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Bond strengths of self-etching primer adhesives to in vitro-demineralized dentin following mineralizing treatment.

PURPOSE
The purpose of this study was to determine if treatment of experimentally demineralized dentin with a calcium phosphate precipitating (CPP) solution could restore the bond strength of self-etching adhesives to that of normal mineralized control values.


MATERIALS AND METHODS
The occlusal surfaces of human teeth were exposed for bonding. The teeth were assigned to a mineralized control group or one of three demineralized (40% phosphoric acid for 60 s) experimental groups. One of the experimental groups remained untreated, while the other two were treated with the CPP solutions for either 1 or 10 min. All experimental groups were then chemically dehydrated with ascending acetone concentrations to prevent shrinkage prior to bonding with Clearfil Liner Bond 2 (LB2) or MacBond II (MBII). Composite buildups were made and vertically, serially sectioned into multiple slabs about 0.7 mm thick. Each slab was then trimmed for microtensile bond testing and SEM examination.


RESULTS
Both self-etching adhesives produced high bond strengths to control mineralized dentin (ca 42 and 37 MPa for LB2 and MBII, respectively). Acid etching with 40% phosphoric acid for 60 s followed by chemical dehydration significantly lowered (p < 0.05) bond strength to 26 and 27 MPa for LB2 and MBII, respectively, and created hybrid layers between 7 and 8 microns thick. When the demineralized dentin was treated with the CPP solution for 1 min, the bond strengths increased (p < 0.05) to 39 for LB2 and 42 MPa for MBII, and the hybrid layers were 11 microns thick. Increasing the CPP treatment time to 10 min lowered (p < 0.05) bond strengths but increased the hybrid layer thickness to 16 to 20 microns.


CONCLUSION
The use of calcium phosphate precipitating solutions may permit higher bond strengths of self-etching primers to demineralized (e.g., caries-affected) dentin.