André Figueiredo Reis

The effects of filling techniques and a low-viscosity composite liner on bond strength to class II cavities

OBJECTIVE The aim of this study was to test the hypothesis that the effects of filling technique, cavity configuration and use of a low-viscosity composite liner influence resin bond strength to the dentin of class II cavities gingival floor; and analyze the failure modes of fractured specimens. METHODS Standardized class II cavities were prepared in the proximal surfaces of freshly extracted third molars, which were randomly assigned to 10 experimental groups. All prepared surfaces were acid-etched, bonded with Single Bond adhesive system and restored with TPH composite, according to each technique: G1 and G2-horizontal layering, G3 and G4-faciolingual layering, G5 and G6-oblique layering, G7 and G8-bulk filling, G9 and G10-control (flat dentin surfaces). Groups were tested, with or without a low-viscosity composite liner (Tetric Flow Chroma). After storage in water for 24h, teeth were vertically serially sectioned to yield a series of 0.8mm thick slabs. Each slab was trimmed into an hourglass shape of approximately 0.8mm(2) area at the gingival resin-dentin interface. Specimens were tested in tension at 0.5mm/min until failure. Fractured specimens were analyzed in an SEM to determine the failure modes. RESULTS No significant difference was found between groups restored with and without a low-viscosity composite liner (p>0.05). Among filling techniques, the bulk filling groups presented the lowest bond strength values (p<0.05), while incremental filling groups did not differ from control (flat dentin surfaces). Failure modes varied significantly among groups restored with and without the low-viscosity composite liner. SIGNIFICANCE Bond strengths were not improved when a low-viscosity composite liner was applied, but it remarkably influenced the failure modes. Incremental techniques improved bond strength.

Effects of ultramorphological changes on adhesion to lased dentin-Scanning electron microscopy and transmission electron microscopy analysis.

Dentin irradiation with erbium lasers has been reported to alter the composite resin bond to this treated surface. There is still a lack of studies reporting the effect of erbium lasers on dentin organic content and elucidating how laser treatment could interfere in the quality of the resin–dentin interface. This study aimed to evaluate the effect of erbium laser irradiation on dentin morphology and microtensile bond strength (μTBS) of an adhesive to dentin. Seventy‐two dentin disks were divided into nine groups (n = 8): G1‐Control (600‐grit SiC paper); Er:YAG groups: G2‐ 250 mJ/4 Hz; G3‐ 200 mJ/4 Hz; G4‐ 180 mJ/10 Hz; G5‐ 160 mJ/10 Hz; Er,Cr:YSGG groups: G6‐ 2 W/20 Hz; G7‐ 2.5 W/20 Hz; G8‐ 3 W/20 Hz; G9‐ 4 W/20 Hz. Specimens were processed for cross‐sectional analysis by scanning electron microscopy (SEM) (n = 3), transmission electron microscopy (TEM) (n = 2), and adhesive interface (n = 3). Forty‐five dentin samples (n = 5) were restored and submitted to μTBS testing. ANOVA (α = 5%) revealed that G1 presented the highest μTBS values and irradiated groups did not differ from each other. TEM micrographs showed a superficial layer of denatured collagen fibrils. For SEM micrographs, it was possible to verify the laser effects extending to dentin subsurface presenting a rough aspect. Cross‐sectional dentin micrographs of this hybridized surface revealed a pattern of modified tags with ringlike structures around it. This in vitro study showed that erbium laser irradiation interacts with the dental hard tissue resulting in a specific morphological pattern of dentin and collagen fibrils that negatively affected the bond strength to composite resin. Microsc. Res. Tech., 2011.

Influence of water-storage time on the sorption and solubility behavior of current adhesives and primer/adhesive mixtures.

