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Objectives: To evaluate the dentine microtensile bond strength (mTBS), nanoleakage (NL), degree of conversion (DC) within the hybrid layer for etch-and-rinse and self-etch strategies of universal simplified adhesive systems. Methods: forty caries free extracted third molars were divided into 8 groups for μTBS (n = 5), according to the adhesive and etching strategy: Clearfil SE Bond [CSE] and Adper Single Bond 2 [SB], as controls; Peak Universal Adhesive System, self-etch [PkSe] and etch-and-rinse [PkEr]; Scotchbond Universal Adhesive, self-etch [ScSe] and etch-and-rinse [ScEr]; All Bond Universal, self-etch [AlSe] and etch-and-rinse [AlEr]. After restorations were constructed, specimens were stored in water (37 °C/24 h) and then resin-dentine sticks were prepared (0.8 mm²). The sticks were tested under tension at 0.5 mm/min. Some sticks from each tooth group were used for DC determination by micro-Raman spectroscopy or nanoleakage evaluation (NL). The pH for each solution was evaluated using a pH metre. Data were analyzed with one-way ANOVA and Tukey's test (α = 0.05). Results: For μTBS, only PkSe and PkEr were similar to the respective control groups ( p > 0.05). AlSe showed the lowest mTBS mean ( p < 0.05). For NL, ScEr, ScSe, AlSe, and AlEr showed the lowest NL similar to control groups ( p < 0.05). For DC, only ScSe showed lower DC than the other materials ( p < 0.05). Results: For μTBS, only PkSe and PkEr were similar to the respective control groups ( p > 0.05). AlSe showed the lowest mTBS mean ( p < 0.05). For NL, ScEr, ScSe, AlSe, and AlEr showed the lowest NL similar to control groups ( p < 0.05). For DC, only ScSe showed lower DC than the other materials ( p < 0.05). [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate microtensile bond strength ( μ TBS) to dentine, interfacial nanoleakage expression, and stability after ageing, of two-step vs. one-step self-etch adhesives. Human molars were cut to expose middle/deep dentine, assigned to groups ( n = 15), and treated with the following bonding systems: (i) Optibond XTR (a two-step self-etch adhesive; Kerr), (ii) Clearfil SE Bond (a two-step self-etch adhesive; Kuraray), (iii) Adper Easy Bond (a one-step self-etch adhesive; 3M ESPE), and (iv) Bond Force (a one-step self-etch adhesive; Tokuyama). Specimens were processed for μ TBS testing after 24 h, 6 months, or 1 yr of storage in artificial saliva at 37°C. Nanoleakage expression was examined in similarly processed additional specimens. At baseline the μ TBS results ranked in the following order: Adper Easy Bond = Optibond XTR ≥Clearfil SE = Bond Force, and interfacial nanoleakage analysis showed Clearfil SE Bond = Adper Easy Bond = Optibond XTR> Bond Force. After 1 yr of storage, Optibond XTR, Clearfil SE Bond, and Adper Easy Bond showed higher μ TBS and lower interfacial nanoleakage expression compared with Bond Force. In conclusion, immediate bond strength, nanoleakage expression, and stability over time were not related to the number of steps of the bonding systems, but to their chemical formulations. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to evaluate the marginal quality and resin-resin transition of milled CAD/CAM glass-ceramic inlays in deep proximal cavities with and without 3-mm proximal box elevation (PBE) using resin composites before and after thermomechanical loading. Materials and methods: MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 48 extracted human third molars. Proximal boxes ending in dentin were elevated for 3 mm with different resin composites (RelyX Unicem, G-Cem, and Maxcem Elite as self-adhesive resin cements and Clearfil Majesty Posterior as restorative resin composite in one or three layers bonded with AdheSE) or left untreated. IPS Empress CAD inlays were luted with Syntac and Variolink II ( n = 8). Marginal quality as well as the PBE-ceramic interface were analyzed under an SEM using epoxy resin replicas before and after thermomechanical loading (100,000 × 50 N and 2,500 thermocycles between +5°C and +55°C). Results: Bonding glass-ceramic directly to dentin showed the highest amounts of gap-free margins in dentin (92%, p < 0.05). Bonded resin composite applied in three layers achieved 84% gap-free margins in dentin; PBE with self-adhesive resin cements exhibited significantly more gaps in dentin ( p < 0.05). Conclusions: With a meticulous layering technique and bonded resin composite, PBE may be an alternative to ceramic bonding to dentin. Self-adhesive resin cements seem not suitable for this indication. Clinical relevance: For deep proximal boxes ending in dentin, a PBE may be an alternative to conventional techniques. [ABSTRACT FROM AUTHOR]

Context: Early observations of enamel surfaces prepared by erbium lasers motivated clinicians to use laser as an alternative to chemical etching. Aims: Evaluate shear bond strength (SBS) values of different dental adhesives on Erbium:Yttrium Aluminum Garnet (Er:YAG) laser prepared enamel and to evaluate possible etching patterns correlations between dental adhesives and SBS values. Subjects and Methods: One hundred bovine incisors were randomly assigned to SBS tests on enamel (n = 15) and to enamel morphology analysis (n = 5) after Er:YAG laser preparation as follows: Group I – 37% phosphoric acid (PA)+ ExciTE®; Group II – ExciTE®; Group III – AdheSE® self‑etching; Group IV – FuturaBond® no‑rinse. NR; Group V – Xeno® V. Teeth were treated with the adhesive systems and subjected to thermal cycling. SBS were performed in a universal testing machine at 5 mm/min. Statistical Analysis Used: One‑way ANOVA and post‑hoc tests (p < 0.05). For the morphology evaluation, specimens were immersed in Ethylenediamine tetraacetic acid (EDTA) and the etching pattern analyzed under Scanning Electron Microscope (SEM). Results: Mean bond strengths were Group I – 47.17 ± 1.61 MPa (type I etching pattern); Group II – 32.56 ± 1.64 MPa, Group III – 29.10 ± 1.34 MPa, Group IV – 23.32 ± 1.53 MPa (type III etching pattern); Group V – 24.43 MPa ± 1.55 (type II etching pattern). Conclusions: Different adhesive systems yielded significantly different SBSs. Acid etching significantly increased the adhesion in laser treated enamel. No differences in SBS values were obtained between AdheSE® and ExciTE® without condition with PA. FuturaBond® NR and Xeno® V showed similar SBS, which was lower in comparison to the others adhesives. No correlation between enamel surface morphology and SBS values was observed, except when PA was used. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations. Materials and methods: A total of 139 Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a poly-acid modified resin composite (Dyract AP) in non-carious cervical lesions without intentional enamel involvement. The materials were cured with a conventional continuous light, a soft-start or a pulse-delay curing mode. The restorations were evaluated at baseline, 6, 12, 18 and 24 months and then yearly during a 7 year follow-up with modified USPHS criteria. Dentine bonding efficiency was determined by the percentage of lost restorations. Results: During the 7 years, 135 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6 and 18 months and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled at 18 months the full acceptance ADA criteria. Tetric Ceram showed at 7 years a 20.9% loss of retention and Dyract AP a 25.0% loss rate (Log rank p =0.48). The loss rates for the 3 curing techniques: continuous, soft start and pulse delay were 17%, 27.9% and 24.4%, respectively (Log rank p =0.52). No secondary caries was observed. Significance: The single-step self-etching adhesive showed acceptable clinical long-time retention rates to dentine surfaces independent of restorative material and curing technique used. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate marginal quality and resin–resin transition of lab made resin composite inlays in deep proximal cavities with and without 3mm proximal box elevation (PBE) using resin composites before and after thermo-mechanical loading (TML). Methods: MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 40 extracted human third molars. Proximal boxes ending in dentine were elevated 3mm with different resin composites (G-Cem, Maxcem Elite as self-adhesive resin cements and Clearfil Majesty Posterior as restorative resin composite in one or three layers bonded with AdheSE), or left untreated. Clearfil Majesty Posterior inlays were luted with Syntac and Variolink II (n =8). Marginal quality as well as the PBE-composite inlay interface was analyzed under an SEM using epoxy resin replicas before and after thermomechanical loading (100,000×50N and 2500 thermocylces between +5°C and +55°C). Results: Bonding resin composite inlays directly to dentine showed similar amounts of gap-free margins in dentine compared to PBE applied in three consecutive layers (p >0.05). The groups with self-adhesive resin cements for PBE exhibited significantly more gaps in dentine (p <0.05). Significances: With layered resin composite, PBE is effective in indirect resin composite bonding to deep proximal boxes. Self-adhesive resin cements are not suitable for this indication. [Copyright &y& Elsevier]

