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INFLUENCE OF DESENSITIZING AGENTS ON THE MICROSHEAR


BOND STRENGTH OF ADHESIVE SYSTEMS TO DENTIN

Fernando A. Maeda1, Ana P.A. Guedes2, Anderson Catelan2, Sabrina Pavan1,


André L.F. Briso2, Renato H. Sundfeld2, Paulo H. dos Santos1
1
Department of Dental Materials and Prosthodontics.
2
Department of Restorative Dentistry. São Paulo State University –
Araçatuba School of Dentistry, UNESP, Brazil.

ABSTRACT dentin adhesive application. Z250 composite resin tubes were


The aim of this study was to evaluate the effect of desensitiz- bonded on the treated surface. After 24 hours, the teeth were
ing agents on the micro-shear bond strength of adhesive tested in a universal machine. Data were submitted to ANOVA
systems to dentin. Forty bovine teeth were divided into 8 and Tukey’s test (5%). The results showed that the groups
groups (n=5): G1 - Single Bond (SB); G2 - G.H.F. + SB; G3 - where Desensibilize and Dessensiv were applied exhibited
Desensibilize + SB; G4 - Dessensiv + SB; G5 - Single Bond 2 smaller bond strength values.
(SB2); G6 - G.H.F. + SB2; G7 - Desensibilize + SB2; G8 -
Dessensiv + SB2. In all of the groups, the desensitizing agents Key words: desensitizing agents, dentinal adhesive, micro-
were applied after phosphoric acid etching and before the shear bond strength.

INFLUÊNCIA DOS AGENTES DESSENSIBILIZANTES SOBRE A RESISTÊNCIA


AO MICRO-CISALHAMENTO DE SISTEMAS ADESIVOS PARA DENTINA

RESUMO aplicação adesiva. A resina composta Z250 foi colocada


O objetivo deste estudo foi avaliar o efeito dos agentes sobre a superfície tratada. Após 24 horas, os dentes foram
dessensibilizantes sobre a resistência de micro-cisalhamento submetidos ao teste em uma máquina universal. Os dados
de sistemas adesivos à dentina. Quarenta dentes bovinos foram submetidos à ANOVA e teste de Tukey (5%). Os resul-
foram divididos em 8 grupos (n = 5): G1 - Single Bond (SB); tados mostraram que os grupos onde foram aplicados
G2 - GHF + SB; G3 - Desensibilize + SB; G4 - Dessensiv + Desensibilize e Dessensiv exibiram menores valores de
SB; G5 - Single Bond 2 (SB2); G6 - GHF + SB2; G7 - Desen- resistência ao micro-cisalhamento.
sibilize + SB2; G8 - Dessensiv + SB2. Em todos os grupos,
os agentes dessensibilizantes foram aplicados após o condi- Palavras chave: agentes dessensibilizantes, adesivos denti-
cionamento da dentina com ácido fosfórico e antes da nários, micro-cisalhamento.

INTRODUCTION gingival recession or periodontal therapy7. Abrasion


Post-operative sensitivity is commonly found in vital is the most common loss of dental structure, caused
teeth after the use of adhesive systems that require by brushing techniques and the use of abrasive tooth-
acid etching. Some clinical studies have revealed the paste. Abfraction is the loss of current dental struc-
presence of post-operative discomfort in up to 14% tures, caused by traumatic occlusion loads. Erosion
subjects after the restorative procedure1,2. is the chemical dissolution of the dental structure,
Dentin sensitivity (DS) is a great challenge to the frequently caused by gastric acids, diet or the dental
dentist3,4. It is a painful clinical condition that affects environment. DS can also be a post-operative com-
40 million Americans who present some kind of dis- plication associated with dental procedures.
comfort at any time during their life5. Murray6 Morphological and physiological studies suggest
(1994) reported that the mean prevalence of sensi- that dentin hypersensitivity results from exposure
tive teeth is 14.8% in six countries around the world. of dentin surfaces to the oral environment8,9. Nowa-
Exposed dentin can be sensitive to mechanical, ther- days, the most accepted theory to explain DS is the
mal or osmotic stimuli. The non-carious etiologies hydrodynamic theory of Brännström10 (1992), who
for DS are abrasion, abfraction or erosion lesions, suggested that dentin sensitivity originates after the

Vol. 22 Nº 1 / 2009 / 41-45 ISSN 0326-4815 Acta Odontol. Latinoam. 2009


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42 Fernando A. Maeda, Ana P. A. Guedes, Anderson Catelan et al.