This study evaluated the effects of water-storage on the water sorption and solubility behavior of five commercially available dental adhesive systems and two primer/adhesive mixtures. The adhesives comprised three different approaches to bonding to hard tooth tissues: a one-step self-etching adhesive (One-up Bond F), two two-step self-etching primers (Clearfil SE Bond and Clearfil Protect Bond) and two etch-and-rinse systems: a water/ethanol-based (Single Bond) and an acetone-based filled adhesive (Prime&Bond NT). The bonding agents and primers of the two-step self-etching systems were mixed in a 1:1 volume ratio. Water sorption and solubility values were determined after 1, 7, 30, 90 and 180 days. The results showed that, except for SB, all adhesives presented increased water sorption with increased storage time. The one-step self-etching adhesive and self-etching primer/adhesive mixtures presented the highest water sorption and solubility values. Equilibrium in the water sorption values was observed for all adhesives after 90 days of water-storage. However, solubility values continued to increase for some materials until 180 days. The sorption and solubility behavior of the materials tested seem to be related to hydrophilicity of the adhesive resin solution and might influence the long-term performance of resin-based composite restorations.

Antibacterial Activity of Various Self-etching Adhesive Systems Against Oral Streptococci

The antibacterial properties of self-etching adhesive systems constitute an important issue in operative dentistry, since viable bacteria can still be present after cavity preparation. The current study evaluated the antibacterial activity of five one-step self-etching adhesives (SEAs) and four self-etching primers (SEPs) against oral streptococci. Clearfil S3 (S3), One-Up Bond F Plus (OU), Futurabond NR (FB), GBond (GB), Xeno IV (X4), Clearfil SE Bond (SE), Clearfil Protect Bond (PB), Adper SE Plus (AS) and AdheSE (AD) were tested for antibacterial activity against five streptococci species: S oralis, S sanguinis, S cricetus, S mutans and S sobrinus. Chlorhexidine (0.12%) and phosphoric acid (37%) gel were used as control. The agar diffusion test method was used. Plates containing BHI agar and 300 uL of bacterial cell suspension (0.5 MacFarland) were prepared. Holes 6 mm in diameter were made and partially filled with bacteriological agar. Then, 10 uL of each SEA or SEP was dropped and the plates were incubated under microaerophilic atmosphere at 37 degrees C for 48 hours and the diameter of each halo was registered. The results were analyzed by two-way ANOVA and Tukey test. PB exhibited the most effective antibacterial activity against oral streptococci. The performances of SE and FB were similar or better than chlorhexidine for all bacteria. S3, X4, AS, AD, OU and GB showed significantly lower inhibition values. Among the species tested, S oralis was the most sensitive to all self-etching adhesive systems; on the other hand, S cricetus, S mutans and S sobrinus were more resistant. Among the self-etching adhesive systems evaluated, Clearfil Protect Bond exhibited the most effective antibacterial activity against oral streptococci.

Bond Strength of Adhesive Systems to Er,Cr:YSGG Laser-Irradiated Dentin

OBJECTIVE The purpose of this study was to evaluate the effects of Er,Cr:YSGG laser irradiation and different adhesive procedures on bond strength of two bonding agents to dentin. BACKGROUND DATA Studies have shown that laser-irradiated dentinal tissue yields lower bond strengths than does nonirradiated dentin. In this study, different treatment methods of laser irradiating dentin were studied to enhance the bond strength of bonding agents to nonirradiated dentin. METHODS Third molars were wet ground with SiC until the occlusal flat dentin surface was exposed, and the teeth were randomly assigned to six groups (n=5). A two-step self-etching primer (Clearfil SE Bond, G1) and a two-step etch-and-rinse adhesive (Single Bond Plus, G2) were applied to the nonirradiated dentin surface according to manufacturers instructions, as control groups. In G3 and G4, the same adhesives were applied after Er,Cr:YSGG laser irradiation, whereas in G5 and G6 adhesives were applied after Er,Cr:YSGG laser irradiation, phosphoric acid etching, and NaOCl deproteinization of etched dentin. The Er,Cr:YSGG laser worked at 2.78??m and the repetition rate was fixed at 20?Hz. Composite blocks were built on bonded surfaces and the teeth were stored for 24?h at 37?C. Restored teeth were vertically and serially sectioned to obtain bonded specimens for the bond strength test. Data were analyzed by two-way ANOVA and Tukey test (?=5%). RESULTS Laser irradiation reduced bond strengths for the two adhesives, regardless of acid etching and deproteinization of dentin post-irradiation (p<0.05). The self-etching primer system showed higher bond strengths to laser irradiated dentin than did Single Bond Plus (p<0.05). The adhesive systems applied to normal dentin yielded higher bond strengths than when they were applied to laser irradiated dentin (p<0.05). CONCLUSIONS The self-etching primer seemed to be less affected by dentin irradiation with Er,Cr:YSGG laser. The additional etching and NaOCl solution did not overcome the effects of laser irradiation on dentin.