The objective of this article is to evaluate the resistance to degradation of resin-dentin bonds formed with three one-step adhesives. Flat, mid-coronal dentin surfaces were bonded with the self-etching adhesives [Tokuyama Bond Force (TBF), One Up Bond F Plus (OUB), and G-Bond (GB)]. The bonded teeth were subjected to fatigue loading, chemical degradation, and stored in distilled water for four time periods (up to 12 months). Specimens were tested for microtensile bond strength and microleakage. Fractographic analysis was performed by scanning electron microscopy. Bonded interfaces were examined by light microscopy using Masson's trichrome staining. An atomic force microscope was employed to analyze phase separation and surface nanoroughness (Ra) at the polymers. Vickers microhardness and the degree of the conversion (DC) were also determined. ANOVA and multiple comparisons tests were performed. Bond strength significantly decreased after the chemical challenge, but not after load cycling. Aging decreased bond strength after 6 months in TBF and GB, in OUB after 12 months. An increase of the nonresin protected collagen zone occurred in all groups, after storing. TBF showed the highest roughness, microhardness, and DC values, and GB showed the lowest. Mild self-etch one-step adhesives (TBF/OUB) showed a higher degree of cure, lower hydrophilicity, and major resistance to degradation of resin-dentin bonds when compared to highly acidic self-etching adhesive (GB). [ABSTRACT FROM PUBLISHER]

Background and Aims: The purpose of this experimental study was to investigate the shear bond strength of three new adhesive systems to enamel and dentin of permanent human teeth using three new etch and rinse and self-etch adhesive systems. Materials and Methods: Sixty intact caries-free third molars were selected and randomly divided into 6 groups. Flat buccal and lingual enamel and dentin surfaces were prepared and mounted in the acrylic resin perpendicular to the plan of the horizon. Adhesives used in this study were Tetric N-Bond, AdheSE and AdheSE-One F (Ivoclar/Vivadent, Schaan, Liechtenstein). The adhesives were applied on the surfaces and cured with quartz tungsten halogen curing unit (600 mW/cm2 intensity) for 20 S. After attaching composite to the surfaces and thermocycling (500 cycles, 5-55?C), shear bond strength was measured using a universal testing machine at a crosshead speed of 0.5 mm/min. The failure modes were examined under a stereomicroscope. The data were statistically analyzed using t-test, one-way ANOVA, Tukey and Fisher's exact tests. Results: In enamel, Tetric N-Bond (28.57±4.58 MPa) and AdheSE (21.97±7.6 MPa) had significantly higher bond strength than AdheSE-One F (7.16±2.09 MPa) (P<0.0001). Tetric N-Bond had higher bond strength than AdheSE but there was not any significant differences between them (P=0.093). In dentin, there were significantly differences among all adhesives (P<0.001). Tetric N-Bond (20.62±3.03 MPa) showed the highest and AdheSEOne F (6.54±1.13 MPa) had the lowest value. The bond strength in enamel was higher than that observed in dentin and the difference was significant in Tetric N-Bond (P=0.044) and AdheSE (P=0.000) groups. There were no significant differences in the mode of failures among groups (P>0.05). Conclusion: Shear bond strength to dentin in Tetric N-Bond (etch and rinse system) was higher than self-etch adhesives (AdheSE and AdheSE-One F). The bond strength to enamel and dentin in two-step self-etch (AdheSE) was higher than one-step self-etch (AdheSE-One F) [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 (a = 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. [ABSTRACT FROM AUTHOR]

Summary: Adhesive technology has evolved rapidly since it was introduced more than fifty years ago. Today, decayed or fractured teeth can be reconstructed minimally invasively and nearly invisibly using adhesive technology. However, the clinical longevity is sometimes still too short. Although water sorption is thought to be the main destabilizer of the biomaterial–tooth bond, the actual interfacial degradation mechanisms are far from understood. The fundamental mechanism of bonding to enamel and dentin is essentially based on an exchange process, in which minerals removed from the dental hard tissues are replaced by resin monomers that upon polymerization become micro-mechanically interlocked in the created porosities. In addition to micro-mechanical interlocking through hybridization, the potential benefit of additional chemical interaction between functional monomers/polymers and tooth substrate components has recently regained attention. In this review paper, we focus on how chemical interaction at the biomaterial–hard tissue interface can improve bond durability. [ABSTRACT FROM AUTHOR]

Aim: To evaluate shear bond strength of silorane and bis-GMA based composite resins using self-etch and total-etch adhesive systems, and compare the effect of Quartz-tungten-halogen (QTH) and Light emitting diode (LED) on the shear bond strength of the experimental materials. Materials and Methods: Flat dentin surfaces were exposed on intact extracted molars and composite resin was built 2 mm in diameter. Teeth were divided randomly into four groups. Groups 1 and 2 were restored with P90 system adhesive and Filtek P90 and cured with QTH and LED units respectively. Groups 3 and 4 were restored with total etch adhesive and Filtek Z100 and cured with QTH and LED units respectively. Specimens were subjected to shear bond strength testing using Instrom Universal testing machine. Results: Data was subjected to one-way analysis of variance. Total-etch groups gave significantly higher shear bond strength values than the self-etch groups. No significant difference in shear bond strength was found between Groups 3 and 4, while Group 1 showed significantly higher values than Group 2. Conclusion: Type of light curing unit is not a significant factor affecting shear bond strength for bis-GMA RBCs using total-etch technique; while for curing silorane resin based composite (RBCs), conventional halogen curing units showed better results. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Self-etch adhesives are well adopted in general practice, obviously primarily thanks to their ease of use and fast application time. Nevertheless, phosphoric acid is still often recommended to beforehand etch enamel following a so-called ‘selective’ enamel-etch technique, this in particular when most cavity margins end in enamel. The purpose of this study was to test if a new one-step adhesive can be applied in a multi-mode manner, this following different, either ‘full’ or ‘selective’, self-etch and etch-and-rinse approaches. Specific research hypotheses tested were that prior phosphoric-acid etching did not affect the bonding effectiveness of the one-step adhesive to enamel and dentine, and that the bonding effectiveness to dentine was also not affected when the adhesive was applied either following a ‘dry-bonding’ or ‘wet-bonding’ etch-and-rinse technique. Methods: The micro-tensile bond strength (μTBS) of the one-step self-etch adhesive G-Bond Plus (GC, Tokyo, Japan; 1-SEA) was measured when it was bonded to bur-cut enamel following either a ‘self-etch’ or an ‘etch-and-rinse’ adhesive protocol, and to bur-cut dentine when applied following either a ‘self-etch’, a ‘dry-bonding’ or a ‘wet-bonding’ etch-and-rinse adhesive protocol. Bond-strength testing was corroborated by ultra-structural analysis of the interfacial interaction at enamel and dentine using transmission electron microscopy (TEM). Results: Prior phosphoric-acid etching significantly increased the bonding effectiveness of the 1-SEA to enamel. A clearly enhanced micro-retentive surface was revealed by TEM. To dentine, no statistically significant difference in bonding effectiveness was recorded when the 1-SEA was either applied following a self-etch or both etch-and-rinse approaches. The ‘dry-bonding’ etch-and-rinse protocol was significantly more effective than its ‘wet-bonding’ version. TEM however revealed indications of low-quality hybridisation following both etch-and-rinse approaches, in particular in the form of a porous and poorly resin-infiltrated collagen mesh. Conclusions: While phosphoric-acid etching definitely improved bonding of the one-step self-etch adhesive to enamel, one should be more careful with additional phosphoric-acid etching of dentine. Although the bond strength was not reduced, the resultant adhesive interface appeared ultra-structurally more vulnerable to biodegradation. [Copyright &y& Elsevier]

