The use of Heliox plasma to improve the adhesion

of a self-adhesive resin cement to NaOCl treated

dentin
Maíra Prado 
(

mairapr@hotmail.com
)
Universidade Veiga de Almeida
Iris Sol Telles 
Universidade Veiga de Almeida
Carolina Oliveira de Lima 
Universidade Federal de Juiz de Fora
Emmanuel João Nogueira Leal da Silva 
Rio de Janeiro State University
Juliana das Neves Marques 
Federal University of Rio de Janeiro
Lucianne Maia 
Federal University of Rio de Janeiro
Renata Simão 
Federal University of Rio de Janeiro

Research Article

Keywords: Bond strength, Non-thermal plasma, Sodium ascorbate, Sodium thiosulfate

Posted Date: May 24th, 2022

DOI: https://doi.org/10.21203/rs.3.rs-1666651/v1

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Abstract
Objectives To evaluate the influence of Heliox plasma to improve the adhesion of self-adhesive resin
cement to sodium hypochlorite (NaOCl) treated dentin, in comparison to antioxidant agents, for fiber post
cementation.

Material and Methods 88 bovine teeth were selected and were cut producing 7mm samples. 65 roots
canals were enlarged and assigned to five groups (n=13) according to the treatments, for 1 minute, as
follows: control (distilled water); NaOCl (immersed in 5.25% NaOCl for 20 minutes); plasma (after NaOCl
immersion, premixed helium and oxygen plasma were applied); sodium thiosulfate (ST) and ascorbate
(SA) (after NaOCl immersion, the samples were immersed in 5% ST or 10% SA, respectively). Fiberglass
posts were cemented and submitted to the push-out bond strength (POBS) in 10 of 13 samples from
each group. Three samples were analyzed by scanning electron microscopy (SEM). Flat dentin surfaces
were obtained from the 23 remaining roots and used for measuring surface energy.

Results POBS values were ranked as: SA>plasma>ST=control>NaOCl. The ascorbate and plasma groups
showed some smear layer removal by SEM. Surface energy was ranked as: control<NaOCl=ST
<SA<plasma.  Heliox plasma and antioxidant agents restored the POBS of NaOCl-treated dentin.

Conclusion The use of Heliox plasma or antioxidant agents for 1 minute improved the adhesion of
fiberglass post to dentin using RelyX U200.

Clinical Relevance Heliox plasma and antioxidant agents restored bond strength of treated dentin.

Introduction
The employment of composites has been strongly suggested for intracoronal sealing, after endodontic
treatment, for fiberglass post cementation and coronal restoration [1–3]. Such adhesive materials are
being used for immediate coronal sealing, preventing leakage and promoting greater strength to the teeth
when compared to temporary or amalgam restorations [4, 5].

Sodium hypochlorite (NaOCl) is the most common irrigant used during endodontic treatment due to its
antimicrobial activity, associated to dissolve organic tissue [6]. However, it modifies the organic
components of dentin, mainly collagen, affecting the mechanical properties of this dentin [7, 8].
Furthermore, the polymerization of adhesive systems can be affected by the oxidative power of NaOCl,
producing a negative effect on the adhesion and bond strength of resin materials [9, 10].

Thus, the use of an antioxidant agent before performing the adhesive procedure was proposed to
neutralize and reverse this oxidizing effect of NaOCl. [11–13]. Sodium ascorbate is the most widely
studied antioxidant agent [11–13]. However, this agent has a short shelf life because it is tough to
preserve the ascorbic acid solution in its original form for a long period of time [11]. Due to this limitation,
an anterior study [13] suggested the use of sodium thiosulfate (Na2S 2O3), an antioxidant that has been

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used as a neutralizing agent of NaOCl in microbiological analysis, that can be used as reducing agent for
NaOCl-treated dentin without causing damage to biological tissues [13–16].

