Search

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Resin composites are commonly used in pediatric dentistry, but there is limited evidence on adhesion to primary teeth, especially primary enamel. In this study, three bonding strategies were assessed - one-step self-etch (1-SE), two-step self-etch (2-SE), and three-step etch-and-rinse (3-ER) - by measuring the immediate and aged microshear bond strength (µSBS) to sound primary enamel. Materials and Methods: 120 extracted human primary molars with sound buccal surfaces were used for µSBS testing. Six adhesive protocols (two per bonding strategy) were selected and µSBS was measured either after 24 h or 10,000 thermal cycles (n = 10). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were used to determine failure modes. Furthermore, 18 primary molars were etched using the different adhesive protocols (n = 3) for the measurement of surface roughness (Sa) using CLSM and morphological analysis using SEM. Results: After 24 h, there was no significant difference in µSBS between 1-SE and 2-SE strategies (p = 0.96), but the 2-SE strategy yielded significantly higher µSBS after thermocycling (p < 0.001). The highest µSBS was obtained using the 3-ER strategy regardless of aging (p < 0.001). The 3-ER strategy clearly exposed enamel prisms and resulted in the highest Sa (p < 0.001). In contrast, if SE strategies were used, enamel prisms were barely recognizable, and Sa was not significantly different from baseline (p > 0.95). Conclusion: The 3-ER strategy is optimal for bonding to primary enamel. The etching effect of SE strategies is weaker, resulting in lower µSBS. Thermocycling revealed that the bonding durability of the 1-SE strategy is inferior to that of to multi-step strategies. [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]

Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing. [ABSTRACT FROM AUTHOR]

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice.

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]

Naji Ziad Arandi Department of Conservative Dentistry, Faculty of Dentistry, Arab American University, Jenin, PalestineCorrespondence: Naji Ziad Arandi, Department of Conservative Dentistry, Faculty of Dentistry, Arab American University, Jenin, Palestine, Tel +972598126111, Email naji.arandi@aaup.eduAbstract: Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords “adhesive agents”, “classification”, “dentin”, “enamel”, “universal”, “self-etch”, “etch-and-rinse”, and “bonding”. The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or “multi-mode” according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.Keywords: adhesive agents, bonding agents, classification, dentine, enamel, etch-and-rinse, self-etch, universal adhesives

With the continuous development of adhesive technology leading to a wide variety of bonding systems in the market, clinicians are often faced with a vast number of systems to choose from. Although research and manufacture of bonding systems is constantly progressing, the focus has generally been on simplifying the bonding process by reducing the number of clinical steps, with little emphasis on evidence-based performance. This article draws attention to the current strategies of common commercially available products to guide clinicians during bonding system selection and application. [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]

Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Purpose: To evaluate the influence of application protocol on the shear bond strength (SBS) and nanoleakage of simplified adhesives over 18 months. Materials and Methods: 810 dentin slices were obtained from 405 caries-free human molars. They were randomly assigned to 54 experimental groups resulting from the combination of "adhesive" (Adper Scotchbond 1XT [S1XT], Solobond M [SM], Scotchbond Universal Adhesive in etch-and-rinse mode [SUER] and self-etch mode [SUSE], Adper Easy Bond [EB], Clearfil S3 Bond Plus [CS3]), "application protocol" (manufacturer's instructions [MI], two extra layers of adhesive [EL], hydrophobic resin layer [HL]), and "aging time" (24 h [24H], 6 months [6M], and 18 months [18M] in water). SBS tests were carried out using a Watanabe device followed by failure mode analysis. For the nanoleakage study, specimens from 54 additional molars were prepared as previously described, immersed in ammoniacal silver nitrate, and evaluated with SEM. SBS data were analyzed with ANOVA followed by Tukey's post-hoc tests; failure mode data were analyzed using chi-squared tests (α = 0.05). Nanoleakage data were analyzed with the Kruskal-Wallis test followed by LSD tests (α = 0.05). Results: After 18M, S1XT and SUSE achieved the highest mean SBS (p < 0.05). Regarding the application protocols, EL and HL provided higher mean SBS than those obtained with MI (p < 0.05). HL resulted in the highest mean SBS and the lowest mean nanoleakage after 18M. Conclusion: Simplified adhesives may need an extra hydrophobic resin layer to achieve a stable and durable adhesive interface. The self-etch approach should be recommended for the universal adhesive. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

This experiment aimed to synthesize a biomimetic mineralized hydrophilic polyurethane dentin primer containing DDDEEKC peptide (DDDEEKC-PU) to fill dentin tubules and induce mineralization. The degree of conversion (DC) was tested. Dentin samples were acid-etched and treated with DDDEEKC-PU. They were immersed in stimulated human fluid (SBF) for 7, 14 and 28 days. Dentin permeability, X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) and Vickers hardness were measured. After 28 days, regenerated minerals were deposited on resin tags which were confirmed to be hydroxyapatite (HAp). The minerals reduced the dentin permeability and improved the microhardness. DDDEEKC-PU was able to fill dental tubules immediately and induce mineralization simultaneously. [ABSTRACT FROM AUTHOR]

The aim of this study was to review and analyze the evidence on the enamel acid etching time when bonding to primary teeth. The research question was: Does the acid-etching time affect the bond strength to primary enamel? A systematic search across PubMed, Web of Science, Scopus and Google Scholar databases was conducted up to April 2024 to select studies that compared acid etching times on the bond strength values of adhesive systems to the primary tooth enamel. Studies evaluating other materials than adhesive systems, absence of bond strength values as mean and standard deviation, or ineligible comparison between intervention and control were excluded. Two reviewers screened studies for eligibility and assessed risk of bias. Bond strength data was the primary outcome. From 411 screened studies, 7 reports were assessed for eligibility, and 5 studies were included in the systematic review. Four studies had a high risk of bias and one study had a moderate risk of bias. Acid etching times range from 5 to 60 s. Three studies considered 15 s as a shorter acid etching time and the time of 30 or 60 s as a control. Two studies evaluated the effect of acid etching times on bond strength by comparing the 5, 20, 30, and 60 s groups. Only one study found statistically significant differences between the acid etching times. The main limitation of the study was the inclusion of only 5 studies with a high or moderate risk of bias. Longer acid etching times do not appear to improve the enamel bond strength in primary teeth. This is the first comprehensive review of enamel acid etching time on bonding to primary teeth. It may support the similar acid etching time for primary and permanent tooth enamel. [ABSTRACT FROM AUTHOR]

Universal adhesives have been widely used in dentistry due to their easy application process and wide range of applications. In the literature, the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors were reported to have an impact on the bonding performance of universal adhesives. This review focused on the factors affecting the bonding performance of universal adhesives and aimed to provide evidence-based recommendations for clinical practice. Current research suggests that the etch-and-rinse mode can achieve a better adhesive strength of enamel and that the etch-and-rinse mode and the self-etch mode exhibit a similar adhesive performance in bonding dentin. The bond strength would be improved by prolonging the application time, applying a double layer of adhesives, and wetting enamel and dentin with water or ethanol before adhesive procedures. Chlorohexidine (0.2%) and metal nanoparticles can inhibit matrix metalloproteinases (MMPs) and improve the long-term bond strength of dentin. Finally, universal adhesives have excellent stability and saliva pollution resistance, although they lack blood pollution resistance. In the clinic, dentists should pay attention to the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors that may affect the effect strength. universal adhesives will be improved in bonding strength of enamel in self-etch mode and bonding performance in demineralized dentals around caries.

