Vinicius Di Hipólito

Effectiveness of self-adhesive luting cements in bonding to chlorhexidine-treated dentin

OBJECTIVES The aim was to investigate the microtensile bond strength (μ-TBS) and failure pattern of self-adhesive luting cements (SLC) to dentin pre-treated with different concentrations of chlorhexidine (CHX) solutions. METHODS The occlusal enamel was removed from 30 extracted sound human molars in order to expose a flat dentin. Resin-composite (Filtek Z250, 3M ESPE) discs (12 mm in diameter, 6.0mm thickness) were cemented to the smear layer-covered dentin using the SLC [RelyX U100, 3M ESPE (U100); Multilink Sprint, Ivoclar Vivadent (MS)] with 0.2% or 2.0% CHX solutions. Results were compared with the control, untreated dentin. Six groups were then created based on the SLC and dentin pre-treatment (n=5). After 24h of water storage, restored teeth were serially sectioned into beams with a cross-sectional area of 0.8mm(2) at the bonded interface. Subsequently, specimens were tested in tension with a crosshead speed of 0.5mm/min in a universal testing machine, and the failure patterns were classified. Two-way ANOVA and Tukeys tests were performed (α=0.05). Additionally, 18 teeth were subjected to energy-dispersive X-ray spectroscopy (EDS) analysis and micromorphology characterization of the smear layer-covered dentin and 0.2% or 2.0% CHX-treated dentin surfaces. RESULTS The μ-TBS obtained for both control groups were significantly higher, regardless of the CHX concentration and/or the cement used. Bond strengths were significantly higher for U100 than for MS, except when 2.0% CHX was applied. Fractographic analysis indicated that most failures in the control groups occurred cohesively in the SLC. Pre-treated dentin with 0.2% and 2.0% CHX solutions presented higher incidences of adhesive failures. EDS/SEM analysis exhibited varied concentrations of chlorine ions and crystal-shaped precipitates, depending upon the CHX concentration. SIGNIFICANCE Pre-treatment of dentin with 0.2% or 2.0% CHX adversely affects the bonding efficacy when associated with the SLCs tested.

Bond strength and interfacial micromorphology of etch-and-rinse and self-adhesive resin cements to dentin.

PURPOSE To evaluate the microtensile bond strength and interfacial micromorphology of indirect composite restorations to dentin using three commercial resin cements after 24 hours and 30 days of water storage. MATERIALS AND METHODS The medium dentin of third human molars was exposed (N = 30, n = 10 per group). Three commercial resin cements were used to cement indirect resin composite restorations to dentin: the auto-cured C&B Cement/All Bond 2, the dual-cured RelyX ARC/Adper Single Bond 2, and the self-adhesive dual-cured RelyX Unicem. Teeth were sectioned after water storage at 37°C (24 hours and 30 days) to obtain beams with a bonded area of 0.8 mm(2) . The specimens were tested in a universal testing machine at a 0.5 mm/min crosshead speed. Scanning electron microscopic fractographic and interfacial micromorphology analyses were performed. Data were analyzed using two-way ANOVA and Tukeys test (α= 0.05). RESULTS Mean bond strength (MPa) after 24 hours: C&B Cement 19.5 ± 3.8, RelyX ARC 40.8 ± 9.4, RelyX Unicem 31.3 ± 7.4; after 30 days: C&B Cement 24.5 ± 5.1, RelyX ARC 44.2 ± 8.5, RelyX Unicem 28.3 ± 7.1. The mean bond strengths of both dual-cure cements were significantly higher than that obtained with C&B Cement after 24 hours. A significant increase in the bond strength of C&B Cement was verified after 30 days, reaching values statistically equivalent to those produced by RelyX Unicem and RelyX ARC. The self-adhesive cement preserved the same level of bond strength after 30 days. Fractographic analysis revealed a prevalence of cohesive fractures in the hybrid layer for C&B Cement, mixed (cohesive in the cement, hybrid layer, and adhesive) for RelyX ARC, and cohesive in the cement for RelyX Unicem. No distinguishable hybrid layer or resin tags were observed in the interaction of RelyX Unicem with dentin. CONCLUSIONS The particular interaction of each cement with dentin results in specific bond strength and failure patterns that varied among groups in both evaluation times. Even though the self-adhesive cement tested exhibited no authentic hybrid layer, it was able to promote reliable adhesion with the underlying dentin.

