Microtensile bond strength of total-etch and self-etching adhesives to caries-affected dentine

Objectives. To evaluate the microtensile bond strength of total-etch or self-etch adhesives to caries-affected versus normal dentine, and to correlate these bond strengths with DIAGNOdent laser fluorescence and Knoop microhardness (KH) measurements of the substrates. Methods. Extracted carious human molars were ground to expose flat surfaces where the caries lesion was surrounded by normal dentine. Surfaces were bonded with either Prime & Bond NT, Scotchbond 1, Clearfil SE Bond or Prompt L-Pop, according to manufacturers' recommendations. A crown was built up using resin composite (Tetric Ceram). After storage in water (37°C, 24 h), teeth were vertically serially sectioned into 0.7 mm thick slabs and trimmed to yield 1 mm² test area that contained either caries-affected or normal dentine. Samples were tested in tension in an Instron machine at 1 mm/min. The quality of the dentine just beneath each fractured specimen was measured by laser fluorescence and KH. Results. Total-etch adhesives yielded higher bond strengths than self-etching systems. Significantly lower results were obtained with Prompt L-Pop. All the adhesives attained higher strengths in normal than in caries-affected dentine, but the differences were only significant for Prime & Bond NT and Clearfil SE Bond. Higher laser fluorescence values and lower KH (p<0.001) were recorded in caries-affected dentine compared to normal dentine. Conclusions. The total-etch adhesives evaluated produced higher bond strengths to normal and caries-affected dentine than self-etching systems. Laser fluorescence measurements discriminated caries-affected dentine from normal dentine, and were strongly correlated with KH. However, laser fluorescence and KH did not permit high correlations with resin-dentine bond strengths in caries-affected dentine.