Impact of Simulated Gastric Acid on Tensile Bond Strength of Class II Inlay Indirect Restorations

Section: Research Paper
Issue
Vol. 25 No. 2 (2025): Volume 25 Issue 2
Pages
212-228

Abstract

Abstract: The current study aimed to determine the impact of using hydrochloric acid (HCl) on the tensile bond strength of four distinct restorative materials. By doing so, we sought to provide valuable insights into the durability and resilience of these materials in the face of gastric acid exposure. Material and Methods: Eighty sound maxillary first premolars were included in this study; Teeth were randomly assigned into four groups (n=20) according to the restorative materials. The first group was restored using Filtek Bulk Fill Posterior Restorative (3MTM). The second group was restored with EverX Posterior Fiber Reinforced Dental Composite (GCTM). The third group was restored with multilayer high-strength cubeX zirconia (Dental Direkt TM), and the fourth group was restored with IPS e-max press (Ivoclar/VivadentTM). The samples in the four main categories were further classified into two subgroups (n = 10) based on their immersion in either artificial saliva or simulated gastric acid solution (SGAS). The specimens underwent a tensile bond strength assessment utilizing a universal testing apparatus. The data were examined utilizing Two-Way ANOVA and the Friedman test. The threshold for statistical significance was established at p < 0.05. Results: The impact of HCl was evident on all tested materials, with a significant difference observed between groups after immersion in HCl (p0.000). The lithium disilicate group demonstrated the greatest tensile bond strength, whereas the cubeX zirconia group exhibited the least. All samples showed a notable decline in tensile bond strength following exposure to simulated gastric acid. However, the extent of tensile bond reduction differed throughout the tested groups. Conclusion: The simulated gastric acid, regardless of its type, significantly reduces the tensile bond strength of the tested materials. This underscores the need for further research and the development of more acid-resistant restorative materials.

Keywords:

