Shear bond strength of calcium silicate-based cements to composite resin using a universal adhesive in different application modes: an in vitro study

Background: To assess the shear bond strength (SBS) of four calcium silicate-based cements (CSCs) to composite resin using a universal adhesive in self-etch (SE) and etch-and-rinse (ER) modes and to evaluate surface microstructure and chemical composition of CSCs after acid-etching. Methods: In total, 30 specimens of each cement, Biodentine (BD), mineral trioxide aggregate (MTA) Angelus (MTA-A), ProRoot MTA (MTA-P) and MTA Repair HP (MTA-HP), were prepared and assigned into 2 groups (n = 15) according to universal adhesive (Clearfil Universal Bond Quick) applied in SE and ER mode. After composite resin (Clearfil Majesty Esthetic) was applied, the SBS was measured. Scanning electron microscope-energy dispersive spectroscopy (SEM-EDS) analysis was used to evaluate the changes in surface structure and elemental composition. Results: MTA-P demonstrated significantly higher SBS than all CSCs, except for MTA-HP in the SE mode. The ER mode exhibited significantly higher SBS compared to the SE mode for MTA-P and MTA-A. Acid-etching caused morphological differences and affected elemental distribution. Conclusions: MTA-P may be a more suitable pulp capping material due to its superior SBS compared to BD and MTA-A. The application of a universal adhesive in ER mode may be suggested to increase the SBS of MTA-P and MTA-A to composite resin.