Taschner M, Nato F, Mazzoni A, Frankenberger R, Falconi M, Petschelt A, Breschi L. Influence of preliminary etching on the stability of bonds created by one-step self-etch bonding systems. Eur J Oral Sci 2012; 120: 239-248. © 2012 Eur J Oral Sci We evaluated the effects of preliminary etching of dentine on the stability of the bond created by one-step self-etch adhesives under different storage conditions. Adper Easy Bond (3M ESPE) and iBond Self-Etch (iBond SE; Heraeus Kulzer) were applied with an etch-and-rinse (i.e. after preliminary phosphoric acid etching for 15 s) or a self-etch approach. Resin-dentine bonded specimens were sectioned perpendicularly to the adhesive interface according to the 'non-trimming technique'. Beams were stored in artificial saliva for 24 h, 6 months, or 1 yr at 37°C, or in 10% NaOCl for 5 h at room temperature, and then stressed until failure; the microtensile bond strengths were calculated. Interfacial nanoleakage of additional teeth was evaluated using light microscopy or transmission electron microscopy. Adper Easy Bond showed higher bond strength than iBond SE, regardless of the dentine treatment. Similar microtensile bond strength results were obtained for teeth subjected to artificial ageing in 10% NaOCl for 5 h at room temperature and for teeth stored in artificial saliva for 6 months at 37°C. The additional etching step increased the microtensile bond strength for Adper Easy Bond and iBond SE. This study supports the use of one-step adhesives on etched dentine because of the increased bond strength compared with their application onto smear-layer-covered dentine, regardless of storage conditions. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the influence of preliminary phosphoric acid etching on the microleakage of a self-adhering flowable composite and a self-etch adhesive used in combination with the proprietary flowable composite. Methods: Standard Class V cavities were prepared on the buccal side of 20 extracted sound human molars. Specimens were randomly divided into five groups: (1) Gel Etchant/Optibond FL/Premise Flowable; (2) Vertise Flow; (3) Optibond XTR/Premise Flowable; (4) Gel Etchant/Vertise Flow; and (5) Gel Etchant/Optibond XTR/Premise Flowable (Kerr). The interfacial sealing ability of the materials was evaluated by scoring the depth of silver nitrate penetration and through scanning electron microscopy observations. Differences in leakage at either the enamel or the dentine interface were evaluated for statistical significance (Kruskal-Wallis ANOVA, Mann-Whitney U test, p < 0.05). Results: At the enamel interface, no significant differences were found among the materials. On dentine, Gel Etchant/Vertise Flow had the highest leakage scores and the difference was statistically significant (p < 0.05). Conclusions: The early sealing ability of the self-adhering flowable composite and the self-etch adhesive in Class V restorations did not significantly benefit from selective enamel etching. Preliminary phosphoric acid etching of dentine negatively affected the quality of the seal when using the adhesive-free flowable composite. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the bond strengths between dentine and resin composite obtained after Er:YAG laser treatment of crown or root dentine used together with self-etch and total-etch adhesive systems. Methods: One etch-and-rinse adhesive (Single Bond, 3M, USA) and one self-etch system (Clearfil SE Bond, Kuraray, Japan) were applied to root and crown dentine prepared with a regular bur in a turbine or with an Er:YAG laser. The shear bond strength was determined after thermocycling and statistically analysed using independent t-tests. Results: Crown sites bonded using Clearfil SE Bond and Single Bond adhesives yielded bond strengths similar to that of root dentine sites (p > 0.05). Clearfil SE Bond was stronger in both the lased and non-lased groups (p < 0.05). The lowest bond strength was obtained when Single Bond without acid etching was used on Er:YAG ablated dentine. When total-etch adhesive was used, there were significant differences (p < 0.05) between the laser-ablated and laser-ablated/acid-etched and bur-cut/acid-etched groups. Conclusions: Er:YAG laser irradiation of root and crown dentine conducted prior to the adhesive protocol adversely affected adhesion and decreased bond strength compared with traditional preparation. [ABSTRACT FROM AUTHOR]

This study was aimed to determine the effectiveness of grinding and pre-etching in promotion of adhesion to human intact enamel using the self-etch adhesive (SEA) Adper Easy Bond (3M ESPE). Etch-and-rinse adhesive Adper Single Bond (3M ESPE) served as control. Composite cylinders (AP-X Kuraray) were built and after 24 h micro-shear bond strengths (MSBS) were measured. Bonding interfaces were evaluated under scanning electron microscope (SEM). For evaluation of average roughness (Pa) and morphological analysis, treated enamel surfaces were observed under SEM and confocal laser scanning microscope (CLSM) with 3D surface profiling. Highest bond strengths were obtained by pro-etching and grinding showed a less significant role. Phosphoric acid (PA) etching compare to grinding created significantly rougher surface (Ra: 0.72 and 0.43 μm respectively). Therefore, this study recommends pre-etching the intact enamel prior to application of the adhesive instead of grinding. [ABSTRACT FROM AUTHOR]

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Aim: The purpose of this study is to evaluate the resin-dentin interface, quality of the hybrid layer of total-etching and selfetching adhesive systems under scanning electron microscopy (SEM). Materials and Methods: Class V cavities were prepared in 40 extracted human molars. In Group I XP bond (Dentsply), in Group II Adper Single Bond II (3M ESPE), in Group III Adper Easy One (3M ESPE), and in Group IV Xeno V (Dentsply) were applied. Teeth were restored with resin composite, subjected to thermocycling, and sectioned in Buccolingual plane. The samples were demineralized using 6N HCl, for 30 sec, and deproteinized with 2.5% NaOCl for 10 min, gold sputtered, and viewed using a scanning electron microscope. Results: Among the total-etch systems used, the XP Bond showed a clear, thick hybrid layer, with long resin tags and few voids. Among the self-etch adhesive systems, the Xeno V did not show a clearly recognizable hybrid layer, but there were no voids and continuous adaptation was seen with the dentin. Conclusion: The adaptation of self-etch adhesives to the resin-dentin interface was good without voids or separation of phases; showing a thin, continuous hybrid layer. [ABSTRACT FROM AUTHOR]

Van Landuyt KL, Peumans M, De Munck J, Cardoso MV, Ermis B, Van Meerbeek B. Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Eur J Oral Sci 2011; 119: 511-516. © 2011 Eur J Oral Sci Despite the fact that one-step adhesives are currently used routinely in clinical practice, long-term studies on their clinical performance are scarce. The objective of this randomized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch-and-rinse adhesive. Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite (Gradia Direct; GC). These restorations were bonded in random order either with the HEMA-free one-step adhesive G-Bond (GC) or with the 'gold-standard' (control) three-step adhesive Optibond FL (Kerr). The restorations were evaluated after 6, 12, 24, and 36 months of clinical service regarding retention, marginal adaptation, microleakage, caries occurrence, and sensitivity. After a medium-long period of 3 yr, similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive. However, the one-step adhesive exhibited significantly more incisal marginal defects and discolorations. Whereas marginal degradation appeared to arrest for the multistep etch-and-rinse adhesive after 12 months, the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate. These incisal marginal defects were, however, small and could easily be removed by polishing. For both adhesives, large and sclerosed lesions appeared to be at higher risk of retention loss. [ABSTRACT FROM AUTHOR]

