The role of polymerization in adhesive dentistry Cadenaro, Milena; Maravic, Tatjana; Comba, Allegra ...
Dental materials,
January 2019, 2019-Jan, 2019-01-00, 20190101, Letnik:
35, Številka:
1
Journal Article
Recenzirano
•Factors that influence polymerization of adhesives are described.•Accurate evaporation of the solvents may improve the polymerization of adhesive system.•Prolonged curing time increase the ...performance and stability of adhesive systems.•The effect on curing reaction of molecules added to adhesive formulations to counteract the degradation of the adhesive interface over time has to be clarified.
Adhesive systems are resin-based materials that reach their final mechanical properties through a polymerization process. Previous literature correlated the failure of the adhesive interface to low polymer setting. Adhesives systems are elaborate mixtures of different molecules of both hydrophilic and hydrophobic nature, included in the formulation to adequately infiltrate the complex dental substrate or added to prolong the stability of the adhesive layer over time. Each adhesive component may influence the polymerization reaction of the material. Photopolymerization is a complex reaction that has several clinical implications, and besides the material composition, it is influenced by multiple factors, including the substrate characteristics, the operator technique, and the light cure unit properties. This review is focused on the analysis of factors that have a potential role in the setting of adhesive materials and thus the ultimate characteristics of the adhesive layer and the stability of the resin-dentin interface.
This review provides a detailed description of matrix metalloproteinases (MMPs), focusing on those that are known to have critical roles in bone and periodontal disease. Periodontal disease is an ...inflammatory process initiated by anaerobic bacteria, which promote the host immune response in the form of a complex network of molecular pathways involving proinflammatory mediators such as cytokines, growth factors, and MMPs. MMPs are a family of 23 endopeptidases, collectively capable of degrading virtually all extracellular matrix (ECM) components. This study critically discusses the available research concerning the involvement of the MMPs in periodontal disease development and progression and presents possible therapeutic strategies. MMPs participate in morphogenesis, physiological tissue turnover, and pathological tissue destruction. Alterations in the regulation of MMP activity are implicated in the manifestation of oral diseases, and MMPs comprise the most important pathway in tissue destruction associated with periodontal disease. MMPs can be considered a risk factor for periodontal disease, and measurements of MMP levels may be useful markers for early detection of periodontitis and as a tool to assess prognostic follow-ups. Detection and inhibition of MMPs could, therefore, be useful in periodontal disease prevention or be an essential part of periodontal disease therapy, which, considering the huge incidence of the disease, may greatly improve oral health globally.
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To answer the PICOS question: “Is the risk of retention loss equal for SEE and SE approach when universal adhesives and composite restorations are indicated for restoring NCCLs?”
Web ...of Science, PubMed, Cochrane Central Register of Controlled Trials, Scopus, Scientific Electronic Library Online, LILACS, Google Scholar™ and OpenGrey were searched. Only randomized controlled clinical trials in which NCCLs were restored with composites and universal adhesives applied in SEE or SE mode were included. The articles were assessed for the risk of bias, after which meta-analyses were run (fixed-effects model was applied; heterogeneity was explored using Cochran Q test and I2 statistics; α = 0.05) and the certainty of evidence was assessed by the GRADE tool.
Fifteen articles were included in qualitative, while 7 articles were included in quantitative analysis. Seven studies were judged as “low” risk of bias, while 8 were considered as “unclear” risk of bias. Statistically significant difference for retention were observed at 6- and 18/24 months (p = 0.05; OR=0.42, 95% CI 0.18, 0.99; very low certainty of evidence and p = 0.007; OR=0.31, 95% CI 0.13, 0.72; low certainty of evidence, respectively), favoring SEE approach. No other significant differences in clinical outcomes were observed between SEE and SE approach (very low certainty of evidence).
When restoring NCCLs, clinicians might consider applying universal adhesives in SEE mode since it could lead to more predictable retention compared to SE approach up to 2 years of follow-up.
Abstract Objectives Contemporary adhesives lose their bond strength to dentin regardless of the bonding system used. This loss relates to the hydrolysis of collagen matrix of the hybrid layers. The ...preservation of the collagen matrix integrity is a key issue in the attempts to improve the dentin bonding durability. Methods Dentin contains collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins, which are responsible for the hydrolytic degradation of collagen matrix in the bonded interface. Results The identities, roles and function of collagenolytic enzymes in mineralized dentin has been gathered only within last 15 years, but they have already been demonstrated to have an important role in dental hard tissue pathologies, including the degradation of the hybrid layer. Identifying responsible enzymes facilitates the development of new, more efficient methods to improve the stability of dentin–adhesive bond and durability of bond strength. Significance Understanding the nature and role of proteolytic degradation of dentin–adhesive interfaces has improved immensely and has practically grown to a scientific field of its own within only 10 years, holding excellent promise that stable resin–dentin bonds will be routinely available in a daily clinical setting already in a near future.
