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Statement of problem Adhesive resin cement has been the preferred choice for the placement of prosthetic restorations, but evidence-based studies supporting this selection are sparse. Purpose The purpose of this study was to test the hypothesis that restoration placement with the adhesive 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tributylborane (4-META/MMA-TBB) resin cement is associated with better longevity of teeth than zinc phosphate cement up to 43 years. Materials and methods Study participants were individuals who had been visiting the clinic regularly for more than 20 years from their first visit between November 1970 and April 1985. The vital teeth with prosthetic restorations (N=454), including cast inlays, onlays, crowns, and fixed partial dentures, of 53 patients were assessed from dental charts and radiographs. Most of the bonding surfaces were precious metal alloy, excluding 4 restorations cemented with zinc phosphate and 6 ceramic crowns cemented with 4-META/MMA-TBB resin cement. The Kaplan-Meier method and log-rank test (α=.05) were used to compare longevity between the 2 materials. Chi-squared tests (α=.001) were also used to examine the occurrence rates of events such as secondary caries, endodontic treatment, and the dislodgement of restorations affecting the longevity of the 2 cements. Results Clinical review examination demonstrated that 55.4% of teeth retained with 4-META/MMA-TBB resin cement had been in service for 30 years compared with 43.5% of those retained with zinc phosphate cement, with a significant difference (P=.006). 4-META/MMA-TBB resin cement also demonstrated lower event occurrence rates than zinc phosphate cement for 3 assessed types of events (P Conclusions Within the limitations of this study, 4-META/MMA-TBB resin adhesive cement demonstrated a higher survival rate than conventional zinc phosphate cement in service for 30 years with a lower occurrence of critical events.

This study aimed to evaluate the impact of fluoride-releasing 4-META/MMA-TBB resin on the degree of enamel demineralization typically detected around orthodontic brackets using μCT. Enamel-dentin blocks were prepared from bovine teeth. Brackets were attached with either 4-META/MMA-TBB resin (SBC), fluoride-releasing 4-META/MMA-TBB resin (SBF), or fluoride-releasing RMGIC (FLC). The specimens were subjected to demineralization (pH 4.5, 21 days) and scanned by μCT (0, 7, and 21 days). Fluoride ion release under the experimental conditions was measured. The degree of demineralization detected in SBF and FLC was significantly lower than that in SBC; there were no significant differences in the degree of demineralization detected in SBF and FLC. The level of fluoride ion detected in FLC was significantly higher than that detected in SBC. Fluoride-releasing 4-META/MMA-TBB resin protected against enamel demineralization around orthodontic brackets when compared to the results from the fluoride-free resin.

A variety of treatment modalities, for mobility of teeth. To treat the mandibular anterior mobile teeth is the most challenging tasks; to splint the mandibular teeth is appreciable approach and is the fastest, simplest and most predictable. This case report presents a successfully accomplished stabilization of mandibular teeth with grade II mobility with resorption of bone seen radiographically, by using 4-META/MMA-TBB self-cure dental adhesive resin (Cand B bond). This present treatment modality offers a conservative, aesthetic and noninvasive treatment which can be considered as a longlasting treatment. The purpose of this report is to present a case of successful stabilization of teeth by using Cand B bond.

