Effect of different adhesive application approaches on bond strength in over-etched dentin.

Purpose: To investigate the effect of over-etching and subsequent use of different adhesive application approaches including active, double, preheated, and ultrasonic application on dentin bond strength.

Methods: Dentin specimens from sound human third molars were prepared and allocated into six groups (n= 10 per group). In Group 1 (negative control), the dentin specimens were over-etched with phosphoric acid for 30 seconds, and a two-step etch-and-rinse adhesive (Prime & Bond XP; Dentsply Sirona) was applied for 20 seconds according to the manufacturer's instructions. In test Groups 2-5, the application of the adhesive varied: In Group 2, the adhesive was actively rubbed into the dentin surface, whereas in Group 3, a second adhesive layer was applied after light-curing of the first one. In Group 4, the adhesive was heated to 68°C prior to application, and in Group 5, the adhesive was ultrasonically activated. Acid-etching for 15 seconds and adhesive application for 20 seconds was performed in the positive control group (Group 6) according to the manufacturer's instructions. After light-curing and composite build-up [Ceram.x Spectra ST (HV); Dentsply Sirona], microtensile bond strength and fracture types were determined. Data were statistically analyzed by Kruskal-Wallis rank test, followed by post-hoc pairwise comparisons using Conover tests and P-value adjustment according to Holm (α= 0.05).

Results: Active, double, preheated, or ultrasonic adhesive application showed no significant effect on dentin bond strength when compared to the control groups. Predominantly adhesive failures were observed in all groups.

Clinical significance: A modification of adhesive application by using active, double, preheated, or ultrasonic application does not improve bonding to accidentally over-etched dentin.