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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 17  |  Issue : 2  |  Page : 60-63

Influence of antioxidant agents on shear bond strength of composite resin to the bleached human enamel: an in-vitro study


Department of Operative Dentistry, Al-Azhar University (Assiut Branch), Assiut, Egypt

Date of Submission27-Aug-2019
Date of Acceptance28-Dec-2019
Date of Web Publication26-Sep-2020

Correspondence Address:
Ahmed A. Abd El-Ghany Abd El-Aal
Lecturer of Operative Dentistry, Al-Azhar University (Assiut Branch) Assiut
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tdj.tdj_38_19

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  Abstract 

Background
Composite restoration success and longevity after bleaching are mainly affected by bond strength which is severely decreased. Many studies have found that bond strength postbleaching is clearly reduced and suggested that bonding procedure should be delayed by a periods varying from 1 day to 3 weeks. Other studies have recorded that antioxidants can increase the bonding strength of composite resin to recently bleached enamel.
Aim
To estimate the effect of different antioxidants on shear bond strength of composite resin to bleached human enamel.
Materials and methods
A total 50 maxillary human central incisors were used in the study and classified into five groups as follow; group 1: unbleached (control group) bonding procedure performed without bleaching. Group 2: a carbamide peroxide 35% of bleaching gel followed by immediate composite bonding. Group 3: 35% of carbamide peroxide bleaching agent followed by delayed bonding procedure 3 weeks later. Group 4: 35% of carbamide peroxide bleaching agent followed by application of 10% of sodium ascorbate. Group 5: 35% of carbamide peroxide bleaching agent leaf extract of Aloe Vera (an antioxidant), for 10 min.
Results
Group 1 recorded the highest mean shear strength value (16.34602 ± 2.6402), while the least mean shear value was recorded for group 2 (9.971 ± 0.6837). Group 3 registered mean shear strength value 12.959 ± 2.279, group 4 recorded mean shear strength value 11.7691 ± 2.0984, and group 5 recorded mean shear strength value 13.8939 ± 2.6837 Mpa.
Conclusion
The leaf extract of Aloe Vera as 10% sodium ascorbate for 10 min could reverse the side effect of the bleaching agent, and enable practitioners to perform bonding procedures without delay.

Keywords: antioxidants, bleached enamel, shear bond strength


How to cite this article:
Abd El-Aal AA, Morsy AS. Influence of antioxidant agents on shear bond strength of composite resin to the bleached human enamel: an in-vitro study. Tanta Dent J 2020;17:60-3

How to cite this URL:
Abd El-Aal AA, Morsy AS. Influence of antioxidant agents on shear bond strength of composite resin to the bleached human enamel: an in-vitro study. Tanta Dent J [serial online] 2020 [cited 2020 Oct 31];17:60-3. Available from: http://www.tmj.eg.net/text.asp?2020/17/2/60/296177


  Introduction Top


Success and longevity of composite restoration is affected by bond strength after bleaching the shear bond strength dramatically decreased [1], so delayed bonding to tooth structure was recommended. Presences of residual peroxides are weakening the bond strength superficially and internally [2],[3],[4],[5], because it interferes with resin tags inhibiting the resin polymerization.

Many studies confirmed that bond strength after bleaching is significantly decreased and recommended to delay bonding procedures by a periods varying from 1 day to 3 weeks. Trials were done to allow immediate bonding by using alcohol treatment to enamel before bonding to remove the outermost enamel layer, then used organic solvent containing adhesives [6],[7],[8]. Other studies were reported that antioxidants can increase bond strength of composite resin to bleached enamel [9].

The antioxidants can reestablish the previously altered redox potential of the oxidized bonding substrate thus permitting the polymerization of the adhesive free radicals and that could occur with ascorbic acid derivatives [10], Aloe Vera has antioxidant, antibacterial and anti-inflammatory properties, as it contains ascorbic acid, anthraquinones which has antioxidant property [11],[12], so this study is conducted to evaluate the effect of different antioxidants on shear bond strength of composite resin to bleached human enamel.