Non-thermal plasma has been suggested to improve the adhesion of resin-based materials to dentin [17–
19]. It is a technology that permits the surface modification of materials and that the bulk properties to
remain unaltered or well-maintained after this treatment [18]. It is partially ionized gases that contain
highly reactive particles, while the gas phase remains near room temperature. Depending on plasma
chemistry or gas composition, these specimens can react with, clean, and etch surface materials, bond to
different substrates, or combine to form a thin layer of plasma coating and, consequently, modify the
surface characteristics [10, 17–19]. Other applications included antimicrobial effects on dental materials
surface [20, 21], root canal disinfection [22], adhesion to zirconia [23], improvement of resin-based sealer
wettability [10] and on adhesion of root canals filling materials [24].

The aim of this study was to evaluate the influence of Heliox plasma to improve the adhesion of self-
adhesive resin cement to sodium hypochlorite (NaOCl) treated dentin, in comparison to antioxidant
agents, for fiber post cementation. The null hypothesis was that the Heliox plasma would not be effective
in reversing the bond strength to dentin compromised by NaOCl.

Material And Methods

Eighty-eight freshly extracted bovine incisors with anatomically similar root segments were used. Sixty-
five teeth were prepared for the push-out bond strength (POBS) test and scanning electron microscopy
(SEM) while the remaining 23 teeth were prepared for surface energy and components analyses.

The solutions used in the present study were prepared by the same manufacturer and used after
preparation.

Sample preparation 

Sixty-five teeth were selected. Each tooth was decoronated below the cementoenamel junction
perpendicularly to the longitudinal axis with a rotary diamond disk at low speed. The apical segment was
also removed. Roots from the cervical and middle thirds were cut to a uniform length of 7 mm. 

Pulp tissue was removed, and the root canals were enlarged and standardized by using a 3-mm
cylindrical drill attached to a bench drill. The roots were randomly divided into five groups (n=13).

In the control group, the roots were rinsed with 10 mL of distilled water (DW) and dried with paper points.

In the NaOCl group, the roots were immersed in 5.25% NaOCl for 20 minutes to simulate the contact time
of irrigant during chemomechanical preparation [25]. The roots were then rinsed and dried as described
for the control group.

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In the plasma group, after the treatment described for the NaOCl group, a non-thermal atmospheric
pressure plasma jet was used. Premixed helium and oxygen gas (98% He and 2% O2) were employed. The
gas pressure was 6 bar and a voltage of approximately 1000 V was applied to generate plasma. During
the treatment, the distance between the tip of the plasma jet and the sample was 5 mm. The teeth were
exposed to the plasma for 1 minute. After the treatments, the root canals were dried with paper points

In the thiosulfate and ascorbate groups, after immersion in NaOCl for 20 minutes, the samples were
rinsed with 10 mL of DW and immersed in 5% sodium thiosulfate or 10% sodium ascorbate for 1 minute,
respectively. Finally, the samples were rinsed with 10 mL of DW and dried with paper points.

Push-out test

Fiberglass post cementation

Post cementation was performed in 10 samples from each group.

For post treatment, the fiberglass posts were submitted to an ultrasonic bath in 70% alcohol for 10
minutes so that any superficial contaminant could be removed [26]. A thin layer of silane was then
applied homogeneously on the fiber post surface using a microapplicator. After 1 minute, the surface was
dried with air jet.

Since a self-adhesive resin cement was used, dentin treatment was not necessary. The cement was
manipulated and placed into the canal using 20-gauge Accudose Needle Tubes. The posts were placed in
position immediately after cement application. Light polymerization was performed for 40 seconds with
an irradiance of 500 mW/cm2.

Push-out test and failure mode

Each root was horizontally sectioned with a slow-speed, water-cooled diamond saw to produce
approximately 1-mm thick slices. The first (coronal) and last (apical) slices were discarded. Three slices
from each root canal were evaluated.

Bond strength was analyzed through the push-out test by using a universal testing machine at a
crosshead speed of 0.5 mm/min and a cylindrical post measuring 1.2 mm in diameter and 20 mm in
length with a 200-kgf load cell.