Purpose: To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. Methods: This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4–8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- ClearfilTMS3Bond Plus (CSB); GII- ClearfilTMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). Results: The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). Conclusions: After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. Trial registration number: ISRCTN11458186. [ABSTRACT FROM AUTHOR]

Abstract Background It is still not fully understood what pretreatment is best for achieving maximum tightness for pit and fissure sealings (PFS). Aim This study investigated microleakage of PFS placed after etching with phosphoric acid or after the application of self‐etching primers/adhesives (SEPA). Design 131 third molars were assigned to ten groups. In Hel‐P, Helioseal® was applied after phosphoric acid etching. In the other groups, SEPA were used (Dyr‐AP: Adper™ Prompt™ L‐Pop™, Dyract® Seal; Bea: BeautiSealant Primer and Paste; Hel‐Exp: Experimental primer, Helioseal®; Hel‐Cl: Clearfil™ SE Bond1, Helioseal®). Specimens were stored in distilled water at 37°C (28 days), followed by 3500 thermocycles and staining with 5% methylene blue (M) or 5% silver nitrate (S). After methylene blue staining and sectioning, microleakage was assessed light microscopically. During silver nitrate staining, specimens were dissolved by 32% HCl and remaining PFS were evaluated under a SEM. Results Tightness, percentage of penetrated area, and maximum dye penetration were best for Hel‐P and Hel‐Cl (p

This experiment aimed to synthesize a biomimetic mineralized hydrophilic polyurethane dentin primer containing DDDEEKC peptide (DDDEEKC-PU) to fill dentin tubules and induce mineralization. The degree of conversion (DC) was tested. Dentin samples were acid-etched and treated with DDDEEKC-PU. They were immersed in stimulated human fluid (SBF) for 7, 14 and 28 days. Dentin permeability, X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) and Vickers hardness were measured. After 28 days, regenerated minerals were deposited on resin tags which were confirmed to be hydroxyapatite (HAp). The minerals reduced the dentin permeability and improved the microhardness. DDDEEKC-PU was able to fill dental tubules immediately and induce mineralization simultaneously.

The cervical area of teeth is the most unpredictable region for durable adhesive bonding. This study evaluated the adhesion potential of resin cement to coronal and cervical/root structures with a focus on enamel, dentin and cementum using etch-and-rinse and self-etch adhesive systems. Anterior teeth (N = 60) were randomly divided into six groups for adhesion tests: (a) unprepared enamel (UE), (b) ground enamel (GE), (c) mid-coronal dentin (D), (d) cervical enamel 2 mm above cementoenamel junction (CE), (e) cementoenamel junction (CEJ), and (f) root cementum (RC). Enamel and dentin surfaces were conditioned using either an etch-and-rinse (Syntac Classic-SY) or self-etch (Clearfil S3 Bond Plus-CS3) adhesive system. Resin cement (Variolink Esthetic) was adhered to the different substrates using polyethylene molds and photo-polymerized. Bonded specimens were stored in water for 24 h at 37 °C. Microshear tests (µSBT) were conducted in a Universal Testing Machine (1 mm/min) and failure types were analyzed after debonding. Data were analyzed using two-way ANOVA and t-test (alpha = 0.05). While substrate type (p < 0.001) and adhesive system (p < 0.001) significantly affected the bond results, interaction terms were not significant (p = 0.063). Within SY adhesive system, adhesion to all substrates were not significant ranging between (8.07 ± 2.39–6.80 ± 4.60) (p > 0.05), except for CEJ (5.19 ± 1.39) and RC (4.08 ± 1.13). With the CS3 adhesive system, all groups presented non-significant results (4.15 ± 1.35–6.04 + 2.38) (p > 0.05), except for D (3.57 ± 1.84) and RC (3.21 ± 1.13) (p < 0.05). µSBT values for D (7.19 ± 2.31) and RC (4.08 ± 1.13) were significantly higher for SY compared to that of CS3 (3.57 ± 1.84–3.21 ± 1.13, respectively) (p < 0.05). [ABSTRACT FROM AUTHOR]

Background: It is still not fully understood what pretreatment is best for achieving maximum tightness for pit and fissure sealings (PFS). Aim: This study investigated microleakage of PFS placed after etching with phosphoric acid or after the application of self‐etching primers/adhesives (SEPA). Design: 131 third molars were assigned to ten groups. In Hel‐P, Helioseal® was applied after phosphoric acid etching. In the other groups, SEPA were used (Dyr‐AP: Adper™ Prompt™ L‐Pop™, Dyract® Seal; Bea: BeautiSealant Primer and Paste; Hel‐Exp: Experimental primer, Helioseal®; Hel‐Cl: Clearfil™ SE Bond1, Helioseal®). Specimens were stored in distilled water at 37°C (28 days), followed by 3500 thermocycles and staining with 5% methylene blue (M) or 5% silver nitrate (S). After methylene blue staining and sectioning, microleakage was assessed light microscopically. During silver nitrate staining, specimens were dissolved by 32% HCl and remaining PFS were evaluated under a SEM. Results: Tightness, percentage of penetrated area, and maximum dye penetration were best for Hel‐P and Hel‐Cl (p < 0.05). Conclusions: Phosphoric acid etching of enamel and Clearfil™ SE Bond resulted in the best sealing quality. Methylene blue staining allowed the evaluation of more criteria (fissure shape, voids, sealant penetration depth) compared to silver nitrate. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the bonding of a new universal adhesive applied using different etching strategies on sound and caries-affected dentin of primary teeth. Materials and Methods: Flat dentin surfaces from 50 primary molars were randomly assigned to 10 groups according to substrate (sound dentin [SD] vs caries-affected dentin [CAD] pH cycled for 14 days) and bonding approach (Scotchbond Universal Adhesive: self-etching, vs dry or wet-bonding etch-and-rinse strategies; Adper Single Bond Plus [two-step etch-and-rinse adhesive] and Clearfil SE Bond [two-step self-etching system] as controls). After 24 h of water storage, bonded sticks with cross-sectional areas of 0.8 mm² were tested for microtensile bond strength (μTBS). Two sticks from each tooth were immersed in silver nitrate solution in order to evaluate nanoleakage (NL) with SEM. The μTBS means were analyzed using two-way ANOVA and Tukey's tests. For NL, the Kruskal-Wallis and Mann-Whitney tests were used (α = 0.05). Results: The influence of the etching strategy on the bonding performance of the universal adhesive was substrate dependent. The self-etching approach resulted in lower μTBS values and higher silver nitrate uptake into hybrid layers for Scotchbond Universal Adhesive on SD, while no difference among experimental groups was observed in CAD. Conclusion: It is preferable to use the universal adhesive following either a dry- or wet-bonding etch-and-rinse approach on both sound and caries-affected primary dentin. [ABSTRACT FROM AUTHOR]

