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Purpose: To investigate the effect of adhesive type and long-term aging on the shear bond strength (SBS) between silicabased ceramics and composite cement (CC). Materials and Methods: Lithium-silicate (LS), feldspathic (FD) and polymer-infiltrated ceramic (PIC) blocks were sectioned (10 x 12 x 2 mm) and divided into 24 groups considering the factors: "ceramics" (LS, FD, and PIC), "adhesive" (Ctrl: without adhesive; 2SC: 2-step conventional; 3SC: 3-step conventional; 1SU: 1-step universal), and "aging" (non-aged or aged [A]). After the surface treatments, CC cylinders (n = 15, ɸ=2mm; height = 2mm) were made and half of the samples were subjected to thermocycling (10,000) and stored in water at 37°C for 18months. The samples were submitted to SBS testing (100 kgf, 1mm/min) and failure analysis. Extra samples were prepared for microscopic analysis of the adhesive interface. SBS (MPa) data was analyzed by 3-way ANOVA and Tukey's test (5%). Weibull analysis was performed on the SBS data. Results: All factors and interactions were significant for SBS (p<0.05). Before aging, there was no significant difference between the tested groups and the respective control groups. After aging, the LS_1SU (22.18±7.74) and LS_2SC (17.32±5.86) groups exhibited significantly lower SBS than did the LS_Ctrl (30.30±6.11). Only the LS_1SU group showed a significant decrease in SBS after aging vs without aging. The LS_1SU (12.20) group showed the highest Weibull modulus, which was significantly higher than LS_2SC_A (2.82) and LS_1SU_A (3.15) groups. Conclusion: No type of adhesive applied after silane benefitted the long-term adhesion of silica-based ceramics to CC in comparison to the groups without adhesive. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of urethane methacrylate precursor (UMP) on the enzymatic resistance of demineralized dentin (DD) matrices. Materials and Methods: Experimental treatments containing 0 (control), 1, and 5 mmol/L UMP dissolved in an acetone (Ace) solution were formulated. Dentin matrix specimens were demineralized in vitro and immersed in the experimental treatments for 1 h. The treated specimens were then stored in 0.1 mg/mL collagenase solution for 24 h, after which their dry mass loss and hydroxyproline (HYP) release were assessed. The swelling ratios of specimens in each group were also evaluated. The interaction between UMP and the dentin matrix was observed using field-emission scanning electron microscopy (FE-SEM). Endogenous enzyme activity in dentin was evaluated using confocal laser scanning microscopy (CLSM). Results: Compared with the other treatment groups, treatment with 1 mM and 5 mM UMP-Ace significantly decreased the dry mass loss, HYP release and swelling ratio of the DD matrix (p < 0.05). FE-SEM and CLSM observations showed that treatment with UMP-Ace protected the structure of the dentin matrix and decreased porosity within the dentin-collagen network. Conclusion: Treatment with 1 mM and 5 mM UMP-Ace protects DD matrix against collagenase degradation and may be clinically useful for improving the durability of the hybrid layer. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the antibacterial effects of Terminalia catappa Linn (TCL) leaf extracts at different concentrations and the effects of these extracts used as primers on the long-term adhesive properties of two universal adhesives. Materials and Methods: After extract preparation, the antimicrobial and antibacterial activities of TCL against Streptococcus mutans (UA 159) were assessed in microdilution assays to provide the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Additionally, to provide quantitative data on the ability of TCL extract to reduce cell viability, colony forming units (CFU) were counted. To examine adhesive properties, 288 human molars were randomly assigned to 32 experimental conditions (n = 9) according to the following variables: (1) treatment agent: negative control (untreated surface), and primers at concentrations of 1xMIC, 5xMIC, and 10xMIC; (2) adhesives: Scotchbond Universal (SBU) and Futurabond Universal (FBU); (3) adhesive strategy: etch-and-rinse (ER) or self-etch (SE); and (4) storage time: 24 h or after 2 years. Primers were applied for 60 s, upon which the teeth were incrementally restored and sectioned into adhesive-dentin bonded sticks. These were tested for microtensile bond strength (pTBS) and nanoleakage (NL) after 24-h and 2-year water storage, as well as in-situ degree of conversion (DC) at 24 h. The chemical profile of the hybrid layer was determined via micro-Raman spectroscopy. Biofilm assay data were analyzed using the Kruskal-Wallis test; the pH of culture media and the chemical profile were analyzed by one-way ANOVA. The adhesive properties (pTBS, NL, DC) were evaluated using a four-way ANOVA and Tukey's test. Significance was set at 5%. Results: Similar values of MIC and MBC were observed (2 mg/ml), showing bactericidal potential. CFU analysis demonstrated that concentrations of 5xMIC and 10xMIC significantly inhibited biofilm formation (p < 0.001). The application of the TCL primer at all concentrations significantly increased the immediate pTBS and DC, and decreased the immediate NL values when compared to the control group (p < 0.05), regardless of the adhesive and adhesive strategies. Despite an increase in the NLvalues for all groups after2years (p > 0.05), in groups where the TCL primerwas applied, the pTBS remained constant after 2 years for both adhesives, while a decrease in the pTBS was observed in the control groups (p < 0.05). Usually, IOxMIC showed better results than 1xMIC and 5xMIC (p < 0.05). The application of TCL promoted cross-linking; cross-linking rates increased proportionally to the concentration of TCL (p < 0.05). Conclusion: Primers containing TCL promoted bactericidal and bacteriostatic action, as well as cross-linking with dentin, while maintaining the adhesive properties of the adhesive-dentin interface after 2 years of water storage. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated and compared the bond strengths, microleakage, microgaps, and marginal adaptation of self-adhesive resin composites (SAC) to dentin with or without universal adhesives. Materials and Methods: Dentin surfaces of 75 molars were prepared for shear and microtensile bond strength testing (SBS and μTBS). Silicon molds were used to build up direct restorations using the following materials to form 5 groups: 1. Surefil One; 2. Prime&Bond active Universal Adhesive + Surefil One; 3. Vertise Flow; 4. OptiBond Universal + Vertise Flow; 5. Scotchbond Universal + Filtek Z500 (control group). Bonded specimens were thermocycled 10,000x before being tested either for SBS or μTBS using a universal testing machine at a crosshead speed of 0.5mm/min. Direct mesial and distal class-II cavities were created on 100 sound premolars, with the gingival margin of distal cavities placed below CEJ and restored according to the five groups. After thermocycling, microleakage scores were assessed following immersion of restored premolars in 2% methylene blue dye for 24h, while marginal gaps and adaptation percentages were investigated on epoxy resin replicas under SEM at magnifications of 2000X and 200X, respectively. Results were statistically analyzed with parametric and non-parametric tests as applicable, with a level of significance set at a = 0.05. Results: Bond strengths, microleakage scores, microgaps, and percent marginal adaptation of Surefil One and Vertise Flow were significantly (p<0.001) inferior to the control group. Dentin preconditioning with universal adhesives significantly increased the study parameter outcomes of Surefil One and Vertise Flow, yet they were still significantly below the performance of the control group. Conclusion: Conventional resin composite outperformed the SAC whether applied solely or in conjunction with their corresponding universal adhesives. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate different protocols for recementation of dislodged glass fiber posts (GFPs).Materials and Methods: The root canals of 50 bovine incisors were prepared to receive GFPs, which were conditioned with 24% hydrogen peroxide, silanized, and cemented with a self-adhesive resin cement. After light curing, the specimens were submitted to a pullout test. The dislodged GPFs were distributed into five experimental groups (n = 10 each) according to surface treatment for recementation: NT = no treatment; SI = silane; ET = 92.8% ethanol/silane; HP = 24% hydrogen peroxide/silane; AL = airborne-particle abrasion (50-μm alumina)/silane. The GFPs were recemented with the same self-adhesive resin cement, and specimens were submitted to a second pullout test. Data were analyzed by Student t test and one-way ANOVA (α = .05).Results: For all groups, the recementation bond strength was higher than the strength obtained after the first cementation (P < .05). There were no statistical differences among the experimental recementation protocols (P = .096).Conclusion: All recementation protocols might be reliably applied since they led to higher bond strength than the first cementation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical performance of two methacrylate-based flowable composites and an ormocer-based flowable composite in noncarious cervical lesions (NCCLs) in adult participants. Method and materials: In total, 183 restorations were performed on NCCLs. All cavities were restored using a universal adhesive system (Futurabond U, Voco) with selective enamel etching and with one of the three evaluated flowable composites (n = 61): low-viscosity methacrylate-based composite (GrandioSO Flow, LV), high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 24 months. Kruskall-Wallis analysis of variance rank (α = .05) was used for statistical analysis. Results: After 24 months of clinical evaluation, 16 restorations were lost (LV = 3, HV = 10, ORM = 3) and the retention rates (95% confidence interval) were 95.0% for LV, 82.2% for HV, and 95.0% for ORM, with statistical differences observed between HV and LV as well as HV and ORM (P < .05). When secondary parameters were evaluated, no significant differences between groups were observed (P > .05). Thirty-three restorations (LV = 8, HV = 13, ORM = 12) showed minor marginal staining, 71 restorations (LV = 26, HV = 20, ORM = 25) presented small marginal adaptation defects, and one restoration for HV presented recurrence of caries. Conclusion: The universal adhesive associated with the ormocer-based and methacrylate-based flowable composite showed promising clinical performance after 24 months. However, the heavy-flow restorations showed significantly more failures. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the long-term push-out bond strength (PBS) and nanoleakage (NL) of universal adhesives with different photo-initiator systems in the root canals of teeth in which fiber posts were luted. Materials and Methods: One-hundred twenty endodontically treated human premolars were randomly divided into 12 groups based on the following factors: adhesives (Scotchbond Universal [SBU], Ambar Universal [AMB], and Ambar Universal APS [AMB-APS]); adhesive strategy (etch-and-rinse and self-etch), and time of testing (immediately vs after 2 years). The posts were cemented, sectioned into slices, tested for PBS at 0.5 mm/min, and examined for NL using scanning electron microscopy immediately thereafter or after 2 years of water storage. Data were evaluated using a four-way ANOVA (root thirds vs time vs universal adhesive vs adhesive strategies) and Tukey's test (1 = 5%). Results: For both evaluation times, AMB-APS demonstrated no significant difference in the PBS or NL when different radicular thirds were compared (p > 0.05). However, for SBU and AMB, the cervical third demonstrated higher PBS and lower NL than those of the apical third at both time points (p < 0.0001). AMB-APS exhibited higher PBS and lower NL in the apical third in comparison with SBU and AMB (p < 0.0001). SBU and AMB displayed a significant decrease in the PBS and increased NL after 2 years (p < 0.0001), whereas AMB-APS demonstrated no significant signs of degradation even after 2 years of water storage (p > 0.05). Conclusion: Independent of the root third evaluated, the universal adhesive containing APS photo-initiator system demonstrated bonding stability at the adhesive interface between the root canal and fiber posts, even after 2 years of water storage. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this randomized controlled clinical trial was to evaluate the 3-year clinical performance of a universal adhesive (Clearfil Universal Bond Quick (CUBQ); Kuraray Noritake) when restoring non-carious cervical lesions (NCCLs) using two different application modes (etch-and-rinse vs self-etch with prior selective enamel etching). Materials and Methods: Fifty-one patients participated in this study. A total of 251 NCCLs (n = 251) were assigned to two groups: 1) CUBQ applied in etch-and-rinse mode (n = 122; CUBQ-ER) and 2) CUBQ applied in self-etch mode with prior selective etching of enamel with phosphoric acid (n = 129; CUPQ-SEE). The same resin composite, Clearfil Majesty ES-2 (Kuraray Noritake), was used for all restorations. The restorations were evaluated at baseline, 1 and 3 years using FDI criteria: marginal staining, fracture and retention, marginal adaptation, post-operative sensitivity and recurrence of caries. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). Materials and Methods: Fifty-one patients participated in this study. A total of 251 NCCLs (n = 251) were assigned to two groups: 1) CUBQ applied in etch-and-rinse mode (n = 122; CUBQ-ER) and 2) CUBQ applied in self-etch mode with prior selective etching of enamel with phosphoric acid (n = 129; CUPQ-SEE). The same resin composite, Clearfil Majesty ES-2 (Kuraray Noritake), was used for all restorations. The restorations were evaluated at baseline, 1 and 3 years using FDI criteria: marginal staining, fracture and retention, marginal adaptation, post-operative sensitivity and recurrence of caries. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). Results: The patient recall rate at 3 years was 90%. After 3 years, both groups presented an increase in the percentage of small but still clinically acceptable marginal defects (CUBQ-ER: 67%, CUBQ-SEE: 63.2%) and marginal staining (CUBQ-ER: 32.6%, CUBQ-SEE: 31.7%). The overall success rate was 82.6% and 83.8% for CUBQ-ER and CUBQ-SEE, respectively. In total, 38 restorations (19 CUBQ-ER, 19 CUBQ-SEE) failed because of loss of retention, fracture, severe marginal defect and/or marginal discoloration. A retention rate of 87.2% and 86.3% was recorded for CUBQ-ER and CUBQ-SEE, respectively. No significant difference was observed between the two bonding-mode groups for any of the evaluated parameters. Conclusion: After 3 years of clinical service, Clearfil Universal Bond Quick performed similarly in etch-and-rinse and selfetch modes with prior selective enamel etching. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively evaluate the clinical behavior of direct anterior composite restorations performed with a universal adhesive or with a three-step etch-and-rinse (E&R) adhesive. Material and Methods: Patients were randomly treated with a three-step E&R adhesive (Optibond FL, Kerr) or a universal adhesive (Clearfil Universal Bond Quick, Kuraray Noritake) applied in E&R mode. All restorations were performed with a nanohybrid composite (ClearFil Majesty ES-2, Kuraray Noritake) by the same experienced operator. Two calibrated examiners evaluated the restorations using a dental mirror and explorer, in accordance with modified United States Public Health Service (USPHS) procedures. Clinical events were registered and classified as either failure (F), survival (SR), or success (S). Results: 168 restorations were evaluated in 90 patients with an average follow-up period of 37.9 (± 22.9) months. A total of 132 restorations were performed on vital teeth, and 36 were performed on endodontically treated teeth (ETT). A total of 128 Class-IV and 40 Class-III restorations were performed. In 89 restorations, a three-step E&R adhesive was applied (14 Class-III and 75 Class-IV), while in 79, a universal adhesive was used (26 Class-III and 53 Class-IV, p = 0.0091). A Cox regression analysis was performed (p < 0.05) to analyze which factors were involved in the failure of the restorations, considering failure (F) as restorations that needed re-intervention at the follow-up period of 37.9 (± 22.9) months. No statistically significant differences were observed when considering parameters directly involved with the adhesives tested. Endodontically treated teeth were more prone to fractures (p = 0.0006) compared to vital teeth. Restorations made with universal adhesives failed by fracturing significantly more frequently (p = 0.0234), while restorations made on endodontically treated teeth had a significantly worse outcome (p = 0.0001). Restorations made on canines also failed significantly more frequently (HR = 3.8, 95% CI = 1.4-10.1, p = 0.0062). Conclusions: Based on the obtained results, both the universal adhesive and the three-step E&R adhesive proved to be good treatment choices for direct anterior restorations after 37.9 (± 22.9) months of follow-up. Tooth vitality seems fundamental for the prognosis of a direct anterior composite restoration over time. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of etching mode (self-etch and etch-and-rinse) on acid-base resistant zone (ABRZ) formation at the resin cement/enamel interface and enamel etching pattern, as well as the effects of thermocycling (0, 5000, and 10,000 cycles) on the enamel microshear bond strength (µSBS) mediated by dual-cure resin cements (DCRC). Materials and Methods: Two DCRC were used in 4 groups: Panavia V5 in self-etch (V5NE) and etch-and-rinse mode (V5E); and Estecem II in self-etch (ENE) and etch-and-rinse mode (EE). For ABRZ observation, the bonded interface was subjected to a demineralizing solution. The morphological attributes of the interface and etching patterns were observed using FE-SEM. For µ-SBS, cylinders with a 0.79-mm internal diameter and 0.5-mm height were made with DCRC and tested in shear after 0, 5000, and 10,000 thermal cycles (TC) (5°C and 55°C) (n = 10). Results: The formation of an enamel ABRZ was observed in all groups with different morphological features between selfetch and etch-and-rinse groups. A funnel-shaped erosion beneath the interface was present using V5NE and ENE modes where enamel was dissolved, while ABRZ formation was confirmed and no funnel-shaped erosion was noticed using V5E and EE. No significant differences in µSBS were observed between resin cements. However, significantly lower µSBSs were recorded when the self-etching mode was used. Thermocycling resulted in a significant reduction in µSBS for all groups. Conclusion: Selective enamel etching should be recommended to improve the interfacial quality when dual-cure resin luting cements are used. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of carbodiimide (EDC) and chitosan (CHI) on the enzymatic activity (EA) and bond strength (BS) of different composite cements to root dentin. Materials and Methods: Ninety (90) maxillary canines were sectioned, standardizing the length of the roots. The roots were endodontically treated, prepared, divided into 3 groups according to dentin treatment (distilled water [DW], CHI 0.2 wt%, or EDC 0.5M), and further subdivided into 3 subgroups according to composite cement (RelyX ARC [3M Oral Care], Panavia F 2.0 [Kuraray Noritaki], or RelyX U200 [3M Oral Care]). Of the slices obtained by sectioning, the most cervical of each third were subjected to a push-out test and the most apical were subjected to in-situ zymography. Half of the slices were analyzed immediately, and the other half after 6 months. The results were analyzed with ANOVA or the chi-squared test. Results: RelyX ARC showed higher BS associated with CHI, while RelyX U200 showed higher BS associated with EDC (p = 0.044). For Panavia F 2.0, the treatment did not influence BS (p > 0.05). For the cervical and middle thirds, no differences were observed between the cements, while the apical third revealed higher BS for RelyX U200 (p < 0.001). The highest percentage of adhesive-to-dentin failures was observed for Panavia F 2.0. EDC showed the lowest percentage of adhesive-to-dentin failures. According to zymographic analysis, DW and CHI showed greater fluorescence for RelyX ARC, while EDC exhibited the lowest fluorescence of all cements (p > 0.05). Conclusion: The different mechanisms of action of solutions for pre-treatment of intraradicular dentin yielded different results depending on the adhesive used. EDC resulted in higher bond strength and higher enzyme inhibition for RelyX U200, while the treatment with chitosan resulted in higher bond strength and lower enzymatic activity for RelyX ARC. Although EDC and chitosan treatments did not influence the bond strength for Panavia F 2.0, both resulted in higher enzyme inhibition for this composite cement. [ABSTRACT FROM AUTHOR]

