Journal of Adhesive Dentistry最新文献

Purpose: To investigate whether interfacial enzymatic activity and adhesion receptiveness of artificial caries-affected dentin (ACAD) simulate those of natural caries-affected dentin (NCAD).

Materials and methods: Thirty dentin specimens were prepared from human molars to determine interfacial gelatinolytic activity using in situ zymography and adhesion experiments (micropermeability and bond strength [µTBS]). Groups were formed according to the type of dentin: artificial caries-affected dentin (ACAD), natural caries-affected dentin (NCAD), or sound dentin. ACAD was produced by incubating dentin with Streptococcus mutans in a chemically defined medium (CDM) with 1% sucrose for 7 days at 37°C under anaerobic conditions. CDM was replaced daily, and the sterility as well as the pH of the culture was monitored. Adhesion experiments employed Single Bond Universal (3M Oral Care) in self-etch mode. Data were individually processed and analyzed using ANOVA and post-hoc tests (α = 0.05).

Results: The enzymatic activity of ACAD was similar to that of sound dentin, but was lower than that of NCAD, which elicited the highest activity (p < 0.05). Interfacial micropermeability intensity at the hybrid layer or in underlying dentin (5 µm below the interface) was similar in all types of dentin (p > 0.05). On the other hand, substrate permeability was higher for NCAD than for ACAD. The highest sealing ability was detected in sound dentin. Bond strengths to ACAD were higher than to NCAD. However, the highest µTBS was observed in sound dentin (p < 0.05).

Conclusion: Artificial caries-affected dentin simulated neither the gelatinolytic activity nor bonding receptiveness of natural caries-affected dentin.

Purpose: This randomized, split-mouth clinical study evaluated the marginal quality of direct class-I and class-II restorations made of microhybrid composite that were applied using two polymerization protocols and two marginal evaluation criteria.

Materials and methods: A total of 50 patients (mean age: 33 years) received 100 direct class-I or class-II restorations in premolars or molars. Three calibrated operators made the restorations. After conditioning the tooth with 2-step etch-and-rinse adhesive, restorations were made incrementally using microhybrid composite. Each layer was polymerized using a polymerization device operated either in regular mode (600-650 mW/cm2 for 20 s) (RM) or high-power (1200-1300 mW/cm2 for 10 s) mode (HPM). Two independent, calibrated operators evaluated the restorations 1 week (baseline) and 6 months after restoration placement, and thereafter annually up to 10 years using modified USPHS and SQUACE criteria. Data were analyzed using the Mann-Whitney U-test (α = 0.05).

Results: Alpha scores (USPHS) for marginal adaptation (76% and 74% for RM and HPM, respectively) and marginal discoloration (70% and 72%, for RM and HPM, respectively) did not show significant differences between the two polymerization protocols (p > 0.05). Alpha scores (SQUACE) for marginal adaptation (78% and 74% for RM and HPM, respectively) and marginal discoloration (70% for both RM and HPM) were also not significantly different at the 10-year year follow-up (p > 0.05).

Conclusion: Regular and high-power polymerization protocols had no influence on the stability of marginal quality of the microhybrid composite tested up to 10 years. Both modified USPHS and SQUACE criteria confirmed that regardless of the polymerization mode, marginal quality of the restorations deteriorated significantly compared to baseline (p < 0.05).

Purpose: To assess the effect of the application of different electric currents on dentin bonding and resin infiltration of self-etching and etch-and-rinse adhesives.

Materials and methods: Two hundred four sound third molars were selected and divided in groups according to the adhesive (self-etch [CSE, Clearfil SE Bond, Kuraray Noritake], universal [SBU, Single Bond Universal, 3M Oral Care], and etch-and-rinse [SB2, Adper Single Bond 2 (SB2), 3M Oral Care]) and electrical current used (0, 5, 10, 15, 20, 25, 30, and 35 μA). Light curing was performed for 10 s with an LED-curing unit at 1000 mW/cm2. Composite blocks were constructed of nanofilled composite in increments of 2 mm, which were light cured for 20 s. Specimens were sectioned into sticks with a cross-sectional area of ~1 mm2 and stored in distilled water at 37°C for 24 h. Microtensile bond strength (μTBS) testing (n = 8) was performed using a universal testing machine at a crosshead speed of 0.5 mm/min until failure. The bonding quality (n = 2) of adhesives applied with or without 35-μA electric current was evaluated using confocal laser scanning microscopy. Bond strengths were analyzed with two-way ANOVA and Tukey's test (α = 0.05).

