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OBJECTIVES: This study aimed to evaluate the adhesive properties in dentine after the application of silver diamine fluoride (SDF) on carious dentine lesions immediately and after 2 years of water storage. METHODS: 96 human molars used were subjected to artificial dentine caries production, and then randomly divided into 12 experimental groups according to 1. application of an SDF solution (carious dentine lesion without SDF treatment [control], with 12 % silver diamine fluoride [SDF 12 %] or 38 % silver diamine fluoride [SDF 38 %]); 2. Universal adhesives (Clearfil Universal Bond Quick [CUQ] and Single Bond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to the microtensile bond strength test (µTBS) and energy-dispersive X-ray spectrometry analysis (SEM/EDX). All tests were performed immediately and after 2 years of water storage. Data from the µTBS were analyzed using four-way ANOVA and Tukey's test (α = 0.05). RESULTS: Only the interaction of factors 'SDF' vs 'time' was significant (p = 0.03). After 2 years of storage, the groups where SDF was applied showed higher µTBS values compared to the control group. No significant decrease in µTBS values was observed for SBU when comparing immediate and 2-year results, but a significant reduction in µTBS values was observed after 2 years for CUQ. CONCLUSION: Independent of the adhesive strategy, the use of SDF may be a promising alternative to maintain the bonding of universal adhesives to carious dentinal lesions. CLINICAL SIGNIFICANCE: This study may clarify and support clinicians regarding the longevity of resin-based restoration in caries-affected dentine treated with silver diamine fluoride.

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OBJECTIVES: to evaluate the quality and stability of adhesive interfaces established by self-etching adhesives on caries-affected primary dentin (CAD) treated with glutaraldehyde (GA) or silver diamine fluoride (SDF). METHODS: 42 primary molars were exposed to a microbiological caries-inducing protocol and divided into 6 groups according to the adhesive system (Clearfil SE - CL or FL Bond II - FL) and pretreatment (water, GA or SDF) applied on CAD. One tooth from each group was analyzed for surface modification using infrared spectroscopy. Crowns were restored with resin composite (n = 36) and cut into beams and slices. The beams were subjected to microtensile testing, Raman spectroscopy and SEM after 24 h and 6 months of storage. The slices were analyzed using Micro-Raman spectroscopy to determine the diffusion zone thickness (DZ) in each period. Data were analyzed by ANOVA and Tukey or Kruskal-Wallis and Dunn tests (α = 0.05%). RESULTS: SDF reduced the immediate bond strength for both adhesives. The control groups showed a decrease in BS after 6 months in artificial saliva. GA increased immediate DZ for FL, while SDF had the opposite effect on CL. GA decreased the DZ for FL at 6 months. There was a predominance of adhesive failures with areas of cohesive dentin fractures within control groups. SIGNIFICANCE: Modifications caused by dentin surface treatments may directly affect the performance of adhesive systems and the quality and stability of adhesive restorations.

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This study aimed to evaluate the antibacterial effect, cytotoxicity, and microtensile bond strength of an adhesive system containing silver nanoparticles (NAg). NAg was synthesized and incorporated (500 and 1000 ppm) into Scotchbond Multi-Purpose (SBMP) primer and bond. A microtensile bond test (µTBS) was performed after 24 h and 1 year. The adhesive interface was characterized using a confocal Raman microscope. The antibacterial activity was assessed using agar diffusion and biofilm inhibition assays (S. mutans). MTT assay was used to assess the cytotoxicity of NAg-conditioned culture media on human dental pulp stem cells (hDPSCs). The results were statistically analyzed using analysis of variance and Tukey's tests (α = .01). Incorporating 500 and 1000 ppm of NAg in the SBMP did not affect the µTBS after 24 h (p > 0.05). However, in the 1 year evaluation, 500 ppm presented the highest µTBS values (p < 0.05). The addition of NAg at 500 and 1000 ppm in the primer and bond led to larger inhibition halos and colony-forming units than the control (p < 0.05). For the unpolymerized and polymerized groups, the combination of primer and bond presented the highest cytotoxic effects on hDPSCs (p < 0.05). In conclusion, incorporating 500 or 1000 ppm of NAg into an etch-and-rinse adhesive system led to an antibacterial effect without altering the cytotoxicity. SBMP at 500 ppm presented a higher µTBS at 1 year.

