Bond strength and cement-tooth interfacial characterization of self-adhesive composite cements

Purposes: (1) To determine the microtensile bond strength (mu TBS) of self-adhesive (SA) composite cements to unetched/etched enamel and dentin, and (2) to characterize the cements' interaction with tooth tissue. Methods: 51 composite blocks were bonded to smear layer-covered enamel and dentin (three teeth per group). Four SA composite cements (Clearfil SA, G-CEM, RelyX Unicem, SmartCem2), and three multi-step composite cements, two used following an etch-and-rinse (E&R) approach (RelyX ARC, Variolink II 'E&R') and one used following a self-etch (SE) approach (Variolink II 'SE') were investigated. The cement-tooth specimens were perpendicularly sectioned into micro-specimens (1.0 x 1.0 mm) in order to measure the mu TBS. The data were statistically analyzed by ANOVA followed by Tukey HSD (P< 0.05). 24 additional specimens (four teeth per group) were prepared for interfacial characterization using SEM. Results: The tested SA cements bonded equally well to enamel and dentin. Etching of enamel improved their bonding effectiveness, which however remained inferior to that of both E&R cements. SEM revealed a very similar interfacial ultrastructure at smear layer-covered enamel and dentin for the SA cements, exhibiting very superficial interaction at enamel and absence of a clearly detectable hybrid layer and resin tags in the dentin tubules. When the SA composite cements were applied to dentin free of a smear layer, regular and long resin tags were formed.