The effect of a vital bleaching technique on enamel surface morphology and the bonding of composite resin to enamel.

This study examined the effect of a nightguard vital bleaching procedure on enamel surface morphology and the shear bond strength of a composite resin luting cement to enamel. Extracted human teeth were bleached for 1 week using a vital bleaching product. Control teeth were brushed with a fluoride toothpaste and processed similarly to the bleached teeth, however the bleaching product was substituted with artificial saliva in the night guards. Teeth were stored in artificial saliva for 24 h, 1, 6 or 12 weeks and then examined for any surface changes using light and scanning electron microscopy. The effect of etching surfaces with 37% phosphoric acid was examined at the scanning electron microscope level. The shear bond strength of composite resin luting cement to both buccal and lingual surfaces of bleached and control teeth was determined. Light microscopy investigation suggested the bleaching process resulted in a loss of mineral from enamel which was evident 24 h after bleaching and was sustained following 12 weeks storage in artificial saliva. Scanning electron microscopy showed a definite change in the surface texture of the bleached enamel surface. Acid etching of the bleached enamel surface produced loss of prismatic form and the enamel appeared overetched. The mean shear bond strength between composite resin luting cement and etched enamel tended to be lower for bleached enamel surfaces, however no significant difference in shear bond strength was noted between control and experimental groups. The results of this study suggest that bleaching resulted in changes to the surface and subsurface layers of enamel. Although surface changes were observed in the etched enamel, the shear bond strength of composite resin luting cement to etched bleached enamel appeared to be clinically acceptable.