Results: CSE presented the highest μTBS for all electrical currents tested. For CSE and SBU, electrical currents from 0-20 μA showed the lowest μTBS. Electrical currents from 0-10 and 20-25 μA yielded the lowest μTBS for SB2. CSE and SB2 applied under 35 μA showed a greater number of resin tags in dentin tubules. Fluorescein penetration into the hybrid layer was found for SBU applied without electric current.

Conclusion: The application of adhesives using 35-μA electric current improved the bond strength and quality of the adhesive interface.

Purpose: To use shear bond strength (SBS) and shear fatigue strength (SFS) testing to determine the durability of adhesion of self-adhesive restorative materials compared to composite resin bonded with a universal adhesive.

Materials and methods: A universal adhesive, Prime & Bond Active, was used in self-etch mode to bond Z-100 composite resin to enamel and dentin. Three commercially available restorative materials and one experimental material with self-adhesive properties, Activa (A), Fuji II LC(F), and Equia Forte (E) and ASAR-MP4 (S) were also bonded to enamel and dentin. The SBS and SFS were determined for all materials. A staircase method was used to determine the SFS with 10 Hz frequency for 50,000 cycles or until failure occurred.

Results: On enamel, S generated similar values to the adhesive/composite materials and higher values than F, E, and A. On dentin, the composite/universal adhesive showed significantly higher SBS and SFS than the self-adhesive materials. S, F, and E generated higher values than A on dentin.

Conclusion: SBS and SFS values to enamel were similar for all materials tested except Activa which generated lower enamel values. On dentin surfaces, the self-adhesive materials generated similar SBS and SFS, with the exception of Activa. Those values were lower than that generated with composite resin and a universal adhesive.

Purpose: The management of complicated crown-root fractures is challenging for endodontic restoration. The present case describes a patient who sustained trauma to the maxillary right central incisor.

Materials and methods: Clinical and radiographic examination showed a complicated crown-root fracture and incomplete root development with periapical radiolucency and inadequate endodontic treatment with overfilling. Orthograde retreatment with MTA apical closure combined with a microsurgical approach to remove of extruded material was performed. Coronal sealing was accomplished with a direct adhesive restoration and marginal relocation.

Results: A 5-year follow-up showed complete healing of the periapical lesion and correct preservation of function and esthetic parameters.

Conclusion: A modern minimally invasive treatment protocol allows the maximum conservation of residual dental tissues.

Purpose: This study evaluated the effect of an aromatic silane compound and acidic functional monomer on the bond strength of fused quartz. Materials and Methods: A total of 264 disk specimens were fabricated from fused quartz for shear bond testing. Two silane compounds were used: 3-(trimethoxysilyl)propyl methacrylate (3-TMSPMA) and 3-(4-methacryloyloxyphenyl) propyltrimethoxysilane (3-MPPTS). As acidic functional monomers, 4-methacryloyloxyethyl trimellitate (4-MET) and 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were used. The disks were primed with one of each silane compound with or without the acidic functional monomer of the same molarity. The specimens were bonded with a tri-n-butylborane (TBB) initiated luting material. The shear bond strength was determined before and after 10,000 thermocycles. Bond strength was statistically evaluated with Kruskal-Wallis, Mann-Whitney U-, and Steel- Dwass tests. To test dye penetration, the specimens were immersed in 0.5 wt% fuchsin solution for 24 h after priming with each condition, bonding, and 10,000 thermocycles. The dye penetration area was determined by observing the backside of the bonded specimen with an optical microscope. The relationship between the shear bond strength and dye penetration ratio was analyzed with Spearman’s rank correlation test. Results: The highest post-thermocycling bond strengths in the 1 mol% and 2 mol% groups were 3-TMSPMA + 10- MDP and 3-MPPTS + 10-MDP. Spearman’s rank correlation coefficient between shear bond strength and dye penetration area was γ = -0.7519, indicating a strong negative correlation. Conclusion: The surface treatments of 3-TMSPMA and 3-MPPTS combined with 10-MDP yielded higher bond strength after 10,000 thermocycles than those combined with 4-MET, despite the similarity in molarity. The shear bond strength was negatively correlated with the dye penetration area.

