Comparison the Effect of Bromelain Enzyme, Phosphoric Acid, and Polyacrylic Acid Treatment on Microleakage of Composite and Glass Ionomer Restorations

Sharafeddin, Farahnaz; Moraveji, Paniz

doi:10.30476/dentjods.2021.88737.1355

Comparison the Effect of Bromelain Enzyme, Phosphoric Acid, and Polyacrylic Acid Treatment on Microleakage of Composite and Glass Ionomer Restorations

Document Type : Original Article

Authors

Farahnaz Sharafeddin ¹

Paniz Moraveji ²

¹ Dept. of Operative Dentistry, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

² Undergraduate Student, Dept. of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

https://doi.org/10.30476/dentjods.2021.88737.1355

Abstract

Statement of the Problem: Resin modified glass-ionomer cement (RMGIC) shows low microleakage values. Bromelain enzyme is a deproteinizing agent with an anti-inflammatory effect in human body.Efective cavity treatment is an important factor in reduction of microleakage.
Purpose: The aim of this study was to determine the effectiveness of the deproteinizing aspect of 10% bromelain enzyme on the microleakage of RMGIC and composite restorations.
Materials and Method: In this experimental study, 40 non-carious extracted human molar teeth were categorized in eight experimental groups (n=5). Standard class V cavities were prepared on the buccal and lingual surfaces of the teeth (n=10). The specimen were classified as Group 1, in which 20% polyacrylic acid (PAA) was applied on the teeth then treated with 10% bromelain enzyme; Group 2: 10% bromelain enzyme was applied; Group 3: 10% bromelain enzyme was applied and then treated with polyacrylic acid; Group 4: 20% polyacrylic acid was applied. Groups1 to 4 were restored with RMGIC (Fuji II LC, GC, Japan). Group 5: etched by 37% phosphoric acid and then treated by 10% bromelain; Group 6: 10% bromelain enzyme was applied without etching; Group 7: teeth were deproteinized with 10% bromelain enzyme and then etched with 37% phosphoric acid; and Group 8: cavities were etched with 37% phosphoric acid. In the groups 5 to 8, Adper single bond (3M, ESPE, USA) and filled with composite resin Z350 (3M, ESPE, USA). After thermocycling, the teeth were sectioned. Microleakage scores were measured using stereomicroscope (40×). Kruskal-Wallis and Mann-Whitney tests were used for data analysis (p< 0.05).
Results: Statistical analysis did not show any significant difference in occlusal and gingival margin microleakage in glass ionomer groups (1-4) (occlusal p= 0.218, gingival p= 0.192). Kruskal-Wallis revealed significant difference in occlusal and gingival margin microleakage of Groups 5 to 8 (occlusal p= 0.006 and gingival p= 0.00). Group 5 demonstrated the lowest occlusal microleakage (occlusal mean=0.00).
Conclusion: Applying bromelain or polyacrylic acid did not affect the microleakage of glass ionomer filling. Due to the antinflamatory effects of bromelain, we suggest using it instead of PAA. Pretreatment of 10% bromelain enzyme after phosphoric acid significantly decreased microleakage in the occlusal and gingival margin of composite filling.

Keywords

Bromelain

Glass ionomer

Polyacrylic acid

Phosphoric acid

Composite resin

Sharafeddin F, Alavi A A, Siabani S, Safari M. Comparison of Shear Bond Strength of Three Types of Glass Ionomer Cements Containing Hydroxyapatite Nanoparticles to Deep and Superficial Dentin. J Dent Shiraz. 2020; 21: 132-140.
Sharafeddin F, Moradian M, Motamedi M. Evaluation of Shear Bond Strength of Methacrylate-and Silorane-based Composite Resin Bonded to Resin-Modified Glass-ionomer Containing Micro-and Nano-hydroxyapatite. J Dent Shiraz. 2016; 17: 142-148.
Sharafeddin F, FeiziEvaluation of the effect of adding micro-hydroxyapatite and nano-hydroxyapatite on the microleakage of conventional and resin-modified Glass-ionomer Cl V restorations. J Clin Exp Dent. 2017; 9: e242-e248.
SharafeddinF, Azar MR, Feizi N, Salehi R. Evaluation of Surface Microhardness of Silver and Zirconia Reinforced Glass-ionomers with and without Microhydroxyapatite. J Dent Biomater. 2017; 4: 454-460.
Sharafeddin F, Ghaboos SA, Jowkar Z. The effect of short polyethylene fiber with different weight percentages on diametral tensile strength of conventional and resin modified glass ionomer cements. J Clin Exp Dent. 2017; 9: e466-e470.
Sharafeddin F, Karimi S, Jowkar Z. Evaluation of the effect of micro-hydroxyapatite incorporation on the diametral tensile strength of glass ionomer cements. J Conserv Dent. 2019; 22: 266-269.
Sharafeddin F, Kowkabi M, Shoale S. Evaluation of the effect of home bleaching agents on surface microhardness of different glass-ionomer cements containing hydroxyapatite.J Clin Exp Dent. 2017; 9: e1075-e1080.
Sharafeddin F, Choobineh MM. Assessment of the Shear Bond Strength between Nanofilled Composite Bonded to Glass-ionomer Cement Using Self-etch Adhesive with Different pHs and Total-Etch Adhesive. J Dent Shiraz. 2016; 17: 1-6.
Sharafeddin F, Shoale S, Kowkabi M. Effects of Different Percentages of Microhydroxyapatite on Microhardness of Resin-modified Glass-ionomer and Zirconomer. J Clin Exp Dent. 2017; 9: e805-e811.
Sharafeddin F, Bakhtiarvand NA, Jowkar Z. Evaluation of the effect of home bleaching gel on microleakage of different glass ionomers reinforced with micro-hydroxyapatite. J Conser Dent. 2019; 22: 64-68.
Dayem RN, Tameesh MA. A new concept in hybridization: Bromelain enzyme for deproteinizing dentin before application of adhesive system. Contemp Clin Dent. 2013; 4: 421-426.
Sharafeddin F, Haghbin N. Comparison of bromelain enzyme, Sodium Hypochlorite, and Titanium Tetrafluoride on Shear Bond Strength of Restorative Composite to dentin: an in vitro study. J Dent Shiraz. 2019; 20: 264-270.
Ferreira JF, Curvelo*Santana JC, Basile*Tambourgi E. The Effect of pH on Bromelain Partition from Ananas comosus by PEG4000/Phosphate ATPS. Brazilian J Biolog Techno. 2011; 54: 125-132.
Dayem RN, Tameesh MA. A new concept in hybridization: Bromelain enzyme for deproteinizing dentin before application of adhesive system. J Contemp Clin Dent. 2013; 4: 421-426.
Chauhan K, Basavanna RS, Shivanna V. Effect of bromelain enzyme for dentin deproteinization on bond strength of adhesive system. J Conserv Dent. 2015; 18: 360–363.
Kasraei S, Yarmohammadi E, Farhadian M, Malek M. Effect of proteolytic agents on microleakage of etch and rinse adhesive systems. Brazilian J Oral Scien. 2017; 16: 1-11.

