Effect of Different Bur Grinding On The Bond Strength of Self-Etching Adhesives
Effect of Different Bur Grinding On The Bond Strength of Self-Etching Adhesives
Effect of Different Bur Grinding On The Bond Strength of Self-Etching Adhesives
Laboratory Research
Clinical Relevance
In some self-etching systems, selecting the proper bur type for cutting dentin is important for improving bond strength.
SUMMARY
This study compared the microtensile bond
strength (MTBS) of three all-in-one adhesive systems and a two-step system using two types of
burs to prepare the dentin surfaces. Flat coronal
Stefano Semeraro, DDS, Department of Prosthodontics,
School of Dentistry, University of Milan, Milan, Italy
Dario Mezzanzanica, DDS, Department of Restorative and
Endodontics, School of Dentistry, University of Milan, Milan, Italy
Diego Spreafico, DDS, Department of Prosthodontics, School
of Dentistry, University of Milan, Milan, Italy
Massimo Gagliani, MD, DDS, PhD, associate professor,
Department of Restorative and Endodontics, School of
Dentistry, University of Milan, Milan, Italy
Dino Re, MD, DDS, PhD, researcher, Department of
Prosthodontics, School of Dentistry, University of Milan,
Milan, Italy
Toru Tanaka, DDS, PhD, assistant professor, Cariology,
Operative Dentistry and Endodontology, Department of Oral
Health Science, Hokkaido University Graduate School of
Dental Medicine, Sapporo, Japan
Sharanbir K Sidhu, BDS, MSc, PhD, FICD, MFDSRCS,
FADM, lecturer, Restorative Dentistry, School of Dental
Sciences, University of Newcastle, Newcastle upon Tyne, UK
*Hidehiko Sano, DDS, PhD, professor, Cariology, Operative
Dentistry and Endodontology, Department of Oral Health
Science, Hokkaido University Graduate School of Dental
Medicine, Sapporo, Japan
*Reprint request: Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586,
Japan; e-mail: sano@den.hokudai.ac.jp
DOI: 10.2341/04-171
surfaces of 24 extracted human molars were produced using either regular-grit or superfine-grit
diamond burs. Resin composite was then bonded
to equal numbers of these surfaces using one of
the four adhesives: Clearfil SE Bond (CSE), GBond (GB), SSB-200 (SSB) or Prompt L-Pop
(PLP). After storage for 24 hours in 37C distilled
water, the bonded teeth were sectioned into
slices (0.7-mm thick) perpendicular to the bonded
surface. The specimens were then subjected to
microtensile testing and the bond strengths were
calculated at failure. Bond strength data were
analyzed by two-way ANOVA and the GamesHowell test for interaction between adhesive and
type of cut dentin. The fractured surfaces were
observed by SEM to determine the failure mode.
In addition, to observe the effect of conditioning,
equal numbers of the two bur-cut dentin surfaces
of eight additional teeth were conditioned with
the adhesives and observed by SEM. Based on the
results, when CSE and SSB were bonded to
dentin cut with a regular-grit diamond bur, the
MTBS values were significantly lower than that
of superfine bur-cut dentin; whereas, GB and
PLP showed no significant differences in MTBS
between the two differently cut surfaces. SEM
observation of the fractured surfaces revealed a
mixed mode (adhesive in some areas and cohesive in others in the same sample) of failure in all
specimens except PLP, which showed cohesive
failure within the adhesive for both types of bur
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318
preparation. Generally, SEMs of the conditioned
surfaces using both types of burs showed partial
removal of the smear layer for CSE, minimal for
GB and SSB and complete removal for PLP.
In conclusion, when cutting dentin, selecting
the proper bur type is important for improving
the bond strength of some self-etching adhesive
systems.
INTRODUCTION
The smear layer has been defined as a layer of debris on
the surface of dental tissues created by cutting a tooth
(Eick & others, 1970). It varies in thickness, roughness,
density and degree of attachment to the underlying
tooth structure according to the surface preparation
(Charbeneau, Peyton & Anthony, 1957; Gilboe & others,
1980). As part of restorative procedures in adhesive dentistry, the smear layer must be removed, modified or
impregnated by the resin to allow for bonding between
the tooth and the restorative material (Swift Jr,
Perdigo & Heymann, 1995; Pashley & Carvalho, 1997).
The poor performance of early dentin adhesive systems was thought to occur because the smear layer was
not removed, resulting in the adhesive bonding to the
surface of the smeared debris (Watanabe, Nakabayashi
& Pashley, 1994a) and not to the underlying dentin
(Eick & others, 1970). The potential of the smear layer
to create an adverse effect on dentin bonding has been
reported by Prati and others (1990). The smear layer
adheres weakly to dentin, and its removal by an acid
demineralizing agent prior to the application of a bonding
system has been reported to result in stronger bonds
(Pashley, 1991). However, others have reported that the
treatment of dentin with acids can cause the collapse of
exposed collagen fibers due to the removal of the supporting hydroxyapatite and the denaturation of
collagen (Nakabayashi, 1992; Pashley & others, 1993).