  Materials and Methods Top


A total 50 maxillary human central incisors were used in the study. The teeth were extracted for periodontal reasons in duration of 3 months. Patients' average age was 35 ± 5. No history of bleaching or restorations of the selected teeth, and the teeth were free from caries, noncarious lesions and cracks. All debris was removed by ultrasonic scaler, and the teeth were stored in distilled water till time of the study. Root separation of the teeth was performed by using diamond disc with coolant (FIEFICO, Geneva City, Switzerland), at the junction of cementoenamel. Removal of the coronal pulp and light body of elastomeric impression material was used to fill the chamber of coronal pulp to prevent self-cured acrylic resin from penetration to pulp chamber. Self-cured resin was packed in aluminum holder and the specimen were placed in the resin to 2 mm depth and waiting until the resin has completely cured then the specimen was placed in cold water.

The specimens were divided into five groups (n = 10) the teeth were divided randomly.

Group 1: unbleached enamel (control group).

Group 2: 35% of carbamide peroxide bleaching agent gel (Opalescence; Ultradent Products Inc., South Jordan, Utah City, USA) was applied on the enamel of labial surfaces of the samples for 30 min and rinsed with water for 30 s, then immediate bonding without any antioxidant treatment.

Group 3: a carbamide peroxide 35% of bleaching agent in gel form (Opalescence; Ultradent Products Inc.) was applied on the enamel of labial surfaces of the samples for 30 min and rinsed with distilled water for 30 s, and then delayed bonding procedure, after 3 weeks.

Group 4: 35% of carbamide peroxide bleaching agent gel (Opalescence; Ultradent Products Inc.) was applied on the enamel labial surfaces of the samples for 30 min and rinsed with distilled water for 30 s, followed by the application of 10% of sodium ascorbate (antioxidant) (FOODCHEM Inc., Shanghai, China), for 10 min. and rinsing for 30 s with deionized water and then bonding procedure was immediately.

Group 5: 35% of carbamide peroxide bleaching agent gel (Opalescence; Ultradent Products Inc.) was applied on the labial surfaces of the samples for 30 min and rinsed with distilled water for 30 s, followed by the application of leaf extract of Aloe Vera (an antioxidant) (Hunan Nutramax Inc., Shanghai, China) for 10 min, and rinsing for 30 s with deionized water and bonding procedure was performed immediately.

The surface of enamel were etched with 37% phosphoric acid, Scotchbond etchant for 15 s and washed with air water spray for 20 s and then blot dried. A layer of the adhesive single bond 2 (3M ESPE, Paul, Minnesota, USA) was applied and translucent plastic tube of 4 mm length and 4 mm diameter (Henso Medical Co. Ltd, China) were placed over the adhesive covered specimen and light cured with an intensity of 800 mW/cm 2 (Woodpecker TMFreelightTM 2, St Paul, Minnesota, USA) for 20 s. Z 250 × T Nanohybrid composite resin (3M ESPE) as shown in [Table 1], was placed in the tube, each increment was cured for 20 s, two increments was placed to fill the tube of 2 mm thickness of each increment and calibrated by a periodontal probe, and then the tubes were cut by scalpel no. 15 and removed then the specimen was placed in distilled water for 24 h. The shear bond strengths were measured by using the NSTRON a universal testing machine (NSTRON Limited, Birmingham City, England) at a cross-head speed of 1.0 mm/min, as shown in [Figure 1]. One-way analysis of variance (ANOVA) test, followed by Turkey's honestly significant difference test were analyzing the statistical significance between the tested groups (P ≤ 0.05).
Table 1: The adhesive and composite resin were used in the study

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Figure 1: Specimen under universal testing machine.

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  Results Top


Group 1 recorded the highest mean shear strength value, while the least mean shear value was recorded for group 2 as shown in [Table 2]. One-way ANOVA showed statistically significant difference between the tested groups (P ≤ 0.05).
Table 2: Mean value of shear bond strength of the tested groups

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All the tested groups showed statistically significant difference according to one-way ANOVA test, as shown in [Table 2]. Turkey honestly significant difference in [Table 3] showed no statistically significant difference between groups 1 (control group) and group 5 (10% Aloe Vera extract), that resulted in improved shear bond strength, as well as the comparison between group 5 and group 3 (delayed bleaching), no statistically significant difference was found, and also group 4 (10% sodium ascorbate) when compared to group 5 (10% Aloe Vera extract) no significant difference was found (P ≤ 0.05).
Table 3: Turkey's honestly significant difference statistically analyzing significance between groups (P≤0.05)

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But group 2 (immediate bonding) registered the lowest shear bonding strength, and when it compared to groups 1, 3, 4, and 5, there was a significant difference. That result confirming the improvements occurred as a result of using antioxidants before bonding procedures as shown in [Table 3].