The current restorative materials used for cervical lesions restoration still need to be improved. A low E-modulus restorative material Bondfill SB (group BF) is developed. This study was to evaluate marginal adaptation and nanoleakage expression at dentin bonding interface of BF before and after artificial aging cycling when used for class V cavity restoration in vitro. Cavities were prepared in human premolars and restored with either Bondfill SB or Z100 (group SZ). Quantitative data were analyzed by t-test (α = 0.05). Before cycling, there was no significant differences between groups for perfect margin and modes of failure. After cycling, SZ showed a higher (p = 0.002) perfect margin value (55.08 ± 15.20%) and less (p = 0.01) adhesive failure (35.35 ± 15.02%) to enamel than BF (25.15 ± 12.47% and 61.78 ± 15.41%, respectively). BF exhibited less (p = 0.01) adhesive failure (12.89 ± 5.58%) to dentin than SZ (44.17 ± 17.50%). BF showed more cohesive failures at both enamel (12.01 ± 3.65%) (p < 0.0001) and dentin (9.58 ± 3.14%) (p = 0.02) sides than SZ (0.77 ± 1.21% and 4.68 ± 1.39%, respectively). Transmission electron microscope (TEM) showed that hybrid layers in SZ and BF were around 0.5 μm thick. Before cycling, more silver deposits were found at dentin bonding interface in SZ. After cycling, the deterioration in SZ mostly occurred at the bottom and on the surface of the hybrid layer. While in BF, the deterioration occurred at the bottom of the hybrid layer and in Bondfill SB. BF showed a more reliable dentin bonding after artificial aging and might buffer the cervical stress concentration. Bondfill SB may be a new promising choice for long-term success of cervical lesions restoration. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2050-2056, 2019.

The purpose of this study was to evaluate the early tensile bond strengths of three different resin cements; Super Bond C&B (conventional and quick type) and ResiCem to a CAD/CAM composite block. A CAD/CAM composite block (Shofu Block HC) was ground and silanized according to the manufacturers' instructions before cementation. A conventional tensile bond strength test (O: 4 mm) was performed 10 min, 1 h and 24 h after bonding. Super Bond C&B (quick type) showed the highest bond strength at 24 h. However, results of a three-point bend test showed the mechanical properties were weaker for the Super Bond C&B cements compared with composite cement, Resicem. The 4-META/MMA-TBB resin is a suitable resin cement to bond to a CAD/CAM composite block.

The purpose of this study was to investigate the healing process of wounded skin following the application of cyanoacrylate or a 4-(2-methacryloxyethyl) trimellitic anhydride/methyl methacrylate-tributylborane resin (4-META resin). Those materials were applied to skin wound areas in rats, and the regenerating tissues were biopsied and examined at days 1, 3, 5, 7, and 14. Paraffin-embedded specimens were sectioned and stained with hematoxylin and eosin or with Azan-Mallory stain. Sections were also immunohistochemically stained with Pan-cytokeratin and CD68 antibodies. In cyanoacrylate-treated wounds, CD68-positive cells were observed in the connective tissue and their number increased up to day 5. The wound surface was completely covered by epithelial tissue at day 14. In 4-META resin-treated wounds, CD68-positive cells appeared in the soft-tissue hybrid layer (STHL) and epithelial tissue had migrated under the STHL by day 5. The wound surface was completely covered by epithelial tissue at day 7. CD68-positive cells were distributed over the entire area of the cyanoacrylate-treated wounds, but accumulated under the STHL in the 4-META resin-treated wounds. In conclusion, the results suggest that covering skin defects with a 4-META resin is an effective strategy to promote wound healing compared to cyanoacrylate.

The purpose of this study was to evaluate the shear bond strength and durability of 4-META/MMA-TBB resin to human enamel. A self-etching primer that contained 4-META (Teeth Primer, TP) and 35-45% or 60-65% concentrations of phosphoric acid (K-Etchant Gel, KE, and Super Bond C&B Red Activator, RA) were used as the surface treatment agents. A methyl methacrylate (MMA)-based self-polymerizing resin (Super-Bond C&B) was used as a luting agent. The shear bond strength was determined both pre and post thermocycling. The results were statistically analyzed with a non-parametric procedure. The post-thermocycling shear bond strength of the TP group was significantly higher than that of other groups, and that of the KE group was significantly higher compared with the RA group. These results demonstrated that 4-META was effective. Furthermore, when the degree of tooth demineralization was compared, surface treatment with less demineralization using TP was the most effective treatment.

