX, N-E64, ACD-W, ACD-CHX, ACD-E64, ERO-W, ERO-CHX and ERO-E64. All specimens were restored with Adper Single Bond Universal (Etch-and-rinse mode)/Filtek Z250. Sticks (0.64 mm2) were obtained and subjected to microtensile test (µTBS) in a universal testing machine at 0.5 mm/min for 7-days, 6 and 18-month analyses. Failure modes were classified using optical microscopy (40X). Data were statistically analyzed by three-way ANOVA and Tukey tests (p < 0.05). All individual factors (p < 0.0001) and interaction between factors were statistically significant (substrate X pretreatment (p = 0.00093); substrate X time (p = 0.01035) and pretreatment X time (p = 0.0035). Caries-affected substrate was the most compromised one, disregarding the pretreatment. CHX was mostly affected compared with E64 up to 18 months, possibly due to its calcium-dependent mechanism.

The Effect of Different Condition of Pulpal Pressure on Microtensile Bond Strength of Several Dentin Bonding Agents on Deep and Superficial Dentin.

The objective of this study was to examine the effect of different conditions of simulated hydrostatic pulpal pressure on the µTBS of HEMA-based and HEMA-free dentin bonding agents (DBAs). The influence of dentin location (deep and superficial) on µTBS was also evaluated. Flat coronal dentin surfaces of extracted human molars were prepared. Three groups of resin-bonded specimens were exposed to different pulpal pressures. Pulpal pressure was maintained for 20 min for each group. A flowable resin composite was used for coronal build-up. The bonded teeth were sectioned and, after 24 h of water storage, stressed to failure using the microtensile tester (µTBS). Failed samples were analyzed by SEM inspection. HEMA-based DBAs were much more sensitive to pulpal pressure conditions than non-HEMA-containing DBAs. Pulpal pressure had a greater influence in deep dentin. The HEMA-free DBA was insensitive to the presence or absence of pulpal pressure condition. SEM inspection confirmed a relationship between the presence of voids inside the HEMA-based DBAs layer and the lower µTBS results. HEMA-based DBAs are more sensitive to pulpal pressure conditions than HEMA-free DBAs. Interestingly, HEMA-free DBA showed a greater number of water droplets at resin-dentin interface in all tested conditions.

Electric current effects on bond strength, nanoleakage, degree of conversion and dentinal infiltration of adhesive systems.

To evaluate the effect of three adhesive systems applied under electric current on microtensile bond strength (µTBS) and degree of conversion (DC). Molar teeth were restored with the aid of three adhesive systems (Adper Single Bond 2-SB2; Clearfil SE Bond-CSE; and Single Bond Universal-SBU) under different electric current intensities (0 µA; 25 µA; and 50 µA). Composite resin blocks were built up in increments (2 mm) and sectioned into 1 × 1 mm beams. The µTBS was tested after 24 h and 1 y distilled water storages. Samples (n = 10) from 24 h to 1 y storages were immersed in a 50% ammoniacal silver nitrate solution and submitted to scanning electron microscopy. The silver nitrate in the hybrid layer was quantified (ImageJ software). The adhesive systems' dentinal infiltration was analyzed using confocal laser scanning microscopy. Fourier transform near infrared spectroscopy was used to measure the DC. The µTBS data were submitted to two-way ANOVA (time vs. electric current) and Bonferroni's test (α = 0.05). Quantitative nanoleakage data were submitted to two-way ANOVA (electric current vs. adhesive) and Bonferroni's test (α = 0.05). DC data were submitted to one-way ANOVA and Tukey's test (α = 0.05) for each adhesive system. The electric current statistically increased the µTBS for SB2 and CSE in 24 h storage, as well as for SB2, CSE and SBU in 1 y storage. No significant difference was observed between storage time for CSE and SBU. When compared to the control, electric currents (25 µA and 50 µA) showed significantly higher DC mean values for SB2 and SBU, and had no effect on CSE. The electric currents (25 µA and 50 µA) reduced the adhesive system's nanoleakage after 1-year storage, and improved the infiltration of SB2 and CSE. Both electric current intensities improved dentinal interface stability.

