Orestes Marangos

Adhesive/Dentin Interface: The Weak Link in the Composite Restoration

Results from clinical studies suggest that more than half of the 166 million dental restorations that were placed in the United States in 2005 were replacements for failed restorations. This emphasis on replacement therapy is expected to grow as dentists use composite as opposed to dental amalgam to restore moderate to large posterior lesions. Composite restorations have higher failure rates, more recurrent caries, and increased frequency of replacement as compared to amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and premature failure. Under in vivo conditions the bond formed at the adhesive/dentin interface can be the first defense against these noxious, damaging substances. The intent of this article is to review structural aspects of the clinical substrate that impact bond formation at the adhesive/dentin interface; to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface.

Parametric study of the effect of phase anisotropy on the micromechanical behaviour of dentin-adhesive interfaces.

A finite element (FE) model has been developed based upon the recently measured micro-scale morphological, chemical and mechanical properties of dentin–adhesive (d–a) interfaces using confocal Raman microspectroscopy and scanning acoustic microscopy (SAM). The results computed from this FE model indicated that the stress distributions and concentrations are affected by the micro-scale elastic properties of various phases composing the d–a interface. However, these computations were performed assuming isotropic material properties for the d–a interface. The d–a interface components, such as the peritubular and intertubular dentin, the partially demineralized dentin and the so-called ‘hybrid layer’ adhesive-collagen composite, are probably anisotropic. In this paper, the FE model is extended to account for the probable anisotropic properties of these d–a interface phases. A parametric study is performed to study the effect of anisotropy on the micromechanical stress distributions in the hybrid layer and the peritubular dentin phases of the d–a interface. It is found that the anisotropy of the phases affects the region and extent of stress concentration as well as the location of the maximum stress concentrations. Thus, the anisotropy of the phases could effect the probable location of failure initiation, whether in the peritubular region or in the hybrid layer.

Viscoelastic and fatigue properties of model methacrylate-based dentin adhesives

The objective of the current study is to characterize the viscoelastic and fatigue properties of model methacrylate-based dentin adhesives under dry and wet conditions. Static, creep, and fatigue tests were performed on cylindrical samples in a 3-point bending clamp. Static results showed that the apparent elastic modulus of the model adhesive varied from 2.56 to 3.53 GPa in the dry condition, and from 1.04 to 1.62 GPa in the wet condition, depending upon the rate of loading. Significant differences were also found for the creep behavior of the model adhesive under dry and wet conditions. A linear viscoelastic model was developed by fitting the adhesive creep behavior. The developed model with 5 Kelvin Voigt elements predicted the apparent elastic moduli measured in the static tests. The model was then utilized to interpret the fatigue test results. It was found that the failure under cyclic loading can be due to creep or fatigue, which has implications for the failure criterion that are applied for these types of tests. Finally, it was found that the adhesive samples tested under dry conditions were more durable than those tested under wet conditions.

Fatigue life prediction of dentin-adhesive interface using micromechanical stress analysis

OBJECTIVES The objective of this work was to develop a methodology for the prediction of fatigue life of the dentin-adhesive (d-a) interface. METHODS At the micro-scale, the d-a interface is composed of dissimilar material components. Under global loading, these components experience different local stress amplitudes. The overall fatigue life of the d-a interface is, therefore, determined by the material component that has the shortest fatigue life under local stresses. Multiple 3d finite element (FE) models were developed to determine the stress distribution within the d-a interface by considering variations in micro-scale geometry, material composition and boundary conditions. The results from these models were analyzed to obtain the local stress concentrations within each d-a interface component. By combining the local stress concentrations and experimentally determined stress versus number of cycle to failure (S-N) curves for the different material components, the overall fatigue life of the d-a interface was predicted. RESULTS The fatigue life was found to be a function of the applied loading amplitude, boundary conditions, microstructure and the mechanical properties of the material components of the d-a interface. In addition, it was found that the overall fatigue life of the d-a interface is not determined by the weakest material component. In many cases, the overall fatigue life was determined by the adhesive although exposed collagen was the weakest material component. Comparison of the predicted results with experimental data from the literature showed both qualitative and quantitative agreement. SIGNIFICANCE The methodology developed for fatigue life prediction can provide insight into the mechanisms that control degradation of the bond formed at the d-a interface.

Quantitative analysis of aqueous phase composition of model dentin adhesives experiencing phase separation

There have been reports of the sensitivity of our current dentin adhesives to excess moisture, for example, water-blisters in adhesives placed on over-wet surfaces, and phase separation with concomitant limited infiltration of the critical dimethacrylate component into the demineralized dentin matrix. To determine quantitatively the hydrophobic/hydrophilic components in the aqueous phase when exposed to over-wet environments, model adhesives were mixed with 16, 33, and 50 wt % water to yield well-separated phases. Based upon high-performance liquid chromatography coupled with photodiode array detection, it was found that the amounts of hydrophobic BisGMA and hydrophobic initiators are less than 0.1 wt % in the aqueous phase. The amount of these compounds decreased with an increase in the initial water content. The major components of the aqueous phase were hydroxyethyl methacrylate (HEMA) and water, and the HEMA content ranged from 18.3 to 14.7 wt %. Different BisGMA homologues and the relative content of these homologues in the aqueous phase have been identified; however, the amount of crosslinkable BisGMA was minimal and, thus, could not help in the formation of a crosslinked polymer network in the aqueous phase. Without the protection afforded by a strong crosslinked network, the poorly photoreactive compounds of this aqueous phase could be leached easily. These results suggest that adhesive formulations should be designed to include hydrophilic multimethacrylate monomers and water compatible initiators.

