The journal of adhesive dentistry最新文献

Purpose: This study evaluated the effects of etching mode, pH, and composition on the shear bond strength of three universal adhesives (UAs), in comparison with conventional adhesives.

Materials and methods: Crowns from 110 extracted third molars were sectioned to obtain 220 dentin surfaces and allocated into 11 groups (n = 20) based on adhesive system (OptiBondFL, ClearfilSE Bond, All-Bond Universal, OptiBond Universal, G2-Bond Universal) and etching mode (etch-and-rinse [ER], self-etch [SE], selective dentin etching [SDE]). Each group was divided into pre- and post-aging sub-groups. Shear bond strength was tested at 24h and after 5,000 thermal cycles. The resin-dentin interface was examined using scanning electron microscopy (SEM). Data were analyzed using one-way ANOVA, LSD post-hoc and paired-sample t-tests (α = 0.05).

Results: All-Bond Universal exhibited the highest bond strength across all modes, while OptiBond Universal showed the lowest. No significant difference was observed between ER and SE modes for most UAs, except G2-Bond Universal. SDE did not result in significantly higher bond strength compared to SE or ER in any group. After aging, G2-Bond Universal in SE mode exhibited the highest bond strength.

Conclusion: Bond strength was influenced by etching mode, pH, and composition of the adhesive. UAs performed comparably to the gold-standard SE adhesive in SE mode; however, their performance in ER mode varied depending on their composition and pH.

Clinical relevance: To ensure predictable clinical outcomes, clinicians should recognize that UAs do not perform uniformly. Selecting both the adhesive and etching mode according to the adhesive's composition may enhance long-term bonding success.

Purpose: This study evaluated the effects of incorporating urethane tetramethacrylate (UTMA) monomers and inorganic nano-fillers on the bonding performance and mechanical properties of a next-generation one-step universal adhesive, Clearfil Universal Bond Quick 2 (UBQ2), with a focus on clarifying its improvements over the previous formulation.

Materials and methods: Five adhesive systems were investigated: UBQ2, two experimental variants lacking either UTMA (UBQ2-U) or nano-fillers (UBQ2-F), the predecessor adhesive (Clearfil Universal Bond Quick, UBQ), and a gold-standard two-step self-etch adhesive (Clearfil SE Bond 2, SE2). Microtensile bond strength (μTBS), bond layer thickness (L), ultimate tensile strength (UTS), and water sorption (Wsp) were evaluated.

Results: UBQ2 demonstrated significantly higher UTS and lower Wsp than UBQ2-U (P 0.001 and P = 0.03, respectively), indicating enhanced mechanical resilience and hydrolytic stability due to the presence of UTMA. Compared to UBQ, UBQ2 showed improved mechanical properties while maintaining comparable μTBS. The absence of nano-fillers (UBQ2-F) significantly reduced μTBS (P 0.05), confirming their critical role in bonding performance. Despite forming a thinner adhesive layer, UBQ2 achieved dentin bond strength comparable to SE2.

Conclusion: By combining UTMA and nano-fillers, UBQ2 has improved wettability compared to conventional products, while also providing high bonding performance and mechanical properties with a one-step application. These findings support the development of universal adhesives through simplified clinical protocols and improved material properties.

Clinical relevance: This study demonstrates that incorporating nano-fillers and UTMA into a one-step universal adhesive (UBQ2) enhances mechanical strength, reduces water sorption, and maintains high dentin bond strength. Clinically, UBQ2 offers a simplified yet reliable bonding performance comparable to SE2.

Purpose: To evaluate whether single-day, gamified training (called 'Battle of the Bonds') improves operators' immediate macro dentin shear bond strength (SBS) values and perceived learning in undergraduate and continuing dental education about dental adhesives, composite resin, and light-curing units.

Materials and methods: In July 2025, 14 dentists and 21 final-year students performed four macro-SBS tests before and eleven after lectures on adhesive systems, composite selection, and light-curing. SBS was measured on human dentin for each participant's routine adhesive and representatives of all actual adhesive/generation families (from three-step etch-and-rinse to universal adhesives). Post-course satisfaction was measured using a 13-item Likert questionnaire (ranging from 1 to 5). Paired and independent t-tests were used to compare the SBS (α = 0.05).