To express the bond strength in Megapascals (MPa), the load value recorded in Newtons (N) was divided
by the area (mm2) of the bonded interface. It was calculated as follows [24]: A= 2prh, where p is equal to
3.14, r is 1.5 mm (the canal was standardized to a diameter of 3 mm) and h is the thickness of the slice in
millimeters. The thickness of each slice was measured using a digital caliper.

All fractured specimens were observed under a stereoscope at 10X magnification to determine the failure
mode. The failure mode was classified into four types [27]: (I) Adhesive between the cement and dentin:

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fracture occurs predominantly at the cement/dentin interface; (II) Mixed cohesive dentin: some fracture
occurs within the dentin; (III) Mixed cohesive post: fracture occurs at the post; (IV) Mixed cohesive
post/dentin: fracture occurs at the post and dentin. 

Topographical Analysis

In each group, three samples were analyzed qualitatively by scanning electron microscopy to verify the
effect of antioxidant agents and non-thermal plasma on the dentin surface. 

Two longitudinal grooves were prepared on both buccal and lingual surfaces by using a diamond disk
without penetrating the canal. The roots were then split into two halves with a hammer and chisel. 

The samples were coated with gold and analyzed under a scanning electron microscope. The most
central area of the canal was selected and three predetermined areas (1 mm from the cervical side, center
of the sample, and 1 mm from the apical side) were selected. Images were recorded at 500X
magnification. 

Surface tension analysis 

The surface tension of the irrigants was measured using the Du Noüy ring method. The TensioCad
tensiometer was used at a constant room temperature of 23 °C. The principle of the instrument depends
on the fact that the force necessary to detach a platinum-iridium ring immersed at the surface is
proportional to the surface tension [28]. The ring dimensions were: mean diameter: 19.09 mm and toric
section diameter: 0.37 mm.

Before measurements, distilled water was used for zero calibrations. 50 mL of each tested solution was
placed into a 3-cm glass dish and the dish was elevated by a precision screw until contact with the
platinum ring was established. Torsion was then applied to the screw until the platinum ring became
detached and readings on the scale were recorded in dyne/cm. Ten readings were made for each irrigant.

Surface free energy analysis

Another 23 bovine teeth were selected. The standardized roots (7 mm), obtained as described later, were
cleaved towards the long axis of the tooth, resulting in two segments, totaling 46 samples. The samples
were planned with the help of a sandpaper (100 grit) under water cooling in a sanding machine to create
a standard smear layer. Forty-five dentin surfaces were analyzed.

The contact angle analysis was done with a Ramé-Hart goniometer (Ramé-Hart Instrument). The contact
angle between the dentin surface and the solutions (water (polar), ethylene glycol (polar), and
diiodomethane (apolar) was measured [10].

Nine samples from each group, three in contact with each solution, were evaluated. Sixty measurements
were made for each drop of the above-mentioned solutions. Based on the data collected, the Ramé-Hart

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software measured the surface free energy, as well as the polar and dispersed components of the
different groups. 

Statistical analysis

Both Kolmogorov-Smirnov and Levene’s tests were used to evaluate normality and heteroscedasticity in
the data. The bond strength data were then analyzed using ANOVA followed by Tukey’s post hoc test for
comparisons (α = 0.05). Surface free energy and components were analyzed using the nonparametric
tests, Kruskal-Wallis, and Mann-Whitney (α = 0.05).

Results
Table 1 shows the mean and standard deviation values for POBS and failure patterns of each group. The
sodium ascorbate group, followed by the plasma group, showed significantly higher POBS values than
the other groups. The sodium thiosulfate and control groups showed statistically similar POBS values
while the NaOCl group had the lowest bond strength.   

As shown in Table 1, the failure pattern was exclusive of type I, adhesive between the cement and dentin,
in the control and NaOCl groups.   In the thiosulfate group, failure was mainly of type I (83.34%). In the
ascorbate group, it was mainly of type IV (50%), mixed cohesive post. In the plasma group, type I
(37.93%) and type IV (34.48%) were the most common.

