Statement of problem: It has been reported that the bond strength of composite to demineralized dentin is lower than that to sound dentin. This can be a problem in the success of so-called sealed restorations.
Purpose: The aim of this study was to evaluate the effect of fluoride application on the tensile bond strength of self-etching adhesive systems to demineralized dentin.
Material and methods: One hundred twenty extracted bovine incisors were ground flat with 600-grit silicone carbide paper. Ninety teeth were then immersed in acetate buffer (pH 4.0) to form demineralized dentin. These teeth were randomly divided into 3 groups of 30 each: surfaces treated with fluoride solution (Group NF), surfaces treated with fluoride solution followed by a water rinse (Group RF), and control surfaces with no pretreatment (Group C). The remaining 30 teeth comprised a group with normal dentin surfaces (Group S). Each group was further divided into 3 subgroups of 10 each to test the bond strength test of Clearfil SE Bond, Unifil Bond, and Mac-Bond II. Tensile bond strengths (in MPa) were measured with a universal testing machine at a crosshead speed of 0.5 mm/min. Mean bond strengths were analyzed by 2-way analysis of variance and Fisher's PLSD (P =.05). SEM observations of the surfaces before and after priming and at resin-dentin interfaces in each group were performed. Elemental analysis of the dentin surfaces before priming was also carried out.
Results: The bond strengths of the adhesives to demineralized dentin in Groups NF, RF, and C were significantly lower than that of the normal dentin in Group S (P <.05). The mean bond strengths of the 3 adhesives in Group NF were higher than those in Groups RF and C, but a significant difference was observed only when Clearfil SE Bond was used (P <.05). In SEM images the open dentinal tubules on the surface and the resin tag formation at the resin-dentin interface were apparent in Group NF but were not observed in Groups RF and C. On elemental analysis, considerable amounts of fluoride and calcium were detected in the surfaces of Group NF.
Conclusion: Within the limitations of this study, the surface treatment with fluoride solution supported the resin tag formation at the resin-dentin interface and slightly improved the bond strength of the self-etching adhesive systems tested to demineralized dentin. This result indicated that the fluoride treatment to demineralized dentin might contribute to the success of the sealed restoration.