Patrícia Nóbrega Rodrigues Pereira

Mechanical characterization of proanthocyanidin-dentin matrix interaction

OBJECTIVES To characterize the properties of dentin matrix treated with two proanthocyanidin rich cross-linking agents and their effect on dentin bonded interfaces. METHODS Sound human molars were cut into 0.5 mm thick dentin slabs, demineralized and either treated with one of two cross-linking agents (grape seed-GSE and cocoa seed-COE extracts) or left untreated. The modulus of elasticity of demineralized dentin was assessed after 10 or 60 min and the swelling ratio after 60 min treatment. Bacterial collagenase was also used to assess resistance to enzymatic degradation of samples subjected to ultimate tensile strength. The effect of GSE or COE on the resin-dentin bond strength was evaluated after 10 or 60 min of exposure time. Data were statistically analyzed at a 95% confidence interval. RESULTS Both cross-linkers increased the elastic modulus of demineralized dentin as exposure time increased. Swelling ratio was lower for treated samples when compared to control groups. No statistically significant changes to the UTS indicate that collagenase had no effect on dentin matrix treated with either GSE or COE. Resin-dentin bonds significantly increased following treatment with GSE regardless of the application time or adhesive system used. SIGNIFICANCE Increased mechanical properties and stability of dentin matrix can be achieved by the use of PA-rich collagen cross-linkers most likely due to the formation of a PA-collagen complex. The short term resin-dentin bonds can be improved after 10 min dentin treatment.

Long-term stability of dentin matrix following treatment with various natural collagen cross-linkers

OBJECTIVES Collagen disorganization is one of the main degradation patterns found in unsuccessful adhesive restorations. The hypothesis of this study was that pretreatment using natural collagen cross-linking agents rich in proanthocyanidin (PA) would improve mechanical properties and stability over time of the dentin collagen and, thus, confer a more resistant and lasting substrate for adhesive restorations. METHODS PA-based extracts, from grape seed (GSE), cocoa seed (CSE), cranberry (CRE), cinnamon (CNE) and açaí berry (ACE) were applied over the demineralized dentin. The apparent elastic modulus (E) of the treated dentin collagen was analyzed over a 12 month period. Specimens were immersed in the respective solution and E values were obtained by a micro-flexural test at baseline, 10, 30, 60, 120 and 240 min. Samples were stored in artificial saliva and re-tested after 3, 6 and 12 months. Data was analyzed using ANOVA and Tukey test. RESULTS GSE and CSE extracts showed a time-dependent effect and were able to improve [240 min (MPa): GSE = 108.96 ± 56.08;CSE = 59.21 ± 24.87] and stabilize the E of the organic matrix [12 months (MPa): GSE = 40.91 ± 19.69;CSE = 42.11 ± 13.46]. CRE and CNE extracts were able to maintain the E of collagen matrices constant over 12 months [CRE = 11.17 ± 7.22;CNE = 9,96 ± 6.11;MPa]. ACE (2.64 ± 1.22 MPa) and control groups immersed in neat distilled water (1.37 ± 0.69 MPa) and ethanol-water (0.95 ± 0.33 MPa) showed no effect over dentin organic matrix and enable their degradation and reduction of mechanical properties. SIGNIFICANCE Some PA-based extracts were capable of improving and stabilizing collagen matrices through exogenous cross-links induction.

Solubility study of phytochemical cross-linking agents on dentin stiffness

OBJECTIVES The effects of interactions between cross-linking proanthocyanidins (PA) in polar solvents and type-I collagen of demineralized dentin were investigated. METHODS Three PA-rich extracts, two from grape seed (GSEP and GSES) and one from cocoa (COE), were dissolved (water, ethanol:water and acetone:water) and analyzed for their ability to increase the modulus of elasticity of demineralized dentin. Sound dentin beams (0.5mmx1.7mmx7mm) were fully demineralized and divided into 12 groups according to the type of cross-linking agent and solvents used. Specimens were immersed in the respective solutions and tested at baseline, 10, 30, 60, 120 and 240min. RESULTS The elastic modulus (EM) of dentin was significantly increased by the PA treatment regardless of time (p<0.05 for all times). The extracts showed different solubility in different solvents. GSEP showed the highest increase in EM when diluted in distilled water and acetone at all exposure times. Both GSEs showed superior results when diluted in distilled water and after 4h of treatment, while COE produced strongest enhancement when dissolved in ethanol:water. CONCLUSIONS The results indicates that herbal extraction process and other pharmacognostic parameters have an important influence on extract solubility as well as constitution and, consequently, on the PA-dentin matrix interaction.

Spotlight on bond strength testing--unraveling the complexities.