The present study compared the efficacies of the self-etching Teeth Primer (TP: 4-META), and the etchants Red Activator (RA; 65% phosphoric acid) and Green Activator (GA; 10% citric acid with 3% ferric chloride), for bonding to enamel and dentine of human primary and permanent teeth, when used with 4-META/MMA-TBB resin (Bondfill SB).Forty-eight non-carious primary canines and third molars were used. Eight groups were prepared: Group 1 (primary enamel with RA), Group 2 (permanent enamel with RA), Group 3 (primary enamel with TP), Group 4 (permanent enamel with TP), Group 5 (primary dentine with GA), Group 6 (permanent dentine with GA), Group 7 (primary dentine with TP) and Group 8 (permanent dentine with TP). Micro-tensile bond strengths (MTBS) were measured and analyzed statistically using ANOVAs and Tukey HSD tests at α=0.05. Efficacy of etching/priming and the morphology of bonded interfaces were observed with SEM.Etching/priming efficacy of TP on enamel was low. The MTBS of Group 2 was significantly higher than the other groups (Groups 1, 3 and 4). For dentine, significant differences in MTBS were observed, in the order of Groups 687=5 (p0.05). The MTBSs of permanent dentine were significantly higher than primary dentine. For primary teeth, there was no significant difference in the MTBSs between enamel and dentine, irrespective of primer or etchant (p0.05).TP primer/Bondfill SB may be used as an alternative to other adhesive/resin composite systems for bonding to enamel and dentine of primary teeth.

4-Methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin is widely used as a direct bonding adhesive for orthodontic appliances because of its strong bonding ability. However, its clinical disadvantages include long setting times and difficult debonding with subsequent residual adhesive left on the enamel surface. To resolve these problems, thermal heating was applied to orthodontic appliances. The setting time was dramatically reduced by thermal heating (160°C for 5 s), with the shear bond strength remaining the same as that stated in the manufacturer's instructions. Debonding of appliances following thermal heating (160°C for 20 s) could be easily performed, decreasing the amount of adhesive left on enamel. These conditions were not accompanied by an increase in the heat pain threshold of pulpal dentin. These results suggest that the use of thermal heating in the bonding/debonding of 4-META/MMA-TBB resin may resolve its clinical weaknesses, making its ease of use similar to light-cured resin.

This study examined whether 4-methacryloxyethyl trimellitate anhydride/methylmethacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin can be used with mineral trioxide aggregate (MTA) to overcome MTA's shortcomings. The biologic reactions of the mixture of MTA powder and 4-META/MMA-TBB resin (MTA/4-META) and its potential in clinical applications were also investigated.MTA powder was mixed with 4-META/MMA-TBB resin instead of water at the appropriate proportions determined by a series of studies prior to this experiment. MTA powder mixed with sterile water was used as control. The setting time, compressive strength, pH, and dye leakage of MTA/4-META and MTA were assessed by Gilmore apparatus, universal mechanical testing machine, pH meter, and methylene blue penetration method, respectively. Cytotoxicity also was evaluated by MTT assay with MC3T3-E1 cells.The setting time of MTA/4-META was significantly lower than that of MTA: 11.2 ± 0.8 minutes versus 318 ± 56.0 minutes, respectively (P.05). The mean compressive strength of MTA/4-META after 24 hours was significantly higher than that of MTA: 57.4 ± 11.6 MPa versus 18.7 ± 3.0 MPa, respectively (P.05). MTA/4-META showed significantly less leakage than MTA (P.05). The initial pHs for MTA and MTA/4-META at 2 hours were 10.73 ± 0.95 and 10.08 ± 0.13, respectively, and reached plateaus of 10.92 ± 0.31 and 10.54 ± 0.39 at 24 hours, respectively. The pH of MTA was higher than that of MTA/4-META in the entire period, but the differences were only significant up to 48 hours (P.05). MTA and MTA/4-META both showed no cytotoxicity.4-META/MMA-TBB resin as a mixing vehicle of MTA powder can improve the setting and handling properties of MTA and may maintain or improve its other biophysical properties.

