To etch or not to etch, Part II: On the hydrophobic-rich content and fatigue strength of universal adhesives

Abstract

<p>Objective: To determine whether smear layer management, via conservative etching pro-tocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces.</p><p>Methods: Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta -phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal ad-hesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sec-tioned and stored in deionized water for 24 h at 37 celcius before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (alpha = 0.05).</p><p>Results: Etching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p < 0.05). Dentin demineralization was ranked as OPA 15 s > MPA 15 s > OPA 3 s > P + R > SE. Less aggressive etching and coating reduced crack formation at hybrid layers.</p><p>Significance: Current oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives. <br></p><p>(c) 2022 Published by Elsevier Inc. on behalf of The Academy of Dental Materials. CC_BY_NC_ND_4.0</p>