Effects of sodium hypochlorite as dentin deproteinizing agent and aging media on bond strength of two conventional adhesives.

This study evaluated the effect of 10% sodium hypochlorite (NaOCl) as deproteinizing agent and storage media on bond strength (BS) of two etch-and-rinse adhesive systems to dentin. Twenty-eight sound extracted human third molars were divided in four groups (n = 7), according to dentin treatment (conventional etching or etching followed by 10% NaOCl application) and adhesive systems (GB-Gluma 2Bond and OS-One-Step). After dentin treatments and adhesive application, a composite block was built-up on dentin surface and teeth were serially sectioned to obtain bonded sticks specimens. The sticks were submitted to three aging conditions: (24H) 24 hr in water (immediate), (SH) 3 hr of NaOCl accelerated-aging or (1Y) 1 year of water storage. Afterward, submitted to microtensile bond strength test (µTBS), failure modes and adhesive interfaces analyzes. Data were analyzed by two-way analysis of variance (ANOVA) and Tukey's test (α = .05). Dentin deproteinization before bonding significantly reduced µTBS for GB-treated group (p < .05), regardless the aging conditions. Water storage for 1 year (1Y) and NaOCl accelerated-aging (SH) decreased µTBS for both adhesives. Yet, the groups stored in NaOCl (SH) exhibited the lowest BS results (p < .05). Bond strength of deproteinized dentin was dependent on the adhesive system composition and NaOCl accelerated-aging promoted decreased bond strength and further degradation than water storage for 1 year.

Effect of an ethanol cross-linker on universal adhesive.

OBJECTIVE: To evaluate the effects of N,N'-dicyclohexylcarbodiimide (DCC), an ethanol-based dentin cross-linker, on the immediate and long-term microtensile bond strength (µTBS) and nanoleakage expression of a universal adhesive employed in self-etch mode (SE) or etch-and-rinse mode (ER). The effect of DCC on the dentinal MMP activity was also investigated by means of in-situ zymography. METHODS: Eighty freshly extracted human molars were sectioned to expose mid-coronal dentin surfaces. The teeth were assigned to one of the following groups, according to the dentin surface priming/adhesive approach: (G1): DCC pre-treatment and Scotchbond Universal (SBU) in ER mode; (G2): SBU in ER mode; (G3): DCC pretreatment and SBU in SE mode; (G4): SBU in SE mode. µTBS test was performed immediately (T0) or after 1-year aging (T12) in artificial saliva. Ten additional teeth per group were prepared for nanoleakage evaluation (N = 5) and for in-situ zymography (N = 5). RESULTS: Three-factor analysis of variance revealed significant difference for the variables DCC pretreatment, application mode and aging (p < 0.05) for both microtensile bond strength testing and in-situ zymography. Nanoleakage analysis revealed reduced marginal infiltration of DCC experimental groups both at T0 and T12. SIGNIFICANCE: The use of an ethanol-based primer containing DCC appears to be promising in preserving the stability of the adhesive interface of a universal adhesive, especially in the SE mode.

Long-term bond strength and endogenous enzymatic activity of a chlorhexidine-containing commercially available adhesive.

OBJECTIVES: The aim of this study was to investigate, by the means of microtensile bond strength (µTBS) test, gelatin and in situ zymography, the influence of 0.2% CHX contained within a commercially available adhesive on long-term bond strength and endogenous enzymatic activity. METHODS: Non-carious teeth were subjected to µTBS test (N = 15 for each group) and stressed until failure. µTBS was evaluated immediately and after 12-month storage in artificial saliva at 37 °C. Dentin powder was obtained from additional teeth (N = 7) for gelatin zymography, while for in situ zymography, 3 teeth for each group were selected. Gelatin and in situ zymography were performed in dentin powder and slices of dentin, respectively, to assess the ability of 0.2% CHX blended within the adhesive to inhibit endogenous enzymatic activity. RESULTS: µTBS bond strength was higher in the CHX-containing groups, immediately as well as after aging. The bond strength significantly decreased after 12-month aging. The activation of endogenous MMPs was found to be related to the presence of CHX within the adhesive system and the bonding strategy employed. CONCLUSIONS: Under this perspective 0.2% CHX blended within Peak Universal adhesive monomer seems to increase immediate bond strength, to preserve bond strength over time and to efficiently inhibit endogenous enzymatic activity in dentin. Hence, blending the CHX in low concentrations within the adhesive could be recommended as a feasible technique in every-day clinical practice. CLINICAL SIGNIFICANCE: Using CHX-containing adhesives could be recommended due to several benefits: it seems to increase the longevity of the hybrid layer; the inhibitor appears to be efficiently delivered to the dentinal substrate and to inhibit endogenous enzymatic activity, without prolonging chair time.