Imperfect polymer formation as well as collagen's susceptibility to enzymatic degradation increase the vulnerability of hybrid layers over time. This study investigated the effect of new dimethyl sulfoxide (DMSO)-containing pretreatments on long-term bond strength, hybrid layer quality, monomer conversion and collagen structure. H 3 PO 4 -etched mid-coronal dentin surfaces from extracted human molars (n = 8) were randomly treated with aqueous and ethanolic DMSO solutions or following the ethanol-wet bonding technique. Dentin bonding was performed with a three-step etch-and-rinse adhesive. Resin-dentin beams (0.8 mm2) were stored in artificial saliva at 37 °C for 24 h and 2.5 years, submitted to microtensile bond strength testing at 0.5 mm/min and semi-quantitative SEM nanoleakage analysis (n = 8). Micro-Raman spectroscopy was used to determine the degree of conversion at different depths in the hybrid layer (n = 6). Changes in the apparent modulus of elasticity of demineralized collagen beams measuring 0.5 × 1.7 × 7 mm (n = 10) and loss of dry mass (n = 10) after 30 days were calculated via three-point bending and precision weighing, respectively. DMSO-containing pretreatments produced higher bond strengths, which did not change significantly over time presenting lower incidence of water-filled zones. Higher uniformity in monomer conversion across the hybrid layer occurred for all pretreatments. DMSO-induced collagen stiffening was reversible in water, but with lower peptide solubilization. Improved polymer formation and higher stability of the collagen-structure can be attributed to DMSO's unique ability to simultaneously modify both biological and resin components within the hybrid layer. Pretreatments composed of DMSO/ethanol may be a viable-effective alternative to extend the longevity of resin-dentin bonds. [ABSTRACT FROM AUTHOR]

Aim: This study assesses the effect of matrix metalloproteinases on microtensile bond strength (μTBS) of an etch‐and‐rinse adhesive system. Methods: This in vitro study evaluated 88 extracted premolars. The teeth were sectioned to expose dentin and were then randomly divided into four groups (n = 22). In group 1 (control), dentin surface was etched, and Adper Single Bond 2 was applied. In groups 2–4, dentin surface was etched and chlorhexidine (CHX), 1‐ethyl‐3‐(3‐dimethylaminopropyl) carbodiimide (EDC), and dimethyl sulfoxide (DMSO) were applied on the surfaces, respectively, and blotted dry. Next, Adper Single Bond 2 was applied and all teeth were built up with Z350 composite. In each group, half the samples immediately and the other half after 10,000 thermal cycles underwent μTBS test. Data were analyzed using ANOVA and Tukey's test (α =.05). Results: In thermocycled samples, maximum μTBS was noted in CHX group followed by DMSO, EDC, and control group (p <.001). The thermocycled μTBS of composite to dentin was significantly higher in CHX group compared with EDC, DMSO, and control groups (p <.001) but was not significantly different in EDC and DMSO groups (p =.498). Conclusion: The thermocycled μTBS obtained by the application of CHX, EDC, and DMSO was significantly higher compared with the value to the control group. [ABSTRACT FROM AUTHOR]

• This is the first long-term clinical study evaluating the first commercial universal adhesive. • The etch-and-rinse (moist or dry) strategy showed better clinical behavior than the self-etch strategy. • For practicing dentists, it is recommended to etch enamel when using a universal adhesive. • FDI and USPHS criteria showed similar results after 5 years. To evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). After 5 years the recall rate was 86%. The retention/fracture rates were 93% for Er m and ER d, 88.4% for SE et and 81.4% for SE. A significant difference was observed for SE vs. ER d and SE vs. ER m (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ER m and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). After 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years. [ABSTRACT FROM AUTHOR]

Abstract Introduction Modern dentistry is reflected in the insertion of new materials with different adhesion forms in dental structures, such as the Universal adhesive system. Objective To evaluate the bond strength of the universal dentin adhesive system, in the form of self-etching and conventional application, compared with a simplified conventional adhesive system, in two distinct periods: 1 week and 6 months. Material and method 48 bovine incisors separated into 6 groups, stored for 7 days, were selected. Worn out the buccal enamel until dentin exposure. Adper Single Bond 2 (3M Espe) or SingleBond Universal (3M Espe) adhesives were applied, and catheters filled with Opallis Flow (FGM) composite were placed. After photoactivation, the catheters were removed and the specimens (n = 48), stored in distilled water at 37 °C for one week and six months, were exposed. The specimens were fixed to a universal testing machine (EMIC DL 2000) with a speed of 0.5 mm / min. Bond strength (BS) was calculated in MPa, and data were statistically analyzed by Anova and Tukey test at 5% significance level. Result For Adper Single bond, the BS was equivalent in the times tested; for Universal conventional and self-conditioning time influenced the BS, with a decrease in the results. At 1 week, all stickers were different from each other, with higher BS for Universal conventional mode, followed by universal self-etching mode and then Adper Single bond. Conclusion The best results were achieved with universal adhesive in conventional mode for both tested times.

