• ISSN 1674-8301
  • CN 32-1810/R
Volume 37 Issue 2
Mar.  2023
Turn off MathJax
Article Contents
Xiangqin Xu, Jiansheng Zhu, May Lei Mei, Huaying Wu, Kaipeng Xie, Shoulin Wang, Yaming Chen. Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration[J]. The Journal of Biomedical Research, 2023, 37(2): 138-147. doi: 10.7555/JBR.36.20220188
Citation: Xiangqin Xu, Jiansheng Zhu, May Lei Mei, Huaying Wu, Kaipeng Xie, Shoulin Wang, Yaming Chen. Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration[J]. The Journal of Biomedical Research, 2023, 37(2): 138-147. doi: 10.7555/JBR.36.20220188

Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration

doi: 10.7555/JBR.36.20220188
Funds:  This work was supported by the Technology Development Fund of Nanjing Medical University [Grants No. NMUB2016115 and NMUB2020117].
More Information
  • Corresponding author: Shoulin Wang, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, China. E-mail: wangshl@njmu.edu.cn; Yaming Chen, Comprehensive Outpatient Department of Stomatology, the Affiliated Hospital of Stomatology of Nanjing Medical University, 136 Hanzhong Road, Nanjing, Jiangsu 210029, China. Tel/Fax: +86-25-6969-3022, E-mail: yaming_chen@njmu.edu.cn
  • Received: 2022-08-24
  • Revised: 2022-10-18
  • Accepted: 2022-10-27
  • Published: 2022-11-28
  • Issue Date: 2023-03-28
  • The current study aims to investigate a suitable adhesive for primary tooth enamel. Shear bond strength (SBS) of primary teeth and the length of resin protrusion were analyzed using one-way ANOVA with Bonferroni multiple comparison tests after etching with 35% H3PO4. SBS and marginal microleakage tests were conducted with Single Bond Universal (SBU)/Single Bond 2 (SB2) adhesives with or without pre-etching using a nonparametric Kruskal-Wallis test. Clinical investigations were performed to validate the adhesive for primary teeth restoration using Chi-square tests. Results showed that the SBS and length of resin protrusion increased significantly with the etching time. Teeth in the SBU with 35% H3PO4 pre-etching groups had higher bond strength and lower marginal microleakage than those in the SB2 groups. Mixed fractures were more common in the 35% H3PO4 etched 30 s + SB2/SBU groups. Clinical investigations showed significant differences between the two groups in cumulative retention rates at the 6-, 12- and 18-month follow-up evaluations, as well as in marginal adaptation, discoloration, and secondary caries at the 12- and 18-month follow-up assessments. Together, pre-etching primary teeth enamel for 30 s before SBU treatment improved clinical composite resin restoration, which can provide a suitable approach for restoration of primary teeth.


  • CLC number: R783.1, Document code: A
    The authors reported no conflict of interests.
    △These authors contributed equally to this work.
  • loading
  • [1]
    Bilgrami A, Maqsood A, Alam MK, et al. Evaluation of shear bond strength between resin composites and conventional glass ionomer cement in class Ⅱ restorative technique-an in vitro study[J]. Materials (Basel), 2022, 15(12): 4293. doi: 10.3390/ma15124293
    Donmez SB, Turgut MD, Uysal S, et al. Randomized clinical trial of composite restorations in primary teeth: effect of adhesive system after three years[J]. Biomed Res Int, 2016, 2016: 5409392. doi: 10.1155/2016/5409392
    Lenzi TL, Gimenez T, Tedesco TK, et al. Adhesive systems for restoring primary teeth: a systematic review and meta-analysis of in vitro studies[J]. Int J Paediatr Dent, 2016, 26(5): 364–375. doi: 10.1111/ipd.12210
    Pires CW, Soldera EB, Bonzanini LIL, et al. Is adhesive bond strength similar in primary and permanent teeth? A systematic review and meta-analysis[J]. J Adhes Dent, 2018, 20(2): 87–97. doi: 10.3290/j.jad.a40296
    Lenzi TL, Soares FZM, de Oliveira Rocha R. Does bonding approach influence the bond strength of universal adhesive to dentin of primary teeth?[J]. J Clin Pediatr Dent, 2017, 41(3): 214–218. doi: 10.17796/1053-4628-41.3.214
    Soares FZM, Lenzi TL, de Oliveira Rocha R. Degradation of resin-dentine bond of different adhesive systems to primary and permanent dentine[J]. Eur Arch Paediatr Dent, 2017, 18(2): 113–118. doi: 10.1007/s40368-017-0282-z
    Farhadian N, Miresmaeili A, Zandi VS. Shear bond strength of brackets bonded with self-etching primers compared to conventional acid-etch technique: a randomized clinical trial[J]. Front Dent, 2019, 16(4): 248–255. doi: 10.18502/fid.v16i4.2083
    Warreth A, Abuhijleh E, Almaghribi MA, et al. Tooth surface loss: a review of literature[J]. Saudi Dent J, 2020, 32(2): 53–60. doi: 10.1016/j.sdentj.2019.09.004
    Tran XV, Tran KQ. Microleakage and characteristics of resin-tooth tissues interface of a self-etch and an etch-and-rinse adhesive systems[J]. Restor Dent Endod, 2021, 46(2): e30. doi: 10.5395/rde.2021.46.e30
    Pollaris E, Broeckx BJG, Rajasekharan S, et al. Fracture resistance of equine cheek teeth with and without occlusal fissures: a standardized ex vivo model[J]. Front Vet Sci, 2021, 8: 699940. doi: 10.3389/fvets.2021.699940
    Al Habdan AH, Al Rabiah R, Al Busayes R. Shear bond strength of acid and laser conditioned enamel and dentine to composite resin restorations: an in vitro study[J]. Clin Exp Dent Res, 2021, 7(3): 331–337. doi: 10.1002/cre2.409
    Prabakar J, John J, Arumugham IM, et al. Comparative evaluation of the viscosity and length of resin tags of conventional and hydrophilic pit and fissure sealants on permanent molars: an in vitro study[J]. Contemp Clin Dent, 2018, 9(3): 388–394. doi: 10.4103/ccd.ccd_131_18
    Ali Abou Neel E, Young AM. Setting kinetics and mechanical properties of flax fibre reinforced glass ionomer restorative materials[J]. J Biomed Res, 2017, 31(3): 264–272. doi: 10.7555/JBR.31.20150023
    Alshehri N, Aljamhan A, Bin-Shuwaish M. The effects of amalgam contamination and different surface modifications on microleakage of dentin bonded to bulk fill composite when using different adhesive protocols[J]. BMC Oral Health, 2022, 22(1): 186. doi: 10.1186/s12903-022-02214-1
    Ryge G, Snyder M. Evaluating the clinical quality of restorations[J]. J Am Dent Assoc, 1973, 87(2): 369–377. doi: 10.14219/jada.archive.1973.0421
    Oz FD, Ozturk C, Soleimani R, et al. Sixty-month follow up of three different universal adhesives used with a highly-filled flowable resin composite in the restoration of non-carious cervical lesion[J]. Clin Oral Investig, 2022, 26(8): 5377–5387. doi: 10.1007/s00784-022-04505-x
    de Carvalho MFF, Leijôto-Lannes ACN, Rodrigues MCN, et al. Viability of bovine teeth as a substrate in bond strength tests: A systematic review and meta-analysis[J]. J Adhes Dent, 2018, 20(6): 471–479. doi: 10.3290/j.jad.a41636
    Shimatani Y, Tsujimoto A, Nojiri K, et al. Reconsideration of enamel etching protocols for universal adhesives: effect of etching method and etching time[J]. J Adhes Dent, 2019, 21(4): 345–354. doi: 10.3290/j.jad.a42933
    Guelmann M, Shapira J, Silva D, et al. Esthetic restorative options for pulpotomized primary molars: a review of literature[J]. J Clin Pediatr Dent, 2011, 36(2): 123–126. doi: 10.17796/jcpd.36.2.34h304265110137r
    Gindri LDO, Fröhlich TT, Rosso CR, et al. Etching time and bonding of adhesive systems to dentin of primary teeth: a systematic review and meta-analysis[J]. Int J Paediatr Dent, 2021, 31(1): 122–130. doi: 10.1111/ipd.12711
    O'Meara RN, Dirks W, Martinelli AG. Enamel formation and growth in non-mammalian cynodonts[J]. R Soc Open Sci, 2018, 5(5): 172293. doi: 10.1098/rsos.172293
    Araújo CTP, Prieto LT, Costa DC, et al. Active application of primer acid on acid-treated enamel: influence on the bond effectiveness of self-etch adhesives systems[J]. Microsc Res Tech, 2017, 80(8): 943–949. doi: 10.1002/jemt.22887
    Bhandari DPK, Anbuselvan GJ, Karthi M. Evaluation of resin penetration depth in enamel surface for orthodontic bonding exposed to five types of enamel conditioning methods: A scanning electron microscopic study[J]. J Pharm Bioall Sci, 2019, 11(6): 221–227. doi: 10.4103/JPBS.JPBS_301_18
    Sai K, Takamizawa T, Imai A, et al. Influence of application time and etching mode of universal adhesives on enamel adhesion[J]. J Adhes Dent, 2018, 20(1): 65–77. doi: 10.3290/j.jad.a39913
    Kensche A, Dähne F, Wagenschwanz C, et al. Shear bond strength of different types of adhesive systems to dentin and enamel of deciduous teeth in vitro[J]. Clin Oral Invest, 2016, 20(4): 831–840. doi: 10.1007/s00784-015-1560-y
    Moradi Z, Akbari F, Valizadeh S. Effects of universal adhesive on shear bond strength of resin cement to zirconia ceramic with different surface treatments[J]. Int J Dent, 2021, 2021: 5517382. https://pubmed.ncbi.nlm.nih.gov/34239567/
    Wang R, Shi Y, Li T, et al. Adhesive interfacial characteristics and the related bonding performance of four self-etching adhesives with different functional monomers applied to dentin[J]. J Dent, 2017, 62: 72–80. doi: 10.1016/j.jdent.2017.05.010
    Sato T, Takagaki T, Matsui N, et al. Morphological evaluation of the adhesive/enamel interfaces of two-step self-etching adhesives and multimode one-bottle self-etching adhesives[J]. J Adhes Dent, 2016, 18(3): 223–229. https://pubmed.ncbi.nlm.nih.gov/27200432/
    Zhang Z, Wang X, Zhang L, et al. The contribution of chemical bonding to the short- and long-term enamel bond strengths[J]. Dent Mater, 2013, 29(7): 103–112. doi: 10.1016/j.dental.2013.04.009
    Scribante A, Gallo S, Pascadopoli M, et al. Effect of different enamel pretreating agents on bonding efficacy and survival rates of orthodontic brackets: in vitro study and split-mouth randomized clinical trial[J]. Am J Orthod Dentofacial Orthop, 2022, 162(3): 297–306. doi: 10.1016/j.ajodo.2022.05.010
    Sfondrini MF, Cacciafesta V, Scribante A, et al. Effect of blood contamination on shear bond strength of brackets bonded with conventional and self-etching primers[J]. Am J Orthod Dentofacial Orthop, 2004, 125(3): 357–360. doi: 10.1016/j.ajodo.2003.09.022
