Manuela Lopes

Effect of a sodium hypochlorite gel on dentin bonding

UNLABELLED It has been suggested that the hybrid layer (HL) does not play any important role in the mechanism of adhesion to dentin. To substantiate this hypothetical insignificance of the HL, sodium hypochlorite (NaOCl) has been used to remove collagen from etched dentin prior to bonding. OBJECTIVES The present study was conducted to determine the effect of a commercial 10% NaOCl gel on the dentin shear bond strengths and HL ultra-morphology of two simplified dentin adhesives. The null hypothesis tested was that treatment of etched dentin collagen with NaOCl would not compromise dentin bonding. METHODS The labial surface of eighty bovine incisors was polished to expose middle dentin. The specimens were randomly assigned to two total-etch adhesive systems (N = 40): Prime&Bond NT (Dentsply Caulk); and Single Bond (3M Dental Products Division). After rinsing off the etchant, one drop of 10% NaOCl (AD Gel, Kuraray Ltd.) was applied to the etched dentin surface and left for 0 (control), 15, 30, or 60 s. The gel was rinsed off with water and the dentin surface kept visibly moist prior to the application of the adhesive as per manufacturers instructions. The respective composite resin was subsequently applied and light-cured. After 24 h in water at 37 degrees C, the specimens were thermocycled for 500 cycles in baths kept at 5 and 55 degrees C and the shear bond strengths measured. The data were analyzed with two-way ANOVA. For TEM, sixteen dentin disks were taken from middle dentin of extracted human third molars, assigned to the eight treatment sequences, and observed. RESULTS The increase in the NaOCl application time resulted in a progressive decrease in shear bond strengths for both dentin adhesives. For Single Bond, the application of AD Gel for 60 s resulted in a reduction of bond strengths to 38% of that obtained for the control. For Prime&Bond NT, the mean bond strength obtained when AD Gel was applied for 60 s was 31% of that obtained for the control. The application of AD Gel resulted in distinct morphology for each one of the two adhesives tested. For Single Bond, the general morphology of the collagen network was maintained, regardless of the deproteinization time. The interfibrillar space within the collagen network increased with increasing deproteinization times. For Prime&Bond NT, the general appearance of the HL was maintained for deproteinization times of 15 and 30 s. When the NaOCl gel was applied for 60 s, the morphological appearance of the HL lost its fibrillar arrangement. While remnants of the collagen fibers were observed in one of the dentin disks, the other specimen showed an amorphous structure without any discernible HL morphological features. SIGNIFICANCE The integrity of the collagen fibrils left exposed upon acid-etching plays a major role in the mechanism of adhesion of the specific adhesive systems tested in this study. The intermingling of the adhesive monomers with the filigree of collagen fibers or HL should still be considered the paramount dentin bonding mechanism.

The effect of a re-wetting agent on dentin bonding

OBJECTIVES Recently, a new generation of simplified one-bottle dentin bonding systems, sensitive to variations in the degree of substrate moisture, was introduced. This in vitro project compared the dentin bond strengths and interfacial ultra-morphology formed by three one-bottle bonding systems [OptiBond SOLO (ethanol-based), Prime&Bond 2.1 (acetone-based), and Single Bond (ethanol- and water-based)]. The null hypothesis tested was that re-wetting a dried dentin surface with a HEMA aqueous solution would not result in bond strengths, and resin impregnation into demineralized dentin, comparable to those obtained for moist dentin. METHODS Dentin specimens were assigned to the following three etched surface conditions: moist dentin-control group; dentin dried for 5 s; and dentin dried for 5 s and re-moistened with a commercial 35% HEMA aqueous solution. Mean shear bond strengths were calculated and analyzed with one- and two-way ANOVA. Dentin discs treated with the same combination of surface condition/adhesive were processed and observed under both transmission and scanning electron microscopes. RESULTS For moist dentin, the morphology of the resin-dentin interfaces showed penetration of the dentin adhesives to the depth of the transition between demineralized and unaffected dentin. Drying dentin for 5 s resulted in a significant decrease in mean bond strengths and an incompletely infiltrated collagen structure with areas of unveiled collagen fibers, regardless of the solvent. Re-wetting dentin with the aqueous HEMA solution re-established the level of bond strengths obtained to moist dentin and resulted in a raise of the fiber network with simultaneous increase in interfibrillar space dimensions. SIGNIFICANCE The results suggest that the use of an aqueous HEMA solution might compensate for the dryness induced on dentin surfaces by using air blasts from an air syringe, after rinsing off the etchant. As the behavior of the material that contained water was also affected by surface dryness, the percentage of water included in the composition of current ethanol- and water-based adhesives, such as Single Bond, may not be enough to compensate for the collapse of the collagen filigree upon drying.