Choltacha Harnirattisai

Effect of Glass-ionomer Cement Lining on Postoperative Sensitivity in Occlusal Cavities Restored with Resin Composite—A Randomized Clinical Trial

This study investigated the ability of a glass-ionomer cement (GIC) lining to reduce postoperative sensitivity in occlusal cavities restored with resin composite. In addition, the effects of a total-etch and self-etch adhesive on postoperative sensitivity were also compared. Patients who had moderate to deep occlusal caries of at least one molar were recruited. Overall, 103 restorations were placed in 70 participants, with an average age of 22.8 +/- 3.8 years. Preoperatively, each tooth was evaluated for cold-stimulated tooth sensitivity using a visual analog scale. If present, tooth sensitivity induced by cold/hot drinks or occlusal function was also noted. Caries was stained with a caries detector dye, then removed using slow-speed burs and hand excavators. The cavity was restored with one of four randomly allocated restorative procedures: 1) bonded with a two-step, total-etch adhesive (Single Bond 2); 2) lined with a resin-modified GIC liner (Fuji Lining LC), then bonded with total-etch adhesive; 3) bonded with a two-step, self-etch adhesive (Clearfil SE Bond) and 4) lined with the GIC liner, then bonded with self-etch adhesive. The cavities were incrementally filled with a nanofilled hybrid resin composite. At recall, postoperative sensitivity was evaluated at one week and one month. Overall, postoperative sensitivity in daily function was rare. No significant difference in postoperative sensitivity, either in daily function or in response to a cold stimulus, was observed between the restorative procedures with or without the GIC liner, regardless of the adhesive used (p > 0.05). In addition, no difference in postoperative sensitivity was noted between use of the self-etch and total-etch adhesive.

Adhesive interface between resin and etched dentin of cervical erosion/abrasion lesions.

The interfacial structure between an adhesive composite resin and the dentinal walls of cervical erosion/abrasion lesions etched with 37% phosphoric acid gel for 60 seconds was investigated. Almost all dentinal tubules were occluded with rod-like structural depositions that remained undissolved even after acid conditioning. The hybrid layer between the adhesive resin and surface-demineralized dentin was found to be 0.3 to 3 microns, much thinner than that routinely found in either normal dentin or cariously affected dentin. The hybrid layer was thinnest at the occlusal walls of the cavity where the dentinal tubules run parallel to the cavity surface. The bond strength of adhesive resin to these areas may differ from that to intact normal dentin.

Bond strengths of two adhesive systems to dentin contaminated with a hemostatic agent.

This study evaluated the bond strength of a total-etch and a self-etch adhesive to dentin contaminated with a hemostatic agent containing aluminum chloride (AlCl3). Eighteen occlusal dentin discs were prepared from human molars. Each disc was ground and sectioned into two halves, one for normal dentin and the other for contaminated dentin. The specimens of both normal and contaminated dentin were randomly divided into three groups and treated with the following materials: (1) Excite (EX); (2) Clearfil SE Bond with 20-second primer application time (CB 20) and (3) Clearfil SE Bond with 40-second primer application time (CB 40). The microshear bond strength specimens were prepared using the resin composite Clearfil APX. The bond strengths were evaluated on a universal testing machine. Statistical analysis was performed at alpha = 0.05. The surface micromorphology and aluminum content of the different dentin conditions were also examined. In EX, no significant difference was found between the bond strengths of normal dentin and contaminated dentin. The bond strength of CB20 to contaminated dentin was significantly lower than that to normal dentin. The extension of primer application time from 20 to 40 seconds significantly increased the bond strength of CB to contaminated dentin.

