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Purpose: To provide an overview of the in-vitro bond strength of universal adhesives to zirconia and analyze whether these adhesives are a reliable alternative to conventional zirconia primers. Materials and Methods: A systematic search was conducted in PubMed/Medline, Scopus, and ISI Web of Science databases up to August 2021. Investigations published in English, assessing resin-mediated bond to zirconia using universal adhesives compared to phosphate/silane-based primer or phosphate-based primer were included. After study selection and data extraction, risk of bias analysis was performed. Statistical analyses were performed using RevMan 5.4, with a random effects model, at a significance level of 0.05. Results: In total, 23 studies were included for qualitative and quantitative analysis. Universal adhesives showed higher bond strengths than did phosphate-based primers (p < 0.00001) to aged zirconia without airborne alumina-particle abrasion. Similar results were observed when the zirconia surface was airborne-particle abraded at baseline and after dynamic aging (p < 0.0001). When universal adhesives and phosphate-silane based primers were compared, similar bond strengths (p ≥ 0.001) were observed after surface abrasion, regardless of storage condition. Conclusion: The results showed that universal adhesives generate higher bond strengths when compared to conventional zirconia primers. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review the literature to evaluate whether the bond strength of resin-based materials to enamel is affected by deproteinizing agents. Materials and Methods: This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed, ISI Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Eligibility criteria included in vitro studies that reported the effect of a deproteinizing agent applied before or after acid etching on the immediate or long-term bond strength of resin-based materials to enamel. The meta-analysis was carried out using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of a = 0.05. Results: A total of 23 studies were included in the meta-analysis. In all the studies, only the immediate bond strength was evaluated. The bond strength of the materials was improved by the application of NaOCl or papain prior to enamel etching with phosphoric acid (p = 0.006). None of the deproteinizing agents had a significant effect when applied after etching with phosphoric acid (p = 0.27). Conclusions: Based on in vitro studies, deproteinization with sodium hypochlorite or papain-based agents increases the immediate bond strength of resin-based materials to enamel only when used prior to phosphoric-acid etching. [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 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 mechanical and physical properties of experimental HEMA-containing and HEMA-free resin adhesives. Materials and Methods: Experimental HEMA-free adhesives containing alternative dimethacrylates (bis-EMA 10 [B10], bis-EMA 30 [B30], PEG 400 [P400], PEG 1000 [P1000], PEG 400 UDMA [UP400]) were formulated and compared with a HEMA-containing adhesive (control). The adhesives were characterized by rheological analysis, polymerization kinetics (PK), water sorption (WS), and solubility (SL) tests. Flexural strength (FS) and flexural modulus (E) tests were performed under dry or wet conditions (distilled water or 70% ethanol solution). One-way and two-way ANOVA as well as Tukey's test were used to evaluate differences between groups (p < 0.05). Results: The control group showed the lowest viscosity and was the only one with a degree of conversion lower than 50%. The control and the P1000 adhesive showed the statistically significantly highest WS (p < 0.05). The control and the UP400 adhesive showed the highest FS and E, and the dry-stored specimens showed more improved mechanical strength than did the wet-stored specimens (p < 0.05). Conclusion: The physicomechanical properties of some of the HEMA-free adhesives were substantially improved when compared with those of the control, indicating that they could be potential monomers for the development of HEMA-free adhesive systems. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the resin-dentin microtensile bond strength (μTBS) of ethanol/water- (Single Bond, [SB] 3M ESPE), ethanol- (Optibond Solo Plus, [OP] Kerr) and acetone-based (One-Step, [OS] Bisco) two-step etch-and-rinse adhesives in the presence or absence of their respective solvents to dry and wet dentin. The ultimate tensile strength (UTS) and the degree of conversion (DC) of the materials were also evaluated. Materials and Methods: Solvent-based and solvent-free adhesives were vigorously applied to occlusal dentin surfaces after phosphoric acid etching. Composite crowns were built up incrementally. After 24-h water storage, the specimens were sectioned in x and y directions to obtain bonded sticks (1.0 mm²) which were immediately tested in tension (0.5 mm/min). The data were analyzed by three-way ANOVA and Tukey's test (α = 0.05). For the UTS measurement, hourglass-shaped specimens of adhesives were prepared and tested in tension. FTIR analysis was used to verify the DC of adhesives. The data from UTS and FTIR was analyzed by two-way ANOVA and Tukey's test (α = 0.05). Results: High μTBS values were obtained for SB and OS, regardless of the presence or absence of solvents or the moisture condition of dentin. A lower μTBS mean was observed for the solvent-free OP compared to its solvent-based version. Significantly higher UTS values were obtained for all adhesives after removal of solvents. The DC of OS in the solvent-based condition was lower than SB and OP. After removal of solvents, only OS showed a significant increase in the DC. Conclusion: The presence of solvents was not essential for SB and OS to achieve high bond strength values to both dry and wet dentin when applied under vigorous application. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of different water concentrations in the solvents of self-etching primers on microtensile bond strength (μTBS) of an experimental adhesive system. Materials and Methods: Five experimental self-etching primers with 0, 5, 10, 20 and 40 (wt%) water as solvent were formulated. An experimental adhesive resin (AD-50) was also synthesized to create one experimental self-etching adhesive system. Clearfil SE Bond (CSEB) was used as the commercial reference. Sixty bovine incisors were randomly separated into 6 groups. Buccal enamel was removed to expose the superficial coronal dentin; this surface was polished wet to create a standardized smear layer. After rinsing, water was removed, leaving the surface visibly dried. The dentin surfaces were etched with primer and air dried, adhesive resin was applied and photoactivated, then the composite resin restoration was placed. After storage for 24 h, the specimens were sectioned with a cooled diamond saw at low speed. Microtensile bond strength was measured and data were analyzed with one-way ANOVA/Tukey's test (α = 0.05). Results: ANOVA showed that primer composition was a significant factor for bond strength. There was no significant difference in bond strengths between the primers with a water concentration of 40% (53.9 ± 12.7 MPa), 20% (51.1 ± 11.5 MPa, and 10% (47.5 ± 11.4 MPa), and CSEB (50.7 ± 9.8 MPa). The groups with 5% (38.6 ± 12.9 MPa) and 0% (31.5 ± 7.5 MPa) water presented similar bond strengths amongst themselves but were statistically significantly lower than that of the other groups. Conclusion: The water concentration in the primer solvent exercises a significant influence on the bond strength of this experimental self-etching adhesive system. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the clinical performance of two polyacid-modified resin composites (Dyract AP and F2000) in posterior teeth after 1 year of clinical service. Materials and Methods: Seventy-two Class I restorations were performed in 33 patients (average age 25 years) by one operator. Eighty-two per cent of the restorations were located in molars. Before the proceedings, patients were informed about the aim of the study and they gave written consent to participate. At least one restoration of each material was placed in each individual. The materials were applied according manufacturer's instructions. Following finishing and polishing, one examiner performed the clinical baseline examination using the adapted USPHS system. To be included in the clinical trial, a restoration had to be rated "Alpha". After one year, 25 patients were recalled and 56 restorations were evaluated using the adapted USPHS system. Results: All restorations were classified as clinically satisfactory (Alpha or Bravo). However, there was a decrease in restoration quality compared to baseline. Statistical analysis (X² and Fisher's exact test) demonstrated differences only in relation to superficial roughness, with exhibiting F2000 more surface roughness than Dyract AP (p < 0.01). Conclusion: Based on the methodology employed, all restorations were satisfactory after one year and the two materials performed similarly, except for the surface roughness criteria. [ABSTRACT FROM AUTHOR]

Purpose: To provide an overview of the in-vitro bond strength of universal adhesives to zirconia and analyze whether these adhesives are a reliable alternative to conventional zirconia primers., Materials and Methods: A systematic search was conducted in PubMed/Medline, Scopus, and ISI Web of Science databases up to August 2021. Investigations published in English, assessing resin-mediated bond to zirconia using universal adhesives compared to phosphate/silane-based primer or phosphate-based primer were included. After study selection and data extraction, risk of bias analysis was performed. Statistical analyses were performed using RevMan 5.4, with a random effects model, at a significance level of 0.05., Results: In total, 23 studies were included for qualitative and quantitative analysis. Universal adhesives showed higher bond strengths than did phosphate-based primers (p < 0.00001) to aged zirconia without airborne alumina-particle abrasion. Similar results were observed when the zirconia surface was airborne-particle abraded at baseline and after dynamic aging (p < 0.0001). When universal adhesives and phosphate-silane based primers were compared, similar bond strengths (p ≥ 0.001) were observed after surface abrasion, regardless of storage condition., Conclusion: The results showed that universal adhesives generate higher bond strengths when compared to conventional zirconia primers.