The variability in methods and outcomes of bond strength testing reports is well documented in the dental literature. Many studies lack important information, which impairs the ability to reproduce them as well as to compare them to other studies in the literature. In order to critically discuss the important issues around bond strength testing methods, and to move closer to at least standardizing the reporting of such studies, the Academy of Dental Materials held a conference in 2009 entitled Adhesion in Dentistry-Analyzing Bond Strength Testing Methods, Variables, and Outcomes. Short synopses of the presentations are presented in this article. This article also provides a list of the variables that should be reported in bond strength studies, regardless of testing methods, to be used by authors conducting future studies, as well as journal reviewers and editors. The goal is to provide guidance and a rationale for what should be included in a study so that reporting might be more standardized and to enhance the possibility that more meaningful comparisons and conclusions may be drawn across studies. The table lists detailed descriptions covering all aspects of testing procedures, including variables related to tooth substrate, restorative material, specimen preparation, pre-testing conditions, testing methods, data reporting and analysis.

Effect of Dentin Biomodification Using Naturally Derived Collagen Cross-Linkers: One-Year Bond Strength Study

Purpose. This study investigated the long-term resin-dentin bond strength of dentin biomodified by proanthocyanidin-rich (PA) agents. Materials and Methods. Forty molars had their coronal dentin exposed, etched, and treated for 10 minutes with 6.5% grape seed extract (GSE), 6.5% cocoa seed extract ethanol-water (CSE-ET), 6.5% cocoa seed extract acetone-water (CSE-AC), and distilled water (CO). Samples were restored either with One-Step Plus (OS) or Adper Single-Bond Plus (SB). Bond strength test was performed immediately or after 3, 6, and 12 months. Results. Higher μTBS were observed for GSE immediately (SB- 62.9 MPa; OS- 51.9 MPa) when compared to CSE-ET (SB- 56.95 MPa; OS- 60.28 MPa), CSE-AC (SB- 49.97 MPa; OS- 54.44 MPa), and CO (SB- 52.0 MPa; OS- 44.0 MPa) (P < 0.05). CSE outcomes were adhesive system and solvent dependant. After 12 months storage SB results showed no difference among treatment types (GSE- 57.15 MPa; CSE/ET- 54.04 MPa; CSE/AC- 48.22 MPa; CO- 51.68 MPa; P = 0.347),while OS results where treatment dependent (GSE- 42.62 MPa; CSE/ET- 44.06 MPa; CSE/AC- 41.30 MPa; CO- 36.85 MPa; P = 0.036). Conclusions. GSE and CSE-ET agents provided enhanced immediate adhesion and stabilization to demineralized dentin after long-term storage, depending on adhesive system.

Cytotoxicity of Universal, Self-Etching and Etch-and-Rinse Adhesive Systems According to the Polymerization Time

This in vitro study evaluated in fibroblast cultures the direct cytotoxicity of universal, self-etching and etch-and-rinse adhesive systems according to the polymerization time. Paper discs were impregnated with adhesives and light-cured (10, 20 or 40 s). The discs were then immersed in culture medium to obtain the eluates for the experimental groups (A1-Single Bond 2; A2-Scotchbond Multi-purpose; A3-Clearfil SE Bond; A4 Scotchbond Universal). As a negative control, paper discs were immersed in culture medium only. After 24 h or 7 days, the eluate obtained was applied on fibroblast culture. Cell viability, cell morphology, membrane damage and the presence of residual monomers were evaluated by MTT assay, SEM, flow cytometry and high-performance liquid chromatography (HPLC), respectively. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (=0.05). All adhesive systems significantly reduced 33-51% cell metabolism when compared to the negative control, regardless of polymerization time, storage period and adhesive system. Moreover, the adhesives caused intense morphological alterations and cell membrane damage. Toxicity was directly related to the presence of residual monomers in the eluates. Residual monomers and additional components are capable of reducing mitochondrial activity, causing morphological alterations and disruption of the cell membrane in fibroblasts, regardless of the polymerization time. This study highlights that despite the more complex composition of the universal adhesive system, its biological response was not more toxic when compared with other systems, even when the shortest polymerization time was tested in cell culture.

