A comparative study of the microtensile bond strength and microstructural differences between sclerotic and Normal dentine after surface pretreatment.

BACKGROUND: The resin bond strength of sclerotic dentine is significantly lower than that of the normal dentine, which paused a challenge for bonding procedures clinically. The aim of this study was to compare the effects of different surface pretreatments on the micro-tensile bond strength and microstructure between sclerotic dentine and normal dentine. METHODS: Eighty teeth that were collected, forty premolars with typical wedge-shaped defects visually graded as class III were assigned as the sclerotic dentine group (SD), the other forty normal premolars with artificial wedge-shaped defects were assigned as the normal dentine group (ND). Each group was randomly subdivided into eight subgroups according to the solution used: 35% phosphoric acid, 15% EDTA, 5% or 10% NaClO. Then the dentine surface was examined using a scanning electron microscope (SEM). The lesions were restored using self-etching adhesive and the subsequent resin composite. The teeth were sectioned into sticks for the micro-tensile bond strength analysis, and the data were analysed using the SPSS17.0 software package (alpha = 0.05). RESULTS: First, for the ND groups, after pretreatment using 35% phosphoric acid, and 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the normal dentine were higher than that of the other groups (P < 0.05). Second, for the SD groups, after pretreatment using 35% phosphoric acid, 15% EDTA, and 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the sclerotic dentine were higher than that of the other groups (P < 0.05). Third, the bond strengths of the sclerotic dentine were lower than that of the normal dentine without any pretreatment (P < 0.05). After pretreatment using 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the sclerotic dentine were higher than that of the normal dentine (P < 0.05). SEM observation showed that the appearances of dentine surface were changed after pretreatment using the above solutions, with the reduced smear layer, opened small groove and increased dentinal tubules. CONCLUSION: Pretreatment of dentine using 35% phosphoric acid+ 5% or + 10% sodium hypochlorite changed the microstructure of the sclerotic dentine surface and subsequently increased the micro-tensile bond strength.