Effect of different conditioning protocols on adhesion of a GIC to dentin

Purpose: This study examined the ultrastructure and microtensile bond strength (uTBS) of a restorative glass-ionomer cement (QIC; Dentsply) to sound dentin that was conditioned with various techniques. Materials and Methods: Dentin surfaces from extracted human third molars were abraded with 180-grit SiC paper. Five groups of three teeth each were prepared: C - no acid pretreatment (control); P - 10% polyacrylic acid (PAA) for 10 s, no rinsing; R - 10% PAA for 20 s, rinsed; K - 25% PAA for 25 s, rinsed; and H 32% phosphoric acid for 15 s, rinsed. TEM was performed on a bonded specimen from each group, using unstained, undemineralized sections. GIG buildups were made on the remaining teeth, and after storage at 100% humidity for 24 h, the teeth were sectioned for uTBS and SEM evaluation. Results: TEM revealed the presence of a structure known as the intermediate layer in all groups. This layer contains metallic salts contributed by both the GIG and dentin. In group C, this layer was restricted to the smear layer. In groups P and R, intermediate layers could be found above partially demineralized zones within the intertubular dentin. In groups conditioned with more aggressive protocols (K and H), the intermediate layers shifted downward to reside within the superficial portions of completely demineralized collagen. Group C had statistically lower uTBS (p < 0.05), while the other groups were not significantly different from each other. SEM revealed adhesive failures along the dentin surface in group C and mixed failures in the other groups. Conclusion: The lower uTBS observed in the control group reflects the weakness of the smear layer attachment to dentin. The higher uTBS in the other groups probably represent the cohesive strength of GIC under tension, rather than its true adhesive strength to dentin. Acid pretreatment dissolves the smear layer, creates a zone of partially demineralized dentin, and allows the PAA to interact with dentin via the intermediate layer. Overly aggressive conditioning renders the dentinal tubules patent, and leaves deeper demineralized dentin that does not form part of the intermediate layer.