Martin J. Tyas

The effect of dentine location and tubule orientation on the bond strengths between resin and dentine

This study determined the influence of dentine structure on the micro-tensile bond strengths between resin and dentine of two different dentine adhesive systems (Single Bond, 3M Dental Products, St Paul, MN; MF-102 (experimental self-etching primer), GC Corporation, Tokyo, Japan). The study was separated into two main parts: bond strength measurement and investigation of the bonding interface. Twenty-two human premolars were used for the bond strength measurement. Each tooth was cut vertically, separating the tooth into mesio-distal halves. One half of the tooth was used to bond to a surface perpendicular to the dentinal tubules and other half to bond to a surface parallel to the tubules. For each half, six locations of dentine were bonded. Each material was used in accordance to the manufacturers directions. Cylindrical hourglass-shaped specimens of 1.2 mm diameter at the bonded interface were manufactured. The bonds were stressed in tension at a crosshead speed of 1 mm/min. Mean bond strengths were compared using LSD, one-way ANOVA, and Students t-test. The fractured surfaces were examined under a scanning electron microscope, and the frequency of fracture modes was compared using the Kruskal-Wallis and Mann-Whitney U tests. For the investigation of the bonded interface, four teeth were prepared by the same procedure used for the bond test specimens. The bonded interfaces were observed after an acid-base treatment or fracturing across the bonded interface, prior to investigation with a field-emission scanning electron microscope. For Single Bond, the bond strengths for mid-root dentine were significantly lower than for other locations (p < 0.05). For MF-102, there was no significant difference for all locations (p > 0.05). MF-102 bonded well to all locations of dentine while Single Bond showed a porous zone at the base of the hybrid layer. The bonds were not influenced by tubule orientation. The results indicate that the bond for Single Bond may be affected by its ability to penetrate demineralised dentine in different locations of a tooth. The self-etching primer of MF-102 produces a good bond and is independent of the position on the tooth.

FDI World Dental Federation: clinical criteria for the evaluation of direct and indirect restorations—update and clinical examples

In 2007, new clinical criteria were approved by the FDI World Dental Federation and simultaneously published in three dental journals. The criteria were categorized into three groups: esthetic parameters (four criteria), functional parameters (six criteria) and biological parameters (six criteria). Each criterion can be expressed with five scores, three for acceptable and two for non-acceptable (one for reparable and one for replacement). The criteria have been used in several clinical studies since 2007, and the resulting experience in their application has led to a requirement to modify some of the criteria and scores. The two major alterations involve staining and approximal contacts. As staining of the margins and the surface has different causes, both phenomena do not appear simultaneously. Thus, staining has been differentiated into marginal staining and surface staining. The approximal contact now appears under the name “approximal anatomic form” as the approximal contour is a specific, often non-esthetic issue that cannot be integrated into the criterion “esthetic anatomical form”. In 2008, a web-based training and calibration tool called e-calib (www.e-calib.info) was made available. Clinical investigators and other research workers can train and calibrate themselves interactively by assessing clinical cases of posterior restorations which are presented as high-quality pictures. Currently, about 300 clinical cases are included in the database which is regularly updated. Training for eight of the 16 clinical criteria is available in the program: “Surface lustre”; “Staining (surface, margins)”; “Color match and translucency”; Esthetic anatomical form”; “Fracture of material and retention”; “Marginal adaptation”; “Recurrence of caries, erosion, abfraction”; and “Tooth integrity (enamel cracks, tooth fractures)”. Typical clinical cases are presented for each of these eight criteria and their corresponding five scores.

Nanoleakage patterns of four dentin bonding systems

OBJECTIVES The purpose of this study was to evaluate the nanoleakage patterns of four dentin bonding systems. METHODS The dentin bonding systems used in this study were: Single Bond, One Coat Bond, Prime & Bond NT/Non Rinse Conditioner (NRC), and PermaQuik. Flat occlusal dentin surfaces from extracted human molars were finished with wet 600-grit silicon carbide paper, and bonded with one of the dentin bonding systems. After 24 h storage at 37 degrees C in water, margins were finished with polishing discs and the surrounding tooth surfaces coated with nail varnish. The samples were immersed in a 50% (w/v) solution of silver nitrate for 24 h, and exposed to photodeveloping solution for 8 h. The samples were cut longitudinally, polished, and mounted on stubs, carbon coated and observed in a Field Emission-SEM using backscattered electron mode. RESULTS Different nanoleakage patterns were observed with the different adhesive systems. However, accumulations of silver particles were often noted at the base of the hybrid layer for all materials. Single Bond and One Coat Bond demonstrated uptake of silver particles both within the hybrid layer and the adhesive resin. Prime & Bond NT/NRC showed silver staining throughout almost the entire thickness of the hybrid layer. The leakage pattern of PermaQuik revealed loose silver deposition within the hybrid layer. The composition of each adhesive system may play a role in forming the different leakage patterns. SIGNIFICANCE The current dentin bonding systems used in this study do not achieve perfect sealing at the restoration/dentin interface, which may influence the durability of the bond to dentin.

