Journal of Adhesive Dentistry最新文献

Purpose: To evaluate push-out bond strength (PBS) and interfacial nanoleakage (NL) of adhesively luted fiber posts using different composite cements and polymerization protocols.

Material and methods: 100 premolars were endodontically treated and assigned to the following groups (n=10): RelyX Universal light-cure (3M Oral Care); RelyX Universal self-cure (3M Oral Care); Maxcem Elite Chroma light-cure (Kerr); Maxcem Elite Chroma self-cure (Kerr); Calibra Universal light-cure (Dentsply Sirona); Calibra Universal self-cure (Dentsply Sirona); Multilink Automix light cure (Ivoclar Vivadent); Multilink Automix self-cure (Ivoclar Vivadent); Luxacore Z Dual light-cure (DMG); Luxacore Z Dual self-cure (DMG). Half of the teeth from each group were subjected to the PBS test after 24 h (T0), while the other half was tested after 12 months (T12) of artificial saliva aging. An additional 4 teeth per group were prepared for NL expression. PBS values were analyzed using multivariate ANOVA and Tukey's post-hoc test. NL scores were analyzed using chi-squared tests (α = 0.05).

Results: Statistical analysis revealed that the variables "cement" and "aging" significantly influenced PBS (p < 0.05), but not "polymerization" and "root region" (p > 0.05). Significantly lower PBS values (p < 0.05) were detected for the Calibra Universal groups compared to other cements, while the RelyX Universal groups performed equally well (p > 0.05) or better than other cements (p < 0.05). At T12, PBS values increased in the majority of groups, irrespective of root region (p < 0.05). Differences in NL expression were present at T0, and in general, the aging process increased marginal infiltration.

Conclusion: Aging and choice of composite cement influenced PBS, while root region and polymerization protocol seemed to have no influence on posts' resistance to dislodgment.

Purpose: The aim of this prospective study was to evaluate the clinical performance of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in patients with severe tooth wear, the effect of the restorative treatment on the oral health-related quality of life (OHRQoL), and the etiology of tooth wear as a risk factor for restoration failure.

Materials and methods: Patients with generalized severe tooth wear were included. Restorations (LAVA Ultimate, 3M Oral Care) were cemented (RelyX Ultimate, 3M Oral Care) on all teeth and were evaluated after 1 month and 1 year. OHRQoL was assessed via questionnaires at baseline and after 1 year. Differences were evaluated (paired t-test). Two mechanical tooth-wear lesions resulting from tooth-tooth contact, and 3 chemical tooth wear lesions resulting from intrinsic or extrinsic acids dissolving natural hard tooth substance, were evaluated to assess the etiology of tooth wear in association with restoration failure using multilevel logistic regression analyses (p < 0.05).

Results: Twenty-one patients (age: 41.7 ± 10.4 years) were evaluated after 1 year (13.5 ± 1.2 months). 568 indirect CAD/CAM restorations were placed. None were replaced or lost. Twelve were repaired and 10 were refurbished. Success rates were 100% to 97.2%. Questionnaires showed a significant positive impact of the treatment on OHRQoL (p < 0.001). The presence of mechanical lesions did not pose a higher risk for restoration failure (p = 0.78). The presence of chemical lesions showed a lower risk of restoration failure (p = 0.002).

Conclusion: The use of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in the restorative treatment of severely worn dentitions showed satisfactory results in the short term.

Purpose: To evaluate the effect of dimethyl sulfoxide (DMSO) on the microtensile bond strength (µTBS), nanoleakage (NL), and degree of conversion (DC) of universal adhesives on eroded dentin.

Materials and methods: One hundred thirty-four extracted (134) human third molars were selected for the study. After the dentin surface was exposed, 128 teeth were randomly assigned to 16 experimental groups as follows: dentin surfaces (sound dentin and eroded dentin), application of DMSO (without or with the application of DMSO), and adhesive strategies (etch-and-rinse [ER] and self-etch [SE]). The universal adhesive systems iBond Universal (IBU) and Scotchbond Universal (SBU) were applied and the teeth were restored using a resin composite. After 24 h in distilled water at 37°C, the samples were sectioned and evaluated for μTBS. Selected sticks from each tooth were used for evaluating NL and DC. The remaining six teeth were used to measure the thickness of the collagen layer of the artificially eroded dentin using scanning electron microscopy. Data on μTBS, NL, and DC (%) were analyzed using three-way ANOVA and Tukey's test (α = 0.05).

Results: Significantly lower μTBS (p = 0.0001) and DC (p = 0.01) were observed for eroded dentin than for sound dentin. However, a significant increase in the μTBS (p = 0.0007) and DC (p = 0.001) was observed for both substrates when DMSO was applied. Moreover, the application of DMSO decreased the concentration of silver nitrate at the bottom of the hybrid layer for both sound and eroded dentin (p = 0.002). Eroded dentin showed enlarged tubules with the presence of a collapsed collagen fibril layer approximately 5.0 ± 2.0 mm of thickness.

