João Carlos Gomes

Influence of the resin cement thickness on bond strength and gap formation of fiber posts bonded to root dentin.

PURPOSE To evaluate the effect of the resin cement thickness (RCT) on bond strength (BS) and gap formation (GF) of fiber posts bonded to root dentin. MATERIALS AND METHODS The roots of 24 extracted human mandibular premolars were treated endodontically and the post spaces were prepared using drills with different diameters according to the following groups (n = 8): well adapted (WA), moderately well adapted (MA) and poorly adapted (PA). The fiber glass posts were cemented (Excite DSC and Variolink II) in accordance with the manufacturers instructions. After 1 week, the roots were transversely sectioned into six 1-mm-thick disks and photographed using an optical microscope to determine the RCT. After this, epoxy resin replicas of each sample were observed using SEM, and the mean length and width of the gaps formed in the cement/dentin/post interface were measured. Finally, each sample was subjected to the push-out test (0.5 mm/min), and the data were statistically analyzed using one-way ANOVA and Tukeys tests at the 5% level of significance. RESULTS The lowest RCT (μm) was observed for WA and the highest for PA. The group MA showed an intermediate value. Significantly higher push-out BS values were observed for WA compared to the other groups. The MA and PA groups were statistically similar. The highest mean gap length (%) and width (μm) were observed for PA. The groups MA and WA were statistically similar. CONCLUSION Lower resin cement thickness resulted in better fiber post adhesion, that is, in higher bond strength and less gap formation.

Regional bond strengths to root canal dentin of fiber posts luted with three cementation systems

This study evaluated the influence of the cementation system on the regional push-out bond strength and failure pattern of fiber posts to radicular dentin. The roots of 48 extracted human incisors were prepared and divided into 3 groups (n = 16), according to the cementation system: AdperScotchbond Multi-Purpose + resin cement RelyX ARC (SBMP+ARC); Adper SingleBond 2 + RelyX ARC (SB+ARC) and; RelyX U100 self-adhesive resin cement (U100). The posts were cemented as per manufacturers instructions for each cementation system. After 1 week, the roots were sectioned transversely into 6 discs. Two discs were obtained from the cervical, middle and apical thirds and the push-out test was carried out. The failure pattern was examined on all debonded specimens. The data were analyzed by two-way repeated measures ANOVA and Tukeys test. When U100 was used, no statistically significant difference (p>0.05) was observed among the different root regions. Statistically higher push-out bond strength values were detected in the cervical third for SBMP+ARC and SB+ARC (p<0.05). The U100 showed significantly more mixed failures than SBMP+ARC in the apical third (p<0.05). In conclusion, the self-adhesive cement RelyX U100 was the only cement not sensitive to the root canal region.

An innovative quaternary ammonium methacrylate polymer can provide improved antimicrobial properties for a dental adhesive system.

A quaternary ammonium methacrylate polymer (QAMP) with antimicrobial potential was synthesized. The resulting product (QAMP) was characterized by FTIR spectroscopy, NMR spectroscopy, visible spectrophotometry, XRPD and TGA. The in vitro susceptibility tests against Streptococcus mutans of QAMP were investigated prior and after incorporation into a commercial adhesive system (Clearfil™ SE Bond). The release of quaternary ammonium compounds from the experimental adhesive system (Clearfil™ SE Bond + 5% QAMP) was performed during 1, 7, 14, 21 and 30 days. Spectroscopic data confirmed that QAMP was successfully obtained. Thermogravimetric analysis indicated that QAMP was heat stable. Prior incorporation into the adhesive system, QAMP revealed an inhibition halo of 18.33 ± 0.6 mm. By agar disk diffusion test, Clearfil™ SE Bond containing 5% QAMP presented an inhibition halo (16.67 ± 1.5 mm) similar to Clearfil™ Protect Bond (positive control, 17.00 ± 1.7, p = 0.815) and significantly higher than Clearfil™ SE Bond (negative control, 11.00 ± 1.0, p = 0.006). The minimum inhibitory/bactericidal concentrations for Clearfil™ SE Bond containing 5% QAMP were 20 μL mL−1. The release of quaternary ammonium compounds from the experimental adhesive containing QAMP was very low (5.1%) when compared to Clearfil™ Protect Bond that released 47.2% of its quaternary ammonium monomer (MDPB) after 30 days. The QAMP can offer enhanced antimicrobial properties for self-etching adhesive systems.