Strain patterns in cervical enamel of teeth subjected to occlusal loading

OBJECTIVES This study was planned to investigate the variations in strains in enamel under different patterns of occlusal loading, using three-dimensional finite element analysis (3D FEA) and strain gage measurements in extracted teeth. METHODS A 3D FEA model of a mandibular second premolar was used to investigate effects of occlusal load on enamel surface strains, particularly in response to oblique directions of cuspal loading. Point loads of 100 N were applied axially and at 45 degrees from the vertical on the buccal or lingual incline of the buccal cusp, either in the bucco-lingual plane or at varying mesio-distal angulations (up to +/- 20 degrees). Patterns of strain observed in the FEA model were confirmed experimentally using strain gages on extracted premolars mounted in a servohydraulic testing machine. RESULTS Strains predicted from the FEA model were in excellent agreement with the strain gage measurements. Strains were concentrated near the cementoenamel junction (CEJ) regardless of load direction. A vertical load on the buccal cusp tip resulted in compressive strains on the buccal surface but small tensile strains in lingual cervical enamel. Strains resulting from oblique loads on buccal cusp inclines were complex and asymmetric, with either tension or compression occurring in any location depending on the site and angle of loading. SIGNIFICANCE The magnitude, direction and character of strains in cervical enamel are highly dependent on patterns of loading. The asymmetric pattern of strains in buccal cervical enamel in response to oblique occlusal forces is consistent with the common clinical picture of asymmetric non-carious cervical lesions.

Fracture toughness of water-aged resin composite restorative materials

OBJECTIVES The purpose of this study was to assess the effects of aging experimental dimethacrylate resin composites in water at 37 degrees C for periods up to 6 wk by measuring the variations in fracture toughness (K(c)), elastic modulus (E), fracture energy (G(c)), and water sorption. METHODS Six experimental resins were formulated from dimethacrylate resins, and were filled to 86 wt% (ca. 70 vol%) with treated inorganic filler to form six experimental composites. The fracture toughness was determined using a double torsion technique, the elastic modulus was measured in flexure, and the fracture energy was calculated from the fracture toughness and elastic modulus. RESULTS As a result of aging in water, K(c) and the G(c) increased, and the elastic modulus decreased, but all values approached a plateau near 6 wk. Water sorption also occurred during this period, mainly during the first 2 wk. SIGNIFICANCE Variations in the mechanical properties are interpreted as being due to plasticization of the resin matrix by water, which appears to lower the yield stress and increase in the size of the plastic zone ahead of the crack, thereby causing the observed increase in G(c) and K(c). After approximately 6 wk, no further changes in properties occurred.

The effect of load cycling on the nanoleakage of dentin bonding systems.

OBJECTIVES The purpose of this study was to evaluate the effects of load cycling on nanoleakage of occlusal flat surface or cervical restorations bonded with three self-etching priming systems and a single bottle system. METHODS The dentin bonding systems used in this study were Clearfil SE Bond, Unifil Bond, Prompt L-Pop and Single Bond. Flat occlusal dentin surfaces and cervical cavities from extracted human molars were bonded with one of the dentin bonding systems. After load cycling of 90N for 5000 cycles, samples were immersed in a 50% w/v solution of silver nitrate for 24h, and exposed to photodeveloping solution for 8h. Specimens were sectioned, mounted on stubs, carbon-coated and observed in a Field Emission-SEM using backscattered electron mode. One-way ANOVA was used for statistical analysis of the leakage scores. RESULTS FE-SEM images showed that samples subjected to load cycling had leakage patterns similar to non-load-cycled samples for all dentin bonding systems. Load cycling did not affect leakage lengths in any system. Prompt L-Pop had greater silver deposition and leakage score than the other systems. SIGNIFICANCE The dentin bonding systems tested were unable to prevent nanoleakage, and the extent of nanoleakage was not increased by load cycling.

The effect of thermocycling regimens on the nanoleakage of dentin bonding systems.