Purpose: The purpose of this multicenter study was to evaluate the survival and quality outcome of direct composite buildups in the anterior dentition based on representative sample sizes. Materials and Methods: At three university clinics in Germany, the survival and quality outcome of n = 667 direct composite buildups performed between 2001 and 2012 was evaluated in n = 198 participants. Survival outcomes were categorized as failure (F), survival (SR), or successful (S). Restorations still in place and without failure prior to follow-up (n = 567) were rated using modified USPHS/FDI criteria to obtain the quality outcome. Detailed failure analysis was done by means of Cox regression models. Results: The restricted mean for overall survival was 15.5 years. N = 576 restorations were classified as successful (S), n = 81 survived with repair (SR) and n = 8 failed (F). Two restorations were removed due to iatrogenic interventions. Overall survival rates after 2, 10, and 15 years were 98.8% (CI: 97.6 and 99.4), 91.7% (CI: 89.0 and 93.8), and 77.6% (CI: 72.2 and 82.2), respectively. Functional survival rates were 100.0%, 98.9% (CI: 97.5 and 99.5), and 98.5% (CI: 96.7 and 99.3), respectively. Clinical quality was rated as excellent or good for most restorations. The dominant failure mode was chipping; however, regression analysis did not detect any influence of the evaluated parameters “enlargement range,” “position in the jaw,” or “tooth type” on failure. Conclusion: This multicenter study represents the first of its type including clinical survival and quality data on 576 direct anterior composite buildups over a restricted mean follow-up of 15.5 years in a relatively large group of participants. In particular, functional survival was outstanding due to the clinical reliability of this treatment option, while simultaneously providing flexibility, reparability, and minimal invasiveness.

Purpose: To evaluate 1. the microtensile bond strength (µTBS) and in situ degree of conversion (DC) of adhesives applied using two bonding strategies after silver diamine fluoride (diamine) application on carious dentinal lesions, and 2. dentin etching patterns using SEM and energy dispersive x-ray spectroscopy.

Materials and methods: Human molars were randomly divided into 12 experimental groups according to: 1. application of a silver diamine fluoride solution (carious dentinal lesion without silver diamine fluoride treatment [control], with 12% silver diamine fluoride [diamine 12%] or 38% silver diamine fluoride [diamine 38%]); 2. adhesives (Clearfil Universal Bond Quick [CUQ] and Scotchbond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to µTBS testing. Sticks from each tooth were used for DC evaluation. To examine the changes induced by diamine before and after phosphoric acid treatment, SEM/EDX analysis was performed. Data from the µTBS and DC tests were analyzed using three-way ANOVA and Tukey's test (α = 0.05).

Results: Both concentrations of diamine resulted in a statistically significantly higher mean µTBS compared to the control (p < 0.0001). Diamine 38% showed a statistically significantly higher mean µTBS for both adhesives in SE mode compared to diamine 12% (p < 0.0001). The application of diamine to carious dentinal lesions did not significantly influence the mean DC values for either adhesive (p = 0.72). SBU showed a higher mean DC compared to CUQ (p = 0.03). After diamine treatment, there was an increase in the Ca peak intensity and the presence of residual silver ions mainly when diamine 38% was applied along with the SE approach.

Conclusion: Independent of the adhesive application approach, the use of diamine may be a promising alternative to increase µTBS without jeopardizing the DC of the two adhesives in carious dentinal lesions.

