Exposed Dentin: Influence of Cleaning Procedures and Simulated Pulpal Pressure on Bond Strength of a Universal Adhesive System

Purpose: To compare various pre-treatments serving as cleaning procedures of dentin on the bond strength of resin composite promoted by a universal adhesive system applied either in the absence or presence of simulated pulpal pressure. Materials and Methods: Prior to application of the adhesive system (Scotchbond Universal) and resin composite (Filtek Z250), ground dentin surfaces were given one of five pre-treatments either without or with simulated pulpal pressure: 1) no pre-treatment, adhesive system in “self-etch” mode, 2) phosphoric acid etching, adhesive system in “total-etch” mode, 3) polishing with pumice on prophylaxis cup, 4) air abrasion with AIR-FLOW PLUS powder, 5) air abrasion with AIR-FLOW PERIO powder; n = 20/group of pre-treatment. After storage (37°C, 100% humidity, 24 h), micro shear bond strength was measured and data analyzed with parametric ANOVA including Bonferroni-Holm correction for multiple testing followed by Student’s t tests (significance level: α = 0.05). Results: The ANOVA found type of pre-treatment and simulated pulpal pressure to have no significant effect on dentin bond strength. The explorative post-hoc tests showed a negative effect of simulated pulpal pressure for phosphoric acid etching (adhesive system in “total-etch” mode; p = 0.020), but not for the other four pre-treatments (all p = 1.000). Conclusion: Air abrasion with powders containing either erythritol and chlorhexidine (AIR-FLOW PLUS) or glycine (AIR-FLOW PERIO) yielded dentin bond strengths similar to no pre-treatment, phosphoric acid etching, or polishing with pumice. Simulated pulpal pressure reduced the bond strength only when the self-etch adhesive system was used in total-etch mode.