Abstract
The effects of deproteinization using sodium hypochlorite (NaOCl) and the subsequent application of an antioxidant (sodium p-toluenesulfinate, STS) onto the bonding durability of universal adhesives on eroded dentin were investigated. Untreated sound dentin served as the control, whereas eroded dentin, which had been prepared by pH-cycling in 1% citric acid and a remineralization solution, was either untreated, deproteinized with a 10% NaOCl gel or deproteinized with the 10% NaOCl gel and subsequently treated with an STS-containing agent. The dentin surfaces were bonded using a universal adhesive (Clearfil Universal Bond Quick, Scotchbond Universal or G-Premio Bond), and the micro-tensile bond strength (µTBS) test was performed after 24 h or 10,000 thermal cycles. The µTBS data were statistically analyzed using a three-way ANOVA and Tukey’s HSD post hoc tests. The lowest µTBS was measured on untreated eroded dentin (p < 0.001). Deproteinization of eroded dentin resulted in µTBS similar to untreated sound dentin (p > 0.05), but the highest µTBS was obtained if deproteinization was followed by the application of STS. Thermocycling significantly decreased µTBS in all groups (p < 0.001), except for STS-treated deproteinized eroded dentin (p > 0.05). This indicated that deproteinization, followed by the application of STS, could enhance the bonding durability of universal adhesives on eroded dentin.
Highlights
While the incidence of caries in developed countries tends to decrease, dental erosion becomes increasingly frequent [1]
According to the European consensus statement on managing severe tooth wear, minimally invasive treatment options are recommended, such as direct composite restorations or partial crowns [8]
These restorations rely on adhesion, which may be compromised on eroded dentin [9,10] because a thick layer of exposed collagen fibrils is present on the demineralized surface, interfering with the penetration of monomers contained in dental adhesives [11]
Summary
While the incidence of caries in developed countries tends to decrease, dental erosion becomes increasingly frequent [1]. Dental erosion manifests as erosive tooth wear, i.e., non-carious loss of hard dental tissues caused by their demineralization, which leads to a decrease in their mechanical properties and increased susceptibility to abrasion or attrition [5]. According to the European consensus statement on managing severe tooth wear, minimally invasive treatment options are recommended, such as direct composite restorations or partial crowns [8]. These restorations rely on adhesion, which may be compromised on eroded dentin [9,10] because a thick layer of exposed collagen fibrils is present on the demineralized surface, interfering with the penetration of monomers contained in dental adhesives [11]. The decomposition of the collagen may contribute to the decreased durability of bonding to eroded dentin, as reported by numerous studies [9,10]
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