Bonding effectiveness of a self-adhesive resin-based luting cement to dentin after provisional cement contamination

To evaluate the influence of provisional luting cements on the bonding performance of a resin-based self-adhesive luting cement to dentin vs that of currently used resin-based luting agents with different adhesion strategies.

Forty-five prepared human molars were randomly and equally divided into three main groups according to the type of provisional luting cement applied: eugenol-containing provisional cement (Temp Bond, Kerr), eugenol-free provisional cement (Temp Bond NE, Kerr), and control where the provisionalization step was omitted. Each group was further subdivided into 3 groups based on the category of adhesive systems/ luting materials used: a two-step etch-and-rinse system (Single Bond/RelyX ARC; 3M ESPE) (RX), a two-step self-etching system (Clearfil Liner Bond 2V/ Panavia F; Kuraray) (PF), and a self-adhesive luting cement (Rely X Unicem; 3M ESPE) (RU). Finally, 9 groups of 5 teeth each were prepared for the microtensile test.

Two-way analysis of variance (ANOVA) and post-hoc Bonferroni tests revealed that definitive luting cement, provisional luting cement, and the interactions of these two factors had significant influences on dentin bond strength. The highest bond strength was obtained for PF (32.05 MPa), followed by RX (26.57 MPa) and RU (16.56 MPa) for the controls. Contamination with either eugenol-containing or eugenol-free provisional cement significantly decreased the bonding effectiveness of RX (19.08 and 19.69 MPa, respectively) and PF (14.21 and 16.67 MPa respectively) to dentin (p < 0.05). RU showed comparable bond strength values before and after provisional cement (13.93 and 14.49 MPa, respectively) application (p > 0.05). Eugenol in provisional luting cement did not produce material-related alterations in the bonding performance of the resin luting cements tested (p > 0.05).

Based on these results, the self-adhesive cement which was not influenced by the provisional cement application may be promising. However, long-term laboratory and clinical performance of this cement needs to be assessed before recommending it as an alternative to the technically more demanding approaches. Moreover, an effective surface cleansing procedure is critical to achieve a successful bond between the contaminated dentin and luting cement.