Efficacy of photodynamic therapy, photobiomodulation and antimicrobial agent on the shear bond strength of composite restorations to hypomineralized teeth

Abdulrahman Al Saffan; Harisha Dewan; Hitesh Chohan; Mohammed Mustafa; Sunil Babu Kotha; Abdulaziz A Al Kheraif

doi:10.1016/j.pdpdt.2021.102188

Efficacy of photodynamic therapy, photobiomodulation and antimicrobial agent on the shear bond strength of composite restorations to hypomineralized teeth

Photodiagnosis Photodyn Ther. 2021 Mar:33:102188. doi: 10.1016/j.pdpdt.2021.102188. Epub 2021 Jan 23.

Authors

Abdulrahman Al Saffan¹, Harisha Dewan², Hitesh Chohan³, Mohammed Mustafa⁴, Sunil Babu Kotha⁵, Abdulaziz A Al Kheraif⁶

Affiliations

¹ Preventive Department, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia. Electronic address: A@riyadh.edu.sa.
² Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.
³ Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia.
⁴ Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O.Box 173, Al-Kharj 11942, Saudi Arabia.
⁵ Preventive Dentistry Department, Pediatric Dentistry Division, Riyadh Elm University, Riyadh, Saudi Arabia.
⁶ Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box 10219, Riyadh 11433, Saudi Arabia.

PMID: 33497813
DOI: 10.1016/j.pdpdt.2021.102188

Abstract

Purpose: The aim of this study was to investigate the adhesive bond strength and fracture analysis of resin based restorations to carious dentin of hypomineralized molars (HMs) after disinfecting with photodynamic therapy (PDT), Nd:YAG and chlorhexidine (CHX).

Materials and methods: Sixty carious HM molars were investigated. After removal of all carious infected tissue, the cavities were condition with methylene blue initiated PDT, a 1064 nm wavelength Nd:YAG laser or 2.0% CHX gel. Non-carious dentin from HM was used as a control without performing any disinfection or conditioning technique. All samples were bonded using a one-step one-coat adhesive bond over the dentin surface, packed with composite and light cured. All specimens were subjected to thermocycling at 5°C and 60°C with a dwell time of 30 s for 10,000 cycles. Bonded specimens were placed on a universal testing machine with a flat loading head. The debonded surface were viewed under light optical microscope to estimate the type of failure including adhesive, cohesive, and admixed.

Results: The highest mean SBS was seen in the non-carious HM (control group). The mean score for control group was 17.64 ± 2.96 MPa. The lowest bond strength value was displayed for Group-PDT (11.37 ± 3.66 MPa) and Group-Nd:YAG (12.69 ± 2.45 MPa). Affected dentin disinfected with the Group-CHX (15.71 ± 3.04 MPa) bonded with composite showed statistically significantly higher SBS values compared to the laser groups (p < 0.05). No statistically significant difference was noted with specimens disinfected with PDT and Nd:YAG laser showed comparable SBS scores (p > 0.05). Fracture analysis showed equal incidence of adhesive and cohesive failures in control group and Group-CHX. Moreover, a significant number of failures in group-PDT were related to adhesive. Whereas in group 4, admixed type failures were common.

Conclusion: Caries infected hypomineralized teeth demonstrated lower bond strength values compared to non-carious hypomineralized teeth. Adhesive bond strength of hypomineralized teeth was highest with chlorhexidine compared to other laser treatment strategies.

Keywords: Bond strength; Chlorhexidine; Failure; Hypomineralized molars; Laser; Photodynamic therapy.

MeSH terms

Anti-Infective Agents*
Composite Resins
Dentin
Low-Level Light Therapy*
Materials Testing
Photochemotherapy* / methods
Photosensitizing Agents / therapeutic use

Substances

Anti-Infective Agents
Composite Resins
Photosensitizing Agents