Methacrylate- and silorane-based composite restorations: Hardness, depth of cure and interfacial gap formation as a function of the energy dose

OBJECTIVES To investigate the influence of the energy dose on the hardness, polymerization depth, and internal adaptation of silorane and methacrylate-based posterior composites in Class II restorations with different bonding approaches. MATERIALS AND METHODS Class II preparations were made on the mesial and distal surfaces of extracted third molars and randomly distributed into 6 groups (n=20), according to the restorative systems [methacrylate-based composite: Filtek P60+Adper Single Bond 2 (etch-and-rinse adhesive) - P60/SB; Filtek P60+Adper Easy One (self-etching adhesive) - P60/EO; silorane-based composite: Filtek P90+P90 System Adhesive - P90 (self-etching adhesive)] and the energy dose (20 and 40 J/cm(2)). Resin composites were applied in two increments, individually photoactivated using an LED light-curing unit. After 24 h, all restorations were mesio-distally sectioned. Hardness was evaluated along the transversal section of the fillings (1-4 mm below the restoration surface) using a load of 50 g for 5 s. In order to evaluate the internal gap formation, specimens were air dried and 1% acid red propylene glycol solution was applied to the internal margins for 20 s. Specimens were then water rinsed, air dried, and digitally image recorded. The internal gap (%) was calculated as the ratio between the stained margins and the total length of the internal margin. Kruskal-Wallis test was conducted to evaluate internal gap formation, and three-way ANOVA and Tukeys test were performed to evaluate hardness/polymerization depth (α=0.05). RESULTS Regarding the internal gap formation, a significant difference was observed among all groups (P60/EO<P90<P60/SB), regardless of the energy dose. For 40 J/cm(2), a significant increase in gap formation was seen for P60/EO and P90 when compared to 20 J/cm(2). The KHN of both resin composites was not affected by the depth of evaluation, but the influence of the material was significant (P60>P90; p<0.05). The highest energy dose (40 J/cm(2)) produced significant increase in the KHN only for Filtek P90 (p<0.05). SIGNIFICANCE Although a higher energy dose produces a slight increase in hardness for the silorane based composite, it also increases the internal gap formation. Dose of 20 J/cm(2) seems to be more suitable as it provides reduced internal gaps and satisfactory hardness. In addition, gap formation seems to be a consequence of an underperformed bonding approach rather than the differences in the resin-composite formulation.

SEM analysis of the acid-etched enamel patterns promoted by acidic monomers and phosphoric acids

Objective: Although self-etching bonding systems (SES) are indicated to prepare dental enamel for bonding, concerns have been expressed regarding their effectiveness. The aim of this study was to analyze the etching pattern (EP) of nine SES in comparison with 35% and 34% phosphoric acid etchants (FA) on intact (IN) and ground (GR) enamel surface. Materials and Methods: Twenty-two human third molars were sectioned in mesial-distal and buccal-lingual directions, and four dental fragments were obtained from each tooth. Half of the fragments were ground using 600-grit SiC paper and the other half remained intact. The fragments were randomly assigned into 22 groups, according to the texture of enamel surface (IN and GR) and the technique to etch the enamel (34% FA, 35% FA, AdheSE primer; Brush & Bond; Clearfil Protect Bond primer; iBond; One-up Bond F; OptiBond Solo Plus primer; Tyrian SPE primer; Unifil Bond primer and Xeno III). Conditioners were applied to IN and GR enamel surfaces, according to the manufacturers instructions. Specimens etched with phosphoric acids were washed with water, while the surfaces treated with SES were submitted to alternate rinsing with alcohol and acetone. The specimens were dried, sputter-coated and examined under a scanning electron microscope. Results: For both IN and GR enamel surfaces, the EP of 34 and 35% FA was deeper and more homogeneous in comparison to EP of SES, except for Tyrian SPE. The acidic monomer action of self-etching systems was more effective on GR enamel. Conclusion: Most of the SES are less aggressive than phosphoric acid etchants and their etching effects were reduced on intact enamel surfaces. Uniterms: Dental acid etching; Dental enamel; Electron microscopy.