Aim: The aim of this clinical trial was to evaluate and compare the performance of a universal adhesive with different adhesive strategies in the restoration of non-carious cervical lesions (NCCLs) over a 36-month period. Material and method: One hundred sixty-five NCCLs in 35 patients (13 female, 22 male) with at least 3 lesions each were included in this study. Three groups were formed according to the adhesive strategy used (n = 55): selective-etch mode, etch-and-rinse mode, or self-etch mode of a universal adhesive, Single Bond Universal. The same nanofilled resin composite, Filtek Ultimate, was used for all restorations by a single operator. The restorations were evaluated by two calibrated examiners at baseline and at 6, 12, 18, 24, and 36 months in accordance with the modified USPHS criteria. The chi-square test was used for intergroup comparison and Cochran's Q test for intragroup comparison (∝ = 5%). Results: At 36 months, the recall rate was 98.1% and three restorations, one from each group, had failed because of retention loss (P > 0.05). The self-etch mode group showed 17 bravo scores for both marginal staining and marginal adaptation after 3 years, which was significantly different from the selective-etch and etch-and-rinse groups (P < 0.05). For all groups, the only statistically significant difference was found when baseline and 36-month evaluations were compared in terms of marginal staining (P = 0.000). When the marginal adaptation values at 36 months were compared with those at the baseline, statistically significant differences were found in the etch-and-rinse and self-etch mode groups (P < 0.05). Neither secondary caries nor postoperative sensitivity was observed at any recall. Conclusion: All adhesive modes showed similar retention rates. Although all restorations were clinically acceptable, restorations in self-etch mode showed less satisfying performance for marginal staining and marginal adaptation. Clinical relevance: At the end of 36 months, the Single Bond Universal adhesive received acceptable scores according to the modified United States Public Health Service (USPHS) criteria. However, clinicians should be aware that its use in self-etch application mode tends to result in marginal staining and marginal deterioration when compared with etch-and-rinse and selective-etch application modes. [ABSTRACT FROM AUTHOR]

The restoration longevity depends on a high dentin-composite bond quality. This study investigated learning outcomes when using etch-and-rinse and self-etch adhesives among general practitioners in a hands-on bonding test course. We recruited 30 general practitioners to perform shear bond strength (SBS) tests using five adhesives: one Peak® Universal Bond (PUB) etch-and-rinse and four Futurabond DC, Single Bond universal (SBU), Versa Optibond (VOB), and Tetric-N Bond Self-Etch (TNS) self-etch adhesives. SBS tests were conducted at pre-demonstration (pre-demo), post-demonstration (post-demo), and 24-h storage (delayed bonding) stages. SBS data were analyzed with paired Student's t -tests. We defined 17 MPa as "qualified bond strength (QBS)". The percentages of samples with SBS achieving QBS were analyzed using Mantel–Haenszel chi-square tests. The fracture surfaces of the samples were examined by scanning electron microscopy (SEM). Using PUB caused no significant differences in SBS between pre- and post-demo samples, whereas the SBS of the two self-etch adhesives (SBU and VOB) improved in post-demo samples (p < 0.05). SBU showed the highest percentage of samples with SBS achieving QBS in all three groups (pre-demo = 70%, post-demo = 83%, and delayed bonding = 76.5%). The QBS percentages of VOB and TNS notably improved from 0% (pre-demo) to 71.4% and 23.5% (post-demo), respectively. SEM indicated bubble-like defects at the dentin-resin interfaces in cases of low SBS. Bonding performance is both operator- and product-dependent. The continuing education hands-on course does help dentists to improve the bond strength especially when the self-etch system is used. [ABSTRACT FROM AUTHOR]

Purpose: To examine the influence of operator experience level on shear bond strength (SBS) of a self-etching adhesive (Clearfil SE Bond [CSE], Kuraray) and an etch-and-rinse adhesive (Single Bond [SB], 3M ESPE). Materials and Methods: Flat dentin surfaces were created on 120 extracted human third molars. Bonding agents and composite resin were applied and light cured according to manufacturers' directions (n = 15). Four operators with different levels of experience in operative dentistry performed the same specimen preparation steps independently: group 1: specialist in operative dentistry; group 2: post-graduate student; group 3: under- graduate dental student; group 4: private general practitioner. Specimens were stored in distilled water for 24 h at 37°C before SBS testing. Statistical analyses were carried out with Mann-Whitney U- and Kruskall-Wallis tests. Results: For CSE, mean SBS and standard deviations were: (1) 54.4 ± 15.6a, (2) 55.3 ± 7.6a, (3) 49.4 ± 10.5ab, (4) 41.6 ± 13.1b. For SB, they were: (1) 28.6 ± 10.3c, (2) 32.7 ± 11.2c, (3) 17.5 ± 5.6d, (4) 24.4 ± 9.5cd. Groups with the same superscript letters are not significantly different. CSE showed higher bond strengths than SB in all groups (p < 0.05). There was no significant difference in mean bond strengths between groups 1 and 2 for each adhesive (p > 0.05). Depending on the adhesives, groups 3 and 4 were significantly different from groups 1 and 2, but not different from each other. Conclusion: Operator experience influences dentin bond strength values of dentin adhesives. An increased level of experience with a specific adhesive system and the associated application procedures correlates with higher SBSs. [ABSTRACT FROM AUTHOR]