    Andrews K, Roberson G, Subramani K, et al. The effect of dental chair light exposure duration on shear bond strength of orthodontic brackets: an in vitro study[J]. J Clin Exp Dent, 2018, 10(11): 1075–1081. doi: 10.4317/jced.55296
    Cerekja E, Cakirer B. Effect of short curing times with a high-intensity light-emitting diode or high-power halogen on shear bond strength of metal brackets before and after thermocycling[J]. Angle Orthod, 2011, 81(3): 510–516. doi: 10.2319/071810-412.1
    Ali AM, Hamouda IM, Ghazy MH, et al. Immediate and delayed micro-tensile bond strength of different luting resin cements to different regional dentin[J]. J Biomed Res, 2013, 27(2): 151–158. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602873/
    Mithiborwala SH, Chaugule V, Munshi A, et al. Comparative evaluation of the adhesive properties of two generations of dentin bonding agents by checking the microleakage in the primary teeth: an in vitro study[J]. Int J Clin Pediatr Dent, 2011, 4(3): 195–202. doi: 10.5005/jp-journals-10005-1109
    Mauro SJ, Durão VCA, Briso ALF, et al. Effect of different adhesive systems on microleakage in class II composite resin restorations[J]. Int J Adhes Adhes, 2012, 34: 6–10. doi: 10.1016/j.ijadhadh.2012.01.004
    Opdam NJM, Van de Sande FH, Bronkhorst E, et al. Longevity of posterior composite restorations: a systematic review and meta-analysis[J]. J Dent Res, 2014, 93(10): 943–949. doi: 10.1177/0022034514544217
    Ortiz-Ruiz AJ, Pérez-Guzmán N, Rubio-Aparicio M, et al. Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis[J]. Sci Rep, 2020, 10(1): 6409. doi: 10.1038/s41598-020-63497-4
    Lawson NC, Robles A, Fu CC, et al. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions[J]. J Dent, 2015, 43(10): 1229–1234. doi: 10.1016/j.jdent.2015.07.009
    de Paris Matos T, Perdigão J, de Paula E, et al. Five-year clinical evaluation of a universal adhesive: a randomized double-blind trial[J]. Dent Mater, 2020, 36(11): 1474–1485. doi: 10.1016/j.dental.2020.08.007
    Han F, Liang R, Xie H. Effects of phosphoric acid pre-etching on chemisorption between Enamel and MDP-containing universal adhesives: chemical and morphological characterization, and evaluation of its potential[J]. ACS Omega, 2021, 6(20): 13182–13191. doi: 10.1021/acsomega.1c01016
    Simsek H, Gurbuz T, Buyuk SK, et al. Evaluation of mineral content and photon interaction parameters of dental enamel after phosphoric acid and Er: YAG laser treatment[J]. Photomed Laser Surg, 2017, 35(5): 270–277. doi: 10.1089/pho.2016.4190
    Mohammad Y, Yassin O, Hardan L, et al. An evaluation of Er: YAG Laser in an intact enamel treatment on bonding to the resin cement compared to four traditional techniques[J]. J Contemp Dent Pract, 2019, 20(9): 1014–1018. doi: 10.5005/jp-journals-10024-2647
    Chauhan S, Mahajan N, Sethuraman R, et al. Evaluation of the effect of dentin surface treatment by air abrasion and Er: YAG laser on the retention of metal crowns luted with glass ionomer cement in teeth with reduced crown height: an in vitro study[J]. J Indian Prosthodont Soc, 2019, 19(2): 141–148. doi: 10.4103/jips.jips_329_18
    Kumar U, Dharmani CK, Singh S, et al. Effect of air abrasion preconditioning on microleakage in class V restorations under cyclic loading: an in-vitro study[J]. J Clin Diagn Res, 2014, 8(5): ZC29–ZC32. doi: 10.7860/JCDR/2014/7029.4363
    Perdigão J. Current perspectives on dental adhesion: (1) dentin adhesion - not there yet[J]. Jpn Dent Sci Rev, 2020, 56(1): 190–207. doi: 10.1016/j.jdsr.2020.08.004
  • 加载中


    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(5)  / Tables(3)

    Article Metrics

    Article views (203) PDF downloads(37) Cited by()
    Proportional views


    DownLoad:  Full-Size Img  PowerPoint