Toledano M, Osorio E, Osorio R, Garacia-Godoy F. Microleakage of class V resin-modified glass ionomer and compomer restorations. J Prosthet Dent. 1999; 81: 610-615.
Falahzadeh F, Yousefi A, Parsafar A. Evaluation the microleakage of class V cavity preparations restored with resin composite and resin modified glass ionomer. J Guilan Univ Med Scien. 2011; 20: 8-14.
Yli-Urpo H, Narhi M, Narhi T. Compound changes and tooth mineralization effects of glass ionomer cements containing bioactive glass (S53P4), an in vivo Biomater J. 2005; 26: 5934-5941.
Liu Y, Tjäderhane L, Breschi L, Mazzoni A, Li N, Mao J, Pashley DH, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011; 90: 953-968.
Dayem RN. Assessment of the penetration depth of dental adhesives through deproteinized acidetcheddentin using neodymium: yttrium–aluminum–garnet laser and sodium hypochlorite. Lasers Med Sci. 2010; 25: 17-24.
Ghensi P, Cucchi A, Bonaccorso A, Ferroni L, Gardin C, Mortellaro C, et al. In vitro effect of bromelain on the regenerative properties of mesenchymal stem cells. J Craniofac Surg. 2019; 30: 1064-1067.
Savadi*Oskoee S, Alizadeh*Oskoee P, Jafari*Navimipour E, Ajami AA, Pournaghi*Azar F, Rikhtegaran S, et al. Comparison of the effect of Nd:YAG and diode lasers and photodynamic therapy on microleakage of class V composite resin restorations. J Dent Res Dent Clin Dent Prospect. 2013; 7: 74-80.
Szep S, Langner N, Bayer S, Börnichen D, Schulz C, Gerhardt T, et al. Comparison of microleakage on one composite etched with phosphoric acid or a combination of phosphoric and hydrofluoric acids and bonded with several different systems. J Prosthet Dent. 2003; 89: 161-169.

Wards DH. Glass ionomer restorative materials are easier to place and are less technique-sensitive. J Cosmet Dent. 2011; 27: 75-80.
Kaushik M, Sharma R, Reddy P, Pathak P, Udameshi P, Vallakuruchi Jayabal N. Comparative evaluation of voids present in conventional and capsulated glass ionomer cements using two different conditioners: an in Vitro study. Int J Biomater. 2014; 2014: 1-5.
Lugassy D, Segal P, Blumer S, Eger M, Shely A, Matalon S. Effect of two traditional polyacrylic acid conditioners and 2% chlorhexidine digluconate on cavosurface microleakage of glass ionomer restorations. J Clin Pediatr Dent. 2018; 42: 287-291.

Karrabi M, Davari AR, Danesh Kazemi Comparison of chlorhexidine 2% and sodium hypochlorite 5% as rewetting agents on resin-dentin micro tensile bond strength. J Dent Mater Tech. 2016; 4: 189-195.
Ghabanchi J, Moattari A, Darafshi R, Andisheh Tadbir A, Khorshidi H, Shakib M. Chlorhexidine mouth wash has a toxic effect on fibroblast cells. Effects of three Commercial Mouth Rinses on the Cultured Fibroblasts: An in Vitro Study. J Dent Shiraz. 2013; 14: 64-67.
Tjan AH, Dunn JR. Microleakage at gingival dentin margins of Class V composite restorations lined with light-cured glass ionomer cement. J Am Dent Assoc. 1990; 121: 706-710.
Unemori M, Matsuya Y, Akashi A, Goto Y, Akamine A. Self-etching adhesives and postoperative sensitivity. Am J Dent. 2004; 17: 191-195.