Background and Aims: This ex vivo study was done to evaluate the effect of different adhesive systems on microleakage of class V composite restorations. Materials and Methods: Thirty extracted human third molar teeth were selected and class V cavities were prepared (3×3×1.5 mm) on buccal and lingual surfaces. Then, teeth were divided into 3 groups. Adhesives used in this study were Excite (Ivoclar/Vivadent), AdheSE(Ivoclar/Vivadent) and AdheSE-one Ivoclar (Vivadent/Vivadent). After application of adhesives, cavities were restored with a resine composite (InTen-S A1/ Ivoclar), in 3 increments and cured with QTH light curing unit (700 mW/cm). After 24 hours storage of teeth in 37°C water, teeth were thermocycled (500 cycles in 5-55°C) and stored in 1% basic fushin for 24 hours. After that, the specimens were rinsed with running water and mounted in a self-cured acryl. Finally, the specimens were sectioned and maximum depth of dye penetration for each restoration was measured using stereomicroscopy. The results were statistically analyzed with Mann-Whitney U test. Results: In comparison between enamel and dentin margins in each group, microleakage in enamel margins were less than that of dentin margins. This difference was statistically significant in Excite and AdheSE-one groups (P=0.001, P=0.043). AdheSE showed the least microleakage in dentin margins; however, there was no significant difference between 3 bonding agents (P=0.14). In enamel margins, there were significant differences between 3 bonding agents (P=0.001). Excite showed the lowest microleakage and AdheSE-one had the highest microleakage. Conclusion: The least enamel microleakage was associated with the total-etch and least dentin microleakage was observed in the two-step self-etch adhesive system. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The purpose of this study was to measure the average depth of dentinal tubule sealer penetration in the middle third of teeth obturated with gutta-percha/AH Plus (Dentsply, DeTrey, Konstanz, Germany), Resilon/Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon/Epiphany self-etch (SE) using scanning electron microscopy (SEM). Methods: The root canals of 36 extracted single-rooted human teeth were prepared and randomly divided into three groups. Obturations were performed with the following filling materials using the lateral compaction technique: group 1, gutta-percha/AH Plus; group 2, Resilon/Epiphany; and group 3, Resilon/Epiphany SE. The specimens were prepared for SEM examination. The average depth of sealer penetration into the dentinal tubules was measured. Data were analyzed by one-way analysis of variance and a post hoc Tukey test. Results: The mean (± standard deviation) values for the average depth of sealer penetration in the middle third of the roots were 22.07 ± 6.92 μm, 31.56 ± 6.80 μm, and 21.50 ± 9.25 μm for AH Plus, Epiphany, and Epiphany SE, respectively. The average penetration depth of Epiphany was significantly higher than that of Epiphany SE and AH Plus (P < .05). There was no significant difference between the penetration depth of Epiphany SE and AH Plus (P > .05). Conclusions: It could be concluded that the average penetration for Epiphany into dentinal tubules within the middle third of the roots was significantly deeper than that of Epiphany SE and AH Plus. [Copyright &y& Elsevier]

Previous research, in which the bonding effectiveness of the 3 self-etch monomers HAEPA, EAEPA, and MAEPA was determined, showed that MAEPA was most effective. In this study, the molecular interactions of these monomers with hydroxyapatite and dentin were investigated by combining x-ray diffraction, infrared spectroscopy, and scanning electron microscopy. We tested the null hypothesis that the bonding performance of these monomers does not correlate to the formation of monomer-calcium salts and to hydrolytic stability of these monomer-calcium complexes. Monomer/ ethanol/water solutions were prepared and applied to synthetic hydroxyapatite and dentin. While HAEPA and EAEPA dissolved dentin considerably and deposited unstable calcium-phosphate salts (DCPD), MAEPA formed hydrolysis-resistant monomer-calcium salts that remained attached to the dentin surface even after being washed. The chemical stability of the monomer-Ca salts was thought to contribute in particular to the bond durability, but this study shows that the formation of stable monomer-calcium salts also enhances the ‘immediate’ bonding performance of self-etch adhesives. [ABSTRACT FROM PUBLISHER]

Self-adhesive resin cements were introduced to dentistry within the past decade but have gained rapidly in popularity with more than a dozen commercial brands now available. This review article explores their chemical composition and its effect on the setting reaction and adhesion to various substrates, their physical and biological properties that may help to predict their ultimate performance and their clinical performance to date and handling characteristics. The result of this review of self-adhesive resin cements would suggest that these materials may be expected to show similar clinical performance as other resin-based and non-resin based dental cements. [ABSTRACT FROM AUTHOR]

Abstract: This paper reflects on the state of the art of self-etch adhesives anno 2010. After presenting the general characteristics of self-etch adhesives, the major shortcomings of the most simple-to-use one-step (self-etch) adhesives are addressed. Special attention is devoted to the AD-concept and the benefit of chemical interfacial interaction with regard to bond durability. Finally, issues like the potential interference of surface smear and the more challenging bond to enamel for ‘mild’ self-etch adhesives are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The objective of this randomized controlled clinical trial was to evaluate the 8-year clinical performance of a mild 2-step self-etch adhesive in non-carious Class-V lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins. Methods: A total of 100 non-carious Class-V lesions in 29 patients were restored with Clearfil AP-X (Kuraray). The composite restorations were bonded following two different approaches: (1) application of Clearfil SE (Kuraray) following a self-etch approach (control group; C-SE non-etch), (2) selective phosphoric acid-etching of the enamel cavity margins before application of Clearfil SE (experimental group; C-SE etch). The restorations were evaluated after 6 months, 1, 2, 3, 5 and 8 years of clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Results: The recall rate at 8 years was 76%. Only two restorations, one of the C-SE non-etch group and one of the C-SE etch group, were clinically unacceptable due to loss of retention leading to a retention rate and a clinical success rate of 97% in both groups. Aging of the restorations was characterized by an increase in the percentage of restorations with a small but clinically acceptable marginal defect (C-SE non-etch: 92%; C-SE etch: 84%) and/or a superficial marginal discoloration (C-SE non-etch: 44%; C-SE etch: 28%). At the enamel side, the presence of small marginal defects (C-SE non-etch: 86%; C-SE etch: 65%) and superficial marginal discoloration (C-SE non-etch: 11%; C-SE etch%) was more frequently noticed in the control group than in the experimental group. The difference, however, was only statistically significant for the presence of superficial marginal discoloration (McNemar, p =0.01). Significance: After 8 years of clinical functioning, the clinical effectiveness of Clearfil SE remained excellent, with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration at enamel. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate marginal integrity of direct resin composite restorations before and after thermo-mechanical loading in vitro, and before and after 6 years of clinical service in a prospective clinical trial. Methods: For the in vitro part, MO cavities with the proximal box beneath the cemento-enamel junction were prepared in 32 extracted human third molars. The specimens were randomly assigned to four groups (n =8) and received bonded resin composite restorations (two groups each Grandio bonded with Solobond M and Tetric Ceram bonded with Syntac). Specimens were subjected to three different aging protocols: 6-year water storage (WS), thermo-mechanical loading (TML; 100,000×50N; 2500×+5/+55°C), and 6-year water storage plus thermo-mechanical loading (WS+TML). Initially and after aging, marginal qualities in enamel and dentin were evaluated using replicas at 200× magnification (SEM). For the in vivo part, 30 patients received 68 direct resin composite restorations of the same materials in a prospective clinical trial. Replicas of 11 selected subjects per group were assessed for marginal quality under a SEM at 200×. Results: in vitro, all initial results showed nearly 100% gap-free margins. For TML, percentages of gap-free margins dropped to 87–90% in enamel and to 58–66% in dentin (p <0.05). For WS, enamel margins still were at 97–99% whereas dentin margins exhibited 67–75% gap-free margins, and for WS+TML, enamel margins were at 85–87% and dentin margins at 42–52% gap-free margins. In vivo, gap-free enamel margins were reduced from initially 86–90% to 74–80% after 6 years of clinical service (p <0.05). Proximally exposed dentin margins were not recordable by impressions, however, clinically no considerable problems like recurrent caries or discolorations were detected. Significance: In vitro, hydrolytic degradation supports mechanical fatigue in dentin–composite bonds over time. In vivo, wear phenomena are superimposing marginal quality aspects. Gaps between enamel and resin composite did not play a major role. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate the dentin bond durability of simplified adhesives after one-year (1y) under water storage and simulated pulpal pressure. Methods: Class I cavities were prepared in sixty human third molars with the pulpal wall located in mid-coronal dentin. The roots were cut off to expose the pulpal chamber, and the teeth were assembled in a pulpal pressure simulator device. A two-step etch-and-rinse adhesive (Single Bond 2/SB), a two-step self-etch adhesive (Clearfil SE Bond/CSE), a three-step self-etch adhesive (Adper Scotchbond SE/SSE) and three all-in-one adhesives (Adper Easy Bond/EB, Clearfil S3 Bond/S3 and Adhese One/AO) were applied according to manufacturerś instructions. No enamel pre-etching was used for the self-etch systems. The cavities were filled with a composite (Z250, 3M ESPE) in four to five horizontal increments and individually cured. Immediately after the final cure, pulpal pressure was set to 15cm H2O. After 24h and 1y under simulate pulpal pressure the teeth were cut following a ‘nontrimming’ microtensile test technique (n =30) and tested in tension. Kruskall–Wallis and post hoc multiple comparisons were used at α=0.05. Weibull statistics was applied to SB, CSE and EB. Fractographic analysis of debonded specimens was performed using scanning electron microscopy. Results: At 24h and 1y periods, SB showed higher bond strength means than all the others adhesives tested. CSE was not statistically different from EB at 24h and from EB and SB at 1y. EB showed bond strength statistically higher than the other three self-etch adhesives, which were not statistically different from each other at 24h. AO showed significantly lower bond strength than all tested materials after 1y. For all adhesives the mean bond strength at 1y were not statistically different from the values measured at 24h (p >0.05). Shifts in failure mode patterns and Weibull modulus decrease indicate some degree of bond degradation after the 1y storage period. Conclusion: One-year of simulated pulpal pressure did not affect dentin bond strength of simplified adhesives in Class I restorations. Signs of degradation were only revealed by fractographic analysis and reliability parameters. [Copyright &y& Elsevier]

