title: Single-step adhesives are permeable membranes.
abstract: OBJECTIVE
  This study tested the hypotheses that micro-tensile bond strengths of all currently available single-step adhesives to dentine are adversely affected by delayed activation of a light-cured composite, and that such a phenomenon only occurs in the presence of water from the substrate side of the bonded interface.
  
  
  METHODS
  In experiment I, a control three-step adhesive (All-Bond 2, Bisco) and six single-step adhesives (One-Up Bond F, Tokuyama; Etch&Prime 3.0, Degussa; Xeno CF Bond, Sankin; AQ Bond, Sun Medical; Reactmer Bond, Shofu and Prompt L-Pop, 3M ESPE) were bonded to sound, hydrated dentine. A microfilled composite was placed over the cured adhesive and was either light-activated immediately, or after leaving the composite in the dark for 20 min. In experiment II, three single-step adhesives (Etch&Prime 3.0, Xeno CF Bond and AQ Bond) were similarly bonded to completely dehydrated dentine using the same delayed light-activation protocol. In experiment III, a piece of processed composite was used as the bonding substrate for the same three single-step adhesives. The microfilled composite was applied to the cured adhesives using the same immediate and delayed light-activation protocols. Bonded specimens were sectioned for micro-tensile bond strength evaluation. Fractographic analysis of the specimens was performed using SEM. Stained, undemineralised sections of unstressed, bonded specimens were also examined by TEM.
  
  
  RESULTS
  When bonded to hydrated dentine, delayed light-activation had no effect on the control three-step adhesive, but significantly lowered the bond strengths of all the single-step adhesives (p < 0.05). This adverse effect of delayed light-activation was not observed in the three single-step adhesives that were bonded to either dehydrated dentine or processed composite. Morphological manifestations of delayed light-activation of composite in the hydrated dentine bonding substrate were exclusively located along the composite-adhesive interface, and were present as large voids, resin globules and honeycomb structures that formed partitions around a myriad of small blisters along the fractured interfaces.
  
  
  CONCLUSIONS
  These features resembled the 'overwet phenomenon' that was previously reported along the dentine-adhesive interfaces of some acetone-based three-step adhesives. The cured adhesive layer in single-step adhesives may act as semi-permeable membranes that allow water diffusion from the bonded hydrated dentine to the intermixed zone between the adhesive and the uncured composite. Osmotic blistering of water droplets along the surface of the cured adhesive layer and emulsion polymerisation of immiscible resin components probably account for the compromised bond strength in single-step adhesives after delayed activation of light-cured composites.
authors.affiliation: Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, People's Republic of China. kfctay@hknet.com
authors.forename: Franklin R
authors.initials: FR
authors.lastname: Tay
authors.forename: David H
authors.initials: DH
authors.lastname: Pashley
authors.forename: Byoung I
authors.initials: BI
authors.lastname: Suh
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Carvalho
authors.forename: Anut
authors.initials: A
authors.lastname: Itthagarun
mesh_terms: D001672:Biocompatible Materials / Q000737:chemistry*; D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003738:Dental Cements / Q000737:chemistry*; D018772:Dental Marginal Adaptation; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003804:Dentin / Q000378:metabolism; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D006801:Humans; D008964:Molar, Third; D010539:Permeability; D010777:Photochemistry; D019279:Resin Cements / Q000737:chemistry; D016369:Smear Layer
chemical_list: D001672:Biocompatible Materials; D003188:Composite Resins; D003738:Dental Cements; D017220:Dentin-Bonding Agents; D019279:Resin Cements