|Year : 2021 | Volume
| Issue : 1 | Page : 11-14
Evaluation and comparison of the effect of 10% sodium ascorbate and propolis solution on the microtensile bond strength and resin tag penetration depth of composite after using 35% carbamide peroxide bleaching agent – An in vitro study
Archa Anil1, Liza George2, Prasanth Dhanapal3, Priya Thomas4, Sinju Paul2
1 Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India
2 Conservative Dentistry and Endodontics, Annoor Dental College, Ernakulam, Kerala, India
3 Conservative Dentistry and Endodontics, Royal Dental College, Palakkad, Kerala, India
4 Oral Pathology, Annoor Dental College, Ernakulam, Kerala, India
|Date of Submission||07-Oct-2019|
|Date of Decision||12-Jan-2020|
|Date of Acceptance||13-Mar-2020|
|Date of Web Publication||23-Mar-2021|
Dr. Archa Anil
Manipuzha House, Karinilam, Mundakayam, Kottayam - 686 513, Kerala
Source of Support: None, Conflict of Interest: None
Aim: The aim of this study was to evaluate and compare the effect of 10% sodium ascorbate and propolis solution on the microtensile bond strength (MTBS) and resin tag penetration depth of composite after using 35% carbamide peroxide bleaching agent.
Materials and Method: Sixty extracted human premolars were divided into five groups with 12 samples in each. Group I samples did not receive bleaching treatment and served as control. Group II samples were bonded with composite 2 weeks later, while those in Group III were bonded immediately after bleaching. The samples in Group IV and Group V were treated with antioxidants 10% SA and propolis solution at the rate of 1ml/min for 10 min, respectively, before composite bonding. The samples were then sectioned mesiodistally into two halves. One half was subjected to MTBS testing using a Universal Testing Machine. The other half was decalcified, sectioned, stained, and viewed under an optical light microscope to assess the resin tag penetration. The results obtained were statistically analyzed using a one-way analysis of variance followed by Post hoc test.
Results: Group III showed significantly lower MTBS and resin tag penetration depth of composite compared to all other groups. Group V (propolis group) showed statistical significance with all groups except Group IV (SA group).
Conclusion: Treatment with antioxidant propolis solution immediately following the bleaching will help to reverse the compromised bond strength which is comparable with sodium ascorbate.
Keywords: Carbamide peroxide, microtensile bond strength, propolis, resin tag penetration, sodium ascorbate
|How to cite this article:|
Anil A, George L, Dhanapal P, Thomas P, Paul S. Evaluation and comparison of the effect of 10% sodium ascorbate and propolis solution on the microtensile bond strength and resin tag penetration depth of composite after using 35% carbamide peroxide bleaching agent – An in vitro study. Endodontology 2021;33:11-4
|How to cite this URL:|
Anil A, George L, Dhanapal P, Thomas P, Paul S. Evaluation and comparison of the effect of 10% sodium ascorbate and propolis solution on the microtensile bond strength and resin tag penetration depth of composite after using 35% carbamide peroxide bleaching agent – An in vitro study. Endodontology [serial online] 2021 [cited 2021 Jun 14];33:11-4. Available from: https://www.endodontologyonweb.org/text.asp?2021/33/1/11/311750
| Introduction|| |
Whitening of discolored tooth is one of the prime reasons for seeking dental care. The extrinsic agents causing discoloration are smoking, food colors, and poor oral hygiene, while intrinsic agents include hereditary and systemic disorders such as amelogenesis and dentinogenesis imperfecta, alkaptonuria, hyperbilirubinemia, and fluorosis. Bleaching of discolored tooth has found to be an effective method for tooth whitening. The commonly used bleaching agents include hydrogen peroxide, carbamide peroxide, sodium perborate, and oxalic acid. The free radicals produced during bleaching causes degradation of higher molecular weight chromogens into molecules with lesser molecular weight that emits radiation of lesser wavelengths and thus appears light. Replacement of any existing composite restoration becomes a necessity since bleaching affects only the tooth and not the restoration. However, the free radicals produced during bleaching inhibits the bonding of composite to the tooth. Hence, a waiting period of at least two weeks was advised by many authors., This requires an additional appointment which may not be affordable in all situations. Hence, the use of antioxidants before composite bonding was recommended. Sodium ascorbate is an effective antioxidant that has shown to improve the bonding of composite resin to tooth immediately after bleaching., Propolis, a bee wax product, has been used in ancient medicine for various inflammatory, bacterial, and viral diseases. It has been proved to have antioxidant property also., The aim of the present study was to evaluate and compare the effect of antioxidant propolis on the resin tag penetration and microtensile bond strength (MTBS) of composite after tooth bleaching.
| Materials and Methods|| |
Sixty maxillary premolars were divided into five groups with 12 samples in each group.
- Group I: Composite was bonded to unbleached enamel
- Group II: Bleaching with 35% carbamide peroxide followed by composite bonding after two weeks
- Group III: Bleaching with 35% carbamide peroxide followed by immediate bonding
- Group IV: Bleaching with 35% carbamide peroxide followed by application of 10% sodium ascorbate solution for 10 min and composite bonding
- Group V: Bleaching with 35% CP followed by application of propolis for 10 min and composite bonding.
The bleaching gel was applied on the buccal and occlusal surfaces of the teeth in Groups II, III, IV, and V using a microbrush for 15 min. The samples were then rinsed with distilled water. Two bleaching sessions at one week interval were performed and three applications of the bleaching agent were made during each session. The specimens were stored in distilled water until use. The occlusal and buccal surfaces were abraded with a diamond disc until dentine exposure. The exposed dentinal surface was etched with 37% phosphoric acid for 10 seconds. Group IV and V were treated with 10% sodium ascorbate and propolis solution at one ml/min for 10 min, respectively. The bonding agent was applied onto the dentinal surface with the help of an applicator brush and cured for 20 seconds with the light-curing unit. Composite was bonded to a thickness of two millimeters and the samples were sectioned longitudinally to obtain two equal halves. One section was used to analyze the MTBS. A metallographic cutter was used underwater cooling at a speed of 800 rpm and was subjected to a static load of 160 g to obtain stick-shaped specimens of one mm2 cross-sectional area from the central region of each sample. These specimens were fixed to the Universal Test Machine using cyanoacrylate adhesive, and a 50N load was applied at a speed of 0.5 mm/min until failure. The bond strength values in Mega Pascal (MPa) were averaged for each group and are tabulated in [Table 1]. The other sections were decalcified, sectioned longitudinally, stained using Brown and Brenn method, and analyzed under an optical light microscope at ×400. The thickness of the hybrid layer and resin tag are given in [Table 2].
| Results|| |
The results based on MTBS and resin tag penetration are as follows.
Microtensile bond strength
The mean MTBS of Group I > Group II > Group V > Group IV > Group III:
- MTBS of Group I had statistical difference between Group III, Group IV, and Group V
- MTBS of Group II had no statistical significance with Group I
- MTBS of Group III was the lowest which was statistically significant from all groups
- MTBS of Group IV showed statistical significance with all groups expect with Group V
- MTBS of Group V had no statistical significance with Group I.
Resin tag and hybrid layer
The mean thickness of Group I > Group II > Group V > Group IV > Group III
- Group I had statistical difference between Group III, Group IV, and Group V
- Group II had no statistical significance with Group I
- Group III was the lowest which was statistically significant from all groups
- Group IV showed statistical significance with all groups expect with Group V
- Group V had no statistical significance with Group IV.
| Discussion|| |
According to various authors, the bond strength of composite is compromised immediately after bleaching. In the present study, MTBS testing was performed as it is more reliable than other conventional tests. Cohesive failures are significantly smaller after microtensile tests when compared with shear bond tests. The maximum microtensile bond strength was obtained in Group I (without bleaching), while the least values were seen in Group III (immediate bonding). The possible reason for this phenomenon is revealed in various studies. The correlation between bond strength and resin tag penetration was studied by various authors. The highly reactive free radicals from the bleaching agents react with free radicals in the composite resin, inhibit polymerization, and generate polymers of reduced mechanical properties. To find the correlation of bond strength and resin tag penetration, in the present study, the same samples were divided and subjected to MTBS and resin tag penetration. The results obtained in this study showed the lowest resin tag penetration depth in Group III (immediate bonding), where the MTBS was also found to be the least. These findings were in accordance with that of Briso et al., where the MTBS strength and resin tag penetration depth were less after immediate bonding.
To improve bonding of composite, a delay of at least two weeks has been proposed. In this study, delaying the composite bonding for two weeks after bleaching improved the composite bonding (Group II). There was statistically no significant difference between Group I (without bleaching) and Group II. This is in accordance with the study conducted by Da Silva et al., in which the penetration depth of composite at different time intervals ranging from 14 days to 30 days after bleaching was assessed and concluded an increased resin tag penetration depth on samples bonded after 30 days.
In a clinical scenario, where immediate composite restoration is required, the delay period posed a major problem. The use of antioxidants has been proposed by few authors before bleaching.,, Among the various antioxidants tested, SA has been found to be useful in regaining the bond strength on immediate post-bleaching composite restoration. Based on the previous studies, SA had been chosen in the current study to evaluate its effect on bleached enamel. The MTBS and also the thickness of the hybrid layer and resin tag penetration depth improved after the use of SA (Group IV) compared to immediate composite bonding (Group III).
In accordance with the relevance of delayed bonding and the use of antioxidants, both the groups were included in the present study. In this study, it was observed that delaying the composite bonding (Group II) showed better results with respect to MTBS as well as resin tag penetration depth compared to SA (Group IV). Various herbal antioxidants such as rosemary extracts, Pedicularis extracts, alpha-tocopherol solution, and green tea were compared with SA in its efficacy to regain the immediate bond strength of composite to bleached enamel. Propolis used in the current study as an antioxidant is a resinous extract from bee glue. The flavonoids present in the extract are responsible for exerting its action, and its antioxidant property was investigated by Goncalves et al. using 2,2-dipheny l-1-picrylhydrazyl free radical scavenging assay. The results showed that around 2% propolis extract showed antimicrobial activity against various species of bacteria and exhibited antioxidant activity even at low concentrations. The propolis used in this study was an ethanol based liquid propolis used at the rate of one ml/min for 10 min. This method of application of propolis is similar to that of SA, as described in previous studies. In the present study, the use of propolis has improved the MTBS of composite, similarly the resin tag penetration and hybrid layer thickness also increased. Since there was statistically significant difference with Group III (immediate bonding), it can be concluded that propolis also can reverse the compromised bonding of composite. However, there was statistically no significant difference with Group IV. Since in this study, propolis is used at the same rate as SA further studies with higher percentage and application time are required to prove its efficiency. Moreover, aqueous extract of propolis should also be tested since it is known to show better antioxidant property.
| Conclusion|| |
Within the limitation of this in vitro study, the following conclusions can be drawn:
- Bleaching of the tooth affects the MTBS and resin tag penetration of composite resin to dentine
- A correlation between resin tag penetration and MTBS was obtained
- The use of antioxidants 10% SA and propolis solution improves the MTBS and resin tag penetration of bleached tooth
- 10% SA and propolis were equally effective in regaining the MTBS and resin tag penetration
- Further studies with propolis at different time duration will help to prove its use in a clinical scenario.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Watts A, Addy M. Tooth discolouration and staining: A review of the literature. Br Dent J 2001;190:309-16.
Joiner A. The bleaching of teeth: A review of the literature. J Dent 2006;34:412-9.
McCaslin AJ, Haywood VB, Potter BJ, Dickinson GL, Russell CM. Assessing dentin color changes from nightguard vital bleaching. J Am Dent Assoc 1999;130:1485-90.
Stokes AN, Hood JA, Dhariwal D, Patel K. Effect of peroxide bleaches on resin-enamel bonds. Quintessence Int 1992;23:769-71.
Dishman MV, Covey DA, Baughan LW. The effects of peroxide bleaching on composite to enamel bond strength. Dent Mater 1994;10:33-6.
Sung EC, Chan SM, Mito R, Caputo AA. Effect of carbamide peroxide bleaching on the shear bond strength of composite to dental bonding agent enhanced enamel. J Prosthet Dent 1999;82:595-9.
Kaya AD, Türkün M. Reversal of dentin bonding to bleached teeth. Oper Dent 2003;28:825-9.
Buettner GR. The pecking order of free radicals and antioxidants: Lipid peroxidation, alpha-tocopherol, and ascorbate. Arch Biochem Biophys 1993;300:535-43.
Thirugnanasampandan R, Raveendran SB, Jayakumar R. Analysis of chemical composition and bioactive property evaluation of Indian propolis. Asian Pac J Trop Biomed 2012;2:651-4.
Wagh VD. Propolis: A wonder Bees product and its pharmacological potentials. Adv Pharmacol Sci 2013;1-11.
Fernandes Jr VVB, Oliani MG, Nogueira Jr L, Silva JM, Araújo RM. Analysis and comparison of different bond strength tests. JSM Dent 2016;4:1076.
Briso AL, Rahal V, Sundfeld RH, dos Santos PH, Alexandre RS. Effect of sodium ascorbate on dentin bonding after two bleaching techniques. Oper Dent 2014;39:195-203.
Miranda CB, Pagani C, Benetti AR, Matuda Fda S. Evaluation of the bleached human enamel by scanning electron microscopy. J Appl Oral Sci 2005;13:204-11.
Da Silva Machado J, Cândido MS, Sundfeld RH, De Alexandre RS, Cardoso JD, Sundefeld ML. The influence of time interval between bleaching and enamel bonding. J Esthet Restor Dent 2007;19:111-8.
Torres CR, Koga AF, Borges AB. The effects of anti-oxidant agents as neutralizers of bleaching agents on enamel bond strength. Braz J Oral Sci 2006;5:971-6.
Kaya AD, Türkün M, Arici M. Reversal of compromised bonding in bleached enamel using antioxidant gel. Oper Dent 2008;33:441-7.
Gökçe B, Cömlekoğlu ME, Ozpinar B, Türkün M, Kaya AD. Effect of antioxidant treatment on bond strength of a luting resin to bleached enamel. J Dent 2008;36:780-5.
Sundfeld RH, Briso AL, De Sá PM, Sundfeld ML, Bedran-Russo AK. Effect of time interval between bleaching and bonding on tag formation. Bull Tokyo Dent Coll 2005;46:1-6.
Datta S, Prasad, Karthik L, Kumar CS, Rajashekhar M, Hemadri M, et al
. Effect of Thulasi and Rosemary on shear bond strength of composite resin to bleached enamel: An in vitro
study. J Res Adv Dent 2015;4:41-7.
Suneetha R, Pavithra S, Thomas J, Nanga GS, Shiromany A, Shivrayan A. An in vitro
comparative study of shear bond strength of composite resin to bleached enamel using synthetic and herbal antioxidants. J Int Oral Health 2014;6:77-81.
Goncalves G, Santos NP, Srebernich SM. Antioxidant and antimicrobial activities of propolis and acai (Euterpe oleracea
Mart) extracts. J Basic Appl Sci 2011;32:349-56
[Table 1], [Table 2]