De Munck J, Mine A, Van den Steen PE, Van Landuyt KL, Poitevin A, Opdenakker G, Van Meerbeek B. Enzymatic degradation of adhesive–dentin interfaces produced by mild self-etch adhesives. Eur J Oral Sci 2010; 118: 494–501. © 2010 Eur J Oral Sci Endogenous matrix metalloproteinases (MMPs) released by adhesive procedures may degrade collagen in the hybrid layer and so compromise the bonding effectiveness of etch-and-rinse adhesives. In this study, endogenous enzymatic degradation was evaluated for several simplified self-etch adhesives. In addition, primers were modified by adding two MMP inhibitors: chlorhexidine, a commonly used disinfectant, but also a non-specific MMP inhibitor; and SB-3CT, a specific inhibitor of MMP-2 and MMP-9. Gelatin zymography of fresh human dentin powder was used to identify the enzymes released by the adhesives. Micro-tensile bond strength (μTBS) testing was used to assess the mechanical properties of resin–dentin interfaces over time. In none of the experimental groups treated with the mild self-etch adhesives was MMP-2 and/or MMP-9 identified. Also, no difference in the μTBS was measured for the inhibitor-modified and the control inhibitor-free adhesives after 6 months of water storage. It is concluded that in contrast to etch-and-rinse adhesives, the involvement of endogenous MMP-2 and MMP-9 in the bond-degradation process is minimal for mild self-etch adhesives. [ABSTRACT FROM AUTHOR]

Taschner M, Nato F, Mazzoni A, Frankenberger R, Krämer N, Di Lenarda R, Petschelt A, Breschi L. Role of preliminary etching for one-step self-etch adhesives. Eur J Oral Sci 2010; 118: 517–524. © 2010 Eur J Oral Sci The aim of this study was to analyse the effect of preliminary phosphoric acid etching of enamel and dentine before the application of two, one-step self-etch adhesive systems. The systems were applied onto acid-etched or smear-layer-covered enamel and dentine. The treatment groups were as follows: group 1, Adper Easy Bond (3M ESPE) on etched substrate; group 2, Adper Easy Bond (control); group 3, iBond Self-Etch (Heraeus Kulzer) on etched substrate; and group 4, iBond Self-Etch (control). Enamel and dentine bond strengths were calculated using microshear and microtensile bond-strength tests. Additional specimens were prepared to evaluate nanoleakage at the dentine–adhesive interface and were investigated using light microscopy or transmission electron microscopy. Both adhesives demonstrated higher microshear bond strengths when enamel was pre-acid-etched with phosphoric acid (Adper Easy Bond 28.7 ± 4.8 MPa; iBond Self-Etch 19.7 ± 3.6 MPa) compared with controls (Adper Easy Bond 19.2 ± 3.3 MPa; iBond Self-Etch 17.5 ± 2.7 MPa) and increased microtensile bond strength when applied on acid-etched (Adper Easy Bond 35.8 ± 5.7 MPa; iBond Self-Etch 24.3 ± 7.9 MPa) vs. smear-layer-covered dentine (Adper Easy Bond 26.9 ± 6.2 MPa; iBond Self-Etch 17.6 ± 4.3 MPa). Adper Easy Bond showed lower nanoleakage than iBond Self-Etch, irrespective of preliminary etching. The results of this study support the use of phosphoric acid etching before the application of one-step self-etch adhesive systems. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The aim of this study was to evaluate the long-term clinical retention to dentin of a two-step self-etching adhesive system Clearfil SE Bond and a two-step etch-and-rinse system PQ1. Methods: A total of 119 Class V restorations were placed in non-carious cervical lesions without intentional involvement of the enamel incisal of the lesions. The restorations were evaluated yearly during an 8-year follow-up. Clinical dentin bonding efficiency was determined by the percentage of lost restorations at each of the recalls. Results: At 8 years, 112 restorations could be evaluated. Both adhesives fulfilled the ADA 18-month full acceptance criteria for retention with a retention rate of 90.6% for PQ1 and 98.2% for Clearfil SE Bond. The loss rates increased then considerably after 2 and 3 years, respectively. The cumulative loss rates at 8 years were 25.5% for Clearfil SE and 39.3% for PQ1 (p =0.12). No significant differences were observed between lesions with sclerotic and non-sclerotic dentin. The size of the lesions did not influence the bonding effectiveness. A lower loss rate was found for the restorations placed in lesions slightly roughened before etching. Conclusion: Both adhesive systems showed acceptable short-term clinical retention to dentin, which decreased after long-time in vivo aging, especially for the simplified etch-and-rinse system. [ABSTRACT FROM AUTHOR]

Summary: Objectives: This study examined changes in the dentinal fluid flow (DFF) during restorative procedures and compared permeability after restoration among restorative materials and adhesives. Methods: A class 1 cavity was prepared and restored with either amalgam (Bestaloy), or composite (Z-250) with one of two etch-and-rinse adhesives (Scotchbond MultiPurpose: MP and Single Bond 2: SB) or one of two self-etch adhesives (Clearfil SE Bond: CE and Easy Bond: EB) on an extracted human third molar which was connected to a sub-nanoliter fluid flow measuring device (NFMD) under 20cm water pressure. DFF was measured from the intact tooth state through the restoration procedures to 30min after restoration, and re-measured at 3 and 7 days post-restoration. Results: Inward flow during cavity preparation was followed by outward flow after preparation. In amalgam restoration, the outward flow changed into an inward flow during amalgam filling, which was followed by a slight outward flow after finishing. In composite restoration, MP and SB showed an inward flow and outward flow for the rinsing and drying steps, respectively. Application of a hydrophobic bonding resin in the MP and CE systems caused a decrease in the flow rate. Air-drying of solvent for the CE and EB systems caused a sudden outward flow, whereas light-curing of the adhesive and composite caused an abrupt inward flow. Conclusions: Each restorative step clearly changed the direction and the rate of the DFF during restoration, which could be well identified with NFMD. [Copyright &y& Elsevier]

