Protocolos adhesivos sobre materiales bioactivos utilizados como recubrimientos pulpares indirectos: efecto de la aplicación de alcohol y silano
Fecha
2023
Tipo
tesis de maestría
Autores
Alfaro González, José Heriberto
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ISSN de la revista
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Editor
Resumen
Objetivo: evaluar el efecto del acondicionamiento superficial con alcohol y silano para materiales bioactivos utilizados como recubrimientos pulpares indirectos, en su interfase y resistencia adhesiva con resinas compuestas.
Materiales y Métodos: se evaluaron cuatro materiales biactivos: Endo-Eze TM MTA Flow TM White, Biodentine TM, ACTIVA BioActive Base/Liner TM y TheraCal LC®, cuyas muestras se prepararon según las instrucciones del fabricante y fueron divididas en tres grupos en función del acondicionamiento de superficie probado: alcohol, silano y grupo control. Se procedió a medir el ángulo de contacto de los materiales antes y después de aplicar los tratamientos utilizando un goniómetro. La presencia de los grupos funcionales de alcohol y silano y su efecto sobre los materiales fueron identificados mediante espectroscopía RAMAN. El efecto de dichos tratamientos en la interfase adhesiva (material/resina compuesta), fue evaluado cualitativamente mediante microscopía electrónica de barrido (MEB) a diferentes magnificaciones. Finalmente, posterior al envejecimiento de las muestras, se midió la resistencia adhesiva de cilindros de resina compuesta (n=18) en cada grupo experimental (según material y tratamiento) mediante la prueba de microcizalla en una máquina universal de pruebas y se determinó el tipo de falla predominante en cada grupo.
Resultados: ANOVA reveló diferencias estadísticamente significativas en el ángulo de contacto de los materiales y de los tratamientos, así como en la interacción entre ambos factores (p<0.0001, α 0.05). Siendo que el tratamiento con silano lo disminuye significativamente (p<0.05) respecto a los demás tratamientos y que los materiales con mayor contenido resinoso presentaron mayor ángulo de contacto (p<0.05). Fue posible identificar la presencia de alcohol y silano en el espectro RAMAN del grupo Biodentine TM. La evaluación de la interfase adhesiva al MEB del Activa Base/Liner TM y del Theracal LC® no reveló cambios, mientras que en el Biodentine TM se evidenció que el alcohol produce un aumento de la porosidad de la superficie externa del material en contacto con el adhesivo y que el silano favoreció la penetración del adhesivo dentro del material; ambos tratamientos en MTA Flow TM produjeron una ruptura de la capa interna del material (fallo cohesivo). ANOVA mostró diferencias estadísticamente significativas en la resistencia adhesiva a resina compuesta de los materiales evaluados (p<0.0001, α 0.05), siguiendo una tendencia al alza relativo a un mayor contenido resinoso en el material. Aunque el acondicionamiento con alcohol y silano sobre la superficie de los materiales evaluados no fue estadísticamente significativo en la resistencia adhesiva, la aplicación de silano sobre la superficie del Biodentine TM reveló una mejoría en los valores obtenidos. El tipo de falla cohesivo en el material bioactivo predominó en los grupos de Activa Base/Liner y Theracal LC®, mientras que en el de Biodentine TM fue el adhesivo; para el grupo MTA Flow TM, predominaron las fallas cohesivas del material en los grupos control y alcohol, mientras que las muestras con silano presentaron 100 % de fallas adhesivas.
Conclusión: el acondicionamiento de las superficies de los materiales bioactivos utilizados para recubrimiento pulpar evaluados con alcohol y silano no mejoró la resistencia adhesiva a la resina compuesta, presentando, además, características de interfase variables según el material y tratamiento. Los materiales bioactivos con mayor contenido resinoso/polimérico, presentaron mejor adhesión con resina compuesta. Continúa siendo un desafío encontrar mecanismos que la favorezcan.
