Citra Kusumasari1, Ahmed Abdou2, Masatoshi Nakajima3, Junji Tagami3. 1. Department of Conservative Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia; Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. 2. Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Biomaterials Department, Faculty of Dentistry, Modern University for Technology and Information, Cairo, Egypt. Electronic address: ahmed.abdou@dnt.mti.edu.eg. 3. Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Abstract
OBJECTIVES: To evaluate the micro-tensile bond strength (μTBS) of self-etch adhesives (SEA) to normal and caries-affected dentin after smear layer deproteinization with papain enzyme-based and NaOCl-based chemo-mechanical caries removal agents (CRAs) and to compare their efficacy to a 6 % NaOCl solution. METHODS: Forty extracted human molars with occlusal carious lesions were randomly divided into four pretreatment groups: no treatment (control), Papacarie for 60 s, Carisolv for 60 s, and 6 % NaOCl for 15 s. After pretreatment, Universal Bond Quick ER (UBQ, one-step, 1-SEA) or Clearfil SE Bond 2 (CSE, two-step, 2-SEA) was applied to the pre-treated surface, and built-up with resin composite (Clearfil AP-X). The μTBS test was performed after 24 h water storage of the specimens at 37 °C, and the modes of failure were determined under SEM. Deproteinizing effects of the tested agents on smear layer-covered dentin was quantified by changes in the amide:phosphate ratio using attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) analysis. RESULTS: On caries-affected dentin the μTBS improved significantly after pretreatment with Papacarie, Carisolv, and 6 % NaOCl with both SEAs (p < 0.05). Papacarie pretreatment significantly improved the μTBS of UBQ on normal dentin compared to NaOCl pretreatment (p < 0.05). ATR-FTIR revealed that all agents significantly decreased the amide:phosphate ratio on the smear layer-covered normal and caries-affected dentin (p < 0.05). CONCLUSIONS: Smear layer deproteinizing with papain enzyme-based and NaOCl-based gel CRAs was effective in improving the micro-tensile bond strength of self-etch adhesives to caries-affected dentin. CLINICAL SIGNIFICANCE: Smear layer deproteinization with Papacarie (a papain enzyme-based gel) or Carisolv (a NaOCl-based gel) can improve the μTBS to normal and caries-affected dentin bonded with 2-step self-etch adhesives.
OBJECTIVES: To evaluate the micro-tensile bond strength (μTBS) of self-etch adhesives (SEA) to normal and caries-affected dentin after smear layer deproteinization with papain enzyme-based and NaOCl-based chemo-mechanical caries removal agents (CRAs) and to compare their efficacy to a 6 % NaOCl solution. METHODS: Forty extracted human molars with occlusal carious lesions were randomly divided into four pretreatment groups: no treatment (control), Papacarie for 60 s, Carisolv for 60 s, and 6 % NaOCl for 15 s. After pretreatment, Universal Bond Quick ER (UBQ, one-step, 1-SEA) or Clearfil SE Bond 2 (CSE, two-step, 2-SEA) was applied to the pre-treated surface, and built-up with resin composite (Clearfil AP-X). The μTBS test was performed after 24 h water storage of the specimens at 37 °C, and the modes of failure were determined under SEM. Deproteinizing effects of the tested agents on smear layer-covered dentin was quantified by changes in the amide:phosphate ratio using attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) analysis. RESULTS: On caries-affected dentin the μTBS improved significantly after pretreatment with Papacarie, Carisolv, and 6 % NaOCl with both SEAs (p < 0.05). Papacarie pretreatment significantly improved the μTBS of UBQ on normal dentin compared to NaOCl pretreatment (p < 0.05). ATR-FTIR revealed that all agents significantly decreased the amide:phosphate ratio on the smear layer-covered normal and caries-affected dentin (p < 0.05). CONCLUSIONS: Smear layer deproteinizing with papain enzyme-based and NaOCl-based gel CRAs was effective in improving the micro-tensile bond strength of self-etch adhesives to caries-affected dentin. CLINICAL SIGNIFICANCE: Smear layer deproteinization with Papacarie (a papain enzyme-based gel) or Carisolv (a NaOCl-based gel) can improve the μTBS to normal and caries-affected dentin bonded with 2-step self-etch adhesives.