Immediate bonding effectiveness of contemporary composite cements to dentin.

The objective of this study was to compare the one-week bonding effectiveness of nine contemporary composite cements used to lute ceramic to dentin and to determine an appropriate processing method for pretesting failures. The microtensile bond strengths (µTBS) of different luting agents including five self-adhesive cements (Unicem, 3 M ESPE; Maxcem, Kerr; Monocem, Shofu; G-Cem, GC; and Multilink Sprint, Ivoclar-Vivadent), two self-etch cements (Panavia F2.0 and Clearfil Esthetic Cement, Kuraray), and two etch-and-rinse cements (Calibra, Dentsply, and Variolink II, Ivoclar-Vivadent) were measured using a standardized protocol. As control, a two-step self-etch adhesive combined with a restorative composite (Clearfil SE+Clearfil APX, Kuraray) were included as luting material. Depending on the processing of the pretesting failures, two groups of cements could be distinguished: (1) those with low bond strength and many pretesting failures and (2) those with relatively high bond strength and few pretesting failures. Nevertheless, the control luting procedure involving a self-etch adhesive combined with a restorative composite presented with a significantly higher µTBS. The µTBS was clearly product-dependent rather than being dependent on the actual adhesive approach. Fracture analysis indicated that failure usually occurred at the dentin-cement interface especially for the cements with low bond strength and many pretesting failures. Depending on the cement system, an adequate immediate ceramic-to-dentin bond strength can be obtained, even with self-adhesive cements that do not use a separate dental adhesive. Yet, the self-etch adhesive Clearfil SE combined with the restorative composite revealed a superior bonding performance and should therefore be preferred in clinical situations where the restoration transmits light sufficiently.