The effect of etching on bacterial microleakage of an adhesive composite restoration.
OBJECTIVE
The incidence of bacterial microleakage, pulp inflammation and necrosis associated with dentine etching treatments prior to restoration are not known. Consequently, to resolve some of the controversy surrounding the effects and importance of vital dentine etching, the authors investigated these factors.


METHODS
110 standardised class V cavities were cut into buccal dentine, without exposing the pulp of teeth scheduled for extraction for orthodontic reasons. Cavities were either left unetched, or etched with the non-equivalent treatments of phosphoric acid gel for 60s or Ethylenediaminetetraacetic acid (EDTA) for 30s, prior to placement of composite resin. Teeth were collected and pulp responses were evaluated according to ISO guidelines, using pathohistomorphometric analysis and ANOVA statistics.


RESULTS
Etching was found to be correlated to bacterial microleakage (p=0.0001) and tertiary dentine formation (p=0.0023). Bacterial microleakage was correlated to inflammatory activity (p=0.0001). The frequency of bacterial microleakage was: no etching (65%), EDTA (51%) and phosphoric acid (PA) (20%).


CONCLUSIONS
Vital dentine etching treatment is of extreme importance for the placement of RC to minimise bacterial microleakage. PA etching proved to be more effective at preventing bacterial microleakage than non-etching, and etching with EDTA.
Murray
Peter E
PE
Oral Biology, Indiana University School of Dentistry, 1121 West Michigan Street, Indianapolis, IN 46202, USA.p.e.murray@bham.ac.uk
Smyth
Thomas W
TW
About
Imad
I
Remusat
Remeille
R
Franquin
Jean-Claude
JC
Smith
Anthony J
AJ
D000134:Acid Etching, Dental / Q000379:methods; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D017438:Bisphenol A-Glycidyl Methacrylate; D002648:Child; D003763:Dental Leakage / Q000150:complications / Q000517:prevention & control*; D003790:Dental Pulp Necrosis / Q000209:etiology; D003793:Dental Restoration, Permanent; D003804:Dentin / Q000187:drug effects; D003809:Dentin, Secondary / Q000378:metabolism; D017220:Dentin-Bonding Agents; D004492:Edetic Acid / Q000494:pharmacology; D005260:Female; D006801:Humans; D008297:Male; D009804:Odontoblasts / Q000166:cytology; D010756:Phosphoric Acids / Q000494:pharmacology; D011671:Pulpitis / Q000209:etiology; D019279:Resin Cements; D016369:Smear Layer
D017220:Dentin-Bonding Agents; D010756:Phosphoric Acids; D019279:Resin Cements; C074318:Scotchbond Dual Cure; D017438:Bisphenol A-Glycidyl Methacrylate; D004492:Edetic Acid; C030242:phosphoric acid