Posterior resin composite restorations with or without resin-modified, glass-ionomer cement lining: a 1-year randomized, clinical trial

Aim:  To investigate the effect of resin-modified, glass-ionomer cement lining on the quality of posterior resin composite restorations, bonded with a two-step, total-etch or self-etching adhesive, at 1 year. Methods:  Patients with 1–4 moderate-to-deep, primary occlusal caries in molars were informed and recruited. A total of 110 composite restorations were placed in 75 participants, with one of four restorative procedures: (a) bonded with a total-etch adhesive (Single Bond 2); (b) lined with glass-ionomer cement (Fuji Lining LC), and then bonded with total-etch adhesive; (c) bonded with a self-etching adhesive (Clearfil SE Bond); and (d) lined with glass-ionomer cement, and then bonded with self-etching adhesive. Results:  At 1 year, 57 patients (86 restorations) attended the recall. Each of the restorations was evaluated and scored from 1 (clinically excellent) to 5 (clinically poor) using the following criteria: (a) patient satisfaction; (b) fracture and retention; (c) marginal adaptation; (d) recurrent caries; and (e) post-operative sensitivity. At 1 year, the qualities of the restorations were not significantly affected by the placement of glass-ionomer cement lining, regardless of the adhesive used (P > 0.05). Most of the restorations were scored 1 for all criteria. Conclusions:  The benefit of placing a glass-ionomer cement liner in resin composite restoration is questionable

Microtensile bond strength of self-etching adhesive systems to differently prepared dentin

Purpose: To evaluate the microtensile bond strength (μTBS) of three self-etching adhesive systems with different degrees of acidity (Clearfil SE Bond, One-Up Bond F, and Xeno III) to dentin prepared with three different methods. Methods: Forty-five extracted human third molars were ground flat to expose occlusal dentin and polished with 600-grit abrasive paper. All teeth were randomly divided into three groups according to the preparation method: baseline surface (AP#600), steel fissure bur (SB) and regular grit diamond bur (DB). Dentin surfaces were bonded with one of the three adhesive systems; then resin composite was incrementally built up. After storage in 37°C water for 24 hours, specimens were cut and trimmed to create an hourglass shape with cross sectional area of approximate 1 mm2. All specimens were subjected to microtensile bond strength testing. The bond strength data were analyzed with one and two-way ANOVA and Dunnett Multiple comparisons test at P< 0.05. Results: For Xeno III and One-Up Bond F, the μTBS to dentin prepared with the different methods were not significantly different. However, the μTBS of Clearfil SE Bond to dentin prepared with the diamond bur was significantly lower than the other preparation methods. Xeno III produced the lowest μTBS that were statistically different from the other adhesive systems when each preparation method was compared (P< 0.01). SEM observation of the prepared dentin surfaces showed that the diamond bur group produced a thicker smear layer that followed by steel bur and 600-grit paper. Therefore, the smear layer from diamond burs had a greater influence in decreasing μTBS of Clearfil SE Bond that has the weakest acidity self-etching adhesive systems evaluated.link_to_subscribed_fulltex

Effect of glass-ionomer cement lining on postoperative sensitivity in occlusal cavities restored with resin composite - A randomized clinical trial

This study investigated the ability of a glass-ionomer cement (GIC) lining to reduce postoperative sensitivity in occlusal cavities restored with resin composite. In addition, the effects of a total-etch and self-etch adhesive on postoperative sensitivity were also compared. Patients who had moderate to deep occlusal caries of at least one molar were recruited. Overall, 103 restorations were placed in 70 participants, with an average age of 22.8 ± 3.8 years. Preoperatively, each tooth was evaluated for cold-stimulated tooth sensitivity using a visual analog scale. If present, tooth sensitivity induced by cold/hot drinks or occlusal function was also noted. Caries was stained with a caries detector dye, then removed using slow-speed burs and hand excavators. The cavity was restored with one of four randomly allocated restorative procedures: 1) bonded with a two-step, total-etch adhesive (Single Bond 2); 2) lined with a resin-modified GIC liner (Fuji Lining LC), then bonded with total-etch adhesive; 3) bonded with a two-step, self-etch adhesive (Clearfil SE Bond) and 4) lined with the GIC liner, then bonded with self-etch adhesive. The cavities were incrementally filled with a nanofilled hybrid resin composite. At recall, postoperative sensitivity was evaluated at one week and one month. Overall, postoperative sensitivity in daily function was rare. No significant difference in postoperative sensitivity, either in daily function or in response to a cold stimulus, was observed between the restorative procedures with or without the GIC liner, regardless of the adhesive used (pgt;0.05). In addition, no difference in postoperative sensitivity was noted between use of the self-etch and total-etch adhesive.link_to_subscribed_fulltex

In vivo adhesive interface between resin and dentin.

V-shaped cervical cavities prepared in monkey teeth were restored with several dentin bonding systems, and the in vivo resin-dentin interfacial structures were observed under the scanning electron microscope using an argon-ion etching technique. The hybrid layer could be clearly observed; its depth was dependent on the conditioner/primer used and tended to be thinner at the deep part of the cavity. Resin tags were also clearly observed, and their structure at the inner part was noted to be rougher than that closer to the tubule orifices. When 37% phosphoric acid gel was used, the tags in the deeper parts of the cavity were much rougher. Hemispherical and spherical roughened structures were observed directly above the tubule orifices, which were thought to be a mixture of dentinal fluid and bonding resin that had flowed out from the tubules. The acidic primer containing maleic acid and HEMA could not remove the smear plugs, and undissolved smear particles were observed in the tubules.link_to_subscribed_fulltex

Bond strength of two adhesive systems to primary and permanent enamel

The bonding performance of current adhesive systems to primary enamel has not been thoroughly researched. This study compared the micro-shear bond strength of two adhesive systems to primary and permanent tooth enamel. Two commercially available resin adhesives, a self-etching primer system (Clearfil SE Bond) and a single-bottle adhesive system (Single Bond) used with a total-etch wet bonding technique were tested. A micro-shear bond test was used to examine the adhesive systems on mid-coronal buccal enamel of extracted primary or permanent teeth. In addition, etched enamel surfaces and etched-bonded enamel interfaces were examined using scanning electron microscopy (SEM). No statistically significant differences of shear bond strength values were found between the primary and permanent enamel or the adhesive systems used (p>0.01). The SEM observations showed that both adhesive systems etched the primary enamel deeper than the permanent enamel, suggesting that the action of acid etch seemed to be more intense on primary enamel than on permanent enamel. Bonding of the adhesive systems to primary enamel was almost identical to permanent enamel. ©Operative Dentistry, 2002.link_to_subscribed_fulltex

Changes in resin-infiltrated dentin stiffness after water storage

Plasticization of polymers by water sorption lowers their mechanical properties in a manner that is predictable by the polarity of their component resins. This study tested the hypothesis that when adhesive resins were used to create resin-infiltrated dentin, the reductions in their flexural moduli after water storage would be lowered proportional to their hydrophilic characteristics. Three increasingly hydrophilic resin blends were used to fabricate polymer beams and macro-hybrid layer models of resin-infiltrated dentin for testing with a miniature three-point flexure device, before and after 1-4 weeks of water storage. Flexural modulus reductions in macro-hybrid layers were related to, and more extensive than, reductions in the corresponding polymer beams. Macro-hybrid layers that were more hydrophilic exhibited higher percent reductions in flexural modulus, with the rate of reduction proportional to the Hoy's solubility parameters for total intermolecular attraction forces (δt) and polar forces (δp) of the macrohybrid layers.link_to_subscribed_fulltex