Conclusion: The bonding performance of both tested universal adhesives improved on both sound and eroded dentin with DMSO pretreatment.

Purpose: To investigate the effect of pretreatment protocols involving Papacarie Duo gel and Scotchbond Universal (SU) on the microshear bond strength (µSBS) of resin composite (RC) to hypomineralised enamel (HE).

Materials and methods: Specimens of normal enamel (NE) and HE were derived from extracted hypomineralised first permanent molars (FPMs). Based on the colour of demarcated opacities, HE specimens were classified as creamy/white (CW) or yellow/brown (YB). The specimens were randomly allocated into eight groups (n = 20). Each group involved pretreatment with Papacarie Duo gel or no pretreatment, and SU applied in etch-and-rinse (E&R) or self-etch (SE) mode. All specimens were bonded with RC and subjected to µSBS testing. Failure modes were analysed using an optical microscope and SEM.

Results: Comparing NE with HE, the following factors were found to be significant (p < 0.001): type of enamel substrate, deproteinising pretreatment, and etching mode. Comparing CW HE with YB HE, a significant interaction between "deproteinising pretreatment" and "etching mode" was demonstrated (p = 0.028). When subjected to the concurrent use of Papacarie Duo gel and phosphoric acid etching, HE specimens showed a significant increase in µSBS (p < 0.001).

Conclusion: Deproteinising pretreatment using Papacarie Duo gel followed by the application of SU in E&R mode led to increased µSBS of resin composite to HE.

Purpose: To evaluate the effect of heated and room-temperature hydrofluoric (HF) acid on surface roughness parameters (Ra and Rq) and microtensile bond strength (μTBS) on feldspathic ceramic and lithium-disilicate glass-ceramics.

Materials and methods: Disk-shaped samples made from both ceramics were divided into groups according to surface treatment: feldspathic ceramic polished surface (FP), feldspathic ceramic + 60 s of 9% HF acid etching at room temperature (FC), feldspathic ceramic + 60 s of 9% HF acid etching heated to 70°C (F70), lithium-disilicate polished surface only (LP), lithium disilicate + 20 s of 9% HF acid etching at room temperature (LC), and lithium disilicate + 20 s of 9% HF acid etching heated to 70°C (L70). To evaluate Ra and Rq, non-overlapping readings were taken on the surface of each sample with a contact stylus profilometer. To measure microtensile bond strength (μTBS), samples of groups FC, F70, LC and L70 received their corresponding surface treatment, were silanized and then bonded using a dual-cure composite cement to resin composite disks. After 24 h, samples were sectioned to obtain specimens for μTBS. Representative samples from each group were examined using scanning electron microscopy (SEM) to analyze the morphology of the etched surface. The data were analyzed for statistical significance using Welch's ANOVA with the Games-Howell multiple-comparison post-hoc test.

Results: For both surface roughness parameters and HF acid etching at room temperature (FC and LC) showed a significant increase (p < 0.001) in surface roughness when compared to polished surfaces (FP and LP). Furthermore, the use of heated HF acid etching significantly increased (p < 0.001) the surface roughness of the ceramic when compared to their counterpart sample of HF acid etching at room temperature. Group L70 obtained the highest μTBS of all groups (29.11 ± 8.26 MPa) and was significantly higher (p < 0.001) than that of the other experimental groups. There were no statistical differences (p > 0.05) between groups FC (19.94 ± 4.14), F70 (18.24 ± 5.29), and LC (17.87 ± 6.96).

Conclusion: The use of 9% HF acid etching heated to 70°C resulted in significantly higher surface roughness and improved bond strength onto lithium-disilicate glass-ceramic compared to surface HF acid etching at room temperature.

Purpose: To validate the rationale of using a conventional light-curing resin-based composite (RBC) to lute thick indirect restorations by measuring mini-interfacial fracture toughness (mini-iFT).

Materials and methods: Freshly exposed dentin of extracted third molars (n = 64) was immediately sealed with a thin layer of an experimental RBC with a 50 wt% or 75 wt% (IDS) filler load. Two- or 6-mm-thick CAD/CAM composite blocks were luted onto IDS using either pre-heated light-cure or dual-cure luting RBC, with the latter having served as control. Samples were cut into sticks, upon which a notch was prepared at the interface between IDS and luting RBC, prior to being submitted to a 4-point bending test to determine mini-iFT. The results were analyzed using a mixed linear model (LME). Failure mode at the fractured interface was determined using scanning electron microscopy (SEM).

Results: LME revealed that mini-iFT was not significantly affected by the composite block thickness (p = 0.39), but by the luting RBC (p < 0.0001) and the IDS RBC filler load (p = 0.0011). Mini-iFT was higher with 50 wt% filler-loaded RBC IDS and when luted using the light-curing RBC.

Conclusion: This work provides the proof of concept that 2- and 6-mm-thick indirect restorations can safely be adhesively luted with pre-heated conventional light-cure RBC under controlled light-irradiation conditions. This strategy even seems beneficial in terms of mini-iFT compared to using a dual-cure luting RBC. IDS with lower filler content also appeared more favorable.