Purpose: To investigate regional shear bond strength to lateral walls of ceramic inlays in occlusal and occlusoproximal cavities using etch-and-rinse and self-adhesive resin cements and a glass-ionomer luting agent. Materials and Methods: IPS e.max Press ceramic inlays were made in 50 Class I and 50 Class II standardized cavities in intact extracted human molars and divided into 5 luting agent subgroups (n 10): Variolink II (VL); Multilink Sprint (MLS); Multilink Automix (MLA); RelyX Unicem (RLX), and Ketac Cem Aplicap (KC). Inlays were pre-etched with IPS Ceramic etching gel for 60s. After 48 h, two disks of ca 1.0 mm thickness, one of superficial and the other of deep dentin, were push-out tested in a universal testing machine at a crosshead speed of 1.0 mm/min. The mode of failure was determined under a stereomicroscope at 20X. Data were analyzed with one-way ANOVA, and Scheffe's test was used for post-hoc comparisons (α= 0.05). Results: There were no significant differences in shear bond strength between Class I and Class II cavities for the dual-curing system in light-curing mode (VL=MLS=RLX), except that RLX demonstrated greater bond strength to deep dentin in Class II cavities. Bond strength values were significantly higher on deep than on superficial dentin. KC showed the worst result. Failures were mixed (adhesive/cohesive) for the resin luting cements and solely adhesive (cement/ceramic) for the glass-ionomer luting agent. Conclusion: Dual-curing etch-and-rinse or self-etching self-adhesive resin luting cements achieved greater bond strength when light curing was applied, with no differences between Class I and Class II cavities but higher values for deep vs superficial dentin. The weakest adhesion was obtained with glass-ionomer luting agent in both cavity types. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to compare the self-etching with the etch-and-rinse adhesives regarding the degree of conversion and antimicrobial activity against cariogenic bacteria. Materials and Methods: The materials used were AdheSE (two-step self-etching), Adper Prompt L-Pop (self-etching, single-step) and Excite (etch-and-rinse) adhesives. The degree of conversion was measured using Fourier Transformation Infrared Spectroscopy. The absorbance peaks of infrared rays by the aliphatic C=C was detected at 1632 to 1637cm-1 and the aromatic C=C peak at 1610 to 1500 cm-1.The antimicrobial activity was evaluated using the microorganisms Streptococcus mutans, Lactobacillus salivarius, and Actinomyces odontolyticus, with a disk diffusion method. Chlorhexidine digluconate solution 0.2% was used as a positive control. Zones of inhibited bacterial growth were observed and measured. Results: AdheSE showed the highest degree of conversion, followed by Excite, while Adper Prompt L-Pop had the lowest values. A significant difference in the degree of conversion was found between Excite and Adper Prompt L-Pop as well as AdheSE and Adper Prompt L-Pop. On the other hand, there was no significant difference between Excite and AdheSE. Adper Prompt L-Pop showed an antimicrobial effect against Streptococcus mutans and Actinomyces odontolyticus while it was unable to inhibit the growth of Lactobacillus salivarius. AdheSE could inhibit the growth of Streptococcus mutans only. Excite did not produce inhibition zones to the tested microorganisms. Conclusion: Adper Prompt L-Pop showed the worst degree of conversion. AdheSE and Excite had the highest degree of conversion. Appreciable antimicrobial activity was noted with self-etching adhesives, while the etch-and-rinse demonstrated no antimicrobial action. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this in vitro study was to compare the degree of microleakage of composite restorations performed by lasers and conventional drills associated with two adhesive systems. Materials and Methods: Sixty bovine teeth were divided into 6 groups (n = 10). The preparations were performed in groups 1 and 2 with a high-speed drill (HD), in groups 3 and 5 with Er:YAG laser, and in groups 4 and 6 with Er,Cr:YSGG laser. The specimens were restored with resin composite associated with an etch-and-rinse two-step adhesive system (Single Bond 2 [SB]) (groups 1, 3, 4) and a self-etching adhesive (One-Up Bond F [OB]) (groups 2, 5, 6). After storage, the specimens were polished, thermocycled, immersed in 50% silver nitrate tracer solution, and then sectioned longitudinally. The specimens were placed under a stereomicroscope (25X) and digital images were obtained. These were evaluated by three blinded evaluators who assigned a microleakage score (0 to 3). The original data were submitted to Kruskal-Wallis and Mann-Whitney statistical tests. Results: The occlusal/enamel margins demonstrated no differences in microleakage for all treatments (p > 0.05). The gingival/dentin margins presented similar microleakage in cavities prepared with Er:YAG, Er,Cr:YSGG, and HD using the etch-and-rinse two-step adhesive system (SB) (p > 0.05); otherwise, both Er:YAG and Er,Cr:YSGG lasers demonstrated lower microleakage scores with OB than SB adhesive (p < 0.05). Conclusion: The microleakage score at gingival margins is dependent on the interaction of the hard tissue removal tool and the adhesive system used. The self-etching adhesive system had a lower microleakage score at dentin margins for cavities prepared with Er:YAG and Er,Cr:YSGG than the etch-and-rinse two-step adhesive system. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the marginal quality of differently bonded direct resin composite restorations in enamel and dentin, before and after thermomechanical loading (TML). Special attention was focussed on the performance of selective enamel etching, etch-and-rinse, and self-etching adhesives. Materials and Methods: Eighty MO cavities with proximal margins beneath the cemento-enamel junction were prepared in extracted human third molars. Direct resin composite restorations (Tetric EvoCeram, n = 8) were placed with 4-step selective enamel etching (Syntac SE), 4-step etch-and-rinse (Syntac ER), 2-step etch-and-rinse (XP Bond, Scotchbond 1 XT/Single Bond Plus), 2-step self-etching (AdheSE, Clearfil SE Bond), 2-step self-etching with selective enamel etching (AdheSE SE, Clearfil SE Bond SE), and 2-step self-etching with etch-and-rinse (AdheSE TE, Clearfil SE Bond TE). Marginal gaps were analyzed using epoxy resin replicas under a scanning electron microscope at 200X magnification. Results: Initially, high percentages of gap-free margins were identified for all adhesives. After TML, the results were as follows: A) Enamel margins: When phosphoric acid was used on enamel, results were constantly higher (∼90%) compared with two-step self-etchin adhesives (~70%; p < 0.05). B) Dentin margins: No statistical differences were found when etch-and-rinse and selective etch approaches were compared (59% to 64%; p > 0.05). When self-etching adhesives were used as per manufacturers' directions, dentin margins exhibited the best marginal quality (74% to 82%; p < 0.05). When self-etching adhesives were used under etch-and-rinse conditions, marginal quality in dentin was significantly reduced to 35% to 42% (p < 0.05). Conclusion: Enamel bonding was generally more effective with phosphoric-acid etching. Enamel bonding performance of 2-step self-etching adhesives was improved when phosphoric acid was applied on enamel selectively. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to clinically evaluate the effect of two different adhesive / resin composite combinations for luting IPS Empress inlays with a special focus on luting gap wear and marginal adaptation. Materials and Methods: In the course of a controlled prospective clinical split-mouth study, 94 IPS Empress restorations were placed in 31 patients. The inlays were luted with EBS Multi + Compolute (EC; 3M ESPE) or with Syntac + Variolink II low (SV; Ivoclar Vivadent). At baseline and after 0.5, 1, 2, 4, and 8 years, the ceramic restorations were examined according to modified USPHS codes and criteria. Thirty-five selected samples were investigated under an SEM regarding morphological changes; marginal quality analysis was carried out using a stereo light microscope, and luting composite wear was scanned with a profilometer. Results: Eight patients (including 25 restorations) missed the recalls; the recall rate at the last investigation was 72%. After 96 months of clinical service, seven restorations in five patients (six EC, one SV) had to be replaced due to hypersensitivities (n = 5) or inlay fractures (n = 2) resulting in a survival rate of 90%. Over the 8-year period, the restorations revealed no statistically significant differences in terms of surface roughness, color matching, proximal contact, sensitivity, or complaints (p > 0.05, Friedman test). Significant deteriorations were found for marginal integrity (p < 0.05). No significant differences were observed for the different luting systems (p = 0.096, Log rank test / Mantel Cox). Marginal analysis revealed no statistical difference among the materials (p > 0.05; Mann-Whitney U-test), however, the scans of the luting gap showed that Compolute was more prone to wear (p < 0.05). Conclusion: For luting of ceramic inlays, no difference between the two luting systems was detectable. The overall failure rate after 8 years was 10%. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate microtensile bond strength to Class I cavity floor dentin beneath adhesive inlays that were luted with different adhesives, temporary cements, cleaning methods, and curing modes. Materials and Methods: Occlusal cavities (4 x 4 mm, depth 3 mm) were prepared in 96 extracted human third molars. One part of the cavities was temporized with different temporary cements, which were removed after one week using three techniques (scaler or air polishing with Prophypearls or ClinPro powder). Direct resin composite inlays (Clearfil AP-X) were then placed with the luting composite Calibra using three adhesives (XP BOND/SCA, Syntac, Opti-Bond FL). Teeth were cut into beams and after 24 h of water storage at 37°C, the sticks were subjected to microtensile bond strength evaluation. Samples were subjected to SEM fractographic analysis of failed interfaces. Results: Contamination with temporary cement reduced dentin bond strengths (p < 0.05). Removing remnants of cements with Prophypearls air polishing resulted in the lowest bond strengths (p < 0.05). Separate light curing of the adhesives did not produce higher dentin bond strengths (p > 0.05). Syntac still worked when Heliobond was omitted (p > 0.05). Immediate dentin sealing prior to temporizing increased internal bond strength (p < 0.05). Conclusion: The dual-cured adhesive provided higher internal bond strengths between adhesive inlays and dentin. Contamination of dentin with temporary cements is a hazard for excellent dentin adhesion of adhesive inlays. Therefore, immediate dentin sealing and resin coating is promising. [ABSTRACT FROM AUTHOR]