Fracture resistance of teeth restored with different resin-based restorative systems

The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.

The effect of polymerization mode on monomer conversion, free radical entrapment, and interaction with hydroxyapatite of commercial self-adhesive cements

OBJECTIVES This study evaluated the degree of conversion, the free radical entrapment, and the chemical interaction of self-adhesive resin cements mixed with pure hydroxyapatite, as a function of the polymerization activation mode among a variety of commercial self-adhesive cements. MATERIALS AND METHODS Four cements (Embrace WetBond, MaxCem Elite, Bifix SE, and RelyX U200) were mixed, combined with hydroxyapatite, dispensed into molds, and distributed into three groups, according to polymerization protocols: IP (photoactivation for 40s); DP (delayed photoactivation, 10 min self-curing plus 40s light-activated); and CA (chemical activation, no light exposure). Infrared (IR) spectra were obtained and monomer conversion (%) was calculated by comparing the aliphatic-to-aromatic IR absorption peak ratio before and after polymerization (n=10). The free radical entrapment values of the resin cements were characterized using Electron Paramagnetic Resonance (EPR) and the concentration of spins (number of spins/mass) calculated (n=3). Values were compared using two-way ANOVA and Tukeys post-hoc test (α=5%). X-ray diffraction (XRD) characterized the crystallinity of hydroxyapatite as a function of the chemical interactions with the resin cements. RESULTS The tested parameters varied as a function of resin cement and polymerization protocol. Embrace WetBond and RelyX U200 demonstrated dependence on photoactivation (immediate or delayed), whereas MaxCem Elite exhibited dependence on the chemical activation mode. Bifix SE presented the best balance based on the parameters analyzed, irrespective of the activation protocol. CONCLUSIONS Choice of polymerization protocol affects the degree of conversion, free radical entrapment, and the chemical interaction between hydroxyapatite and self-adhesive resin cement mixtures.

Resin composite characterizations following a simplified protocol of accelerated aging as a function of the expiration date

This study evaluated the mechanical, thermal, and morphological characteristics of different classifications of dental composites as a function of the material condition (new, aged and expired). Specimens were obtained according to these factors: Composites: Filtek P60, Filtek Z250, Filtek Z350XT, and Filtek Silorane; and Material conditions: new, aged, and expired. The syringe composites underwent an accelerated aging protocol (Arrhenius model). The flexural strength (FS) and flexural modulus (E) were obtained. The thermogravimetric analysis (TGA) and differential thermal analysis (DTA) were also performed and the glass transition temperature (Tg) and the weight loss calculated. Topographic analysis of the composites was performed under SEM. The material conditions influenced the mechanical properties of the composites. The silorane composite exhibited a characteristic thermal behavior different from that of the methacrylates. In general, the Tg increased after the accelerated aging protocol and decreased for expired ones, compared to the new composites. A significant increase in FS of Filtek Z350XT after aging was accompanied by an increase in the Tg. The filler packings were in accordance with the manufacture׳s information. The topographic aspects of the composites were modified as a function of the material condition. The mechanical properties of the composites following a simplified protocol of accelerated aging varied as a function of the expiration date. The silorane composite presented a characteristic thermal behavior. Although the dental manufacturers may not be able to control variables as storage temperature and transportation conditions, these effects on the composite clinical performance can be minimized if properly considered.

