College of Dental Medicine Student Theses, Dissertations and Capstones

Document Type

Thesis

Degree Name

Master of Science (M.S.) in Dentistry

Department

College of Dental Medicine

First Advisor

Singer, Richard

Publication Date / Copyright Date

2014

Publisher

Nova Southeastern University. College of Health Care Sciences.

Abstract

Introduction: A critical issue and concern that has been documented in dentistry is the complexity of bonding to dentin, a fact that has been referred to as a less reliable technique due to the intrinsic characteristics of the dentin substrate. Effectiveness on dentin bonding is a clinical important approach for indirect bonded restorations in order to achieve a good adhesion that can surpass the test of time. Long-term clinical trials have shown that indirect bonded restorations have an increased risk of failure when using dentin as the major substrate. Consequently, an effort should be made to improve techniques and materials utilized in dentin bonding to make restorations more predictable and durable. Among these efforts, Immediate Dentin Sealing (IDS) a concept introduced in the late nineties-had demonstrated outstanding in vitro outcomes when tested on dentin in the field of adhesive dentistry. Even though there is moderate evidence in support of the utilization of IDS over the conventional (DDS) approach, few studies have really emphasized on the correct utilization of IDS on indirect bonded restorations. The purpose of this study was to evaluate and compare the microtensile bond strength of coronal dentin following the application of two different techniques (IDS versus conventional) and two different dentin bonding systems (4 th and 5th generation), when using indirect bonded restorations. Methods: After Institutional Review Board (IRB) approval, extracted sound human third molars were collected. Occlusal dentinal area was used for testing. Specimens were divided into 4 groups (n=20). Group 1: IDS using a 4th generation dentin bonding system (DBS); Group 2: IDS using a 5th generation DBS; Group 3: Conventional (DDS) using a 4 th generation DBS; and Group 4: DDS using a 5th generation DBS. All specimens were restored using a light-cure indirect micro ceramic/composite restorative material and stored on moist environment for 24 hours before testing. Each tooth was sectioned perpendicular to the bonding interface 1 x 1 x 10 mm beams. Specimens were subjected to microtensile bond strength test (μTBS). Statistical analysis was done using ANOVA comparing technique and bonding system. Results: For bonding techniques, the conventional technique exhibited lower strength than IDS, this difference being statistically significant (p = 0.0100). When bonding systems were compared 4th generation (Optibond FL) and 5th generation (Optibond Solo Plus), the higher mean was found with the 5th generation which was statistically significant (p =0.0121). In the conventional group when 4th generation and 5th generation are compared, the bond strength in the 5th generation was higher with this difference being statistically significant (p = 0.0024). In the IDS group, the bond strength was higher again in the 5th generation, however this difference was not statistically significant (p = 0.18). The results of two-way ANOVA for bonding system and technique, and interaction showed significant main effect for technique (p = 0.007) and dentin bonding system (p = 0.010). No significant interaction effect was found for dentin bonding system by technique (p = 0.797). Conclusions: The immediate dentin sealing IDS performed better than the conventional. The 5th generation bonding system performed better than the 4th generation bonding system. Restorative approach or technique immediate dentin sealing IDS versus conventional will increase significantly the bond strength of the dentin to indirect composite restorations of the tested adhesive systems.

Disciplines

Dental Materials | Dentistry | Medicine and Health Sciences

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