title: How can nanoleakage occur in self-etching adhesive systems that demineralize and infiltrate simultaneously?
abstract: OBJECTIVE
  Single-step adhesives which etch and prime simultaneously and are not rinsed should not exhibit areas of incomplete infiltration within hybrid layers produced in sound dentin. This study examined the extent of silver uptake using ammoniacal silver nitrate in three two-step, self-etching primers (Imperva Fluoro Bond, Shofu; UniFil Bond, GC, ABF system, Kuraray) and one single-step, self-etching adhesive (AQ Bond, Sun Medical) bonded to dentin and four poly(HEMA) resins used as controls.
  
  
  METHODS
  Flat dentin surfaces were bonded with these adhesives and sectioned into 0.8-mm-thick slabs that were then coated with nail varnish except for the bonded interfaces and immersed in AgNO3 for 24 h. Four types of poly(HEMA) resins were made: 100% HEMA; 90% HEMA-10% water; 75% HEMA-10% water, all polymerized with TBBO at 50 degrees C for 6 h; 100% HEMA polymerized at 25 degrees C for 30 min. After developing, undemineralized, unstained, epoxy resin-embedded sections were prepared for TEM.
  
  
  RESULTS
  Nanoleakage patterns were observed in all bonded specimens. Fine segregated silver particles and reticular silver-staining patterns were found within the thin hybrid layers created by the three self-etching primers. For the single-step, self-etching adhesive, heavy silver deposits were identified within the hybridized complex formed by this adhesive within the smear layer, the underlying intact dentin, and in the adhesive layer. Increasing amounts of silver uptake were observed in poly(HEMA) specimens containing more water or that were polymerized at 25 degrees C for a short time instead of 50 degrees C for 6 h.
  
  
  CONCLUSIONS
  Silver uptake in hybrid layers formed by self-etching adhesives in sound dentin is not necessarily caused by disparities between the depths of demineralization and resin infiltration. They represent areas of increased permeability within a polymerized resin matrix in which water is incompletely removed resulting in regions of incomplete polymerization and/or hydrogel formation.
authors.affiliation: Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China. kfctay@hknet.com
authors.forename: Franklin R
authors.initials: FR
authors.lastname: Tay
authors.forename: Nigel M
authors.initials: NM
authors.lastname: King
authors.forename: Kar-mun
authors.initials: KM
authors.lastname: Chan
authors.forename: David H
authors.initials: DH
authors.lastname: Pashley
mesh_terms: D000134:Acid Etching, Dental; D000269:Adhesives / Q000737:chemistry*; D003763:Dental Leakage / Q000209:etiology*; D003804:Dentin / Q000648:ultrastructure; D003806:Dentin Permeability; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D006801:Humans; D008689:Methacrylates / Q000737:chemistry; D008854:Microscopy, Electron; D008963:Molar; D019279:Resin Cements / Q000737:chemistry*; D012834:Silver / Q000737:chemistry; D016622:Silver Staining; D017001:Tooth Demineralization
chemical_list: C453842:AQ bond; D000269:Adhesives; D017220:Dentin-Bonding Agents; C074806:Imperva-Bond; C471994:KBF Bond; D008689:Methacrylates; D019279:Resin Cements; C407402:Unifil Bond; C000212:ammoniacal silver; C474103:imperva fluoro bond; D012834:Silver; C005044:hydroxyethyl methacrylate