The remaining matted collagen surface becomes more
difficult to impregnate with adhesive monomers. To
overcome this problem, the application of a primer aims
to restore the permeability of acid-treated dentin and
facilitates the penetration of applied monomers.
Therefore, the use of an acidic conditioner is necessary
to dissolve and remove the smear layer to expose the
intertubular and peritubular dentin, remove the debris
from the dentin surface and demineralize the superficial dentin matrix, thus allowing the subsequent infiltration of the resin into the dentin surface.
Clinically, after carious dentin has been removed or
any other kind of dentin instrumentation has been
performed, a smear layer is formed over the dentin
surface (Pashley & Carvalho, 1997; Ogata & others,
2001). The nature of the smear layer depends on the
type of bur used. In addition, different speeds of the
bur and the pressure applied may influence the kind of
smear layer.
Coarse and superfine diamond burs each create a different smear layer. Coarse diamond burs create a thick
smear layer containing cut collagen fibers and hydroxyapatite crystallites (Ayad, Rosenstiel & Hassan, 1996;
Gwinnett, 1984). This can interfere with bonding of the
adhesive agents, as it is not easy for some adhesive
monomers to permeate dentin smears and impregnate
the underlying dentin (Nakabayashi & Saimi, 1996).
Differences in the smear layer generated by burs and
abrasive papers have been reported to affect the bond
strengths of resins to dentin (Tagami & others, 1991;
Watanabe, Saimi & Nakabayashi, 1994b).
The all-in-one adhesive systems are simple to use,
as the steps of etching, priming and bonding occur in
one single application step. A previous study of these
systems has demonstrated the influence of the type of
smear layer generated on their bond strength (Inoue &
others, 2001). However, that study found that use of a
coarse diamond bur may reduce the possibility of penetration of bonding monomers into dentinal substrate in
these systems. It is not known whether these differences are also true for the newer, all-in-one adhesives.
The reasons for using self-etching primers include easy
handling by the operator (Sano & others, 1998;
Miyazaki, Onose & Moore, 2000) and high clinical performance (Latta & others, 1997). These primers were
marketed in the last decade and since then, there have
been many self-etching primers available. Current
advances in these systems are toward one-bottle, all-inone adhesives. Older versions of self-etching primers
were believed to be susceptible to the presence of the
smear layer in terms of bond strengths (Toida,
Watanabe & Nakabayashi, 1995). When self-etching
primers are applied to the smear layer situated on the
tooth surface, the acid primer can simultaneously modify
or dissolve the smear layer and decalcify the dentin
(Watanabe & others, 1994a); this procedure produces
good adhesion both to enamel and dentin (Kanemura,
Sano & Tagami, 1999). Recent reports have demonstrated that some all-in-one systems bond well to thinner
smear layer covered dentin (Inoue & others, 2001;
Koase & others, 2004).
This study compared the microtensile bond strength
of four adhesive systems (including three all-in-one systems) after preparing the dentinal surface with either a
coarse or superfine diamond bur. The null hypothesis
was that there are no differences in microtensile bond
strengths to dentin prepared with either a coarse diamond bur or a superfine bur.
METHODS AND MATERIALS
Adhesives and Bonding Procedures
Twenty-four caries-free extracted human molars,
stored at 37C in distilled water, were used for this
study, in accordance with local institutional guidelines.
The coronal surfaces of the teeth were trimmed using a
319
Semeraro & Others: Effect of Different Bur Grinding on the Bond Strength of Self-etching Adhesives
model trimmer (MT-7 Morita Corp, Kyoto, Japan) in
order to form a long, flat dentin surface at the midcrown level. A smear layer was then created by removing a thin layer of the surface with a high-speed diamond bur under water-cooling. Twelve teeth were prepared with a regular-grit diamond bur (Diamond Point
FG, #106RD, Shofu, Kyoto, Japan), while the
remainder were prepared using a superfine-grit diamond bur (Diamond Point FG, #SF 106RD, Shofu Inc).
These two types of dentin substrates were randomly
assigned to one of the four bonding treatments carried
out according to the respective manufacturers instructions.
After applying the adhesive in each tooth, resin composite (Clearfil AP-X, Kuraray, Okayama, Japan) was
built-up incrementally (in three increments) to a height
of 5 mm. Each increment was light cured for 40 seconds, and the specimens were then stored in distilled
water for 24 hours at 37C.