  Discussion Top


Dental bleaching is a conservative technique for discolored tooth treatment [13]. In the current study, there was significant decrease in shear bonding strength postbleaching, that is in agreement with Dishman et al.[14], and García-Godoy et al.[15], so it is recommended to delay the bonding procedure as concluded by Cavalli et al.[16]. The decrease in bond strength was explained by Demarco et al. [17] as it is due to the changes in the structure of the enamel leading to presence of erosive areas and porosity increased as the over etching appearance detected on enamel surfaces after bleaching. These changes in the structure of enamel was evaluated by Josey et al.[18] and Ben-amar et al.[19], they noticed that there was decrease in surface microhardness and the changes occurred in organic/inorganic ratio postbleaching with carbamide peroxide as it has a caustic effect.

A second explanation by McCracken and Haywood [20], Perdigao et al.[21], Hegedu et al.[22] and Adibfar et al.[23] for decreasing the shear bond strength postbleaching is presence of residual oxygen in enamel and it leached out by time, that the residual oxygen interferes with rein penetration to enamel and dentin preventing the polymerization of resin, this explanation is in agreement with the results of the current study, because of the improvements of shear bond strength of antioxidants application.

After 2 weeks of storage, the results of shear bond strength improved, that in agreement with Dabas et al.[24], and Titley et al.[11], that improvement may due to that the ions of peroxide decomposed and the substituted by hydroxyl ions entering the lattice of apatite again.

In the current study antioxidant could improve the shear bond strength significantly, that in agreement with Zhao et al.[10], they explained that by the antioxidants can reestablish the previously altered redox potential of the oxidized bonding substrate thus permitting the polymerization of the adhesive free radicals of and that could occur with ascorbic acid derivatives.

The current study recommended using of antioxidants for 1: 3 of the time of application of the bleaching agent, that in agreement with Lai et al.[7]. The current study also revealed that Aloe Vera and sodium ascorbate groups could significantly improve the shear bond strength after bleaching without delaying the bonding procedures, and both has similar effect, that in agreement with Vinothkumar et al.[12].


  Conclusion Top


The leaf extract of Aloe Vera as 10% sodium ascorbate for 10 min could reverse the side effect of the bleaching agent, and enable practitioners to perform bonding procedures without delay.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Yoon M, Burrow MF, Wong R, Parashos P. Effect of sodium ascorbate on resin bonding to sodium perborate-bleached dentin. Oper Dent 2014; 39:98–106.  Back to cited text no. 1
    
2.
Sulieman M, Addy M, Macdonald E, Rees JS. A safety study invitro for the effects of an inoffice bleaching system on the integrity of enamel and dentine. J Dent 2004; 32:581–590.  Back to cited text no. 2
    
3.
Lai SCN, Tay FR, Cheung GP, Mak YF, Carvalho RM, Wei SH, et al. Reversal of compromised bonding in bleached enamel. J Dent Res 2002; 81:477–481.  Back to cited text no. 3
    
4.
Torneck CD, Titley KC, Smith DC, Adibfar A. Adhesion of light cured composite resin to bleached and unbleached bovine dentin. Endod Dent Traumatol 1990; 6:97–103.  Back to cited text no. 4
    
5.
McGuckin RS, Thurmond BA, Osovitz S. Enamel shear bond strengths after vital bleaching. Am J Dent 1992; 5:216–222.  Back to cited text no. 5
    
6.
Thapa A, Vivekananda PA, Thomas MS. Evaluation and comparison of bond strength to 10% carbamide peroxide bleached enamel following the application of 10% and 25% sodium ascorbate and alfa tocopherol solution: an in vitro study. J Conserv Dent 2013; 16:111–115.  Back to cited text no. 6
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7.
Lai SCN, Mak YF, Cheung GSP, Osorio R, Toledano M, Carvalho RM, et al. Reversal of compromised bonding to oxidized etched dentin. J Dent Res 2001; 80:1919–1924.  Back to cited text no. 7
    
