Effects of Self-curing Activator and Curing Protocol on the Bond Strength of Composite Core Buildups

Purpose: To determine the effect of the polymerization mode of simplified bonding systems and the corresponding core buildup resin composite on the bond strength to dentin. Materials and Methods: Composite core buildups were bonded to flat prepared dentin surfaces of 320 human molars using a two-step etch-and-rinse (Excite, ER) and a two-step self-etching (AdheSE, SE) bonding system. Bonding systems were used both with and without their respective self-curing activators (Excite DSC, ER+SC; AdheSE DC, SE+SC). Six curing protocols for the dual-curing composite (MultiCore Flow) were examined: self-curing for 5 min (a); irradiation with light from each aspect for 10 s (b), 20 s (c), and 40 s (d); and irradiation with light from the occlusal aspect only for 60 s (e) and 120 s (f). Shear bond strengths were measured immediately after curing. Additional measurements were performed after water storage of the specimens for 24 h at 37°C. These specimens had been cured according the curing protocols given in the manufacturer's instructions (groups a and d). Failure modes were analyzed using scanning electron microscopy. Results: Immediate bond strengths were significantly different among the bonding systems (p 0.001): SE > ER > ER+SC > SE+SC. Immediate bond strengths of ER and SE were significantly lower when the composite was self-cured (p 0.05). The use of SC activators reduced the bond strength and promoted adhesive failures to dentin. A severe incompatibility problem was observed between the composite and SE+SC. Conclusion: Dentin bonding of dual-curing composite core buildups in combination with simplified bonding systems is still unsatisfactory, even when SC activators are employed. For adequate bonding to dentin, polymerization of the dual-curing composite should always be light initiated. Keywords: self-curing activator, bonding system, composite core buildup, curing protocol, incompatibility, bonding effectiveness