The effect of cavity pretreatment procedures on dentin bonding: a four-year clinical evaluation

Cervical abrasion and erosion lesions were restored with composite resin restorations bonded with four different dentin-bonding resins, an enamel-bonding resin, or restorations of a glass ionomer cement. The long-term clinical retention of the restorations were evaluated during a 4-year period. The surrounding enamel was not acid-etched. Four cleaning methods for dentin pretreatment were used to study their effects on the bonding between dentin and the restorative materials. The dentin was treated with either (1) etching for 60 seconds or (2) 15 seconds with 37% phosphoric acid, (3) cleaning with 5% sodium hypochlorite (NaOCL) for 20 seconds, or (4) cleaning with Tubulicid etchant for 60 seconds. None of the composite resin restorations, regardless of pretreatment or bonding method, showed acceptable restorations. All glass ionomer cement restorations were retained after pretreatment with Tubulicid etchant and 5% NaOCL after a 6-month period. Full acceptance, in other words, 3 year retention, was reached only after pretreatment with NaOCL.