Purpose: to evaluate the effect of surface conditioning with alcohol and silane for bioactive materials used as indirect pulp capping, on their interface and adhesive resistance with dental composites. Methods and Materials: four bioactive materials were evaluated: Endo-Eze TM (MTA Flow TM White, Biodentine TM, ACTIVA BioActive Base/Liner TM y TheraCal LC®. All materials were prepared according to the manufacturer's instructions. The samples were divided in three groups (n=18) according to surface treatments: alcohol, silane, and control group. The contact angle of the materials was measured before and after applying the treatments using a goniometer. The presence of alcohol and silane functional groups and their effect on the materials were identified by RAMAN spectroscopy. The effect of these treatments on the surface of the materials was qualitatively evaluated by scanning electro microscopy (SEM). After aging the samples, the microshear bond strength test was done using a universal testing machine and the predominant type of failure (adhesive, cohesive in material, cohesive in dental composite, mixed) was determined. Data was compared by ANOVA analysis. Results: ANOVA revealed statistically significant differences in the contact angle of materials and treatments, as well as in the interaction between both factors (p<0.0001, α 0.05). Being that the treatment with silane decreases it significantly (p<0.05) with respect to the other treatments and that the materials with the highest resinous content presented a greater contact angle (p<0.05). It was possible to identify the presence of alcohol and silane in the RAMAN spectrum of the Biodentine TM group. The evaluation of the interface by SEM of Activa Base/Liner TM and Theracal LC® didn´t show changes, in Biodentine TM it was evidenced that alcohol produces an increase in the porosity of the external surface of the material in contact with the adhesive, while with silane, the penetration of the adhesive was improved. For MTA, a rupture of the internal layer of the material (cohesive failure) was observed. ANOVA revealed statistically significant differences in bond strength between materials (p<0.0001, α 0.05), following an upward trend relative to a higher resinous content in the material. Although conditioning with alcohol and silane on the surface of the evaluated materials was not statistically significant in the shear bond strength for each material, the application of silane on the Biodentine TM surface revealed an improvement in the resistance values obtained. Cohesive failures in the bioactive material prevailed in Activa Base/Liner TM and Theracal LC® groups while adhesive failure prevailed in the BiodentineTM. Concerning the MTA Flow TM White group, cohesive failures in the bioactive material, predominated in the control and alcohol groups, while the samples with silane presented 100% adhesive failure. Conclusion: the conditioning of the surfaces of the evaluated bioactive materials used for pulp capping with alcohol and silane did not improve the bond strength to the composite resin, presenting, in addition, variable interface characteristics depending on the material and treatment. Bioactive materials with higher resinous/polymeric content presented better adhesion with composite resin. It remains a challenge to find mechanisms to improve it.
Purpose: to evaluate the effect of surface conditioning with alcohol and silane for bioactive materials used as indirect pulp capping, on their interface and adhesive resistance with dental composites. Methods and Materials: four bioactive materials were evaluated: Endo-Eze TM (MTA Flow TM White, Biodentine TM, ACTIVA BioActive Base/Liner TM y TheraCal LC®. All materials were prepared according to the manufacturer's instructions. The samples were divided in three groups (n=18) according to surface treatments: alcohol, silane, and control group. The contact angle of the materials was measured before and after applying the treatments using a goniometer. The presence of alcohol and silane functional groups and their effect on the materials were identified by RAMAN spectroscopy. The effect of these treatments on the surface of the materials was qualitatively evaluated by scanning electro microscopy (SEM). After aging the samples, the microshear bond strength test was done using a universal testing machine and the predominant type of failure (adhesive, cohesive in material, cohesive in dental composite, mixed) was determined. Data was compared by ANOVA analysis. Results: ANOVA revealed statistically significant differences in the contact angle of materials and treatments, as well as in the interaction between both factors (p<0.0001, α 0.05). Being that the treatment with silane decreases it significantly (p<0.05) with respect to the other treatments and that the materials with the highest resinous content presented a greater contact angle (p<0.05). It was possible to identify the presence of alcohol and silane in the RAMAN spectrum of the Biodentine TM group. The evaluation of the interface by SEM of Activa Base/Liner TM and Theracal LC® didn´t show changes, in Biodentine TM it was evidenced that alcohol produces an increase in the porosity of the external surface of the material in contact with the adhesive, while with silane, the penetration of the adhesive was improved. For MTA, a rupture of the internal layer of the material (cohesive failure) was observed. ANOVA revealed statistically significant differences in bond strength between materials (p<0.0001, α 0.05), following an upward trend relative to a higher resinous content in the material. Although conditioning with alcohol and silane on the surface of the evaluated materials was not statistically significant in the shear bond strength for each material, the application of silane on the Biodentine TM surface revealed an improvement in the resistance values obtained. Cohesive failures in the bioactive material prevailed in Activa Base/Liner TM and Theracal LC® groups while adhesive failure prevailed in the BiodentineTM. Concerning the MTA Flow TM White group, cohesive failures in the bioactive material, predominated in the control and alcohol groups, while the samples with silane presented 100% adhesive failure. Conclusion: the conditioning of the surfaces of the evaluated bioactive materials used for pulp capping with alcohol and silane did not improve the bond strength to the composite resin, presenting, in addition, variable interface characteristics depending on the material and treatment. Bioactive materials with higher resinous/polymeric content presented better adhesion with composite resin. It remains a challenge to find mechanisms to improve it.
Descripción
Palabras clave
Dental Pulp Capping, mineral trioxide aggregate, tricalcium silicate, TheraCal, ACTIVA BioACTIVE-BASE LINER, Composite Resins, Dental Bonding, TRATAMIENTO MÉDICO