Bulimia nervosa, Gastric acid, GERD, Tensile bond strength

References

  1. Schmidt J, Huang B. Awareness and knowledge of dental erosion and its association with beverage consumption: a multidisciplinary survey. BMC Oral Health. 2022 Feb 11;22(1):35.
  2. Pîrvulescu IL, Pop D, Moacă EA, Mihali CV, Ille C, Jivănescu A. Effects of simulated gastric acid exposure on surface topography, mechanical and optical features of commercial CAD/CAM ceramic blocks. Applied Sciences. 2021 Sep 18;11(18):8703. https://doi.org/10.3390/app11188703
  3. Aldamaty MF, Haggag K, Othman HI. Effect of simulated gastric acid on surface roughness of different monolithic ceramics. Al-Azhar Journal of Dental Science. 2020 Oct 1;23(4):327-34. https://doi.org/10.21608/ajdsm.2020.34007.1070
  4. Saksena R, Bartlett DW, Smith BG. The role of saliva in regurgitation erosion. The European Journal of Prosthodontics and Restorative Dentistry. 1999 Dec 1;7(4):121-4.
  5. Cruz ME, Simões R, Martins SB, Trindade FZ, Dovigo LN, Fonseca RG. Influence of simulated gastric juice on surface characteristics of CAD-CAM monolithic materials. The Journal of Prosthetic Dentistry. 2020 Mar 1;123(3):483-90. https://doi.org/10.1016/j.prosdent.2019.04.018
  6. Colombo M, Poggio C, Lasagna A, Chiesa M, Scribante A. Vickers micro-hardness of new restorative CAD/CAM dental materials: evaluation and comparison after exposure to acidic drink. Materials. 2019 Apr 16;12(8):1246. https://doi.org/10.3390/ma12081246
  7. Tulek A, Vieira AR, Weber ML, Bezamat M, Deeley K, Stenhagen KR, Sehic A, Sovik JB, Mulic A. Aquaporins’ influence on different dental erosive wear phenotypes in humans. Caries Research. 2020 Feb 11;54(2):165-75. https://doi.org/10.1159/000505965
  8. Yu OY, Zhao IS, Mei ML, Lo EC, Chu CH. A review of the common models used in mechanistic studies on demineralization-remineralization for cariology research. Dentistry journal. 2017 Jun 18;5(2):20. https://doi.org/10.3390/dj5020020
  9. Delgado AJ, Olafsson VG, Donovan TE. pH and erosive potential of commonly used oral moisturizers. Journal of Prosthodontics. 2016 Jan;25(1):39-43. https://doi.org/10.1111/jopr.12324
  10. Crăciunescu EL, Romînu M, Negruţiu ML, Sinescu C, Novac AC, Caplar BD, Pop DM. Indirect Restorative Polymeric Dental Materials. https://doi.org/10.5772/intechopen.113089
  11. Elshahawy W, Ajlouni R, James W, Abdellatif H, Watanabe I. Elemental ion release from fixed restorative materials into patient saliva. Journal of oral rehabilitation. 2013 May;40(5):381-8.https://doi.org/10.1111/joor.12041
  12. Esquivel-Upshaw JF, Dieng FY, Clark AE, Neal D, Anusavice KJ. Surface degradation of dental ceramics as a function of environmental pH. Journal of dental research. 2013 May;92(5):467-71.https://doi.org/10.1177/0022034513484332
  13. Kulkarni A, Rothrock J, Thompson J. Impact of gastric acid induced surface changes on mechanical behavior and optical characteristics of dental ceramics. Journal of Prosthodontics. 2020 Mar;29(3):207-18.
  14. Al‐Thobity AM, Gad MM, Farooq I, Alshahrani AS, Al‐Dulaijan YA. Acid effects on the physical properties of different CAD/CAM ceramic materials: an in vitro analysis. Journal of Prosthodontics. 2021 Feb;30(2):135-41.https://doi.org/10.1111/jopr.13232
  15. Al-alaa JM, Ali AH, Mahdee AF. Cusp deflection and fracture strength of root canal filled premolars with two access cavities designs (Conservative vs Traditional). Journal of Clinical and Experimental Dentistry. 2022 Sep;14(9):e705. https://doi.org/10.4317/jced.59460
  16. Bicalho AA, Pereira RD, Zanatta RF, Franco SD, Tantbirojn D, Versluis A, Soares CJ. Incremental filling technique and composite material—Part I: Cuspal deformation, bond strength, and physical properties. Operative dentistry. 2014 Mar 1;39(2):e71-82. https://doi.org/10.2341/12-441-l
  17. Salama F, Abdelmegid F, Alhussain M, Muaddi H, AlMaflehi N, Alhowaish L. Comparison of Fracture Resistance of Primary Incisors Restored with Different Intracanal-Reinforcement Materials. Clinical, Cosmetic and Investigational Dentistry. 2021 Dec 3:507-12. https://doi.org/10.2147/ccide.s335333
  18. Bhanot S, Mahajan P, Bajaj N, Monga P, Sood A, Yadav R. Fracture resistance of lab composite versus all-ceramic restorations in class II inlay cavity preparations: An: in vitro: study. Journal of Conservative Dentistry and Endodontics. 2022 May 1;25(3):258-63.
  19. Gupta R, Brizuela M. Dental impression materials.
  20. Vijetha V. A Clinical Comparison of a New Direct Hybrid Resin and Zirconium Reinforced Indirect Composite Restorations (Master's thesis, Rajiv Gandhi University of Health Sciences (India)).
  21. Conejo J. Current Adhesive Protocols for Indirect Ceramic Restorations. Compendium of Continuing Education in Dentistry (15488578). 2022 Oct 1;43(9).