This study investigated the short- and long-term effects of dental adhesives doped with nano-sized bioactive glass 45S5 (BAG) on the resin–dentin interfacial bond strength. Two etch-and-rinse adhesives (Adper Scotchbond Multi-Purpose (ASB) and Solobond Plus (SB)) and one self-etch adhesive (Clearfil SE Bond (CF)) were doped with different concentrations of BAG (5, 10, and 20 wt%). The unmodified (0 wt% BAG) commercial adhesives served as control groups. Dentin of 120 molars (n = 10 per group) was treated with the different adhesives, followed by buildups with a conventional composite restorative material. From each tooth, 14 sticks were prepared for micro-tensile bond strength (µTBS) testing. The sticks were stored in simulated body fluid at 37 °C and tested after 24 h or six months for µTBS and failure mode. Data were analyzed using Kruskal–Wallis tests in combination with post-hoc Conover-tests and Wilcoxon signed-rank tests at a level of significance of α = 0.05. After 24 h and six months, both etch-and-rinse adhesives with a low BAG content (up to 10 wt% for ASB and 5 wt% for SB) showed similar µTBSs as their respective control groups (0 wt% BAG). CF showed a significant decrease in µTBS even after addition of 5 wt% BAG. At a high concentration of added BAG (20 wt%), all three adhesives showed a significant decrease in µTBS compared to the unmodified controls. The CF control group showed significantly lower µTBS after 6 months of storage than after 24 h. In contrast, the µTBS of all CF groups modified with BAG was unaffected by aging. In conclusion, the tested etch-and-rinse adhesives can be modified with up to 5 wt% (SB), or 10 wt% (ASB) of BAG without reducing their short- and long-term dentin bond strength. Moreover, the addition of nano-sized BAG may prevent long-term bond strength deterioration of a self-etch adhesive.

The aim of this study was to investigate margin integrity of Class V composite restorations in demineralized and sound enamel after bonding with different etch-and-rinse and self-etch adhesive systems. Out of a total of 60 specimens from bovine incisors, 30 specimens were demineralized (21 days, acid buffer, pH 4.95) to create artificial enamel lesions. Circular Class V cavities were prepared in all 60 specimens and treated with either an unfilled etch-and-rinse adhesive (Syntac Classic; Ivoclar Vivadent), a filled etch-and-rinse adhesive (Optibond FL; Kerr), or a self-etch adhesive (iBond Self Etch; Heraeus) (n = 10 per group). The cavities were restored with a nanofilled resin composite and thermocycled (5000×, 5–55 °C). Scanning electron microscopy was used to evaluate margin integrity of the composite restorations, and the percentage of continuous margin was statistically analyzed (α = 0.05). Demineralized enamel led to a significantly lower margin integrity when the self-etch adhesive iBond Self Etch was applied, but did not affect margin integrity when the etch-and-rinse adhesives Optibond FL (filled) or Syntac Classic (unfilled) were used. No significant differences in margin integrity in sound and demineralized enamel were observed between the different adhesives. Demineralized enamel reduces margin integrity of composite restorations when bonded with a self-etch adhesive, but does not affect margin integrity when an etch-and-rinse approach is used. [ABSTRACT FROM AUTHOR]

The aim of current study was to assess interfacial bonding effectiveness of self-etch and etch-and-rinse dental adhesives to untreated and Er:YAG laser-treated dentine using mini-interfacial fracture toughness (mini-iFT) test. 32 selected non-carious third molars were divided into two groups: untreated and Er:YAG laser treated. The laser-treated specimens were subjected to Er:YAG laser with energy density of 25.82 J/cm2. Both groups were further assigned to two groups based on adhesive systems: self-etch and etch-and-rinse. The teeth were sectioned perpendicular to the adhesive/dentine interface to obtain 1.5 × 2 mm wide longitudinal rectangular sections. A single notch then was prepared at the adhesive-dentine interface. The mini-iFT test was done via a 4-point bend testing until failure and the KIC was calculated. All specimens were observed using a, scanning electron microscope (SEM). The data were analysed using two-way analysis of variance (ANOVA) at a significant level of 0.05. Weibull parameters including Weibull modulus and characteristic strength also were calculated for each experimental group. Two-way ANOVA showed both variables (the type of adhesive system and laser treatment) significantly influenced the mini-iFT values of specimens (p ≤ 0.001). The self-etch and laser-treated group showed lower mini-iFT than the etch-and-rinse and untreated samples. SEM observations revealed that the fracture region was located at the adhesive-dentine interface in most of the specimens. The Er:YAG laser treatment may adversely affects the bonding effectiveness of the dentine/adhesive interface. The mini-iFT method can be used as a discriminative and valid method for the evaluation of bonding effectiveness at the adhesive-dentine interface. [ABSTRACT FROM AUTHOR]

