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Movement of resin cement components through acid-treated dentin during crown cementation in vitro.

This study examined the hypothesis that components of crown cements may be forced through acid-treated dentin during cementation. Freshly extracted, human third molar teeth were prepared to accept full crowns. Roots were removed to allow irrigation of the pulp chamber with saline before, during, and after crown placement with resin dentin bond and resin composite cement. Saline samples were collected and analyzed by high performance liquid chromatography to identify and quantify resin components arriving in the pulp space. Two components of the bond-cement system used were identified in the pulp space samples immediately after crown cementation. These were 2-hydroxyethylmethacrylate and 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane. The amounts of these components in the pulp space decreased when the bonding agent was cured prior to crown placement. The results of this study supported the hypothesis that crown cementing components may flow through acid-treated dentin during crown cementation.

Adolescent↗

Effect of a sodium hypochlorite gel on dentin bonding.

UNLABELLED: It has been suggested that the hybrid layer (HL) does not play any important role in the mechanism of adhesion to dentin. To substantiate this hypothetical insignificance of the HL, sodium hypochlorite (NaOCl) has been used to remove collagen from etched dentin prior to bonding. OBJECTIVES: The present study was conducted to determine the effect of a commercial 10% NaOCl gel on the dentin shear bond strengths and HL ultra-morphology of two simplified dentin adhesives. The null hypothesis tested was that treatment of etched dentin collagen with NaOCl would not compromise dentin bonding. METHODS: The labial surface of eighty bovine incisors was polished to expose middle dentin. The specimens were randomly assigned to two total-etch adhesive systems (N = 40): Prime&Bond NT (Dentsply Caulk); and Single Bond (3M Dental Products Division). After rinsing off the etchant, one drop of 10% NaOCl (AD Gel, Kuraray Ltd.) was applied to the etched dentin surface and left for 0 (control), 15, 30, or 60 s. The gel was rinsed off with water and the dentin surface kept visibly moist prior to the application of the adhesive as per manufacturer's instructions. The respective composite resin was subsequently applied and light-cured. After 24 h in water at 37 degrees C, the specimens were thermocycled for 500 cycles in baths kept at 5 and 55 degrees C and the shear bond strengths measured. The data were analyzed with two-way ANOVA. For TEM, sixteen dentin disks were taken from middle dentin of extracted human third molars, assigned to the eight treatment sequences, and observed. RESULTS: The increase in the NaOCl application time resulted in a progressive decrease in shear bond strengths for both dentin adhesives. For Single Bond, the application of AD Gel for 60 s resulted in a reduction of bond strengths to 38% of that obtained for the control. For Prime&Bond NT, the mean bond strength obtained when AD Gel was applied for 60 s was 31% of that obtained for the control. The application of AD Gel resulted in distinct morphology for each one of the two adhesives tested. For Single Bond, the general morphology of the collagen network was maintained, regardless of the deproteinization time. The interfibrillar space within the collagen network increased with increasing deproteinization times. For Prime&Bond NT, the general appearance of the HL was maintained for deproteinization times of 15 and 30 s. When the NaOCl gel was applied for 60 s, the morphological appearance of the HL lost its fibrillar arrangement. While remnants of the collagen fibers were observed in one of the dentin disks, the other specimen showed an amorphous structure without any discernible HL morphological features. SIGNIFICANCE: The integrity of the collagen fibrils left exposed upon acid-etching plays a major role in the mechanism of adhesion of the specific adhesive systems tested in this study. The intermingling of the adhesive monomers with the filigree of collagen fibers or HL should still be considered the paramount dentin bonding mechanism.

Acid Etching, Dental↗

The effect of hybrid layer thickness on bond strength: demineralized dentin zone of the hybrid layer.