Purpose: This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model. Materials and Methods: The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM. Results:CTRL exbited significantly higer UTBD At baseeline in comparison to PRIM p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL. Conclusions: CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of universal adhesives on the long-term bond strength to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). Materials and Methods: Polyethylene tubes filled with composite cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were adhesively luted to 60 fully sintered Y-TZP slabs (7 x 7 x 2 mm) with or without (control) previous application of a 10-MDP-based adhesive (All Bond Universal, Bisco) - ABU; Clearfil Universal Bond Quick, Kuraray Noritake - CUB; Scotchbond Universal Adhesive, 3M Oral Care - SUA) on the zirconia surface. The bonded specimens were stored in water for 24 h, 6 months, or 1 year and subjected to microshear bond strength testing. The data were analyzed by one-way ANOVA and Tukey's test (p < 0.05). The contact angle was measured after adhesive application to evaluate surface wettability. The adhesive-treated specimens were analyzed with x-ray photoelectron spectroscopy (XPS) and time-of-flight secondary ion mass spectrometry (ToF-SIMS) for chemical characterization. Results: The application of a 10-MDP-based adhesive significantly improved bond strength of composite cement to zirconia when compared to the control group (no adhesive application) (p < 0.05). One-year water storage significantly decreased bond strength for ABU- and CUB-bonded specimens, but not for SUA-bonded specimens. The analysis by XPS and ToF-SIMS showed peaks of carbon, phosphorus, and silicon in all adhesive-treated specimens. Conclusions: One-year water storage affected the bond strength of composite cement to zirconia when All Bond Universal or Clearfil Universal Bond Quick were used. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 24-month clinical performance of a "no wait" universal adhesive with different application modes in comparison with an etch-and-rinse and two-step self-etch adhesive in noncarious cervical lesions (NCCLs). Materials and Methods: A total of 234 noncarious cervical lesions in 34 patients were restored following 5 different adhesive approaches: 1. Clearfil Universal Bond Quick (Kuraray Noritake), self-etch mode (CUQ-SE); 2. Clearfil Universal Bond Quick, selective enamel-etch mode (CUQ-SLE); 3. Clearfil Universal Bond Quick, etch-and-rinse mode (CUQ-ER); 4. Clearfil SE Bond (Kuraray Noritake; self-etch adhesive) (CSEB); 5. Tetric N-Bond Universal (Ivoclar Vivadent), etch-and-rinse mode (TBU-ER). All NCCLs were restored with a nanohybrid composite (Tetric N-Ceram; Ivoclar Vivadent). The restorations were evaluated at baseline, 6, 12, and 24 months of clinical service regarding retention, marginal adaptation, marginal discoloration, secondary caries, post-operative sensitivity, color match, surface texture using modified United States Public Health Service (USPHS) criteria. Results: The patient recall rate at 24 months was 73.5%. Eleven restorations, 6 of the CUQ-SE group, 4 of the CSEB group and 1 of the TBU-ER group, were clinically unacceptable due to retention loss. Regarding marginal adaptation and discoloration, CUQ-SE and CSEB groups exhibited higher bravo scores than other groups after 24 months (p < 0.05). At the end of 24-month examinations, no significant differences were detected among the groups regarding secondary caries, post-operative sensitivity, color match and surface texture. Conclusion: The clinical survival rates of the "no wait" universal adhesive at self-etch mode after 24 months were not acceptable. The "no wait" universal adhesive showed clinically acceptable performance in selective enameletch and etch-and-rinse mode, according to the evaluated USPHS criteria. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the microtensile bond strength (µTBS) and silver nitrate uptake (SNU) of three universal adhesives used in etch-and-rinse (ER) and self-etch (SE) modes on dry, wet, and oversaturated dentin surfaces after 24 h and 1 year of water storage. The morphology of the hybrid layer (MHL) and the degree of conversion (DC) were also evaluated. Purpose: To evaluate the microtensile bond strength (µTBS) and silver nitrate uptake (SNU) of three universal adhesives used in etch-and-rinse (ER) and self-etch (SE) modes on dry, wet, and oversaturated dentin surfaces after 24 h and 1 year of water storage. The morphology of the hybrid layer (MHL) and the degree of conversion (DC) were also evaluated. Results: When 24-h vs 1-year data were compared, there was a significant decrease in µTBS and an increase in SNU values for the majority of experimental groups (p < 0.0001). On dry (ER) and oversaturated (ER and SE) dentin, AMB showed higher µTBS than did PBA (p < 0.00001). No significant decrease in µTBS was observed when universal adhesives were applied in the SE mode to dry dentin (p > 0.05). Regarding SNU, at all moisture levels, AMB showed lower SNU values than SBU (p < 0.001). Regarding MHL, SBU showed several imperfections when applied to oversaturated dentin in comparison with AMB and PBA. Regarding DC, when dentin was kept dry or was oversaturated, AMB showed a higher DC than PBA (p < 0.0001). Conclusion: The behavior of the different universal adhesives evaluated did not vary when applied to wet or dry dentin. However, the results with oversaturated dentin were dependent on the universal adhesive. Independent of the moisture level and the universal adhesive evaluated, significant degradation of the bonding properties occurred after 1 year of water storage, with the exception of universal adhesives applied to dry dentin in the SE strategy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether varying thicknesses of universal adhesives utilizing the additional coating strategy would affect their microtensile bond strength (µTBS) to dentin, hardness, and elastic modulus (mechanical properties). Materials and Methods: Ninety-nine human maxillary premolars were cut to expose coronal dentin, ground with regular-grit diamond burs, and randomly distributed into nine groups based on 1. adhesive: Scotchbond Universal Adhesive (SB; universal), G Premio Bond (GP; universal) and Clearfil Megabond 2 (MB; two-step self-etch; control); and 2. application strategy (one, two or three coats; each coat light cured). After adhesive application and resin composite buildup, the bonded teeth were stored in distilled water (37°C; 24 h). Resin-dentin sticks from eight premolars per group (each premolar yielded three sticks; n = 24 sticks altogether) were prepared for the µTBS test, followed by measurement of the adhesive thicknesses at their fractured ends using SEM. The mechanical properties of the adhesive layers produced by different coats were evaluated on separate resin-dentin slices (n = 3 teeth per group). Results: Two coats significantly increased the µTBS (p < 0.001) of all the adhesives. The correlation between adhesive thickness and bond strength was positive for GP but negative for SB. MB did not show any correlation. Additional coating significantly increased the mechanical properties of GP (p < 0.05) but did not affect SB and MB (p < 0.05). Conclusion: An additional adhesive coating over the manufacturers' recommendations improved the bond strength of all the adhesives tested. However, the increased mechanical properties of the adhesives with additional curing was material dependent. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of roughness and drying time of dentin as well as the number of coats of a selfadhesive composite-cement primer on the bond strength of self-adhesive composite cement. Material and Methods: Sixty human teeth were prepared and assigned to 12 groups (n = 5), according to three experimental factors: 1) dentin surface roughness, rough or fine, as achieved by 250- and 600-grit silicon carbide papers, respectively; 2) dentin wetness based on air-drying time (5 or 10 s); and 3) the self-adhesive composite-cement primer applications (no-coat, 1-coat, and 2-coat). Composite resin blocks were made with hybrid composite resin (M1 GraceFil) and cemented with G-CEM ONE (both GC). Cement-dentin sticks (12) were prepared, and the microtensile bond strength (µTBS) test was performed. Failure modes were observed with a stereomicroscope (40X), and bonding interfaces were evaluated with confocal laser scanning microscopy (CLSM). Statistical analysis was performed using threeway ANOVA and Tukey's post-hoc comparisons test (a = 0.05). Results: Dentin roughness (250-grit > 600-grit, p = 0.000), drying time (5-s drying > 10-s drying, p = 0.000), and primer application (no-coat < 1-coat = 2-coat, p = 0.000) had significant effects on bond strength. These factors also showed significant interactions with each other (p = 0.003). The highest µTBS (31.8 ± 3.1 MPa) was observed in the 1-coat/fine roughness/10-s drying group and the lowest µTBS (13.4 ± 2.7 MPa) in the no-coat/coarse roughness/5-s drying group. CLSM showed higher penetration of cement in the primer-coated groups compared to that in the no-coat groups. Conclusion: Bond strength between the self-adhesive composite cement and dentin was higher in the fine-roughness dentin group than in the coarse-roughness dentin group, and in the 5-s drying group compared to the 10-s drying group. Applying a primer to dentin improved bond strength of the self-adhesive composite cement. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effect of active pre-conditioning with 17% ethylenediaminetetraacetic acid (EDTA) vs 37% phosphoric acid (PA) on the resin-enamel microshear bond strength (µSBS), enamel-etching pattern, and in situ degree of conversion (in situ DC) of four universal adhesives on sound and fluorotic enamel. Material and Methods: In this study, 448 extracted human molars (224 without fluorosis and 224 with fluorosis) were sectioned into four parts and divided into 16 experimental groups based on the enamel surface (sound or fluorotic enamel), adhesive (Clearfil Universal Bond [CUB], Futurabond U [FBU], iBond Universal [IBU], or Scotchbond Universal [SBU]), and enamel conditioning agent (PA or EDTA). The specimens were stored for 24 h and tested under shear stress at 1.0 mm/min to determine the µSBS. The adhesive-enamel interfaces were evaluated for in situ DC using micro-Raman spectroscopy. The enamel-etching pattern was evaluated using a scanning electron microscope. The µSBS and in situ DC data were analyzed separately using three-way ANOVA and Tukey's post-hoc test (a = 0.05). Results: Sound enamel showed higher µSBS and in situ DC compared to fluorotic enamel (p < 0.05). However, no significant difference was observed for µSBS, in situ DC (p > 0.05), or etching patterns when PA and EDTA etching were compared in sound and fluorotic enamel. Moreover, CUB and SBU showed higher mean µSBS than did FBU and IBU in both sound and fluorotic enamel (p < 0.05). Conclusions: Compared to PA, active pre-conditioning with EDTA showed similar µSBS and enamel etching patterns for all the adhesives in fluorotic enamel, without compromising the in situ DC. [ABSTRACT FROM AUTHOR]

Objectives: This clinical trial evaluated the effects of red wine exposure on the effectiveness of at-home bleaching with 10% carbamide peroxide, degree of tooth sensitivity, and levels of periodontal inflammatory markers. Method and materials: Eighty participants were assigned to two groups, namely, those who drank red wine (experimental group), and those who did not drink red wine (control group). The experimental group participants rinsed their mouths with 25 mL of red wine four times a day during the bleaching period. Shade evaluation was assessed visually by using the Vita Classical and Vita Easyshade techniques. Tooth sensitivity was evaluated by the numeric and visual analog scales, and the salivary and gingival crevicular fluids were collected for assessment of nitric oxide (NO) levels, a marker of inflammation. Differences in color change were analyzed by oneway analysis of variance (ANOVA). The absolute risks of tooth sensitivity were compared by the Fisher exact test. Tooth sensitivity intensity data sets for both the visual analog scale and the numeric rating scale were compared using the Wilcoxon signed rank test (α = .05). Repeated measures and two-way ANOVA followed by the Bonferroni test were used to assess time-course and differences between groups in NO production. Results: The bleaching technique was effective regardless of wine consumption (P > .05). Tooth sensitivity was classified as mild, with no differences between groups (P > .05). Red wine reduced both the gingival crevicular fluid and salivary levels of NO (P < .05). Conclusion: Red wine does not interfere with the effectiveness and sensitivity of at-home teeth bleaching with 10% carbamide peroxide and protects against bleaching-induced inflammation. [ABSTRACT FROM AUTHOR]

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 (a = 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated whether active application of self-etching adhesives would influence their microtensile bond strength (µTBS) to dentin cut with burs of different grit sizes. Materials and Methods: Eighty-four human premolars were divided into 12 groups according to 1) two dentin surface preparations with either superfine- or regular-grit diamond burs; 2) three adhesives - Clearfil SE Bond 2 (SE2), Scotchbond Universal (SBU, 3M Oral Care) and G-Premio Bond (GPB, GC); and 3) two application modes of each adhesive (active or passive). Six bonded teeth per group were sectioned into sticks for µTBS testing. Statistical analyses were performed using 3-way ANOVA followed by Duncan's test (p < 0.05). Additional teeth were prepared to observe the interaction between the dentin smear layer obtained from each bur with adhesives under different application modes using transmission electron microscopy (TEM). Results: Active application significantly increased the dentin bond strength of SE2, irrespective of the kind of bur used (p < 0.05). The highest bond strength of SBU was observed when bonded to superfine-grit diamond bur-cut dentin with the active application. There was, however, no influence of the tested factors on GPB group (p > 0.05). TEM observation showed that active application promoted dentin smear layer dissolution in all adhesive groups. Conclusions: Bond strengths of self-etching adhesives to dentin are influenced by bur-cut smear layers and mainly by application mode of adhesive materials. Active application improves µTBS of self-etching adhesives by enhancing smear layer modification and resin penetration into bur-cut dentin. [ABSTRACT FROM AUTHOR]

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 (a = 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. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effect of different methods of cleaning residual composite cement from the surface of lithium-disilicate glass-ceramic on its bond strength. Materials and Methods: Blocks of lithium-silicate glass-ceramic (e.max CAD) were coated with composite cement. Blocks in a positive control (CO+) group received no cement; negative controls (CO-) received composite cement. After water storage (24 h), specimens were cleaned as follows (n = 20/group): BUR: grinding with a fine-grit diamond bur (20 s); ALUM: air abrasion with 50-µm alumina (10 s); GLASS: air abrasion with 50-µm glass beads (10 s); FURN: firing in ceramic furnace and cleaning with ethanol; SULF: immersion in sulfonic acid solution (1 h); HYFL: no additional treatment. All specimens were etched with hydrofluoric acid, aside from the CO-group, and treated with silane. A 1.5-mm diameter cement-filled tube was affixed to the specimens and light polymerized. Specimens were stored in 37°C water for 24 h (n = 10) or 90 days (n = 10). Shear bond strength was tested. Twoway ANOVA and post-hoc Tukey tests were performed. Specimens from each group were examined with SEM. Results: Bond strength significantly differed according to surface cleaning method (p < 0.01) and storage time (p < 0.01), but their interaction was not significant (p = 0.264). Longer storage time decreased the bond strength. BUR, ALUM, GLASS, and FURN did not differ statistically significantly from CO+, but were significantly greater than CO-. SULF and HYFL did not differ statistically significantly from CO- and were significantly lower than CO+. Conclusions: Cleaning composite cement with BUR, ALUM, GLASS, and FURN restored bond strengths to that of the positive control. However, only GLASS and FURN did not roughen the surface of the underlying lithium-silicate glass-ceramic. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of the etching strategy of universal adhesives on bond degradation to sound and artificially-induced caries-affected dentin. Materials and Methods: The universal adhesives (Scotchbond Universal Adhesive; All-Bond Universal; Prime&Bond Elect) and adhesives used as controls (Adper Single Bond 2 and Clearfil SE Bond) were applied to sound and artificially-induced caries-affected bovine dentin. Microtensile bond strength was evaluated immediately (24 h) and after one year of water storage (1 year). Representative specimens were also prepared to assess nanoleakage. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 0.05), considering each substrate separately. Results: Bonding degradation was observed for all universal adhesives on caries-affected dentin, irrespective of the etching strategy. On sound dentin, bonding degradation was observed when adhesives were used on the etchand-rinse strategy. Conclusion: The universal adhesives were not capable of maintaining bond stability over time on caries-affected dentin. The self-etch strategy seems better able to maintain the durability of adhesive interfaces created on sound dentin. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of several etching products prior to the application of a one-step self-etch adhesive (1-SEA) or two-step self-etch adhesive (2-SEA) on enamel by microshear bond strength (μSBS) testing and observation of the adhesive-enamel interface. Materials and Methods: Ground human enamel surfaces were randomly assigned to one of eight groups according to the combination of surface treatments (either no conditioner [NC], ME [Multi Etchant], EC [Enamel Conditioner], or KE [K-etchant Gel]) and adhesive (ADU [Adhese Universal] or SE2 [Clearfil SE Bond 2]). All groups were further divided into two subgroups: 0 or 10,000 thermal cycles (TC). Then, the μSBS test was performed. The adhesive-enamel interface after acid-base challenge and the surface structure after conditioner application were also observed. Results: With 10,000 TCs, there was no statistically significant difference between ME-ADU and NC-ADU. On the other hand, the μSBS of EC-ADU or KE-ADU was significantly higher than that of NC-ADU, while that of ME-SE2 was significantly lower than NC-SE2. There was no significant difference between EC-SE2, NC-SE2, and KE-SE2. Formation of an acid-base resistance zone (ABRZ) was confirmed in all groups. However, funnel-shaped erosion, which indicates interfacial defects, was observed in the NC-ADU, ME-ADU, and ME-SE2 groups. Conclusion: For enamel bonding, application of EC or KE prior to ADU increased the bond strength and created a stable adhesive-enamel interface. On the other hand, SE2 also had stable shear bond strength and interface without the use of conditioners. However, ME decreased the bonding performance of SE2. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of pretreatment with different crosslinking agents on glass-fiber-post adhesive luting. Materials and Methods: Single-rooted human teeth (n = 20) were randomly assigned to four groups: proanthocyanidins (PA) from grape-seed extract, cardol and cardanol (separated from cashew nut-shell liquid) and negative control (hydroethanolic solution). The solutions were applied on 37% phosphoric acid-etched dentin for 60 s. Glassfiber posts were cemented using a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M Oral Care) and composite cement (RelyX ARC, 3M Oral Care). Slices for the push-out bond strength test were cut and tested after 24-h or 6-month storage in distilled water. The dentin underlying the adhesive layer was analyzed by micro-Raman spectroscopy to evaluate vibrational formation of collagen crosslinks. Three additional slices per group were also made and the adhesive in-situ degree of conversion (DC) was analyzed by micro-Raman spectroscopy. The results were analyzed using two-way ANOVA and Tukey's test (p < 0.05). Results: No statistically significant changes in bond strength were found over time for any of the groups, except with cardol, which increased bond strength (8.4 ± 3.9 MPa at 24 h to 15.0 ± 2.9 MPa after 6 months, p < 0.001) after aging. The formation of peaks at 1117 cm-1 and 1235 cm-1 showed the presence of collagen crosslinks for all three biomodification agents. The DC outcomes showed no statistically significant differences between groups (p = 0.514). Conclusion: Biomodification agents did not impair adhesive polymerization. Cardol demonstrated a positive influence on intraradicular dentin bonding for glass-fiber post luting. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the push-out bond strength (PBS) of glass-fiber posts (GFP) in different root canal zones (cervical, middle, and apical), bonded with experimental simplified adhesives (ESAs) containing different initiator systems (camphorquinone [CQ] or phenylpropanodione [PPD]) with or without diphenyl iodonium hexafluorophosphate (DPI), in combination with a DPI-containing composite cement. Materials and Methods: ESA blends were prepared with bisphenol glycidyl methacrylate (bis-GMA), triethylene glycol dimethacrylate (TEG-DMA), 1,3-glycerol dimethacrylate (GDMA), 2-hydroxyethyl methacrylate (HEMA), and ethanol, then divided into 12 experimental groups (n = 10) according to the initiator systems (CQ, PPD, or CQ + PPD) and the presence or absence of DPI. The roots of 120 extracted bovine incisors were prepared with #5 Largo drills and the GFP were cemented with each ESA and experimental composite cements containing 0.05 mol% of DPI. The push-out bond strength (PBS) test was performed after 24 h of storage. Failure patterns were analyzed under a stereomicroscope. Data were analyzed with split-plot two-way ANOVA and Tukey's test (α = 0.05). Results: PBS was significantly higher for DPI-containing ESAs in all regions evaluated, with the group containing 0.5 CQ + 1 PPD + 0.5 DPI exhibiting the highest PBS. There was no statistically signficant difference among groups without DPI. Most failures were classified as adhesive at the cement-dentin interface. Conclusions: The combination of an adhesive and a composite cement containing DPI salt can improve GFP bonding to root dentin, even in the apical region. [ABSTRACT FROM AUTHOR]

Purpose: Mild and intermediately strong 2-step self-etch adhesives (2SEa) have been shown to bond efficiently to dentin. In general, their bonding efficiency to enamel is inferior to that of etch & rinse adhesives (E&Ra). On the other hand, their application procedure is less elaborate, and consequently leaves less room for application mistakes. The aim of this randomized controlled trial was to evaluate the clinical performance of an intermediately strong 2SEa, as compared with that of a 3-step E&Ra after 6 years of clinical functioning. Materials and Methods: 239 non-carious cervical lesions in 50 patients were restored with the nanohybrid composite Herculite XRV (Kerr), bonded in random order either with the 2SEa Optibond XTR ('O-XTR', Kerr) or the goldstandard control 3E&Ra Optibond FL ('O-FL', Kerr). The restorations were recalled after 1, 2 and 6 years of clinical service and examined for retention, marginal adaptation, marginal discoloration, caries occurrence, and postoperative sensitivity. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). Results: The patient recall rate at 6 years was 94%. The overall clinical success rate was 81.9% and 80.9% for O-XTR and O-FL, respectively. In total, 42 restorations (21 O-XTR, 21 O-FL) failed because of retention loss, severe abfraction/abrasion/erosion, severe marginal defects and/or discoloration, and/or caries. A retention rate of 92.9% and 88.9% was recorded for O-XTR and O-FL, respectively. Progressive marginal deterioration was observed over the 6-year period. Small clinically acceptable marginal defects were recorded in about 70% of the restorations (O-XTR: 69.9%; O-FL: 74.1%). Regarding marginal discoloration, 37% of the O-XTR and 30.2% of the O-FL restorations showed superficial clinically acceptable marginal discoloration. Six O-XTR and 4 O-FL restorations exhibited caries at the restoration margin. No significant difference was observed between the two groups for any of the evaluated parameters (p > 0.05). Conclusion: After 6 years of clinical service, Class-V restorations bonded with the 2SEa performed clinically equally well as those bonded with the 3E&Ra. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate in vitro the effect of saliva contamination on bond strength of a universal adhesive applied with actively (with rubbing motion) and passively (without rubbing motion). Materials and Methods: A total of 144 bovine dentin samples were used, and the universal adhesive, Clearfil Universal Bond Quick, was either applied in accordance with the manufacturer's instructions (passive application) or applied with rubbing motion for 10 s (active application). These 2 groups were divided into 6 subgroups according to saliva contamination (n = 12): 1. control: etch-and-rinse (no saliva); 2. control: self-etch (no saliva); 3. etching/saliva/bonding; 4. etching/bonding/saliva; 5. saliva/bonding; 6. bonding/saliva. A resin composite, Filtek Ultimate, was filled into a polyethylene mold (0.9 mm diameter, 1.2 mm height) on the surfaces. Samples were subjected to microshear bond strength testing, and five specimens from each group were examined using SEM. Resin-dentin interfaces were also observed using transmission electron microscopy (TEM). All failure modes were determined using light microscopy. Statistical analyses were performed with two-way ANOVA, the Kruskall-Wallis test, and the Mann-Whitney U-test (p < 0.05). Results: Active-application groups showed statistically significantly higher bond strengths than did passive groups, regardless of adhesive strategy and saliva contamination (p < 0.05). Application of Clearfil Universal Bond Quick in self-etch mode with rubbing motion improved the µSBS among control groups (p < 0.05). The active application did not make a significant difference among the active groups (p > 0.05), except in group 2. Groups 2 and 5 showed significantly higher µSBS than group 3 among the passive groups (p < 0.05). Conclusion: Rubbing the universal adhesives without any prior etching may increase the dentin bond strength. Following etching, passive application of the universal adhesive (without any additional rubbing motion) could affect the bonding to dentin in the presence of saliva. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the fatigue performance and stress distribution of endodontically treated maxillary premolars with occlusal (O), mesio-occlusal (MO), or mesio-occluso-distal (MOD) cavities filled directly with bulk-fill composite. Materials and Methods: Besides the intact teeth (control group), sixty sound maxillary first premolars, standardized by size and morphology, were subjected to root canal treatment and randomly allocated to three groups throughout cavity preparations (O/MO/MOD). All cavities were restored with a bulk-fill composite (Tetric N-Ceram Bulk fill) and universal adhesive (Tetric N-Bond Universal) using etch-and-rinse mode. Half of the specimens of each group underwent 20,000 thermocycles (5°C-55°C). All specimens were subjected to a 50-N load perpendicular to their buccal bevels on the palatal cusps for 1,200,000 cycles. The survival curve and fracture mode were analyzed by log-rank and Fisher's exact tests, respectively. Finite element analysis (FEA) was conducted to simulate the working condition of premolars with O/MO/MOD cavities. The von Mises stress and the first principal stress were calculated for three FEA models. Results: Premolars with O cavity restorations exhibited better stress distributions than did those with MO and MOD cavity restorations. Compared to the intact premolars, no significant difference was detected in the fatigue performance of O/MO/MOD restorations, regardless of whether they underwent thermocycling. Only one specimen presented unrestorable fracture, while the rest of the fractured premolars were restorable. Conclusion: The cavity design of endodontic premolars restored with a bulk-fill composite has no influence on the stress distribution or fatigue survival, with a biomechanical performance similar to that of an intact tooth. [ABSTRACT FROM AUTHOR]

