Marginal Integrity of Cervical Restorations with Caries-Affected Dentinal Walls: Effect of Contamination with Hemostatic Agents
AbstractObjectives: The aim of this study was to compare the microleakage in normal and caries-affected dentin (CAD) and to investigate the effect of three hemostatic agents on the microleakage of Class V composite resin restorations in CAD. Materials and Methods: Ninety-six Class V non-beveled cavities were prepared in 48 third molars at 1 mm below the cementoenamel junction (CEJ) in the cervical margin with the occlusogingival size of 2 mm, mesiodistal dimension of 3 mm, and a depth of 1.5 mm. Next, the teeth were divided into 8 groups (n=12): G1-4 included normal dentin (N) substrate, while G5-8 were exposed to mineralization/demineralization cycles to produce CAD substrate. Groups 1 and 5 were the controls. ViscoStat was used in groups 2 and 6, ViscoStat Clear was used in groups 3 and 7, while trichloroacetic acid (TCA) was used in groups 4 and 8. The cavities were restored with composite resin. The samples were sectioned after thermocycling and immersion in 2% fuchsin for 24 hours. The degree of dye penetration was evaluated under a stereomicroscope at 40× magnification. Data were evaluated using Kruskal-Wallis and Mann-U-Whitney tests in SPSS 15 software (α=0.05). Results: Significant differences were recorded on the mean microleakage of different groups (P=0.047). There was a significant difference in the mean dentinal microleakage between N and CAD groups (P=0.014). The dentinal microleakage in group 3 was significantly higher than that in groups 4 to 8. Conclusions: According to the results, CAD showed less microleakage in comparison with intact dentin. ViscoStat Clear caused a greater microleakage than did ViscoStat or TCA.
- Geerts S, Bolette A, Seidel L, Gueders A. An in vitro evaluation of leakage of two etch and rinse and two self-etch adhesives after thermocycling. Int J Dent. 2012 May;2012:852841.
- Khoroushi M, Mansoori M. Marginal sealing durability of two contemporary self-etch adhesives. ISRN Dent. 2012 Apr;2012:204813.
- Siso HS, Kustarci A, Goktolga EG. Microleakage in resin composite restorations after antimicrobial pre-treatments: effect of KTP laser, chlorhexidine gluconate and Clearfil Protect Bond. Oper Dent. 2009 May-Jun;34(3):321-7.
- Kumar P, Shenoy A, Joshi S. The effect of various surface contaminants on the microleakage of two different generation bonding agents: A stereomicroscopic study. J Conserv Dent. 2012 Jul-Sep;15(3):265-9.
- Kimmes NS, Olson TL, Shaddy RS, Latta MA. Effect of ViscoStat and ViscoStat Plus on composite shear bond strength in the presence and absence of blood. J Adhes Dent. 2006 Dec;8(6):363-6.
- Yazici AR, Tuncer D, Dayangac B, Ozgunaltay G, Onen A. The effect of saliva contamination on microleakage of an etch-and-rinse and a self-etching adhesive. J Adhes Dent. 2007 Jun;9(3):305-9.
- Chaiyabutr Y, Kois JC. The effect of tooth-preparation cleansing protocol on the bond strength of self-adhesive resin cement to dentin contaminated with a hemostatic agent. Oper Dent. 2011 Jan-Feb;36(1):18-26.
- Khoroushi M, Tavasoli M. The effect of trichloracetic acid as a hemostatic and etching agent on the morphological characteristics and shear bond strength of resin composite to enamel. Oper Dent. 2010 Mar-Apr;35(2):187-93.
- Bernades Kde O, Hilgert LA, Ribeiro AP, Garcia FC, Pereira PN. The influence of hemostatic agents on dentin and enamel surfaces and dental bonding: a systematic review. J Am Dent Assoc. 2014 Nov;145(11):1120-8.
- Arslan S, Ertas H, Zorba YO. Effect of a plant-based hemostatic agent on microleakage of self-etching adhesives. Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18(1):e124-9.
