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PubMed1999

Dentin bonding--state of the art 1999.

The adhesion of restorative materials to the hard components of tooth structure has been a goal pursued by many researchers ever since Buonocore established the foundation for adhesive and preventive dentistry. Based on the industrial use of phosphoric acid to obtain better adhesion of paints and resin coatings to metal surfaces, Buonocore proposed that phosphoric acid could be used to transform the surface of enamel to "render it more receptive to adhesion." Subsequent research indicated that the formation of taglike resin prolongations into the enamel microporosities was the leading bonding mechanism of resin to phosphoric acid-etched enamel. The enamel bonding agents of the 1960s and 1970s progressively evolved into complex multibottle or universal adhesives in the early 1990s, which were designed to bond to enamel, dentin, composite, amalgam, porcelain, and non-precious metal. Although bonding to enamel has been a dependable technique, bonding to dentin still represents an overwhelming task because dentin is a naturally wet organic tissue penetrated by a tubular maze containing the odontoblastic process, which communicates with the pulp. This intrinsic moisture may actually benefit the chemistry of the newest adhesive systems, which must be applied on moist dentin to be effective. In fact, the collapse of the collagen that occurs on air-drying may prevent the adhesive monomers from penetrating the network of nano-channels formed by the dissolution of hydroxyapatite crystals between collagen fibrils. In view of the complexity of the mechanisms associated with these mechanisms, the objective of this review article is to summarize the most recent concepts in dentin bonding.

Acid Etching, Dental↗
PubMed2001

Fractographical analysis of resin-dentin bonds.

PURPOSE: To characterize resin-dentin bond structures of three adhesive resin systems using fractographic analysis to measure the area of failure at the fractured surface. MATERIALS AND METHODS: Flat dentin surfaces were ground perpendicular to the long axis of the tooth. The prepared dentin surfaces were treated by one of three adhesive resin systems (Mac Bond II, One-Step, and Single Bond). The samples were sectioned perpendicular to the adhesive interface to produce a square bar-shaped specimen (adhesive area: 0.9 mm2) using a diamond saw. A micro-tensile test was then conducted at a crosshead speed of 1.0 mm/min. The mean tensile bond strengths were statistically compared using one-way ANOVA and Fisher's PLSD test (P< 0.05). The fractured surfaces of all specimens were examined using SEM and the area of failure was measured using an image analyzer on SEM microphotographs. RESULTS: No significant differences in tensile bond strength were observed between Single Bond (62.1+/-18.2 MPa) and One-Step (53.8+/-13.1 MPa) (P > 0.05). However, the bond strength of Mac Bond II (36.5+/-13.7 MPa) was significantly lower than that of One-Step or Single Bond (P< 0.05). At the fractured surface, except for the cohesive failure of the bonding resin and resin-based composite, different failure patterns were observed for each resin system as follows: the failure of the hybrid layer and demineralized dentin was observed in the two wet bonding systems (One-Step and Single Bond) and of the hybrid layer but not the demineralized dentin in the self-etching primer system (Mac Bond II). The results demonstrated that the integrity of the hybrid layer depends on the adhesive system.

Analysis of Variance↗
PubMed2003

Effect of ultrasonic vibration on dentin bond strength and resin infiltration.

PURPOSE: To apply a vibration technique to compare the bond strength and resin penetration depth into the dentin tubules with those gained using conventional techniques. METHODS: Eighty-eight noncarious extracted human permanent molar teeth were sectioned to remove the coronal enamel. They were embedded in a 1-inch PVC pipe with an acrylic resin. The occlusal surfaces were placed so that the tooth and the embedding medium were at the same level to form a single flat surface. The samples were subsequently polished with silicon carbide abrasive papers, and randomly assigned to four groups (n=22). In Groups 1 and 2, Single Bond was used, and in Groups 3 and 4, One-Step was used. Each adhesive system was applied according to its manufacturer's instructions. For Groups 2 and 4, vibration was applied with an ultrasonic scaler for 10 seconds, and the adhesive was light-cured for 10 seconds. The resin composite was condensed onto the prepared surface in two increments using a Teflon mold and each increment was light-cured for 40 seconds. After 24 hours soaking in tap water at room temperature, the specimens were thermocycled, and the shear bond strengths were measured using a universal testing machine. One-way ANOVA test followed by Student-Newman-Keuls test (P < 0.05) were used to analyze the results. To investigate the infiltration patterns of the adhesive materials, the surface of the specimens was examined with electron microscopy. RESULTS: The shear bond strengths of the vibration groups (Groups 2, 4) were significantly higher than those of the non-vibration groups (Groups 1, 3). The shear bond strengths of Single Bond and One-Step were not significantly different. The vibration groups showed greater numbers of resin tags in the tubules and lateral branches under SEM than the non-vibration groups.