Aim: Dental bleaching could adversely affect dentine hardness. The aim of the present study was to evaluate the effect of cervical dentine thickness on hardness reduction of outer dentine following intracoronal bleaching. Materials and methods: Thirty-six intact anterior teeth were selected and the root segments were separated 2 mm below the cementoenamel junction. Using a diamond fissure bar, dentine substrate was removed so that cervical dentine thickness in one part of the separated tooth was twice that in the other half. A resin-modified glass-ionomer cement plug was placed in 2-mm thickness from the apical side. Teeth were randomly divided into three groups (n = 12) to be treated with bleaching agents containing 35% hydrogen peroxide, sodium perborate, and distilled water in the control group. Vickers hardness numbers were measured for outer and inner dentine in each tooth sample. Data were analysed using Mann-Whitney U tests. Results: The mean Vickers hardness number between the two dentine thicknesses showed a statistically significant difference only in the sodium perborate bleaching group (P = 0.000). The mean Vickers hardness number of inner dentine was significantly higher in the small dentine thickness in comparison to the large dentine thickness (P = 0.000). The mean Vickers hardness number of outer dentine was significantly higher in the large dentine thickness in comparison to the small dentine thickness (P = 0.000). Conclusions: Within the limitations of this laboratory study, even in the presence of an orifice barrier, removal of excessive dentine from the root canal walls during root canal preparation could increase the damaging effect of bleaching materials on outer dentine microhardness. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the roughness, surface energy, and the bond strength of lithium disilicate yielded by two different types of nonthermal plasma (NTP), oxygen- or argon-based, compared to the conventional method. Materials and Methods: Ninety-three lithium disilicate (IPS e.max Press) samples were divided into 3 groups: HF (hydrofluoric acid group); ONTP (oxygen-based NTP group); ANTP (argon-based NTP group). Surface energy and roughness analyses were performed before and after surface treatment, and bond strength testing was performed before and after 5000 thermocycles. Scanning electron microscopy (SEM) was used to characterize the surface treatments. Data were submitted to ANOVA and Bonferroni's test with statistical significance set at 5%. Results: The ONTP group presented the highest surface energy values, followed by ANTP and HF. In addition, the ONTP group had higher surface roughness. SEM revealed exposed lithium disilicate crystals in the HF group, but a homogeneous film coverage in both NTP groups. Regarding bond strength, ANTP presented statistically significantly higher values than the other groups before thermocycling, and statistically significantly lower values than the other groups after thermocycling. The HF and ONTP groups presented statistically similar values after thermocycling. Conclusion: The bond strength of resin cement to lithium disilicate obtained after oxygen-based NTP was comparable with that obtained after conventional hydrofluoric acid treatment. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of root-canal dentin pretreatment with the crosslinker EDC combined with chitosan nanoparticles (Csnp) on the bonding quality of fiber posts in root canals in terms of bond strength, nanoleakage, quantification of collagen degradation, and degree of conversion (DC) of adhesive. Materials and Methods: Forty-eight single-rooted teeth were prepared endodontically and etched using UNI-ETCH (Bisco) as per the adhesive procedure for fiber posts. They were randomly divided into three groups before adhesive (All-Bond 3) application, according to different pretreatments: a. immersed in 2.5% glutaraldehyde for 24 h; b. treated with Csnp solution under ultrasonic agitation for 60 s and immersed in EDC crosslinker for 24 h; c. without treatment (control). Bond strength, nanoleakage, DC within the interface, and collagen fiber degradation were evaluated. Results: The pretreatments had a significant influence on the bonding stability of fiber posts in root canals, but not on the degree of conversion (p = 0.552). Enzymatic degradation significantly influenced bond strength for all groups (p = 0.001), with the greatest effect found in group c. The amount of amino acids released from the adhesive interface differed significantly between groups after hydrolysis and enzymatic degradation (p = 0.000); group c released the highest amount of amino acids. Conclusions: Csnp binding to dentin in combination with EDC reduced degradation of dentinal collagen and improved the stability of the adhesive interface without jeopardizing adhesive polymerization. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the long-term effect of 0.05% or 0.1% caffeic acid phenethyl ester (CAPE) on dentin matrix stability and hybrid layer stability, using an etch-and-rinse (Adper Scotchbond Multipurpose/ASB) or a self-etch adhesive (Clearfil SE Bond/CSE). Materials and Methods: Dentin matrix specimens were assigned to five groups: 0.05% or 0.1% CAPE, green tea (GT), and the controls distilled water (DW) and dimethyl sulfoxide (DMSO). Following immersion of specimens for 1 h, modulus of elasticity (ME) and dentin mass change (MG) were determined at 3 post-treatment time points: immediately afterwards and at 3 and 6 months. Collagen solubilization (CS) was estimated by hydroxyproline (HYP) quantification. Resin-dentin interfaces with both adhesives were assessed with in situ zymography tests to evaluate gelatinolytic activity (GA). The dentin pretreatments were actively applied for 60 s. The sealing ability of aged resin-bonded slices was assessed by nanoleakage tests. Results: GT increased immediate ME, which decreased significantly after 3 months (p < 0.0001). The CAPE groups did not differ from the control groups. GT provided a significant increase in dentin matrix mass after treatment (p < 0.0001). No significant differences regarding MG were observed for CAPE 0.1%, CAPE 0.05%, DW, and DMSO groups after 3 and 6 months. Cumulative HYP release revealed that CAPE groups and GT were statistically similar to DW and DMSO; the GT group exhibited statistically significantly less HYP release than did CAPE groups (p = 0.0073). Treatment with 0.05% or 0.1% CAPE presented lower GA when applied to ASB before acid conditioning (p < 0.05), but no differences were detected when the CAPE groups were applied to CSE. CAPE at 0.1% significantly reduced nanoleakage for CSE, and 0.05% CAPE with CSE presented levels of nanoleakage similar to those of the CSE control group. Conclusion: CAPE at 0.05% or 0.01% did not influence ME, MG, or CS, but reduced GA when applied to ASB before acid conditioning. CAPE at 0.1% with CSE promoted adhesive layer integrity. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the present prospective and randomized clinical trial was to evaluate the clinical performance of noncarious cervical lesions (NCCLs) restored with different adhesion strategies on the dental substrate. Method and materials: An adhesive restorative system (Single Bond Universal/Z350XT) with and without selective enamel conditioning was evaluated, as well as a resin-modified glass-ionomer cement (Vitremer), with and without pretreatment with ethylenediaminetetraacetic acid (EDTA). Two operators placed a total of 200 restorations in 50 patients (four restorations per patient). Data from decayed, missing, and filled teeth (DMFT), visible plaque, and gingival bleeding were collected prior to the restorations and at each evaluation time. All restorations were evaluated using the modified United States Public Health Service (USPHS) evaluation system at baseline, and at 6 and 12 months. Data were analyzed by the Friedman, chi-square, Cochran, Wilcoxon, and multiple logistic regression analysis tests (P = .05). Results: There was a gradual and significant increase in DMFT with a difference among the three evaluations (P = .001). There was no difference for the Visible Plaque Index over time (P = .28); however, there was a significant reduction in the Gingival Bleeding Index between the baseline and the other evaluations (P = .001). There was no statistically significant difference among groups and periods of evaluations (P > .05). Regarding logistic regression, the model as a whole was statistically significant (P = .034). Conclusion: The four different adhesion strategies in the NCCL restorations presented similar clinical performance after 1 year of follow-up. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study evaluated marginal integrity, 2-body wear, and fracture behavior of an array of bonded and nonbonded posterior restorative materials after thermomechanical loading (TML). Materials and Methods: Eighty-eight MOD cavities with one proximal box beneath the CEJ were prepared in extracted human third molars according to a well-established protocol. Direct restorations were made using the following materials: amalgam (Dispersalloy), Ketac Molar Quick, Surefil One (with or without light curing), Activa, AdheSE Universal/Heliomolar, Fuji II LC improved, Equia Forte, Scotchbond Universal/Filtek Supreme, Xeno V+/CeramX.mono+, Prime&Bond active/Spectra ST CeramX HV, Prime&Bond elect/Spectra ST CeramX HV. Before and after thermomechanical loading (2500/5000/12,500 thermocycles between 5°C and 55°C + 100,000/200,000/500,000 x 50 N), marginal gaps and 2-body wear depths were analyzed on epoxy resin replicas using SEM and CLSM. Fractures were observed under a light microscope (20X). Results were analyzed with Kruskal-Wallis and Mann-Whitney U-tests (p < 0.05). Results: For marginal quality, Surefil One showed promising in vitro behavior close to that of resin composite bonded with a self-etch adhesive (p > 0.05). For wear, amalgam and resin composites with recent filler technology were still superior (p < 0.05), but Surefil One LC outperformed Activa, Ketac Molar Quick, Equia Forte Fil, and Fuji II LC (p < 0.05). When Surefil One was occlusally light cured, no fractures occured, even after 500,000 cycles of TML. Conclusion: The novel self-adhesive posterior restorative Surefil One did not exhibit superior outcomes for all evaluated aspects. However, it showed stable fracture behavior, good marginal quality, and acceptable wear resistance in vitro. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of ceramic-surface conditioning and aging on the bond strength between composite cement and zirconia-reinforced lithium-silicate glass-ceramics (ZLS) under simulated clinical conditions. Materials and Methods: ZLS disks (Celtra Duo, Dentsply Sirona, n = 110 test group n = 10, diameter: 8.3 mm, height: 3.4 mm) were assigned to four surface-conditioning groups: (I) 30 s of ~5% hydrofluoric-acid etching (Vita Ceramics Etch, Vita; HF), silanization (Calibra Silane; SIL); (II) successive contamination with saliva and silicone (CONT), HF, SIL; (III) CONT, tribochemical silicatization (CoJet), SIL; (IV) HF, SIL, application and light polymerization of an adhesive (Prime&Bond Active), CONT, reapplication and light polymerization of the adhesive. The ZLS disks were bonded to composite-resin cylinders in acrylic tubes (inner diameter: 3.3 mm) using self-adhesive composite cement (Calibra Universal). The tensile-bond strength (TBS) was measured after both 24 h and 6 months of water storage (WS). Additional aging protocols were tested for group I (3-day WS; 30-day WS including 7500 thermocycles between 6.5 and 60°C; 150-day WS including 37,500 thermocycles). Results: After 24 h, the mean TBS ranged between 21 MPa (group III) and 30-35 MPa (remaining groups). With the exception of 3-day WS, TBS was statistically significantly reduced by aging. The greatest reduction was observed for silicatized specimens (group III, mean TBS after aging: 9.8 MPa). Conclusion: Both ceramic surface conditioning and aging had a statistically significant effect on the bond strength between composite cement and ZLS. A treatment protocol based on tribochemical silicatization cannot be recommended for the adhesive cementation of ZLS. [ABSTRACT FROM AUTHOR]