8.
Athiban PP, Borthakur BJ, Ganesan S, Swathika B. Evaluation of antimicrobial efficacy of Aloe Vera and its effectiveness in decontaminating gutta-percha cones. J Conserv Dent 2012; 15:246–248.  Back to cited text no. 8
  [Full text]  
9.
Danesh-Sani SA, Esmaili M. Effect of 10% sodium ascorbate hydrogel and delayed bonding on shear bond strength of composite resin and resin-modified glass ionomer to bleached enamel. J Conserv Dent 2011; 14:241–246.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Zhao H, Li X, Wang J, Qu S, Weng J, Zhang X. Characterization of peroxide ions in hydroxyapatite lattice. J Biomed Mater Res 2000; 52:157–163.  Back to cited text no. 10
    
11.
Titley KC, Torneck CD, Ruse ND. The effect of carbamide peroxide gel on the shear bond strength of a microfil resin to bovine enamel. J Dent Res 1992; 71:20–24.  Back to cited text no. 11
    
12.
Vinothkumar TS, Rubin MI, Balaji L, Kandaswamy D. In vitro evaluation of five different herbal extracts as an antimicrobial endodontic irrigant using real time quantitative polymerase chain reaction. J Conserv Dent 2013; 16:167–170.  Back to cited text no. 12
[PUBMED]  [Full text]  
13.
Goldstein RE, Haywood VB, Heymann HO. Bleaching of vital and nonvital teeth. In: Cohen S, Burns RC eds. Pathways of the pulp 6th ed. St Louis: Mosby Year Book Inc.; 2017. p. 584–603.  Back to cited text no. 13
    
14.
Dishman MV, Covey DA, Baughan LW. The effects of peroxide bleaching on composite to enamel bond strength. Dent Mater 1994; 10:33–36.  Back to cited text no. 14
    
15.
García-Godoy F, Dodge WW, Donohue M, O'Quinn JA. Composite resin bond strength after enamel bleaching. Oper Dent 1993; 18:144–147.  Back to cited text no. 15
    
16.
Cavalli V, Reis AF, Giannini M, Ambrosano GM. The effect of elapsed time following bleaching on enamel bond strength of resin composite. Oper Dent 2001; 26:597–602.  Back to cited text no. 16
    
17.
Demarco FF, Turbino M, Jorge AG, Matson E. Influence of bleaching on dentin bond strength. Am J Dent 1998; 11:78–82.  Back to cited text no. 17
    
18.
Josey AL, Meyers IA, Romaniuk K, Symons AL. The effect of a vital bleaching technique on enamel surface morphology and the bonding of composite resin to enamel. J Oral Rehabil 1996; 23:244–250.  Back to cited text no. 18
    
19.
Ben-amar A, Liberman R, Gorfil C, Bernstein Y. Effect of mouthguard bleaching on enamel surface. Am J Dent 1995; 8:29–32.  Back to cited text no. 19
    
20.
McCracken MS, Haywood VB. Demineralization effect of 10% carbamide peroxide. J Dent 1996; 24:395–398.  Back to cited text no. 20
    
21.
Perdigao J, Francci C, Swift EJJr, Ambrose WW, Lopes M. An ultra-morphological study of the interaction of dental adhesives with carbamide peroxide-bleached enamel. Am J Dent 1998; 11:291–301.  Back to cited text no. 21
    
22.
Hegedu SC, Bistey T, Flora-nagy E, Keszthelyi G, Jenei A. An atomic force microscopy study on the effect of bleaching agents on enamel surface. J Dent 1999; 27:509–515.  Back to cited text no. 22
    
23.
Adibfar A, Steele A, Torneck CD, Titley KC, Ruse D. Leaching of hydrogen peroxide from bleached bovine enamel. J Endod 1992; 18:488–491.  Back to cited text no. 23
    
24.
Dabas D, Patil AC, Uppin VM. Evaluation of the effect of concentration and duration of application of sodium ascorbate hydrogel on bond strength of composite resin to bleached enamel. J Conserv Dent 2011; 14:356–360.  Back to cited text no. 24
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