Abstract
Objective: this study aimed to assess the effect of treatment of phosphoric acid etched dentin surface with 5% bromelain enzyme and Nd:YAG laser prior to the use of etch and rinse adhesive systems on microleakage margins of class V composite restorations. Materials and Methods: sixty sound premolar teeth were selected. Standard class V cavities were prepared in the buccal and lingual surfaces of each teeth. Preparation in that way 1 mm of the cavity was above and 1 mm of it was below the cementoenamel junction. The teeth were then randomly divided into three groups including 20 teeth(40cavities in each gorup). Two ethanol base etch and rinse system (Adper Single Bond and OptiBond Solo) was applied in each group. In the control group, cavities were etched with 37% phosphoric acid. Adper Single Bond was applied to 20 and OptiBond Solo was applied to the remaining 20 cavities and they were restored with Z250 composite (n=40). The same procedures were performed in bromelain and Nd:YAG laser groups with the difference that prior to the application of adhesive, aqueous 5% bromelain was applied in bromelain group while Nd:YAG laser was irradiated in laser group. All teeth were thermocycled and their apices were sealed with sticky wax. The tooth surfaces were coated with nail varnish except for 1 mm around the restoration margins, and the teeth were then immersed in fuchsine and sectioned by a diamond disc into mesial and distal halves. Marginal microleakage at both sides was determined and scored under a stereomicroscope at x40 magnification. Then data were analyzed using the Kruskal Wallis and Mann Whitney tests (α=0.05). Results: according the result of Mann Whitney test, Cervical margins showed significantly higher microleakage than the occlusal margins (P=0.000) but no significant difference was noted in microleakage of occlusal (P=0.362) or gingival (P=0.147) margins among the three groups by Kruskal Wallis test. Conclusion: in conclusion, application of proteolytic agents(5% bromelain solution and Nd:YAG laser) on acid-etched dentin surface prior to the application of adhesive has no significant effect on marginal microleakage of class V composite restorations.
References
Dayem RN. Assessment of the penetration depth of dental adhesives through deproteinized acid-etched dentin using neodymium: yttrium–aluminum–garnet laser and sodium hypochlorite. Lasers Med Sci. 2010 Jan;25(1):17-24. doi: 10.1007/s10103-008-0589-4.
Dayem RN. A novel method for removing the collagen network from acid-etched dentin by neodymium: yttrium-aluminum-garnet laser. Lasers Med Sci. 2009 Jan;24(1):93-9.
Dayem RN, Tameesh MA. A new concept in hybridization: Bromelain enzyme for deproteinizing dentin before application of adhesive system. Contemp Clin Dent. 2013 Oct;4(4):421-6. doi: 10.4103/0976-237X.123015.
Xu C, Wang Y. Cross‐linked demineralized dentin maintains its mechanical stability when challenged by bacterial collagenase. J Biomed Mater Res B Appl Biomater. 2011 Feb;96(2):242-8. doi: 10.1002/jbm.b.31759.
Scheffel DL, Hebling J, Scheffel RH, Agee KA, Cadenaro M, Turco G, et al. Stabilization of dentin matrix after cross-linking treatments, in vitro. Dent Mater. 2014 Feb;30(2):227-33. doi: 10.1016/j.dental.2013.11.007.
Spencer P, Ye Q, Park J, Topp EM, Misra A, Marangos O, et al. Adhesive/dentin interface: the weak link in the composite restoration. Ann Biomed Eng. 2010 Jun;38(6):1989-2003. doi: 10.1007/s10439-010-9969-6.
Scheffel DLS, Hebling J, Scheffel RH, Agee K, Turco G, de Souza Costa CA, et al. Inactivation of matrix-bound matrix metalloproteinases by cross-linking agents in acid-etched dentin. Oper Dent. 2014 Mar-Apr;39(2):152-8. doi: 10.2341/12-425-L.
Liu Y, Tjäderhane L, Breschi L, Mazzoni A, Li N, Mao J, Pashley DH, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011 Aug;90(8):953-68. doi: 10.1177/0022034510391799.
Pashley DH, Tay FR, Breschi L, Tjäderhane L, Carvalho RM, Carrilho M, et al. State of the art etch-and-rinse adhesives. Dent Mater. 2011 Jan;27(1):1-16. doi: 10.1016/j.dental.2010.10.016.
Carrilho M, Geraldeli S, Tay F, de Goes MF, Carvalho RM, Tjäderhane L, et al. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res. 2007 Jun;86(6):529-33.
Zhang S-c, Kern M. The role of host-derived dentinal matrix metalloproteinases in reducing dentin bonding of resin adhesives. Int J Oral Sci. 2009 Dec;1(4):163-76. doi: 10.4248/IJOS.09044.
Summitt JB, Robbins JW, Hilton TJ, Schwartz RS. Fundamentals of operative dentistry: a contemporary approach. Quintessence Pub.; 2006.
