An in-vitro investigation of the bond strength of experimental ion-releasing dental adhesives to caries-affected dentine after 1 year of water storage. (April 2022) - Cascales, Álvaro Ferrando
Abstract: Objective: The aim of this study was to evaluate the bonding performance after 1 year storage of an experimental dental adhesive containing analogues of phosphoproteins and fluoride-doped bioglass (EXP), applied in self-etching (SE) or etch & rinse (ER) mode, to caries-affected dentine after selective caries removal. Materials and Methods: Fifty human molars with dentine carious lesions were excavated selectively using Carisolv TM gel and then connected to simulated pulpal pressure system. Teeth were divided randomly into five groups based on the tested materials: EXP-SE, EXP-ER, a resin-modified glass-ionomer cement (RMGIC), a three-step adhesive system (OPT) and a universal adhesive applied in SE mode (UA-SE). The specimens were submitted to different analytical tests (μTBS, SEM fractographic analysis and dye-enhanced confocal microscopy) at baseline (T0) and after 1 year (T1). Results: At T0 there was no difference in bond strength between the tested materials (p>0.05). At T1, EXP-SE and EXP-ER were the only materials to show no significant reduction in bond strength (p<0.05). The SEM showed a clear presence of minerals deposited on the dentine surface after bonding in the EXP-SE and EXP-ER groups. The specimens restored with RMGIC showed no exposure of the dentine surface after failure. The OPT and UA-SE specimens showed clear signs of degradation at the interface. Confocal microscopy imaged mineral precipitation at the interface of the EXP groups. Conclusion: Conventional adhesives may have inadequate bonding performance with evident degradation at the dentine-bonded interface over time. Although the RMGIC may present a drop in bond strength after prolonged storage, the bonding interface may result less affected by degradation over time. Innovative ion-releasing adhesives may remineralise the caries-affected dentine and achieve a stable bond over time. Clinical significance: GIC-based materials may represent an appropriate dentine replacement material after selective chemo-mechanical caries removal rather than conventional adhesive systems.