title: Micro-shear bond strength and morphological analysis of a self-etching primer adhesive system to fluorosed enamel.
abstract: OBJECTIVE
  The aim of this study was to evaluate micro-shear bond strength and morphological analysis of a self-etching primer adhesive system to fluorosed enamel.
  
  
  METHODS
  Extracted human molars were classified according to the severity of fluorosis using Thylstrup and Fejerskov index into four groups (TFI: 0, normal; 1-3, mild fluorosis; 3-6, moderate fluorosis; 6-7, severe fluorosis) and divided into following two sub-groups. For the first sub-group, a self-etching primer adhesive system was applied to the ground enamel surfaces and the other sub-group was conditioned with 37% phosphoric acid for 30s prior to application of the same adhesive system. Teeth were then restored with a resin composite, stored for 24h in water and micro-shear bond strengths were measured. After shear testing, the fracture modes were observed under a laser scanning microscope. Morphological study of etching patterns and adhesive interface was done under a scanning electron microscope (SEM). The data were analyzed using two-way ANOVA and Sheffe test (p=0.05).
  
  
  RESULTS
  No statistically significant difference was there between the different degrees of fluorosis in each sub-group. However, significant difference in the bond strengths between phosphoric acid etching and self-etching was found in moderate and severe groups. The SEM observations showed at the resin-enamel interface, thick resin tag like extensions penetrated around 3.5 microm into the enamel etched with phosphoric acid, while self-etching primer created, 1 microm lamina like penetration.
  
  
  CONCLUSIONS
  Severity of fluorosis affects the micro-shear bond strength of a self-etching bonding system to fluorosed enamel.
authors.affiliation: Graduate School, Cariology and Operative Dentistry, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. dinesh.ope@tmd.ac.jp
authors.forename: Dinesh S
authors.initials: DS
authors.lastname: Weerasinghe
authors.forename: Toru
authors.initials: T
authors.lastname: Nikaido
authors.forename: Kamal A
authors.initials: KA
authors.lastname: Wettasinghe
authors.forename: Janaka B
authors.initials: JB
authors.lastname: Abayakoon
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods*; D000704:Analysis of Variance; D003188:Composite Resins; D001840:Dental Bonding; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D003799:Dental Stress Analysis; D019243:Enamel Microabrasion; D009050:Fluorosis, Dental / Q000628:therapy*; D006801:Humans; D016014:Linear Models; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D010756:Phosphoric Acids; D019279:Resin Cements; D033081:Shear Strength
chemical_list: C438313:Clearfil SE Bond; D003188:Composite Resins; D010756:Phosphoric Acids; D019279:Resin Cements; C030242:phosphoric acid