How can droplet formation occur in endodontically treated teeth during bonding procedures?

The aim of this in vivo study was to clarify how blistering formation occurs along intraradicular dentin bonded interfaces.

Patients were selected and post space was prepared in vivo in endodontically treated teeth. Post space was etched, dried with ethanol, and bonded with one of the following adhesive systems: All Bond 2, XP-Bond, Clearfil SE Bond, Xeno III. The four adhesives were considered as representative of each bonding system class. An additional group was prepared with phosphoric acid treatment + application of Pre-Bond unfilled resin of All Bond 2, without the use of the primer agent. Etching was avoided for self-etching materials. Replicas of the post space were taken (1) after post space preparation; (2) after etching, rinsing, and drying; (3) after ethanol drying, and (4) after adhesive application. Replicas were analyzed with SEM and blisters were counted by independent observers. Statistical analysis was performed with Kruskal-Wallis ANOVA and Dunn's multiple comparison tests at p = 0.05.

No blister formation occurred on replicas taken prior to adhesive application, while blister formation was evident in all replicas of bonded interfaces, irrespective of the adhesive system. No statistical difference in the number of droplets was found between All Bond 2, XP-Bond, and Clearfil SE Bond. Xeno III exhibited the highest number of blisters. Specimens bonded with Pre-Bond unfilled resin of All Bond 2 without primer application showed no blister formation.

This study revealed that blister formation occurs only if the priming agent of the adhesive system was applied, thus supporting the hypothesis that blistering occurs due to adhesive phase separation or insufficient solvent evaporation.