Reconsidering the double etching of enamel: do self-etching primers contaminate phosphoric acid-etched enamel? 2013

Andreas Rathke, and Veit Ostermeier, and Rainer Muche, and Bernd Haller
Department of Operative Dentistry and Peridontology, University of Ulm, Ulm, Germany. andread.rathke@uniklinik-ulm.de

OBJECTIVE To evaluate the composite-to-enamel bond following double etching of the enamel using phosphoric acid and different self-etching (SE) bonding systems with and without the application of their respective acidic primers. METHODS The enamel surfaces of 90 human molars were ground (600 grit) flat and randomly divided into nine groups (n = 10). Three two-step SE systems (AdheSE, ASE; Clearfil SE Bond, CSE; OptiBond Solo Plus SE, OSE) were tested, both with and without primer application on enamel pre-etched with phosphoric acid under dry bonding conditions. As the controls, the SE systems were applied according to their original directions without pre-etching. All the specimens were built up with a microhybrid composite resin (Arabesk Top). After water storage for 24 h at 37°C, the bonded specimens were sheared to failure in the Zwicki 1120. Etching and failure patterns were evaluated using a scanning electron microscope (SEM). Shear bond strength was analyzed with two-way ANOVA and Tukey's test. Failure modes were analyzed with Fisher's exact test. RESULTS Without pre-etching, CSE showed significantly higher bond strengths than ASE and OSE (p < 0.05). Enamel etching prior to the application of the SE systems tended to result in higher bond strengths, but significantly increased the values only for ASE (p < 0.05). Contamination of the pre-etched enamel with the SE primer decreased the bond strength by values of 19% for ASE (p > 0.05), 36% for CSE (p < 0.05), and 75% for OSE (p < 0.05). SEM analysis showed that omission of the priming step significantly increased the number of cohesive failures within the resin for OSE (p < 0.0001). CONCLUSIONS Additional etching with phosphoric acid before the application of SE systems does not necessarily result in better enamel bonding, since unavoidable primer contamination of the pre-etched enamel was shown to significantly reduce the bond strength for two of the three systems tested.

UI MeSH Term Description Entries
D008689 Methacrylates Acrylic acids or acrylates which are substituted in the C-2 position with a methyl group. Methacrylate
D010756 Phosphoric Acids Inorganic derivatives of phosphoric acid (H3PO4). Note that organic derivatives of phosphoric acids are listed under ORGANOPHOSPHATES. Pyrophosphoric Acids,Acids, Phosphoric,Acids, Pyrophosphoric
D001840 Dental Bonding An adhesion procedure for orthodontic attachments, such as plastic DENTAL CROWNS. This process usually includes the application of an adhesive material (DENTAL CEMENTS) and letting it harden in-place by light or chemical curing. Bonding, Dental,Cure of Orthodontic Adhesives,Curing, Dental Cement,Dental Cement Curing,Orthodontic Adhesives Cure
D003188 Composite Resins Synthetic resins, containing an inert filler, that are widely used in dentistry. Composite Resin,Resin, Composite,Resins, Composite
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D003799 Dental Stress Analysis The description and measurement of the various factors that produce physical stress upon dental restorations, prostheses, or appliances, materials associated with them, or the natural oral structures. Analyses, Dental Stress,Analysis, Dental Stress,Stress Analyses, Dental,Stress Analysis, Dental,Dental Stress Analyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000134 Acid Etching, Dental Preparation of TOOTH surfaces and DENTAL MATERIALS with etching agents, usually phosphoric acid, to roughen the surface to increase adhesion or osteointegration. Dental Acid Etching,Etching, Dental Acid
D000180 Acrylic Resins Polymers of high molecular weight which are derived from acrylic acid, methacrylic acid or other related compounds and are capable of being molded and then hardened to form useful components. Acrylic Resin,Resin, Acrylic,Resins, Acrylic
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses

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