The purpose of this study was to evaluate the hardness of the adhesive interface between resin and Er:YAG laser-irradiated bovine dentin by nano-indentation.It has been reported that laser output energy and pulse repetition rate affect the tensile bond strength in Er:YAG laser-irradiated dentin.Three laser settings were evaluated at the same total energy level (approximately 1.0 W): 100 mJ/pulse-10 pps (100-10), 50 mJ/pulse-20 pps (50-20), and 33 mJ/pulse-30 pps (33-30). Laser-irradiated dentin in each group was conditioned with 10% citric acid solution containing 3% ferric chloride for 15 sec, rinsed with distilled water for 30 sec, and bonded to PMMA rods with 4-META/MMA-TBB resin. The bonded specimens were sectioned vertically, embedded in epoxy resin, and their nano-hardness measured. A non-irradiated control group was also investigated.The adhesive resin interface in the controls showed the lowest level of hardness, which gradually increased from the top of the hybrid layer (0 microm) through the bottom of the hybrid layer (5 microm) and into the underlying dentin ( approximately 10 microm). Significant differences in hardness were observed between the 5 microm point in the controls, the 10 microm and 15 microm points in the 100-10 group, and the 10 microm point in the 50-20 and 33-30 groups.The results suggest that laser settings affect hybrid layer thickness, even when the total energy level is constant.

This study evaluates a modified 4-META/MMA-TBB resin (M4M) as a candidate material for filling screw-retained implant access hole. Its characteristics were compared with a conventional composite resin (CR) with or without a bonding agent (BA) or a ceramic primer (CP). Ceramic blocks were divided into five groups, including (A) CR, (B) CR with BA, (C) CR with CP and BA, (D) M4M, and (E) M4M with CP. Shear bond strengths were measured after 5000 times of thermocycling. Groups A, B, and D were excluded from further tests as they showed no adhesion. A cylindrical cavity (2.5 mm diameter, 3 mm depth) simulating access hole was prepared in a ceramic block and glazed to evaluate micro-leakage and wear test of groups C and E. The results were statistically analyzed with Mann–Whitney test (p

The population of the world grows every year, and life expectancy tends to increase. Thus, longterm preservation of teeth in aged individuals is an urgent issue. The main causes of tooth loss are well known to be periodontitis, caries, fractures, and orthodontic conditions. Although implant placement is a widely accepted treatment for tooth loss, most patients desire to preserve their own teeth. Many clinicians and researchers are therefore challenged to treat and preserve teeth that are irreversibly affected by deep caries, periodontitis, fractures, and trauma. Tissue engineering techniques are beneficial in addressing this issue; stem cells, signal molecules, and scaffolds are the main elements of such techniques. In this review, we describe these three elements with respect to their validation for regeneration of the periodontium and focus particularly on the potency of diverse scaffolds. In addition, we provide a short overview of the ongoing studies of 4- methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl-borane resin including calcium chloride or hydroxyapatite for periodontium regeneration.

Aim The aim was to test the hypothesis that the resin and bonding agent 4-META/MMA-TBB (4-META), has the potential to prevent transdentinal antigenic challenges. Methodology Class I cavity preparation and immediate restoration with 4-META were made in the maxillary right first molars of 36 six-week-old Wistar rats. Contralateral teeth with an unrestored cavity served as positive control (cavity without 4-META) group. The maxillary first molars of 12 age-matched normal rats (total 24 teeth) were also examined as negative control (intact tooth group). At 3 or 28 days after cavity preparation, the teeth were subjected to immunoperoxidase staining using OX6 (anticlass II molecules) and ED1 (antimacrophages) as primary antibodies. Results A total of 10 teeth were not available for histological examination. In the teeth filled with 4-META at 3 days, the density of OX6+ and ED1+ cells in the coronal pulp was significantly higher than that in the intact tooth group. At 28 days, formation of sound reparative dentine was noted and the density of the immunocompetent cells was comparable to the intact teeth. In the teeth without 4-META at 3 days, pulpal abscess was observed in 14 out of 16 and the density of OX6+ and ED1+ cells was significantly increased (P

The aim of this study was to evaluate 4-META/MMA-TBB resin as an alternative to sling sutures for fixation of membrane to tooth in GTR in terms of its effect on tissue regeneration. Dehiscence periodontal defects were created in 6 dogs which were divided at random into two groups, 3 dogs in each group: an experimental group, in which non-absorbable or absorbable membrane was fixed to the teeth with 4-META/MMA-TBB resin; and a control group, in which sling sutures were applied to fix the two types of membrane. Histologic and histometric evaluation was carried out at 8 weeks post-operatively to determine healing response in each group. Both methods of achieving membrane fixation to tooth were effective in inhibiting epithelial migration and encouraging formation of regenerated periodontal tissues around the root surfaces. These results suggest that 4-META/MMA-TBB resin is as effective as sling sutures in achieving membrane fixation in GTR and is, moreover, easier to apply.