Results: The baseline SBS with the participants' own adhesive was similar between the dentists and the students (12.5 ± 6.4 MPa vs 13.1 ± 6.6 MPa, P = 0.68). After training, the mean SBS with the participants' own adhesive significantly increased to 18.5 ± 6.3 MPa for the dentists (+67%) and to 17.3 ± 6.0 MPa for the students (+27%) (both P 0.05). Satisfaction with training and perceived knowledge gains were very high (4.9 ± 0.5 for dentists and 4.9 ± 0.3 for students).

Conclusions: A single-day, competition-based curriculum that couples concise lectures with hands-on SBS testing yields rapid, clinically meaningful improvements and strong engagement across predoctoral and practitioner audiences. This experiential format may help standardize technique-sensitive restorative skills in dental education.

Purpose: This study aimed to evaluate the effects of bioactive, inorganic, and organic fillers on the curing time, mechanical properties, mineralization ability, and shear bond strength to dentin of 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin-based restorative materials.

Materials and methods: Experimental resins were prepared by incorporating 3 wt% organic composite filler, bioactive glass, or aluminosilicate glass into 4-META/MMA-TBB resin. A commercial organic-filler-containing 4-META/MMA-TBB resin (Bondfill SB Plus (BSP)) was also tested for comparison. The curing time, three-point flexural strength, and shear bond strength to root dentin were measured and statistically analyzed with a significance level of α = 0.05. The mineralization ability of groups containing bioactive glass was evaluated based on the formation of hydroxyapatite in simulated body fluid.

Results: The bioactive glass group exhibited prolonged curing times and reduced flexural strengths compared to BSP. Bioactive glass induced slight mineralization. Organic composite filler reduced the curing time and significantly increased the shear bond strength to dentin. After thermal cycling, the organic composite filler groups retained higher bond strengths than the other groups.

Conclusion: Incorporating organic composite fillers into 4-META/MMA-TBB resin may improve clinical handling by reducing the curing time while maintaining or enhancing the bond strength to dentin, suggesting their suitability for restorative applications, particularly in moisture-compromised environments.

Purpose: This prospective crossover clinical study evaluated the effectiveness of different moisture control methods on intraoral humidity and examined the influence of external environmental humidity.

Materials and methods: Forty adult participants (31 females, 9 males; mean age 36.6 ± 11.3 years) were enrolled. Intraoral relative humidity was measured above anterior and posterior teeth under four randomized conditions: control (mouth breathing), rubber dam isolation, vacuum-assisted isolation (ZOO), and saliva ejector. External humidity was recorded simultaneously and categorized as high (≥60%) or low (60%).

Results: Both rubber dam isolation and vacuum-assisted isolation significantly reduced intraoral humidity compared with the saliva ejector and control. Under low external humidity, rubber dam and vacuum-assisted isolation achieved the lowest intraoral humidity (all P 0.001). Under high external humidity, all methods reduced humidity compared with control, but vacuum-assisted isolation remained significantly more effective than the rubber dam and saliva ejector. External humidity showed a strong correlation with intraoral humidity in the rubber dam group (ρ up to 0.77, P 0.001).

Conclusion: Moisture control methods differ in their ability to reduce intraoral humidity, with rubber dam and vacuum-assisted isolation providing the most effective reduction. However, high external humidity significantly increases intraoral humidity regardless of the isolation method, indicating that clinicians should consider both the isolation strategy and environmental conditions when aiming to minimize intraoral humidity.

Purpose: To evaluate the influence of functional monomer type and powder-to-liquid ratio on the interfacial properties and degree of conversion of experimental self-adhesive flowable resin composites (SAFRCs) bonded to dentin.

Materials and methods: Nine experimental SAFRC formulations were developed by varying the powder-to-liquid ratio (1.9, 2.2, 2.5) and the functional monomers included (10-MDP, GPDM, HEMA). Human molars (n = 27) were restored using each formulation and analyzed using a rheometer to assess viscosity, Raman micro-spectroscopy for inter-diffusion zone (IDZ) width, and degree of conversion at the interface (DC%). Two-way ANOVA and post-hoc tests were performed for statistical analysis (α = 0.05).