OBJECTIVES: The purpose of this study was to evaluate the correlation between hybrid layer thickness and bond strength using specimens acid-conditioned for varying lengths of time. METHODS: The dentin surfaces of human premolars, sectioned to remove the enamel from the labial surface, were conditioned with 35.0% phosphoric acid of an adhesive resin system (Scotchbond Multi-Purpose; 3M) for 15 (as directed by the manufacturer), 60, 120, or 180 s (experimental acid-conditioning times). The bonded specimens were then sectioned perpendicular to the adhesive interface to measure the hybrid layer thickness by SEM. The specimens for the micro-tensile test were sectioned perpendicular to the adhesive interface and trimmed to an hourglass-shape. Then, the micro-tensile test was performed at a crosshead speed of 1.0 mm/min. The bond strengths and hybrid layer thickness were statistically compared with Student's t-test (p < 0.05). All fractured surfaces were also observed by SEM. RESULTS: Significant differences between the groups exposed to acid for 15 and 60 s, and those exposed for 120 and 180 s were observed in hybrid layer thickness and bond strength (p < 0.05). SEM observation of the fractured surfaces revealed that a demineralized dentin zone without resin impregnation remained within the hybrid layer. SIGNIFICANCE: A demineralized dentin zone was formed in the bond structures after prolonged acid-conditioning, resulting in low bond strength. The shrinkage of the hybrid layer due to desiccation during the SEM examination process provided evidence of the presence of the demineralized dentin zone within the hybrid layer.

Acid Etching, Dental↗

Dimensional changes of demineralized dentin treated with HEMA primers.

OBJECTIVES: The purpose of this study was to measure the dimensional changes of demineralized dentin before and after application of HEMA (2-hydroxyethyl methacrylate) by confocal laser scanning microscopy (CLSM). METHODS: The middle portion of bovine dentin was ground, polished, and covered with a vinyl tape with a 4-mm hole punched through it. A strip of polysiloxane impression material was then placed across the center of the dentin surface to preserve a strip of the original unetched surface. Dentin surfaces were etched with 32% phosphoric acid for 60 s and rinsed with water. The impression material was then removed and the following sequential steps were performed: the dentin surface was mildly air-dried, then strongly air-dried, then treated with either 35 wt.% HEMA/water or 100 wt.% HEMA and mildly air-dried, and then strongly dried again. The shrinkage of the demineralized dentin surface from the original unetched level was measured by CLSM in each step and results analyzed by one-way ANOVA. RESULTS: The dimensional changes of demineralized dentin after mild air drying were approximately -1 micron and, following strong air drying, resulted in -5 microns shrinkage. Following the application of 35 wt.% HEMA/water, the height of the demineralized dentin changed to a level of -3.3 microns, but then shrank to -4.8 microns after strong drying. ANOVA indicated that re-expansion of the shrunken etched dentin was significant (p < 0.05); however, the treated surface collapsed when it was strongly dried again (p < 0.05). 100% HEMA did not re-expand the shrunken demineralized dentin under any of the application on protocols (p > 0.05). SIGNIFICANCE: Thirty-five wt.% HEMA in water re-expanded the collapsed demineralized dentin matrix, however not to the original level. One hundred wt.% HEMA did not cause any re-expansion.

Acid Etching, Dental↗

Bonding of all-porcelain crowns: structural characteristics of the substrate.

OBJECTIVES: The aim of this in vitro study was to evaluate the morphology of dentin in teeth prepared for single-unit all-porcelain crowns (SUAPC) in terms of tubule orientation, density and increase in surface area after etching. METHODS: Twenty anterior and 20 posterior teeth from adults were prepared 1mm below the cemento-enamel junction (CEJ) for SUAPC. The samples were divided into groups based on type of tooth (anterior or posterior) and bonding system employed. The teeth were processed for evaluation of morphology of the substrate, hybrid layer thickness and resin tag formation. The observations were subdivided according to location in the preparation and tubule density was calculated. RESULTS: The observations revealed the variability in tubule density and orientation in different areas within any one preparation. The morphology of the cervical margin was less predictable with the presence of cementum and an ill-defined cemento-dentinal junction. Statistically significant differences in the density of tubules were found depending on location. Groups 2, 3, 5 and 6 samples showed that the hybrid layer thickness and resin tag morphology depended on the density and direction of tubules. In those sectors with parallel and oblique tubule orientation and with a low density of tubules, the hybrid layer was significantly thinner than in areas with cross-sectioned tubules. SIGNIFICANCE: The cementum and the peripheral intertubular dentin surface area are likely to be responsible for the bond strength after acid etching of crown preparations, but not all areas exhibited equal responses to etching. In particular, the bonding substrate at the gingival margins may contribute little in terms of micromechanical retention.