Purpose: To determine the effect of Weibull analysis with censoring of cohesive failures on the evaluation of the effect of surface treatment and adhesive on the microtensile composite-composite bond strength.

Materials and methods: Surfaces of Filtek Z250 (3M Oral Care) specimens aged in distilled water for five months at 37°C were ground with SiC paper P320 or air abraded with Al2O3 and built up with the same composite using Optibond FL (OPF, Kerr), Clearfil SE Bond (CSE, Kuraray Noritake) and Gluma Comfort Bond (GLU, Kulzer) adhesives. After sectioning and trimming, the specimens were stored at 37°C in distilled water for 24 h and then tested in a microtensile bond strength setup. Complete datasets of all strength data and adhesive datasets containing adhesively failed specimens were analyzed with a one-way Welch ANOVA at α = 0.05 and compared with the results of Weibull analysis applied on complete and adhesive datasets as well as complete datasets right censored for cohesive failures. Weibull shape (m) and scale (σo) parameters were estimated using the maximum likelihood method and used to calculate bond strength (σ0.10) at 10% probability of failure as a measure of system performance. The surface morphology was studied using light and scanning electron microscopy.

Results: While ANOVA indicated a significant effect of surface treatment and non-significant effect of the adhesive, the Weibull analysis results depended on bond strength characteristics and censoring. The scale parameter of the complete dataset indicating a significant effect of surface treatment for all adhesives became statistically non-significant for CSE after censoring. When this effect was evaluated by σ0.10, the non-significant effect of surface treatment for OPF and GLU became statistically significant due to censoring. The effect of the adhesive evaluated by the scale parameter was non-significant both for surfaces as well as complete and censored datasets. On the other hand, s0.10 suggested significant differences between adhesives on the ground surface for complete datasets which became statistically non-significant for the censored datasets.

Conclusion: This study indicates that the results of statistical evaluation of bond strength can be affected not only by the experimental set-up and statistical model but also the bond strength characteristics and the manner in which the strengths of cohesively failed specimens are included in calculations.

Purpose: To evaluate interfacial gap and fracture resistance of endodontically treated maxillary premolars, restored with different glass-fiber reinforced materials.

Materials and methods: Eighty-four extracted intact premolars were endodontically treated and MOD cavities prepared. Specimens were divided into 7 groups (n = 12 for each) as follows: sound teeth (G1); no restoration (G2); direct composite restoration with fiber-reinforced composite (everX Posterior GC) (G3); direct composite restoration (Filtek Supreme XTE, 3M Oral Care; "FSXTE") (G4); a horizontal layer of high-viscosity flowable composite (G-ænial Flow, GC) was placed on the pulp chamber floor, 10 mm x 3 mm glass fibers (everStick NET, GC) were inserted into the cavity (G5); same procedure as in group 5 except the direct restoration was made incrementally with FSXTE (3M Oral Care) (G6); composite overlays were placed (G7). Specimens were scanned with micro-CT to evaluate 3D interfacial gaps before and after chewing simulation using Mimics software to calculate voids between restoration and tooth (dentin and enamel). These data (in mm3) were collected for statistical analysis. Thereafter, specimens were loaded to fracture using a universal testing machine. Maximum breaking loads were recorded in Newton (N). The data obtained were analyzed using two-way ANOVA and post-hoc Tukey's test (p < 0.05).

Results: ANOVA showed that horizontal glass-fiber insertions statistically significantly reduced interfacial gaps after chewing simulation. No differences in fracture resistance were found between Filtek Supreme XTE and everX Posterior; moreover, glass-fiber insertion did not significantly improve fracture resistance in either case. Composite overlays achieved significantly better fracture toughness than did direct restorations.

Conclusions: For the direct restoration of endodontically treated premolars, the insertion of glass fibers into direct composite restorations was unable to guarantee a significant increase in the fracture resistance or a significant change in the fracture pattern. However, it significantly reduced interfacial gap volume after cycling fatigue.