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      Effect of Orthophosphoric Acid and Er:YAG Laser Etching on Micro-shear Bond Strength to Enamel: An In Vitro Pilot Study

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          Abstract

          Background:

          Dental conditioning is one of the most important phases during enamel bonding procedures to obtain clean surfaces, smear layer removal with collagen active sites and hydroxyapatite exposure.

          Objective:

          The aim of this study was to compare the micro-shear bond strength (µSBS) of different adhesive systems after two different etching techniques: 37% orthophosphoric acid (H 3PO 4) and Er:YAG laser.

          Methods:

          Ninety permanent extracted molars were embedded into epoxy resin blocks and sectioned longitudinally. Specimens were randomly assigned to one of the following groups (n=30), depending on the etching protocol: 37% H 3PO 4 for 30 s (Group 1), Er:YAG laser 100mJ-10Hz (Group 2), and Er:YAG laser 100mJ-10Hz followed by 37% H3PO4 for 30 s (Group 3). Each group was further divided into two subgroups depending on the bonding agent used on enamel (n=15): A) EE-Bond (Tokuyama) and B) Peak universal (Ultradent). A two-way analysis of variance (two-way ANOVA) was conducted and the level of significance was set to p=0.05.

          Results:

          The etching procedure was a significant factor influencing the results (p=0.006), while no differences were observed for the two adhesive systems tested (p>0.05). Group 3 recorded the highest bond strength values, according to the following sequel: Group 3 < Group 2 < Group 1 < 0.05.

          Conclusion:

          The combination of phosphoric acid etching with Er:YAG laser provided the most favourable bond strength to enamel. Further morphological studies are currently ongoing.

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          Most cited references19

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          Dental adhesion review: aging and stability of the bonded interface.

          Most of current dental adhesive systems show favorable immediate results in terms of retention and sealing of bonded interface, thereby counteracting polymerization shrinkage that affects resin-based restorative materials. Despite immediate efficacy, there are major concerns when dentin bonded interfaces are tested after aging even for short time period, i.e. 6 months. This study critically discusses the latest peer-reviewed reports related to formation, aging and stability of resin bonding, focusing on the micro and nano-phenomena related to adhesive interface degradation. Most simplified one-step adhesives were shown to be the least durable, while three-step etch-and-rinse and two-step self-etch adhesives continue to show the highest performances, as reported in the overwhelming majority of studies. In other words, a simplification of clinical application procedures is done to the detriment of bonding efficacy. Among the different aging phenomena occurring at the dentin bonded interfaces, some are considered pivotal in degrading the hybrid layer, particularly if simplified adhesives are used. Insufficient resin impregnation of dentin, high permeability of the bonded interface, sub-optimal polymerization, phase separation and activation of endogenous collagenolytic enzymes are some of the recently reported factors that reduce the longevity of the bonded interface. In order to overcome these problems, recent studies indicated that (1) resin impregnation techniques should be improved, particularly for two-step etch-and-rinse adhesives; (2) the use of conventional multi-step adhesives is recommended, since they involve the use of a hydrophobic coating of nonsolvated resin; (3) extended curing time should be considered to reduce permeability and allow a better polymerization of the adhesive film; (4) proteases inhibitors as additional primer should be used to increase the stability of the collagens fibrils within the hybrid layer inhibiting the intrinsic collagenolytic activity of human dentin.
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            • Record: found
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            • Article: not found

            Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications

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              • Abstract: found
              • Article: not found

              Differences in bonding to acid-etched or Er:YAG-laser-treated enamel and dentin surfaces.

              Er:YAG (erbium-doped yttrium aluminium garnet) lasers have been effective in the removal of dental tissues. It has been suggested that they are also useful for preparing dental surfaces for adhesion, but results to date have been controversial. This study compared the tensile strength of bracket-tooth bonds obtained after preparation of the surface for adhesion (dentin or enamel) by conventional acid-etching or by Er:YAG laser etching and investigated microstructure of resin-tooth interfaces using the 2 procedures. Eighty healthy human premolars were used. Brackets were cemented to acid-etched enamel, laser-etched enamel, acid-etched dentin, or laser-etched dentin (20 teeth per group). Dentin was previously exposed using a high-speed handpiece. Acid-etching was with 37% orthophosphoric acid (15 seconds for enamel, 5 seconds for dentin). Laser etching was with Er:YAG laser (four 200 mJ pulses per second for enamel; four 160 mJ pulses per second for dentin). Brackets were bonded with autocuring resin paste, having first applied a primer (dentin only) and then light-cured bonding resin. Tensile strength was determined with a universal testing machine. Data were analyzed with 2-way ANOVA and subsequent t test with Bonferroni correction. Fracture patterns were compared by the Wilcoxon test with Bonferroni correction. For SEM studies of the resin-tooth interface, a total of 12 premolars were used (3 for each tissue per treatment combination). Mean tensile bond strength for acid-etched enamel (14.05 +/- 5.03 MPa) was significantly higher (P<.05) than for laser-etched enamel (8.45 +/- 3.07 MPa), and significantly higher (P<.05) for acid-etched dentin (4.70 +/- 2.50 MPa) than laser-etched dentin (2.48 +/- 1.94 MPa). Bond failure after laser etching was due to microcohesive fracture of tooth tissue. SEM studies of both resin-enamel and resin-dentin interfaces indicated extensive subsurface fissuring after laser etching. Adhesion to dental hard tissues after Er:YAG laser etching is inferior to that obtained after conventional acid etching. Enamel and dentin surfaces prepared by Er:YAG laser etching show extensive subsurface fissuring that is unfavorable to adhesion.
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                Author and article information

                Journal
                The Open Dentistry Journal
                TODENTJ
                Bentham Science Publishers Ltd.
                1874-2106
                October 13 2022
                October 13 2022
                : 16
                : 1
                Article
                10.2174/18742106-v16-e2208012
                66b6064f-5ce8-4fe4-ae77-9d71c9811dce
                © 2022

                Free to read

                https://creativecommons.org/licenses/by/4.0/legalcode

                History

                Medicine,Chemistry,Life sciences
                Medicine, Chemistry, Life sciences

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