Rodrigo Stanislawczuk

Influence of chlorhexidine digluconate concentration and application time on resin–dentin bond strength durability

Although it is known that chlorhexidine application may preserve resin-dentin bonds from degradation, the lowest optimal concentration and application time have yet to be established. This study evaluated the effects of different concentrations of chlorhexidine digluconate and different application times on the preservation of resin-dentin bonds formed using two etch-and-rinse adhesives. In experiment 1, after acid etching, the occlusal demineralized dentin was rewetted either with water or with 0.002, 0.02, 0.2, 2, or 4% chlorhexidine for 60 s. In experiment 2, the surfaces were rewetted with water, or with 0.002% or 2% chlorhexidine for 15 or 60 s. After this, both adhesives and composite resin were applied and light-cured. Bonded sticks (0.8 mm(2)) were tested under tension (0.5 mm min(-1)) immediately or after 6 months of storage in water. Two bonded sticks from each tooth were immersed in silver nitrate and analyzed quantitatively using scanning electron microscopy. Reductions in microtensile bond strengths and higher silver nitrate uptake were observed for both adhesives when the rewetting procedure was performed with water. Stable bonds were maintained for up to 6 months under all chlorhexidine conditions tested, irrespective of the chlorhexidine concentration and application time. The use of 0.002% chlorhexidine for 15 s seems to be sufficient to preserve resin-dentin interfaces over a 6-month period.

A 2-year in vitro evaluation of a chlorhexidine-containing acid on the durability of resin-dentin interfaces

OBJECTIVE This study evaluated the effect of 2% chlorhexidine-containing acid (Ac/CHX) and 2% chlorhexidine digluconate solution (CHX) on immediate (IM) and 2-year (2Y) resin-dentin bond strength (BS) and silver nitrate uptake (SNU) for two simplified etch-and-rinse adhesives. METHODS Forty-two caries-free extracted molars had a flat dentin surface exposed. In the control groups (groups 1), the surfaces were acid etched with conventional phosphoric acid and the adhesives Prime&Bond NT (PB) or Adper Single Bond 2 (SB) was applied after rinsing, drying and rewetting with water. In groups 2, Ac/CHX groups the adhesives were applied in a similar manner; however a 2% CHX-containing acid was previously applied. In groups 3, the adhesives were applied according to the control group; however the rewetting procedure was performed with an aqueous solution of 2% CHX for 60s. Composite build-ups were constructed incrementally and microtensile specimens (0.8mm(2)) were prepared for microtensile bond strength testing in the IM or 2Y periods at 0.5mm/min. For SNU, 2 bonded sticks from each tooth were coated with nail varnish, placed in the silver nitrate, polished down with SiC papers and analysed by EDX-SEM. The data from each adhesive was submitted to a two-way repeated measures ANOVA and Tukeys test (α=0.05). RESULTS After 2Y, significant reductions of BS were observed for both adhesives in the control group (p<0.05). In Ac/CHX or CHX groups the BS remained stable for both systems. SNU was more evident in the control than in the experimental groups (p<0.05) both in IM and 2Y periods. The use of CHX in an aqueous solution or associated with the acid conditioner was effective to reduce the degradation of dentin bonds over a 2-year period. SIGNIFICANCE The addition of CHX digluconate in the acidic conditioner may be an excellent tool to increase the long-term stability of collagens fibrils within the hybrid layer against host-derived metalloproteinases without the need for additional steps for the bonding protocol.

Evaporating solvents with a warm air-stream: effects on adhesive layer properties and resin-dentin bond strengths.