Cross-linking effect on dentin bond strength and MMPs activity.

OBJECTIVE: The objectives of the study were to evaluate the ability of a 1-ethyl-3 (3-dimethylaminopropyl) carbodiimide (EDC)-containing primer to improve immediate bond strength of either self-etch or etch-and-rinse adhesive systems and to stabilize the adhesive interfaces over time. A further objective was to investigate the effect of EDC on the dentinal MMPs activity using zymographic analysis. METHODS: Freshly extracted molars (n=80, 20 for each group) were selected to conduct microtensile bond strength tests. The following groups were tested, immediately or after 1-year aging in artificial saliva: G1: Clearfil SE (CSE) primer applied on unetched dentin, pretreated with 0.3M EDC water-solution for 1min and bonded with CSE Bond; G2: as G1 but without EDC pre-treatment; G3: acid-etched (35% phosphoric-acid for 15s) dentin pretreated with 0.3M EDC, then bonded with XP Bond (XPB); Group 4 (G4): as G3 without EDC pre-treatment. Further, gelatinase activity in dentin powder treated with CSE and XPB with and without EDC pre-treatment, was analyzed using gelatin zymography. RESULTS: The use of 0.3M EDC-containing conditioner did not affect the immediate bond strength of XPB or CSE adhesive systems (p>0.05), while it improved the bond strength after 1year of aging (p<0.05). Pre-treatment with EDC followed by the application of CSE resulted in an incomplete MMPs inactivation, while EDC pretreatment followed by the application of XPB resulted in an almost complete inactivation of dentinal gelatinases. SIGNIFICANCE: The µTBS and zymography results support the efficacy of EDC over time and reveal that changes within the dentin matrix promoted by EDC are not adhesive-system-dependent.

Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications.

OBJECTIVES: Efforts towards achieving durable resin-dentin bonds have been made for decades, including the understanding of the mechanisms underlying hybrid layer (HL) degradation, manufacturing of improved adhesive systems, as well as developing strategies for the preservation of the HL. METHODS: This study critically discusses the available peer-reviewed research concerning the formation and preservation of the HL, the mechanisms that lead to the degradation of the HL as well as the strategies to prevent it. RESULTS: The degradation of the HL occurs through two main mechanisms: the enzymatic degradation of its collagen fibrils, and the leaching of the resin from the HL. They are enabled by residual unbound water between the denuded collagen fibrils, trapped at the bottom of the HL. Consequently, endogenous dentinal enzymes, such as the matrix metalloproteinases (MMPs) and cysteine cathepsins are activated and can degrade the denuded collagen matrix. Strategies for the preservation of the HL over time have been developed, and they entail the removal of the unbound water from the gaps between the collagen fibrils as well as different modes of silencing endogenous enzymatic activity. SIGNIFICANCE: Although there are many more hurdles to be crossed in the field of adhesive dentistry, impressive progress has been achieved so far, and the vast amount of available research on the topic is an indicator of the importance of this matter and of the great efforts of researchers and dental material companies to reach a new level in the quality and longevity of resin-dentin bonds.

Antibacterial Activity of Commercial Dentine Bonding Systems against E. faecalis-Flow Cytometry Study.