Acid Etching, Dental↗

Effect of Phenyl-P/HEMA acetone primer on wet bonding to EDTA-conditioned dentin.

OBJECTIVES: The purpose of this study was to examine the effect of 2-methacryloyloxyethyl phenyl phosphoric acid (Phenyl-P)/2-hydroxyethyl methacrylate (HEMA) acetone-based primer on moist dentin surfaces that were preconditioned with ethylenediaminetetraacetate (EDTA) to remove the smear layer. METHODS: Bovine dentin were prepared with 180-grit paper, conditioned with 0.5M EDTA (pH 7.4) for 60s followed by water rinsing and then blot drying. Each surface was then primed with Phenyl-P/30 wt% HEMA in acetone for 10s followed by blot drying. A light-cured bonding agent was then applied, cured and trimmed to give dumbbell-shaped specimens. The Phenyl-P concentration ranged from 1 to 20 wt%. During the bonding procedure, no compressed air was used. After storage in water at 37 degrees C for one day, tensile bond strengths were measured and analyzed using one-way ANOVA. Dentin discs treated under the same conditions were observed under a scanning electron microscope (SEM). RESULTS: When the concentration of Phenyl-P was 12 wt%, the highest mean tensile bond strength was obtained (27 MPa). It was significantly higher than that of the 3, 5, 15 or 20 wt% groups (9-11 MPa) (p<0.05). The samples of 1 wt% group were all broken during trimming the dumbbell-shaped specimens. SEM observations showed a 1 microm-thick layer of hybridized dentin after polished cross-sections were chemically challenged with 6N HCl for 30s and then 1% NaOCl for 60 min. SIGNIFICANCE: The experimental Phenyl-P/HEMA acetone primer is effective in bonding resin to EDTA-conditioned dentin. Acetone as a solvent for Phenyl-P/HEMA primer has the clinical advantage of not requiring an air-stream to evaporate the solvent. The experimental bonding procedure can minimize the skin irritation by HEMA.

Acetone↗

An SEM evaluation of several adhesive systems used for bonding fiber posts under clinical conditions.

OBJECTIVES: The objective of this investigation was to evaluate the effectiveness of three 'one-bottle' and two 'three step' adhesive systems (as controls) in the formation of resin tags, adhesive lateral branches and a resin dentin interdiffusion zone (RDIZ) when used to bond fiber posts under clinical conditions. This study was performed using standardized SEM observations and scoring resin tag formation and density. METHODS: Fifty root canal treated teeth, already scheduled for extraction for endodontic or periodontal reasons, were selected for this study. The patients were informed and their written consent was obtained. The samples were randomly allocated to five groups of ten samples each. Group 1: All Bond 2 with C & B (Bisco); Group 2: Scotchbond Multipurpose Plus with Opal Luting Composite (3M); Group 3: Scotchbond 1 in combination with Rely X ARC resin cement (3M); Group 4: One-step with C & B resin cement (Bisco); Group 5: All Bond Experimental with Post Cement HI-X (Bisco). The adhesive systems and resin cements were used strictly according to the manufacturers' instructions. The priming-adhesive solution of each 'one-bottle' system was light-cured before placing the resin cement and the post. Fifty Aestheti-Plus posts (white quartz fiber posts, RTD, France) were used. A week later, the roots were extracted and processed for SEM observations. RESULTS: All the adhesive systems showed a RDIZ and resin tag and adhesive lateral branch formation. Microscopic examination of the restored interfaces of Groups 1 and 2 showed a higher percent of RDIZ than those found in samples of Groups 3, 4 and 5. RDIZ morphology was easily detectable and uniform in the first two thirds of the root canals, whilst in the apical third the RDIZ was not uniformly present. Resin tag morphology and formation were significantly more detectable in the cervical and middle areas than in the apical zone. No statistically significant differences were found among the five groups coronally, while in the apical and middle thirds two 'one-bottle' systems (Groups 3 and 4) showed significantly less resin tags than the control Groups 1, 2 and the experimental Group 5. No statistically significant differences were found among the three 'one-bottle' systems in the three evaluated areas. The standardization of SEM observations and scoring resin tag formation allowed statistical evaluation. CONCLUSIONS: The 'three step' adhesive systems can create a wider micromechanical interlocking between adhesive materials and etched dentin than 'one-step' systems.

