The Effect of Trichloracetic Acid as a Hemostatic and Etching Agent on the Morphological Characteristics and Shear Bond Strength of Resin Composite to Enamel

Abstract

©Operative Dentistry, 2010, 35-2, 187-193 M Khoroushi • M Tavasoli Clinical RelevanceTCA gel etches enamel surfaces and produces surface morphological characteristics and bond strength similar to that produced by phosphoric acid. When TCA is used as a hemostatic agent on marginal gingiva, its inadvertent contact with enamel improves the immediate bond strength of resin composite to enamel. However, when using phosphoric acid and 50% TCA, an erosive enamel surface is produced. SUMMARYIntroduction: Trichloracetic acid (TCA) is a soft tissue chemical cauterizing agent that is used on gingival margins prior to restoring cervical cavities with resin materials. This study evaluated the effect of TCA gel as an etchant, its use before etchant on the shear bond strength between resin composite and enamel and also its effect on enamel surface morphological characteristics. Materials and Methods: Seventy-five sound, extracted human anterior maxillary teeth were selected for the purpose of this in vitro study. The teeth were equally divided into five groups prior to enamel surface preparation with silicone carbide papers. In Group 1, the enamel surfaces were etched with 35% phosphoric acid for 30 seconds. In Groups 2 and 3, a 35% TCA gel and 50% TCA gel, respectively, were used on the enamel surfaces for 30 seconds. The enamel surfaces were then rinsed with water for 10 seconds. In Groups 4 and 5, the specimens were prepared in the same manner as Groups 2 and 3 and the enamel surfaces were then In all the experimental groups, after rinsing and drying the samples, Single Bond adhesive (3M ESPE) was used to bond Z250 composite cylinders onto the enamel surfaces.After 500 rounds of thermocycling, the composite cylinders were loaded to failure in shear in a DARTEC test machine and the data were analyzed using the ANOVA and Scheffé's tests (α α=0.05). Two specimens from each group were prepared for surface morphology evaluation under SEM. Results

Effect of dentin contamination with two hemostatic agents on bond strength of resin-modified glass ionomer cement with different conditioning

“…Amr SAAD 1,2 , Go INOUE 1 , Toru NIKAIDO 1 , Ahmed M. A ABDOU 1,3 , Mahmoud SAYED 1 , Michael F. BURROW 4 and Junji TAGAMI 1 bond strength of RMGIC to dentin. Therefore, the aim of this study was to evaluate the effect of two hemostatic agents containing AlCl 3 or Fe2(SO4)3 on bond strength of RMGIC to root dentin after using different conditioning solutions that includes the use of a self-etching primer from an enamel-dentin adhesive system.…”

“…One of the clinical challenges that dentists face during restorative procedures, especially in the cervical area, is blood and gingival crevicular fluid contamination which may affect the quality of the bond between a restoration and tooth structure 1,2) . Therefore, where possible, rubber dam placement is used to achieve optimal isolation, however, in some clinical situations rubber dam placement is not possible 3) .…”

Influence of Ankaferd Blood Stopper on shear bond strength of bonding systems

“…A previous study showed that H2O2 had negative effects on bond strength 6) . The bond strength of a self-etching adhesive to dentin contaminated with ferric sulfate or aluminum chlorite dramatically decreases compared to the normal dentin group 8,9) . On the other hand, trichloracetic acid had a positive effect on bond strength between enamel and resin composite 7) .…”

“…The influence of blood contamination on bond strength can be attributed to its high protein content which, along with macromolecules such as fibrinogen and platelets, can form a film on the dentine surface, obstructing the penetration of the adhesive system into dentine tubules 1,5) . Clinical and in vivo studies have been reported discussing various haemostatic agents used for the management of hemorrhage in clinical dentistry, such as hydrogen peroxide (H2O2), ferric sulfate, aluminum chloride, trichloracetic acid and Ankaferd Blood Stopper (ABS) (Ankaferd Drug INC, Istanbul, Turkey) [6][7][8][9][10] . A previous study showed that H2O2 had negative effects on bond strength 6) .…”

Authors’ response

“…6 Although it is not a "common" hemostatic agent, it may be used as both hemostatic and etchant in cervical restorative lesions. 7,8 I hope that we were able to clarify the reason why we did not mention trichloroacetic acid in our systematic review. We would like to thank Dr. Flanagan for his interest in our article and for his comments.…”