Implication of ethanol wet-bonding in hybrid layer remineralization

During mineralization, unbound water within the collagen matrix is replaced by apatite. This study tested the null hypothesis that there is no difference in the status of in vitro biomimetic remineralization of hybrid layers, regardless of their moisture contents. Acid-etched dentin was bonded with One-Step with ethanol-wet-bonding, water-wet-bonding, and water-overwet-bonding protocols. Composite-dentin slabs were subjected to remineralization for 1-4 months in a medium containing dual biomimetic analogs, with set Portland cement as the calcium source and characterized by transmission electron microscopy. Remineralization was either non-existent or restricted to the intrafibrillar mode in ethanol-wet-bonded specimens. Extensive intrafibrillar and interfibrillar remineralization was observed in water-wet-bonded specimens. Water-overwet specimens demonstrated partial remineralization of hybrid layers and precipitation of mineralized plates within water channels. The use of ethanol-wet-bonding substantiates that biomimetic remineralization is a progressive dehydration process that replaces residual water in hybrid layers with apatite crystallites.