An in Vitro Comparison of Bonding Effectiveness of Different Adhesive Strategies on Erbium:Yttrium-Alluminum-Garnet Laser Irradiated Dentin

Background: To date there is not a material considered ideal for the lased dentin. Objective: To compare the bond strength to human lased dentin of self-etch and etch-and-rinse adhesive sys- tems, a self-adhesive resin composite and a glass-ionomer cement. Methods: Forty human molars were sectioned to obtain a 2 mm-thick slab of mid-coronal dentin. The occlusal surface of each slab was polished by SiC paper (P600) for 10 s. Then an half part of dentin slabs was randomly se- lected for receiving treatment with 2.94 μm Er:YAG laser (DEKA, Smart 2940D Plus) with 10 Hz at 100 mJ, pulse duration of 230 μs with contact tip. Dentin slabs were randomly divided into four groups (n = 10). Six conical frustum-shaped build-ups were constructed on the occlusal surface of each dentin slab using bonding agents (OptiBond Solo Plus Group 1; OptiBond All-in-one Group 2) combined with a resin composite (Premise Flow), self-adhesive resin composites (Vertise Flow Group 3) and a glass-ionomer cement (Ketac-Fil Group 4). Specimens were subjected to μSBS test. Data were analyzed by a mixed model and Tukey’s test. Results: Measured bond strengths were (mean ± standard deviation): 20.8 ± 5.5 MPa (laser treatment) and 15.6 ± 4.5 MPa (SiC paper) for Group 1, 18.9 ± 5.3 MPa (laser treatment) and 14.0 ± 4.3 MPa (SiC paper) for Group 2, 7.9 ± 2.8 MPa (laser treatment) and 4.3 ± 2.2 MPa (SiC paper) for Group 3, 4.7 ± 1.9 MPa (laser treatment) and 2.6 ± 1.2 MPa (SiC paper) for Group 4. The inferential analysis showed that the dentin laser treatment significantly affected the bond strength within each individual group. On dentin treated with laser the bond strengths recorded for build-ups constructed with etch and rinse and self-etch adhesive systems were significantly higher than those recorded for build-ups constructed with self-adhesive resin composite and glass-ionomer cement (p < 0.0001). Similarly, on dentin treated with SiC paper the bond strengths recorded for build-ups constructed with etch and rinse and self-etch adhesive systems were significantly higher than those recorded for build-ups con- structed with self-adhesive resin composite and glass-ionomer cement (p < 0.0001). Conclusion: Er:YAG laser treatment has increased the shear bond strength of all the adhesive materials used.