Long-term effect of dentin primers on enamel bond strength and marginal adaptation

Contamination of etched enamel with dentin adhesive systems is unavoidable in clinical situations. The aim of this in vitro study was to evaluate the long-term effect of dentin adhesives and application technique on resin composite bond strength and marginal adaptation to enamel. Six hundred freshly extracted mandibular bovine incisors were used. Three hundred teeth were flat ground, and the enamel was etched for 30 seconds with 32% phosphoric acid. The etched surface was treated by different dentin adhesive systems with and without intensive rubbing by use of application brushes. As a control, only the enamel adhesive resin was applied and air thinned. Furthermore, contamination with saliva was performed after the etching process. Etched and silanated CEREC blocks were bonded onto the enamel specimens with different adhesive resins and stored for 1 and 365 days (37 degrees C, aqua dest). After storage, the specimens were thermocycled for 24 hours (1150 cycles between 5 degrees C and 55 degrees C), and subjected to shear bond testing. Three hundred box-shaped cavities were prepared on buccal surfaces of the incisors and filled with one resin composite using the same pretreatment modes as in the shear bond test groups. After 1 and 365 days of storage, a margin analysis was performed using a SEM (X200 magnification). Dentin adhesive systems did not show an adverse effect on long-term enamel bond strength and marginal adaptation. Rubbing application of the primers decreased the bond strength by values of approximately 20% after 24 hours and approximately 40% after 1 year of storage. Marginal adaptation showed 94-98% gap-free margins in the control and dentin adhesive system-only groups; however, after rubbing of primers, the proportion of gap-free margins decreased significantly to 85-88%. The lowest bond strength (8-10 MPa) and margin quality (49-69% gap-free margins) were recorded for the groups with saliva contamination.