Changes in Resin-infiltrated Dentin Stiffness after Water Storage

Plasticization of polymers by water sorption lowers their mechanical properties in a manner that is predictable by the polarity of their component resins. This study tested the hypothesis that when adhesive resins were used to create resin-infiltrated dentin, the reductions in their flexural moduli after water storage would be lowered proportional to their hydrophilic characteristics. Three increasingly hydrophilic resin blends were used to fabricate polymer beams and macro-hybrid layer models of resin-infiltrated dentin for testing with a miniature three-point flexure device, before and after 1–4 weeks of water storage. Flexural modulus reductions in macro-hybrid layers were related to, and more extensive than, reductions in the corresponding polymer beams. Macro-hybrid layers that were more hydrophilic exhibited higher percent reductions in flexural modulus, with the rate of reduction proportional to the Hoy’s solubility parameters for total intermolecular attraction forces (δt) and polar forces (δp) of the macro-hybrid layers.

Adhesion of a glass-ionomer root canal sealer to the root canal wall.

Glass-ionomer root canal sealer is commonly used because of its chemical bonding and favorable physical characteristics when bonding to dentin. This study was designed to determine the tensile bond strength of a glass-ionomer sealer (Ketac Endo, Espe, Seefeld, Germany) on root canal walls after pretreatment with different conditioners. Flat inner surfaces of root canal specimens were prepared. The specimens were divided into five groups of 10 teeth, and the groups were conditioned with one of the following smear layer removal solutions: 15% EDTA/NaOCl, 10% polyacrylic acid, 35% phosphoric acid, 6% citric acid, and 5.25% NaOCl as a control. Then the exposed root canal areas were coated with Ketac-Endo. Tensile bonding was measured using a universal testing machine until ultimate failure was obtained. The groups that were treated with phosphoric acid and citric acid showed significantly higher bond strengths than the groups that were treated with 15% EDTA and polyacrylic acid (p < 0.05). Bonding to dentin without smear layer removal (NaOCl group) was too low to be measured in the testing apparatus. Scanning electron microscopy confirmed that phosphoric and citric acids were more effective in removing smear layer than EDTA or polyacrylic acid. The result supported the view that pretreatment with phosphoric acid or citric acid should be used in association with glass-ionomer root canal sealer to achieve the most effective removal of the smear layer and to provide better adhesion.

Bond Strengths of Resin Cements to Astringent-contaminated Dentin

The current study evaluated the micro-shear bond strength of two resin cements to astringent-contaminated dentin. Twelve occlusal dentin discs were prepared from extracted caries-free human molars and divided into two groups subjected to two types of resin cements, Panavia F (PF) and Variolink II (VL). Each disc was ground with 600 grit SiC paper and sectioned into two semi-disks, one for the normal dentin surface and the other for the contaminated dentin surface. For contaminated dentin, an astringent containing aluminum chloride was applied for two minutes and rinsed before the bonding procedures. A micro tygon tube was placed on the dentin surface following the bonding application and then filled with a resin cement. After the resin was polymerized, the specimen was kept in water for 24 hours before the micro-shear bond strengths evaluation. The micro morphology of the treated surfaces and resin-dentin interfaces were observed under a scanning electron microscope (SEM). Aluminum content under different dentin conditions was also examined. No significant differences were found between the dentin bond strengths to normal dentin and contaminated dentin surfaces in both the PF and VL groups (p>0.05). PF showed similar bond strengths to VL on normal and contaminated dentin (p>0.05). SEM observations of the VL groups revealed no differences in the treated dentin surfaces and the resin-dentin interfaces between normal and contaminated dentin. However, for the PF group, an inconsistent etching pattern of the self-etching primer and gap formation at the interface of resin cement to contaminated dentin were observed.

Effect of dentine smear layer on the performance of self-etching adhesive systems: A micro-tensile bond strength study

This study aimed to evaluate the effect of the smear layer on the micro-tensile bond strength when two self-etching adhesives were used with different techniques. Flat dentine surfaces were prepared using either medium grit diamond burs or tungsten carbide burs. Ten specimens from each prepared surfaces were subjected for smear layer evaluation under SEM. Forty specimens from each of the prepared surfaces were further divided into two groups, bonded with either Clearfil SE Bond (SE) or Clearfil S(3) Bond (S3) using one of four applications (as manufacturers instructions, agitation, reapplication, and increased application time), restored with composites and subjected to a micro-tensile bond strength test. Smear layers created with diamond burs were thicker than those created with tungsten carbide burs. Surfaces prepared with tungsten carbide burs produced a higher bond strength than those prepared with diamond burs and the same type of adhesive resin. SE demonstrated a higher bond strength than S3 for all surfaces. S3 applied with the agitation technique demonstrated a higher bond strength to dentine prepared with tungsten carbide and diamond burs than that applied with other techniques. SE applied with increased time on dentine treated with carbide burs produced the highest bond strength. In conclusion, a thick smear layer decreased bond strength to dentine, and this might be improved by modification of application technique.