The purposes of this study were twofold, namely to evaluate: (1) the effect of hybridization on microtensile bond strength (microTBS) to dentin, and (2) the ultrastructure of the dentin-adhesive interface with 4-META/MMA-TBB resin after acid-base challenge. Dentin surfaces, which received no treatment (NT), 65% phosphoric acid (PA), or 10% citric acid-3% ferric chloride (10-3), were bonded with a 4-META/MMA-TBB resin. To evaluate dentin bond strength, microTBS test was performed at a crosshead speed of 1 mm/min. For ultrastructural evaluation of the adhesive interfaces, SEM was used to examine the interfaces of the bonded specimens after acid-base challenge. The microTBS of NT was not determined, while that of 10-3 was significantly higher than that of PA (p0.05). With PA and 10-3, the hybrid layer was clearly observed, but no so for the acid-base resistant zone. Wall lesion was found in NT only. In conclusion, hybridization is vital to improving microTBS to dentin and enhancing resistance at the adhesive interface against acid-base challenge.

The purpose of this study was to compare root-end sealing using 4-META/MMA-TBB resin with that using conventional retrograde root filling technique, and thereby determine if 4-META/MMA-TBB resin offers long-term prevention against dye leakage from the root canal of human teeth. Thirty-five teeth had the apical 2.5 mm of the root resected. In the Sealing (SB) group, 4-META/MMA-TBB resin was applied to the resected surface. In the Filling (Am and EBA) groups, a root-end cavity was prepared and retrofilled with high copper amalgam alloy or reinforced zinc oxide-eugenol cement. Root canals were filled with methylene blue dye solution. Then, dye leakage outside the root canal was measured for 50 weeks. The integrated amount of leakage in SB group was significantly lower than those in Am group (p < 0.05) and EBA group (p < 0.05). Therefore, it can be concluded that root-end sealing using 4-META/MMA-TBB resin resulted in better, long-term sealing than conventional retrograde root filling.

4-META/MMA-TBB resin has shown good biocompatibility and remarkable adhesion to dentin. It seems to be suitable for use in periodontal tissues for retrograde root sealing and treatment of vertically fractured roots. For an adhesive resin to be useful clinically, it must bond not only to the dentin but also to the cementum. The purpose of this study was to evaluate the long-term adhesion durability of 4-META/MMA-TBB resin to cementum kept in water at 37 degrees C. Bovine root cementum and dentin surfaces were treated with 10-3 solution before 4-META/MMA-TBB resin was applied on treated surfaces. The micro-tensile bond strength (microTBS) decreased during the first two months; dye leakage value increased during the first four months and stabilized thereafter. No significant differences in adhesion durability were recognized between the dentin and cementum.

Recently, it has been erroneously reported that adhesive bonds to various substrates produced with 4-META/MMA-TBB type resins degrade by hydrolysis. This paper dispels this myth. The author cites a number of independent research studies indicating that bonds mediated by 4-META/MMA-TBB systems are extremely stable when subjected to extensive thermocycling in a wet environment.

The effect of adding micro filler to 4-META MMA/TBB dentin bonding agent was examined by measuring the wall-to-wall polymerization contraction gap of a commercial light-cured resin composite in a cylindrical dentin cavity and the tensile bond strength of the flat dentin surface. Gap formation was not completely prevented by using a filled dentin bonding agent although the tensile bond strength was significantly greater than that obtained using the unfilled dentin bonding agent. These results indicate that the addition of micro filler to the dentin bonding agent does not produce complete adaptation of the resin composite to the dentin cavity wall.