Ó

Operative Dentistry, 0000, 00-0, 000-000

The Effects of Aluminablasting on

Bond Durability Between Universal
Downloaded from www.jopdentonline.org by University of Saskatchewan on 12/15/19. For personal use only.

Adhesives and Tooth Substrate

H Ouchi  T Takamizawa  K Tsubota  A Tsujimoto
A Imai  WW Barkmeier  MA Latta  M Miyazaki

Clinical Relevance
Aluminablasting may adversely affect the dentin bond strength of universal adhesives in
self-etch mode.
Operative Dentistry

SUMMARY Bond (GC), and Scotchbond Universal (3M

The aim of this study was to determine the ESPE) were used in self-etch mode. The pre-
effect of aluminablasting on the bond durabil- pared bovine enamel and dentin specimens
ity of universal adhesives and adherent sur- were divided into two groups based on wheth-
face characteristics. Adhese Universal (Ivoclar er they received an aluminablasting prior to
Vivadent), All-Bond Universal (Bisco), Bondm- application of the universal adhesives. The
er Lightless (Tokuyama Dental), G-Premio resin composite bonded specimens were stored
in distilled water at 378C for 24 hours, follow-
Hajime Ouchi, DDS, Nihon University School of Dentistry,
ing which the shear bond strength (SBS) of
Operative Dentistry, Tokyo, Japan
half of the specimens was measured (24-hour
*Toshiki Takamizawa, DDS, PhD, Nihon University School of
group). The other half was subjected to 30,000
Dentistry, Operative Dentistry, Tokyo, Japan
thermal cycles between 5 and 558C before SBS
Keishi Tsubota, DDS, PhD, Nihon University School of
measurement (TC group). Surface roughness
Dentistry, Operative Dentistry, Tokyo, Japan
(Ra) and surface free energy (SFE) of the
Akimasa Tsujimoto, DDS, PhD, Nihon University School of
adherent surfaces were also measured, and
Dentistry, Operative Dentistry, Tokyo, Japan
scanning electron microscopy observation and
Arisa Imai, DDS, Nihon University School of Dentistry,
scanning electron microscopy/energy-disper-
Operative Dentistry, Tokyo, Japan
sive X-ray analysis were carried out. Most of
Wayne W Barkmeier, EBM, DDS, MS, Creighton University
the adhesives did not show any significant
School of Dentistry, General Dentistry, Omaha, NE, USA
differences in enamel SBS values between the
Mark A Latta, DMD, MS, Creighton University, General
two pretreatment groups, regardless of the
Dentistry, Omaha, NE, USA
storage condition. However, the dentin SBS
Masashi Miyazaki, DDS, PhD, Nihon University School of
values were significantly lower in specimens
Dentistry, Operative Dentistry, Tokyo, Japan
that underwent aluminablasting compared
*Corresponding author: 1-8-13, Kanda-Surugadai, Chiyoda-
with those that did not, irrespective of their
Ku, Tokyo, 101-8310 Japan; e-mail: takamizawa.toshiki@
nihon-u.ac.jp
storage conditions. Significantly higher Ra
and SFE values were observed in the enamel
DOI: 10.2341/18-170-L
and dentin of specimens that underwent alu-
 Operative Dentistry

minablasting. Although aluminablasting in- purpose of application. Aluminablasting of indirect

creased the Ra and SFE values of enamel and restorations such as metal alloy, zirconia, and cured
dentin, its effect on the SBS value was depen- resin composites has been reported to be a reliable
dent on the tooth substrate. In addition to C, O, method of pretreatment,11,13-15 and the resulting
Na, Mg, P, and Ca, the element Al was detected surface modifications can increase mechanical inter-
in the enamel and dentin of samples that had locking and modify the adhered surface.16 In con-
undergone aluminablasting. These results sug- trast, Loomans and others2 suggested that none of
gest that although aluminablasting of the the surface treatments for restoration repair can be
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tooth surface is thought to be effective for recommended as a universally applicable repair

modification of the adherent surface, it may technique for the different types of resin composites.
not enhance enamel bond performance and Moreover, the effects of aluminablasting on the bond
may also adversely affect the dentin bond strength and surface characteristics of the restora-
effectiveness of the universal adhesives. tions are still unknown, and there is a possibility
that residual alumina particles and surface modifi-
INTRODUCTION cations of the teeth may negatively affect the
It is inevitable that restorations in the oral cavity chemical bond with the universal adhesives by
will partially fracture or develop recurrent caries interfering with the chemical reactions between the
around their margins over time. In such cases, the functional monomers and the hydroxyapatite (HAp).
surrounding sound tooth structures can be preserved The aim of this study was to examine the effects of
by adopting a minimally invasive approach, which aluminablasting enamel and dentin on the bonding
advocates the use of composite resins to repair performance and surface characteristics when using
defective or aged restorations.1 The tooth cavity is universal adhesives in self-etch mode. This was
typically made up of more than one material and determined by testing the bond strength and surface
Operative Dentistry

exhibits a complicated configuration, making it free energy measurements of the adherent surfaces
desirable that the resin composites bond effectively before and after thermal cycling. The null hypothe-
to all of these materials. Several procedures, includ- ses tested were 1) the bond performance of universal
ing phosphoric acid etching, airborne particle abra- adhesives would not be influenced by aluminablast-
sion, and the use of different primers on the aged ing, 2) the surface characteristics of the adherent
restorations prior to application of the adhesive, surface would be altered by aluminablasting, and 3)
have been recommended for the achievement of there would be no difference in the effects of
durable bonds between different substrates.2-4 How- aluminablasting between enamel and dentin.
ever, these pretreatments require additional clinical
steps, and it may be difficult to apply pretreatments METHODS AND MATERIALS
on just the aged restorations or the tooth substrates
of the cavity. Moreover, contamination of the tooth Study Materials
substrate by metal primers or silane coupling agents The materials used in this study are shown in Table
may negatively affect the bond strength between the 1. The five universal adhesives used were 1) All Bond
substrate and resin composite.5,6 Universal (ABU; Bisco, Schaumburg, IL, USA) 2),
Universal adhesives have distinctive characteris- Adhese Universal (ADU; Ivoclar Vivadent, Schaan,
tics and versatility when compared with the previous Liechtenstein), 3) Bondmer Lightless (BML; Tokuya-
generations of adhesive systems.7 Different etching ma Dental, Tokyo, Japan), 4) G-Premio Bond (GPB;
techniques, including self-etch, etch and rinse, or GC, Tokyo, Japan), and 5) Scotchbond Universal
selective etching, can be used in direct composite (SBU; 3M ESPE, St. Paul, MN, USA). Clearfil AP-X
resin restorations with universal adhesives.8,9 Fur- (Kuraray Noritake Dental, Tokyo, Japan) was used
thermore, universal adhesives have also simplified as a restorative material for bonding to enamel and
bonding procedures considerably as they contain dentin. A halogen quartz tungsten curing unit
various functional monomers that allow them to (Optilux 501, sds Kerr, Danbury, CT, USA) at an
bond to surfaces other than tooth substrates.10 average light irradiance of 600 mW/cm2 was used.
Airborne particle abrasion has been used exten-
sively in various dental treatments, including stain Specimen Preparation
removal, cavity preparation, and inner surface This study used extracted mandibular bovine inci-
modification of indirect restorations.11,12 The mate- sors as a substitute for human teeth. The labial
rial and size of the abrasion particles depend on the surfaces of the teeth were ground using wet #240-
 Ouchi & Others: Aluminablasting Effect on Enamel and Dentin Bonds

Table 1: Materials Used in This Study

Code Adhesive (Lot No.) Main Components Manufacturer
ABU All-Bond Universal (1300008503) MDP phosphate monomer, bis-GMA, HEMA, Bisco Inc., Schaumburg, IL, USA
ethanol, water, initiators
ADU Adhese Universal (U49302) MDP, bis-GMA, HEMA, MCAP, D3MA, Ivoclar Vivadent Schaan, Lichtenstein
ethanol, water, initiator stabilizers, silicon
dioxide
BML Bondmer Lightless (004067) Liquid A: phosphate monomer, bis-GMA, Tokuyama Dental Corp., Tokyo, Japan
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TEGDMA, HEMA, MTU-6, others

Liquid B: acetone, isopropanol, water, acryl
borate catalyst, c-MPTES, peroxide, others
GPB G-Premio Bond (4G0011) MDP, 4-MET, MEPS, BHT, acetone, GC Corp., Tokyo, Japan
dimethacrylate resins, initiators, water
SBU Scotchbond Universal (41256) MDP, HEMA, dimethacrylate resins, Vitrebond 3M ESPE Dental Products, St. Paul, MN, USA
copolymer, filler, ethanol, water, initiators,
silane
Resin composite Clearfil AP-X bis-GMA, TEGDMA, silane barium glass filler, Kuraray Noritake Dental, Tokyo, Japan
(N416713) silane silica filler, silanated colloidal silica, CQ,
pigments, others
Abbreviations: 4-MET, 4-methacryloxyethyl trimellitate; BHT, butylated hydroxytoluene; bis-GMA, 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy) phenyl)] propane;
CQ, dl-camphorquinone; D3MA, decandiol dimethacrylate; HEMA, 2-hydroxyethyl methacrylate; MCAP, methacrylated carboxylic acid polymer; MDP, 10-
methacryloyloxydecyl dihydrogen phosphate; MEPS, methacryloyloxyalkyl thiophosphate methylmethacrylate; MTU-6, 6-methacryloyloxyhexyl-2-thiouracil-5-
carboxylate; TEGDMA, triethyleneglycol dimethacrylate; c-MPTES, c-methacryloyloxypropyltriethoxysilane.

Table 2: Protocols for Bonding Procedures grit silicon carbide (SiC) paper (Fuji Star Type DDC,
Operative Dentistry

Sankyo-Rikagaku, Saitama, Japan) to create flat

Method Code Pretreatment for Adherent Surface
enamel and dentin surfaces. Each tooth was then
w/o Aluminablasting was not performed. mounted in self-curing acrylic resin (Tray Resin II,
w Aluminablasting was performed on the Shofu, Kyoto, Japan) to expose the flattened area,
adherent surface with 50 lm Al3O2 powder for
five seconds at an angle of 458 and a distance and the enamel and dentin adherent surfaces were
of 10 mm with pressure of 0.25 MPa. The polished using a water coolant and a sequence of SiC
treated surface was rinsed with water for 15 s polishing papers (up to #320 grit; Fuji Star Type
(three-way dental syringe) and air dried.
DDC).
Adhesive Code Adhesive Application Protocol
ABU Adhesive applied to air-dried enamel or dentin
surface (not desiccated for dentin) with rubbing
Thermal Cycling and Shear Bond Strength
action for 10-15 s per coat. No light cure Tests
between coats. Gentle stream of air applied
over the liquid for at least 10 s. Light irradiation
The experimental protocol for tooth preparation is
performed for 10 s. shown in Table 2. The prepared enamel and dentin
ADU Adhesive applied to the air-dried enamel or specimens were divided into two groups depending
dentin surface with rubbing action for 20 s and on whether they received aluminablasting before the
then medium air pressure applied to surface application of the universal adhesive or not. The
for 5 s. Light irradiate for 10 s.
aluminablasting was performed with a chairside
BML Adhesive applied to the air-dried enamel or
dentin surface, and after 10 s, medium air sandblaster (MicroEtcher IIA, Zest Dental Solutions,
pressure applied over the liquid adhesive for 5 Carlsbad, CA, USA). For each group, the adhesive
s. No light irradiation. agents were applied in accordance with each man-
GPB Adhesive applied to air-dried enamel or dentin ufacturer’s instructions for self-etch mode. Following
surface, and after 10 s, a strong stream of air
application of the adhesive, bonded resin composite
applied over the liquid adhesive for 5 s or
until the adhesive no longer moved and the cylinders were built on the tooth surfaces by placing
solvent had completely evaporated. Light the resin composite in plastic molds (Bonding Mold
irradiate for 10 s. Insert, internal diameter: 2.4 mm, height: 2.4 mm,
SBU Adhesive applied to air-dried enamel or dentin Ultradent Products, South Jordan, UT, USA) and
surface with rubbing action for 20 s medium air
pressure applied to surface for 5 s. Adhesive
subjecting it to light irradiation for 30 seconds. The
light cured for 10 s. bonded specimens were then stored in distilled water
Abbreviations: ABU, All-Bond Universal; ADU, Adhese Universal; BML, at 378C for 24 hours, following which the shear bond
Bondmer Lightless; GPB, G-Premio Bond; SBU, Scotchbond Universal.
strength (SBS) was measured in half of the speci-
 Operative Dentistry

mens (24-hour group). The remaining half were of three test liquids: 1-bromonaphthalene, diiodo-
treated with 30,000 thermal cycles between 5 and methane, and distilled water. The SFE parameters
558C and a dwell time of 30 seconds prior to SBS of these liquids have been reported previously.18,19
measurement (thermal cycling [TC] group). The The contact angles were measured automatically
SBSs were measured using the notched edge SBS using a contact angle meter (Drop Master DM 500,
test, as described by ISO 29022.17 Kyowa Interface Science, Saitama, Japan) that had
There were 40 experimental groups in total, been connected to a charge-coupled device camera.
arising from four variables: enamel or dentin, with The equilibrium contact angle (h) was measured in
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or without aluminablasting, five different universal 10 enamel and dentin specimens for each test liquid.
adhesives, and 24-hour or thermal cycling. Fifteen Sessile drops (1.0 lL in volume) of each liquid were
specimens were used for each group, as this number dispensed at 238C 6 18C using a micropipette, and
gives a statistical power of 0.95 with an a = 0.05 for the SFE parameters of the solids were calculated
typical SBS values, as calculated using statistical based on the fundamental concepts of wetting. The
power analysis. A total of 600 specimens were used. Young-Dupré equation describes the adhesion be-
tween a solid (S) and liquid (L) that are in contact
The bonded specimens were loaded to failure at 1.0 (WSL), the interfacial free energy between the solid
mm/min with an Ultradent shearing fixture (Test and the liquid (cSL), and the SFE of the liquid and
Base Clamp, Ultradent Products) using a universal solid (cL and cS, respectively), as follows:
testing machine (Type 5500R, Instron, Canton, MA,
USA), and the SBS values (MPa) were obtained. WSL ¼ cL þ cS  cSL ¼ cL ð1 þ coshÞ:
Thereafter, the bonding sites on the tooth surfaces
and resin composite cylinders were observed under
The Fowkes equation can be extended using the
an optical microscope (SZH-131, Olympus, Tokyo,
Kitazaki-Hata approach, as follows20:
Japan) at a magnification of 103 to determine the
Operative Dentistry

bond failure type. Based on the proportion of the

cSL ¼ cL þ cS  2ðcdL cdS Þ1=2  2ðcpL cpS Þ1=2  2ðchL chS Þ1=2
substrate area (adhesive–resin composite–enamel or
dentin) observed in the debonded cylinders and
tooth-bonding sites, the bond failures were classified cL ¼ cdL þ cpL þ chL ; cS ¼ cdS þ cpS þ chS ;
into 1) adhesive failure, 2) cohesive failure in
composite resin, 3) cohesive failure in tooth, or 4) where cd, cp, and ch are the dispersion force, polar
mixed failure (partially adhesive and partially (permanent and induced) force, and hydrogen-bond-
cohesive). ing force, respectively, and are components of the
SFE (c). h values were determined for all three test
Surface Roughness Measurements liquids, and the surface-energy parameters of the
The treated surfaces with or without aluminablast- treated surfaces were calculated according to the
ing were observed under a three-dimensional laser equations using an add-on software and the interface
scanning microscope (LSM; VK-8700; Keyence, Osa- measurement and analysis system (FAMAS; Kyowa
ka, Japan) with the excitation light at a spectral Interface Science). A statistical power analysis
maximum of 658 nm and the light intensity and indicated that a minimum of nine samples was
amplification of the photomultiplier being kept necessary for effective measurement of the Ra and
constant during the observation period. The surface SFE. Therefore, this experiment included a sample
roughness (Ra) values were measured using the of 10 specimens, and post hoc power tests performed
software (VK-Analyzer; Keyence) included with the after data collection indicated that this would result
LSM, and each region of measurement was 0.1 mm 3 in adequate statistical power.
0.1 mm in size. The Ra was measured at three points
as close to the center as possible in 10 specimens Scanning Electron Microscopy Observation
from each group, and the mean value was calculated The aluminablasted surfaces and tooth/resin inter-
for each group thereafter. faces were observed using field-emission scanning
electron microscopy (SEM; ERA-8800FE, Elionix,
Surface Free Energy Measurements Tokyo, Japan). For ultrastructural morphological
The surface free energy (SFE) of treated surfaces observations of the tooth-resin interfaces, the bonded
with or without aluminablasting was determined by specimens were embedded in epoxy resin and
measuring the contact angles formed on the surfaces longitudinally sectioned using a diamond saw (Iso-
 Ouchi & Others: Aluminablasting Effect on Enamel and Dentin Bonds

Table 3: Influence of Aluminablasting on Enamel Bond Strengtha

24-h 30,000 TC
w/o With w/o With
ABU 27.9 (2.7)aA [100%] 26.8 (4.2)aA [96.1%] 27.6 (3.0)bA [98.9%] 25.8 (2.0)aA [92.5%]
ADU 26.8 (1.8)aA [100%] 26.9 (2.0)aA [100.3%] 27.5 (3.5)bA [102.6%] 28.2 (3.1)aA [102.5%]
BML 29.0 (3.8)aA [100%] 30.8 (3.6)aA [106.2%] 30.2 (4.2)abA [104.1%] 28.8 (3.4)aA [99.3%]
aAB aB aA
GPB 28.2 (4.6) [100%] 27.0 (4.1) [95.6%] 32.9 (4.5) [116.7%] 29.5 (3.9)aAB [104.6%]
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aA aA bA
SBU 28.1 (3.3) [100%] 27.2 (4.2) [96.8%] 27.4 (3.2) [97.5%] 26.6 (3.4)aA [94.7%]
Abbreviations: ABU, All-Bond Universal; ADU, Adhese Universal; BML, Bondmer Lightless; GPB, G-Premio Bond; SBU, Scotchbond Universal.
a
N=15, mean (SD) in MPa. The same lowercase letter in vertical columns indicates no difference at the 5% significance level. The same uppercase letter in horizontal
rows indicates no difference at the 5% significance level. Values in parentheses indicate standard deviation.

Met 1000, Precision Sectioning Saw, Buehler, Lake statistical analysis included the analysis of variance
Bluff, IL, USA). The sectioned surfaces were pol- (ANOVA) followed by Tukey’s honestly significant
ished to a high gloss using SiC papers (Fuji Star difference (HSD) test at a significance level of 0.05. A
Type DDC) followed by diamond pastes up to a three-way ANOVA along with a Tukey’s HSD test
particle size of 0.25 lm (DP-Paste, Struers, Ballerup, (a=0.05) was used for analysis of the SBS data,
Denmark). All SEM specimens were dehydrated in followed by multiple one-way ANOVA tests to
ascending grades of tert-butyl alcohol and then compare the adhesives. A one-way ANOVA followed
transferred to a critical-point dryer (Model ID-3, by Tukey’s HSD test was performed for all other
Elionix) for 30 minutes. The tooth-resin interfaces of variables. All statistical analyses were performed
the specimens were etched (EIS-200ER, Elionix) for using the Sigma Plot software version 11.0 (SPSS
40 seconds using an argon-ion beam (accelerating Inc., Chicago, IL, USA).
Operative Dentistry

voltage 1.0 kV, ion current density 0.4 mA/cm2)

directed perpendicular to the polished surfaces. RESULTS
Finally, all SEM specimens were coated with a thin Enamel Bond Strength
film of gold in a vacuum evaporator (Quick Coater,
Type SC-701, Sanyu Denshi, Tokyo, Japan). All The effects of aluminablasting on the SBS of enamel
observations were performed under SEM at an are shown in Table 3. The three-way ANOVA test
operating voltage of 10 kV. showed that the type of adhesive system significant-
ly affected the SBS values (p,0.001), while varia-
tions in the storage conditions (24-hour or TC,
Energy Dispersive X-Ray Microanalysis
p=0.239) and pretreatment methods (with or with-
The elements present in the tooth surfaces with or out aluminablasting, p=0.104) did not. The three-
without aluminablasting were analyzed using SEM/ way interaction between the factors was not statis-
energy dispersive X-ray (EDX; GENESIS 2000, tically significant (p=0.728), and the interaction
EDAX, Tokyo, Japan) at 20 kV and 25003 magnifi- between storage condition and adhesive system
cation. The measurements were conducted perpen- was the only pairwise interaction that exhibited
dicular to the prepared tooth surface, and the statistical significance (p=0.03; storage condition
elemental content (wt%) of the carbon-coated (Quick and pretreatment, p=0.277; pretreatment and adhe-
Coater, Type SC-701, Sanyu Denshi) surface was sive system, p=0.386).
measured in five specimens from each group. The
In the 24-hour group, no significant differences
measurements were carried out at three points as
were observed between the five universal adhesives,
close to the center of the specimen as possible, and
regardless of their aluminablasting status. In the TC
the mean value was calculated for each group
group, no significant differences were observed
thereafter. The analysis was performed using the
between the universal adhesives when alumina-
ZAF correction method (atomic number, absorption,
blasting was performed. However, GPB exhibited a
and fluorescence), based on standard-less correc-
significantly higher SBS value compared with all
tion.21
other adhesives, except BML, in the absence of
aluminablasting. When the enamel SBS value (24
Statistical Analysis hours without aluminablasting) was defined as 100%
As the data were normally distributed (determined for each tested adhesive, SBS values in 24 hours
by the Kolmogorov-Smirnov test), the tests used for with aluminablasting ranged from 95.6% to 106.2%,
 Operative Dentistry

Table 4: Influence of Aluminablasting on Dentin Bond Strengtha

24-h 30,000 TC
w/o With w/o With
ABU 38.4 (1.3)aA [100%] 25.5 (3.6)abB [66.4%] 37.5 (3.8)aA [97.7%] 24.5 (3.8)abB [63.8%]
ADU 33.8 (3.2)bA [100%] 23.3 (2.7)bB [68.9%] 34.0 (3.1)aA [100.5%] 19.3 (2.9)cC [57.1%]
BML 36.9 (3.9)abA [100%] 27.7 (4.0)aB [75.1%] 34.2 (3.0)aA [92.7%] 21.1 (2.3)bcC [57.2%]
bA bC bB
GPB 32.9 (3.0) [100%] 23.1 (2.6) [70.2%] 28.4 (2.3) [86.3%] 26.2 (4.0)aBC [79.6%]
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abA aB aA
SBU 36.2 (5.4) [100%] 28.8 (3.8) [79.6%] 35.2 (3.4) [97.2%] 24.3 (3.5)abB [67.1%]
Abbreviations: ABU, All-Bond Universal; ADU, Adhese Universal; BML, Bondmer Lightless; GPB, G-Premio Bond; SBU, Scotchbond Universal.
a
N=15, mean (SD) in MPa. The same lowercase letter in vertical columns indicates no difference at the 5% significance level. The same uppercase letter in horizontal
rows indicates no difference at the 5% significance level. Values in parentheses indicate standard deviation.

in TC without aluminablasting ranged from 97.5% to specimens, except for two, exhibited adhesive failure
116.7%, and in TC with aluminablasting ranged regardless of the storage condition, aluminablasting
from 92.5% to 104.6%. status, and type of adhesive (Figure 1). However, the
dentin debonded specimens exhibited a different
Dentin Bond Strength trend compared with the enamel (Figure 2), with all
The effects of aluminablasting on the SBS of dentin debonded specimens that had undergone alumina-
are shown in Table 4. The three-way ANOVA test blasting exhibiting adhesive failure patterns, re-
showed that all of the factors examined significantly gardless of the storage condition and type of
affected the SBS values (p,0.001). In addition, the adhesive. Conversely, adhesives in the specimens
three-way interaction between the factors was that did not undergo aluminablasting tended to
mainly exhibit mixed and cohesive failures in the
Operative Dentistry

statistically significant (p=0.002). Although the

interaction between the aluminablasting status and dentin.
the adhesive system was significant (p,0.001), none
of the other pairwise interactions were statistically Ra and SFE
significant (storage condition and pretreatment, The effects of aluminablasting on the Ra and SFE of
p=0.396; storage condition and adhesive system, the enamel and dentin surfaces are shown in Table
p=0.124). 5. No significant differences were observed in the Ra
In the 24-hour group, GPB and ADU tended to values of the enamel and dentin surfaces that did not
exhibit lower SBS values compared with the other undergo aluminablasting. Conversely, the Ra values
adhesives, regardless of their aluminablasting status. of specimens with aluminablasting were significant-
In the TC group, the SBS values of the aluminablast- ly higher compared with the specimens without
ing group varied with the adhesive, with ADU aluminablasting, regardless of the tooth substrate.
exhibiting a significantly lower SBS compared with In particular, aluminablasted dentin surfaces exhib-
the other adhesives. In contrast, no significant ited a significantly higher Ra value compared with
differences in the SBS values were observed between aluminablasted enamel surfaces, and it was almost
the adhesives, except for GPB, in the group without four times rougher than enamel and dentin without
aluminablasting. When the dentin SBS value (24 aluminablasting.
hours without aluminablasting) was defined as 100% In the aluminablasting group, the enamel speci-
for each tested adhesive, 24 hour SBS values with mens exhibited significantly higher total free energy
aluminablasting ranged from 66.4% to 79.6%, in TC (cS) values compared with the dentin. When com-
without aluminablasting ranged from 86.3% to paring groups, the enamel and dentin specimens
100.5%, and in TC with aluminablasting ranged from with aluminablasting exhibited significantly higher
57.2% to 79.6%. Most of the adhesives exhibited cS values than those of specimens without alumina-
significantly lower SBS values with aluminablasting blasting. The dispersion force (cSd) was found to be
compared with the absence of aluminablasting, similar in all groups, and no statistically significant
irrespective of their storage conditions. differences were observed between the aluminablast-
ing and no aluminablasting groups. However, the csp
Failure Type of Debonded Specimens and csh values were seen to be affected by alumina-
The frequencies of the different failure types are blasting, with significantly higher values being
shown in Figures 1 and 2. All enamel debonded observed in specimens that had undergone alumina-
 Ouchi & Others: Aluminablasting Effect on Enamel and Dentin Bonds
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Operative Dentistry

Figure 1. Failure mode analysis of the debonded enamel specimens.

Figure 2. Failure mode analysis of the debonded dentin specimens. ABU w, All Bond Universal with aluminablasting; ABU w/o, All Bond Universal
without aluminablasting; ADU w, Adhese Universal with aluminablasting; ADU w/o, Adhese Universal without aluminablasting; BML w, Bondmer
lightless with aluminablasting; BML w/o, Bondmer lightless without aluminablasting; GPB w, G-Premio with aluminablasting; GPB w/o, G-Premio
without aluminablasting; SBU w, Scotchbond Universal with aluminablasting; SBU w/o, Scotchbond Universal without aluminablasting.
 Operative Dentistry

Table 5: Influence of Aluminablasting on Ra and SFE of

enamel surface. In addition, the smear layer of the
Adherent Surfacea dentin appeared to be compressed by aluminablast-
ing.
Enamel Dentin
w/o With w/o With Representative SEM images of the tooth-resin
Ra 0.71 (0.02) c
1.81 (0.05) b
0.70 (0.02) c
2.48 (0.10) a interfaces with or without aluminablasting are
cs 58.9 (3.9)c 76.5 (2.8)a 50.9 (3.8)d 68.6 (3.9)b shown in Figure 5. The interface between the enamel
cs d
41.8 (0.5)a
42.0 (0.7) a
41.4 (0.6)a
42.1 (0.8)a substrate and adhesive in the specimens with
aluminablasting appeared to be more irregular
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p b a b
cs 3.7 (1.7) 6.7 (2.0) 3.5 (1.2) 6.2 (1.9)a
cs h
13.4 (2.2)c
27.8 (1.2) a
6.0 (2.4)d
20.3 (3.5)b compared with those without aluminablasting (Fig-
Abbreviations: Ra, surface roughness; SFE, surface free energy; cs, total ure 5A,B). A similar trend was observed in the
surface free energy; csd, dispersion force; csp, polar force; csh, hydrogen dentin-resin interfaces (Figure 5C,D), although the
bonding force.
a
N=10, mean (SD) in MPa. The same uppercase letter in horizontal rows irregularities in the dentin interfaces of specimens
indicates no difference at the 5% significance level. Values in parentheses with aluminablasting were deeper than those seen in
indicate standard deviation.
the enamel substrate. A high-density transitional
layer was observed in the vicinity of the adhesive-
blasting compared with those that had not, irre- dentin interface, regardless of the type of adhesive
spective of the tooth substrate. The enamel of and the aluminablasting status.
specimens with aluminablasting exhibited signifi-
cantly higher csh values than the dentin. EDX Microanalysis
Representative images of the elemental spectra for
SEM Observations
enamel and dentin surfaces of specimens with or
SEM images of the tooth surfaces with or without without aluminablasting are shown in Figure 6, and
Operative Dentistry

aluminablasting are shown in Figures 3 and 4. their elemental compositions are shown in Table 6.
Scratches from the SiC papers and smear layers The elements C, O, Na, Mg, P, and Ca were detected
were obvious in the enamel and dentin of all in the enamel and dentin specimens without alumi-
specimens without aluminablasting (Figures 3A nablasting (Figure 6A,C). In addition to C, O, Na,
and 4A). In addition to the scratches from the SiC Mg, P, and Ca, the element Al was also detected in
paper, the specimens that underwent aluminablast- the enamel and dentin of samples with alumina-
ing also exhibited impact marks from the alumina blasting (Figure 6B,D). No significant differences in
particles, regardless of the substrate, and partial the wt% of Na, Mg, or Al were observed between the
removal of the smear layer, thus exposing the enamel and dentin of specimens with aluminablast-

Figure 3. Representative scanning electron micrographs of enamel and dentin adherent surfaces. Arrows indicate evidence of impact marks from
alumina particles. (A): Enamel adherent surface without aluminablasting (25003). (B): A longitudinal section of the enamel adherent surface without
aluminablasting (50003). (C): Enamel adherent surface with aluminablasting (25003). (D): A longitudinal section of the enamel adherent surface with
aluminablasting (50003).

Figure 4. Representative scanning electron micrographs of enamel and dentin adherent surfaces. Arrows indicate evidence of impact marks from
alumina particles. (A): Dentin adherent surface without aluminablasting (25003). (B): A longitudinal section of the dentin adherent surface without
aluminablasting (50003). (C): Dentin adherent surface with aluminablasting (25003). (D): A longitudinal section of the dentin adherent surface with
aluminablasting (50003).
 Ouchi & Others: Aluminablasting Effect on Enamel and Dentin Bonds

sound tooth substrate during repair procedures is

available. The purpose of this study was to deter-
mine the bonding effectiveness of universal adhe-
sives to different tooth substrates after alumina-
blasting from several perspectives.
In the group without aluminablasting, none of the
adhesives exhibited a reduction in enamel or dentin
bond strength after thermal cycling. This was
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consistent with previous in vitro studies examining

the bond durability of universal adhesives.22,23 In
particular, Suzuki and others23 reported that no
reduction of enamel bond strengths in self-etch mode
was observed in the degradation condition groups
(30,000 thermal cycles and two-year water storage)
when compared with the immediate groups (24-hour
water storage). These findings suggest that adhesion
between the enamel substrate and universal adhe-
sives remains stable once the bond has been
established. On the other hand, although alumina-
blasting had a negligible effect on the bonds to
enamel, dentin bond strength tests showed that
aluminablasting had a negative impact in both
groups (24 hour and TC), regardless of the type of
Operative Dentistry

universal adhesive. Therefore, the first null hypoth-

esis that aluminablasting would not affect the bond
performance of universal adhesives was rejected
only for dentin.
In the group without aluminablasting, none of the
adhesives exhibited a reduction in enamel and
Figure 5. Representative scanning electron micrographs of the dentin bond strength after thermal cycling. This
resin-tooth interfaces of Scotchbond Universal (SBU). The visible was consistent with previous in vitro studies exam-
material is indicated by abbreviations: Ad, adhesive; En: enamel; De: ining the bond durability of universal adhesives.22,23
dentin; RC: resin composite. (A): SBU and enamel without alumina-
blasting at magnification (a) 25003 and (b) 20,0003. (B): SBU and In particular, Suzuki and others23 reported that no
enamel with aluminablasting at magnification (a) 25003 and (b) reduction of enamel bond strengths in self-etch mode
20,0003. (C): SBU and dentin without aluminablasting at magnifica- was observed in degradation condition groups
tion (a) 25003 and (b) 20,0003. (D): SBU and dentin with
aluminablasting at magnification (a) 25003 and (b) 20,0003. (30,000 thermal cycles and two-year water storage)
when compared with the immediate groups (24-hour
Figure 6. Representative images of element spectra for enamel and water storage). These findings suggest that adhesion
dentin surfaces with or without aluminablasting. C, carbon; O, oxygen;
Na, sodium; Mg, magnesium; Al, aluminum; P, phosphorus; Ca, between the enamel substrate and universal adhe-
calcium. (A): Enamel adherent surface without aluminablasting. (B): sives remain stable once the qualitative bond has
Enamel adherent surface with aluminablasting. (C): Dentin adherent been established.
surface without aluminablasting. (D): Dentin adherent surface with
aluminablasting. To obtain a rough and clean surface on restora-
tions, aluminablasting is commonly used in both
ing. In addition, the wt% of oxygen in samples with dental laboratories and clinics.11,13-16 In addition,
aluminablasting was significantly higher than that aluminablasting is used in orthodontic treatment to
of samples without aluminablasting. create roughness on the enamel surface and increase
the mechanical interlocking effect for bracket bond-
DISCUSSION ing on occasion.24 Patcas and others25 reported that
aluminablasting of intact enamel enhanced the
Many studies have investigated optimal repair surface roughness, and it could produce a rougher
techniques with a focus on bonding to aged restora- surface than phosphoric acid etching to enamel. In
tions.2-4 However, little information about the bond- the results for changes in surface characteristics
ing effectiveness when aluminablasting exposes after aluminablasting, the aluminablasted enamel
 Operative Dentistry

Table 6: Influence of Aluminablasting on Elemental Composition (wt%) of Adherent Surfacea

Enamel Dentin
w/o With w/o With
Carbon 32.8 (0.8)bB 32.4 (1.2)bB 37.0 (1.8)aA 38.2 (1.0)aA
Oxygen 36.1 (0.9)aB 38.0 (1.1)aA 32.3 (1.8)bC 37.3 (0.5)aAB
Sodium 1.1 (0.3)eA 1.1 (0.1)eA 0.8 (0.2)eB 0.8 (0.1)dB
eA eA eB
Magnesium 0.6 (0.1) 0.6 (0.1) 1.1 (0.2) 1.1 (0.1)dB
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eA
Aluminum NA 0.9 (0.1) NA 1.0 (0.1)dA
dA dA dA
Phosphorus 11.6 (0.5) 10.9 (0.5) 11.3 (0.9) 9.0 (0.2)cB
cA cA cA
Calcium 17.7 (1.0) 16.3 (1.0) 17.4 (2.8) 12.7 (0.4b)bB
a
N=10, mean (SD) in wt%. The same lowercase letter in vertical columns indicates no difference at the 5% significance level. The same uppercase letter in horizontal
rows indicates no difference at the 5% significance level. Values in parentheses indicate standard deviation.

and dentin exhibited twofold and threefold increases esis, that the effect of aluminablasting would not
in Ra values, respectively, when compared with the differ between enamel and dentin, was rejected. In
specimens that did not undergo aluminablasting. In general, larger Ra values and higher SFE are
addition, the total SFE of the aluminablasted thought to be advantageous for bond performance
surfaces of the specimens was 30% higher than the because of enhanced wettability.19 However, the
surfaces of specimens that did not undergo alumi- presence of a rough surface and higher SFE by
nablasting. Therefore, the second null hypothesis, aluminablasting did not contribute to enamel and
that the surface characteristics of the teeth would dentin bond performance; instead, the dentin spec-
not differ irrespective of whether they had been imens that had undergone aluminablasting exhibit-
ed a reduction in bond strength. Soares and others26
Operative Dentistry

aluminablasted or not, was rejected.

investigated the effect of pretreatments on the
Changes in surface roughness are only to be
dentin bond strength of two self-etching adhesives
expected, but the changes in SFE may need more
and reported that the aluminablasting group showed
explanation. The cSh parameter represents the water
significantly lower micro tensile bond strength
and hydroxyl components of the substrate, while cSp
values than the no-treatment group (control) in both
is thought to be dependent on electric and metallic
self-etch adhesives. However, they claimed that the
interactions in addition to dipolar interactions.18,19
reasons for the dentin bond strength reduction in
The increased cS values of the enamel and dentin
self-etch adhesives were unclear. Integrating our
specimens that underwent aluminablasting can be
laboratory results and those of the previous investi-
attributed to the enhanced surface cleanliness and
gation, we may be able to explain this phenomenon.
the presence of residual alumina particles, which are
The dentin bond strength reduction after alumina-
highly polar. This speculation was supported by
blasting and the different trends observed with
SEM observations and SEM/EDX analysis, which
regard to the enamel and dentin bond strengths
revealed that Al was present in the enamel and
could be explained by the physical properties of the
dentin of only those specimens that had undergone
adherent substrates and the smear layer character-
aluminablasting. These results were consistent with
istics. Dentin substrate might suffer more damage
a previous study examining orthodontic bracket
than enamel substrate because of lower surface
bonding that reported the presence of residual
hardness and elastic modulus.27 A previous study
alumina on the aluminablasted enamel.25 Further-
reported that air-powder polishing of dentin surfaces
more, the elemental composition of oxygen was also
using sodium bicarbonate powder increased damage
seen to increase in the aluminablasted surfaces to the dentin substructure and reduced bond perfor-
when compared with the surfaces of the specimens mance of two-step and single-step self-etching
that did not undergo aluminablasting, irrespective of adhesive systems,28 leading to the development of a
the tooth substrate considered. The additional Al prophylactic polishing powder.29,30 In addition, since
and O are presumably derived from the blasting alumina particles are harder than sodium bicarbon-
alumina particles. ate powder, aluminablasting may cause much more
The findings of the current study suggest that damage not only to dentin but also to an enamel
aluminablasting affected the bond strength and substrate, such as micro cracks. The dentin smear
surface characteristics of enamel and dentin sub- layer is composed of disorganized organic debris with
strates differently. Therefore, the third null hypoth- HAp minerals, while the enamel smear layer is
 Ouchi & Others: Aluminablasting Effect on Enamel and Dentin Bonds

