Journal of Adhesive Dentistry最新文献

Purpose: To evaluate the 24-month clinical performance of Adhese Universal (ADH) (Ivoclar Vivadent) using two different application modes (etch-and-rinse vs self-etch) when restoring non-carious cervical lesions.

Materials and methods: Twenty-six patients participated in this study. A total of 117 non-carious cervical lesion restorations (N = 117) were assigned to two groups: 1) ADH in the etch-and-rinse mode (n = 59) and 2) ADH in the self-etch mode (n = 58). The same resin composite (Tetric EvoCeram, Ivoclar Vivadent) was used for all restorations. The restorations were evaluated at baseline and at 24 months using the World Dental Federation (FDI) criteria. The results were analyzed statistically using the McNemar test (α = 0.05) and a generalized estimating equation.

Results: In self-etch mode, significant differences were found for marginal coloring (p = 0.002), marginal adaptation (p = 0.031), and hypersensitivity (p = 0.031) between baseline and the end of the 24-month period. In the etch-and-rinse mode, significant differences were found for marginal coloring (p = 0.004), fractures/retention (p = 0.002), marginal adaptation (p = 0.002), and hypersensitivity (p = 0.000). Significant differences were also detected between groups at 24 months for fractures/retention (p = 0.001). At 24 months, 10 restorations of the etch-and-rinse group were lost and 2 restorations of the self-etch group were lost.

Conclusion: In terms of fractures and retention criteria, this universal adhesive obtained better results when applied in self-etch mode than in etch-and-rinse mode.

Purpose: To investigate the changes in the dentin bond strengths of universal adhesives during the early phase and evaluate the effect of a double-layer adhesive application on the performance of the dentin bond.

Materials and methods: Three universal adhesives and a two-step self-etch adhesive were employed to ascertain the shear bond strengths (SBS) of specimens to bovine dentin with the use of the etch-and-rinse or self-etch mode. The specimens were further divided into two groups based on adhesive application in a single or a double layer. The bonded specimens were stored in distilled water at 37°C for 5 min or 1, 6, 12, or 24 h prior to SBS measurement and the adhesives' Knoop hardness number (KHN).

Results: All the adhesives showed increased SBS with prolonged storage periods regardless of the adhesive layer (single or double) or etching mode. Most universal adhesives in the double adhesive layer groups showed significantly higher SBS than single adhesive layer groups for the same storage period. All the adhesives also showed increased KHN with increased storage period.

Conclusion: The SBS and KHN values of the adhesives increased with increasing storage duration over a 24-h period. Double adhesive layer application mediated increased dentin bond strength in the early phase.

Purpose: To compare different concepts of direct composite restorations in class-II cavities using bulk-fill composites and a conventional composite with different layer thicknesses in a clinical study over a period of 2 years.

Materials and methods: A low-viscosity (SDR), a high-viscosity bulk-fill (Tetric EvoCeram Bulk Fill) and a conventional nanohybrid composite (Tetric EvoCeram) were randomly assigned and placed in different layer thicknesses up to 4 mm in 160 class-II cavities in 94 patients. Restorations were clinically examined at baseline (n = 160), after 12 (n = 150) and 24 months (n = 148) and evaluated according to eight selected FDI criteria. In case of complete loss of the restoration or irreversible pulpitic symptoms, the restoration was rated as failure; repair was considered as relative failure.

Results: The materials investigated showed no significant differences regarding the FDI scores and failure rate during the entire follow-up. After 12 months, 7 failures and after 24 months a total of 8 failures were observed. After 2 years, Tetric EvoCeram Bulk Fill with a 4-mm layer thickness and SDR in combination with Tetric EvoCeram Bulk Fill with a 2-mm layer thickness exhibited a non-significant tendency towards increased hypersensitivity (FDI score 5) as compared to the reference material Tetric EvoCeram with a 2-mm layer thickness (p = 0.051; Kruskal-Wallis test).

Conclusion: The clinical stability of bulk-fill materials in layers up to 4 mm is comparable to nanohybrid composites after 2 years.

Purpose: This study evaluated dentin bond strength, failure mode, interface morphology, adhesive infiltration into dentin, and marginal adaptation of bulk-fill composites used with different adhesives.

Materials and methods: Third molars received occlusal class I cavities (4 mm x 4 mm x 4 mm) that were bulk-filled with Admira Fusion x-tra (Voco) or SonicFill 2 (Kerr) using four adhesives (Scotchbond Multipurpose, 3M Oral Care; Clearfil SE Bond, Kuraray Noritake; OptiBond All-In-One, Kerr; Futurabond U, Voco). Scotchbond was used with acid-etching, while the remaining adhesives were applied in self-etch mode. Sixty-four teeth were selected for the microtensile bond strength test (n = 8). Failure modes were analyzed with scanning electron microscopy (SEM). Interface morphology and adhesive infiltration (n = 3) were investigated using confocal laser scanning microscopy (CLSM). Marginal adaptation (n = 3) was also evaluated using SEM. Bond strength, failure mode, and adhesive infiltration data were analyzed for distribution and homocedasticity, followed by appropriate statistical analyses (α = 0.05).

