Abstract
PurposeTo compare various pre-treatments serving as cleaning procedures of dentin on the bond strength of resin composite promoted by a universal adhesive system applied either in the absence or presence of simulated pulpal pressure.Materials and MethodsPrior to application of the adhesive system (Scotchbond Universal) and resin composite (Filtek Z250), ground dentin surfaces were given one of five pre-treatments either without or with simulated pulpal pressure: 1) no pre-treatment, adhesive system in “self-etch” mode, 2) phosphoric acid etching, adhesive system in “total-etch” mode, 3) polishing with pumice on prophylaxis cup, 4) air abrasion with AIR-FLOW PLUS powder, 5) air abrasion with AIR-FLOW PERIO powder; n = 20/group of pre-treatment. After storage (37°C, 100% humidity, 24 h), micro shear bond strength was measured and data analyzed with parametric ANOVA including Bonferroni-Holm correction for multiple testing followed by Student’s t tests (significance level: α = 0.05).ResultsThe ANOVA found type of pre-treatment and simulated pulpal pressure to have no significant effect on dentin bond strength. The explorative post-hoc tests showed a negative effect of simulated pulpal pressure for phosphoric acid etching (adhesive system in “total-etch” mode; p = 0.020), but not for the other four pre-treatments (all p = 1.000).ConclusionAir abrasion with powders containing either erythritol and chlorhexidine (AIR-FLOW PLUS) or glycine (AIR-FLOW PERIO) yielded dentin bond strengths similar to no pre-treatment, phosphoric acid etching, or polishing with pumice. Simulated pulpal pressure reduced the bond strength only when the self-etch adhesive system was used in total-etch mode.
Highlights
Exposed dentin is a frequently occurring clinical problem caused by abrasive and/or erosive forces [1]
The ANOVA found type of pre-treatment and simulated pulpal pressure to have no significant effect on dentin bond strength
Simulated pulpal pressure reduced the bond strength only when the self-etch adhesive system was used in total-etch mode
Summary
Exposed dentin is a frequently occurring clinical problem caused by abrasive and/or erosive forces [1]. Durable adhesive bonding to exposed dentin may be hampered since this dentin is prone to alteration by mechanical and/or chemical modifications [4], often combined with the presence of bacteria in the biofilm invariably found on non-shedding surfaces [5]. Bearing in mind that sodium bicarbonate powder impairs the dentin bonding performance of adhesive systems [9,10,11] and that exposed dentin may be of varying nature (e.g. with open dentin tubules in the case of dentin hypersensitivity, with alterations due to mechanical and/or chemical modifications, and in some cases with a biofilm), it might be indicated to use one of the two newer powders as a cleaning procedure before application of adhesive systems as dentin desensitizers or before placement of resin composite restorations. The aim of the present study was to investigate bond strength of resin composite and a universal adhesive system (Scotchbond Universal; 3M ESPE) to dentin under different conditions, including absence or presence of simulated pulpal pressure since clinically, pulpal pressure may lead to moisture in the form of dentinal fluid, which has previously been shown to potentially compromise bonding of adhesive systems [12,13]
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