Purpose: To compare the adhesive-enamel microshear bond strength (μSBS), in situ degree of conversion (DC), and the enamel-etching pattern of universal adhesives when applied for a prolonged period in the self-etch vs the etch-and-rinse mode in fluorotic enamel. Materials and Methods: Ninety-six human molars (48 with a Thylstrup and Fejerskov index [TFI] score of 0 and 48 with TFI score of 4) were sectioned into four parts and divided into 24 experimental groups based on enamel surface (sound enamel or fluorotic enamel), adhesive (Clearfil Universal Bond, Futurabond U, iBond Universal, or Scotchbond Universal), and enamel treatment/application time (etch-and-rinse mode [ER] or self-etch mode with application times of 20 s [20SE] and 40 s [40SE]). The specimens were stored for 24 h and tested in shear at 1.0 mm/min (μSBS). Adhesive-enamel interfaces were evaluated for DC using micro-Raman spectroscopy. The enamel-etching pattern was evaluated using SEM. For each adhesive, data from μSBS and DC were analyzed separately using two-way ANOVA and Tukey's post-hoc test at α = 0.05. Results: On sound enamel, 40SE usually resulted in statistically similar mean μSBS (p > 0.52) and statistically significantly improved mean DC values (p < 0.001) compared with the ER mode. Moreover, significantly improved mean μSBS and DC values were obtained compared with 20SE (p < 0.01). On fluorotic enamel, there was no statistically significant difference in μSBS between the experimental groups (p > 0.76). However, for each applied adhesive, 40SE resulted in improved mean DC values compared with 20SE or ER (p < 0.001). The deepest enamel-etching pattern was obtained in ER mode, followed by 40SE in sound and fluorotic enamel. Conclusion: Compared with ER mode, the prolonged application time of universal adhesives in SE mode in fluorotic enamel increased the DC, enhanced enamel-etching pattern and promoted similar results in terms of adhesiveenamel bond strength. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of human and bovine root dentin age on the bond strength of fiber posts fixed with resin cements. The degree of conversion (DC) of the resin cements in different root thirds also was evaluated. Materials and Methods: Ninety-six single-rooted teeth were divided into groups according to the origin and age: young human (20-30 years), old human (over 60 years), young bovine (24-36 months) and adult bovine (over 48 months). The teeth were endodontically treated, and fiber posts were cemented with resin cements (RelyX Ultimate and RelyX U200). After 24 h, the teeth were sectioned perpendicularly and the push-out test was performed in a universal testing machine at a speed of 0.5 mm/min, until failure. One specimen from each third from each group (n = 6) was selected, and the DC of the resin cements was analyzed by FT-Raman spectroscopy. Results: For both resin cements, the young human root dentin group presented the highest bond strengths and the old human root dentin group presented the lowest (p < 0.05). The bond strengths of bovine root dentin groups were not affected by aging (p > 0.05). For the DC of resin cements, there were differences among the root thirds (p < 0.05), with the lowest values observed in the apical third. Conclusions: The bond strengths were higher in the young human root canal than in the bovine substrate, with a negative effect of aging in the human substrate. The DC of dual-curing resin cements decreased from the coronal to apical root thirds. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether different etching methods with reduced etching times would improve the enamel bonding efficacy of universal adhesives. Materials and Methods: Three enamel etching methods were evaluated - 1. phosphoric acid ester monomer etching (PPM); 2. phosphoric acid etching (PPA); and 3. polyalkenoic acid etching (PLA) - as were three universal adhesives: 1. BeautiBond Universal (BU); 2. Prime&Bond elect (PE); and 3. Scotchbond Universal Adhesive (SU). The shear bond strengths of the universal adhesives to ground enamel and ground enamel etched for 1, 5, 10, and 15 s with different etching methods were determined after 24 h and 10,000 thermal cycles. Surface roughness average (Ra) and surface area ratio (surface area:planar area) were measured using a confocal laser scanning microscope. Field-emission scanning electron microscope (FE-SEM) observations of enamel with different etching protocols were also conducted. Results: The bond strengths of universal adhesives to enamel subjected to PPA etching with maximum times of 1-15 s and PLA etching for 15 s were significantly higher than those to ground enamel. The bond strength to enamel subjected to PPM etching did not increase and was similar to that for ground enamel. PPA and PLA etching were effective at increasing the Ra and surface area ratio of enamel. Although both values were significantly higher than those of ground enamel, those subjected to PPA etching were significantly higher than those which underwent PLA etching. In addition, the Ra and surface area of enamel subjected to PPM etching were similar to those of ground enamel, regardless of the etching time. Conclusions: Phosphoric acid etching for <1-15 s and polyalkenoic-acid etching for 15 s both improve the bonding of universal adhesives, the Ra, and the surface area ratio of enamel. However, phosphoric acid ester monomer etching was not effective, regardless of the etching time. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of different application modes of a recently introduced self-etching ceramic primer on the microshear bond strength (μSBS) and ceramic surface-etching pattern of two glass-ceramic surfaces. Materials and Methods: Twenty-two CAD/CAM blocks of lithium disilicate (LD) and feldspathic glass ceramic (VTR) were each cut into 4 rectangular sections (n = 88 for ceramic surface). The LD and VTR specimens were divided into one control group (hydrofluoric acid + silane coupling agent [HF+SII]), and 10 experimental groups using Monobond Etch and Prime (MEP) applied for a combination of scrubbing times (5, 10, 20, 40, and 60 s) and reaction times (20 or 40 s). After each treatment, Tygon matrices (n = 8) were filled with a resin cement and light cured for each ceramic specimen. The specimens were stored in water at 37°C for 24 h and subjected to the μSBS test. The failure pattern and μSBS were statistically evaluated (α = 0.05). In addition, the ceramic surface etching pattern was analyzed using scanning electron microscopy. Results: For the LD groups, the application of MEP 60/40 resulted in a higher mean μSBS compared to HF+SI (p < 0.05). Groups 5/40, 10/40, and 20/40 resulted in mean μSBS similar to that obtained by HF+SI (p > 0.05). For VTR, no significant difference was observed among the groups (p = 0.32). Compared with MEP, HF better promoted the dissolution of glass matrix for both ceramics. However, prolonged MEP scrubbing or reaction caused significant dissolution of the glass matrix for both evaluated ceramics. Conclusion: Active and prolonged application of MEP may be a viable alternative to HF+SI for increasing the bond strength to LD. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the bond strength to dentin produced by experimental adhesives formulated with an elastomeric methacrylate monomer (EMM) and an alternative initiator system based on a Thioxanthone derivative (QTX). Materials and Methods: A self-etching primer was used. For the bonding resin, a model adhesive (G1) was formulated containing bis-GMA/TEG-DMA/HEMA (co-monomeric blend) + CQ/EDAB (initiator system). The other groups were formulated by adding to this formulation: EMM only (G2), QTX (G3), or EMM and QTX (G4). Clearfil SE Bond was used as the commercial control group. Fifty bovine teeth (n = 5) were restored with each one of the five adhesives. After restorative procedures, half of the specimens were stored in distilled water at 37°C for 24 h. The other half was fixed on a metal stub and subjected to 200,000 mechanical (50 N loading at 2 Hz frequency) and 1000 thermal cycles (5°C and 55°C). Afterwards, specimens were serially sectioned into beams and tested in tension until fracture. Bond strengths were statistically analyzed by two-way ANOVA and Tukey's test (a = 5%). Results: After 24 h, significantly higher µTBS was observed for the formulation containing EMM and QTX (G4) when compared to Clearfil SE Bond (p < 0.05). No significant differences in µTBS were detected among the experimental groups after 24 h (p>0.05). After thermomechanical cycling, no significant differences were observed among groups. Conclusion: The addition of EMM and QTX can be considered as possible alternative in dental adhesive formulations. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of grape seed extract (GSE) pretreatment on the reduction of active gelatinases when using universal adhesives in etch-and-rinse mode. Materials and Methods: Fifty extracted non-carious human teeth were used in this study. Dentin powder was prepared for analysis of active MMP-2 by ELISA. Resin-dentin slices were prepared for in situ zymography in order to localize active gelatinases by quenched fluorescein-conjugated gelatin under a confocal microscope. Fluorescence intensity was analyzed quantitatively. Specimens were allocated into 6 groups: a non-treated control, phosphoric acid etched (PA), PA followed by Single Bond Universal (SBU, 3M Oral Care) or G-Premio Bond (GPB, GC), and PA followed by GSE for 1 min prior to SBU or GPB. The data were analyzed with one-way ANOVA and Bonferroni's test at a significance level of 0.05. Results: Application of the universal adhesives SBU and GPB in etch-and-rinse mode reduced active MMP-2 in dentin matrices. However, the only further significant reduction was found in GPB pre-treated with GSE, as analyzed by ELISA. In situ zymography demonstrated the location of active gelatinases, and fluorescence intensity analysis confirmed significant reduction of active gelatinases in the hybrid layer of GPB pre-teated with GSE compared to GPB alone. Conclusion: The present study demonstrated the potential advantage of applying GSE to reduce active gelatinases especially at the hybrid layer, with greater benefit achieved for hydrophobic adhesives. Nevertheless, the mechanism of action, analysis of bond strength, and long-term efficacy require further study. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of two phosphoric acids containing protease inactivators (chlorhexidine and proanthocyanidin) on the resin/eroded-dentin microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives applied in the etch-and-rinse mode. Materials and Methods: One hundred twenty-six molars were randomly assigned to 18 experimental conditions according to the combination of the independent variables: eroded dentin (soft drink and citric acid), adhesive (Prime&Bond Elect [PBE, Dentsply Sirona], Scotchbond Universal Adhesive [SBU, 3M Oral Care], and Tetric N-Bond Universal [TEU, Ivoclar Vivadent]), and acid pretreatment (conventional phosphoric acid [CP acid]; chlorhexidine acid [CHX acid]; and proanthocyanidin acid [PA acid]). After restorations, specimens were sectioned into resin-dentin sticks (ca 0.8 mm2) that were then tested under tension (crosshead speed: 0.5 mm/min). Selected sticks from each tooth were used to evaluate NL and DC. Data from all tests were subjected to three-way ANOVA and Tukey's test (α=0.05). Results: Dentin eroded with citric acid showed a significant reduction in μTBS for each adhesive in comparison to dentin eroded with the soft drink (p < 0.001). For dentin eroded with CHX acid and PA acid, the μTBS (p > 0.03) significantly improved and NL decreased for all adhesives (p < 0.004); in addition, the DC improved for two of the three adhesives tested (SBU and TEU) (p < 0.03) when CHX acid and PA acid were compared to CP acid. Conclusion: The addition of chlorhexidine and proanthocyanidin to phosphoric acid improved the adhesive performance when compared with conventional phosphoric acid, without jeopardizing adhesive polymerization at the resin/eroded-dentin interface. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of ethanol-wet/hydrophobic resin bonding (EWB) in a simplified dehydration protocol with ultrasonic agitation (UA) of etch-and-rinse adhesives on the bonding quality in root canals. Materials and Methods: 56 extracted human maxillary central incisors were divided into 4 groups (n = 14) according to the procedures of bonding fiber posts in root canals: A: conventional etch-and-rinse adhesive as control (All- Bond 3, Bisco); B: EWB in a simplified dehydration protocol, ie, after 100% ethanol dehydration (30 s, 3 times), ethanol/hydrophobic resin (50% bis-GMA + TEG-DMA, 50% ethanol) was applied into the root canal as a primer, followed by applying pure co-monomer adhesive; C: EWB in a standard dehydration protocol, ie, ascending concentrations of ethanol (50%, 70%, 80%, 90%) for 30 s and 100% ethanol (30 s, 3 times) for dehydration, with the remaining procedure conducted as in group B; D: EWB in a simplified dehydration protocol under ultrasonic agitation (UA), ie, 100% ethanol under ultrasonic agitation for 30 s, ethanol/hydrophobic resin as a primer applied under UA for 60 s, followed by the application of pure co-monomer adhesive. All the specimens were cemented with Duo-Link (Bisco) and immersed in artificial saliva for 24 h or thermocycled for 10,000 times. Bond strength, failure mode, and nanoleakage were evaluated. Hybrid layer and resin tags were also observed with SEM. Data were analyzed with two-way ANOVA (bond strength) and Kruskal-Wallis analysis (nanoleakage, resin tag score) (α = 0.05). Results: Significant differences existed in bond strength (p = 0.02) and nanoleakage (p = 0.02) among groups. After 24 h and after thermocycling, group D exhibited higher bond strengths than did group B (p = 0.02 after 24 h, p = 0.03 after aging) and group A (p = 0.06 after 24 h, p = 0.04 after aging). Bond strength and nanoleakage showed no significant difference after aging (p > 0.05). There was no significant difference in resin tag scores between any of the groups, but the apical third of the roots exhibited the lowest score (p = 0.001). Conclusion: The synergistic effects of the two pretreatment strategies (EWB in a simplified dehydration protocol and UA) improved the bonding quality. UA had a positive effect on the adhesion of the etch-and-rinse adhesives, when EWB in a simplified procedure was applied into the root canal. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this in vitro study was to compare the shear bond strength of different universal adhesives to enamel and dentin with and without additional phosphoric acid etching before and after thermocycling (TC). Materials and Methods: The mesial, distal, lingual, and buccal surfaces of the teeth were ground flat to expose two enamel areas and two dentin areas. Specimens were randomly divided into 36 groups (n = 10). Four adhesives were tested: Scotchbond Universal (SBU), Prime & Bond Elect (PBE), All-Bond Universal (ABU), and iBond Universal (IBU). The application was performed in the self-etch mode (SE) or in the etch-and-rinse mode (ER). Optibond FL (OFL) was used as an etch-and-rinse control. After composite buildups were made, half of the groups were tested before and the other half after TC. The failure mode was evaluated using a light microscope. Results: In enamel, mean bond strengths ranged from 13.4 to 21.9 MPa in the SE mode before TC. When used as an ER adhesive, mean bond strengths exceeded 30 MPa. TC did not influence the mean bond strengths in either application mode. Regarding dentin, significant differences in the SE mode were adhesive dependent. Differences were only detected between SBU and IBU before TC and were not present after TC. When SBU, PBE, and ABU were used as ER adhesives, no differences were detected before TC. TC only affected IBU when compared to the other adhesives. Conclusion: Universal adhesives benefit from phosphoric acid etching, as bond strengths increased especially at enamel surfaces. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate through a systematic review and meta-analysis whether the immediate and long-term bonding performance of universal adhesives would be improved by prior acid etching. Materials and Methods: Two reviewers performed a literature search up to April 2018 in eight databases: PubMed, Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BBO. Only studies that evaluated the dentin or enamel bond strength of universal adhesives using a self-etch or etch-and-rinse strategy were included. Analyses were carried out using RevMan 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). A global analysis comparing self-etch or etch-and-rinse strategies and the influence of aging on bonding performance was performed with random-effects models at a significance level of p < 0.05. Results: A total of 59 in vitro studies were included in the meta-analysis. The enamel bond strength of universal adhesives was improved by the etch-and-rinse approach (p < 0.05). In dentin, this effect was observed for ultramild and intermediately strong universal adhesives (p < 0.05). Irrespective of the strategy employed, intermediately strong adhesives showed a decrease in bond strength after all types of aging. This effect was also observed for ultra- mild universal adhesives used in the etch-and-rinse approach (p < 0.05). Mild universal adhesives showed bond strength stability in both strategies (p > 0.05). Conclusions: The in vitro evidence suggests that bonding performance of mild universal adhesives can be improved by using the selective enamel-etch strategy. Mild universal adhesives seem to be the more stable materials, in both etch-and-rinse or self-etch strategies. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of double application of self-etch adhesives on their microtensile bond strength (μTBS) to dentin, as well as the hardness (H) of resin-dentin interfacial structures. Materials and Methods: Midcoronal dentin surfaces (n = 45) were polished with 180-grit SiC paper and randomly allocated to 9 groups based on three adhesives -- Scotchbond Universal Adhesive (SB), G Premio Bond (GP), and Clearfil Megabond 2 (MB) -- and three application modes: single application (S), double application with light curing after each application (DL), and double application with light curing only at the end (D). Following composite-resin build up and water storage (37°C; 24 h), μTBS were obtained. The hardness of adhesive, resin-dentin interface and dentin were evaluated by nanoindentation. The μTBS and H data were analyzed by two-way ANOVA to demonstrate the effects of adhesive and application mode as well as their interaction, followed by Tukey's test (α = 0.05). Fracture modes were determined using a stereomicroscope. Results: μTBS and H were significantly affected by the adhesives and their application modes (p < 0.001). Double application significantly increased the μTBS and H of adhesive and resin-dentin interface (p < 0.05). SB and MB showed significantly higher μTBS than GP (p < 0.05). Conclusion: Double applications during bonding of dentin having clinically relevant smear layers were beneficial for three contemporary self-etch adhesives. The improvement in bonding performance is believed to be the result of increased chemical interaction, better solvent removal, and improved resin infiltration, leading to improved mechanical properties of the resin-dentin interface or thicker adhesive layers providing improved stress distribution. [ABSTRACT FROM AUTHOR]