Influence of filler addition, storage medium and evaluation time on biaxial flexure strength and modulus of adhesive systems

Abstract Objective. This study evaluated the effects of filler addition, storage medium and time on biaxial flexural strength and flexural modulus of six adhesive systems. Materials and methods. The adhesives were either unfilled resins: Single Bond, Prime&Bond 2.1 and One-Step; or filled resins: Single Bond Plus, Prime&Bond NT and One-Step Plus. Resin discs of each product (0.5 mm thick × 6.0 mm diameter) were prepared using silicon molds (n = 10). The discs were stored dry, in water, mineral oil or ethanol for 1 week or 3 months before biaxial flexural testing. Data were statistically analyzed by 3-way ANOVA and Tukeys post-hoc test (α = 0.05). The specimens were tested in a universal testing machine at 1.27 mm/min until failure occurred. Results. In general, the storage in ethanol led to significantly lower flexural strength and flexural modulus values than the other storage conditions for all adhesives in both storage periods. Filler addition increased flexural strength and flexural modulus for Prime&Bond NT, when it was stored dry or in water for 1 week. For Single Bond Plus, the filler addition resulted in higher flexural modulus, when it was stored for 1 week in oil and in ethanol. No significant differences in flexural modulus were observed between One-Step and One-Step Plus in any storage medium. Conclusions. Results suggested that filler addition does not necessarily have to increase the flexural strength and flexural modulus. Ethanol and oil storages tended to yield opposite effects.

Bond Strength and Interfacial Ultramorphology of Current Adhesive Systems

This study evaluated the bond strength and ultramorphology of the resin-dentin interfaces produced by current dental adhesive systems. Nine dentin bonding agents were investigated. Restored teeth were vertically, serially sectioned to obtain bonded slices for interfacial TEM analysis or to produce bonded beams for the microtensile bond strength test. The one-step self-etching adhesives (Futurabond® NR and Hybrid Bond®) showed lower bond strength values than the three-step etch-&-rinse adhesive system All-Bond 3. Most bonding agents presented statistically similar mean bond strength values, which ranged from 41.3 ± 17.9 to 35.0 ± 5.3 MPa. The thickness of the hybrid layer varied according to the type of adhesive system used. While the etch and rinse adhesives with alcohol as organic solvent showed bond strength means higher than 40 MPa, the self-etching systems showed bond strength lower than 40 MPa. Resin-dentin interdifusion zone and resin tags were noted in all bonded interfaces.

Effect of partially demineralized dentin beneath the hybrid layer on dentin–adhesive interface micromechanics