Dental Bonding↗

Effect of surface conditioning and restorative material on the shear bond strength and resin-dentin interface of a new one-bottle nanofilled adhesive.

OBJECTIVES: To determine the effect of different combinations of surface conditioning (DeTrey Conditioner 36, NRC, no etching) and restorative materials (Dyract AP, Spectrum TPH) on the shear bond strength of Prime and Bond NT to enamel and dentin, and to characterize the resin-dentin interface produced by these combinations. METHODS: Shear bond strength was tested on 30 enamel and 30 dentin flat labial surfaces of extracted bovine teeth. The enamel and dentin specimens were randomly assigned to six groups of five teeth each and treated using different combinations of surface conditioners and restorative materials with Prime and Bond NT. Scanning electron microscope (SEM) observation of argon-ion-etched specimens was done to evaluate the resin-dentin interface. RESULTS: The type of surface conditioning and restorative material had significant effects on dentin bond strengths. Etching the dentin prior to application of Prime and Bond NT significantly increased bond strength and caused formation of a hybrid layer for Spectrum TPH. For Dyract AP, dentin etching generally did not improve bond strength despite the formation of a hybrid layer. On enamel, Prime and Bond NT had consistently high bond strengths on etched specimens. SIGNIFICANCE: The results showed that Dyract AP and Spectrum TPH, when used with Prime and Bond NT have different bonding mechanisms and the effect of surface conditioning on their shear bond strength differs. Clinicians should be aware of these effects in order to optimize bonding.

Acid Etching, Dental↗

Analysis of the dentin-resin interface by use of laser Raman spectroscopy.

OBJECTIVES: Adhesion of resin-bonding agents to dentin is currently believed to result from impregnation of adhesive resin into superficially demineralized dentin. The purpose of this study was to investigate the chemical composition of the resin-impregnated dentin (hybrid) layer using a micro-Raman spectroscopy. METHODS: Resin composites were bonded to bovine dentin with the two-step bonding systems, and specimens were sectioned parallel to dentinal tubules. These surfaces were then polished down to 1 microm diamond pastes. Raman spectra were successively recorded along a line perpendicular to the dentin-adhesive interface by steps of 0.2 microm on a computer controlled X-Y stage. The relative amounts of hydroxyapatite (960 cm(-1), P-O), adhesive resin (640 cm(-1), aromatic ring), and organic substrate (1450 cm(-1), C-H) in the dentin-adhesive bonding area were calculated. RESULTS: From the Raman spectroscopy results, the hybrid layer represents a gradual transition in the relative amount of adhesive from the resin side to dentin side. Evidence of poor saturation of the adhesive resin in the demineralized dentin with the one-bottle adhesive system was detected. SIGNIFICANCE: From the results of this study, inhomogeneity of the hybrid layer composition was detected, and the degree of resin impregnation was found to be different between the bonding systems tested.

