Influence of de/remineralization of enamel on the tensile bond strength of etch-and-rinse and self-etching adhesives.

PURPOSE: To evaluate the bonding behavior of resin composite and different adhesives applied to demineralized or remineralized enamel. METHODS: Bovine tooth crowns were polished to prepare a 5 mm2 enamel bonding area, and divided into five groups (n= 48) according to the surface treatment: CONT (sound enamel control), DEM (demineralized with acid to create white spot lesions), REMS (DEM remineralized with artificial saliva), REMF (DEM remineralized with sodium fluoride) and INF (DEM infiltrated with Icon resin infiltrant). The surface-treated teeth were divided into two subgroups (n= 24) according to adhesive type: ER (etch-and-rinse; Single Bond Universal) and SE (self-etching; Clearfill S3 Bond), and further subdivided into two categories (n= 12) according to aging process: Thermo (thermocycling) and NA (no aging). Composite blocks were made over bonded enamel and sectioned for microtensile bond strength (MTBS) testing. Data were analyzed with three-way ANOVA and post-hoc Tukey's test (alpha= 0.05). RESULTS: Significant differences were observed for enamel surface treatment (P< 0.0001), adhesive type (P< 0.0001) and aging (P< 0.0001). CONT and INF groups had higher MTBS than the other groups; Single Bond Universal had higher MTBS than Clearfil S3 Bond; thermo-aging resulted in lower MTBS irrespective of adhesive type and surface treatment condition. The predominant failure mode was mixed for all groups. Enamel surface infiltrated with Icon does not interfere with adhesive resin bonding procedures. CLINICAL SIGNIFICANCE: Treatment of enamel surface containing white spot lesions or cavities with cavosurface margins in partially-demineralized enamel can benefit from infiltration with a low viscosity resin infiltrant prior to adhesive bonding of resin composites.