Abstract: Introduction: Retreatment procedures might affect the adhesion capability of refilling materials to dentinal walls. The purpose of this study was to compare the effect of different retreatment techniques on bond strength of Resilon (Resilon Research LLC, Madison, CT)/Epiphany (Pentron Clinical Technologies, LLC, Wallingford, CT) self-etch (SE) with radicular dentin after canal reobturation. Methods: Sixty extracted single-rooted human teeth were prepared using Mtwo rotary files (VDW, Munich, Germany) and obturated with Resilon/Epiphany SE. The roots were randomly divided into four groups; in group 1, no retreatment procedure was done; group 2 was retreated using Mtwo R/Mtwo files; group 3 was retreated using Mtwo R/Mtwo combined with chloroform; and group 4 was retreated using Mtwo R/Mtwo combined with Endosolv R (Septodont, Paris, France). The root canals were then reobturated with Resilon/Epiphany SE. One-millimeter slices of midroot dentin were prepared for the push-out test (n = 30 slices per group). Failure modes after the push-out test were examined under microscopy. The data were analyzed by using a one-way analysis of variance and the Dunnett post hoc test. Results: Group 3 showed significantly the lowest mean bond strength (p < 0.02). No significant difference was found between the values of groups 1, 2, and 4 (p > 0.26). The mode of bond failure was predominantly adhesive for all groups. Conclusions: This study showed that the bond strength of Resilon/Epiphany SE after root canal retreatment using Mtwo files, either alone or combined with Endosolv R, was not significantly different from that of nonretreated specimens. Chloroform used for retreatment had an adverse effect on the bond strength of Resilon/Epiphany SE after root canal reobturation. [Copyright &y& Elsevier]

Abstract: Objectives: The study was aimed at assessing the bonding potential of all-in-one adhesives to dentin. Methods: The microtensile bond strength of the all-in-one adhesives Bond Force (Tokuyama), AdheSE One (Ivoclar-Vivadent), and Xeno V (Dentsply) was measured in comparison with the etch-and-rinse system XP Bond (Dentsply). The ultrastructural characteristics of dentin–adhesive interface were observed under scanning electron microscope (SEM). Twenty human extracted third molars had their mid-coronal dentin exposed and ground with wet 600-grit SiC paper in order to create a standardized smear layer. Bonding procedures were performed according to the manufacturers’ instructions and microtensile beams were obtained with the “non-trimming” technique. The bond strengths in MPa were statistically analyzed including pre-test failures as “zero” values (Kolmogorov–Smirnov test, Levene''s test, One-Way ANOVA, Tukey''s test p <0.05). Results: The following bond strengths were recorded in MPa (mean±standard deviation): AdheSE One 31.7±21.3; Xeno V 42.8±26.4; Bond Force 43.3±22.1; XP Bond 51.9±18.6. The statistical analysis demonstrated that the bond strengths achieved by Bond Force and Xeno V were similar to that of the etch-and-rinse adhesive, whereas the bond strength of AdheSE One was significantly lower. A distinct hybrid layer with resin tags was seen only in XP Bond specimens. All-in-one adhesives demonstrated a rather superficial interaction with the dentin substrate. Conclusions: Although the strongest bond to dentin was established by the etch-and-rinse system, however the all-in-one adhesives containing organic solvents reached bond strength levels that were comparable from a statistical point of view. [Copyright &y& Elsevier]

Mild self-etching adhesive systems modify and/or incorporate the smear layer into the resin-infiltrated demineralised dentin. Some factors such as type of bur and use of water spray might affect the thickness of the smear layer on substrates, enamel and dentin. Because of this, the present study evaluated the thickness of smear layers created by different finishing procedures, after the application of three simplified self-etching primers (Adper Prompt L-Pop and two experimental formulations) on enamel and dentin. After the application and removal of the primers’ resinous component, the specimens were prepared for examination under a scanning electron microscope. Smear layers were thicker on enamel than on dentin, irrespective of the finishing methods used. Therefore, different thicknesses of smear layer on enamel/dentin might be an important factor to consider when evaluating the bonding efficacy of self-etching adhesives to both tooth substrates. [ABSTRACT FROM AUTHOR]

Aim To investigate and compare the displacement resistance of glass fibre reinforced composite (FRC) posts to root dentine after luting with different adhesive systems. Methodology A total of 32 noncarious extracted human mandibular premolars were prepared for post-cementation using the FRC Postec system (Ivoclar Vivadent, Schaan, Liechtenstein) and divided into four groups ( n = 8). The posts in each group were luted with one or other of the following materials. Group 1: Variolink II/Excite DSC (etch-and-rinse, dual-curing), group 2: Clearfil Esthetic Cement/ED Primer II (self-etch, dual-curing), group 3: Multilink/Multilink Primer (self-etch, chemical-curing) and group 4: Multilink Sprint (self-adhesive, dual-curing). Specimens were sectioned to obtain slices with the post in the centre and with the root dentine overlaid by the autopolymerizing acrylic resin on each side. The displacement resistance was measured using a Universal Testing Machine at a crosshead speed of 0.5 mm min−1. The displacement resistance of the specimens were calculated and expressed in MPa. Data were analysed with one-wayanova and post hoc Tukey’s test ( P < 0.05). Results Mean (SD) values of displacement resistance data in MPa are as follows: group 1, 12.08 (2.13); group 2, 12.39 (2); group 3, 11.3 (1.23); group 4, 14.29 (1.84). There were statistically significant differences amongst the groups ( P = 0.021). A statistically significant difference was observed for the displacement resistance values between groups 3 and 4 ( P = 0.015), that is between Multilink/Multilink Primer and Multilink Sprint. Conclusions Glass FRC posts luted with self-adhesive luting system exhibited higher displacement resistance than when luted with chemical-curing self-etch luting system. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The purpose of this study was to evaluate the microtensile bond strength of a total etch (XP-Bond) and a self-etch (Clearfil SE Bond) adhesive system to dentine surfaces treated using endodontic irrigants. Methods: Twenty-four freshly extracted third molars were used. After creating a smear layer on the coronal midthird portion of the crowns, the teeth were divided into three groups and surfaces were irrigated with distilled water, 5.25% NaOCl + 17% EDTA, and 1.3% NaOCl + BioPure MTAD, respectively. Each group was divided into two subgroups, and a self-etching adhesive and an etch-and-rinse adhesive were applied respectively. The teeth were restored with a composite material and sectioned to produce sticks for microtensile bond testing. Results: The microtensile bond strength of the MTAD + Clearfil SE group was found to be significantly lower than the microtensile bond strength of the distilled water + Clearfil SE Bond group and the NaOCl, EDTA, + Clearfil SE Bond group (p = 0.0001, p = 0.009). Conclusions: Because of the significant reduction of Clearfil SE Bond to coronal dentine after MTAD application, an etch-and rinse adhesive such as XP-Bond may be preferred if this irrigant has been chosen during endodontic treatment. [Copyright &y& Elsevier]