Posterior resin composite restorations with or without resin‐modified, glass‐ionomer cement lining: a 1‐year randomized, clinical trial

AIM   To investigate the effect of resin-modified, glass-ionomer cement lining on the quality of posterior resin composite restorations, bonded with a two-step, total-etch or self-etching adhesive, at 1 year. METHODS   Patients with 1-4 moderate-to-deep, primary occlusal caries in molars were informed and recruited. A total of 110 composite restorations were placed in 75 participants, with one of four restorative procedures: (a) bonded with a total-etch adhesive (Single Bond 2); (b) lined with glass-ionomer cement (Fuji Lining LC), and then bonded with total-etch adhesive; (c) bonded with a self-etching adhesive (Clearfil SE Bond); and (d) lined with glass-ionomer cement, and then bonded with self-etching adhesive. RESULTS   At 1 year, 57 patients (86 restorations) attended the recall. Each of the restorations was evaluated and scored from 1 (clinically excellent) to 5 (clinically poor) using the following criteria: (a) patient satisfaction; (b) fracture and retention; (c) marginal adaptation; (d) recurrent caries; and (e) post-operative sensitivity. At 1 year, the qualities of the restorations were not significantly affected by the placement of glass-ionomer cement lining, regardless of the adhesive used (P > 0.05). Most of the restorations were scored 1 for all criteria. CONCLUSIONS   The benefit of placing a glass-ionomer cement liner in resin composite restoration is questionable.

Biodegradation of all-in-one self-etch adhesive systems at the resin-dentin interface.

This study evaluated the effects of two exogenous enzymes on the resin-dentin interface. Collagenase (Col) and acetylcholinesterase (Ach) were used to simulate salivary enzymes and accelerate the aging process of the bonding interfaces. Four adhesives, Adper Single Bond 2 (SB), Clearfil SE Bond (SE), Clearfil tri-S Bond (S3) and G-Bond (G), were bonded to the dentin surfaces. After storage in water with collagenase or acetylcholinesterase, the specimens were examined using a microtensile bond strength test (MTBS). Nanoleakage patterns were observed with a scanning electron microscope (SEM). The MTBS results demonstrated significantly lower bond strengths in the groups stored with either enzyme than in water. SB exhibited severe degradation after exposure to collagenase, while G showed severe degradation after exposure to acetylcholinesterase. All of the self-etch systems (SE, S3 and G) exhibited water-tree patterns within the adhesive layer when immersed in water for three months. The etch-and-rinse system (SB) showed nanoleakage within the hybrid layer and the adhesive.

Microtensile Bond Strengths of Two Adhesive Resins to Discolored Dentin after Amalgam Removal

Studies have reported the discoloration of dentin beneath amalgam restorations. The purpose of this study was to test the hypothesis that the bond strengths of adhesive resins to this discolored dentin are lower than those to normal dentin, and are related to the presence of metallic ions or corrosion products. Amalgam-filled extracted human teeth were used. After the removal of amalgam, the discolored dentin and surrounding normal dentin were bonded with Single Bond or Clearfil SE Bond and tested for microtensile bond strengths. The bond strengths of Single Bond and Clearfil SE Bond to normal dentin were greater than to discolored dentin. Clearfil SE Bond demonstrated higher bond strength to normal dentin than did Single Bond. However, no differences were found between the bond strengths to the discolored dentin of both adhesives. Elemental micro-analysis revealed various amounts of tin in all discolored dentin.