Adhesive Performance Assessment of Universal Adhesives and Universal Adhesive/Composite Cement Combinations.

PURPOSE: To investigate the bonding performance of three universal adhesives (UAs) to dentin and the effect of different curing modes and hydrofluoric-acid (HF) etching of lithium-disilicate glass-ceramic on the adhesive performance of two UA/composite cement (CC) combinations. MATERIALS AND METHODS: In the first project part, the immediate and aged (25k and 50k thermocycles) microtensile bond strength (microTBS) of the two light-curing UAs G2-Bond Universal (G2B; GC) and Scotchbond Universal Plus (SBUp; 3M Oral Care), and the self-curing UA Tokuyama Universal Bond II (TUBII; Tokuyama) to flat dentin was measured, when applied in both E&R and SE bonding mode using a split-tooth design (n = 10). The resultant adhesive-dentin interfaces were characterized using TEM. In the second project part, CAD/CAM composite blocks were luted to flat dentin with either Scotchbond Universal Plus/RelyX Universal (SBUp/RxU; 3M Oral Care) or Tokuyama Universal Bond II/Estecem II Plus (TUBII/ECIIp; Tokuyama Dental) using different curing modes (AA mode: auto-curing of both adhesive and cement; AL mode: auto-curing of adhesive and light-curing of cement), upon which their immediate and aged (25k and 50k thermocycles) microTBS was measured. In the third project part, the same UA/CC combinations were luted to CAD/CAM glass-ceramic to measure their immediate and aged (6-month water storage) shear bond strength (SBS). RESULTS: In E&R bonding mode, the performance of G2B, SBUp and TUBII was not significantly different in terms of microTBS, while G2B and SBUp significantly outperformed TUBII in SE bonding mode. No significant difference in microTBS was found between the SBUp/RxU and TUBII/ECIIp UA/CC combinations, regardless of bonding mode, aging time, or curing mode. The cement-curing mode did not significantly influence microTBS, while a significantly higher microTBS was recorded for the UA/CC combinations applied in E&R bonding mode. HF significantly improved the SBS of the UA/CC combinations to glass-ceramic. CONCLUSION: The self-curing adhesive performed better when applied in E&R than in SE bonding mode. The curing mode did not influence the adhesive performance of the composite cements, while an E&R bonding mode rendered more favorable adhesion in a self-curing luting protocol. When bonding to glass-ceramic, the adhesive performance of the universal adhesive/composite cement combinations benefited from HF etching.