Table 1: Mean (standard deviation) values for bond strength and failure pattern.

Groups POBS values Failure Pattern (%)

Mean (Standard deviation)        

MPa Type I Type II Type III Type IV

Distilled water 2.04 (0.73)C 100 0 0 0

NaOCl 0.83 (0.64)D 100 0 0 0

Heliox Plasma 3.93 (1.32)B 37.93 27.59 0 34.48

Sodium thiosulfate 2.92 (2.00)C 83.34 13.33 0 3.33

Sodium ascorbate 5.64 (1.45)A 20 30 0 50

Superscript lettersA-D indicate statistically significant values (Tukey’s test, P < 0.05).

Fig. 1 shows the representative photomicrographs of the dentin after different treatments. Note that the
smear layer covers the whole dentin surface in the distilled water (control), NaOCl, and sodium thiosulfate
groups. Two out of three samples obtained from the cervical area in the plasma group showed partial
smear layer removal. In the sodium ascorbate group, all images show some smear layer removal.

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Fig. 2 shows the surface tension of the solutions used in the present study. Sodium thiosulfate presented
the lowest values (47.81±0.56 dyne/cm), followed by sodium ascorbate (55.6±1.82 dyne/cm), NaOCl
(58.9±0.64 dyne/cm), and distilled water (69.2±1.00 dyne/cm).

Table 2 shows the values of polar and dispersed components and surface energy. The lowest values of
surface energy were observed in the distilled water group. The NaOCl and sodium thiosulfate groups
showed similar surface energy and polar component values, followed by the sodium ascorbate group.
The plasma group showed the highest surface energy and component values.

Table 2: Component and surface energy results.

Groups Polar component Dispersed component Surface Energy

(mJ/m2) (mJ/m2) (mJ/m2)

Distilled water 12.34A 39.90A 52.95A

NaOCl 24.51B 41.95B 66.46B

Heliox Plasma 30.16C 50.39D 80.67D

Sodium thiosulfate 19.76B 45.39C 65.14B

Sodium ascorbate 26.70B 45.19C 71.88C

Superscript letters A-D indicate statistically significant values (Mann-Whitney test, P < 0.05).

Discussion
An effective bonding of fiber posts to cement and of cement to dentin is essential for the longevity of
restorations and for endodontic prognosis [27]. The present study evaluated the efficacy of non-thermal
plasma and antioxidant agents, sodium ascorbate, sodium thiosulfate, on adhesion of fiberglass post to
dentin using the self-adhesive resin cement RelyX U200, using the push-out test. Additionally, qualitative
(topographic findings and surface tension) and quantitative (surface free energy) investigations were
performed to assist in the interpretation and analysis of the results.

Though sodium hypochlorite is the most common irrigant used during endodontic therapy, its use has a
negative effect on the bond strength of resin-based materials to dentin [2, 9, 29]. This effect was
confirmed in the present study, where the NaOCl group exhibited the lowest bond strength. This effect can
be explained by the degradation of the organic components of dentin, associated with the creation of an
oxygen-rich layer on the dentin surface, which has a negative effect on the polymerization of dental
adhesive systems [2, 7, 29].

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Non-thermal plasma was proposed in the present study due to its antimicrobial properties, combined with
its positive effect on the bonding properties of different dental substrates [10, 17, 18, 22]. The use of non-
thermal atmospheric pressure plasma jet using premixed helium and oxygen gas (98% He and 2% O2,
White Martins, Rio de Janeiro, RJ, Brazil) and its positive effect was previously described by an anterior
study [24].

Previous studies reported that sodium ascorbate and sodium thiosulfate were efficient in reversing the
bond strength of NaOCl-treated dentin [1, 5, 12, 13]. However, in most cases, this reversal is time-
consuming. Weston et al.1 demonstrated that the negative effect produced by 5.25% NaOCl irrigation on
bond strength could be reversed using 10% sodium ascorbate for 1 minute. Based on Weston et al. and
on clinical applicability, the solutions and non-thermal plasma used in the present study were applied for
1 minute.

