Adhesion of resin cement to dentin: effects of adhesive promoters, immediate dentin sealing strategies, and surface conditioning

Abstract

PURPOSE
This study evaluated the shear bond strength (SBS) of resin cement to dentin after applying two adhesive (A) systems with a combination of four different immediate dentin sealing (IDS) strategies, and two surface conditioning (SC) methods.
MATERIAL AND METHODS
Human third molars (n = 140) were collected and randomly split (n = 70 each) between the two A systems (Clearfil SE Bond; Kuraray [AC] and Optibond FL; Kerr [AO]). The A groups were further divided into four IDS strategies (2 x one adhesive layer (IDS-1L); 2 x two adhesive layers (IDS-2L); 2 x one adhesive layer and one flowable layer (IDS-F); 2 x no adhesive layer (delayed dentin sealing [DDS]). Finally, each strategy group was categorized into one of the two SC methods (only pumice [SC-P] or pumice and silica coating [SC-PS]), except the DDS group, where only SC-P was used. This resulted in 14 groups of 10 specimens each. The occlusal coronal third was removed from each molar crown with a diamond saw (Isomet 1000), and IDS was applied, followed by temporary restorations. These were removed after 2 weeks of water storage, and the IDS surfaces were subsequently conditioned. The standard adhesive procedure (Syntac Primer and Adhesive, Heliobond; Ivoclar Vivadent) was executed, followed by the application of a resin cement (Variolink II; Ivoclar Vivadent) and photopolymerization. All specimens were subjected to thermocyclic aging (10,000 cycles, 5°C to 55°C). Shear force was applied to the adhesive interface in a universal testing machine (1 mm/min). Fracture types and locations after loading were classified. The data were analyzed using analysis of variance (ANOVA) and independent samples t tests.
RESULTS
AO groups exhibited higher mean SBS values (14.4 ± 6.43) than AC groups (12.85 ± 4.97) (P = 0.03). ANOVA showed the main effect of the applications on the SBS in the different groups (P = 0.00). Both DDS groups showed significantly lower SBS values compared with all the IDS groups (IDS-1L, IDS-2L, IDS-F). No significant differences in SBS results were found between the IDS groups (P = 0.43) and between the SC methods (P = 0.76). Dentin-cement interface failures diminished with the application of IDS.
CONCLUSION
IDS improves the SBS compared with DDS. No significant differences were found between the tested conditioning methods.