Effect of a Novel Quaternary Ammonium Methacrylate Polymer (QAMP) on Adhesion and Antibacterial Properties of Dental Adhesives

This study investigated the resin–dentin bond strength (μTBS), degree of conversion (DC), and antibacterial potential of an innovative adhesive system containing a quaternary ammonium methacrylate polymer (QAMP) using in situ and in vitro assays. Forty-two human third molars were flattened until the dentin was exposed and were randomly distributed into three groups of self-etching adhesive systems: Clearfil™ SE Bond containing 5% QAMP (experimental group), Clearfil™ Protect Bond (positive control) and Clearfil™ SE Bond (negative control). After light curing, three 1 mm-increments of composite resin were bonded to each dentin surface. A total of thirty of these bonded teeth (10 teeth per group) was sectioned to obtain stick-shaped specimens and tested under tensile stress immediately, and after 6 and 12 months of storage in distilled water. Twelve bonded teeth (4 teeth per group) were longitudinally sectioned in a mesio-to-distal direction to obtain resin-bonded dentin slabs. In situ DC was evaluated by micro-Raman spectroscopy. In vitro DC of thin films of each adhesive system was measured using Fourier transform infrared spectroscopy. In vitro susceptibility tests of these three adhesive systems were performed by the minimum inhibitory/minimum bactericidal concentration (MIC/MBC) assays against Streptococcus mutans, Lactobacillus casei, and Actinomyces naeslundii. No statistically significant difference in μTBS was observed between Clearfil™ SE Bond containing 5% QAMP and Clearfil™ SE Bond (p > 0.05) immediately, and after 6 and 12 months of water storage. However Clearfil™ Protect Bond showed a significant reduction of μTBS after 12 months of storage (p = 0.039). In addition, QAMP provided no significant change in DC after incorporating into Clearfil™ SE Bond (p > 0.05). Clearfil™ SE Bond containing 5% QAMP demonstrated MIC/MBC values similar to the positive control against L. casei and A. naeslundii and higher than the negative control for all evaluated bacterial strains. The use of QAMP in an adhesive system demonstrated effective bond strength, a suitable degree of conversion, and adequate antibacterial effects against oral bacteria, and may be useful as a new approach to provide long-lasting results for dental adhesives.

Marginal microleakage of class V resin-based composite restorations bonded with six one-step self-etch systems

This study compared the microleakage of class V restorations bonded with various one-step self-etching adhesives. Seventy class V resin-based composite restorations were prepared on the buccal and lingual surfaces of 35 premolars, by using: Clearfil S3 Bond, G-Bond, iBond, One Coat 7.0, OptiBond All-In-One, or Xeno IV. The Adper Single Bond etch-and-rinse two-step adhesive was employed as a control. Specimens were thermocycled for 500 cycles in separate water baths at 5°C and 55°C and loaded under 40 to 70 N for 50,000 cycles. Marginal microleakage was measured based on the penetration of a tracer agent. Although the control showed no microleakage at the enamel margins, there were no differences between groups (p = 0.06). None of the adhesives avoided microleakage at the dentin margins, and they displayed similar performances (p = 0.76). When both margins were compared, iBond® presented higher microleakage (p < 0.05) at the enamel margins (median, 1.00; Q3-Q1, 1.25-0.00) compared to the dentin margins (median, 0.00; Q3-Q1, 0.25-0.00). The study adhesives showed similar abilities to seal the margins of class V restorations, except for iBond®, which presented lower performance at the enamel margin.