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The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

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OBJECTIVES: To evaluate the effect of Nd:YAG laser irradiation as a prior desensitizing strategy on immediate and medium-term microtensile bond strength (µTBS) to simulated hypersensitive dentin. MATERIALS AND METHODS: Flat mid-coronal dentin was obtained from third molars and submitted to a 600-grit SiC paper (1 min; N: normal dentin) or subsequently challenged with citric acid (6%, 1 min; H: simulated hypersensitive dentin). Afterwards, dentin was or was not (C: control; HC, NC - each n = 7) irradiated with Nd:YAG laser (L: laser; 1.0 W/10 Hz/100 mJ/4 irradiations of 50-60 s; HL, NL - each n = 7). A 2-step self-etch adhesive (Clearfil SE Bond) was applied and composite (Filtek Z350) buildups were constructed. After 24-h (distilled water/37 °C) storage, specimens were sectioned into beams and tested (µTBS; 0.5 mm/min) immediately or after 6-month aging. Three-way ANOVA and Tukey tests were applied (α = 0.05). Qualitative evaluation of the adhesive interface (n = 1 extra tooth per group) was performed by Confocal Laser Scanning Microscopy. RESULTS: Substrate condition (p < 0.001), laser irradiation (p < 0.001), and aging (p = 0.002) influenced the results. Furthermore, there was interaction between substrate and irradiation (p < 0.001). Laser irradiation favored µTBS exclusively to hypersensitive dentin immediately and after aging. µTBS to hypersensitive dentin was higher than that to the normal substrate only when it was laser-irradiated. In any case, immediate µTBS was always higher than that after aging. CLSM revealed longer and more numerous resin tags for simulated hypersensitive dentin, and shorter and fewer resin tags for laser-irradiated dentin. No differences were observed in the hybrid layer itself. CONCLUSION: Nd:YAG laser irradiation prior to restoration favored the µTBS of a self-etch adhesive and resin composite to hypersensitive dentin. CLINICAL RELEVANCE: Desensitizing strategies are usually tried before performing restorative treatments in hypersensitive dentin; therefore, they may influence behavior of the adhesive interface established. However, instead of causing concern, Nd:YAG laser irradiation revealed a favorable effect on the aforementioned interface.

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OBJECTIVES: The objective of this study is to formulate experimental dental adhesives with different polyhexamethylene guanidine hydrochloride concentrations (PHMGH) and evaluate their physical, chemical, and biological properties. MATERIALS AND METHODS: The experimental adhesives were formulated with 0 (control, GCTRL), 0.5 (G0.5%), 1 (G1%), or 2 (G2%) wt.% into the adhesive. The adhesives were analyzed for degree of conversion (DC%), softening in solvent (ΔKHN%), ultimate tensile strength (UTS), microtensile bond strength (µTBS) immediately and after 1 year of aging, antibacterial activity, and cytotoxicity. RESULTS: There were no differences among groups for DC%, ΔKHN%, and UTS (p > 0.05%). There were no differences between each PHMGH-doped adhesive compared to GCTRL in the immediate µ-TBS (p > 0.05). Adhesives with at least 1 wt.% of PHMGH presented better stability of µ-TBS. PHMGH-doped adhesives showed improved longitudinal µ-TBS compared to GCTRL (p < 0.05). Lower Streptococcus mutans biofilm formation was observed for PHMGH-doped adhesives (p < 0.05). There was lower viability of planktonic S. mutans in the media in contact with the samples when at least 1 wt.% of PHGMGH was incorporated (p < 0.05). The formulated adhesives showed no cytotoxicity against pulp cells (p > 0.05). CONCLUSIONS: The adhesive with 2 wt.% of PHMGH showed the highest antibacterial activity, without affecting the physicochemical properties and cytotoxicity, besides conferring stability for the dental adhesion. CLINICAL RELEVANCE: PHMGH, a positively charged polymer, conveyed antibacterial activity to dental adhesives. Furthermore, it did not negatively affect the essential physicochemical and biocompatibility properties of the adhesives. More importantly, the incorporation of PHMGH provided stability for the µ-TBS compared to the control group without this additive.

