Dentin bonding: effect of degree of mineralization and acid etching time

This in vitro study verifies whether there are differences between bonding to hypermineralized dentin and normal dentin and if longer acid etching can improve the bond strength to this modified substrate without damaging the bond to normal dentin. Forty-two extracted human molars with chronic occlusal caries were transversally cut with a diamond saw under refrigeration. The occlusal surfaces were ground until the carious lesion was removed, exposing the sclerotic dentin in the center and polished to 600/grid. A 35% phosphoric acid (3M) was applied for 15 seconds in 15 specimens. SingleBond (3M) adhesive system was applied and a hybrid resin composite (Filtek Z250, 3M) was inserted in four 1-mm increments and light-cured. The remaining 15 molars were prepared in the same manner, but with an acid etching time of 30 seconds. After 24 hours in water, the specimens were cut in two perpendicular directions to obtain a cross section of approximately 0.7 mm2 (n=25). A visual examination was conducted to select sticks between the two groups: sclerotic dentin (G15S or G30S) and normal dentin (G15N or G30N). Sticks without 100% sclerotic dentin (translucent area) or those with normal areas were not tested. Two-way ANOVA computed the mu-TBS data taking into consideration dentin type and acid etching time. The dentin Knoop hardness number (KHN) of the sticks was verified. A t-test compared the KHN data between sclerotic and normal dentin. Twelve additional molars (n=6) were prepared to observe the interface under a SEM. The mean (+/- SD) microtensile bond strengths (mu-TBS) were: G15S=56.4(+/- 14.9), G15N=69.7(+/- 17.2), G30S=63.2(+/- 15.6) and G30N=67.7(+/- 13.3). Two-way ANOVA showed higher mu-TBS to normal dentin than sclerotic dentin. Duncan's Post Hoc showed G15N had higher mean mu-TBS than G15S. Other comparisons were not significantly different. The t-test showed statistically higher microhardness in sclerotic dentin than in normal dentin (p<0.0001). The hybrid layer (HL) formation was observed in all specimens without gap formation in any region. In sclerotic dentin (G15S), the HL was very thin, with minimal resin tags in the dentinal tubules and, when present, they were shorter. Doubling the etching time (G30S) resulted in more resin tags with an HL formation on peritubular dentin. The HL on normal dentin was thicker when it was acid etched for 30 seconds (G30N). Numerous resin tags were present with both etching times. The results suggest that the higher mineral amount in sclerotic dentin makes it difficult to bond to this substrate, resulting in a lower mu-TBS. However, doubling the etching time resulted in mu-TBS similar to normal dentin.