Purpose: To systematically review the literature to evaluate whether the bond strength of resin-based materials to enamel is affected by deproteinizing agents., Materials and Methods: This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed, ISI Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Eligibility criteria included in vitro studies that reported the effect of a deproteinizing agent applied before or after acid etching on the immediate or long-term bond strength of resin-based materials to enamel. The meta-analysis was carried out using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of α = 0.05., Results: A total of 23 studies were included in the meta-analysis. In all the studies, only the immediate bond strength was evaluated. The bond strength of the materials was improved by the application of NaOCl or papain prior to enamel etching with phosphoric acid (p ≤ 0.006). None of the deproteinizing agents had a significant effect when applied after etching with phosphoric acid (p ≥ 0.27)., Conclusions: Based on in vitro studies, deproteinization with sodium hypochlorite or papain-based agents increases the immediate bond strength of resin-based materials to enamel only when used prior to phosphoric-acid etching.

Purpose: To evaluate the mechanical and physical properties of experimental HEMA-containing and HEMA-free resin adhesives., Materials and Methods: Experimental HEMA-free adhesives containing alternative dimethacrylates (bis-EMA 10 [B10], bis-EMA 30 [B30], PEG 400 [P400], PEG 1000 [P1000], PEG 400 UDMA [UP400]) were formulated and compared with a HEMA-containing adhesive (control). The adhesives were characterized by rheological analysis, polymerization kinetics (PK), water sorption (WS), and solubility (SL) tests. Flexural strength (FS) and flexural modulus (E) tests were performed under dry or wet conditions (distilled water or 70% ethanol solution). One-way and two-way ANOVA as well as Tukey's test were used to evaluate differences between groups (p < 0.05)., Results: The control group showed the lowest viscosity and was the only one with a degree of conversion lower than 50%. The control and the P1000 adhesive showed the statistically significantly highest WS (p < 0.05). The control and the UP400 adhesive showed the highest FS and E, and the dry-stored specimens showed more improved mechanical strength than did the wet-stored specimens (p < 0.05)., Conclusion: The physicomechanical properties of some of the HEMA-free adhesives were substantially improved when compared with those of the control, indicating that they could be potential monomers for the development of HEMA-free adhesive systems.

Purpose: To evaluate the effect of variations in 2-hydroxyethyl methacrylate (HEMA) concentrations in an experimental comonomer blend on degree of conversion, water sorption, solubility, and ultimate tensile strength of adhesive resin., Materials and Methods: The effect of HEMA content (0, 15, 30, and 50%wt - control, G15, G30, and G50 groups, respectively) was tested in an experimental comonomer blend of bis-GMA, bis-EMA, TEG-DMA, and HEMA. The degree of conversion, polymerization rate, ultimate tensile strength, water sorption, and solubility of the adhesive resin blends were determined., Results: At 40 s of light activation time, groups G30 and G50 showed a decrease of 30% and 61%, respectively, in degree of conversion compared to control. Water sorption and solubility differed for all groups, and was statistically higher in G50. For ultimate tensile strength, the control and G15 groups showed statistically higher values than the other groups (p < 0.05)., Conclusion: Higher HEMA content increases dental adhesive resin degradation.