Purpose: To compare the clinical performance and treatment times between glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat, GC) and adhesive/nanofilled resin composite restorations (RC; OptiBond FL, Kerr/Filtek Supreme XTE, 3M Oral Care) of sclerotic non-carious cervical lesions (sNCCL).

Materials and methods: This is an 18-month interim analysis of a 36-month cluster-randomized trial (ClinicalTrials.gov Identifier: NCT02631161). Eighty-eight patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC restorations. Restorations were placed without mechanical cavity preparation, and treatment time was recorded. After 18 months, restorations were evaluated using FDI criteria. Factors associated with restoration survival were evaluated using multi-level Cox-regression analysis. Generalized linear mixed modelling was used to analyze factors associated with treatment time.

Results: After a mean of 18 months (min/max: 8/25), 78 patients (160 restorations) were assessed. Fifteen restorations (18%) failed in GH, and 11 (12%) in the RC, without a significant difference in survival (p = 0.904/Cox). Retention loss was the most common reason for failure in both groups. Restorations placed in older patients showed lower risk of failure [OR (95% CI): 0.90 (0.81-0.99) per year], while mandibular teeth showed higher risks [2.89 (1.00-8.31)]. Treatment time was significantly shorter for GH (mean ± SD: 8.6 ± 4.3 min) than RC (11.7 ± 5.7 min; p < 0.001).

Conclusions: GH may be a suitable alternative to RC for restoring sNCCLs, without any significant difference in survival between the two materials at this interim analysis. In addition, placing GH restorations required less chairtime than did placing RC restorations.

Purpose: To characterize experimental adhesives containing natural antimicrobial agents (proanthocyanidins, apigenin, tt-farnesol) in the primer and to evaluate their anti-caries effect.

Materials and methods: Natural agents were incorporated in the primer of an experimental adhesive: 4.5% proanthocyanidins (PA), 1 mM apigenin (API), 1 mM apigenin + 5 mM tt-farnesol (API + FAR), and primer without antimicrobial agent (control). Microtensile bond strength (μTBS) to dentin and nanoleakage were measured immediately (n = 7) and after 1 year of storage (n = 7). Water sorption (WS), solubility (SO), and degree of conversion (DC%) of the adhesives were measured. The hardness loss of enamel (n = 6) and dentin (n = 6) at the restorative margin was evaluated after biofilm formation.

Results: DC%, nanoleakage, and immediate μTBS were similar for all groups. After 1 year, API + FAR showed higher nanoleakage and lower μTBS than the other groups, which were similar. WS and SO of API + FAR were lower than in the other groups. PA, API, and API + FAR presented less hardness loss than did the control group. At enamel, PA and API presented less hardness loss than the control and API + FAR groups at distances 50 µm and 100 µm; the hardness loss of enamel was similar for all groups 150 µm from the margin.

Conclusion: The addition of proanthocyanidins and apigenin to the adhesives decreased the hardness loss of dentin and enamel submitted to biofilm formation, without jeopardizing the physical properties of the adhesives. The combination of apigenin + tt-farnesol decreased the hardness loss of dentin but not of enamel, and decreased the μTBS after 1 year of storage.

Purpose: A new two-step self-etch adhesive (2-SEA) free of hydrophilic monomers was evaluated. Its microtensile bond strength (µTBS) to dentin under various aging conditions, interfacial gap formation, water sorption/solubility, and formation of an acid-base resistant zone (ABRZ) were evaluated and compared with a gold-standard 2-SEA.

Materials and methods: The new 2-SEA G2-Bond Universal (G2; GC) was compared to Clearfil SE Bond 2 (CSE2, Kuraray Noritake). Their µTBS to sound coronal dentin was tested after 1 week, 10,000 thermal cycles (TC), 20,000 TC, 6 months and 1 year. Failure mode was determined using scanning electron microscopy (SEM). Gap formation at the interface of 2-mm deep tapered cavities with an enamel border was observed using swept-source optical coherence tomography after 1 day, 1 week, 10,000 TC, and 20,000 TC. In addition, water sorption and solubility of the bonding agents was measured, and ABRZ formation was evaluated using SEM.

Results: There was no significant difference in µTBS between G2 and CSE2 (p > 0.05), and the aging conditions had no significant effect on µTBS (p > 0.05). In all groups, cohesive failures prevailed (55%-95%). Interfacial gap formation was initially similar for both adhesives (p > 0.05), but G2 exhibited a significantly lower gap formation than CSE2 after TC (p < 0.05). The water sorption of G2 was significantly lower compared to CSE2 (p < 0.05), and their solubility was statistically similar (p > 0.05). ABRZ of similar thickness was observed with both adhesives.

Conclusion: The new 2-SEA exhibited stable dentin bonding and increased hydrophobicity resulting from the absence of hydrophilic monomers.