Abstract The objective of this study was to evaluate the effect of sonic application of universal adhesives on the enamel microshear bond strengths (µSBS), in situ degree of conversion (DC) and etching pattern. Ninety-six extracted third molars were sectioned in four parts (buccal, lingual, proximal) and divided into 12 groups, according to the combination of 1) adhesive system (All-Bond Universal [ABU], G-Bond Plus [GBP], Prime&Bond Elect (PBE), and Scotchbond Universal Adhesive [SBU]), and 2) adhesive application mode (manual active etch-and-rinse [M-ER], manual active self-etch [M-SE], and sonic vibration self-etch [S-SE]). Specimens were stored in water at 37 °C during 24 h and tested at 1.0 mm/min (µSBS). DC was evaluated in the enamel-resin interfaces using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a field- emission scanning electron microscope. Data were analyzed with two-way ANOVA and Tukey's test (α = 0.05). S-SE application increased µSBS and DC for all universal adhesives when compared to M-SE (p < 0.05). S-SE application resulted in mean bond strengths that were statistically similar to those obtained with the respective ER application mode (p > 0.05). A deeper enamel-etching pattern was observed for all universal adhesives in the etch-and-rinse strategy. An improvement in etching ability was observed in S-SE application compared to M-SE application. In light of the improved performance of universal adhesives when applied sonically in SE mode, selective enamel etching with phosphoric acid may not be crucial for their adhesion to enamel. The sonic application of universal adhesives in self-etch mode may be a practical alternative to enamel etching. [ABSTRACT FROM AUTHOR]

To evaluate the effect of SDF-based treatments following delayed bonding and surface treatment approaches on resin-dentin bonding efficiency of a universal adhesive under different application modes. Mid-coronal dentin surfaces from sound third molars were randomly treated with 38% silver diamine fluoride (SDF) and/or additionally with potassium iodide (SDF/KI). Untreated dentin served as control. SDF-treated teeth were assigned to groups according to surface treatment approaches (air-abrasion and water rinsing), the application mode of a mild universal adhesive (etch-and-rinse or self-etch) and delayed bonding (immediate, 7, 15 or 30 days). Microtensile bond strength (n = 5), SEM analyses of hybrid layer formation and dentin etching patterns and dentin permeability were evaluated. Data were analyzed with factorial ANOVA. SDF-based treatments affected dentin bonding depending on application mode and surface treatment approaches (p <0.001). Etch-and-rinse bonding was not affected by SDF-based treatments (p <0.05), producing more homogenous hybrid layers. While dentin etching patterns of etch-and-rinse application were not affected by SDF-based treatments, self-etching presented limitations. Bond strength reductions of self-etched dentin were restored by silver-removal strategies containing a water-rinsing step (p <0.05). Delayed bonding additionally reduced dentin permeability (p <0.05), further decreasing with longer periods (p <0.05). Although the negative effect of SDF-based treatments on resin-dentin bonding can be avoided by strategies incorporating water-rinsing before hybridization, delayed bonding brings additional advantages due to higher mineral deposition. While the etch-and-rinse technique avoids major bonding drawbacks to SDF-treated dentin, self-etch bonding requires removal of excess silver deposits before hybridization. Performing SDF-based treatments and dentin hybridization in separate sessions (>15 days apart) potentialize mineral deposition improving caries control and service life of composite restorations. • Resin bonding to SDF-treated dentin should not be underestimated. • Application mode affects bonding to SDF-treated dentin. • Strategies incorporating water rinsing before hybridization eliminate bonding issues. • Mineral deposition on SDF-treated dentin increases with time in wet environments. • Delayed bonding reduces permeability and reverts SDF-related bonding inefficiencies. [ABSTRACT FROM AUTHOR]

Background: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is applied for remineralization of early caries lesions or tooth sensitivity conditions and may affect subsequent resin bonding. This in vitro study investigated the effect of CPP-ACP on the shear bond strength of dental adhesives to enamel. Materials and Methods: Sixty extracted human molar teeth were selected and randomly divided into three groups and six subgroups. Buccal or lingual surfaces of teeth were prepared to create a flat enamel surface. Adhesives used were Tetric N-Bond, AdheSE and AdheSE One F. In three subgroups, before applying adhesives, enamel surfaces were treated with Tooth Mousse CPP-ACP for one hour, rinsed and stored in 37°C temperature with 100% humidity. This procedure was repeated for 5 days and then adhesives were applied and Tetric N-Ceram composite was adhered to the enamel. This procedure was also fulfilled for the other three subgroups without CPP-ACP treatment. After 24 hour water storage, samples were tested for shear bond strength test in a universal testing machine. Failure modes were determined by stereomicroscope. Data were analyzed by t-test and one-way analysis of variance with P < 0.05 as the level of significance. Results: In comparison between applied and non-applied CPP-ACP subgroups, there was no significant decrease in the shear bond strength to enamel only in Tetric N-Bond (P > 0.05). In non-applied CPP-ACP subgroups, there were statistically significant differences among all subgroups. Tetric N-Bond had the highest and AdheSE One F had the lowest shear bond strength. Conclusion: CPP-ACP application reduces the shear bond strength of AdheSE and AdheSE One F to enamel but not Tetric N-Bond.

Objectives To evaluate whether selective dentin etching protocols using reduced phosphoric acid (H 3 PO 4 ) etching-times would affect the resin-dentin interaction of a universal adhesive to improve long-term bonding effectiveness. Methods Mid-coronal flat dentin surfaces were produced on sound third molars, selectively etched with 32% H 3 PO 4 for 3, 5, 10 or 15 s and bonded with a universal adhesive (Scotchbond Universal, 3 M ESPE: SU). SU in self-etch mode and a three-step etch-and-rinse adhesive were used as control groups. Bonded specimens were stored in deionized water for 24 h and sectioned into beams (cross sectional area of 0.7 mm 2 ). Micro-tensile bond strength test (n = 6) and nanoleakage evaluation were performed immediately, after thermocycling or 6-month storage in artificial saliva. Energy dispersive X-ray analysis (n = 6) was performed to determine the residual Ca-content ratio at the hybrid layers and scanning electron microscopy (SEM) was used to observe the micromorphology of the etched dentin surfaces before and after SU application. Data were analyzed by ANOVA and Tukey test (α = 0.05). Results Selective dentin etching for 3 s improved the interaction depth of the tested universal adhesive without overexposing demineralized collagen or reducing Ca-content availability at the bonded interface. The improved immediate bond strengths of the selective etching protocol remained significantly higher ( p  < 0.05) after long-term aging producing hybrid layers without significant differences ( p  > 0.05) in silver uptake levels compared to those produced on non-etched dentin. Conclusions Despite the adjunctive conclusion that universal adhesives used in self-etch mode produce superior long-term dentin bonding compared to the etch-and-rinse mode, selective etching for 3 s with conventionally used H 3 PO 4 improves dentin bonding effectiveness; nonetheless, longer etching times should be strictly avoided. [ABSTRACT FROM AUTHOR]