RelyX U200, a self-adhesive cement, was chosen because it requires no pretreatment of the tooth surface,
and because it is a simplified and time-saving cementation procedure. The bonding mechanism of this
cement is based on micromechanical retention and chemical adhesion [2].

Regarding the topographic effect of the different protocols used in the present study, a smear layer
covered the whole dentin surface in the distilled water (control), NaOCl, and sodium thiosulfate groups.
Partial smear layer removal was observed in the plasma group, in two out of the three samples from the
cervical area. In the sodium ascorbate group, all images showed some smear layer removal.

Surface tension was measured in the present study. In general, the wettability of a solution depends on its
surface tension, which is defined as the force between molecules that produces a tendency for the
surface area of a liquid to decrease. The efficiency of an irrigant can be associated with its reduced
surface tension [28]. Considering surface tension values, solutions were ranked as follows: sodium
thiosulfate < sodium ascorbate < NaOCl < distilled water.

Regarding surface roughness, wettability is one of the most important physicochemical properties and it
can be expressed in terms of contact angle, which is formed between the drop of a liquid and the flat
surface of a solid. This measurement shows the tendency of a liquid to spread on a solid surface [30].
The contact angle has an inverse relationship with surface free energy (wettability), that is, the lower the
contact angle, the greater the surface free energy [26, 31]. In the present study, the surface energy of
dentin was evaluated after the use of different irrigants. The groups were ranked as follows: distilled
water < NaOCl = sodium thiosulfate < sodium ascorbate < plasma.

The lower surface tension of NaOCl compared with distilled water can favor wettability, leading to a more
reactive surface with increased surface energy. Sodium thiosulfate and sodium ascorbate were the
irrigants with the lowest surface tension. After the treatments, the dentin surface presented a larger
amount of apolar components while polar components remained unchanged (when compared with
NaOCl group). The positive surface energy results for the sodium ascorbate group compared with the
sodium thiosulfate group can be associated with the capacity of smear layer removal of the former,
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improving surface roughness. Surface energy values obtained for the plasma group can be associated
with chemical modifications on the surface.

The null hypothesis tested in the present study was rejected. Antioxidant agents and non-thermal plasma
were effective in reversing the bond strength of NaOCl-treated dentin to cement. The use of sodium
thiosulfate after NaOCl revealed POBS values like control (without NaOCl). The sodium ascorbate group,
followed by the plasma group, showed the highest POBS values when compared with the other groups.
All the proposed treatments were effective at a given time of clinical use.

The positive results obtained for sodium thiosulfate are associated with its reduced surface tension and
its antioxidant action [13]. The positive results of plasma can be associated with chemical modifications
on the surface, which eventually improved surface energy and the partial smear layer removal. In the
sodium ascorbate group, positive results can be associated with antioxidant action [11–13] as well as
with the improvement of surface energy and capacity of smear layer removal. As this removal was not so
efficient in the plasma group, the nonhomogeneous surface led to an increase in surface energy [31] but
had a negative effect on bond strength when compared with the ascorbate group.

The improvement of bond strength is associated with the reduction of adhesive failure. Failure, both in
the control and NaOCl groups, was exclusively of type I, adhesive between the cement and dentin. In the
thiosulfate group, failure was mainly of type I (83.34%). In the plasma group, type I (37.93%) and type IV
(34.48%) were the most common. The best results were observed for the ascorbate group, in which failure
was mainly of type IV (50%), mixed cohesive post/dentin. This can be explained by the fact that the
ascorbate group had a more homogeneous surface than the plasma group regarding smear layer
removal.

Conclusion
The use of Heliox plasma or antioxidant agents, for 1 minute, improved the adhesion of fiberglass post to
dentin using RelyX U200 cement.

Declarations
Acknowledgments

This work was supported by the Brazilian agency: Coordination for the Improvement of Higher Education
Personnel (CAPES), Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro
(FAPERJ) and National Foundation for the Development of Private Higher Education (FUNADESP).

CRediT author statement

Conceptualization: [Maíra do Prado], Methodology: [Juliana das Neves Marques, Carolina Oliveira de
Lima], Formal analysis and investigation: [Emmanuel João Nogueira Leal da Silva, Lucianne Maia, Iris

Page 9/14
Sol Telles], Writing - original draft preparation: [Iris Sol Telles, Juliana das Neves Marques, Emmanuel
João Nogueira Leal da Silva]; Writing - review and editing: [Carolina Oliveira de Lima, Lucianne Maia],
Resources: [Maíra do Prado, Renata Simão], Supervision: [Maíra do Prado, Renata Simão].

Compliance with Ethical Standards

Disclosure of potential conflicts of interest

The authors deny conflicts of interest related to this study. The authors certify that they have no
commercial or associative interest that represents a conflict of interest in connection with the manuscript.

Research involving Human Participants and/or Animals

This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration
of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Non-applicable

References
1. Weston CH, Ito S, Wadgaonkar B, Pashley DH (2007) Effects of time and concentration of sodium
ascorbate on reversal of NaOCl-induced reduction in bond strengths. J Endod 33:879–881.
2. Cecchin D, Farina AP, Souza MA, Carlini-Júnior B, Ferraz CC (2011) Effect of root canal sealers on
bond strength of fibreglass posts cemented with self-adhesive resin cements. Int Endod J 44:314–
320.
3. Zhou L, Wang Q (2013) Comparison of fracture resistance between cast posts and fiber posts: a
meta-analysis of literature. J Endod 39:11–15.
4. Ray HA, Trope M (1995) Periapical status of endodontically treated teeth in relation to the technical
quality of the root filling and the coronal restoration. Int Endod J 28:12–18.
5. Vongphan N, Senawongse P, Somsiri W, Harnirattisai C (2005) Effects of sodium ascorbate on
microtensile bond strength of total-etching adhesive system to NaOCl treated dentine. J Dent
33:689–695.
6. Zehnder M (2006) Root canal irrigants. J Endod 32:389–398.
7. Moreira DM, Almeida JF, Ferraz CC, Gomes BP, Line SR, Zaia AA (2009) Structural analysis of bovine
root dentin after use of different endodontics auxiliary chemical substances. J Endod 35:1023–
1027.
8. Slutzky-Goldberg I, Maree M, Liberman R, Heling I (2004) Effect of sodium hypochlorite on dentin
microhardness. J Endod 30:880–882.