Abstract Objectives The aim of this study was to investigate the adhesive stability over time of a multi-mode one-step adhesive applied using different bonding techniques on human coronal dentine. ...The hypotheses tested were that microtensile bond strength (μTBS), interfacial nanoleakage expression and matrix metalloproteinases (MMPs) activation are not affected by the adhesive application mode (following the use of self-etch technique or with the etch-and-rinse technique on dry or wet dentine) or by ageing for 24 h, 6 months and 1 year in artificial saliva. Methods Human molars were cut to expose middle/deep dentine and assigned to one of the following bonding systems ( N = 15): (1) Scotchbond Universal (3M ESPE) self-etch mode, (2) Scotchbond Universal etch-and-rinse technique on wet dentine, (3) Scotchbond Universal etch-and-rinse technique on dry dentine, and (4) Prime&Bond NT (Dentsply De Trey) etch-and-rinse technique on wet dentine (control). Specimens were processed for μTBS test in accordance with the non-trimming technique and stressed to failure after 24 h, 6 months or 1 year. Additional specimens were processed and examined to assay interfacial nanoleakage and MMP expression. Results At baseline, no differences between groups were found. After 1 year of storage, Scotchbond Universal applied in the self-etch mode and Prime&Bond NT showed higher μTBS compared to the other groups. The lowest nanoleakage expression was found for Scotchbond Universal applied in the self-etch mode, both at baseline and after storage. MMPs activation was found after application of each tested adhesive. Conclusions The results of this study support the use of the self-etch approach for bonding the tested multi-mode adhesive system to dentine due to improved stability over time. Clinical significance Improved bonding effectiveness of the tested universal adhesive system on dentine may be obtained if the adhesive is applied with the self-etch approach.
•EDC pre-treatment efficiently preserves bond strength over time.•Pre-treatment with EDC resulted in an almost complete inhibition of MMPs.•Changes within the dentin matrix promoted by EDC are not ...adhesive-system-dependent.
The objectives of the study were to evaluate the ability of a 1-ethyl-3 (3-dimethylaminopropyl) carbodiimide (EDC)-containing primer to improve immediate bond strength of either self-etch or etch-and-rinse adhesive systems and to stabilize the adhesive interfaces over time. A further objective was to investigate the effect of EDC on the dentinal MMPs activity using zymographic analysis.
Freshly extracted molars (n=80, 20 for each group) were selected to conduct microtensile bond strength tests. The following groups were tested, immediately or after 1-year aging in artificial saliva: G1: Clearfil SE (CSE) primer applied on unetched dentin, pretreated with 0.3M EDC water-solution for 1min and bonded with CSE Bond; G2: as G1 but without EDC pre-treatment; G3: acid-etched (35% phosphoric-acid for 15s) dentin pretreated with 0.3M EDC, then bonded with XP Bond (XPB); Group 4 (G4): as G3 without EDC pre-treatment. Further, gelatinase activity in dentin powder treated with CSE and XPB with and without EDC pre-treatment, was analyzed using gelatin zymography.
The use of 0.3M EDC-containing conditioner did not affect the immediate bond strength of XPB or CSE adhesive systems (p>0.05), while it improved the bond strength after 1year of aging (p<0.05). Pre-treatment with EDC followed by the application of CSE resulted in an incomplete MMPs inactivation, while EDC pretreatment followed by the application of XPB resulted in an almost complete inactivation of dentinal gelatinases.
The μTBS and zymography results support the efficacy of EDC over time and reveal that changes within the dentin matrix promoted by EDC are not adhesive-system-dependent.
Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of ...irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely.