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AIM: This study evaluated the influence of chitosan added to a universal adhesive system used in totaletch (TE) or self-etch (SE) mode on dentin permeability, and on the micromorphology of the adhesive layer. MATERIALS AND METHOD: Dentin discs were obtained from human third molars and randomly distributed according to bonding strategy (TE or SE), and to whether or not 1% chitosan (C) was added to a universal adhesive system (Single Bond Universal/3M ESPE), to create the following groups (n=10): TE, TEC, SE, and SEC. Dentin permeability was measured at baseline and after application of dentin treatments. The surface of the adhesive layer (AL) and the dentin adjacent to the AL were examined under a scanning electron microscope. RESULTS: There were no significant differences in permeability percentage between the groups with and without C (TE and SE versus TEC and SEC) (p>0.05; Mann Whitney test). Dentin permeability was lower when the adhesive system was applied in the SE mode, regardless of the addition of C. The micromorphology of the AL surface showed irregularities, and a greater degree of porosity, when the adhesive system was applied in the SE mode, regardless of chitosan addition. There was a greater depth of penetration of the adhesives into the dentin adjacent to the AL in both the TE and TEC groups. Chitosan added to the adhesive system did not influence dentin permeability. CONCLUSIONS: The self-etch strategy led to lower dentin permeability, and to more irregularities on the surface of the adhesive layer.

OBJETIVO: Este estudo avaliou a influência da quitosana adicionada a um sistema adesivo universal usado no modo total-etch (TE) ou self-etch (SE) na permeabilidade dentinária e na micromorfologia da camada adesiva. Materiais e método: Discos de dentina foram obtidos de terceiros molares humanos e distribuídos aleatoriamente de acordo com a estratégia de união (TE ou SE), e para incorporação ou não de quitosana a 1% (Q) em um sistema adesivo universal (Single Bond Universal/3M ESPE), para obter os seguintes grupos (n=10): TE, TEQ, SE e SEQ. A permeabilidade da dentina foi medida no início e após a aplicação dos tratamentos de dentina. A superfície da camada adesiva (CA) e a dentina adjacente à CA foram examinadas em microscópio eletrônico de varredura. RESULTADOS: Não houve diferenças significativas no percentual de permeabilidade entre os grupos com e sem Q (TE e SE versus TEQ e SEQ) (p>0,05; teste de Mann Whitney). Houve um menor percentual de permeabilidade dentinária quando o sistema adesivo foi aplicado no modo SE, independentemente da incorporação de Q. A micromorfologia da superfície da CA apresentou irregularidades e maior grau de porosidade quando o sistema adesivo foi aplicado no modo SE, independentemente da adição de Q. Houve maior profundidade de penetração dos adesivos na dentina adjacente à CA nos grupos TE e TEQ. A quitosana adicionada ao sistema adesivo não influenciou a permeabilidade dentinária. Conclusões: A estratégia autocondicionante levou a uma menor permeabilidade dentinária e a mais irregularidades na superfície da camada adesiva.

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This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.

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This study evaluates the bond strength of four self-etching adhesive systems with different acidity levels in normal and artificially hypermineralized dentin substrate. Healthy human molars were divided into groups: normal dentin-N (n = 36) and artificially hypermineralized dentin-H (n = 36). Self-etching adhesive systems Clearfil S3 Bond (n = 9), Optibond All in One (n = 9), Clearfil SE Bond (n = 9), and Adhese (n = 9) were used for both the N and H groups. Transparent cylindrical matrices were positioned on the treated dentin surfaces, filled with composite resin, and light-cured for 40 s. After the transparent cylindrical matrices were removed, the specimens were stored for 24 hr in a humid environment at 37°C and were subjected to a micro-shear bond strength test. For each group, a specimen was prepared and evaluated in scanning electron microscope for adhesive interface observation. Normality was confirmed and the two-way analysis of variance and Games-Howell post-tests were conducted (α = .05). The data demonstrated an interaction between the adhesive system and type of dentin substrate (p < .01). For normal dentin, all adhesive systems assessed were adequate; however, in the hypermineralized dentin, the Clearfil SE Bond two-step self-etching adhesive system with mild pH presented the highest immediate bond strength. There was a predominance of adhesive failures for all adhesive systems in the different dentin substrates evaluated. It was concluded that the self-etching adhesive systems evaluated were efficient for both substrates, and for the hypermineralized dentin, the Clearfil SE Bond presented a higher bond strength value.

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Abstract: This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.

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