Thermal and bioactive optimization of a unidose 3-step etch-and-rinse dentin adhesive.

Abstract Statement of problem The limited durability of resin-dentin bonds is considered a major disadvantage of adhesive restorations. Therefore, clinical strategies have been developed to improve hybrid layer stability over time. These strategies require testing. Purpose The purpose of this in vitro study was to evaluate the influence of preheating and the inclusion of a bioactive glass in a unidose 3-step etch-and-rinse adhesive system on the adhesion of direct composite resin restorations. Material and methods Dentin disks from 80 molars were assigned to 8 groups (n=10): CG-T1/CG-T2: control group; PG-T1/PG-T2: adhesive preheated to 68 °C; BG-T1/BG-T2: 0.05 mg of Bioglass 45S5 (BAG) (particle size: 3 μm) added to primer; PBG-T1/PBG-T2: adhesive and BAG-modified primer preheated to 68 °C. Sticks were fabricated for microtensile bond strength (μTBS) testing and were tested at 1 week (T1) and after 6 months (T2) of storage. μTBS data were analyzed by using 2-way ANOVA and the Tukey-Kramer post hoc test (α=.05). Scanning electron microscopy was used to analyze the failure mode. Attenuated total reflection Fourier transform infrared spectroscopy was used to quantitatively analyze the modifications to the chemical structure of the adhesive system from preheating and BAG inclusion. Results The mean bond strength values at 1 week were statistically different, with PG-T1 (69.8 ±7.8 MPa) superior to all other groups. CG-T1 (58.2 ±6.7 MPa), BG-T1 (60.7 ±4.4 MPa), and PBG-T1 (61.0 ±4.6 MPa) were not statistically different (P>.05). PG-T2 maintained the highest bond strength at 6 months (68.3 ±3.7 MPa), with no decrease in μTBS observed over time. Failure modes were mostly adhesive. Attenuated total reflection Fourier transform infrared spectroscopy analysis reported that primer preheating caused solvent evaporation and revealed that preheating the bonding agent promoted the condensation reaction between the silane and adhesive fillers. Conclusions No decrease in μTBS was observed for any group after 6 months. Preheating the adhesive system (primer and bonding resin) significantly increased the 1-week and 6-month μTBS. Inclusion of BAG did not affect the bond strength.