Hybridization quality and bond strength of adhesive systems according to interaction with dentin

Objective: To evaluate the hybridization quality and bond strength of adhesives to dentin. Materials and Methods: Ten human molars were ground to expose the dentin and then sectioned in four tooth-quarters. They were randomly divided into 5 groups according to the adhesive used: Two single-step self-etch adhesives - Adper Prompt (ADP) and Xeno III (XE), two two-step self-etching primer systems - Clearfil SE Bond (SE) and Adhe SE (ADSE), and one one-step etch-and-rinse system - Adper Single Bond (SB). Resin composite (Filtek Z250) crown buildups were made on the bonded surfaces and incrementally light-cured for 20 s. The restored tooth-quarters were stored in water at 37΀C for 24 h and then sectioned into beams (0.8 mm 2 in cross-section). Maximal microtensile bond strength (μ-TBS) was recorded (0.5 mm/min in crosshead speed). The results were submitted to one-way ANOVA and Tukey′s test (α = 0.05). Thirty additional teeth were used to investigate the hybridization quality by SEM using silver methenamine or ammoniacal silver nitrate dyes. Results: SE reached significantly higher μ-TBS (P < 0.05); no significance was found between ADSE and XE (P > 0.05), and between SB and ADP (P > 0.05); ADSE and XE were significantly higher than SB and ADP (P < 0.05). The bonding interface of SB showed the most intense silver uptake. SE and ADSE showed more favorable hybridization quality than that observed for ADP and XE. Conclusions: The bond strength and hybridization quality were affected by the interaction form of the adhesives with dentin. The hybridization quality was essential to improve the immediate μ-TBS to dentin.

Effect of dentinal surface preparation on the bonding of self-adhesive luting cements

The purpose of the present study was to evaluate the bond strength and the interaction morphology of self-adhesive resin luting cements (SLCs) to dentin prepared with different methods. Four SLCs were used: RelyX U100®, RelyX U200®, Clearfil SA Luting®, and SmartCem2®. A flat dentin surface of 40 human molars was exposed and each tooth was sectioned in four tooth-quarters, which were distributed into four groups according to the SLC used to cement indirect resin composite restorations. The tooth-quarters of each group were then distributed in four subgroups according to the method used for dentin preparation: flat-ended cylindrical fine-grit diamond, flat-ended cylindrical median-grit diamond, flat-ended cylindrical plain-cut tungsten carbide, or abraded with #600-grit SiC paper (control). The restored tooth-quarters were sectioned to obtain beams (0.8 mm2) and submitted to the microtensile bond strength test (n = 10). The results were analyzed using two-way ANOVA/Tukey (α = 0.05). Forty-four additional teeth were used for micromorphological investigation of the SLC/dentin interface and of the topographic aspect of the dentin surfaces after application of the SLCs. Only the bond strength of RelyX U200 was significantly influenced by the surface preparation. No interference was identified on the micromorphological aspect of the bonding interfaces. The topographic investigation of the dentinal surfaces showed that the SLCs were not able to effectively remove the smear layer and etch the underlying dentin, irrespective of the preparation method. So, the interference of the dentin preparation on the bond strength of SLCs is material dependent, but don’t influence the micromorphologic aspect of the interaction zone.

Effect of Replacing a Component of a Self-Etch Adhesive by Chlorhexidine on Bonding to Dentin

The purpose of this study was to evaluate the effect of replacing a component of the self-etch adhesive Adper Scotchbond SE (liquid A + liquid B) by 2% chlorhexidine (CHX) on bond strength to dentin after 1 day, 3 months or 6 months of water storage. Eight human teeth were sectioned to expose a flat dentin surface and were then randomly assigned to 2 groups. In the control group, the dentin surfaces were treated with the adhesive according to the manufacturers instructions. In the experimental group, liquid A was replaced by 2% CHX. Next, a 6-mm-high resin composite block was incrementally built on the bonded surfaces. The restored teeth were then sectioned to produce stick-shaped specimens (cross-sectional area - 0.8 mm2). The microtensile bond strength (µTBS) was recorded, and the failure modes were assessed. Data were analyzed by two-way repeated measures ANOVA (α=0.05). Four additional teeth were processed in order to conduct a micromorphological analysis of the resin-dentin interface. The µTBS values did not significantly decrease after water storage in either the control or the experimental group, whose values did not differ significantly irrespective of storage time. The morphological aspect of the bonding interface appears not to have been affected by CHX. A higher incidence of cohesive failures within the adhesive and mixed failures (cohesive within adhesive and resin composite) was observed for both groups. It may be concluded that dentin pre-treatment with 2% CHX did not influence significantly the bonding performance of the evaluated adhesive.