Abstract: Objectives: In order to predict the long-term performance of dental adhesives, it is necessary to understand their mechanical properties. The objective of this study was to use a new nanoindentation technique to characterize the in-plane linear viscoelastic properties of dental adhesive layers. Methods: The dental adhesives used were Clearfil SE Bond (CSE) and Clearfil Tri-S Bond (CTS) by Kuraray Medical and Single Bond (SIB) and Single Bond Plus (SBP) by 3M ESPE. A thin film of each adhesive was made on a micro-glass slide, and was then tested on a nanoindenter system (ENT 1100, Elionix) with a Berkovich indenter at a constant loading rate of 0.1mN/s up to a maximum load of 1.8mN. The load–displacement data of the loading segment were fitted to a curve to find best fit parameters for a generalized Kelvin viscoelastic model, from which creep compliance and Young''s modulus were calculated. The modulus results were compared to the values calculated by the nanoindentation device. Results: The experimental data fitted well to the viscoelastic model for all materials (R >0.9999). SIB and CTS showed higher creep compliance compared to SBP and CSE. The modulus values obtained using the model were 4.0, 2.6, 2.4 and 4.2GPa for CSE, CTS, SIB and SBP, respectively. The nanoindentation default software designed for time-independent materials significantly overestimated the modulus values up to 2.5 times. Conclusion: As generally expected for polymer materials, the adhesives tested showed time-dependent viscoelastic behavior. The mechanical evaluation techniques developed for time-independent materials ignore this behavior and may not be appropriate for dental adhesives. [Copyright &y& Elsevier]

Introduction: The continuous appearance of new restorative materials, especially from the composite resins class, and the development of the correspondent adhesive systems has brought major changes about the way in which cavities are being prepared. Thus, a big part of the restorative therapy in modem dentistry is based on the composite resins adhesion to the hard dental tissues, achieved through adhesive systems. The purpose of the present study was to evaluate the adhesion strength to the dentin of four commercial adhesive systems. Experimental: Twenty primary, caries-free and without previous restorations, molars and premolars were used in the study. For testing we used three total-etch adhesives and a self-etch one. In order to obtain standard samples, a Teflon® mould was designed and manufactured, which helped us to apply the same resin volume on the same dentin surface for all the teeth used in this test. Results: Statistical analysis was completed using one- way ANOVA, Tukey and Bonferroni tests. Significantly differences were observed between Point4®/Optibond SoloPlus® and the rest of the samples, the former achieving higher values. Conclusions: The self-etch adhesive system did not match the performances of the total-etch adhesives, at least not in this study. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard). Methods: Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the ‘all-in-one’ adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient). Results: The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond. Conclusions: After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects. [Copyright &y& Elsevier]

Abstract: Objectives: The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. Methods: A total of 270 Class V restorations of four etch-and-rinse, one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline, 6, 12, 18, and 24 months and then every year during a 13-year follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. Results: During the 13 years, 215 restorations could be evaluated. The cumulative loss rate at 13 years was 53.0%, with significant different failures rates for the different systems varying between 35.6 and 86.8%. Four systems fulfilled the ADA 18-month full acceptance retention criteria. Two systems showed at 18 months and earlier high debonding rates. The annual failure rates for the etch-and-rinse systems were Optibond 3.1%, Permagen 13.0%, Scotchbond MP 4.8%, Syntac classic 2.8%; for the self-etch system P&S 4.4%; and the resin-modified glass ionomer cement Vitremer 2.7%. Conclusion: It can be concluded that all systems showed a continuous degradation of the bond with a wide variation, which was independent of the adhesion strategy. Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41% with the best retention for the resin-modified glass ionomer cement and a four-step etch-and-rinse system. [Copyright &y& Elsevier]

Abstract: Objectives: This study evaluated the immediate and 6-month resin–dentin μ-bond strength (μTBS) of one-step self-etch systems (Adper Prompt L-Pop [AD] 3M ESPE; Xeno III [XE] Dentsply De Trey; iBond [iB] Heraeus Kulzer) under different application modes. Materials and methods: Dentin oclusal surfaces were exposed by grinding with 600-grit SiC paper. The adhesives were applied according to the manufacturer''s directions [MD], or with double application of the adhesive layer [DA] or following the manufacturer''s directions plus a hydrophobic resin layer coating [HL]. After applying the adhesive resins, composite crowns were built up incrementally. After 24-h water storage, the specimens were serially sectioned in “x” and “y” directions to obtain bonded sticks of about 0.8mm2 to be tested immediately [IM] or after 6 months of water storage [6M] at a crosshead speed of 0.5mm/min. The data from each adhesive was analyzed by a two-way repeated measures ANOVA (mode of application vs. storage time) and Tukey''s test (α =0.05). Results: The adhesives performed differently according to the application mode. The DA and HL either improved the immediate performance of the adhesive or did not differ from the MD. The resin–dentin bond strength values observed after 6 months were higher when a hydrophobic resin coat was used than compared to those values observed under the manufacturer''s directions. Conclusions: The double application of one-step self-etch system can be safety performed however the application of an additional hydrophobic resin layer can improve the immediate resin–dentin bonds and reduce the degradation of resin bonds over time. [Copyright &y& Elsevier]

The two-fold aims of this study were: (1) to evaluate the microtensile bond strengths of different adhesive systems to sclerotic and sound palatal dentin; and (2) to observe the respective resin-dentin interfaces. Thirty extracted human incisor teeth were divided into two groups. Group I comprised sclerotic defects in the palatal zone. Group II comprised sound palatal dentin surfaces as control. Each group (n=15) was divided into three subgroups according to dentin adhesive systems: self-etch (Clearfil SE Bond), total-etch (Scotchbond Multi-Purpose Plus), and glass ionomer (Reactmer Bond) adhesive systems. The specimens were subjected to tensile forces. Obtained data were analyzed by two-way ANOVA and post hoc Duncan's test. Fracture sites and resin-dentin interfaces were observed using a light microscope and SEM. With sound dentin, Clearfil SE Bond showed a significantly higher bond strength than the other adhesives (p<0.05). With sclerotic dentin, although there were no significant differences in bond strength among the adhesives groups (p>0.05), the bond strength values of Clearfil SE Bond and Scotchbond Multi-Purpose Plus were significantly decreased. On resin-dentin interface observation, different images were presented by different bonding systems. [ABSTRACT FROM AUTHOR]

