etching systems with mixing self-etching Etch & Rinse systems 3-year Water-storage Class-V Dentin Margin Integrity of Adhesives

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1 3-year Water-storage Class-V Dentin Margin Integrity of Adhesives Introduction U. BLUNCK Charité - Universitätsmedizin Berlin Dental School Dept. of Operative Dentistry and Periodontology P. ZASLANSKY Max Planck Institute of Colloids and Interfaces Wissenschaftspark Golm (Potsdam) Dept. of Biomaterials T. ATTIN University of Zurich Clinic of Preventive Dentistry, Cariology and Periodontology Introduction Etch & Rinse systems primers multi-bottle s two-step-application one- bottle s with mixing all-in-one s without mixing One Introduction Can we predict the clinical long-term effectiveness of s systems? Objective to evaluate the effectiveness of 9 different systems at the margins of composite resin filled Cass V cavities after three years of water storage ca. 3. mm ca. 4. mm ca. 1.5 mm

2 application of the systems Etch & Rinse systems multi-bottle s two-step application FL Clearfill SE Bond SE Bond One Etch & Rinse systems one- bottle s light-curing dual-curing 1XT Complete One with mixing all-in-one s One Futurabond Adper Prompt M L-Pop all-in-one s without mixing One OptiBond All In All-in-one One V application of the systems incremental technique Filtek Z25 (3M Espe)

3 application of the systems incremental technique Estelite Sigma (Tokuyama) (Tokuyama) application of the systems incremental technique finishing and polishing to avoid any overhangs 2 s with agitation 2 s without agitation application of the systems waterstorage for 21 days 1 st thermocycling before TC 1 st thermocycling after TC Class V cavities application of the systems margin quality 1: continuous margin waterstorage for 21 days 1 st thermocycling waterstorage for 1 year 2 nd thermocycling waterstorage for 2 years 3 rd thermocycling Margin analysis in the SEM margin quality 2: margin irregularities margin quality 3: hairline cracks margin quality 4: severe gaps Margin analysis in the SEM

4 % % box plot after 21 days waterstorage XT LC DC with agitation / Z25 with agitation / Estelite continuous margin w/o agitation / Estelite in % of the entire margin length in 1 % in % of the entire margin length in 1 % % % after 21 days waterstorage + 1 st thermocycling XT LC DC XT LC DC with agitation / Z25 with agitation / Estelite with agitation / Z25 with agitation / Estelite w/o agitation / Estelite w/o agitation / Estelite in % of the entire margin length in 1 % in % of the entire margin length in 1 % % % total ranking with agitation / Z25 with agitation / Estelite XT special results light-curing vs. dual-curing XT LC DC with agitation / Z25 with agitation / Estelite LC w/o agitation / Estelite DC w/o agitation / Estelite in % of the entire margin length in 1 % p > in % of the entire margin length in 1 % p <.5

5 2 4 special results 6 active vs. passive application 8 1 % XT LC DC with agitation / Z25 with agitation / Estelite w/o agitation / Estelite Method: in-vitro margin analysis significant correlation between in-vitro and in-vivo data when combining the same / composite in % of the entire margin length in 1 % p <.5 Heintze SD, Blunck U, Göhring TN, Rousson V. Marginal adaptation and clinical outcome of Class V restorations. Dent Mater 25:65-2, 29 from other studies: Reasons for decrease in bond strength: water storage reduces bond strengths data better results for 3-step etch & rinse s 2-step self-etch s and Erhardt MC et al. Gen Dent 56:372-7 (28) Abdalla AI, Feilzer AJ. Oper Dent 34:732-4 (29) Itoh S et al. Dent Mater J 29:623-3 (21) Garcia-Godoy F et al. Dent Mater 26: (21) Hashimoto M et al. Eur J Oral Sci 118:44-1 (21) Osorio R et al. Odontology 98: (21) Abdalla AI Am J Dent 23:29-33 (21) De Munck J et al. Dent Mater J Epub (211) Etch&rinse-s: - degradation of resin composite - hydrolysis of collagen fibrils - incomplete encapsulation as a result of poor curing of the - degradation of naked collagen fibrils by MMPs - elution of resin from hybrid layers due to hydrolysis of resin Hashimoto M. A review - micromorphological evidence of degradation in resin bonds and potential preventional solutions. J Biomed Mater Res B Appl Biomater 92:268-8 (21) Reasons for decrease in bond strength: Self-etching s: - nanoleakage within the bonding resin or hybrid layer - presence of a more hydrophilic layer may induce water sorption and water uptake - phase separation of or microsize bubble formation in bonding resin Effect of light-curing vs. dual-curing of light-curing positive effect of light-curing: - better cross-linking of polymerized s Rueggeberg FA, Caughman WF.: Oper Dent. 18:48-55 (1993) el-badrawy WA, el-mowafy OM.: J Prosthet Dent 73: (1995) Hashimoto M. A review - micromorphological evidence of degradation in resin bonds and potential preventional solutions. J Biomed Mater Res B Appl Biomater 92:268-8 (21) dual-curing in % of the entire margin length in 1 % LC DC p <.5

6 Effect of active vs. passive application of positive effect of active application: through the smear layer into the solid - better evaporation of the solvent Effect of active vs. passive application of positive effect of active application: through the smear layer into the solid - better evaporation of the solvent in % of the entire margin length in active passive 1 % p <.5 Chan KM et al. Am J Dent 16, (23) van Landyt KL et al. J Dent Res 84, (25) do Amaral RC et al. J Dent 37, 82-9 (29) van Landyt KL et al. J Adhes Dent 11, (29) Conclusion In the used experimental design only long-term water-storage shows significant effects on marginal adaptation depending on -the - the curing mode (light-curing > dark-curing) - the application technique (with agitation > no agitation) 3-year Water-storage Class-V Dentin Margin Integrity of Adhesives Acknoledgement: 3M Espe Cosmedent Dentsply Kerr Kuraray Tokuyama