Effects of the application techniques of self-adhesive resin cements on the interfacial integrity and bond strength of fiber posts to dentin

ABSTRACT Objective: To evaluate the influence of an application technique of a glass-fiber post using self-adhesive resin cements on the push-out bond strength and the presence of bubbles in the root thirds. The cements were either applied according to the manufacturers instruction or using a commercial delivering system (Centrix), at which the cement pastes were collected and applied after manipulation. Material and Methods: Self-adhesive resin cements (RelyX U200/3M ESPE-U200; Maxcem Elite/Kerr-MAX; Clearfil SA Cement/Kuraray-CSA) and a conventional cement (RelyX ARC/3M ESPE-ARC) were used to cement a post and applied either based on the manufacturers instructions or using a Centrix syringe to deliver the cements directly onto the post of choice, or directly into canal. The roots were scanned with a micro-computed tomography (μCT) and then sectioned into nine 1-mm thick slices for a push-out bond strength test. The μCT images showed the percentage of bubbles in the root thirds (cervical, medium, and apical). Data were analyzed with three-way ANOVA/Tukey (α=0.05). Results: Triple interaction was not significant (p>0.05). The interaction “material” vs “root third” was not significant. A significant interaction was observed between “material” vs “application technique” (p<0.05). For ARC, U200, and MAX, significantly lower percentages of bubbles were observed when the Centrix syringe delivered the cements. Equivalent percentages of voids were observed for CSA, irrespective of the application technique (p>0.05). Significantly higher bond strength was observed when the self-adhesive resin cements were applied using the Centrix delivery system, in comparison with the manufacturers instructions (p<0.05). Bond strength varied with the root third: cervical>medium>apical (p<0.05). No correlations were found between the bond strength and voids. Conclusions: Bond strength and voids are negatively influenced by the conventional application technique for luting fiber posts. The delivery system (Centrix) seems to produce better results when cementing fiber posts.

The influence of hemostatic agents on dentin and enamel surfaces and dental bonding: a systematic review.

BACKGROUND Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers investigated the effects of hemostatic agents on dentin and enamel surfaces and on bonding of adhesive systems and resin cements. TYPES OF STUDIES REVIEWED The authors screened PubMed and Scopus databases for studies in English published from 1980 to 2013. They read the titles and abstracts to identify literature that fulfilled the inclusion criteria. The authors included studies in which researchers evaluated the hemostatic action on the dentin and enamel surfaces or its influence on the bond strength of adhesive systems or resin cements. They used cross-referencing to identify more articles. RESULTS Twenty in vitro studies met the inclusion criteria. Investigators in 12 of these studies evaluated the bond strength to contaminated dentin. Investigators in 10 of these studies reported a significant decrease in bond strength. Those in two studies evaluated the influence of a hemostatic agent on the dental enamel and reported decreases in bond strength. Researchers also reported significant increases in microleakage of self-etching adhesives on contaminated dentin. Scanning electron microscopy revealed partial removal of the smear layer or an etching effect of dentin as a result of the application of hemostatic agents on dentin. PRACTICAL IMPLICATIONS Adhesive procedures may be affected adversely when performed on dentin and enamel contaminated by hemostatic agents. Hemostatic agents may induce changes in the dentin surface morphology. The results of this review indicate that the bond strength of self-etching adhesive systems is affected more negatively than is that of etch-and-rinse systems. The authors found that a 60-second application of ethylenediaminetetraacetic acid followed by a water spray restored the bond strength of a self-etching adhesive to dentin; use of phosphoric acid for 15 seconds followed by a water spray also was an effective cleaning method. Direct comparison of selected studies was not possible, however, mainly because of methodological differences hampering definitive conclusions.

One-Year Water Sorption and Solubility of All-in-One Adhesives

The aim of this study was to evaluate the water sorption and solubility of different adhesives. Adper Easy Bond, Adper Single Bond Plus, Bond Force, Clearfil SE Bond (bonding resin only), and Xeno IV were the materials evaluated. Ten disks of each adhesive were made in Teflon molds and evaporation of any volatile components was allowed. The disks were weighed daily in an analytical balance until a constant mass was obtained (m1). Disks were then immersed in water for 12 months when their wet weight was recorded (m2). The disks were again weighed daily until a constant mass was obtained and the final weight recorded (m3). Water sorption and solubility (percentages) were calculated using the recorded mass values. Kruskal-Wallis tests were used to compare the average water sorption and solubility among the different adhesives. Mann-Whitney tests with a Bonferroni correction were used to determine the pairwise differences between adhesives in water sorption and solubility. The level of significance was set at 0.05. Water sorption and solubility were significantly different among the groups (p<0.05). Pairwise comparisons showed no significant differences (p>0.05) between Adper Single Bond Plus and Bond Force, or between Clearfil SE Bond and Xeno IV in either water sorption or solubility. Xeno IV did not differ from Adper Easy Bond in water sorption (p>0.05). Water sorption and solubility of all-in-one adhesives increased with time, and the rates of increase were composition-dependent. The results suggest that monomers other than HEMA contribute to water sorption and solubility of adhesive systems from different categories.