Results: Rheological testing revealed, as expected, non-Newtonian flow behavior in all composites, with significant effects of both powder-to-liquid ratio (P 0.001) and monomer type (P 0.001) on viscosity. 10-MDP composites exhibited optimal viscosity (1.12-2.86 mPa·s) across all ratios, significantly lower than GPDM and HEMA. Raman mapping showed a distinct IDZ with hybrid characteristics for 10-MDP formulations, contrasting with abrupt transitions or gaps in GPDM and HEMA groups. IDZ width was significantly greater in 10-MDP formulations (P 0.0001). The DC% at the interface was highest for 10-MDP and HEMA formulations, exceeding 68%, while GPDM composites showed lower values (P 0.001).

Conclusion: Functional monomer type critically affects the interfacial bonding performance and conversion rate of SAFRCs, with 10-MDP outperforming GPDM and HEMA in interdiffusion and adhesive quality. Variations in powder-to-liquid ratio influenced viscosity but had a limited impact on interfacial performance. Optimized formulations with 10-MDP may enhance the clinical efficacy of SAFRCs.

Clinical relevance statement: Refining acidic-monomer chemistry and viscosity in SAFRCs could improve their bonding predictability.

Purpose: The popularity of Biodentine (Septodont) use for vital pulp therapies requires verifying its bonding ability to other restorative materials. The null hypotheses were that different restorative materials and adhesive strategies did not influence shear bond strength (SBS) to Biodentine, nor its setting time.

Materials and methods: 204 plastic molds were filled with Biodentine, half set for 12 min, and the rest for 7 days. Specimens were divided into six groups according to the strategy and material used to restore over Biodentine (n = 17): (1) SE: Universal adhesive application in self-etch mode; (2) ER: Universal adhesive in etch-and-rinse mode; (3) Bur: Roughening with a bur followed by SE; (4) AO: Airborne-particle abrading with Al2O3 particles before SE; (5) RMGIC: Restoration with a resin-modified glass-ionomer; (6) SARC: Restoration with a self-adhesive resin cement. Groups 1 to 4 were restored with a flowable bulk-fill composite. Specimens were subjected to SBS, and the mode of failure was determined. Five additional specimens were evaluated under SEM-EDX. Data were analyzed with Kruskal-Wallis and U-Mann-Whitney tests (P 0.05).

Results: AO and SARC groups showed 100% pretest failures. At 12 min setting, the RMGIC group and Bonferroni correction achieved the lowest SBS values. At a 7-day setting, the Bur group registered the lowest SBS, and the groups restored with universal adhesive achieved the highest values. SBS results for the Bur and RMGIC groups were influenced by the setting time.

Conclusion: Bur roughening or alumina airborne-particle abrading did not improve Biodentine adhesion to composite resin restorations, whereas the application of a universal adhesive achieved the highest SBS results regardless of the evaluated setting time.

Purpose: To evaluate the effects of dentin pre-treatment with an ammonia- and water-based 2-step silver-containing solutions on the microtensile bond strength (µTBS), chemo-morphological characterization (SEM/EDS), and matrix metalloproteinases (MMPs) activity of a universal adhesive after 2 years of artificial aging.

Materials and methods: Mid-coronal dentin surfaces of sound human molars (N = 60) were exposed and grouped according to the following pre-treatment and universal adhesive (Zipbond Universal, SDI) etching mode (n = 10): G1) Zipbond in the self-etch mode (control SE group, ZSE); G2) Riva Star (SDI) and ZSE; G3) Riva Star Aqua (SDI) and ZSE; G4) Zipbond in the etch-and-rinse mode (control ER group, ZER); G5) Riva Star and ZER; G6) Riva Star Aqua and ZER. µTBS test, SEM/EDS, and in-situ zymography analyses were conducted at baseline (T0) and after 2 years (T2) of storage in artificial saliva. Data were statistically analyzed (P = 0.05).

Results: Experimental groups exhibited significantly lower bond strength compared to control groups (Control>Riva Star=Riva Star Aqua; P >0.05). Artificial aging reduced bond strength values in all the groups (P 0.05). ER groups provided higher bond strength than SE ones (P 0.05). No silver ions were detected at T0 and T2 in the adhesive interfaces of specimens treated with both silver-containing solutions (SEM/EDS). Riva Star significantly decreased the MMPs activity (P 0.05) compared to control and Riva Star Aqua (P 0.05).

