Microtensile Bond Strength Evaluation of Composite Resin to Discolored Dentin After Amalgam Removal

Background To obtain prolonged clinical success with composite restorations, better bonding of resin to the tooth substrate is crucial. Aim The study was aimed to evaluate the microtensile bond strength (µTBS) of bulk-fill composite resin restorations when bonded to a cavity previously restored with amalgam, comparing with that of freshly prepared dentin. Materials and method Mesio-occlusal cavity preparations were done on 80 extracted human mandibular molars with a buccolingual width of 4 mm and a 1.5 mm axial depth by placing the gingival seat 0.5 mm coronal to the cementoenamel junction (CEJ) and were restored with fine-grain amalgam alloy. After thermocycling, the amalgam restorations were removed. Disto-occlusal cavities with similar dimensions of mesial cavities were prepared, and both the proximal surfaces were filled with bulk-fill composite using either etch-and-rinse or self-etch adhesives. Following thermomechanical cyclic loading, all the teeth were sectioned for µTBS testing. Bond strength data expressed in megapascals (MPa) were subjected to statistical analyses using analysis of variance (ANOVA) and Tukey's multiple post-hoc tests. Results The total-etch adhesive exhibited statistically higher bond strength values to both dentin substrates compared to self-etch adhesives (p<0.05). Failure mode analysis reported more of adhesive failures. Conclusion The µTBS of bulk-fill composite resin restorations bonded to a cavity previously restored with amalgam was significantly lower than that of freshly prepared dentin. Total-etch adhesives bond strength was higher than self-etch adhesives to both the substrates tested.