OBJECTIVES This study evaluated the effect of a warm or cold air-dry stream for solvent evaporation on the microtensile resin-dentin bond strength (muTBS), nanoleakage pattern (SEM), degree of conversion (DC) and solvent evaporation rates (SE) of an ethanol/water- (Adper Single Bond, [SB] 3MESPE) and an acetone-based (Prime & Bond 2.1, [PB] Dentsply), two-step etch-and-rinse adhesive system. MATERIALS AND METHODS Adhesives were applied on demineralized dentin surfaces. For SE, a warm or cold air-dry stream (10 s) was applied prior to light-activation (10 s). Bonded sticks (0.8mm2) were tested in tension (0.5 mm/min). Two bonded sticks from each tooth were immersed in a 50% (w/v) solution of silver nitrate (24 h), photodeveloped (8 h) and analyzed by SEM. The DC and solvent evaporation rate of the adhesives were evaluated under FTIR and analytical balance, respectively. Data were analyzed by two-way ANOVA and Tukey test (alpha=0.05). RESULTS Higher muTBS and lower nanoleakage were observed when the SE step was performed with warm air-dry stream. However, the DC of the adhesives was not altered by the use of a warm air-dry. CONCLUSIONS The use of a warm air-dry stream seems to be a clinical tool to improve the bond strength and the quality of the hybrid layer (less nanoleakage infiltration), since it might reduce the number of pores within the adhesive layer.

Active application improves the bonding performance of self-etch adhesives to dentin

OBJECTIVES To evaluate the effect of application method on immediate and 6-month resin-dentin microtensile bond strength (microTBS) and nanoleakage (NL) of three one-step self-etch adhesives systems (Clearfil S(3) Bond (S3), Xeno III (XE) and Adper Prompt L-Pop (AD)). METHODS The oclusal enamel of 30 human molar was removed in order to expose a flat dentin surface. The adhesives were applied under two modes: inactive (IN) or active (AC) application. After light-curing (600mW/cm2 for 10s), composite buildups were constructed incrementally and sectioned to obtain bonded sticks (0.8mm2) to be tested in tension immediately (IM) or after 6 months (6M) of water storage. For NL, three bonded sticks from each tooth at each time were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The microTBS data were submitted to a two-way ANOVA and Tukeys test for each adhesive (alpha=0.05). RESULTS The AC showed higher microTBS to dentin when compared to IN in both periods of time (p=0.001). Only for AD, lower microTBS was seen after 6M for IN and AC techniques. XE and S3 adhesives applied under IN showed a higher amount of silver penetration throughout the hybrid layer. Low silver nitrate deposition was seen for these adhesives under AC. After 6M, AD showed a higher amount of silver nitrate uptake under IN and AC techniques. CONCLUSIONS AC improves the bonding performance of all one-step self-etch adhesive systems tested regardless of the time and this tendency was maintained over time.

Effect of 3-year water storage on the performance of one-step self-etch adhesives applied actively on dentine

OBJECTIVES To evaluate the effect of the application method on the immediate and 3-year resin-dentine bond strength (μTBS) and nanoleakage (NL) for 3 one-step self-etch adhesives (Adper Prompt L-Pop; Clearfil S(3) Bond and Xeno III). METHODS The occlusal enamel of 42 human molars were removed to expose a flat dentine surface. The adhesives were applied under inactive or active application. After light-curing (600mW/cm(2) for 10s), composite buildups were constructed incrementally and sectioned to obtain bonded sticks (0.8mm(2)) to be tested in tension immediately or after 3 years of water storage of water storage. For NL, 2 bonded sticks from each tooth at each time were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The μTBS data was submitted to a two-way repetead mesures ANOVA and Tukeys test for each adhesive (α=0.05). RESULTS The active application showed higher immediate and 3-year μTBS than the inactive application (p<0.05). An increase in the silver nitrate deposition was seen for all conditions after 3 years; however this was more pronounced for all materials under inactive application (p<0.05). CONCLUSIONS The active application improves the immediate bonding performance of the adhesive systems. Reductions of the bond strength were observed for all materials after 3 years, however reduced degradation rate was observed when the materials are applied actively in dentine.