Objectives Aim of the present study was to evaluate resin composite adhesion to dental hard tissues affected by molar incisor hypomineralisation (MIH). Methods 94 freshly extracted human molars and incisors (53 suffering MIH) were used. 68 teeth (35 with MIH) were used for μ-TBS tests in enamel and dentin, 26 (18 with MIH) for qualitative evaluation. Specimens were bonded with Clearfil SE Bond, Scotchbond Universal, and OptiBond FL. For MIH affected enamel, additional OptiBond FL groups with NaOCl and NaOCl + Icon were investigated. Beside fractographic analysis, also qualitative evaluations were performed using SEM at different magnifications as well as histological sectioning. Results Highest μ-TBS values were recorded with dentin specimens (ANOVA, mod. LSD, p < 0.05). Results were independent of adhesive and dentin substrate (p > 0.05). Pre-test failures did not occur in dentin specimens. Sound enamel specimens exhibited significantly higher μ-TBS values than MIH enamel (p < 0.05). The two-step self-etch adhesive (Clearfil SE Bond) and the two-step etch-and-rinse adhesive (Scotchbond Universal) showed the lowest values in affected enamel specimens (p < 0.05) with most pre-test failures (p < 0.05). OptiBond FL on affected enamel showed better results than Clearfil SE Bond (p < 0.05). An additional pre-treatment of affected enamel with NaOCl or NaOCl and Icon did not enhance enamel bonding (p > 0.05), however, it caused less pre-test failures (p < 0.05). Micromorphological analyses revealed that conventional phosphoric acid etching produces a much less pronounced etching pattern in affected enamel and a porous structure as weak link for the resin-enamel bond was identified. Significance Bonding to porous hypomineralized MIH enamel is the limiting factor in adhesion to MIH teeth. MIH-affected dentin may be bonded conventionally. [ABSTRACT FROM AUTHOR]

This study evaluate the effect of nanoparticles (Bi 2 O 3 - bismuth oxide; YbF 3 - ytterbium trifluoride; SiO 2 - silicon dioxide) on radiopacity (R), translucency parameter (TP), degree of conversion (DC), bond strength to dentin (µTBS), and quality of the adhesive interface of experimental two-step, etch-and-rinse adhesive systems. The R was evaluated using an x-ray equipment. TP was verified in five replications and DC was performed in triplicate. The µTBS was evaluated in specimens stored in distilled water after 24 h, 6, 12 and 24 months. The bonded interfaces were qualitatively examined by scanning electron microscopy (SEM), and using x-ray energy dispersive spectroscopy (EDS) for elemental analysis. Data were statistically analyzed at α = 0.05. YbF 3 resulted in statistically greater R when compared with all the other groups ( p = 0.024), which did not differ from each other. Bi 2 O 3 was the adhesive with lowest TP. For DC, the YbF 3 and C showed similar results ( p = 0.627). Similar µTBS was obtained between groups. The addition of nanoparticles affected the chemical-mechanical properties. The incorporation of YbF 3 could be considered a promising approach for the development of radiopaque dental adhesives. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the influence of CO2 9.3 μm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO2 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa). [ABSTRACT FROM AUTHOR]

Background and aims. The aim was to evaluate the effect of casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) on microtensile bond strength (μTBS) to carious affected dentin (CAD) using etch-and-rinse and self-etch ad-hesive systems. Materials and methods. The occlusal surface of 32 human molars with moderate occlusal caries was removed. Infected dentin was removed until reaching CAD and the teeth were randomly divided into two groups based on the Single Bond (SB) and Clearfil SE Bond (CSE) adhesive systems. Before composite resin bonding, each group was subdivided into three subgroups of ND, CAD and CPP-ACP-treated CAD (CAD-CPP) based on the dentin substrate. After dissecting samples to l-mm-thick cross-sections (each subgroup: n = 13), μTBS was measured at a strain rate of 0.5 mm/min. Data was analyzed using two-way ANOVA, independent samples t-test and post-hoc Tukey tests (α=0.05). Results. Bond strength of both adhesive systems to ND was significantly higher than that to CAD (P < 0.001) and CAD/CPP (P < 0.001). There were no significant differences between the μTBS of SB to CAD and CAD-CPP (P > 0.05). μTBS of CSE to CAD-CPP was higher than that to CAD; however, the difference was not significant (P > 0.05). Significant differences were found between SB and CSE systems only with CAD substrate (P < 0.001). Conclusion. Regardless of the adhesive system used, surface treatment of CAD with CPP-ACP did not have a significant effect on bond strength. However, bond strength to CAD was higher with SB rather than with CSE.

Aim The aim of the present study was to evaluate the effect of the application of a hydrophobic resin on the microleakage of Cl V composite resin restorations using a universal adhesive system applied in the self-etch ( SE) and etch-and-rinse ( ER) modes. Method Cl V cavities were prepared on the buccal surfaces of 64 human premolar teeth and divided into four groups ( n = 16): ER, ER with hydrophobic resin ( ERH), SE, and SE with hydrophobic resin ( SEH). Microleakage at occlusal and gingival margins was evaluated using 0.5% methylene blue dye penetration technique under stereomicroscope at 40 × magnification. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests ( P < 0.05). Results At the enamel margins, the ER group had significantly less microleakage than the SE and SEH groups ( P < 0.001), but had no significant difference compared with the ERH group ( P > 0.05). There was also no statistically-significant difference between the SE and SEH groups ( P > 0.05). At the dentinal margins, the SE group had significantly less microleakage compared with the ER ( P < 0.001) and ERH groups ( P = 0.005). Furthermore, microleakage of the SEH group was significantly less than the SE group ( P < 0.001). Conclusion Applying an extra layer of hydrophobic resin significantly decreased microleakage in the SE mode at the dentinal margin, but had no significant effect in the ER mode. [ABSTRACT FROM AUTHOR]

Background and aims. Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS) of silica- (Spectrum TPH) and zirconia-filled (Filtek Z250) composite resins. Materials and methods. Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05). Results. Analysis of data showed that the effect of composite resin type was not significant (p > 0.05), but the effects of the type of surface treatment (p = 0.01) and the type of adhesive system (p = 0.01) were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05). However, the cumulative effects of the adhesive system-surface treatment (p = 0.03) and the composite type-the adhesive system-surface treatments (p = 0.002) were significant. Conclusion. Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently.