pyrig

No Co

ht
t fo
Effect of Physicochemical Aging Conditions on therP

by N
ub

Q ui
lica
Composite-Composite Repair Bond Strength te
tio
n ot

n
ss e n c e fo r
Johannes Brendekea/Mutlu Özcanb

Purpose: This study evaluated the effect of different physicochemical aging methods and surface conditioning tech-
niques on the repair bond strength of composite. It was hypothesized that the aging conditions would decrease the
repair bond strength and surface conditioning methods would perform similarly for the repair of resin composites.

Materials and Methods: Disk-shaped resin composite specimens (Clearfil Photo Bright, Kuraray) were randomly as-
signed to one of the three aging conditions (N = 120, n = 12/per group): (1) immersion in deionized water (37°C, 1
week), (2) immersion in citric acid (pH: 3.0, 1 week), (3) boiling in water (8 h), (4) thermocycling (5000 times, 5°C to
55°C), (5) immersion in water (37°C, 2 months). After aging procedures, the specimens were subjected to one of the
following surface conditioning methods: (1) chairside silica coating (30-μm SiOx) (CoJet, 3M ESPE) + silane (ESPE-Sil)
(SC method), (2) silane (Clearfil SE Bond Primer and Clearfil Porcelain Bond Activator) + bonding agent (Clearfil SE
Bond) (SB method). The fresh and aged composite surfaces were also examined using SEM (n = 6, 1/group). Resin
composite (Quadrant Anterior Shine) was bonded to the conditioned substrates using polyethylene molds and then
light polymerized. Shear force was applied to the adhesive interface in a universal testing machine (1 mm/min). The
failure types were categorized as: A) cohesive in the substrate, B) adhesive at the interface, or C) cohesive in the ad-
herend. Bond strength values were statistically analyzed using two-way ANOVA and Tukey’s test (α ≤ 0.05).

Results: A significant influence of the conditioning method (p < 0.0001) and aging method was observed (p < 0.01)
(two-way ANOVA, Tukey-Kramer). The SC method showed significantly higher bond values (7.8 ± 1.2 to 11.6 ± 5 MPa)
than those of SB method (4.6 ± 2.3 to 7.6 ± 3.9 MPa) in all groups (p < 0.0001). While the SC method showed 96%
cohesive (A type), the SB method demonstrated 92% adhesive failures (B type). SEM images showed distinct pattern
of microcracks in the boiled specimens and filler dissolution with disorganized matrix resin in the other aged speci-
mens. Aging the composite substrates through water storage for 2 months produced significantly lower bond
strengths than those of water or acid storage for 1 week (p = 0.011).

Conclusion: Chairside silica coating and silanization provided the highest bond strength values with almost exclu-
sively cohesive failures on aged composites. Aging methods showed significant differences on the composite-com-
posite repair strength.

Keywords: physicochemical aging, repair, resin composite, silica coating, surface conditioning.

J Adhes Dent 2007; 9: 399-406. Submitted for publication: 04.09.06; accepted for publication: 18.12.06.

a Dental Student, University Medical Center Groningen, University of Gronin-

gen, Department of Dentistry and Dental Hygiene, Groningen, The Nether-
lands.
b Professor and Research Associate, University Medical Center Groningen, Uni-
versity of Groningen, Department of Dentistry and Dental Hygiene, Clinical
Dental Biomaterials, Groningen, The Netherlands.
Reprint requests: Dr. Mutlu Özcan, University Medical Center Groningen, Uni-
versity of Groningen, Department of Dentistry and Dental Hygiene, Clinical Den-
tal Biomaterials, Antonius Deusinglaan 1, 9713 AV Groningen, The
Netherlands. Tel: +31-50-363-8528, Fax: +31-50-363-2696. e-mail:
mutluozcan@hotmail.com
T he use of resin-based composite materials in operative
dentistry is increasing, including applications in stress-
bearing areas. Composite resin restorations have good es-
thetic properties and allow for minimally invasive prepara-
tions, or no preparations at all, for the replacement of miss-
ing tooth tissues by means of the basic layering technique.15
The degradation processes of dental composites are
complex and may be due either to mechanical degradation
mechanisms such as wear, abrasion, and fatigue, or chem-
ical degradation mechanisms such as enzymatic, hydrolyt-
ic, and acidic action, or temperature-related breakdown.28

Vol 9, No 4, 2007 399

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r Pin this study
Table 1 Brand names, manufacturers, chemical composition, and batch numbers of the materials used

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Material Manufacturer Chemical composition
lica
Batch number
tio
te n ot

n
se nc e
sF42028
PMMA AutoPlast, Candulor; Polymethylmethacrylate
fo r
Wangen, Switzerland

Clearfil Photo Bright Kuraray; Osaka, Japan - Silanized silica 009EA

- Silanized colloidal silica 009EA
- Prepolymerized organic filler containing colloidal silica 010AA
- Urethane tetramethacrylate 012EA
- Bisphenol A diglycidylmetharcrylate 012GA
- Triethyleneglycol dimethacrylate 012GA
- dl-camphorquinone 014AA
018AA

Quadrant Anterior Cavex; Haarlem, Methacrylate-based monomers 23.7 wt%, silica, 010026C
Shine The Netherlands silicate glass and fluoride containing fillers 75.6 020026C
wt%, polymerization catalysts 0.6 wt%, inorganic
pigments 0.1 wt%

CoJet-Sand 3M ESPE; Seefeld, Aluminium trioxide particles coated with silica 165092
Germany

ESPE-Sil 3M ESPE 3-methacryloxypropyltrimethoxysilane 152745

Clearfil SE Bond Kuraray MDP, HEMA, dimethacrylate monomer, water, photoinitiator 00262A
Primer

Clearfil Porcelain Kuraray Bisphenol a polyethoxy dimethacrylate, 3-methacryloxypropyl- 001248

Bond Activator trimethoxysilane

These degradation mechanisms may result in discoloration,
microleakage, ditching at the margins, delamination, or sim-
ply fracture, which are often experienced in clinical situa-
tions and may require repair or replacement of the restora-
tion.4,14,40,42,45
Total replacement of the restoration is the most common
procedure in daily clinical practice. Clinicians spend 70% of
their chairside time replacing restorations.24 However, this
approach may be regarded as overtreatment, since in most
cases, large portions of the restorations may clinically be con-
sidered intact. Moreover, complete removal of the restoration
inevitably results in weakening of the tooth, unnecessary re-
moval of intact dental tissue, and repeated injuries to the
pulp.14 Repair, as an alternative to complete removal, would
preserve the tooth, as it is often difficult to remove an adhe-
sive restoration without removing an integral part of the
tooth.1,35,43 Therefore, repair of composite resin restorations
by partial replacement of the restorative material maintains
the intact part of the restoration and/or dental tissues, and
could be considered an alternative to total replacement.
A number of techniques have been developed to improve
the bond strength of composite repair through roughening,
etching the substrate surface with acidulated phosphate
fluoride, hydrofluoric acid gel, airborne particle abrasion, or
using adhesive intermediate resins.8,13,17,20,21,29,30,36,37,
44,47 Although promising results were obtained in these ear-
lier studies, the tests were often performed on fresh sub-
strates where the results could be considered optimistic
and not representative of the in vivo situations, as they did
not simulate the aggressive conditions in the oral environ-
ment. Furthermore, under clinical conditions, often the com-
position of the substrate material is not known and therefore
dissimilar composite materials are adhesively bonded to the
aged substrate during repair procedures.
Chemical degradation may result in decreased physical
or mechanical properties of the composite. The latter in-
cludes diametral tensile strength, fracture toughness, hard-
ness, and wear.26,41 The most common aging methods men-
tioned in the dental literature are surface roughening using
silicone carbide abrasives,9,40,43 water storage for different
periods ranging from 7 days to 1 year,1,5,9,14,37,41 acid chal-
lenges,47 or boiling.26 Considering the fact that the com-
posite restorations often fail after being exposed to the oral
environment, changes on the surfaces of the polymeric ma-
terials are expected, and these changes may affect the
bonding properties when repair is considered as a treatment
option in restorative dentistry. Thus, it was hypothesized
that the aging conditions would decrease the repair bond

400 The Journal of Adhesive Dentistry


strength and surface conditioning methods would perform
similarly when aged resin composites are repaired.
Therefore, the objective of this study was to evaluate the
effect of different physicochemical degradation methods
and surface conditioning techniques on the repair bond
strength of composites.
MATERIALS AND METHODS
The brand names, manufacturers, chemical composition
and batch numbers of the materials used in this study are
listed in Table 1. Test specimens were fabricated by packing
unpolymerized composite (Clearfil Photo Bright; Osaka,
Japan) with a hand instrument into cylindrical undercut cav-
ities (diameter: 6 mm, thickness: 2 mm) that were prepared
in auto-polymerized polymethylmethacrylate (PMMA) sur-
rounded by a PVC cylinder (N = 120, n = 12/per group, 3
specimens per cylinder) (Fig 1). The composites were built
up incrementally and light polymerized in layers of approxi-
mately 2 mm until the undercut cavities were slightly over-
filled. Each increment was light polymerized with a hand
light polymerization unit (Demetron LC, SDS Kerr; Orange,
CA, USA) for 60 s from a constant distance of 2 mm from the
surface. Light intensity was 800 mW/cm2, verified by a ra-
diometer (Demetron LC, Kerr). The exposed surfaces of each
specimen were ground using 1200-grit silicone carbide pa-
pers (3M ESPE; St Paul, MN, USA) under water cooling and
cleaned with an air-water spray for 10 s.
Aging Methods
The specimens were randomly assigned to one of the five
aging conditions (N = 120, n = 12/per group): (1) immersion
in deionized water at 37°C for 1 week, (2) immersion in cit-
ric acid (pH:3.0) (1 week), (3) boiling in water (8 h), (4) ther-
mocycling (5000 times, 5°C to 55°C, dwell time: 30 s, trans-
fer time from one bath to the other: 5 s) (Willytec; Gräfelfing,
Germany) and (5) immersion in deionized water at 37°C for
2 months.
In an additional experiment, the fresh (control) and aged
surface of one specimen from each group (n = 6, 1/group)
was first gold sputtered and then examined using a scan-
ning electron microscope (SEM) (JSM-5500, Jeol Instru-
ments; Tokyo, Japan).
Surface Conditioning Methods
After aging methods, the specimens were assigned to one
of the following treatment conditions.
Chairside silica coating (SC)
Silica coating was achieved using an intraoral air-abrasion
device (Dento-Prep, RØNVIG; Daugaard, Denmark) filled with
30-μm alumina particles coated with silica (CoJet-Sand, 3M
ESPE; Seefeld, Germany) from a distance of approximately
10 mm at a pressure of 2.5 bars for 4 s. The conditioned
substrates were then coated with a 3-methacryloxypropyl
trimethoxysilane coupling agent, γ -MPS (ESPE-Sil, 3M ESPE)
and left to react for 5 min.
Vol 9, No 4, 2007
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tio
Fig 1 Schematic drawing of te ot n
n
the cylindrical undercut cavi- ss e n c e
fo r
ties that were prepared in
auto-polymerized polymethyl-
methacrylate surrounded by a
PVC cylinder.
Silane + bonding agent (SB)
Silane coupling agent (Clearfil SE Bond Primer and Clearfil
Porcelain Bond Activator, Kuraray; Osaka, Japan) was mixed
according to the manufacturer’s instructions with a micro-
brush and left in place for 5 s. Then the bonding agent
(Clearfil SE Bond, Kuraray) was applied with a microbrush,
air thinned, and light polymerized for 20 s.
Repair Composite Application
Following surface conditioning, a low viscosity methacry-
late-based composite (shade B3) (Quadrant Anterior Shine,
Cavex; Haarlem, The Netherlands) was bonded onto the sub-
strates using translucent polyethylene molds with an inner
diameter of 3.6 mm and a height of 5 mm. Bonding proce-
dures were carried out in accordance with the manufactur-
ers’ instructions by the same operator (JB) throughout the
experiments. Composite was packed against the substrate
with a hand instrument and polymerized for 40 s. Polyethyl-
ene molds were gently removed from the test specimens.
Specimens were then mounted in the jig of the universal
testing machine (Zwick ROELL Z2.5 MA 18-1-3/7; Ulm, Ger-
many) and the shear force was applied to the adhesive in-
terface until failure occurred. The specimens were loaded at
a crosshead speed of 1.0 mm/min and the stress-strain
curve was analyzed with a software program (Zwick ROELL).
Subsequently, digital photos (Canon Ixus 40, Canon; Tokyo,
Japan) were taken of the substrate surfaces and the types
of failures were categorized as A) cohesive in the substrate,
B) adhesive at the interface, or C) cohesive in the adherend.
Statistical Analysis
Statistical analysis was performed using the software Sta-
tistix 8.0 for Windows (Analytical Software; Tallahassee, FL,
USA). Bond strength data (MPa) were submitted to two-way
ANOVA. Multiple comparisons were made with Tukey’s ad-
justment test (=0.05) with the two surface conditioning
methods and five aging procedures as the independent fac-
tors. Statistical significance was set at p < 0.05 in all tests.
RESULTS
The results of the shear bond strength test for the 5 physic-
ochemical aging methods and the 2 surface conditioning
techniques are presented in Fig 2. Results of two-way ANO-
VA are demonstrated in Table 2.
401
 pyrig
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Table 2 Results of two-way ANOVA for the experimental conditions rP

by N
ub

Q ui
lica
Source of variation df SS MS F P tio
te ot n

n
TECH (SC, SB) 1 544.5450994 544.5450994 49.53
ss
fo r
e n c e
<0.0001
GROUPS (1,2,3,4,5) 4 153.2862203 38.3215551 3.49 0.0105
TECH*GROUP 4 22.7630806 5.6907702 0.52 0.7229
Error 97 1066.402478 10.99384
Total 106 1786.996879

Water storage for 2 months (7.8 ± 1.2 and 4.6 ± 2.3 MPa)
showed significantly lower bond strength results than those
of 1 week water storage (11.4 ± 4 and 7.1 ± 3.3 MPa) (p =
0.0307) or 1 week of acid challenge (11.6 ± 5 and 7.6 ± 3.9
MPa) (p = 0.011) for SC and SB groups, respectively.
While the SC method showed 96% cohesive (A type),
the SB method demonstrated 92% adhesive failures (B
type) (Fig 3). SEM analysis at 5000X magnification, com-
plementary to the bond strength tests, showed a distinct
pattern of microcracks on the surface of the boiled speci-
mens, whereas the specimen stored in citric acid demon-
strated loss of filler particles with a disorganized resin
matrix. In contrast, the fresh specimen presented a
smooth surface at the same magnification (Fig 4).

Fig 2 The mean shear bond strength values (MPa) for two sur-
face conditioning methods and aging conditions as box plots. The
horizontal line in the middle of each box plot shows the mean
value; horizontal lines in the box give 25% and 75% quartiles;
lines outside the box give 5% and 95% quartiles.
a b
Fig 3a Representative specimen from the SC conditioned group
with cohesive failure in the substrate (type A).
Fig 3b Adhesive failure at the interface in an SB conditioned
specimen (type B).
Both the surface conditioning method (p < 0.0001) and
the aging methods (p < 0.01) influenced the bond strength
results significantly (two-way ANOVA, Tukey-Kramer). The in-
teraction term was not significant (p = 0.7229).
The SC method showed significantly higher bond
strength values (7.8 ± 1.2 to 11.6 ± 5 MPa) than those of
the SB method (4.6 ± 2.3 to 7.6 ± 3.9 MPa) in all groups
(p < 0.0001).
DISCUSSION
This study was undertaken in order to examine the effect of
aging and conditioning methods on repair strength of fresh
composite resins to aged ones employing the shear bond
strength test. Similar studies with the same objective, but on
fresh composites, have utilized the same test method or the
microtensile test33 with various adhesive promoters or com-
posites.20,37,41,43,44 Although it can serve as a good testing
method for screening the performance of materials, the
shear test is often not considered an ideal mechanical test
since it often leads to nonuniform stress distribution in the
adhesive interface. In this kind of test, maximum tensile
forces occur close to the load application area, consequently
affecting the substrate more than the adhesive interface it-
self.7,46 The microtensile test, suggested by Sano et al,39 as-
sesses the bond strength of specimens with reduced areas
of the adhesive joint, where fractures essentially occur at the
adhesive interface. When the results of this study are com-
pared with that of a recent study33 where the microtensile
test was used, despite the differences between the test
methods, a similar trend was observed with superior results
using the SC method.
Particle deposition techniques using airborne particle
abrasion increase the ability of the new composite resin to
mechanically interlock to the substrate due to the increase
in the surface area.36,43 Moreover, these retentive surfaces
favor the surface wettability, which allows optimal adapta-
tion of the composite. Thus, micromechanical retention is of-
ten considered as one of the primary requirements for

402 The Journal of Adhesive Dentistry


Fig 4a Representative SEM image (5000X magnification) of non-
aged resin composite substrate with smooth surface (control
specimen).
Fig 4c Representative SEM image (5000X magnification) of cit-
ric-acid challenged specimen with filler loss (E).
achievement of proper bond strength during composite re-
pair.41,42 The chairside tribochemical SC system used in the
present study resulted in the highest mean repair bond
strength values (7.8 to 11.6 MPa) regardless of the com-
posite aging method, when compared with SB method (4.6
to 7.6 MPa). Silica coating consists of air abrasion with
30 μm Al2O3 particles that are modified with silica (CoJet-
Sand), which leads to deposition of a mixture of alumina and
silica particles on the surface.29,34 The surface is then coat-
ed with silane, which makes the surface more reactive for
the methacrylate groups of the repair resin. In the study by
Frankenberger et al,13 fatigue resistance of the repaired
resin after utilization of silica coating or carbide burs gave
similar results but Bouschlicher et al3 reported better out-
comes with utilization of the CoJet-Sand compared to other
repair methods. The fact that the former study did not em-
ploy a silane coupling agent could be the reason for the im-
paired performance of this surface treatment method, since
silane application is a crucial step in silica coating. Similar-
ly, even though some studies did not find any significant dif-
Vol 9, No 4, 2007
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E tio
te ot n
n
ss e n c e
fo r
*
Fig 4b Representative SEM image (5000X magnification) of
boiled specimen. Note the distinct pattern of microcracks on the
resin matrix (*). (E) = filler loss.
Fig 4d Representative SEM image (5000X magnification) of
specimen stored in water for 2 months with disorganized matrix
(*) and filler loss (E).
ference in repair bond strength of composites with or with-
out the use of silane,23 others observed an increase in bond
strength with utilization of silane.18,42,44 According to Söder-
holm and Roberts,42 wear of composite surface exposes
silane-free inorganic filler particles that impair chemical
bonding to the new composite layers. After storing the spec-
imens for 6 months in water, the authors observed that the
specimens repaired using silane presented the same mean
flexural strength compared to original specimens, ie, the
same cohesive strength.
Hisamatsu et al18 also found similar values of cohesive
strength when silanes were employed in the repair proce-
dure of composites.
In this study, after conditioning the surface with silica-
modified alumina particles, γ-MPS silane was applied on the
resin surface. Silanes are molecules with two functional
groups: silanol groups react with the inorganic filler particles
of resin and the organofunctional group reacts with the
methacrylate groups in the adhesive system. After finishing
and polishing procedures and aging caused by the condi-
403

Brendeke/Özcan
tions in the oral environment, degradation of the silane lay-
er surrounding the fillers may be expected. However, a co-
valent bond may again be established between the
monomers in the adhesive system and the inorganic filler
particles in the composite using the silanes. The silica and
alumina present on the composite surface, on the other
hand, form covalent bonds between hydroxyl groups and
silanol groups in the silane. Moreover, the silane also in-
creases the wettability of the adhesive system, allowing it to
more easily infiltrate into the irregularities created by air
abrasion. The use of silane and adhesive systems also does
not necessitate the purchase of additional equipment in the
dental practice, such as chairside air abrasion devices, mak-
ing repairs cost-effective for the practitioners. However, in
this study, the SB method did not reveal increased repair
strength in any of the aged groups compared to SC method.
In fact, it was expected that utilization of intermediate ad-
hesive monomers would increase the repair bond stregth as
reported earlier.6,30,37,41 Nonetheless, this hypothesis was
rejected. Adhesive promoters allow penetration of mo-
nomers into the roughened composite surface, creating a
nonpolymerized layer by inhibition of oxygen that would
eventually aid adhesion and optimal wetting of new com-
posite layers. Intermediate adhesive resins also have an
affinity for inorganic filler particles through bonding to hy-
drogen and silane.41
Investigations evaluating the influence of different adhe-
sive systems commercially available for composite repair
presented variations in bond strength values depending on
the adhesive type.4,9 However, these studies were conduct-
ed on non-aged composites. In this study, the adhesive resin
used in the SB method was mainly based on MDP
monomers. Although different crosshead speeds were used
for the shear tests (5 mm/min), our values are considerably
lower than those of a recent study37 where an acetone/
ethanol based adhesive resin was used. Diffusion rate of the
adhesives and chemical compositions therefore may affect
the results.
After the SC method, no intermediate resin was used as
it was not recommended by the manufacturer. Considering
the better results obtained using this method (vs the SB
method) without the use of intermediate resin, it can be ar-
gued whether the intermediate resin is always necessary to
improve the repair bond strength. Since the SC system pre-
sented significantly higher results in all aged groups com-
pared to the SB method, the former seemed to offset the sur-
face characteristics. This is most probably due to the thin
coating created after particle deposition and silane film on
the aged composite surface.31 This finding emphasizes the
importance of the silica-alumina layer that creates a good
basis for the reaction of the silane on the composite.
Unfortunately, in ex-vivo conditions it is almost impossible
to find a standardized simulation method for aging of com-
posite resin materials. High or elevated temperatures are al-
so known to weaken the composite.3,23 Temperature alter-
ations could also decrease the number of unreacted double
bonds on the surface or within the composite, which conse-
quently may affect the composite-composite repair strength.
Thermocycling is a combination of hydrolytic and thermal
degradation and a method to simulate temperature-related
404
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by N
breakdown by repeated sudden temperature
ever, in contrast to the findings of a previous u bli 33 where
Q ui
study
cat
thermocycling seemed to be more effective in degradation ion
of the composite tested, in this study,t eneither 5000 ther-
ot
n
mocycles nor boiling produced significantsdifferences e
s e n c in re-
fo r
pair bond strength when compared to other aging methods.
This could be attributed to the differences in the test
methodologies between the two studies. On the other hand,
although the bond strength results were not significantly dif-
ferent, matrix crazing or disorganized surfaces with filler
loss were clearly visible in the SEM images of the aged sub-
strates.
Immersion in boiling water or long term acid challenge, al-
though not likely to occur in the oral cavity, are considered
worst-case scenarios, and are employed in order to create a
combined effect of hydrolytic and thermal breakdown and to
accelerate aging.26 The results of this study showed that
thermocycling and boiling both showed a trend to lower bond
strengths, but there were no significant differences between
the two aging methods for both surface conditioning meth-
ods tested.
Water is absorbed by a diffusion-controlled process and
causes leaching of unreacted monomers and swelling of the
matrix. Water acts like a plasticizer and thereby weakens the
polymer structure. Water also degrades the matrix-filler in-
terface directly by hydrolytic breakdown of the silane inter-
face and the surface of the filler particles.11,28 Specimens
of the control group were stored in water for 1 week to rep-
resent the situation in which a restoration fails only after a
short time of service. The specimens in group 5 were stored
in water for 2 months to allow for more water diffusion into
the substrate.37 The results indeed showed significantly low-
er bond strength data after 2 months’ water storage com-
pared to 1 week in both conditioning methods. Thus, the hy-
pothesis was confirmed.
The amount of monomers leached out of the polymer
may vary with the type of monomers in the matrix system.
For the bis-GMA-containing polymers, the conversion degree
ranges from 54% to 85%.12 The substrate composite used
in our study was based on bis-GMA/UTMA. The monomer
leached from the polymer matrix is inversely correlated to
the amount of TEG-DMA in the system and positively corre-
lated to base monomer concentration.10,22 The results
therefore may be affected when other composites are used,
such as those with a UDMA/TEG-DMA matrix or when simi-
lar composites are bonded.
Strong acids could dissolve filler particles on the surface
of a composite.32 While this process increases microporosi-
ties on the surface due to filler loss, it does not necessarily
increase the adhesion of resins to etched surfaces.32 Kula
et al19 examined decomposition of the inorganic filler parti-
cles after immersion of the composite in an acidic medium.
This decomposition may impair the adhesion between com-
posite layers, but no difference was observed between uti-
lization of acid alone or acid followed by adhesive in the
study by César et al,5 with results ranging from 20 to 22
MPa. In contrast, Sau et al40 found shear strength values
ranging between 3 and 11 MPa. The results obtained from
the acid-challenged group ranged from 7.6 to 11.6 MPa for
the two surface conditioning methods.
The Journal of Adhesive Dentistry