Animals↗

Dimensional changes and ultimate tensile strengths of wet decalcified dentin applied with one-bottle adhesives.

OBJECTIVES: The objectives of this study were to test the null hypothesis that no dimensional changes in wet decalcified dentin matrices will occur during the application of one-bottle adhesives, and to evaluate the ultimate tensile strengths (UTS) of resin-infiltrated dentin matrices using the microtensile test. METHODS: Dentin disks 0.2 mm thick were prepared from mid-coronal dentin of human unerupted third molars. They were completely decalcified in 0.5 M EDTA (pH 7.4) for 5 days at 25 degrees C and then placed in the bottom of an aluminum well to permit use of the LVDT portion of a thermal mechanical analyzer. Changes in matrix height in response to the application of Single Bond, One-Step or Prime & Bond NT were measured along with the UTS of resin-infiltrated specimens that were compared using a one-way ANOVA and Fisher's PLSD test. RESULTS: All one-bottle adhesives produced a gradual, progressive shrinkage of the decalcified matrix of 26-33%. The shrinkage produced by Single Bond was significantly greater (p<0.05) than that produced by the other adhesives. The UTS of One-Step was significantly higher (<0.05) than that of Prime & Bond NT (42.0+/-13.6 vs 29.7+/-1.9 MPa, respectively), with Single Bond producing intermediate UTS (34.3+/-7.4 MPa). SIGNIFICANCE: If the durability of resin-dentin bonds depends upon the size of interfibrillar spaces for both diffusion channels and resin uptake, then adhesive formulations should be designed to minimize matrix shrinkage during resin infiltration.

Analysis of Variance↗

Optimizing filler content in an adhesive system containing pre-reacted glass-ionomer fillers.

OBJECTIVES: (1) To evaluate the optimal concentration of the calcium type pre-reacted glass-ionomer (PRG-Ca) fillers in experimental light-activated adhesives for bonding to tooth substrates and fluoride release; (2) to evaluate the polymerization reactivity of these experimental filled adhesives; and (3) to examine the ultrastructure of the resin-dentin interface bonded with the commercial version of this self-etching adhesive (Imperva Fluoro Bond, Shofu Inc., Kyoto, Japan). MATERIALS AND METHODS: PRG-Ca fillers were prepared from the acid-base reaction of calcium type fluoroaluminosilicate glass with poly(acrylic acid) in water. Different experimental light-cured adhesives were prepared, with 0-57wt% PRG-Ca fillers and 3wt% aerosil silica incorporated in a resin matrix. Twenty-four hours shear bond strengths to bovine enamel and dentin were assessed using the adhesive with/or without accelerated aging. The cumulative amount of fluoride released from the cured adhesives and differential scanning calorimetry (DSC) measurements were also conducted. 180-grit SiC paper polished human dentin disks were treated with Imperva Fluoro Bond that contains 17wt% PRG-Ca fillers and prepared for TEM examination. RESULTS: Increase in PRG-Ca filler content of experimental adhesives was highly correlated with the decrease in bond strengths to dentin (r=-0.96 to -0.99), the increase in cumulative fluoride release, (r=0.97) and the decrease in polymerization energy (cal/g) of the adhesives (r=-0.99) (p<0.001). A PRG-Ca content of 17wt% provided optimal bond strength to enamel and dentin after accelerated aging and fluoride release. TEM showed that salt-like matrices were present around the hydrogels and remnant glass cores of the PRG-Ca fillers. The commercial self-etching primer completely dissolved the smear layer and formed 2 micrometer thick hybrid layers in intact dentin. SIGNIFICANCE: The use of silanized PRG-Ca fillers provides good adhesion and a source of fluoride release in a commercially available self-etching adhesive system.

Analysis of Variance↗

Effect of cavity preparation instruments (oscillating or rotating) on the composite-dentin interface in primary teeth.

