A self-etch bonding system with potential to eliminate selective etching and resist proteolytic degradation

Rana Alkattan; Reem Ajaj; Garrit Koller; Subir Banerji; Sanjukta Deb

doi:10.1016/j.jdent.2023.104501

A self-etch bonding system with potential to eliminate selective etching and resist proteolytic degradation

J Dent. 2023 May:132:104501. doi: 10.1016/j.jdent.2023.104501. Epub 2023 Mar 24.

Authors

Rana Alkattan¹, Reem Ajaj², Garrit Koller³, Subir Banerji⁴, Sanjukta Deb⁵

Affiliations

¹ Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia; Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 17, Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK.
² Department of Restorative Dentistry, Biomaterials Division, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia; Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 17, Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK.
³ Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 17, Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK; Centre for Host Microbiome Interactions, King's College London Dental Institute at Guy's Hospital, King's Health Partners, London, UK; London Centre for Nanotechnology, London, UK.
⁴ Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 17, Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK; Department of Prosthodontics, University of Melbourne, Melbourne, Australia.
⁵ Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Floor 17, Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK. Electronic address: sanjukta.deb@kcl.ac.uk.

PMID: 36967082
DOI: 10.1016/j.jdent.2023.104501

Abstract

Objectives: Bonded restorations using self-etch (SE) systems exhibit a limited lifespan due to their susceptibility to hydrolytic, enzymatic or fatigue degradation and poor performance on enamel. This study was conducted to develop and assess the performance of a two-step SE system using a functional monomer bis[2-(methacryloyloxy)ethyl]phosphate (BMEP) and demonstrate a strategy to enhance stability of bonded resin composite restorations to both enamel and dentine.

Methods: A two-step SE system was formulated with a primer containing BMEP, with an adhesive with or without BMEP, and compared to a commercial 10-MDP-containing system, Clearfil^TM SE Bond 2 (CFSE). The systems were evaluated on enamel for surface roughness and microshear bond strength (µSBS) and on dentine for microtensile bond strength (µTBS), nanoleakage, MMP inhibition and cyclic flexural fatigue.

Results: Whilst all bonding systems resulted in statistically similar µSBS, BMEP-based primers yielded greater enamel surface roughness than the CFSE primer. The BMEP-free adhesives resulted in statistically similar or higher µTBS and lower nanoleakage compared to CFSE. In situ zymography revealed minimal to no MMP activity within the hybrid layer of BMEP-based systems. The BMEP-free adhesive exhibited flexural strength and fatigue resistance statistically similar to CFSE.

Conclusions: Incorporation of BMEP in the primer led to satisfactory bond strengths with both enamel and dentine, potentially eliminating the need for selective enamel etching. Combined with an adhesive formulation that is solvent-free and hydrophobic, and confining the acidic functional monomer in the primer resulted in minimal interfacial leakage, and resistance to proteolytic degradation and the cyclic nature of chewing.

Clinical significance: The SE bonding system containing BMEP combines the potent etching of phosphoric acid with the therapeutic function of the phosphate-based monomer in creating a homogenous hybrid layer with protection against endogenous proteolytic enzymes. This strategy may overcome current challenges that arise during selective enamel etching.

Keywords: Adhesives; Degradation; Dental etching; Dental leakage; Fatigue; Matrix metalloproteinases (MMPs).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Dental Bonding*
Dental Cements*
Dentin-Bonding Agents / chemistry
Materials Testing
Peptide Hydrolases
Phosphates
Resin Cements / chemistry
Surface Properties
Tensile Strength

Substances

Dental Cements
Dentin-Bonding Agents
Resin Cements
5-(6)-carboxyfluorescein diacetate succinimidyl ester
Peptide Hydrolases
Phosphates