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Bonding of Self-etch and Total-etch Adhesives to Carious Dentin

¹ Department of Operative Dentistry, Okayama University Graduate School of Medicine and Dentistry, 2-5-1, Shikata-cho, Okayama 700-8525, Japan;
² Department of Conservative Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong, China;
³ Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, 17012-901, Brazil;
⁴ Department of Operative Dentistry, Tokyo Medical and Dental University, Tokyo, Japan; and
⁵ Department of Oral Biology, Medical College of Georgia, Augusta, Georgia 30912-1129, USA;

View larger version (436K): [in a new window]   Figure 1. Transmission electron micrographs (TEM) of undemineralized specimens. (A) Unstained section of the resin-dentin interface in a specimen bonded by means of the self-etch ABF system. A 1-µm-thick hybrid layer (H) could be seen within the partially demineralized dentin. Sodium fluoride crystals (pointer) were present in the filled adhesive (A). D, undemineralized sound dentin. (B) Stained section of the resin-dentin interface in a specimen bonded with the total-etch adhesive Single Bond. A thick layer of the polyalkenoic acid copolymer (P) component of the adhesive (A) was formed on top of a 5-ìm-thick hybrid layer. C, resin composite; U, undemineralized sound dentin.

View larger version (664K): [in a new window]   Figure 2. TEM of undemineralized specimens of resin-bonded caries-affected dentin. (A) Stained TEM of undemineralized specimens following the application of the self-etch ABF system to caries-affected dentin. The hybrid layer (H; between arrows) was about 3 µm thick, and the underlying undemineralized dentin (U) was highly porous (arrowhead). The dentinal tubule was covered with a smear plug (SP) and was partially obliterated with large caries crystals (pointer). A, filled adhesive. (B) Stained section of the total-etch Single Bond adhesive bonded to caries-affected dentin. A hybrid layer (H) between 15 and 19 µm thick could be seen, with a partially demineralized zone (open arrows) above the undemineralized caries-affected dentin (U). T, dentinal tubule. C, composite. (C) Higher magnification of the basal part of the unusually thick hybrid layer (H) shown in Fig. 2A. Banded collagen fibrils (open arrow) were separated by unusually wide and porous interfibrillar spaces (open arrowheads). A partially demineralized zone (Pd) was present along the demineralization front. This zone was not seen in phosphoric-acid-etched sound dentin (Fig. 1B). U, undemineralized caries-affected dentin.

View larger version (872K): [in a new window]   Figure 3. TEM of undemineralized specimens, showing the variability in bonding of a self-etch and a total-etch adhesive to caries-infected dentin. (A) Stained section of a specimen bonded with the self-etch ABF system. The hybrid layer region (between open arrows) consisted of a superficial layer of carious-infected dentin (CI) that contained bacteria (arrowhead) mixed with some caries-affected dentin (CA). The underlying caries-affected dentin (U) was highly porous. The dentinal tubules (T) were completely obliterated with minerals. (B) Stained section of a specimen bonded with the ABF system, showing a thick layer of caries-infected dentin that contained loose dentin chips (L) and bacteria (B). The extent of the hybrid layer could not be clearly discerned. Caries-infected dentin did not form a hybrid layer in the underlying caries-affected dentin (CA). A gap (asterisk) was present between the unfilled primer component of the adhesive (P) and the surface of the caries-infected dentin. This gap was subsequently filled with the more electron-lucent epoxy resin that was used for laboratory specimen preparation. (C) High magnification of stained section of an ABF specimen showing caries-affected dentin that was about 100 µm beneath the bonded interface. Destruction of the intertubular and peritubular dentin resulted in the confluence of tubules that were filled by micro-organisms. Glycogen-like intracellular polysaccharide granules could be identified within the cytoplasm of the bacteria, some of which were dividing. (D) Stained section of the superficial part of the hybrid layer (H) in a caries-infected dentin specimen bonded with the total-etch, Single Bond adhesive. A loose dentin fragment (pointer) was trapped within the copolymer (P) of the adhesive (A). B, bacteria within dentinal tubules; C, composite.