Analysis of Variance↗
PubMed1997

Effect of NSAID administration on tissue levels of immunoreactive prostaglandin E2, leukotriene B4, and (S)-flurbiprofen following extraction of impacted third molars.

Post-operative pain and inflammation are frequently managed with non-steroidal anti-inflammatory drugs (NSAIDs). Despite the prevalence of their use, however, relatively little is known about in vivo tissue concentrations of inflammatory mediators at the site of tissue injury and their modulation by NSAIDs. This study compares the effect of oral administration of the NSAID flurbiprofen, to placebo, on tissue levels of immunoreactive prostaglandin E2 (iPGE2), leukotriene B4 (iLTB4), and (S)-flurbiprofen within the surgical wound using implanted microdialysis probes in the dental impaction pain model. Twenty-four healthy patients in need of extraction of partial to complete bony mandibular third molars were recruited for this randomized, double-blind, placebo-controlled study. Following pre-operative administration of N2O/O2, midazolam i.v., and regional block anesthesia with 3% mepivacaine, each patient underwent surgical removal of their impacted third molars. Immediately following completion of the surgery, two semi-permeable microdialysis probes (3 kDa molecular weight cut-off) were implanted into each mandibular surgical site. Patients were taken to a recovery room and microdialysis samples and patient pain reports (visual analog scale, VAS) were collected at 30 min intervals for 4 h. Patients randomly received either flurbiprofen (200 mg orally) or placebo at the onset of post-operative pain. Dialysate samples were collected, frozen, and later assayed for iPGE2, iLTB4, and (S)-flurbiprofen levels. Results of this study show that flurbiprofen decreased post-operative pain by approximately 70% compared to placebo-treated patients (P < 0.001). During the 4 h post-operative timecourse of this study, flurbiprofen treatment significantly reduced peak tissue levels of iPGE2 (9.2 +/- 2.6 vs. 0.4 +/- 0.15 nM; P < 0.001), without having a significant effect on peak tissue levels of iLTB4 (2.5 +/- 1.4 vs. 1.49 +/- 0.86 nM) compared to placebo treatment. Levels of (S)-flurbiprofen significantly increased within the surgical wound exceeding therapeutic levels by 60 min after administration. Flurbiprofen is able to significantly suppress the local production of iPGE2 and provide significant analgesic efficacy without altering iLTB4 tissue levels in this model of acute post-operative inflammatory pain. These data indicate that NSAIDs selectively alter eicosanoid levels within surgical wound and evoke analgesia at time points coincident with elevated wound levels of the drug. The combined use of microdialysis probes in awake patients who provide simultaneous pain reports may offer insight into peripheral mechanisms of inflammatory mediator release and pain.

Adolescent↗
PubMed2004

Effect of brushing on fluoride release from 3 bracket adhesives.

The purpose of this in vitro study was to compare fluoride ion release from 3 orthodontic bracket adhesives with and without brushing the bracketed teeth with a fluoridated dentifrice. The bracket adhesives included a light-cured composite resin (Transbond; 3M Unitek, Monrovia, Calif), a fluoride-releasing composite resin (Advance; L D Caulk Division, Dentsply International, Milford, Del), and a resin-modified glass ionomer (Fuji Ortho LC; GC America, Alsip, Ill). The teeth in the control group were not bonded with brackets. Sixty extracted human teeth were randomly assigned to 6 groups of 10 each: (1) Transbond, brushed; (2) Advance, brushed; (3) Advance, not brushed; (4) Fuji, brushed; (5) Fuji, not brushed; and (6) control, brushed. After bonding, each tooth was placed in a sealed plastic test tube containing 4 ml of deionized water. The toothpaste used in brushing contained 0.15% weight per volume sodium fluoride, 1500 parts per million parts fluoride (Winter-fresh gel; Colgate-Palmolive Co., New York, NY). Brushing began 24 hours after the teeth were bonded and placed in deionized water. After brushing, the teeth were thoroughly rinsed with deionized water and returned to a sealed test tube. Fluoride measurements were taken before brushing began, at intervals of 72 hours for 22 days, and 90 and 93 days after bonding. Findings included: (1) brushing significantly increased the release of fluoride ions from the teeth in the composite resin and control groups, (2) the enamel crowns of the unbonded control teeth absorbed and re-released a substantial amount of fluoride ions obtained from the toothpaste, (3) the brushed group of teeth bonded with the fluoride-releasing composite resin released significantly more fluoride on the last 4 days that measurements were taken after brushing than the nonbrushed group bonded with the same adhesive, (4) the brushed group of teeth bonded with the resin-modified glass ionomer released significantly more fluoride on the last 4 days that measurements were taken after brushing than the nonbrushed group bonded with the same adhesive, and (5) all groups released small amounts of fluoride ions 90 and 93 days after bonding (68.5 and 71.5 days after brushing ended); the resin-modified glass ionomer groups released significantly more fluoride than the other groups. Brushing with fluoridated toothpaste produced significantly greater fluoride release from teeth bonded with all 3 adhesives, and from the unbonded control teeth.