Literature presents inconsistent results on the antibacterial activity of dentine bonding systems (DBS). Antibacterial activity of adhesive systems depends on several factors, including composition and acidity. Flow cytometry is a novel detection method to measure multiple characteristics of a single cell: total cell number, structural (size, shape), and functional parameters (viability, cell cycle). The LIVE/DEAD® BacLightTM bacterial viability assay was used to evaluate an antibacterial activity of DBS by assessing physical membrane disruption of bacteria mediated by DBS. Ten commercial DBSs: four total-etching (TE), four self-etching (SE) and two selective enamel etching (SEE) were tested. Both total-etching DBS ExciTE F and OptiBond Solo Plus showed comparatively low antibacterial activity against E. faecalis. The lowest activity of all tested TE systems showed Te-Econom Bond. Among SE DBS, G-ænial Bond (92.24% dead cells) followed by Clearfil S3 Bond Plus (88.02%) and Panavia F 2.0 ED Primer II (86.67%) showed the highest antibacterial activity against E. faecalis, which was comparable to isopropranol (positive control). In the present study, self-etching DBS exhibited higher antimicrobial activity than tested total-etching adhesives against E. faecalis.

Bond strength of a new generation of universal bonding systems to zirconia ceramic.

The purpose of this laboratory study was to evaluate the tensile bond strength of a new generation of universal bonding systems to zirconia ceramic and to compare the results with the bond strength of a clinically-established bonding system. Eighty zirconia ceramic test specimens (e.max ZirCAD) were air-abraded and bonded to Plexiglas tubes, filled with an aliphatic dimethacrylate filling material (Clearfil F II), using three so called universal bonding systems of a new generation with different compositions (Monobond Plus/MultilinkAutomix, NX3, Scotchbond Universal/RelyX Ultimate). The latter was used also without the phosphate monomer containing primer Scotchbond Universal. A clinically established phosphate monomer containing adhesive cement served as control group (Panavia F2.0). The specimens were stored in water at 37°C for 3 or 150 days and the long-term storage series were additionally thermal cycled between 5 and 55°C for 37,500 times to simulate oral conditions. All specimens underwent tensile bond strength testing. The statistical analysis was performed using Kruskal-Wallis and Wilcoxon-Test with a Bonferroni-Holm correction for multiple testing. After 150 days the median bond strength of RelyX Ultimate, with and without Scotchbond Universal, and Panavia F2.0 did not differ statistically (range: 21.7-28.8MPa), while the bond strength of Monobond Plus/Multilink Automix was significantly lower (15.4MPa), and that of NX3 the lowest (6.6MPa). After 150 days of water storage with thermal cycling, all adhesive system showed significantly reduced tensile bond strengths compared to that after 3 days. Only RelyX Ultimate was comparable to the established bonding system Panavia F2.0. The additional use of Scotchbond Universal did not result in a significant effect.

Indirect Bonding Revisited.

In recent years, the popularity of indirect bonding increased due to advantages such as reduction of chair time and enhancement of patient comfort. Although the indirect bonding technique has improved over the years, the literature has shown different techniques of bracket placement; furthermore, new materials were specially developed for this technique. The aim of this article is to provide a review of the literature, advantages, disadvantages, and laboratory and clinical stages of the indirect bonding technique.

Comparison of shear bond strength and bonding time of a novel flash-free bonding system.