Response of Human Pulps to Different In-Office Bleaching Techniques: Preliminary Findings

This study evaluated a whitening effect and the likely side effect (tooth sensitivity and pulp response) of human teeth subjected to different in-office bleaching (IOB) techniques and materials, mainly the presence of calcium in the IOB materials. A calcium-free (CF) and a calcium-containing (CC) 35% hydrogen peroxide (HP) gels were evaluated. The CF was refreshed every 15 minutes, three times (CF 3-15) or in a single 45-min application (CF 1-45) at one bleaching appointment. The CC was used only in a single 45-min application (CC 1-45). Each technique was applied in 5 mandibular incisors scheduled for extraction for different patients. In control group, no tooth bleaching was performed. The tooth colour (TC) and tooth sensitivity (TS) were recorded at baseline and after IOB. The teeth were extracted 2 days after the application of IOB and subjected to histological analysis. The data was submitted to appropriate statistical analysis (α=0.05). The changes of TC were similar between groups and statistically different from the control (p<0.05). However, TS of groups bleached with CF was statistically higher than that recorded for CC and the control (p<0.05). In CF 3-15 and CF 1-45 groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. In CC 1-45 group smaller area of necrosis occurred only in three bleached teeth in which tertiary dentin deposition was observed. The calcium-containing 35%HP gel could be preferable for in-office bleaching because it caused less tooth sensibility and pulp damage.

Effect of tetracycline on the bond performance of etch-and-rinse adhesives to dentin

This study evaluated the effect of modified tetracycline on the resin-dentin bond strength (µTBS), silver nitrate uptake (SNU) and solution homogeneity (SH) of two adhesives. Dentin surfaces were treated with phosphoric acid, rinsed off and either rewetted with water (control group - CO), 2% minocycline (MI), 2% doxycyline (DO) or 2% chlorhexidine (CH). Adhesive systems (Adper Single Bond 2 and Prime Bond NT) and composite were applied and light-polymerized. Specimens were sectioned to obtain bonded sticks (0.8 mm²) to test under tension at 0.5 mm/min. For SNU, specimens were immersed in silver nitrate and analyzed by EDX-SEM. SH was qualitatively analyzed after mixing the adhesives with different solvent-based solutions containing MI, DO and CH. Lower µTBS values were observed in the DO group compared with MI and CH (p = 0.01). Lower SNU was observed for MI and CH. The lowest µTBS for both adhesives was observed for the DO group (p = 0.01). Signs of phase separation were observed for DO with both adhesives. MI or CH used as rewetting solutions after acid etching did not affect the µTBS and hybrid layer quality.

Effects of diphenyliodonium salt addition on the adhesive and mechanical properties of an experimental adhesive.

OBJECTIVES The aim of this study was to assess the microtensile bond strength (μTBS), nanoleakage (NL), nano-hardness (NH) and Youngs modulus (YM) of resin-dentine bonding components formed by an experimental adhesive system with or without inclusion of diphenyliodonium salt (DPIH) in the camphorquinone-amine (CQ) system. METHODS On 12 human molars, a flat superficial dentine surface was exposed by wet abrasion. A model simplified adhesive system was formulated (40 wt.% UDMA/MDP, 30 wt.% HEMA and 30 wt.% ethanol). Two initiator systems were investigated: 0.5 mol% CQ+1.0 mol% EDMAB and 0.5 mol% CQ+1.0 mol% EDMAB+0.2 mol% DPIH. Each adhesive was applied and light-cured (10s; 600 mW/cm(2)). Composite build-ups were constructed incrementally and resin-dentine specimens (0.8mm(2)) were prepared. For NL, 3 bonded sticks from each tooth were coated with nail varnish, placed in the silver nitrate, polished down with SiC papers and analysed by EDX-SEM. NH and YM were performed on the hybrid layer in 2 bonded sticks from each teeth. The remaining bonded sticks were tested on μTBS (0.5mm/min). The data from each test were submitted to a Student t-test (α=0.05). RESULTS No significant difference was found for μTBS between groups (p>0.05). Significant lower NL and higher NH and YM were found in the hybrid layer and adhesive layer produced with the iodinium salt-containing adhesive (p<0.05). CONCLUSIONS The inclusion of the DPIH to the traditional CQ is a good strategy to improve the adhesive and mechanical properties of a simplified etch-and-rinse adhesive system.

Tooth sensitivity with a desensitizing-containing at-home bleaching gel—a randomized triple-blind clinical trial

OBJECTIVES Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).