12093
Cariology and Operative Dentistry, Department of Oral Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan;
Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand; 3Global
Center Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo
Medical and Dental University, Tokyo, Japan; and 4Division of Conservative Dentistry, Kings College London Dental Institute
at Guys, Kings and St Thomas Hospitals, Kings College London, London, UK
2
Abstract
Thitthaweerat S, Nakajima M, Foxton RM, Tagami
J. Effect of solvent evaporation strategies on regional bond
strength of one-step self-etch adhesives to root canal dentine.
International Endodontic Journal, 46, 10231031, 2013.
Introduction
Correspondence: Masatoshi Nakajima, Cariology and Operative Dentistry, Department of Oral Health Sciences, Tokyo
Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku,
Tokyo 113-8549, Japan (Tel.: +81(0)3 5803 5483; fax:
+81(0)3 5803 0195; e-mail: nakajima.ope@tmd.ac.jp).
2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
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demineralized matrix. Meanwhile, they play an important role in removal of water from the adhesive surface due to azeotropic dehydration (Van Landuyt et al.
2007, Loguercio et al. 2009). Air-drying after adhesive application can facilitate the evaporation of
water/solvent from the applied dentine substrate
(Spreafico et al. 2006) and thin the adhesive layer,
leading to diminishing amounts of water/solvent in
the adhesive layer (Zheng et al. 2001). However, complete water/solvent evaporation is difficult to achieve
in the clinical situation because the air-blowing procedure is restricted in the oral environment (Ikeda et al.
2005). Many studies have demonstrated that residual
water and solvent can dilute the monomer and inhibit
the polymerization reaction, resulting in a reduction of
bond strength (Galan et al. 1991, De Munck et al.
2005). Moreover, blister formation and higher permeability of the adhesive layer would occur, leading to a
reduction in the quality of adhesive interface (Hashimoto et al. 2005, Ferrari et al. 2008).
To improve the bonding performance of one-step
self-etch adhesives, many studies have investigated
solvent evaporation strategies using flat coronal dentine surfaces, such as using warm air stream (Galan
et al. 1991, Klein-Junior et al. 2008, Garcia et al.
2009, Reis et al. 2010), extending the air-drying time
(Furuse et al. 2008, Giannini et al. 2008, Ikeda et al.
2008, Garcia et al. 2009) and increasing the airpressure (El-Askary & Van Noort 2011). However, it
has been indicated that these evaporation strategies
were not enough to completely remove residual
water/solvent from the adhesive layer (De Munck
et al. 2005, Hashimoto et al. 2006).
Unlike coronal flat dentine surfaces, the root canal
dentine cavity appears to be a challenging bonding
substrate due to various factors, such as attenuation
of the light energy in the deeper region (Foxton et al.
2003, Aksornmuang et al. 2006, 2009, Mao et al.
2011) and limited accessibility to the root canal post
for bonding application and/or solvent evaporation
(Schwartz 2006, Breschi et al. 2009), which could
adversely affect the adhesive performance to root
canal dentine. Moreover, due to the narrower orifice
of the post cavity and/or further distance from the
air-blowing source to deeper region, efficient water/
solvent evaporation would deteriorate in the deeper
region. Spreading of the adhesive by air-blowing
would contribute to better solvent evaporation of the
adhesives and more polymerization (Galan et al.
1991). El-Askary & Van Noort (2011) have mentioned that increasing the distance from the dentine
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2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
Table 1 The chemical compositions and bonding procedure of the materials used in this study
Materials
Chemical compositions
Bonding procedure
Apply a mixture of liquid
A&B and leave for 20 s,
strong air blow for 10 s,
Light cured for 20 s
10-MDP, 10-Methacryloyloxydecyl dihydrogen phosphate; HEMA, 2-hydroxyethyl methacrylate; Bis-GMA, 2,2-bis[4-(2-hydroxy-3methacryloyloxypropoxy)phenyl]propane; CQ, Camphorquinone; BPO, Benzoyl peroxide; TEGDMA, Triethylene glycol dimethacrylate.
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Fracture analysis
After testing, both the resin and dentine sides of the
fractured beams were mounted on brass tablets and
gold sputter-coated. Fracture surfaces were observed
using a scanning electron microscope (JSM-5310;
JEOL, Tokyo, Japan) at magnifications of 150 and
500. The failure mode was classified as one of the following: adhesive failure, cohesive failure in resin,
cohesive failure in dentine and mixed adhesive. To
observe the presence of blister formation in each root
canal region within the adhesive layer, adhesive failure areas in the fractured beams were observed using
SEM at the magnification of 500.