Abstract
Objectives of the study were to investigate biomechanical properties of severely compromised premolars restored with composite restorations using finite element analysis (FEA), and in vitro ...fracture resistance test. A 3-D model of an endodontically treated premolar was created in Solidworks. Different composite restorations were modelled (direct restoration-DR; endo-crown-EC; post, core, and crown-C) with two different supporting tissues: periodontal ligament/alveolar bone (B), and polymethyl methacrylate (PMMA). Models were two-point axially loaded occlusally (850 N). Von Mises stresses and strains were calculated. The same groups were further tested for static fracture resistance in vitro (n = 5, 6.0 mm-diameter ball indenter, vertical load). Fracture resistance data were statistically analyzed (
p
< 0.050). The highest stresses and strains in all FEA models were observed on occlusal and vestibular cervical surfaces, corresponding to fracture propagation demonstrated in vitro. C showed the lowest stress in dentin, while EC showed lower stresses and strains in crown cement. B models demonstrated larger high stress areas in the root than PMMA models. No significant differences in fracture resistance (N) were observed between groups (DR: 747.7 ± 164.0, EC: 867.3 ± 108.1, C: 866.9 ± 126.3;
p
= 0.307). More conservative restorations seem a feasible alternative for endodontically treated premolars to conventional post-core-crown.
Objective
To investigate the long-term microtensile bond strength (µTBS), interfacial nanoleakage expression (NL), and adhesive stability of dual-cure resin cements with/out light activation to ...dentin.
Materials and methods
Composite overlays (
N
= 20) were luted to deep dentin surfaces with RelyX Ultimate (RXU, 3M) or Variolink EstheticDC (VAR, Ivoclar-Vivadent). A universal adhesive was used for bonding procedures (iBond universal, Heraeus Kulzer). The resin cements were either self-cured (SC; 1 h at 37 °C) or dual-cured (DC; 20s light-cure followed by 15 min self-cure at 37 °C). Specimens were submitted to µTBS immediately (
T
0
) or after 1 year of laboratory storage (
T
12
). The fracture pattern was evaluated using scanning electron microscopy (SEM). Data were statistically analyzed with two-way ANOVA/Tukey test. Further, the NL was quantified and analyzed (chi-square test) and in situ zymography was performed to evaluate the endogenous enzymatic activity within the hybrid layer (HL) at
T
0
and
T
12
(Mann–Whitney test)
.
The significance level for all statistical tests was set at
p
= 0.05.
Results
DC resulted in higher bond strength and decreased fluorescence at the adhesive interface, irrespective of the material and the storage period (
p
< 0.05). Significantly lower bonding performances (
p
< 0.05) and higher endogenous enzymatic activity (
p
< 0.05) were observed within the HL at
T
12
compared to
T
0
in all tested groups.
Conclusions
Light-curing the dual-cure resin cements, more than the cement materials, accounted for good bonding performances and higher HL stability over time when used with a universal adhesive.
Clinical significance
The curing condition influences the bonding performances of dual-cure resin cements to dentin when used with a universal adhesive.
Objectives
Matrix metalloproteases (MMPs) are a family of enzymes that operate a proteolytic activity at the level of the extracellular matrix. MMPs are regulated by tissue inhibitors of ...metalloproteinases (TIMPs) that can ubiquitously bind different enzyme forms. The study aims to identify a morfo-functional association between TIMP-1 and MMP-2 and -9 in human dentin.
Materials and methods
Proteins were extracted from demineralized human sound dentin powder and centrifuged to separate two aliquots with different molecular weights of proteins, higher and lower than 30 kDa. In each aliquot, the evaluation of the presence of TIMP-1/MMP-2 and TIMP-1/MMP-9 was performed using co-immunoprecipitation/immunoblotting analysis. The distribution of TIMP-1, in association with MMP-2 and -9, was investigated using a double immunohistochemical technique. Furthermore, the activity of TIMP-1 was measured by reverse zymography, where acrylamide gel was copolymerized with gelatin and recombinant MMP-2.
Results
Co-immunoprecipitation/immunoblotting analysis showed the association TIMP-1/MMP-2 and TIMP-1/MMP-9 in human sound dentin. Electron microscopy evaluation revealed a diffuse presence of TIMP-1 tightly associated with MMP-2 and -9. Reverse zymography analysis confirmed that TIMP-1 present in human dentin is active and can bind different MMPs isoforms.
Conclusions
The strict association of TIMP-1 with MMP-2 and -9 in situ appeared a constant finding in the human sound dentin.
Clinical relevance
Considering the role of TIMP-1, MMP-2, and MMP-9 within the connective tissues, clinically applicable protocols could be developed in the future to increase or decrease the level of TIMPs in human dentin to regulate the activity of MMPs, contributing to reduce caries progression and collagen degradation.
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