Physico-mechanical properties determination using microscale homotopic measurements: Application to sound and caries-affected primary tooth dentin

Microscale elastic moduli, composition and density have rarely been determined at the same location for biological materials. In this paper, we have performed homotopic measurements to determine the physico-mechanical properties of a second primary molar specimen exhibiting sound and caries-affected regions. A microscale acoustic impedance map of a section through this sample was acquired using scanning acoustic microscopy (SAM). Scanning electron microscopy was then used to obtain mineral mass fraction of the same section using backscattered images. Careful calibration of each method was performed to reduce system effects and obtain accurate data. Resorption, demineralization and hypermineralization mechanisms were considered in order to derive relationships between measured mineral mass fraction and material mass density. As a result, microscale mass density was determined at the same lateral resolution and location as the SAM data. The mass density and the acoustic impedance were combined to find the microscale elastic modulus and study the relationship between microscale composition and mechanical properties.

Rock-Joint Micromechanics: Relationship of Roughness to Closure and Wave Propagation

The closure behavior of rock joints is intimately related to joint roughness. Here we utilize a micromechanical approach that explicitly considers asperity interactions on joint surfaces to study the rock-joint closure and wave propagation behavior. Elastic deformations and inelastic frictional sliding are considered at inclined asperity contacts. Rock-joint roughness is modeled through distributions of asperity heights and asperity contact orientations. The micromechanical approach developed in this paper establishes the link between the rock-joint closure behavior, the initial overlap of the joints, the asperity height distribution parameters, and the average asperity slope. The model is verified by comparison with experimental measurements. Subsequently a parametric study is performed. The results show that rock joints with the same roughness can exhibit a range of closure behavior depending upon initial overlap and rock intrinsic friction. Therefore, unique descriptions of rock-joint closure behavior ...

Scanning acoustic microscopy investigation of frequency-dependent reflectance of acid- etched human dentin using homotopic measurements

Composite restorations in modern restorative dentistry rely on the bond formed in the adhesive-infiltrated acid-etched dentin. The physical characteristics of etched dentin are, therefore, of paramount interest. However, characterization of the acid-etched zone in its natural state is fraught with problems stemming from a variety of sources including its narrow size, the presence of water, heterogeneity, and spatial scale dependency. We have developed a novel homotopic (same location) measurement methodology utilizing scanning acoustic microscopy (SAM). Homotopic measurements with SAM overcome the problems encountered by other characterization/imaging methods. These measurements provide us with acoustic reflectance at the same location of both the pre- and post-etched dentin in its natural state. We have applied this methodology for in vitro measurements on dentin samples. Fourier spectra from acid-etched dentin showed amplitude reduction and shifts of the central frequency that were location dependent. Through calibration, the acoustic reflectance of acid-etched dentin was found to have complex and non-monotonic frequency dependence. These data suggest that acid-etching of dentin results in a near-surface graded layer of varying thickness and property gradations. The measurement methodology described in this paper can be applied to systematically characterize mechanical properties of heterogeneous soft layers and interfaces in biological materials.

Micro-scale Analysis of Compositional and Mechanical Properties of Dentin Using Homotopic Measurements

High resolution techniques are being increasingly applied to image or measure biomaterial properties. Data interpretations from these measurements have to be performed carefully to extract meaningful information. Two aspects become significant when such techniques are used in a complementary manner. Firstly, the measurements have to be performed using a homotopic methodology such that property correlations or ‘data fusion’ considers the same material volume. Secondly, appropriate mathematical models must be applied to interpret the data in terms of material properties since the high resolution technique seldom measure the properties directly. In this paper, we have described the application of scanning acoustic and scanning electron microscopy to measure the mechanical and the compositional properties of primary tooth dentin using a homotopic methodology. We have then utilized a homogenization technique in order to understand the variation in the measured elastic moduli.

Dentin/Adhesive Interface in Teeth

Clinical studies have demonstrated an alarmingly high failure rate for posterior composite dental restorations. The premature failure of moderate-to-large composite restorations can be traced to a breakdown of the bond at the tooth surface/composite material interface and increased levels of cariogenic bacteria at the perimeter of these materials. In this chapter, we discuss the dentin/adhesive bond, with a focus on the failure of current adhesives to consistently seal and adhere to the dentin. The concept of forming a resin-reinforced hybrid layer for improved adhesion is presented. The complex role of water in dentin/adhesive bonding is then described. Finally, mechanisms leading to mechanical property changes at the interface are discussed.