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      The effects of amalgam contamination and different surface modifications on microleakage of dentin bonded to bulk fill composite when using different adhesive protocols

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          Abstract

          Background

          To evaluate the effect of amalgam contamination, different surface treatments, and adhesive protocols on dentin microleakage to bulk-fill composite resin material.

          Methods

          Forty teeth were fixed in (polyvinyl siloxane) PVS molds, and the Class II cavities were placed on mesial and distal aspects. Thirty teeth were restored by amalgam and thermocycled to 10,000 cycles (5 and 55 °C, 30-s dwell time). The rest were restored with Filtek one Bulk Fill composite without amalgam predecessor. Samples were divided into: G1 (dentin pretreated with 2% chlorhexidine gluconate), G2 (0.5 mm of dentin was removed), G3 (no surface modification), and G4 (control, where composite was bonded to sound dentin without amalgam predecessor.). Single Bond Universal Adhesive system was used to bond the composite material, by using the etch-and-rinse protocol in the mesial cavity preparation and self-etch protocol in the distal. Specimens underwent thermocycling for 5000 cycles, then embedded in silver nitrate and sectioned for stereomicroscope examination. Descriptive statistics, Mann–Whitney U test, and Kruskal–Wallis test were used to analyze the results at p < 0.05.

          Results

          The highest microleakage score values (4.00) were found in the G2, and G4 in etch-and-rinse protocol. While the lowest scores were found in G2 when using self-etching protocol (1.5). Lower microleakage values were associated with the chlorhexidine treatment group for both adhesive protocols. No significant differences were found between amalgam contaminated and non-contaminated groups.

          Conclusions

          Amalgam contamination did not affect microleakage. Self-etching adhesive protocol significantly reduced microleakage for all groups irrespective of the surface treatment. Chlorhexidine pretreatment improved microleakage for both adhesive protocols but had no significant effect.

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          Most cited references51

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          A critical review of the durability of adhesion to tooth tissue: methods and results.

          The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
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            Thermal cycling procedures for laboratory testing of dental restorations.

            Exposure of restorations in extracted teeth to cyclic thermal fluctuations to simulate one of the many factors in the oral environment has been common in many tracer penetration, marginal gap and bond strength laboratory tests. Temperature changes used have rarely been substantiated with temperature measurements made in vivo and vary considerably between reports. Justification and standardization of regimen are required. An assessment of reports describing temperature changes of teeth in vivo is followed by an analysis of 130 studies of laboratory thermal cycling of teeth by 99 first authors selected from 25 journals. A clinically relevant thermal cycling regimen was derived from the in vivo information, and is suggested as a benchmark standard. Variation of regimens used was large, making comparison of reports difficult. Reports of testing the effects of thermal cycling were often contradictory, but generally leakage increased with thermal stress, although it has never been demonstrated that cyclic testing is relevant to clinical failures. However, should this be done, the standard cyclic regimen defined is: 35 degrees C (28 s), 15 degrees C (2 s), 35 degrees C (28 s), 45 degrees C (2 s). No evidence of the number of cycles likely to be experienced in vivo was found and this requires investigation, but a provisional estimate of approximately 10,000 cycles per year is suggested. Thermal stressing of restoration interfaces is only of value when the initial bond is already known to be reliable. This is not the case for most current restorative materials.
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              Relationship between bond-strength tests and clinical outcomes.

              One often alleges that laboratory bond-strength testing cannot predict clinical effectiveness of adhesives. Major argument to sustain this claim is the wide variation in bond-strength values recorded for one specific adhesive among different research institutes worldwide. The main reason for these inconsistent bond-strength measurements is supposedly the current lack of a standard bond-strength testing protocol. This paper (and presentation) aimed to report on an extensive literature review with regard to the different laboratory bond-strength test methods and their data provided, along with a second extensive literature review on clinical effectiveness data of adhesives in terms of retention rates of adhesive Class-V restorations. Combining both systematic reviews, we have subsequently searched for a potential relationship between bond-strength data and clinical outcomes. Copyright 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                alshehri.nojoud@gmail.com
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                18 May 2022
                18 May 2022
                2022
                : 22
                : 186
                Affiliations
                GRID grid.56302.32, ISNI 0000 0004 1773 5396, Restorative Dental Sciences Department, College of Dentistry, , King Saud University, ; Riyadh, Kingdom of Saudi Arabia
                Article
                2214
                10.1186/s12903-022-02214-1
                9118798
                35585533
                0431f1ec-d32f-427b-a51b-f5ee553f631c
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 2 November 2021
                : 5 May 2022
                Funding
                Funded by: college of dentistry research center
                Award ID: PR 0092
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Dentistry
                chlorhexidine,dentin refreshment,resin-based composite,universal adhesive system
                Dentistry
                chlorhexidine, dentin refreshment, resin-based composite, universal adhesive system

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