Bond strength and cement-tooth interfacial characterization of self-adhesive composite cements

(1) To determine the microtensile bond strength (µTBS) of self-adhesive (SA) composite cements to unetched/etched enamel and dentin, and (2) to characterize the cements' interaction with tooth tissue.

51 composite blocks were bonded to smear layer-covered enamel and dentin (three teeth per group). Four SA composite cements (Clearfil SA, G-CEM, RelyX Unicem, SmartCem2), and three multi-step composite cements, two used following an etch-and-rinse (E&R) approach (RelyX ARC, Variolink II 'E&R') and one used following a self-etch (SE) approach (Variolink II ' SE') were investigated. The cement-tooth specimens were perpendicularly sectioned into micro-specimens (1.0 × 1.0 mm) in order to measure the µTBS. The data were statistically analyzed by ANOVA followed by Tukey HSD (P< 0.05). 24 additional specimens (four teeth per group) were prepared for interfacial characterization using SEM.

The tested SA cements bonded equally well to enamel and dentin. Etching of enamel improved their bonding effectiveness, which however remained inferior to that of both E&R cements. SEM revealed a very similar interfacial ultrastructure at smear layer-covered enamel and dentin for the SA cements, exhibiting very superficial interaction at enamel and absence of a clearly detectable hybrid layer and resin tags in the dentin tubules. When the SA composite cements were applied to dentin free of a smear layer, regular and long resin tags were formed.

No significant differences in bonding effectiveness were recorded for the self-adhesive composite cements when bonded to unetched/etched enamel and to dentin. Multi-step etch-and-rinse composite cements showed a better bonding effectiveness to enamel, although this could be approximated by the self-adhesive composite cements when enamel was acid-etched beforehand. On dentin, however, the bond strength of the etch-and-rinse composite cement RelyX ARC was superior.