Results: Regarding bond strength, no differences were found among adhesives for SonicFill; Clearfil showed a significantly lower mean value than did Scotchbond (p ≤ 0.05) for Admira; the two composites did not differ. Adhesive and mixed failures were observed for all groups. Scotchbond led to thicker hybrid layers with deeper adhesive infiltration as opposed to Futurabond. The groups Admira+Futurabond, SonicFill+Clearfil, and SonicFill+Futurabond presented the highest marginal discontinuity.

Conclusion: The tested bulk-fill composites did not affect dentin bonding. Scotchbond and Clearfil seem to be reliable for bonding SonicFill 2 to dentin. The performance of Futurabond was questionable, given its poor-quality interface and higher percentages of marginal gaps.

Purpose: To three-dimensionally evaluate the interfacial gap of bulk-fill resin composites applied in deep Class-I restorations with different layering techniques and curing modes.

Materials and methods: Ninety-six (n = 96) samples were prepared with standardized deep Class-I cavities and adhesive procedures. Four materials were tested: SDR (SDR), SonicFill2 (SF), Admira Fusion X-Tra (AFXT), Filtek Supreme XTE (FS). Four subgroups (n = 6) were created according to layering and curing techniques: 2+2mm increments with soft start curing (SG1), 2+2 mm with conventional curing (SG2), a 4-mm increment with soft start curing (SG3), a 4-mm increment with conventional curing (SG4). All samples underwent micro-CT scans; afterwards, voids surrounding the restorations automatically underwent a thresholding procedure (Mimics, Materialise; Geomagic Studio 12, 3D Systems) to analyze the 3D interfacial gap. Statistical analysis was performed using three-way ANOVA with Tukey's test (significance p < 0.05).

Results: Statistically significant differences were reported between materials, layering techniques and their interaction. No statistically significant differences were reported for polymerisation mode. Bulk-fill materials showed average interfacial gap volumes ranging from 0.031 mm3 to 0.200 mm3, while FS showed volumes ranging from 0.416 mm3 to 1200 mm3.

Conclusions: All bulk-fill materials performed statistically significantly better than did FS (p < 0.05), with no statistically significant differences between them. Curing mode did not influence interfacial gap volume in any group (p > 0.05), while bulk-filling vs layering influenced the volume of interfacial gaps only in the FS group, which performied better when incrementally applied. Regarding gap localisation, the floor of the cavity was the area with the highest likelihood of gaps in all samples.

Different kinds of interactions between the restorative material and mineralized dental tissues result in secondary caries around dental composites. Of these, the mechanical interactions have to be carefully investigated. Due to the elastic mismatch between dental tissues and the composite restoration, complex stresses and strains develop at their interface. This complex mechanical environment disturbs the demineralization-remineralization equilibrium of dental hard tissues. The fluid flow both over and within enamel and dentin, associated with their complex ultrastructure and mechanical behavior, is a key factor. It is known that external mechanical loading can indirectly promote the dissolution of enamel and dentin through a pumping action of cariogenic fluids in and out of microgaps at the interface between mineralized tissues and composite. Mechanical loading can also directly influence the physicochemical behavior of dental hard tissues by inducing complex strain and stress fields on the crystal scale. It is important to consider both the direct and indirect paths by which mechanical loading can influence the apatite dissolution kinetics. Therefore, a systematic approach should be used to investigate the mechanism of secondary caries formation considering the tooth-composite interface as a unique complex in which each element has an influence on the other.

Purpose: To systematically review the literature to evaluate whether the bond strength of resin-based materials to enamel is affected by deproteinizing agents.

Materials and methods: This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed, ISI Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Eligibility criteria included in vitro studies that reported the effect of a deproteinizing agent applied before or after acid etching on the immediate or long-term bond strength of resin-based materials to enamel. The meta-analysis was carried out using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of α = 0.05.

Results: A total of 23 studies were included in the meta-analysis. In all the studies, only the immediate bond strength was evaluated. The bond strength of the materials was improved by the application of NaOCl or papain prior to enamel etching with phosphoric acid (p ≤ 0.006). None of the deproteinizing agents had a significant effect when applied after etching with phosphoric acid (p ≥ 0.27).

Conclusions: Based on in vitro studies, deproteinization with sodium hypochlorite or papain-based agents increases the immediate bond strength of resin-based materials to enamel only when used prior to phosphoric-acid etching.

Purpose: To evaluate the effect of different concentrations of ethylene-diamine-tetra acetic acid (EDTA) on bond strength (BS) and nanoleakage (NL) of fiber posts bonded into root canals.

Materials and methods: Seventy-two single roots were endodontically treated and divided into six groups (n = 12), according to the combination of the following factors: surface treatment (no irrigation [control], 17% EDTA, or 24% EDTA), and composite cement applied with an adhesive used in a self-etch mode (Single Bond Universal/RelyX Ultimate [SB], 3M Oral Care; Ambar Universal/Allcem [AM], FGM). After fiber post cementation, six 1-mm-thick disks were obtained for each root. Push-out bond strength (BS) was evaluated using 8 specimens per group, and the other 4 specimens were used to examine nanoleakage (NL). Data from BS and NL of each adhesive were evaluated by two-way ANOVA (surface treatment vs root region) and Tukey's test (α = 0.05).

Results: The application of 17% and 24% EDTA did not influence the bond strengths of either adhesive. In general, the application of 17% and 24% EDTA increased NL values for both adhesives.

Conclusion: Pre-treatment with different concentrations of EDTA was not able to improve the adhesion of fiber posts into root canals with universal adhesives..