Acrylic Resins↗
PubMed2003

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↗
PubMed2001

Microtensile bond strength and confocal microscopy of dental adhesives bonded to root canal dentin.

PURPOSE: To evaluate the bond strength of two dentin-bonding systems to root canal dentin. MATERIALS AND METHODS: Six central incisors, extracted for periodontal reasons, were endodontically treated, no obturation of the root canal space was performed. The teeth were cut parallel to their long axis. One half of each tooth was randomly assigned to one of two experimental groups. The teeth of the first group were treated with All-Bond 2 dental adhesive and those of the second group with Panavia F. The root canal dentin was conditioned as suggested by the manufacturers and, after the application of the dental adhesives, a layer of resin-based composite was polymerized over the adhesive layer. After the composite had completely set, the sections were prepared for microtensile test and kept in a wet environment at a relative humidity of 90 +/- 2% measured with a digital relative humidity meter and at a temperature of 22 degrees C for 24 hrs. The specimens were sectioned perpendicularly to the bonded interface, into slabs 1.5 mm thick (10 sections for each experimental group). The slabs were then trimmed by super fine diamond burs for the microtensile bond test with the narrowest region located at the respective bonded interface. The thickness of the slab was then exactly established by three measurements performed in three points of each slab by a digital micrometer. The specimens were then subjected to a tensile force at a crosshead speed of 0.2 mm/min. The test was observed using a confocal microscope and the failure modes were noted. The load at failure was registered and the bonded area was measured using a confocal microscope at a magnification of x25 in conjunction with an image-processing program. The failure data were analyzed using the Wilcoxon-Gehan test with exact non-parametric inference. RESULTS: The mean value at failure was the same for the two experimental groups (17.1 MPa). There was no statistically significant difference between Panavia F and All-Bond 2 (P> 0.8671). Most of the specimens showed a debonding of the adhesive from the hybrid layer. The results showed that the bond strength of the two bonding systems tested to the dentin of the root canal are slightly lower than to those obtained with the latest adhesive systems, in the coronal dentin.

Composite Resins↗
PubMedDate not supplied

Effect of dentin primer on shear bond strength of composite resin to moist and dry enamel.

The etched enamel-composite resin bond is the most reliable bond known to us. Moisture and dentin primers are the two most important variables that can interfere with this bond. This study investigated the effect of dentin primer on bond strengths of composite resin to moist and dry enamel. One hundred freshly extracted molar teeth were used for shear bond strength testing. The teeth were mounted in phenolic rings with an approximal enamel surface exposed. The exposed enamel surface on each tooth was flattened using 320- 400- and 600-grit silicon carbide papers and etched using 34-38% phosphoric acid gel. The teeth were then divided into 10 groups (n = 10). Four groups were assigned to each of the two dentin bonding systems, Scotchbond Multi-Purpose and OptiBond FL. Two groups were assigned to the single-bottle bonding agent (Single Bond). Each bonding system was tested on moist and dry enamel. OptiBond FL and Scotchbond MP were tested with and without the use of primer. All samples were thermocycled and tested in shear. Fracture analysis was performed using a binocular microscope. For scanning electron microscopy, approximal samples of enamel (1 mm thick) were flattened, etched, and bonded with and without primer on moist and dry enamel. A 1 mm-thick layer of Z100 was bonded to the specimens, which were then immersed in 10% HCl for 24 hours to dissolve the enamel. The specimens were viewed under a scanning electron microscope. Results indicated that the use of primer on dry enamel did not significantly affect (P > 0.05) shear bond strengths for the two bonding systems, Scotchbond MP (primed 24.10 +/- 4.83 MPa, unprimed 29.57 +/- 7.49 MPa) and OptiBond FL (primed 26.82 +/- 4.44, unprimed 25.66 +/- 2.95). However, the use of primer was found to be essential on moist enamel to obtain acceptable bond strengths with both Scotchbond MP (primed 25.61 +/- 10.29 MPa, unprimed 3.26 +/- 0.95 MPa) and OptiBond FL (primed 30.28 +/- 3.49 MPa, unprimed 8.37 +/- 3.31 MPa). Moisture on enamel did not significantly affect (P > 0.05) bond strengths for the single-bottle bonding agent, Single Bond (moist enamel 31.34 +/- 9.03 MPa, dry enamel 27.93 +/- 5.41 MPa). Fracture analysis revealed that most fractures were adhesive or mixed, with a greater percentage being cohesive for the groups with dry enamel or with primer on moist enamel. Scanning electron micrographs corroborated the shear bond strength data. The specimens without primer on moist enamel showed very poor penetration of adhesive and composite resin into the etched enamel microporosities.

Analysis of Variance↗