  22. Müller N, Al-Haj Husain N, Chen L, Özcan M. Adhesion of different resin cements to zirconia: effect of incremental versus bulk build up, use of mould and ageing. Materials. 2022 Mar 16;15(6):2186. https://doi.org/10.3390/ma15062186
  23. Eltoukhy RI, Elkaffas AA, Ali AI, Mahmoud SH. Indirect resin composite inlays cemented with a self-adhesive, self-etch or a conventional resin cement luting agent: A 5 years prospective clinical evaluation. Journal of Dentistry. 2021 Sep 1;112:103740. https://doi.org/10.1016/j.jdent.2021.103740
  24. Zortuk M, Bolpaca P, Kilic K, Ozdemir E, Aguloglu S. Effects of finger pressure applied by dentists during cementation of all-ceramic crowns. European journal of dentistry. 2010 Oct;4(04):383-8. https://doi.org/10.1055/s-0039-1697857
  25. Stamatacos C, Simon JF. Cementation of indirect restorations: an overview of resin cements. Compendium of Continuing Education in Dentistry (15488578). 2013 Jan 1;34(1).
  26. Yu H, Wegehaupt FJ, Wiegand A, Roos M, Attin T, Buchalla W. Erosion and abrasion of tooth-colored restorative materials and human enamel. Journal of Dentistry. 2009 Dec 1;37(12):913-22 .https://doi.org/10.1016/j.jdent.2009.07.006
  27. Ünal M, Candan M, İpek İ, Küçükoflaz M, Özer A. Evaluation of the microhardness of different resin‐based dental restorative materials treated with gastric acid: Scanning electron microscopy–energy dispersive X‐ray spectroscopy analysis. Microscopy Research and Technique. 2021 Sep;84(9):2140-8.https://doi.org/10.1002/jemt.23769
  28. Soygun K, Soygun A, Dogan MC. The effect of gastric acid on chitosan modified glass ionomer cement: SEM‐EDS. Microscopy research and technique. 2020 Jan;83(1):3-9. https://doi.org/10.1002/jemt.23382
  29. Andre CB, Aguiar TR, Ayres AP, Ambrosano GM, Giannini M. Bond strength of self-adhesive resin cements to dry and moist dentin. Brazilian Oral Research. 2013 Sep;27:389-95.https://doi.org/10.1590/s1806-83242013000500002
  30. Türkmen C, Durkan M, Cimilli H, Öksüz M. Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin. Journal of Applied Oral Science. 2011;19:363-9.https://doi.org/10.1590/s1678-77572011005000011
  31. Paolone G. Direct composites in anteriors: A matter of substrate. Int. J. Esthet. Dent. 2017 Dec 1;12:468-81.
  32. Alp CK, Gündogdu C, Ahısha CD. The effect of gastric acid on the surface properties of different universal composites: a SEM study. Scanning. 2022;2022(1):9217802. https://doi.org/10.1155/2022/9217802
  33. Cengiz S, Sarac S, Oezcan M. Effects of simulated gastric juice on color stability, surface roughness and microhardness of laboratory-processed composites. Dental materials journal. 2014 May 30;33(3):343-8.https://doi.org/10.4012/dmj.2013-265
  34. Backer AD, Münchow EA, Eckert GJ, Hara AT, Platt JA, Bottino MC. Effects of simulated gastric juice on CAD/CAM resin composites—morphological and mechanical evaluations. Journal of Prosthodontics. 2017 Jul;26(5):424-31. https://doi.org/10.1111/jopr.12420
  35. İnci MA, Özer H, Özaşık HN, Koç M. The effects of gastric acid on pediatric restorative materials: SEM analysis. Journal of Clinical Pediatric Dentistry. 2023 Sep 1;47(5).
  36. Omara AA, Othman HI, Aldamaty MF, Metwally MF. Effect of acidic environment on color and translucency of different indirect restorative materials. BMC Oral Health. 2024 Apr 19;24(1):472.https://doi.org/10.1186/s12903-024-04218-5
  37. Almeida Bastos-Bitencourt N, Basso Bitencourt S, Alfrisany N, Hajhamid B, Mendonca De Souza G. Effect of Simulated Gastric Acid on the Interface Between Zirconia and Resin Cement. International Journal of Prosthodontics. 2024 Mar 1;37(2) .https://doi.org/10.11607/ijp.8162
  38. Osorio R, Pisani-Proenca J, Erhardt MC, Osorio E, Aguilera FS, Tay FR, Toledano M. Resistance of ten contemporary adhesives to resin–dentine bond degradation. Journal of dentistry. 2008 Feb 1;36(2):163-9. https://doi.org/10.1016/j.jdent.2007.12.002
  39. Pandoleon P, Sarafidou K, Pouroutzidou GK, Theocharidou A, Zachariadis GA, Kontonasaki E. Effect of Thermal Cycling or Simulated Gastric Acid on the Surface Characteristics of Dental Ceramic Materials. Ceramics. 2024 Apr 15;7(2):530-46. https://doi.org/10.3390/ceramics7020035

Authors

Yasser Khalis Al-Qaissei

Department of Conservative Dentistry, College of Dentistry, Mosul University, Mosul / Iraq

Ali M. Al-Naimi

1 Department of Conservative Dentistry, College of Dentistry, Mosul University, Mosul / Iraq

Abdulhaq A. Suliman

Centre of Medical and Bio-Allied Health, College of Dentistry, Ajman University, United Arab Emirates

Identifiers

DOI: 10.33899/rdenj.2025.188577

Download this PDF file
##submission.supplementaryFiles##
pdf

Statistics

Copyright and Licensing
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.