OBJECTIVES: To evaluate the effect of preparation of instruments on the interfacial integrity between cavity wall and composite restoration. METHODS: Two class II slot preparations were done in 10 primary teeth either with SonicSys or with a conventional bur. The cavities were filled using an adhesive system. One layer of a flowable composite and one layer of a condensable composite were applied. The specimens were analyzed by confocal laser scanning microscopy. RESULTS: In the SonicSys group the mean thickness of the hybrid layer was 6.12 (0.60) microm; in the control group it was 6.04 (0.63) microm. The difference was not statistically significant. Two fractures were observed in one tooth of each group. These were located only in the enamel. The cavity margins were beveled in all specimens. SIGNIFICANCE: Compared to conventional preparations, cavity preparation with SonicSys has no deleterious effect on the integrity of the interface.

Composite Resins↗

Degradation of resin-dentin bonds using NaOCl storage.

OBJECTIVE: Several recent studies have reported collagen hydrolysis within bonds over the long-term. This may be one reason for the degradation of the bonds. This study therefore aimed to determine the effects of NaOCl on adhesive system bonds (total-etch bonding system vs. self-etching primer system) to dentin in order to accelerate the durability testing. METHODS: Resin-dentin bonded specimens were produced using Liner Bond 2V (Kuraray), a self-etching primer system, and OptiBond SOLO (Kerr), a total-etch bonding system, according to the manufacturers' instructions. The bonded specimens were serially sectioned in both x and y directions across the adhesive interface to obtain beams (adhesive area: 0.9 mm(2)). The specimens were immersed in 10% NaOCl solution for 1-5h after being stored in water at 37 degrees C for 24h. Control specimens were tested without exposure to NaOCl. After storage, micro-tensile bond tests were performed. Results were analyzed by two-way ANOVA and Fisher's PLSD tests (p<0.05). All fractured surfaces were observed by SEM, and examined using an image analyzer. RESULTS: The bond strengths decreased with increasing storage time in NaOCl. Fractography showed that NaOCl had a greater effect on the bond structure of OptiBond SOLO than on that of Liner Bond 2V, although both adhesives were susceptible. SIGNIFICANCE: Deterioration of the bonds was responsible for the effect of NaOCl on the hybrid layer. This deterioration may occur in humans in cases of deproteinization within the bonds.

Acid Etching, Dental↗

Dentin bond durability after three years using a dentin bonding agent with and without priming.

OBJECTIVES: This three-year study was conducted to evaluate the tensile bond strengths of a dual-cured bonding resin, with and without priming, to bovine dentin. METHODS: Superficial bovine dentin was conditioned with 37% phosphoric acid and left unprimed (control) or was primed with 5-NMSA. Clearfil Photobond (Kuraray Co., Japan) was placed and light-cured, a layer of Protect Liner (Kuraray Co.) was applied, cured, then covered with Photo Clearfil Bright (Kurary Co.) resin composite and cured. Bonds were stressed in tension to failure at 1 d, 1 mon, 3 mon, 6 mon, 1 y and 3 y after preparation. Ten specimens were made for each group. Results were analyzed using one-way ANOVA and Duncan's multiple range test. Visual and SEM observations determined mode of failure and were analyzed using the Mann-Whitney U-test. Separate 1 d and 3 y specimens were fractured across the bonded interface and observed using a Field Emission SEM. After observation, the photomicrographs were compared for visual qualitative changes between the two time periods. RESULTS: The control (non-primed) group showed only a small decrease in bond strengths over 3 y, but in the primed group, a significant decrease was observed (p < 0.05). The bond strength of the non-primed group (5.2 MPa) was less than the primed group (10.6 MPa) at 1 d (p < 0.01), but by 3 y, the bonds of both groups were similar, 4.3 MPa and 5.5 MPa, respectively. Fractography indicated that only adhesive failure occurred in the control group. Failure in the primed group was cohesive in dentin initially, but shifted to the base or top of the hybrid layer after 1 y. Field Emission SEM observations showed hybrid layer formation in the primed group, but minimal resin infiltration in the control group. SIGNIFICANCE: Initially greater bond strengths were obtained for the primed group compared to the unprimed group (p < 0.01). However, by 3 y, the bond strength had decreased markedly in the primed group (p < 0.01), being almost the same for both groups. It was concluded that priming may only be useful to achieve strong bonding in the short term. These results may have significant implications related to clinical longevity of restorations.

