Tensile bond strength of Er,Cr:YSGG laser-irradiated human dentin and analysis of dentin-resin interface.

OBJECTIVES: As the bond strength of composite resin to Er,Cr:YSGG laser-irradiated dentin has not yet been evaluated, the objectives of this study were to investigate the tensile bond strength and to analyze the resin-dentin interface among bur-cut/acid-etched, Er,Cr:YSGG laser-ablated/acid-etched and Er,Cr:YSGG laser-ablated human dentin.
METHODS: Crown dentin disks prepared from extracted human third permanent molars were used for the observation of surface morphological changes by scanning electron microscope (SEM). The laser energy parameters were 3.5 W and 20 Hz with water spray (air pressure level, 80%; water pressure level, maximum level). Another group of crown dentin disks were prepared for composite resin restoration and observation of resin-dentin bond interface after demineralization in 6N hydrochloric acid (HCl) for 1 min and deproteinization in 1% sodium hypochlorite solution (NaOCl) for 10 min. The tensile bond strengths of the three groups were measured by a universal testing machine at a crosshead speed of 0.5 mm/min. Fracture types at the dentin-resin interface were analyzed using the digital stereoscopic microscope and fractured surfaces of the debonded specimens were examined by SEM.
RESULTS: All three groups showed that the treated surfaces were free of dentin debris and smear layer. The peritubular dentin protruded from the surrounding intertubular dentin after laser irradiation. The dentin-resin interface treated with Er,Cr:YSGG laser irradiation and acid etching demonstrated numerous resin tags converging into a bulge and then diverging again. The length of resin tags was greater than 100 microm. The tensile bond strengths of bur-cut/acid-etched, laser-ablated/acid-etched and laser-ablated human dentin were 5.37+/-1.51, 5.17+/-1.41 and 3.29+/-0.86 MPa, respectively. No statistical significance was found between the bur-cut/acid-etched and laser-ablated/acid-etched groups. The predominant fracture modes of bur-cut/acid-etched, laser-ablated/acid-etched and laser-ablated human dentin were Type 1 (50%), Type 2 (70%) and Type 1 (70%), respectively. SIGNIFICANCE: Er,Cr:YSGG laser irradiation affects adversely adhesion of resin to dentin but acid etching following laser irradiation could increase the tensile bond strength as high as that of bur-cut/acid-etched human dentin.