Effect of an extrafibrillar dentin demineralization strategy on the durability of the resin–dentin bond

Objectives: This study aimed to evaluate the potential of the extrafibrillar dentin demineralization strategy on the long-term dentin bond strength of an etch-and-rinse adhesive. Methods: A water-soluble glycol chitosan-EDTA (GCE), a chelating conditioner, was synthesized and subjected to size-exclusion dialysis to obtain molecules >40 kDa. The conjugation of EDTA to glycol chitosan was analyzed by Fourier transform infrared (FTIR) spectroscopy. Mid-coronal dentin surfaces of 80 teeth were either acid-etched with 35% phosphoric acid or conditioned with 25 mg/mL GCE (n = 40) and thoroughly water-sprayed before applying the etch-and-rinse adhesive Adper Single Bond Plus and placing Z250 composite resin (3 M Oral Care; St Paul, MN, USA). Resin-bonded specimens were prepared into beams with a cross-sectional area of about 0.9 mm² vertically through the resin–dentin interfaces before the microtensile bond strengths (MTBS) were determined immediately or after 3, 6, or 12 months of water storage. The resin–dentin interfaces were analyzed using transmission electron microscopy (TEM). The MTBS data were analyzed using two-way ANOVA followed by the LSD post-hoc multiple comparisons (P < 0.05). Results: FTIR spectra showed that EDTA was successfully conjugated to glycol chitosan. The phosphoric acid-etching group and GCE-conditioning group showed similar bond strength values after 24 h of water storage. The bond strength of the phosphoric acid-etching group after 12-month water aging was significantly reduced from 51.61 ± 3.30 MPa to 38.57 ± 4.81 MPa, while the bond strength of the GCE-conditioning group was not significantly reduced from 50.28 ± 3.62 MPa to 46.40 ± 4.71 MPa.The degradation of the hybrid layer could be detected in the phosphoric acid-etching group after 12 months of water aging, but not in the GCE-conditioning group. Conclusion: The extrafibrillar dentin demineralization strategy using GCE conditioner could defy the hybrid layer degradation of the dentin bond after 12 months of water aging and enhance the dentin bond durability of the etch-and-rinse adhesive Adper Single Bond Plus.