highly porous.31 The SEM observations showed that Regarding clinical practice, the results of this study
the dentin smear layer was compressed after suggest that aluminablasting should normally not be
aluminablasting (Figure 4C,D). This layer contains used with universal adhesives, because dentin bond
collagen fragments that can block the penetration of performance was noticeably affected. Further, the
adhesive functional monomers, and this may be bond strength and surface characteristic tests were
related to the fact that the intermolecular spacing of performed using flat specimens in this study. How-
collagen (1.3 nm) is smaller than the size of the ever, when considering the clinical situation, the
functional monomers (approximately 2 nm).32 In the cavity when repairing a restoration is likely to have a
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case of self-etch universal adhesives, penetration of complex configuration. It is probable that many more
the resin monomers into the smear layer and alumina particles may remain in a cavity than on a
demineralization of the tooth surface are essential flat specimen and would be difficult to remove. There
for chemical bonding with HAp. Tamura and is a possibility that remnant alumina particles might
others33 investigated how air-powder polishing in- be an inhibiting factor for immediate and long-term
fluences bonding between dentin and universal bond durability of dentin. In addition, although the
adhesives. They suggested that the presence of enamel bond effectiveness did not change in response
residual sodium bicarbonate powder on dentin to aluminablasting, there are still reasons to avoid it
surfaces leads to chemical and/or mechanical chang- when repairing aged restorations surrounded by
es to collagen fibrils and prevention of adhesive sound enamel structures, because enamel loss after
penetration into dentin. It can be speculated that aluminablasting is much higher than after phospho-
although a different blasting material is used in this ric acid etching.25 Wendler and others13 reported that
study, the same situation might occur. Moreover, a no significant difference in Ra value was observed
previous study comparing the enamel and dentin between aluminablasting and bur roughening. There-
bond durability of self-etch adhesives with different fore, instead of aluminablasting the tooth structure, it
Operative Dentistry

smear layers showed that the dentin was more may be better to roughen the surface of the aged
susceptible to the condition of the smear layer restoration with burs, avoiding damage to enamel as
condition than the enamel.34 far as possible, and use a suitable application primer.
Therefore, it can be speculated from the integrated The results of this study suggest that alumina-
results that the compressed dentin smear layer and blasting should not be used when universal adhe-
embedded alumina particles may interfere with the sives are used to make a repair restoration in situ.
penetration of the resin monomer and interaction Thus, further work to determine the bonding
with the functional monomer of universal adhesives. characteristics of universal adhesives to bur-rough-
These may lead to lower bond strength because the ened aged restorations would be valuable. The
dentin HAp has a higher affinity for the functional flexibility of universal adhesives (used with or
monomer than enamel.35,36 without phosphoric acid etching, bonding to multiple
Changes in the elemental composition after alu- substrates), gives reason to hope that an effective
minablasting showed significantly lower wt% of P and conservative protocol can be developed.
and Ca in dentin surfaces than enamel surfaces and
dentin surfaces without aluminablasting. Although CONCLUSION
the mineral content of dentin was lower than that of In conclusion, most universal adhesives in self-etch
enamel, the dentin HAp has a high affinity for the mode with aluminablasting exhibited lower dentin
functional monomer, thus creating greater nano- SBS values compared with the specimens without
layering between them.35,36 Therefore, it might be aluminablasting. Moreover, the enamel and dentin
inferred that the lower concentration of P and Ca substrates exhibited similar Ra and SFE results in
and the consumption of functional monomers by both groups. These results suggest that although
residual alumina particles in the aluminablasted aluminablasting of the tooth surface is thought to be
dentin surfaces may lead to a weaker chemical bond effective for modification of the adherent surface, it
compared with those in the dentin surfaces of may not enhance enamel bond performance and may
specimens that did not undergo aluminablasting. also adversely affect the dentin bond effectiveness of
Notably, all debonded specimens of aluminablasted the universal adhesives tested in this study. There-
dentin exhibited adhesive failure patterns, and this fore, when considering repair techniques using
was in contrast to the specimens that did not aluminablasting, we should take into account both
undergo aluminablasting. the interaction between functional monomers and
 Operative Dentistry

HAp and the infiltration capability of resin mono- various substrates Operative Dentistry 42(2) e59-e70,
mers beyond the smear layer. https://doi.org/10.2341/15-353-L.
11. Al Jabbari YS, Zinelis S, & Eliades G (2012) Effect of
sandblasting conditions on alumina retention in repre-
Conflict of Interest
sentative dental alloys Dental Materials Journal 31(2)
The authors of this article certify that they have no 249-255, https://doi.org/10.4012/dmj.2011-210.
proprietary, financial, or other personal interests of any
nature or kind in any product, service, and/or company that 12. Bühler J, Amato M, Weiger R, & Walter C (2016) A
is presented in this article. systematic review on the effects of air polishing devices on
oral tissue International Journal of Dental Hygiene 14(1)
Downloaded from www.jopdentonline.org by University of Saskatchewan on 12/15/19. For personal use only.

(Accepted 7 October 2018) 15-28, https://doi.org/10.1111/idh.12120.

13. Wendler M, Belli R, Panzer R, Skibbe D, Petschelt A, &
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