Conclusion: Dentin pre-treatment with the tested two-step silver-containing solutions impaired the 2-year bonding performance of composite resin restorations placed with a universal adhesive. The detected level of endogenous enzymatic activity was found to be product-dependent.

Purpose: To evaluate bonding to dentin contaminated with primers/etchants used for adjacent ceramic repair.

Materials and methods: Mid-coronal dentin of sound human third molars was exposed and allocated to 10 experimental groups. The universal adhesive (UA) Single Bond Universal ('SBU,' 3M Oral Care), applied either in etch-and-rinse (E&R) or self-etch (SE) bonding mode, and the considered gold-standard SE adhesive Clearfil SE Bond X ('CSE,' Kuraray Noritake) were bonded to dentin contaminated with either Monobond Etch & Prime ('MEP,' Ivoclar) or IPS Ceramic Etching Gel ('HF,' Ivoclar) following 10 scenarios: phosphoric acid (PA)+SBUE&R (uncontaminated E&R UA control), HF+PA+SBUE&R, MEP+PA+SBUE&R, PA+MEP+SBUE&R, SBUSE (uncontaminated SE UA control), HF+SBUSE, MEP+SBUSE, CSESE (uncontaminated SE control), HF+CSESE, MEP+CSESE. Upon adhesive and composite application, the specimens were stored in artificial saliva at 37°C. After 1 week, all specimens were sectioned into resin-bonded dentin sticks, which were randomly distributed over two groups to be subjected to a microtensile bond-strength test immediately at 1 week or upon aging by storage in artificial saliva for 6 months. Statistics involved linear mixed-effects modeling with Bonferroni correction (P 0.05).

Results: E&R bonding to dentin contaminated with MEP or HF did not significantly differ from bonding to non-contaminated dentin (controls). However, SE bonding to MEP- and HF-contaminated dentin was significantly less effective than to non-contaminated dentin (controls). Aging for 6 months did not reduce E&R bonding as compared to the 1-week data, while SE bonding was significantly less effective upon 6-month aging. E&R bonding was affected more when dentin was contaminated with MEP before phosphoric acid (PA) etching than when dentin was contaminated with MEP after PA etching.

Conclusions: Dentin contamination with MEP and HF impacted self-etch (SE) bonding but not etch&rinse (E&R) bonding.

Several adhesion strategies have been proposed for restoring non-carious cervical lesions (NCCLs). Long-term clinical trials are essential to guide clinicians toward the most effective approach.

Purpose: To evaluate the 5-year clinical performance of NCCLs restored using different adhesion strategies.

Materials and methods: Four strategies were assessed: an adhesive system (Scotchbond Universal; SBU/Filtek Z350XT) applied without (SBU) and with selective enamel conditioning (E-SBU), and a resin-modified glass-ionomer cement (Vitremer; RMGIC) applied without (RMGIC) and with ethylene-diaminetetraacetic acid pretreatment (E-RMGIC). Two hundred restorations were evaluated using United States Public Health Service criteria after 5 years. Kappa test, Wilcoxon Signed-Rank test, Kaplan-Meier analysis, equality tests of two proportions, and multiple logistic regression were applied (α = 0.05).

Results: One hundred and nineteen restorations were re-evaluated after 5 years. No significant differences were observed in restoration survival among groups. E-SBU exhibited more Bravo scores for marginal integrity compared to the ionomer groups and for marginal discoloration compared to RMGIC. Ionomer groups had higher Bravo scores for surface texture. RMGIC showed greater wear than E-SBU, being statistically similar to SBU. No significant differences were found for color and secondary caries over time. Multiple logistic regression analysis revealed that restoration retention was significantly influenced by the type of tooth (premolars), the degree of dentin sclerosis, and the degree of marginal tissue recession.

Conclusions: All four adhesion strategies demonstrated similar 5-year survival. Marginal defects were more frequent in the selective enamel etching group than in ionomeric restorations. Surface luster was reduced in ionomer restorations. The retention of NCCL restorations may be affected by tooth type, degree of dentin sclerosis, and marginal tissue recession. The four adhesion strategies had similar survival after 5 years; however, composite resin restorations applied after selective enamel etching promote more initial marginal defects than ionomer-based restorations following the manufacturer's instructions. Clinical factors such as lesion location, dentin sclerosis, and gingival recession can influence the retention of NCCL restorations.