OBJECTIVE To investigate the presence of non-infiltrated, partially demineralized dentin (PDD) beneath the hybrid layer for self-etch adhesive systems, and its effect on micromechanical behavior of dentin-adhesive interfaces (DAIs). This in-vitro laboratory and computer simulation study hypothesized that the presence of non-infiltrated PDD beneath the hybrid layer does not influence the mechanical behavior of the DAI of self-etch adhesive systems. METHODS Fifteen sound third molars were restored with composite resin using three adhesive systems: Scotchbond Multipurpose (SBMP), Clearfil SE Bond (CSEB) and Adper Promp L-Pop (APLP). The thickness and length of all DAIs were assessed using scanning electron microscopy, and used to generate three-dimensional finite element models. Elastic moduli of the hybrid layer, adhesive layer, intertubular dentin, peritubular dentin and resin tags were acquired using a nano-indenter. Finite element software was used to determine the maximum principal stress. Mixed models analysis of variance was used to verify statistical differences (P<0.05). RESULTS Elastic moduli and morphology were found to differ between the adhesive systems, as well as the presence and extension of PDD. SIGNIFICANCE Both self-etch adhesive systems (APLP and CSEB) had PDD. The DAI stress levels were higher for the one-step self-etch adhesive system (APLP) compared with the etch-and-rinse adhesive system (SBMP) and the self-etch primer system (CSEB).

Use of statistical procedures in Brazilian and international dental journals

A descriptive survey was performed in order to assess the statistical content and quality of Brazilian and international dental journals, and compare their evolution throughout the last decades. The authors identified the reporting and accuracy of statistical techniques in 1000 papers published from 1970 to 2000 in seven dental journals: three Brazilian (Brazilian Dental Journal, Revista de Odontologia da Universidade de Sao Paulo and Revista de Odontologia da UNESP) and four international journals (Journal of the American Dental Association, Journal of Dental Research, Caries Research and Journal of Periodontology). Papers were divided into two time periods: from 1970 to 1989, and from 1990 to 2000. A slight increase in the number of articles that presented some form of statistical technique was noticed for Brazilian journals (from 61.0 to 66.7%), whereas for international journals, a significant increase was observed (65.8 to 92.6%). In addition, a decrease in the number of statistical errors was verified. The most commonly used statistical tests as well as the most frequent errors found in dental journals were assessed. Hopefully, this investigation will encourage dental educators to better plan the teaching of biostatistics, and to improve the statistical quality of submitted manuscripts.

Effect of long-term simulated pulpal pressure on the bond strength and nanoleakage of resin-luting agents with different bonding strategies.

This study evaluated the effects of simulated hydrostatic pulpal pressure (SPP) on the microtensile bond strength (μTBS) to dentin and nanoleakage patterns produced by self-adhesive luting agents after 12 months. Three self-adhesive luting agents (RelyX Unicem [UN], RelyX U100 [UC], and Clearfil SA Luting [SA]) and three conventional luting agents (Rely X ARC [RX], Panavia F [PF], and a two-step self-etching adhesive system [Clearfil SE Bond] associated with Panavia F [PS]) were evaluated. One hundred twenty-three human molars were abraded to expose occlusal surfaces. Resin cements were used to lute cylindrical composite blocks to the teeth either subjected or not to SPP. Sixty specimens were subjected to 15 cm H2O of SPP for 24 hours before and 24 hours or 12 months after cementation procedures. Afterward, restored teeth were serially sectioned into beams with a cross-sectional area of 1 mm(2) at the bonded interface and were tested in tension (cross-head speed of 1 mm/min). Failure mode was determined using scanning electron microscopy (SEM). Data were statistically analyzed by three-way analysis of variance and post hoc Tukey test (p=0.05). Two additional teeth in each group were serially sectioned into 0.9-mm-thick slabs, which were submitted to a nanoleakage protocol with AgNO3 and analyzed with scanning and transmission electron microscopes. The μTBS values of the etch-and-rinse group (RX) were negatively influenced by SPP and long-term water storage with SPP. After 12 months, UC and SA presented premature failures in all specimens when submitted to SPP. SPP increased silver deposition in most groups in both evaluation times. The hydrostatic pulpal pressure effect was material dependent. The storage time without SPP did not affect bond strength. However, long-term SPP influenced the performance of the etch-and-rinse and self-adhesive cements regarding μTBS and nanoleakage pattern, except to UN.