Table 1: Materials used in this study

Materials Composition Manufacturer Batch #


Adper Single Bond Bis-GMA, HEMA, ethanol, water 3M ESPE, St. Paul, MN, USA 1GA

Adper Single Bond 2 Bis-GMA, HEMA, dymetacrylate, 3M ESPE, Irvine, CA, USA HYK
ethanol, water,

Z-250 Bis-GMA, UDMA, Bis-EMA, 3M ESPE, St. Paul, MN, USA 5RF
Zircon/silica

Tooth Conditioner Gel 37% Phosphoric acid Dentsply Latin America, 242437
Petrópolis, RJ, Brazil

Desensibilize Strontium chloride, potassium FGM Produtos Odontológicos, 02 Mar 05


nitrate, water, thickener and Joinville, SC, Brazil
humectant

Dessensiv Potassium oxalate, potassium S.S.White, Rio de Janeiro, RJ, 003


fluoride, potassium nitrate, Brazil
hydroxyethylcellulose,
phosphoric acid and water

G.H.F. Glutaraldehyde, HEMA Biodinâmica, Ibiporã, PR, Brazil 479/05

displacement of the tubular fluid, stimulating a Tooth preparation


nerve receptor, which results in the transmission of Forty bovine incisors were stored in distilled water
the stimuli10. at room temperature for 1 month until the beginning
Based on this hypothesis, desensitizing agents have of the study. The teeth were cleaned and polished
been used for treatment of DS. These agents have using pumice and water with a brush in a low-speed
different mechanisms of action, but generally seek to handpiece. The roots were sectioned and the crowns
obliterate the dentin tubules, precipitate proteins that embedded in acrylic resin (Clássico, Dental Prod-
constitute Tomes process (silver nitrate, zinc chlo- ucts, São Paulo, SP, Brazil) in PVC tubes, with the
ride), inhibit the formation and deposition of crystals buccal surface 1 mm above the edge of the tube.
in the mouth and interior of the dentin tubules (fluo- The buccal surface of each tooth was ground with
ride compounds, strontium chloride, potassium wet 180-, 400-, and 600-grit silicon carbide abra-
oxalate), or cover the dentin by impregnation of the sive paper in a horizontal grinder (APL-4, Arotec,
tubules. Finally, some agents employ dentin bonding São Paulo, SP, Brazil) until a dentin surface was
agents with and without resin-based composite11,12. exposed. The exposed dentin surface was then
Few studies evaluating the effect of desensitizing examined using a 63X stereoscopic loupe (Carl
on micro-shear bond strength of bonding agents to Zeiss, Jena, Germany) for complete removal of
dentin have been reported in the literature. Thus, enamel. Teeth were randomly divided into 8 groups
this study evaluated the influence of some desensi- (n=5), according to the bonding procedures.
tizing agents on the bond strength of adhesive sys-
tems to dentin. Bonding procedures
All the samples were etched with 37% phosphoric
MATERIALS AND METHODS acid for 15 seconds and rinsed with water for 20
The compositions, manufacturers and batch num- seconds. The surfaces were gently dried with
bers of the materials used in this study are listed in absorbing paper and submitted to the procedure
Table 1. described below (Table 2).

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Influence of desensitizing agents on the microshear... 43

Z250 composite resin cylinders


Table 2: Bonding procedures in the tested groups
were prepared inserting the
composite in Tygon-Micro- Group Desensitizing agent Wash Adhesive
bone (TGY-030, Small Parts G1 None None Single Bond
Inc.) tubes, 0.7 mm in internal G2 G.H.F. (30s) rinsed in water (60s) Single Bond
diameter and 0.7 mm in height, G3 Desensibilize (10 min) rinsed in water (60s) Single Bond
and photo-cured for 20 seconds G4 Dessensiv (30s) rinsed in water (60s) Single Bond
using Ultralux (Dabi Atlanti,
G5 None None Single Bond 2
Ribeirão Preto, Brazil) with
500 mW/cm2, and the tip posi- G6 G.H.F. (30s) rinsed in water (60s) Single Bond 2
tioned close to the Tygon G7 Desensibilize (10 min) rinsed in water (60s) Single Bond 2
microtubes. After the proce- G8 Dessensiv (30s) rinsed in water (60s) Single Bond 2
dure, the tubes were removed
carefully. Three cylinders of
Z250 composite resin were bonded with the dentin Dessensibilize and Dessensiv, decreased the micro-
adhesive in each prepared tooth in all of the groups. shear bond strength for Single Bond (16.04 ± 2.91
All teeth were stored in distilled water for 24 hours MPa; 14.85 ± 2.11 MPa) and Single Bond 2 (15.02 ±
at 37ºC. 0.75 MPa; 15.97 ± 2.51 MPa) (p<0.05). These results
are shown in Fig. 1.
Microshear bond test Fig. 2 demonstrates that, in all of the studied groups,
The samples were submitted to micro-shear bond there was no statistically significant difference in
testing in a universal machine EMIC (model DL micro-shear bond strength between the two dentin
3000) operated at 0.5 mm/minute. For this proce- adhesives (p>0.05).
dure, an orthodontic wire - 0.3 mm in diameter and
5 mm in length - was used to form a loop involving DISCUSSION
the composite cylinder in the bonded area, induc- The choice of dentin adhesive should consider both
ing a tensile effort which generated a shear move- its final adhesion to dentine and its capacity to resist
ment. The micro-shear bond strength was calculated the stress generated by the polymerization of the
by the following formula: restoring material13, in order to avoid the invasion
R = F/A where: R is the micro-shear bond strength; of bacteria and post-operative sensitivity.
F is the applied force; and A is the bonded area. Dentin desensitizing agents have been used before
The micro-shear bond strength values were submit- the application of dentin adhesives that require acid
ted to two-way ANOVA and the
averages compared by Tukey’s
test (5%).

