In order to achieve excellent aesthetic appearance and high durability of the direct restoration, it is important to select initially the appropriate biomaterial for use and then to base preference for a polishing technique on achieving perfect results in the surface texture.
Immediate dentin sealing (IDS) involves applying an adhesive system to dentin directly after tooth preparation, before impression. This was considered an alternate to delayed dentin sealing (DDS), a technique in which hybridization is performed following the provisional phase and just before the indirect restoration luting procedure. This study aimed to compare the bond strength of restorations to dentin of the IDS and the DDS techniques throughout a systematic review and meta-analysis. The following PICOS framework was used: population, indirect restorations; intervention, IDS; control, DDS; outcomes, bond strength; and study design, in vitro studies. PubMed (MedLine), The Cochrane Library, ISI Web of Science, Scielo, Scopus, and Embase were screened up to January 2022 by two reviewers (L.H. and R.B.). In vitro papers studying the bond strength to human dentin of the IDS technique compared to the DDS technique were considered. Meta-analyses were carried out by using a software program (Review Manager v5.4.1; The Cochrane Collaboration). Comparisons were made by considering the adhesive used for bonding (two-step etch-and-rinse, three step etch-and-rinse, one-step self-etch, two-step self-etch, and universal adhesives). A total of 3717 papers were retrieved in all databases. After full-text assessment, 22 potentially eligible studies were examined for qualitative analysis, leaving a total of 21 articles for the meta-analysis. For the immediate bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p < 0.001). Taking into account the subgroup analysis, it seems that the use of the IDS technique with a two-step etch-and-rinse or a one-step self-etch adhesive system does not represent any advantage over the DDS technique (p = 0.07, p = 0.15). On the other hand, for the aged bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p = 0.001). The subgroups analysis shows that this improvement is observed only when a three-step etch-and-rinse adhesive system (p < 0.001) or when a combination of an adhesive system plus a layer of flowable resin (p = 0.01) is used. The in vitro evidence suggests that the use of the IDS technique improves the bond strength of dentin to resin-based restorations regardless of the adhesive strategy used. The use of a three-step etch-and-rinse adhesive system or the combination of an adhesive system plus a layer of flowable resin seems to considerably enhance the bond strength in the long term.
The bonding efficacy of current dentin adhesives is not affected by the dentin substrate age. Chemical bonding may play a role in the bonding effectiveness of specific adhesives. SUMMARYPurpose: To study the effect of dentin age and adhesive composition on the microtensile dentin bond strengths (lTBS) of five dentin adhesives.Materials and Methods: Sixty extracted caries-free human teeth were assigned to the appropriate age group: less than 21 years of age (,21), 21-40 years of age (21-40), and greater than 40 years of age (.40). For each age group, specimens were randomly divided into five dentin adhesives: (1) Adper Easy Bond (EB, 3M ESPE), a one-step self-etch adhesive; (2) Experimental Adper Easy Bond without the Vitrebond Co-polymer (CP) (EBnoCP, 3M ESPE); (3) Adper Single Bond Plus (SB, 3M ESPE), a two-step etch&rinse adhesive; (4) Experimental Adper Single Bond Plus without CP (SBnoCP, 3M ESPE); and (5) Adper Scotchbond Multi-Purpose (MP, 3M ESPE), a threestep etch&rinse adhesive, as the control group. Specimens were sectioned in X and Y directions and the resulting beams were tested to failure in tension mode at a crosshead speed of 1 mm/min. Statistical analysis was computed using t-test and two-way analysis of variance followed by Fisher least significant difference multiple comparison post hoc test at p , 0.05.Results: The highest mean lTBS values were obtained in the control group (MP) for all age groups. EB resulted in statistically similar mean lTBS compared to EBnoCP for all age groups: p = 0.538 for (,21); p = 0.974 for (21-40); and p = 0.909 for (.40). SB resulted in statistically higher mean lTBS than SBnoCP for all age groups [p,0.009 for (,21); p,0.028 for (21-40); and p,0.041 for (.40)]. MP, the control group, resulted in statistically lower mean lTBS when applied to the oldest age group
There is still a lack of consensus concerning the recommended etching concentration, application time and type of silane when bonding lithium disilicate-reinforced glass ceramics manufactured by CAD/CAM. The purpose of this study was thus to conduct an in vitro study which investigates the influence of hydrofluoric acid (HF) concentration, etching time and silane type on the microtensile bond strength (μTBS) of lithium disilicate to resin composites. Thirty-nine IPS e.max CAD blocks were randomly divided between thirteen groups (n = 3). The variables were HF concentration (9.5 or 4.9%), etching time (20 or 60 s) and silane type (Bis-Silane, Monobond Plus and ESPE Sil Silane). The blocks were cut into beams, aged for 10,000 cycles in a thermocycler and submitted to tensile stress to determine μTBS. A control group featuring the Monobond Etch & Prime (MEP) agent that combines etching/silanisation into a simultaneous process was also added. This group was discarded from the analysis due to only having pre-test failures. The data were analysed using a three-way ANOVA (α = 0.05). The HF concentration, etching time and silane type significantly influenced μTBS (p < 0.001). Significant interactions between time and silane type (p = 0.004), HF concentration and silane type (p < 0.001) and among the three factors (p < 0.001) were noted. Etching lithium disilicate with 9.5% HF (60 s), followed by the application of Bis-Silane, resulted in the highest μTBS (16.6 ± 9.0 MPa). The highest concentration and etching time under study, combined with a two-part silane, resulted in the highest bond strength, while the application of MEP showed a complete pre-test failure.
Surface properties of composites such as roughness and color impact periodontal health and aesthetic outcomes. Novel bulk-fill composites with improved functionality are being introduced and, in light of the existing variety of finishing/polishing procedures, research of their surface properties is warranted. Sixty discs were prepared from bulk-fill composites (Filtek™ Bulk Fill Posterior Restorative and Fill-Up™) and incremental-fill Filtek™ Z250. They were further divided according to different polishing procedures (n = 5): three multi-step polishing procedures or finishing with a bur (control). Surface roughness (Ra) was measured using an atomic force microscope (The AFM Workshop TT-AFM). A spectrophotometer (Spectroshade Micro Optic) was used to determine color stability, after exposure to a coffee solution. Data were analyzed using two-way MANOVA (significance level of 5%). Resin composite type, polishing procedure, and their interaction had a statistically significant effect on surface roughness (p < 0.001) and color change (p < 0.001). Fill-Up™ exhibited the highest surface roughness and greatest color change. Differences in color change were statistically significant (p < 0.001). Filtek™ Bulk Fill registered the lowest surface roughness and color change, after the three-step polishing procedure. Both parameters were significantly correlated (ρ = 0.754, p < 0.001) and found to be material dependent and polishing-procedure dependent. Higher surface roughness relates to greater color changes.
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