In vivo temperature rise in anesthetized human pulp during exposure to a polywave LED light curing unit

OBJECTIVES This in vivo study evaluated pulp temperature (PT) rise in human premolars during exposure to a light curing unit (LCU) using selected exposure modes (EMs). METHODS After local Ethics Committee approval, intact first upper premolars, requiring extraction for orthodontic reasons, from 8 volunteers, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a minute pulp exposure was attained. A sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted directly into the coronal pulp chamber, and real time PT (°C) was continuously monitored while the buccal surface was exposed to polywave light from a LED LCU (Bluephase 20i, Ivoclar Vivadent) using selected EMs allowing a 7-min span between each exposure: 10-s either in low (10-s/L) or high (10-s/H); 5-s-turbo (5-s/T); and 60-s-high (60-s/H) intensities. Peak PT values and PT increases from baseline (ΔT) after exposure were subjected to one-way, repeated measures ANOVAs, and Bonferronis post hoc tests (α=0.05). Linear regression analysis was performed to establish the relationship between applied radiant exposure and ΔT. RESULTS All EMs produced higher peak PT than the baseline temperature (p<0.001). The 60-s/H mode generated the highest peak PT and ΔT (p<0.001), with some teeth exhibiting ΔT higher than 5.5°C. A significant, positive relationship between applied radiant exposure and ΔT (r(2)=0.916; p<0.001) was noted. SIGNIFICANCE Exposing intact, in vivo anesthetized human upper premolars to a polywave LED LCU increases PT, and depending on EM and the tooth, PT increase can be higher than the critical ΔT, thought to be associated with pulpal necrosis.

Effects of Adding Barium-Borosilicate Glass to a Simplified Etch-and-rinse Adhesive on Radiopacity and Selected Properties

PURPOSE To evaluate the radiopacity, ultimate tensile strength (UTS), microhardness (KHN), degree of conversion (DC), water sorption (WS) and solubility (SL) of experimental adhesives. MATERIALS AND METHODS Five experimental adhesives with different concentrations of barium-borosilicate oxide microfillers [0% (R0), 30% (R30), 40% (R40), 50% (R50), 60% (R60)] were formulated based on the adhesive system Ambar (FGM). The adhesive Adper Single Bond 2 (SB, 3M ESPE) was used as commercial reference. For the radiopacity (n = 5), KHN (n = 5), WS (n = 10), and SL (n = 10) tests, adhesive disks were constructed (5.0 mm in diameter and 1.0 mm thick), while for UTS (n = 5), hourglass-shaped specimens with a cross-sectional area of 0.8 mm2 were used. The FTIR spectra of unpolymerized and polymerized adhesives were used to determine the DC. Data were submitted to a one-way ANOVA and Tukeys test (α = 0.05). RESULTS All experimental adhesives showed radiopacity similar to enamel, except those of R0 and SB. Filler addition did not jeopardize the UTS, KHN, or WS of the filled adhesives in comparison with the unfilled version. Except for R40, filler addition reduced the SL. The filled adhesives showed lower DC when compared with R0, but the DC was similar or higher when compared with SB. CONCLUSIONS The addition of barium-borosilicate glass up to 50% did not jeopardize the mechanical properties of the adhesive layer and seems to reduce its solubility.

Ultrastructural evaluation of enamel after dental bleaching associated with fluoride.

This study evaluated the effects on human enamel after two bleaching procedures: with a fluoridated bleaching agent and with topical fluoride application postbleaching. It used 43 enamel blocks (3 mm2) that were ground flat (600–2,000 grit) and polished with polishing paste (one and one‐fourth). Specimens were randomly divided into three groups according to the bleaching procedure: (1) control group, (2) hydrogen peroxide 35% (HPF) and topical application of fluoride 1.23%, and (3) HP 38% (OP) with fluoride in its composition. Bleaching agents were used according to the manufacturers instructions. Three methodologies were used: nanoindentation, to observe surface hardness and elastic modulus; atomic force microscopy, to observe surface roughness (Ra − Rz); and scanning electron microscopy, to observe the enamel surface effects. Group OP had a decrease in the elastic modulus after bleaching, which was recovered at 14 days. An increased roughness (Ra; 32%) was observed on group HPF and had an increased erosion on enamel surface (67%). It was concluded that topical application of fluoride, after using the nonfluoridated whitening agent, increased the roughness values and erosion of enamel. Microsc. Res. Tech. 75:1093–1098, 2012.

