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27 protocols using ultra etch

1

Adhesive Resin Bonding Protocol for Composite Restorations

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A three-step adhesive system (OptiBond FL, Kerr, Orange, CA, USA) was applied according to the manufacturer’s instructions. After phosphoric acid etching (Ultra-Etch, Ultradent, South Jordan, UT, USA) for 15 s and rinsing with water for 15 s, the primer was applied for 15 s to the gently air-dried dentin. Then the primer was air-dried until the dentin acquired a shiny appearance. The adhesive was subsequently applied, and light cured at 1160 mW/cm2 for 10 s.
The carrier of the specimen was clamped in a custom-made holder which allowed to press a 5 mm wide and 4 mm high silicone tube on the flat dentin surface. This enabled the stable placement of the composite in one increment. The surface was flattened using conventional modelling instruments.
According to their group, the composites were light cured with either low- or high-irradiance. Thus, each composite was cured for 3 s at 2850 mW/cm2 (Bluephase PowerCure, Ivoclar Vivadent, Schaan, Liechtenstein; emission wavelength range: 385–515 nm) or for 10 s at 1160 mW/cm2. The tip of the light guide locked in the opening of the custom-made holder. This ensured keeping a distance of 1 mm to the composite buildup.
The radiant exitances were periodically controlled using a calibrated dental radiometer (FieldMaxII-TO, Coherent; Santa Clara, CA, USA). The specimens were dark-stored in tap water at 37 °C during 24 h before μTBS testing.
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2

Silicone vs. PTFE Stamp Technique for RBC Restorations

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To each of the two groups (i.e., silicone stamp technique or PTFE stamp technique), 14 prepared teeth were assigned to be restored with the resin-based composite (RBC) Grandio® (Shade A2, Lot: 1736598, VOCO GmbH, Cuxhaven, Germany). The restoration technique involved etching the entire cavity with Ultra-Etch (Lot: BHDFX, Ultradent Products GmbH, Cologne, Germany), and the RBC was bonded to the tooth structure with OptiBond™ FL (Prime Lot: 7038745, Adhesive Lot: 7101804, KerrHawe SA, Bioggio, Switzerland). RBC restorations were performed on all teeth using an oblique two-layering technique. The individual increments were light irradiated for 20 s with a VALO® light-curing unit (Ultradent Products GmbH, Köln, Germany) with an output intensity of 1000 mW/cm2. The surface layers of the restorations were created by either the silicone stamp technique or the PTFE stamp technique.
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3

Adhesive Bonding Procedures for Composite Restorations

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After cavity preparation, the enamel, dentin, and cement were each treated with 35% phosphoric acid (Ultra-Etch®; Ultradent Products, Inc., South Jordan, UT, USA) for 10 to 20 seconds. The cavity was rinsed thoroughly with water and dried with a mild oil-free air stream. A total-etch adhesive system (Optibond™ FL; Kerr Corp., Orange, CA, USA) was applied to all cavities according to the manufacturer’s instructions. Primer was applied to the entire cavity wall and was left to dry for 20 seconds. After conditioning the tooth surface for 20 seconds, the cavity was exposed to a mild oil-free air stream. Following the primer procedures, bond was applied to the entire surface of the cavity, obtaining the bond film, as uniform as possible, by using a gentle oil-free air stream. The tooth surfaces were polymerized with an Elipar™ S10 LED curing light (3M ESPE, St. Paul, MN, USA) for 20 seconds. The composite resin (Filtek™ extreme XTE; 3M ESPE, Seefeld, Germany) was inserted in two increments and light cured for 40 seconds. The restorations were then polished with Sof-Lex (3M ESPE, USA).
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4

Adhesive Performance on Enamel and Dentin

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Adhesives used are shown in Table 1. A three-step etch-and-rinse adhesive, OptiBond FL (Kerr, Orange, CA, USA), a two-step E&R adhesive, Prime&Bond NT (Dentsply Sirona, Charlotte, NC, USA), a two-step self-etch adhesive, Clearfil SE Bond 2, a two-step universal adhesive, G2-BOND Universal (GC), and a one-step universal adhesive, Scotchbond Universal Plus (3M Oral Care, St. Paul, MN, USA) were used to bond a resin composite (Filtek Supreme Ultra, 3M Oral Care) to both enamel and dentin. In addition, phosphoric acid etchant (UltraEtch, Ultradent Products, South Jordan, UT, USA) was used. Adhesives, except for the universal adhesives, were applied in either etch-and-rinse or self-etch mode and universal adhesives were used in both modes based on the manufacturers’ instructions in this laboratory study.
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5