Lu S, Zhao S-j, Gao Y, Sun Y, Li X, Chen J-h. Proteoglycans affect monomer infiltration in the etch-and-rinse bonding technique. Dent Mater. 2014 Nov;30(11):e289-99. doi: 10.1016/j.dental.2014.05.015.
Breschi L, Lopes M, Gobbi P, Mazzotti G, Falconi M, Perdigão J. Dentin proteoglycans: an immunocytochemical FEISEM study. J Biomed Mater Res. 2002 Jul;61(1):40-6.
Breschi L, Gobbi P, Lopes M, Prati C, Falconi M, Teti G, et al. Immunocytochemical analysis of dentin: A double‐labeling technique. J Biomed Mater Res A. 2003 Oct 1;67(1):11-7.
Shin TP, Yao X, Huenergardt R, Walker MP, Wang Y. Morphological and chemical characterization of bonding hydrophobic adhesive to dentin using ethanol wet bonding technique. Dent Mater. 2009 Aug;25(8):1050-7. doi: 10.1016/j.dental.2009.03.006.
Chauhan K, Basavanna RS, Shivanna V. Effect of bromelain enzyme for dentin deproteinization on bond strength of adhesive system. J Conserv Dent. 2015 Sep-Oct;18(5):360-3. doi: 10.4103/0972-0707.164029.
Han B, Jaurequi J, Tang BW, Nimni ME. Proanthocyanidin: a natural crosslinking reagent for stabilizing collagen matrices. Journal of Biomedical Materials Research Part A. 2003;65(1):118-124.
Al‐Ammar A, Drummond JL, Bedran‐Russo AK. The use of collagen cross‐linking agents to enhance dentin bond strength. J Biomed Mater Res A. 2003 Apr 1;65(1):118-24.
Bedran‐Russo AKB, Pashley DH, Agee K, Drummond JL, Miescke KJ. Changes in stiffness of demineralized dentin following application of collagen crosslinkers. J Biomed Mater Res B Appl Biomater. 2008 Aug;86(2):330-4.
Castellan CS, Bedran-Russo AK, Karol S, Pereira PNR. Long-term stability of dentin matrix following treatment with various natural collagen cross-linkers. J Mech Behav Biomed Mater. 2011 Oct;4(7):1343-50. doi: 10.1016/j.jmbbm.2011.05.003.
Macedo G, Yamauchi M, Bedran-Russo A. Effects of chemical cross-linkers on caries-affected dentin bonding. J Dent Res. 2009 Dec;88(12):1096-100. doi: 10.1177/0022034509351001.
Hass V, Luque-Martinez IV, Gutierrez MF, Moreira CG, Gotti VB, Feitosa VP, et al. Collagen cross-linkers on dentin bonding: Stability of the adhesive interfaces, degree of conversion of the adhesive, cytotoxicity and in situ MMP inhibition. Dent Mater. 2016 Jun;32(6):732-41. doi: 10.1016/j.dental.2016.03.008.
Savadi Oskoee S1, Alizadeh Oskoee P, Jafari Navimipour E, Ahmad Ajami A, Pournaghi Azar F, Rikhtegaran S, et al. Comparison of the effect of Nd: YAG and diode lasers and photodynamic therapy on microleakage of class V composite resin restorations. J Dent Res Dent Clin Dent Prospects. 2013;7(2):74-80. doi: 10.5681/joddd.2013.013.
Wen X, Liu L, Nie X, Zhang L, Deng M, Chen Y. Effect of pulse Nd: YAG laser on bond strength and microleakage of resin to human dentine. Photomed Laser Surg. 2010 Dec;28(6):741-6. doi: 10.1089/pho.2009.2579.
Ribeiro CF, Anido AA, Rauscher FC, Yui KCK, Gonçalves SEDP. Marginal leakage in class V cavities pretreated with different laser energy densities. Photomed Laser Surg. 2005 Jun;23(3):313-6.
Castro FL, Andrade MF, Hebling J, Lizarelli RF. Nd: YAG laser irradiation of etched/unetched dentin through an uncured two-step etch-and-rinse adhesive and its effect on microtensile bond strength. J Adhes Dent. 2012 Apr;14(2):137-45. doi: 10.3290/j.jad.a21854.
Marimoto A, Cunha L, Yui K, Huhtala MF, Barcellos DC, Prakki A, et al. Influence of Nd: YAG laser on the bond strength of self-etching and conventional adhesive systems to dental hard tissues. Oper Dent. 2013 Jul-Aug;38(4):447-55. doi: 10.2341/11-383-L.
Gan J, Liu S, Zhou L, Wang Y, Guo J, Huang C. Effect of Nd: YAG Laser Irradiation Pretreatment on the Long-Term Bond Strength of Etch-and-Rinse Adhesive to Dentin. Oper Dent. 2017 Jan/Feb;42(1):62-72. doi: 10.2341/15-268-L.
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