Reducing the incompatibility between two-step adhesives and resin composite luting cements.

PURPOSE To determine whether the adverse interaction between a two-step/acidic etch-and-rinse adhesive (One-Step Plus [OS], Bisco) and chemically cured resin luting cement [Variolink II, Ivoclar Vivadent] can improve adhesive coupling by reducing the dentin permeability with an oxalate desensitizer (BisBlock, Bisco). MATERIALS AND METHODS After exposing dentin on the occlusal surfaces of human third molars, bonding was performed on either oxalate treated (BB) or nontreated (NB) demineralized dentin. A resin luting cement was placed in the format of a crown following the light-curing mode (only with the base syringe [LC]) or the chemically curing mode (mixture of base and catalyst syringes [CC]). The activation of the LC or CC cements was either immediately [IM], meaning soon after the placement of LC and the initial set of CC cement (5 min), or after a delay of 20 min [DP] for both modes of polymerization. Five teeth were assigned to each experimental condition. Teeth were sectioned to obtain sticks with a cross-sectional area of 0.95 mm2, which were tested using the microtensile bond strength test soon after the specified periods of polymerization. The bond strength values of each adhesive were analyzed by three-way repeated measures ANOVA and Tukeys tests (α = 0.05). Fractographic analysis of the specimens was performed using SEM. RESULTS The delayed polymerization (for both LC and CC cements) produced low bond strength values compared to IM activation. When the BB was employed, the bond strength values of the CC cement was approximately doubled, while the BB did not affect the bond strength of the LC cement. Bond strength values of LC cements were higher than CC. The use of BB significantly improved the bond strength of CC cement only. The morphological observations confirmed the bond strength results. A myriad of voids could be detected in the luting cement side when BB was not applied, except for the immediately light-cured group. CONCLUSION The use of an oxalate desensitizer (BisBlock) reduced the incompatibility between a two-step etch-and rinse adhesive and chemically cured resin cements and light-cured systems in the delayed polymerization mode.

Evaluation of different restorative techniques for filling flared root canals: fracture resistance and bond strength after mechanical fatigue.

PURPOSE To evaluate the fracture resistance (FR) and bond strength (BS) after mechanical fatigue (MF) of flared root canals restored with different restorative techniques for fiber post cementation. MATERIALS AND METHODS The root canals of 84 single-rooted premolars were endodontically treated and prepared in order to simulate an oversized root canal, except for the positive control group (PC), in which a prefabricated fiber post (PFP) with a diameter compatible with the post cavity was cemented. In the oversized root canals, alternative restorative techniques for post cementation were tested, as follows: NC: negative control (PFP with a diameter smaller than that of the root canal); AP: PFP + accessory posts; RR: root reinforcement with composite resin; DAP: direct anatomical post; IAP: indirect anatomical post. After the luting procedures using Excite DSC and Variolink II, indirect composite crowns were cemented on composite resin cores and the specimens were mechanically fatigued (1.2 x 106 cycles, 40 N). From each group, 8 specimens were subjected to the push-out BS test and the others 6 specimens to the FR test. For both tests, the data were subjected to ANOVA and Scheffes tests (α = 0.05). RESULTS In terms of FR, all alternative techniques showed intermediate performance, being similar to both control groups. In terms of BS, only the groups DAP and IAP were similar to the well-adapted condition (positive control group). CONCLUSION The use of DAP and IAP should be the first choice for fiber post cementation in oversized root canals.