Pushout Bond Strength in Coronal Dentin: A Standardization Approach in Comparison to Shear Bond Strength.

Abstract

To find an alternative that is closer to clinical reality in terms of cavity geometry and configuration factor, this study investigated the pushout test on in vitro adhesive testing to coronal dentin when compared to the established shear test, both in a standardized approach. For a feasible comparison between both tests, the pushout specimen was adjusted in thickness (1.03 ± 0.05 mm) and cavity diameter (1.42 ± 0.03 mm) to receive a bonding area (4.63 ± 0.26 mm2) that matches that of the shear test (4.57 ± 0.13 mm2). Though, the configuration factor between both tests differs largely (pushout 1.5 ± 0.08; shear bond 0.20 ± 0.01). The bond strength of five different adhesives (n = 20) was investigated for both tests. The pushout test registered a high number of invalid measurements (30%) due to concomitant dentin fracture during testing. In contrast to the shear test, the pushout test failed to discriminate between different adhesives (p = 0.367). Both tests differed largely from each other when comparing adhesive groups. When solely looking at the valid specimens, Weibull modulus reached higher values in the pushout approach. Conclusively, the pushout test in this specific setup does not distinguish as precisely as the shear bond test between different adhesives and needs adaption to be routinely applied in adhesive dentistry.