Analysis of Variance↗

Effect of removal of surface collagen fibrils on resin-dentin bonding.

OBJECTIVES: The aim of this study was to evaluate the effects of NaOCl at removing the demineralized layer by examining the morphology of the hybrid layer and measuring shear bond strengths after different dentin treatments. METHODS: Dentin disks were treated with: (1) 35% phosphoric acid (PA) 20 s; (2) PA treatment followed by 1.5% NaOCl, 2 min; (3) PA treatment, followed by a 10% NaOCl immersion for 120 h. SEM was used to analyze the morphology of dentin and its interface with dentin bonding agents (DBAs), while shear bond strength tests were used to measure adhesion. All specimens were then fractured into two halves: One half was inspected under SEM; the other half was sequentially placed in 10% PA followed by 12.5% NaOCl for 70 h, to remove all dentin from the resin replica of the original bonded interface. RESULTS: SEM observations showed that collagen fibrils were completely removed from the acid-etched surface by NaOCl treatment. The diameter and the size of dentinal tubules and the number of lateral branches of the tubules were increased following NaOCl treatment. NaOCl applied on dentin smear layers did not significantly modify their SEM morphology. Resin tags were larger in diameter after phosphoric acid/NaOCl treatment than after only phosphoric acid treatment. Resin-infiltrated dentin-layers were only observed after the single phosphoric acid (i.e. conventional etching) procedure, and were not observed after combined phosphoric acid/NaOCl treatment. Etched/NaOCl samples showed a lower bond strength using Scotchbond MP and 3M Single Bond, but were higher in Optibond FL and unmodified in Prime & Bond 2.0 groups when compared with acid-etched controls. Treatment of etched dentin with NaOCl for 120 h produced an unusual type of resin infiltration of mineralized dentin that could be called a "reverse hybrid layer" which may explain the mechanism of resin bonding to NaOCl treated dentin. SIGNIFICANCE: The use of acidic conditioners for exposure of the collagen matrix exposes a soft delicate mesh that can collapse, thereby interfering with resin infiltration. If acid-etching is followed by NaOCl treatment, high bond strengths can be achieved via "reverse hybrid layer" formation, a proposed new mechanism of micromechanical resin retention. This mechanism is not yet recommended for clinical use but demonstrates a new type of resin retention.

Adolescent↗

Association between microtensile bond strength and leakage in the indirect resin composite/dentin adhesively bonded joint.

PURPOSE: Develop a methodology to correlate microtensile bond strength (microTBS) and leakage within the same site of a specimen and evaluate the predominate debond and leakage pathways. MATERIALS AND METHODS: A Class II (MO) slot cavity was prepared in 37 extracted human molars and restored with indirect resin composite restorations. The restored teeth were thermocycled 300X between 5 and 55 degrees C and then stained with silver. Two specimens per tooth were obtained by diamond saw sectioning for measurement of leakage (microm) and microtensile bond strength (MPa) at the gingival wall and then tested for association with regression analysis. Scanning electron microscopy techniques and energy dispersive spectroscopy (EDS) were used to evaluate the debond and leakage pathways. RESULTS: Association between leakage and bond strength was not significant (t=1.31, p=0.198). All 74 samples debonded within the joint, predominantly at the hybrid layer-adhesive resin region with only one specimen including a small portion of resin cement in the debond pathway. Secondary and backscatter imaging and EDS analysis showed leakage in all samples that involved the hybrid layer. CONCLUSION: This study demonstrates a feasible method for evaluating leakage and bond strength at the joint interface within the same specimen.