Abstract: Discovering a durable restorative method to reconstruct and reinforce pulpless teeth is a vital key to help prevent root fractures. Complete and firm adhesion of resin cement in root canal dentin using a post is critical to achieve it. The null hypothesis in the present study was that the bond strength of dual-cured and chemical-cured adhesive resin cements to root canal dentin is not affected by their vertical locations in the root canal. In the experiments, extracted human incisors restored with fiber-reinforced posts and adhesive resin cements were subjected to microtensile bond strength testing. Then, the failure modes and the dentin-bonding interfaces were observed. Self-etch and self-adhesive dual-cured resin cements showed frequent pretesting failure despite using a silane coupling agent. Chemical-cured total-etch adhesive material showed stable bonding performances throughout the entire post space and thus has an advantage in post-core restorations. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate resin–dentine bond degradation after 1 year of water storage. Methods: Human dentine surfaces were bonded with two etch-and-rinse self-priming adhesives (Single Bond/SB and Prime & Bond NT/PBNT), three 2-step self-etching adhesives (Clearfil SE Bond/SEB, Resulcin Aqua Prime/RES and Non-Rinse Conditioner with Prime & Bond NT/NRC-PBNT), and five 1-step self-etching adhesives (Etch & Prime 3.0/EP, Prompt L-Pop/PLP, Solist/SOL, Futurabond/FUT and AQ Bond/AQ). Adhesives were applied according to manufacturers’ instructions. Composite build-ups were constructed and the bonded teeth were stored (24h, 6 months, 1 year) in distilled water at 37°C. After storage, the intact teeth were sectioned into beams and all specimens were tested for microtensile bond strengths (MTBS). ANOVA and multiple comparisons tests were applied at α =0.05. Fractographic analysis of debonded beams was performed using scanning electron microscopy. Results: SB, PBNT and SEB attained the highest MTBS, regardless of the storage period. A significant decrease in MTBS was observed after 6 months for SOL. After 12 months the only groups that did not reduce bond strength were SB and SEB. Bonded specimens in NRC-PBNT, RES and FUT produced pre-testing failures after 12 months, and MTBS could not be measured. Conclusions: The resistance of resin–dentine bonds to degradation is material-dependent. When the enamel–resin interface is preserved, the etch-and-rinse adhesives and the mild 2-step self-etch adhesive SEB exhibited the best resin–dentine bond durability. Those tested self-etching adhesives having a pH≤1 and using water or acetone as solvent attained catastrophic bond failure after 1 year of water storage. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate marginal integrity of IPS Empress inlays luted with different adhesives and cements before and after thermo-mechanical loading (TML). Methods: MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 72 extracted human third molars. IPS Empress inlays were luted with nine combinations of adhesive and luting composite or self-etch cement alone (n =8): Prime&Bond NT Dual-Cure+Calibra (PC), XP BOND/SCA+Calibra (XC), XP BOND/SCA light-cured+Calibra (XL), Syntac+Variolink II (SV), Multilink Primer+Multilink (ML), AdhesSE DC+Variolink II (AV), ED Primer+Panavia F 2.0 (EP), RelyX Unicem (RU), and Maxcem (MC). Marginal quality was analyzed under an SEM using epoxy resin replicas before and after thermo-mechanical loading (100,000×50N and 2500 thermocylces between +5 and +55°C). Results: All systems involving the etch-and-rinse approach resulted in significantly higher percentages of gap-free margins in enamel than all other luting systems (p <0.05). ML and AV achieved higher percentages of gap-free margins in enamel than EP and RU (p <0.05), with EP and RU being significantly above MC (p <0.05). For dentine margins, XP Bond resulted in significantly higher percentages of gap-free margins than Prime&Bond NT, independent of a separate light-curing step (p <0.05). Between the luting systems XC, XL, SV, ML, AV, ED, EP, and RU, no significant differences were computed (p >0.05). MC ranged at the end of the statistical subsets with 62% gap-free margins (p <0.05; Mann–Whitney U-test). Significances: Etch-and-rinse adhesives combined with conventional luting resin composites reveal still the best prognosis for adhesive luting of glass ceramic inlays. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate microtensile bond strength and micro-morphology at the resin–dentin interfaces of two self-etching adhesive systems subjected to simultaneous mechanical and enzymatic stress. Methods: Sixteen enamel/dentin discs were bonded with a two-step self-etching adhesive (AdheSE, n =8) and a one-step self-etching adhesive (Xeno III, n =8) to a 2mm thick resin composite layer. One resin–dentin bar was obtained per tooth. In half of the specimens of each group μTBS and micro-morphological evaluations (TEM) was performed without loading. The other half was mechanically loaded in a cholinesterase-containing solution. μTBS as well as ultra-morphological evaluations of the directly loaded areas using TEM were performed on the loaded specimens. Results: The μTBS of the specimens (non-loaded/loaded) were of 39.6±14.7/35.4±22.1 and of 21.8±29.8/15.9±25.5 for AdheSE and Xeno III, respectively. Under TEM, both materials presented signs of nanoleakage. However, on loaded specimens the extent of nanoleakage was slightly reduced for AdheSE and no silver staining was observed on the adhesive interface of Xeno III. TEM evaluations of the specimens’ loaded area revealed no decrease in the width of the adhesive interface for AdheSE. The contrary was observed in the interface created by Xeno III. Significance: The adhesive interfaces created by the two-step self-etching adhesive (AdheSE) could better withstand both mechanical and enzymatic stresses on the long-term than the one-step self-etching system (Xeno III) tested in the present study. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate the influence of operator skill on microleakage in class V restorations using simplified bonding systems. Methods: Two cavities were carried out on the buccal and lingual surfaces of 50 human bicuspid teeth. The teeth were randomly assigned to two groups according to the operator''s skill: student group and expert group. The two cavities of each tooth were randomly treated with Adper Scotchbond 1 XT (total-etch adhesive) and Adper Prompt L-Pop (self-etch adhesive). All cavities were restored with a 0.2mm thick layer of flowable composite (Filtek flow) followed by one bulk increment of resin composite (Filtek Supreme XT). Specimens were thermocycled, immersed in 2% methylene blue and sectioned in a bucco-lingual plane. They were then examined under a stereomicroscope and scored according to microleakage. The data was subjected to a multilevel statistical model. Results: At the dentine margin the microleakage resulting from both the self-etch adhesive and the total-etch one was similar in the student and in the expert groups. The interaction term skill×adhesive was not statistically significant (p =0.4156). At the enamel margin the self-etch adhesive microleakage within the student group resulted lower than that within the expert group. On the other hand, the total-etch adhesive microleakage within the expert group resulted lower than that within the student group. The interaction term skill×adhesive was statistically significant (p =0.0037). Conclusions: Both the adhesives used were sensitive to operator skill in obtaining a reliable seal with the enamel. On the dentine, both adhesives demonstrated little sensitivity to operator skill. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate the microtensile bond strength (MTBS) of self-etch (with or without H3PO4-etching) and total-etch bonding systems bonded to different regions of dentin. Methods: Long flat dentin cavity preparations extending from top-crown to root-apex within the same tooth were performed and bonded: using two-step (Clearfil SE Bond/SEB, Resulcin Aqua Prime/RES) and one-step (Etch & Prime 3.0/EP, One-Up Bond F/OUB, Prompt L-Pop/PLP, Solist/SOL and Futurabond/FUT) self-etch adhesives; these same adhesives were also applied following H3PO4-etching of dentin and finally two more groups were bonded with total-etch adhesives (Single Bond/SB and Prime & Bond NT/PBNT). Build-ups of resin composite were constructed incrementally to ensure sufficient bulk for the MTBS test and the different regions of dentin were identified by painting with different colours on the top of the resin composite. Specimens were sliced into beams and tested in tension. ANOVA and multiple comparisons tests were used (p <0.05). Results: Regardless of the tested dentin region, SEB attained the highest MTBS to smear layer-covered surfaces (i.e., coronal dentin: 42.7MPa), while H3PO4-etching of dentin hampered bonds (i.e., coronal dentin: 27.7MPa). When bonding with PBNT, SB, RES, EP, PLP, SOL and FUT, MTBS was similar for different dentin regions. H3PO4-etching of dentin did not alter the attained MTBS. Significance: SEB yielded the highest MTBS to all regions of dentin. When bonding to parallel-cut dentin, previous H3PO4-etching of dentin did not increase MTBS and differences in bond strength among dentin regions were absent. [Copyright &y& Elsevier]

Abstract: Objectives: The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. Methods: A total of 337 Class V restorations of three three-step etch-and-rinse, one two-step etch-and-rinse and three self-etch adhesive systems were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and then every 6 months during a 13 years follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. Results: During the 13 years, 275 restorations could be evaluated. The cumulative loss rate at 13 years was 60.3%, with significant different failures rates for the different systems varying between 26.3 and 94.7%. Three materials fulfilled the ADA 18 months full acceptance criteria. Three systems showed already at 18 months or earlier catastrophical debonding rates. The annual failure rates for the three-step etch-and-rinse systems were: Allbond 2 4.1%, Clearfil LB 2.0% and Denthesive 7.3%. For the two-step etch-and-rinse Gluma 2000 6.5%, and for the self-etch systems ART 3.2%, Denthesive 2 5.7% and PUB 3 4.5% Conclusion: A continuous degradation of the resin–dentin bond was observed for all bonding systems during the follow-up expressed by the increasing loss rates. A wide variation of dentin bonding effectiveness was seen between the systems independent to adhesion strategy. [Copyright &y& Elsevier]