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      Adhesion of 10-MDP containing resin cements to dentin with and without the etch-and-rinse technique

      research-article
      , DDS, PhD 1 , , , DDS, PhD 1 , , DDS, PhD 1 , , DDS, DMD, PhD 2
      The Journal of Advanced Prosthodontics
      The Korean Academy of Prosthodontics
      Adhesion, Bond strength, Dentin, Hybrid layer, Self-adhesive cement

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          Abstract

          PURPOSE

          This study evaluated the adhesion of 10-MDP containing self-etch and self-adhesive resin cements to dentin with and without the use of etch-and-rinse technique.

          MATERIALS AND METHODS

          Human third molars (N=180) were randomly divided into 6 groups (n=30 per group). Conventional (Panavia F2.0, Kuraray-PAN) and self-adhesive resin cements (Clearfil SA, Kuraray-CSA) were bonded to dentin surfaces either after application of 3-step etch-and-rinse (35% H 3PO 4 + ED Primer) or two-step self-etch adhesive resin (Clearfil SE Bond). Specimens were subjected to shear bond strength test using the universal testing machine (0.5 mm/min). The failure types were analyzed using a stereomicroscope and quality of hybrid layer was observed under a scanning electron microscope. The data (MPa) were analyzed using two-way ANOVA and Tukey's tests (α=.05).

          RESULTS

          Overall, PAN adhesive cement showed significantly higher mean bond strength (12.5 ± 2.3 - 14.1 ± 2.4 MPa) than CSA cement (9.3 ± 1.4 - 13.9 ± 1.9 MPa) ( P<.001). Adhesive failures were more frequent in CSA cement groups when used in conjunction with two-step self-adhesive (68%) or no adhesive at all (66%). Hybrid layer quality was inferior in CSA compared to PAN cement in all conditions.

          CONCLUSION

          In clinical situations where bonding to dentin substrate is crucial, both conventional and self-adhesive resin cements based on 10-MDP can benefit from etch-and-rinse technique to achieve better quality of adhesion in the early clinical period.

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          Most cited references25

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          Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges.

          Bonding to tooth tissue can be achieved through an "etch&rinse," "self-etch" or "glass-ionomer" approach. In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore, bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine "bonding effectiveness" in the laboratory) are evaluated upon their value and relevance in predicting clinical performance. A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device. Eventually, today's adhesives will be critically weighted upon their performance in diverse laboratory studies and clinical trials. Special attention has been given to the benefits/drawbacks of an etch&rinse versus a self-etch approach and the long-term performance of these adhesives. Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness. Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term. Nevertheless, a self-etch approach may have the best future perspective. Clinically, when adhesives no longer require an "etch&rinse" step, the application time, and probably more importantly, the technique-sensitivity are substantially reduced. Especially "mild," two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional three-step systems in bonding performance.
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            Systematic review of the chemical composition of contemporary dental adhesives.

            Dental adhesives are designed to bond composite resins to enamel and dentin. Their chemical formulation determines to a large extent their adhesive performance in clinic. Irrespective of the number of bottles, an adhesive system typically contains resin monomers, curing initiators, inhibitors or stabilizers, solvents and sometimes inorganic filler. Each one of these components has a specific function. The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients. This paper includes an extensive table with the chemical formulation of contemporary dental adhesives.
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              Comparative study on adhesive performance of functional monomers.

              Mild self-etch adhesives demineralize dentin only partially, leaving hydroxyapatite around collagen within a submicron hybrid layer. We hypothesized that this residual hydroxyapatite may serve as a receptor for chemical interaction with the functional monomer and, subsequently, contribute to adhesive performance in addition to micro-mechanical hybridization. We therefore chemically characterized the adhesive interaction of 3 functional monomers with synthetic hydroxyapatite, using x-ray photoelectron spectroscopy and atomic absorption spectrophotometry. We further characterized their interaction with dentin ultra-morphologically, using transmission electron microscopy. The monomer 10-methacryloxydecyl dihydrogen phosphate (10-MDP) readily adhered to hydroxyapatite. This bond appeared very stable, as confirmed by the low dissolution rate of its calcium salt in water. The bonding potential of 4-methacryloxyethyl trimellitic acid (4-MET) was substantially lower. The monomer 2-methacryloxyethyl phenyl hydrogen phosphate (phenyl-P) and its bond to hydroxyapatite did not appear to be hydrolytically stable. Besides self-etching dentin, specific functional monomers have additional chemical bonding efficacy that is expected to contribute to their adhesive potential to tooth tissue.
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                Author and article information

                Journal
                J Adv Prosthodont
                J Adv Prosthodont
                JAP
                The Journal of Advanced Prosthodontics
                The Korean Academy of Prosthodontics
                2005-7806
                2005-7814
                August 2013
                31 August 2013
                : 5
                : 3
                : 226-233
                Affiliations
                [1 ]University of Istanbul, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey.
                [2 ]University of Zurich, Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland.
                Author notes
                Corresponding author: Volkan Turp. Department of Prosthodontics, Faculty of Dentistry, University of Istanbul, 34093 Fatih Istanbul, Turkey. Tel. 905353521632: vturp@ 123456istanbul.edu.tr
                Article
                10.4047/jap.2013.5.3.226
                3774935
                24049562
                876b653b-5572-4a48-9563-1a683b94831e
                © 2013 The Korean Academy of Prosthodontics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 December 2012
                : 16 July 2013
                : 07 August 2013
                Categories
                Original Article

                Dentistry
                adhesion,bond strength,dentin,hybrid layer,self-adhesive cement
                Dentistry
                adhesion, bond strength, dentin, hybrid layer, self-adhesive cement

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