Effect of chemomechanical caries removal on bonding of resin-modified glass ionomer cement adhesives to caries-affected dentine

Background: This study evaluated the effect of: (1) chemomechanical caries removal (CMCR); (2) dentine surface treatments and (3) dentine substrates on adhesion of resin-modified glass ionomer cement (RMGIC) adhesives.

Methods: One hundred and twenty permanent molars exhibiting moderate cavitation on the occlusal surface into dentine were used. Seventy-five carious molars were used for bond strength testing; the remaining 45 for micromorphological evaluation of the bonded interface. Caries was excavated with NaOCl-based CMCR (Carisolv), enzyme-based CMCR (Papacarie), or conventional rotary caries removal methods. Dentine surface treatment was performed using 37% phosphoric acid, 25-30% PAA or 20% PAA + 3% AlCl3 .

Results: Three-way ANOVA revealed that all three factors 'caries removal methods', 'dentine surface treatments' and 'dentine substrates' did not significantly affect bond strength (p > 0.05). Scanning electron microscopy micrographs showed that the acid-base resistant layer was thicker in caries-affected dentine compared to sound dentine.

Conclusions: NaOCl- and enzyme-based CMCR methods have no adverse effect on adhesion of RMGIC adhesives to sound and caries-affected dentine. Dentine surface treatment with 37% phosphoric acid for 5 s has no negative effect on bonding of RMGIC adhesives to dentine compared with using polyacrylic acid for 10 s. RMGIC adhesives bonded well to both sound and caries-affected dentine.