Microtensile Bond Strength Testing
The specimens were sectioned into six slabs, approximately 0.7-mm thick, perpendicular to the bonded surface using a low-speed diamond saw (Isomet, Buehler,
Lake Bluff, IL, USA) under water. These slabs were
trimmed to an hourglass shape to form a gentle curve
along the adhesive interface from both sides, using a
superfine-grit diamond bur as described by Sano and
others (1994). The width at the narrowest portion was
approximately 1.4 mm, and the thickness of the bonded
area of each specimen was verified by a digital micrometer. The specimens were then attached to a Ciucchis
jig (Paul & others, 1999) with cyanoacrylate adhesive
(Model Repair II Blue, Dentsply-Sankin, Otahara,
Japan) connected to a desktop testing apparatus (EZ
test, Shimadzu, Kyoto, Japan).
Mode
PF
Mean (SD)
PF
49.04 (13.43)*
Mean (SD)
20
65.16 (13.96)*
20
G-Bond (GB)
33.21 (9.24)
18
27.00 (6.40)
16
SSB-200 (SSB)
32.20 (6.83)**
21
40.08 (4.98)**
23
15.28 (8.67)
20
7.60 (9.73)
19
11
Values marked with either * or with ** were significantly different from each other (p<0.05)
N= total number of specimens including the pre-testing failures
PF= pre-testing failure
320
Operative Dentistry
Figure 1. SEM photomicrograph of a typical (both regular and superfinegrit) specimen of GB showing interfacial fracture (I) between the hybrid
layer and the adhesive, as well as areas where the failure occurred within planes in the adhesive (A). In addition, blisters (arrowed) can be seen
in the adhesive.
Figure 2. SEM image of a typical PLP (of both regular and superfine-grit)
sample showing a cohesive fracture that occurred within the adhesive
layer.
within the adhesive. Those prepared with a superfinegrit bur displayed fractures at different planes within
the adhesivecohesive failure within the adhesive.
Semeraro & Others: Effect of Different Bur Grinding on the Bond Strength of Self-etching Adhesives
321
Figure 3A. SEM image of a dentin surface cut with a regular-grit diamond bur, conditioned with CSE, which was not light-cured, followed by
rinsing with acetone for 1 minute. The micrograph shows shows partial
removal of the smear layer and the peritubular dentin appears to be
slightly etched.
DISCUSSION
This study assessed the effect of different smear layers
generated by two different types of burs on the
microtensile bond strengths to dentin.
CSE performed significantly better with superfine cut
dentin. CSE primer partially dissolves the smear layer
as seen in Figures 3A and 3B. It was previously reported
Operative Dentistry
322
that a hybridized smear layer and hybridized dentin
were observed when using CSE (Tay & others, 2000).
CSE can penetrate the partially demineralized smear
layer and create a hybrid layer (Tay & others, 2000).
The greater porosity of intertubular dentin observed in
this study with the superfine-grit preparation implies
more channels of penetration of adhesive monomers.
This could be the reason for the greater bond strengths
achieved with the superfine diamond bur.
For GB, there were no differences in bond strengths
between the dentin cut with a regular-grit bur and
dentin cut with a superfine diamond bur. This may be
attributed to the similar mild removal of the smear
layer in both. Another reason there were no differences
in bond strengths may be the presence of blisters
within the adhesive resin. Blisters may create defects
within the adhesive resin during tension and initiate
the propagation of cracks within the adhesive. The
elimination of blisters should be important for producing
good bonding between the resin and dentin. Further
work is required to determine why blisters occur.
PLP was the only adhesive tested which had pretesting failures in both groups. In addition, PLP tended
to show the lowest bond strengths for both groups and
consistently demonstrated cohesive failure within the
adhesive. Although Figures 4A and 4B show complete
dissolution of the smear layer (due to the low pH of 0.8)
to expose the collagen fibrils, whether or not the subsequent penetration of resin monomers into the exposed
collagen web occurs is not clear. The authors speculate
that the relatively lower bond strengths with this adhesive suggest incomplete hybridization. Future studies
should focus on the quality of the resin-dentin interface
of this system.
Miyazaki M, Onose H & Moore K (2000) Effect of operator variability on dentin bond strength of two-step bonding systems
American Journal of Dentistry 13 101-104.
CONCLUSIONS
This study showed that the type of bur used to prepare
the dentinal surface may affect microtensile bond
strength when using some of the current all-in-one systems. Hence, the null hypothesis that there are no differences in microtensile bond strengths to dentin prepared with either a coarse diamond bur or a superfine
bur was rejected. In conclusion, when cutting dentin,
selecting the proper bur type is important for improving
the bond strength of some self-etching adhesive systems.
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