OBJECTIVES The purpose of this study was to compare nanoleakage associated with polished and fractured specimens, and evaluate the effects of thermocycling on nanoleakage. METHODS The dentin bonding systems used in this study were PermaQuik and Prime and Bond NT (PBNT). Flat occlusal dentin surfaces and class V cavities from extracted human molars were bonded with one of the dentin bonding systems. With or without thermocycling, samples were immersed in a 50% w/v solution of silver nitrate for 24h, and exposed to photodeveloping solution for 8h. The specimens were cut or fractured, and mounted on stubs, carbon coated and observed in a Field Emission-SEM using backscattered electron mode. RESULTS Polished and fractured specimens showed similar nanoleakage patterns for both dentin-bonding systems. Thermocycling with regimens of different temperatures and number of cycles did not result in different nanoleakage patterns and leakage lengths in controls and thermocycled groups. PBNT combined with non-rinse conditioner (NRC) produced no significant difference in nanoleakage length, but a somewhat different nanoleakage pattern, compared with PBNT and 34% phosphoric acid. SIGNIFICANCE Thermocycling does not have an effect on nanoleakage of dentin bonding systems. The smearing effect from sectioning and polishing procedures does not affect the nanoleakage result.

The influence of the modification of etched bovine dentin on bond strengths.

OBJECTIVE The aim of this study was to modify demineralized bovine dentin surfaces by application of either 12.5% sodium hypochlorite (NaOCl), or 0.1% (w/w) Type I collagenase, after conditioning with phosphoric acid, to observe the demineralized surface and to investigate the effect on tensile bond strength. METHODS The NaOCl was applied to etched dentin for 30 s, 1 or 2 min and the collagenase for 1, 3 or 6 h. A control group was used without NaOCl or collagenase treatment. Prior to bonding, treated surfaces were examined using an Atomic Force Microscope (AFM). A 2.3 mm diameter area of dentin was conditioned, treated and bonded with either One Coat Bond or Single Bond following each manufacturers instructions, and a resin composite rod attached. Bonds were stressed in tension at a rate of 1 mm/min until failure. Mean bond strengths were calculated (MPa) and mode of failure was determined by observation at 20x magnification. Results were analyzed using multiple regression analysis and LSD test at the 95% level of confidence (n = 12). RESULTS AFM results showed progressive changes of the surface collagen as the treatment time of NaOCl or collagenase increased. For both bonding systems, the bond strengths of 1 min NaOCl and 3 h collagenase treatments were significantly higher than the control or other treatment groups (p < 0.05). Bond failure consisted of mostly adhesive failure between dentin and resin combined with small regions exhibiting cohesive failure of resin. SIGNIFICANCE Bond strengths were not dependent on the thickness of the hybrid layer, but rather quality of the hybrid layer.

Structure and properties of methaerylate based dental restorative materials

Abstract The chemistry and structure of the dimethacrylate resins and the nature of the filler systems in dental composite resins are reviewed in relation to their influence on the setting behaviour, dimensional stability, aesthetics, fracture behaviour and adhesive potential. It is clear that a deeper understanding of the structure of the polymeric matrix and the mechanism of clinical wear is required. As a result of ongoing research in this area and with the development of dentine adhesives, the future prospects of composite resins are encouraging.

Fluoride release from glass ionomer cements and resin composites coated with a dentin adhesive

OBJECTIVES This laboratory study compared the effect of surface coatings on patterns and amounts of fluoride released from four glass ionomer cements and two fluoride-containing resin composites. METHODS Twelve cylinders of each material were prepared in a polyethylene mold. The experimental groups (n = 6) were coated with one layer of an adhesive resin (3M Scotchbond Multipurpose Adhesive), while the control groups (n = 6) remained uncoated. Cumulative fluoride release into deionized water was measured on days 1, 2, 3, 7, 14, 21 and 28 using an ion analyzer. Total fluoride release after 28 days was analyzed for significant differences among materials using one-way ANOVA and Student-Newman-Keuls test (p < 0.05). RESULTS The total amounts of fluoride release from the coated samples were found to be significantly less than the uncoated samples for all materials, except Solitaire. The uncoated samples released a total amount of fluoride of between 2.3 and 85.4 ppm, while the coated samples released a total amount of fluoride of between < 0.2 and 24.1 ppm. Similar patterns of fluoride release were found in coated and uncoated samples. SIGNIFICANCE The results indicated that the application of a dentin adhesive coating did not completely prevent fluoride release from glass ionomer cements and fluoridated resin composites, although the amounts were significantly less. Clinically, it suggests that a continued release of fluoride from glass ionomer cements and fluoridated resin composites is possible after placing a thin layer of resin adhesive. The clinical significance of these findings is not known.