To date, clinically sufficient bond strength is not known.
Aiming for higher bond strength could perhaps be thought
unnecessary, yet it should also be noted that higher repair
bond strength and thereby good surface wetting of the repair
resin on the substrate would also decrease the microleak-
age between the repaired layers. Microleakage is often one
of the reasons why composite restorations need to be re-
placed.33 In the SC conditioned groups, almost all the spec-
imens (96%) failed cohesively in the substrate, whereas in
the SB treated groups, 92% of the specimens failed adhe-
sively. Thus, in the SC conditioned groups, the bond strength
of the new composite to the aged composite exceeds the in-
ternal strength of the substrate. Therefore, it is very impor-
tant to assess the failure type when measuring the bond
strength between two materials. When there is no significant
difference in the bond strengths between the experimental
groups, there may still be significant differences between
failure types. However, shear tests often lead to non-homo-
geneous stress distributions in the bonded interface, per-
haps leading to erroneous interpretation of the results.7,46
Since failure often starts in one of the substrates and not at
the adhesive zone, often cohesive failures of the substrates
occur. One should expect the same phenomenon happening
to the all specimens in both conditioning groups.7 Never-
theless, it was interesting to note that although the shear
test was employed, the incidence of cohesive failures in the
SB method was remarkably low. It is well known that as the
adhesive zone is composed of resin-resin material, it is very
difficult to distinguish the substrate and the adherend.7,33
However in this study, the cohesive failures in the substrates
were even macroscopically evident, due to the obvious and
substantial cavitations.
The importance of including dynamic stress in dental ma-
terial testing is important since quasi-static test methods
cannot be sufficient for understanding fatigue properties of
the bonded joints.2,27 Fatigue loading and thermal stresses
may lower the bond strengths achieved.27 The findings of
this study also need to be confirmed by fatigue investiga-
tions. However, early clinical reports indicate promising out-
comes of repaired composite restorations.16
Clinically it is also important to know how much compos-
ite should be removed from the surface of the restoration to
exclude the possible effects of aging. Yap et al47 have looked
at the thickness of the degradation layer after conditioning
the composite substrates for one week in different chemi-
cals. They found a mean thickness of the degradation layer
of 5 to 10 μm in cross-section photos at 600X magnification.
However, this thickness was determined by naked eye. Sur-
face chemistry studies are in progress in our laboratories to
determine in greater detail how the aging process affects the
deeper levels of the composite.
Future studies are also warranted to examine the aging
effect not only on the substrate but also on the repaired sub-
strate-adherend complex with and without surrounding den-
tal tissues with similar and dissimilar composites.
CONCLUSIONS
Based on the results of this study, it can be concluded that:
Vol 9, No 4, 2007
opyrig
No CBrendeke/Özcan
ht
t fo
r P the high-
by N
1. Chairside silica coating and silanization provide
ub with
Q ui
est repair bond strength values on aged compositeslica
almost exclusively cohesive failures in the substrates tio
compared to silane and bonding agentt eapplication only. n
ot
n
ss e n c esignifi-
2. The different chemical aging methods produced
fo r
cant differences in the composite-composite repair bond
strengths.
3. Aging the composite substrates through water storage for
2 months showed significantly worse results than those
of water or acid storage for 1 week.
ACKNOWLEDGMENTS
The authors acknowledge Mr. Ietse Stokroos for his assistance with the
SEM images.
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406 The Journal of Adhesive Dentistry