Page 10/14
 9. Santos JN, Carrilho MR, De Goes MF, et al. (2006) Effect of chemical irrigants on the bond strength
of a self-etching adhesive to pulp chamber dentin. J Endod 32:1088–1090.
10. Prado M, Roizenblit RN, Pacheco LV, Barbosa CA, Lima CO, Simão RA (2016) Effect of Argon Plasma
on Root Dentin after Use of 6% NaOCl. Braz Dent J 27:41–45.
11. Muraguchi K, Shigenobu S, Suzuki S, Tanaka T (2007) Improvement of bonding to bleached bovine
tooth surfaces by ascorbic acid treatment. Dent Mater J. 26:875–881.
12. Prasansuttiporn T, Nakajima M, Kunawarote S, Foxton RM, Tagami J (2011) Effect of reducing
agents on bond strength to NaOCl-treated dentin. Dent Mater 27:229–234.
13. Pimentel Corrêa AC, Cecchin D, de Almeida JF, Gomes BP, Zaia AA, Ferraz CC (2016) Sodium
Thiosulfate for Recovery of Bond Strength to Dentin Treated with Sodium Hypochlorite. J Endod
42:284–288.
14. Gomes BP, Martinho FC, Vianna ME (2009) Comparison of 2.5% sodium hypochlorite and 2%
chlorhexidine gel on oral bacterial lipopolysaccharide reduction from primarily infected root canals. J
Endod 35:1350–1353.
15. Sooriyaarachchi M, Narendran A, Gailer J (2012) The effect of sodium thiosulfate on the metabolism
of cis-platin in human plasma in vitro. Metallomics 4:960–967.
16. Rôças IN, Siqueira JF (2011) Comparison of the in vivo antimicrobial effectiveness of sodium
hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study. J Endod
37:143–150.
17. Ritts AC, Li H, Yu Q, et al. (2010) Dentin surface treatment using a non-thermal argon plasma brush
for interfacial bonding improvement in composite restoration. Eur J Oral Sci. 118:510–516.
18. Chen M, Zhang Y, Sky Driver M, Caruso AN, Yu Q, Wang Y (2013) Surface modification of several
dental substrates by non-thermal, atmospheric plasma brush. Dent Mater 29:871–880.
19. Abreu JL, Prado M, Simão RA, Silva EM, Dias KR (2016) Effect of non-thermal argon plasma on bond
strength of a self-etch adhesive system to NaOCl-treated dentin. Braz Dent J. 27:446–451.
20. Park C, Park SW, Yun KD, et al. (2018) Effect of plasma treatment and its post process duration on
shear bonding strength and antibacterial effect of dental zirconia. Materials (Basel). 11:2233.
21. Lee MJ, Kwon JS, Jiang HB, Choi EH, Park G, Kim KM (2019) The antibacterial effect of non-thermal
atmospheric pressure plasma treatment of titanium surfaces according to the bacterial wall
structure. Sci Rep 9:1938.
22. Pan J, Sun K, Liang Y, et al. (2013) Cold plasma therapy of a tooth root canal infected with
enterococcus faecalis biofilms in vitro. J Endod 39:105–110.
23. Elias AB, Simão RA, Prado M, Cesar PF, Botelho Dos Santos G, Moreira da Silva E (2019) Effect of
different times of nonthermal argon plasma treatment on the microtensile bond strength of self-
adhesive resin cement to yttria-stabilized tetragonal zirconia polycrystal ceramic. J Prosthet Dent
121:485–491.

Page 11/14
24. Menezes M, Prado M, Gomes B, Gusman H, Simão R (2017) Effect of photodynamic therapy and
non-thermal plasma on root canal filling: analysis of adhesion and sealer penetration. J Appl Oral Sci
2:396–403.
25. Morris MD, Lee KW, Agee KA, Bouillaguet S, Pashley DH (2001) Effects of sodium hypochlorite and
RC-prep on bond strengths of resin cement to endodontic surfaces. J Endod 27:753–757.
26. Costa Dantas MC, do Prado M, Costa VS, Gaiotte MG, Simão RA, Bastian FL (2012) Comparison
between the effect of plasma and chemical treatments on fiber post surface. J Endod 38:215–218.
27. Ferreira R, Prado M, de Jesus Soares A, Zaia AA, de Souza-Filho FJ (2015) Influence of using clinical
microscope as auxiliary to perform mechanical cleaning of post space: a bond strength analysis. J
Endod 41:1311–1316.
28. Taşman F, Cehreli ZC, Oğan C, Etikan I (2000) Surface tension of root canal irrigants. J Endod
26:586–587.
29. Monticelli F, Toledano M, Silva AS, Osorio E, Osorio R (2008) Sealing effectiveness of etch-and-rinse
vs self-etching adhesives after water aging: influence of acid etching and NaOCl dentin pretreatment.
J Adhes Dent 10:183–188.
30. de Assis DF, Prado M, Simão RA (2011) Evaluation of the interaction between endodontic sealers and
dentin treated with different irrigant solutions. J Endod 37:1550–1552.
31. Cassie ABD, Baxter S (1944) Wettability of porous surfaces. Transactions of the Faraday Society
40:546–551.

Figures

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Figure 1

Representative photomicrographs (500X) of control (a), NaOCl (b), plasma (c) sodium thiosulfate (d),
sodium ascorbate (e) groups 

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Figure 2

Surface tension of substances

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