Statistical analysis
Three-way ANOVA was performed to evaluate interactions among the three variables (material tested, solvent evaporation strategy, root region), and the
Duncan post hoc test was used for multiple comparisons (a = 0.05). The failure mode data were analysed
using the chi-squared test. All statistical analyses
were performed using SPSS software version 17 (SPSS
Inc., Chicago, IL, USA).
Results
The means and standard deviations of the regional
microtensile bond strengths of the materials and evaporation strategies are illustrated in Table 2. Threeway ANOVA revealed that material tested, solvent evaporation strategy and root region significantly affected
the lTBS to root canal dentine (P = 0.002,
P < 0.0001 and P < 0.0001, respectively). Significant
interactions between evaporation technique and root
Table 2 The lTBS to root canal dentin in each resin core system, evaporation technique and root region. There were significant differences in lTBS between coronal and apical region, except in APA group of Clearfil DC Core Plus (P > 0.05).
Materials
Root regions
(n = 12)
Coronal
Apical
Coronal
Apical
AP
APA
28.01 3.971A
P < 0.05
20.78 2.871a
29.15 3.081A
P < 0.05
24.21 2.941b
38.39 4.282A
P < 0.05
26.79 3.612a
38.43 4.232A
P < 0.05
28.52 4.172a
38.40 3.422A
P < 0.05
30.86 3.333a
38.72 3.482A
P < 0.05
32.05 3.973a
38.73 3.502A
P < 0.05
31.56 3.843a
39.00 3.842A
NS
36.53 3.434b
The same superscript number indicates no significant differences in lTBS for each row, while the same superscript capital and
small letter indicates no significant differences within each column at coronal and apical region (P > 0.05).
P, paper point; A, air blow; AP, air blow+ paper point; APA, air blow+ paper point+ air blow.
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2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
Figure 1 The percentages of failure modes for each root region in different evaporation techniques. There were significant
differences in failure mode among different evaporation techniques at the apical regions in both materials.
Discussion
Clinically, the placement of a post is critical for the
restoration of root filled teeth (Schwartz & Robbins
2004). However, post placement was not performed
in this study because the focus was on evaluating the
bonding performance of one-step self-etch adhesives
to root canal dentine. Aksornmuang et al. (2011)
recently reported that post placement decreased the
bond strength due to the increase of C-factor and
increased the number of pretesting failure specimen
comparing with no post placement.
Push-out tests and microtensile tests have been used
for the assessment of bonding to root canal dentine.
Push-out tests are useful to evaluate the retention of
posts luted in root canals (Van Meerbeek et al. 2010),
but the measured value includes a friction effect as well
as the bonding effect (Goracci et al. 2005, Faria-e-Silva
et al. 2008). On the other hand, microtensile tests can
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(a)
(b)
(c)
(d)
Figure 2 Representative SEM micrographs of the adhesive and/or mixed failure among solvent evaporation strategies at the
apical region of post space in Clearfil DC Core Automix (left) and Clearfil DC Core Plus (right); a) The paper point application
only [P]; b) The air-blowing only [A]; c) The use of paper point without additional air-blowing [AP]; d) The use of paper point
with additional air-blowing technique [APA]. Numerous blisters formation could be found when the adhesive was air blown
solely and only the paper point was used, while the use of paper point with additional air-blowing produced few blister formation within adhesive layer. The smaller size of blister formation was found in Clearfil DC Core Plus comparing to Clearfil DC
Core Automix.
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Conclusion
Within the limitations of this study, it can be
concluded that the use of paper points with additional
air-blowing for removing excessive adhesive and
evaporating residual water/solvent would be effective
in producing higher bond strength for one-step selfetch adhesives (Clearfil Tri-S Bond Plus and Clearfil
DC Bond) and fewer blister formations in deeper
regions of the post space.
Acknowledgements
The authors gratefully acknowledge the financial support
received from the Japanese Ministry of Education, Global
Center of Excellence (GCOE) Program, International
Research Center for Molecular Science in Tooth and
Bone Diseases, Tokyo Medical and Dental University.
References
Aksornmuang J, Nakajima M, Foxton RM, Tagami J (2006)
Effect of prolonged photo-irradiation time of three self-etch
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1031
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