Composite Resins↗

A morphological and tensile bond strength evaluation of an unfilled adhesive with low-viscosity composites and a filled adhesive in one and two coats.

OBJECTIVE: The purpose of this study was to measure the tensile bond strength (TBS) testing of resin composite to dentin of three low-viscosity composites, in association with an unfilled adhesive, and a filled adhesive one and two coats respectively, and to evaluate and compare the SEM morphological observations. METHODS: The labial surface of 120 bovine lower incisors were ground to obtain a flat dentin surface allowing demarcation of a 4 mm diameter area with adhesive tape. The teeth were randomly divided in six groups of 20 each. The dentin of each ground surface was etched with 35% H(3)PO(4) for 15s, followed by application of the respective adhesive: Single Bond (SB) for Groups 1, 2, 3 and 6; Optibond Solo (OS) for Groups 4 and 5. In Groups 1 and 4, a resin composite rod with a wire loop was luted directly to the adhesive surface with Z100. Group 2 received an intermediate layer of Flow It (FI) composite; Group 3 received an intermediate layer of Protect Liner F (PLF) composite; Group 5 received a second coat of OS; and Group 6 received an intermediate layer of an experimental low-viscosity composite (EM). A resin composite rod was luted to the surface of each specimen with Z100 resin composite. All specimens were stored in distilled water at 37 degrees C for 24h prior to TBS testing. Each specimen was inspected by SEM and classified according to adhesive or cohesive failure mode. One specimen of each group was cut longitudinally, polished and prepared for SEM observation. RESULTS: The TBS values were: Group 1 (7.86MPa+/-2.28), Group 2 (7.62MPa+/-1.85), Group 3 (7.60MPa+/-2.14), Group 4 (7.96MPa+/-2.36), Group 5 (7.50MPa+/-2.70) and Group 6 (7.18MPa+/-2.40). No significant statistical differences were observed among the groups. However, the analyses of the failure mode presented a considerable variation. SIGNIFICANCE: The use of a filled adhesive or an unfilled adhesive along with a low-viscosity composite as an intermediate layer may provide a stress absorbing layer, whereby improving the preservation of the bonded interface area.

Adhesives↗

Effects of one versus two applications of an unfilled, all-in-one adhesive on dentine bonding.

OBJECTIVES: This study examined the null hypothesis that there is no difference between the effect of a one versus two-layer applications of Prompt L-Pop (3M ESPE, Seefeld, Germany) to sound, abraded human coronal dentine. METHODS: In group I, the mixed adhesive was applied for 15s, and light-cured for 10s. In group II, after light-curing the first layer, the adhesive was re-applied and light-cured. Specimens bonded with a hybrid composite were sectioned into beams for microtensile bond strength evaluation. Additional teeth from each group were bonded similarly using a lining composite for transmission electron microscopy examination of the resin-dentine interfaces, and nanoleakage evaluation using ammoniacal silver nitrate. RESULTS: A significant difference (p<0.001) was detected between microtensile bond strengths in the two groups. Stained, demineralized sections revealed 3-5 microm thick hybrid layers in both groups. An electron-lucent layer between 7 and 20 microm thick was present between the adhesive and the overlying composite. This layer was absent from the interfaces after removal with ethanol before composite placement. The use of a single application in group I resulted in the direct contact of the electron-lucent layer with the dentine surface and tubular orifices. In unstained, undemineralized sections used to evaluate nanoleakage, silver deposits were found mostly in the hybrid layer in group II, but throughout the entire adhesive layer in group I. CONCLUSION: Bonding of this unfilled all-in-one adhesive to dentine may be improved by application of a second adhesive layer after light-curing the first layer. This ensures that the exposed dentine surface and dentinal tubules are coated with adhesive that is adequately polymerized.

Composite Resins↗