- Lewinstein I, Rotstein I. Effect of trichloracetic acid on the microhardness and surface morphology of human dentin and enamel. Endod Dent Traumatol. 1992 Feb;8(1):16-20.
- Aguilera FS, Osorio E, Toledano M, Osorio R. Ultra-structure characterization of self-etching treated cementum surfaces. Med Oral Patol Oral Cir Bucal. 2011 Mar 1;16(2): e265-70.
- Atoui JA, Chinelatti MA, Palma-Dibb RG, Corona SA. Microleakage in conservative cavities varying the preparation method and surface treatment. J Appl Oral Sci. 2010 Jul-Aug;18(4):421-5.
- Koibuchi H, Yasuda N, Nakabayashi N. Bonding to dentin with a self-etching primer: the effect of smear layers. Dent Mater. 2001 Mar;17(2):122-6.
- Tay FR, Pashley DH. Aggressiveness of contemporary self-etching systems. I: Depth of penetration beyond dentin smear layers. Dent Mater. 2001 Jul;17(4):296-308.
- Suyama Y, Luhrs AK, De Munck J, Mine A, Poitevin A, Yamada T, et al. Potential smear layer interference with bonding of self-etching adhesives to dentin. J Adhes Dent. 2013 Aug;15(4):317-24.
- Sirin Karaarslan E, Yildiz E, Cebe MA, Yegin Z, Ozturk B. Evaluation of micro-tensile bond strength of caries-affected human dentine after three different caries removal techniques. J Dent. 2012 Oct;40(10):793-801.
- Kuphasuk W, Harnirattisai C, Senawongse P, Tagami J. Bond strengths of two adhesive systems to dentin contaminated with a hemostatic agent. Oper Dent. 2007 Jul-Aug;32(4):399-405.
- Mohammadi N, Kimyai S, Bahari M, Pournaghi-Azar F, Mozafari A. Effect of aluminum chloride hemostatic agent on microleakage of class V composite resin restorations bonded with all-in-one adhesive. Med Oral Patol Oral Cir Bucal. 2012 Sep;17(5):e841-4.
- Tuncer D, Basaran S, Halacoglu DM, Yamanel K, Celik C, Arhun N. Effect of haemostatic agent application on the shear bond strength of contemporary/multi-mode adhesive systems. Oral Health Dent Manag. 2014 Mar;13(1):103-6.
- Ebrahimi SF, Shadman N, Abrishami A. Effect of ferric sulfate contamination on the bonding effectiveness of etch-and-rinse and self-etch adhesives to superficial dentin. J Conserv Dent. 2013 Mar-Apr;16(2):126-30.
- Rocha C, Faria-E-Silva A, Peixoto A. Bond strength of adhesive luting agents to caries-affected dentin. Oper Dent. 2014 Jul-Aug;39(4):383-8.
- Arrais CA, Giannini M, Nakajima M, Tagami J. Effects of additional and extended acid etching on bonding to caries-affected dentine. Eur J Oral Sci. 2004 Oct;112(5):458-64.
- Joves GJ, Inoue G, Nakashima S, Sadr A, Nikaido T, Tagami J. Mineral density, morphology and bond strength of natural versus artificial caries-affected dentin. Dent Mater J. 2013 Jan;32(1):138-43.
- Yoshiyama M, Urayama A, Kimochi T, Matsuo T, Pashley DH. Comparison of conventional vs self-etching adhesive bonds to caries-affected dentin. Oper Dent. 2000 May-Jun;25(3):163-9.
- Khoroushi M, Hosseini-Shirazi M, Farahbod F, Keshani F. Composite resin bond strength to caries-affected dentin contaminated with 3 different hemostatic agents. Gen Dent. 2016 Jul-Aug;64(4):e11-5.
- Erhardt MC, Toledano M, Osorio R, Pimenta LA. Histomorphologic characterization and bond strength evaluation of caries-affected dentin/resin interfaces: effects of long-term water exposure. Dent Mater. 2008 Jun;24(6):786-98.