OBJECTIVE: To evaluate the bonding time, shear bond strength (SBS), and adhesive residue index (ARI) of APC(TM) Flash-Free bonding system. MATERIALS AND METHODS: Thirty-six extracted human maxillary premolars were randomly divided into three groups (12 per group) and used for this in vitro study: group 1, APC Flash-Free Adhesive Coated Appliance System; group 2, Clarity ADVANCED Ceramic Bracket pasted manually; group 3 (control group), 3M APC PLUS Adhesive prepasted brackets bonded with the extruded flash removed. Bonding time was measured using a stopwatch. Bond strength was measured using an Instron at a cross-head speed of 1 mm/min. The ARI was graded on a scale from 1 to 5. Repeated-measures analysis of variance and post hoc Tukey tests were used for statistical analysis. RESULTS: It took significantly (P < .001) less time to bond in the APC Flash-Free Adhesive group (30.7 ± 3.3 seconds) compared with the control group (41.8 ± 4.0 seconds) and the manual group (39.2 ± 2.8 seconds). The APC Flash-Free Adhesive coated bracket had significantly (P < .001) greater SBS (13.7 ± 2.2 MPa) compared with the control group (10.8 ± 2.0 MPa) and the manual group (10.4 ± 1.4 MPa). The ARI was significantly (P < .001) greater with the APC Flash-Free Adhesive coated bracket compared with that of the other two groups. CONCLUSIONS: Compared with other methods of bonding, the APC Flash-Free Adhesive Coated System can potentially reduce bonding time while increasing SBS.

Tensile bond strength of different universal adhesive systems to lithium disilicate ceramic.

BACKGROUND: Today, many adhesive systems with different coupling agents for tooth structures and restorative materials are available. The purpose of this in vitro study was to evaluate the tensile bond strength (TBS) of different universal adhesive systems to etched lithium disilicate ceramic. METHODS: The authors etched and bonded 96 disk-like lithium disilicate ceramic specimens (IPS e.max CAD, Ivoclar Vivadent) with 4 different adhesive bonding systems to Plexiglas tubes filled with a composite resin. The authors stored the specimens in water at 37°C for 3 days without thermal cycling or for 30 or 150 days with 7,500 or 37,500 thermal cycles between 5°C and 55°C, respectively. Then, all specimens underwent TBS testing. The authors performed statistical analysis by using Kruskal-Wallis and Wilcoxon tests with a Bonferroni-Holm correction for multiple testing. RESULTS: Initially, all adhesive systems exhibited considerable TBS, but some showed a significant reduction after 30 days of storage. After 3, 30, and 150 days, the Monobond Plus and Multilink Automix (Ivoclar Vivadent) silane-containing adhesive system showed significantly higher bond strengths to lithium disilicate ceramic than did the other universal adhesive systems, some of which do not contain silanes. CONCLUSIONS: The bond strength to lithium disilicate ceramic is affected significantly by the adhesive bonding system used. PRACTICAL IMPLICATIONS: Universal adhesive systems that do not contain a silane should be avoided for bonding lithium disilicate ceramic restorations because of their inferior bond strength.

Hydrophilicity of dentin bonding systems influences in vitro Streptococcus mutans biofilm formation.

OBJECTIVE: To evaluate in vitro Streptococcus mutans (S. mutans) biofilm formation on the surface of five light-curing experimental dental bonding systems (DBS) with increasing hydrophilicity. The null hypothesis tested was that resin chemical composition and hydrophilicity does not affect S. mutans biofilm formation. METHODS: Five light-curing versions of experimental resin blends with increasing hydrophilicity were investigated (R1, R2, R3, R4 and R5). R1 and R2 contained ethoxylated BisGMA/TEGDMA or BisGMA/TEGDMA, respectively, and were very hydrophobic, were representative of pit-and-fissure bonding agents. R3 was representative of a typical two-step etch-and-rinse adhesive, while R4 and R5 were very hydrophilic resins analogous to self-etching adhesives. Twenty-eight disks were prepared for each resin blend. After a 24h-incubation at 37°C, a multilayer monospecific biofilm of S. mutans was obtained on the surface of each disk. The adherent biomass was determined using the MTT assay and evaluated morphologically with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). RESULTS: R2 and R3 surfaces showed the highest biofilm formation while R1 and R4 showed a similar intermediate biofilm formation. R5 was more hydrophilic and acidic and was significantly less colonized than all the other resins. A significant quadratic relationship between biofilm formation and hydrophilicity of the resin blends was found. CLSM and SEM evaluation confirmed MTT assay results. CONCLUSIONS: The null hypothesis was rejected since S. mutans biofilm formation was influenced by hydrophilicity, surface acidity and chemical composition of the experimental resins. Further studies using a bioreactor are needed to confirm the results and clarify the role of the single factors.