Comprehensive Adhesive Performance Evaluation

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Three universal adhesives used were Scotchbond Universal (SU, 3M, St. Paul, MN, USA), G-Premio Bond (GB, GC, Tokyo, Japan), and All-Bond Universal (AU, BISCO, Schaumburg, IL, USA). Adhesives are listed in Table 1 along with these associated lot numbers and components are shown. Ultra-Etch (Ultradent, South Jordan, UT, USA) was used as a 35% phosphoric acid pre-etching agent.
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6

Dentin Specimens Evaluation by SEM

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Tooth dentin specimens with a 1 mm thickness were prepared under the dentin–enamel junction, with a low-speed diamond saw (Strauer Accutom-50, Ballerup, Denmark). Each sample was etched with 35% H3PO4 (Ultra Etch; Ultradent, South Jordan, UT, USA) for 15 s. After etching each sample, washing and air-drying were simultaneously performed for 5 s, to keep the samples slightly wet, to prevent collapse of collagen.
After being etched and washed, each dentin specimen was immediately submerged in a 1.5 mL tube containing one of the four solutions for 1 min: (1) 100% Ethanol (EtOH, control), (2) 2 mg/mL of CPICs solution, (3) 1 mg/mL of CPICs solution, and (4) metastable Ca-P solution. The tooth specimens were then prepared for scanning electron microscopy (SEM, JSM-7900F, JEOL, Peaboy, MA, USA) imaging, without separate washing and drying, following the protocol of Tay et al. [13 (link)].
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7

Enamel Surface Acid-Etching Procedure

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Enamel surfaces were acid-etched according to the manufacturers’ instructions with 35% phosphoric acid (Ultra Etch, Ultradent Products, INC) for 30 s, rinsed with water spray for 15 s, air-dried until desiccated.
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8

Morphological Analysis of Root Canal Surfaces

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Four roots from each group after different post space pretreatments were used for SEM assessment to observe the morphologic patterns of the root canal surfaces. Two roots were observed without considering the effect of etching. The other two roots in each group were etched with 35% phosphoric acid gel (PA, Ultra-etch; Ultradent Products, South Jordan, UT, USA) for 15 s and rinsed with distilled water and dried with paper points, considering the pre-etching step when the etch-and-rinse adhesive SB2 being used. The PA treated roots from different groups were referred as PA + BC group, PA + NA, PA + NEG group and PA + NE group respectively. All roots were then split along the axis in the lingual-buccal direction using a chisel and a hammer to expose the entire extent of the post space. The exposed post spaces were then gold-sputtered (Hitachi E-1045, Tokyo, Japan) and observed under SEM (SEM, Hitachi FE-SEM 4800, Tokyo, Japan). The SEM microphotographs were taken at 2 mm and 6 mm levels from the cemento–enamel junction of each root, and identified as coronal and apical portion of post spaces respectively.
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9

Etchant and Bonding Agent Application

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The dentin surface was conditioned using 35% phosphoric acid (Ultra-Etch; Ultradent Products, Inc., South Jordan, UT, USA) for 15sec and rinsed for 10sec. A universal bonding agent (Tetric N-Bond Universal, Ivoclar-Vivadent) was agitated and light cured (Bluephase G2, Ivoclar, Vivadent) for 20 s on 40 specimens only.
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10

Adhesive Bonding of Ceramic Restorations

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The cementation protocols varied within the two different tooth substrate groups (enamel or dentin) and followed the manufacturer's recommendations. The restorations were etched for 20 s with 5 % hydrofluoric acid (HF; Ivoclar Vivadent) before water-spraying and air-drying. A silane was applied for 60 s (Monobond Plus; Ivoclar Vivadent) and gently air-dried. Enamel and dentin were etched 30 s with 35 % phosphoric acid (Ultraetch; Ultradent, Utah, USA) and subsequently sprayed with water before gently air-drying. In the groups with exposed dentin, latter was additionally conditioned (Syntac Primer/Syntac Adhesive; Ivoclar Vivadent). Thereafter, a bonding agent was applied on the prepared teeth and on to the restorations (Heliobond; Ivoclar Vivadent) before gently air-dried.
After conditioning, the restorations were adhesively bonded to the prepared teeth, using a dual-curing resin cement (Variolink Esthetic; Ivoclar Vivadent). The excess cement was carefully removed before light-curing for 6 x 40 s was performed.
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