RESULTS
For Single Bond dentin adhe-
sive, the control (23.79 ± 4.58
MPa) and G.H.F. (20.68 ± 3.82
MPa) groups exhibited the high-
est values of micro-shear bond
strength, with no statistical dif-
ference between them (p>0.05).
Similarly, these groups present-
ed the highest values when Sin-
gle Bond 2 was used as dentin
adhesive (22.51 ± 2.13 MPa; Fig. 1: Micro-shear bond strength, comparing the groups for both Single Bond and
20.39 ± 4.28 MPa, respectively). Single Bond 2 dentin adhesives. Bars with different letters are statistically different
The application of the agents, (p<0.05).

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44 Fernando A. Maeda, Ana P. A. Guedes, Anderson Catelan et al.

adhesives under study. Desensi-


bilize contains strontium chlo-
ride in its composition; the
decrease in bond strength
observed with this material may
be due to the deposition of crys-
tals, formed by the change in the
calcium of the dentine as a
result of its interaction with
strontium. Seara23 et al. (2002)
reported that the formation of
acid-resistant crystals is caused
by the reaction between stron-
tium chloride and dentin and
Fig. 2: Micro-shear bond strength, comparing the Single Bond and Single Bond 2 could inhibit, chemically and/or
dentin adhesives for all the treated groups. Bars with different letters are statistically
different (p<0.05).
physically, the permeability of
dentin and mechanical retention
among the resinous monomers
etching, to prevent dentin sensitivity. According to in the dentin. Permeability would be one of the most
Brannström’s Hydrodynamic theory10 (1992), important factors in incomplete infiltration of the
dentin sensitivity originates from the dentinal fluid adhesive, decreasing the bond strength to dentin24. In
displacement due to dentin exposure. Within this some studies, the use of desensitizing agents reduced
context, desensitizing agents act as a type of plo- dentin permeability by 80%25-27.
sive, obliterating the dental tubules. The application of Dessensiv caused a decrease in
G.H.F. is a desensitizing agent, containing glu- the micro-shear bond strength for both adhesives
taraldehyde and HEMA. Glutaraldehyde is believed when compared with the control groups (Fig. 1).
to provoke dentinal fluid protein coagulation, and This effect could be attributed to the presence of
coagulation is facilitated by HEMA that is highly potassium oxalate, which reacts with the dentin,
water soluble.14,15 forming calcium oxalate crystals. This result is in
Some researchers have reported the clinical efficien- keeping with Al Qahtani28 et al. (2003) and Have-
cy of glutaraldehyde and HEMA containing products man & Charlton29 (1994), who obtained lower val-
in the treatment of dentin hypersensitivity16,17. Prior ues when desensitizing materials with potassium
application of G.H.F. did not show any statistical dif- oxalate in their composition were used.
ference with the control groups for both the adhe- The compositions of Single Bond and Single Bond
sives under study (Figure 1). These results agree with 2 dentin adhesives are similar, with the latter includ-
those obtained by Cobb18 et al. (1997), Reinhardt19 et ing 10% w/w spherical 5 nm diameter silica parti-
al. (1995) and Soeno20 et al. (2001), who used a prod- cles. It is suggested by the manufacturer that the
uct containing glutaraldehyde and HEMA, that did nanoparticles may create a more uniform hybrid
not interfere in the bonding of resinous cements to layer, and contribute to increasing the bond strength
the dentine. In our study, however, the product was to dentin. However, in our study, no difference in
applied before acid conditioning. the micro-shear bond strength was observed, even
The efficiency of adhesion is related to factors such in the treated groups (Fig. 2).
as viscosity and degree of conversion of the adhesive
and the collapse of the collagen fibril mesh that may CONCLUSION
hinder the penetration of the monomers into the inter- The results obtained in this study suggest that
fibril spaces and the complete involvement of the col- G.H.F. does not interfere in the micro-shear bond
lagen fibrils exposed for conditioning etching21,22. strength of dentin adhesives to dentin; however, the
The groups treated with Desensibilize demonstrated desensitizing agents, Desensibilize and Dessensiv,
a reduction in bond strength that was statistically sig- reduced the bond strength when Single Bond and
nificant in relation to the control groups for both Single Bond 2 were used.

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Influence of desensitizing agents on the microshear... 45

CORRESPONDENCE
Dr. Paulo Henrique dos Santos
Department of Dental Materials and Prosthodontics
Araçatuba School of Dentistry - UNESP
Rua José Bonifácio, 1193 Araçatuba - SP. Brazil
Zip code: 16015-050
paulosantos@foa.unesp.br

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Vol. 22 Nº 1 / 2009 / 41-45 ISSN 0326-4815 Acta Odontol. Latinoam. 2009