Effect of Phosphoric Acid Containing MMP-Inactivator on the Properties of Resin Bonding to Eroded Dentin

Purpose: To evaluate the effect of two phosphoric acids containing protease inactivators (chlorhexidine and proanthocyanidin) on the resin/eroded-dentin microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives applied in the etch-and-rinse mode. Materials and Methods: One hundred twenty-six molars were randomly assigned to 18 experimental conditions according to the combination of the independent variables: eroded dentin (soft drink and citric acid), adhesive (Prime&Bond Elect [PBE, Dentsply Sirona], Scotchbond Universal Adhesive [SBU, 3M Oral Care], and Tetric N-Bond Universal [TEU, Ivoclar Vivadent]), and acid pretreatment (conventional phosphoric acid [CP acid]; chlorhexidine acid [CHX acid]; and proanthocyanidin acid [PA acid]). After restorations, specimens were sectioned into resin-dentin sticks (ca 0.8 mm2) that were then tested under tension (crosshead speed: 0.5 mm/min). Selected sticks from each tooth were used to evaluate NL and DC. Data from all tests were subjected to three-way ANOVA and Tukey's test (α=0.05). Results: Dentin eroded with citric acid showed a significant reduction in μTBS for each adhesive in comparison to dentin eroded with the soft drink (p 0.001). For dentin eroded with CHX acid and PA acid, the μTBS (p > 0.03) significantly improved and NL decreased for all adhesives (p 0.004); in addition, the DC improved for two of the three adhesives tested (SBU and TEU) (p 0.03) when CHX acid and PA acid were compared to CP acid. Conclusion: The addition of chlorhexidine and proanthocyanidin to phosphoric acid improved the adhesive performance when compared with conventional phosphoric acid, without jeopardizing adhesive polymerization at the resin/eroded-dentin interface. Keywords: eroded dentin, phosphoric acid, chlorhexidine, proanthocyanidin, universal adhesives