The Effect of Trichloracetic Acid as a Hemostatic and Etching Agent on the Morphological Characteristics and Shear Bond Strength of Resin Composite to Enamel

Abstract

Trichloracetic acid (TCA) is a soft tissue chemical cauterizing agent that is used on gingival margins prior to restoring cervical cavities with resin materials. This study evaluated the effect of TCA gel as an etchant, its use before etchant on the shear bond strength between resin composite and enamel and also its effect on enamel surface morphological characteristics. Seventy-five sound, extracted human anterior maxillary teeth were selected for the purpose of this in vitro study. The teeth were equally divided into five groups prior to enamel surface preparation with silicone carbide papers. In Group 1, the enamel surfaces were etched with 35% phosphoric acid for 30 seconds. In Groups 2 and 3, a 35% TCA gel and 50% TCA gel, respectively, were used on the enamel surfaces for 30 seconds. The enamel surfaces were then rinsed with water for 10 seconds. In Groups 4 and 5, the specimens were prepared in the same manner as Groups 2 and 3 and the enamel surfaces were then etched with 35% phosphoric acid for 30 seconds. In all the experimental groups, after rinsing and drying the samples, Single Bond adhesive (3M ESPE) was used to bond Z250 composite cylinders onto the enamel surfaces. After 500 rounds of thermocycling, the composite cylinders were loaded to failure in shear in a DARTEC test machine and the data were analyzed using the ANOVA and Scheffé's tests (alpha = 0.05). Two specimens from each group were prepared for surface morphology evaluation under SEM. The mean bond strengths and standard deviations in Groups 1 through 5 were 23.77 +/- 1.64, 22.43 +/- 3.02, 23.48 +/- 3.48, 25.31 +/- 1.42 and 28.68 +/- 1.28 MPa, respectively. Analysis of the variances demonstrated statistically significant differences in the study groups (p < 0.05). Pairwise testing showed statistically higher bond strength in Group 5 than all the other groups (p < 0.05). The morphology of surfaces etched with TCA in Groups 2 and 3 was similar to that of surfaces etched with phosphoric acid alone (Group 1). TCA is capable of etching enamel surfaces in a manner similar to phosphoric acid. Although the inadvertent contact of TCA with enamel prior to conventional etching with phosphoric acid may have a positive effect on bond strength between enamel and resin composite, microscopical evaluations also show an overetching pattern that is more prominent with 50% TCA.