Effect of calcium removal on dentin bond strengths

Objective: The purpose of this in vitro study was to determine the microtensile bond strengths (μTBS) of 3 dental adhesives when applied to dentin decalcified with ethylenediaminetetraacetic acid (EDTA). The null hypothesis tested was that the removal of calcium from dentin would not influence the bond strengths. Method and materials: Eighteen extracted human molars were cut in 2 equal halves. One half served as the control, having no EDTA treatment, while the other half was assigned to 1 of 3 periods (1 hour, 24 hours, or 100 hours) of decalcificatioin with buffered 0.5 mol/L EDTA. Middle dentin was bonded with 1 of 3 dentin adhesive groups: a self-etching primer, Clearfil SE Bond (SE); an acetone-based total-etch adhesive, Prime&Bond NT (NT); and an ethanol- and water-based total-etch adhesive, Single Bond (SB). The specimens were restored with Z-250 resin composite and sectioned in 0.9 ± 0.2 mm² sticks that were tested in tensile mode. Results: For each adhesive, the control group (not decalcified) resulted in statistically higher bond strengths than the treatment groups. For specimens that were not decalcified, SE and SB had statistically similar bond strengths, but both resulted in statistically higher bond strengths than NT. For specimens decalcified for 1 hour, SE resulted in statistically higher bond strengths than either SB or NT, which were ranked in the same statistical group. SE was the only dentin adhesive to result in measurable μTBS after decalcification with EDTA for 24 hours, while SB/24 hour and NT/24 hour specimens debonded spontaneously prior to testing. All the specimens treated with EDTA for 100 hours debonded prior to testing. Conclusion: Three conclusions were drawn: (1) All 3 adhesive systems included in this project bonded significantly better to calcified than to decalcified dentin, regardless of their composition; (2) The self-etching primer-based adhesive ranked consistently equal to or better than the 2 total-etch-based adhesives, regardless of the EDTA decalcification time; and (3) Removal of calcium may be more detrimental for adhesives that rely on dentin acid etching than for adhesives based on self-etching primers.