Bonding Protocols to Reverse the Bond Strength of a Universal Adhesive to Hemostatic Agent-contaminated Dentin

SUMMARY Objective: To evaluate the effect of different bonding protocols on the microtensile bond strength (μTBS) of a universal adhesive to dentin contaminated with a hemostatic agent. Methods and Materials: Ninety-five extracted premolars were used in this study. For the μTBS test, 80 teeth were cut to expose mid-coronal dentin and randomly divided into two groups (uncontaminated dentin and hemostatic agent-contaminated dentin). Each group was further divided into five subgroups (n=8/group): 1) SE: no additional treatment, 2) ER: etching with 32% phosphoric acid, 3) CHX: rinsing with 0.2% chlorhexidine, 4) EDTA: rinsing with 17% EDTA, and 5) T40: application of universal adhesive for 40 seconds. A universal adhesive was applied followed by resin composite build-up. μTBS test was performed after 24 hours of water storage. Two-way analysis of variance (ANOVA) was calculated followed by the Duncan testing (α=0.05). The failure mode was analyzed using light microscopy. Additional teeth were prepared for energy-dispersive X-ray (EDX) analysis (n=1/group) and resin-dentin interface observation (n=2/group) using scanning electron microscopy. Results: Adverse effects of hemostatic agent contamination on the bonding performance of a universal adhesive was found in the SE, CHX, and T40 groups (p<0.05). Fewer and shorter resin tags were observed in the SE, CHX, and T40 groups. A higher percentage of adhesive failure and mixed failure was found in contaminated dentin. All bonding protocols revealed lower amounts of Al and Cl after dentin contamination, except for the SE group. Conclusions: Hemostatic agent contamination adversely affected dentin bond strength. However, this bond strength could be reversed using the etch-and-rinse technique or rinsing with EDTA prior to adhesive application.