title: Effect of chemomechanical caries removal on bonding of self-etching adhesives to caries-affected dentin.
abstract: OBJECTIVE
  To evaluate the effect of enzyme-based (Papacárie) and sodium-hypochlorite-based (Carisolv) chemomechanical caries removal methods on bonding of self-etching adhesives to caries-affected dentin, in comparison to the standard rotary-instrument caries removal method.
  
  
  METHODS
  Seventy-eight carious permanent molars exhibiting frank cavitation into dentin were used. Forty-eight teeth were randomly divided into three groups, according to the caries excavation methods: (i) Papacárie, (ii) Carisolv and (iii) a round steel bur. After caries removal, each group was subdivided into two groups for two-step (Clearfil SE Bond) or one-step (Clearfil S3 Bond) self-etching adhesive application and resin composite buildups. Bonded specimens were sectioned into beams for microtensile bond strength testing. Bond strength data were analyzed using three-way ANOVA and Tukey's test. For interfacial nanoleakage evaluation using a field-emission scanning electron microscope, caries was similarly removed from the remaining thirty carious molars, bonding was performed as for bond strength testing, and the teeth were sectioned.
  
  
  RESULTS
  RESULTS of three-way ANOVA revealed that bond strength was significantly affected by "adhesive" (p<0.001) and "dentin" (p<0.001), but not "caries excavation methods" (p>0.05). The bond strength of the two-step self-etching adhesive was significantly higher than that of the one-step self-etching adhesive (p<0.001). Conversely, the bond strength of self-etching adhesives to sound dentin was significantly higher than to residual caries-affected dentin (p<0.001). Greater silver penetration was observed in the bonded interfaces of residual caries-affected dentin and in interfaces bonded with the one-step self-etching adhesive vs those bonded with the two-step self-etching adhesive.
  
  
  CONCLUSIONS
  Chemomechanical caries removal did not affect the bonding of self-etching adhesives to caries-affected dentin as compared to caries excavation with rotary instruments.
authors.forename: Hamdi Hosni Hamdan
authors.initials: HH
authors.lastname: Hamama
authors.forename: Cynthia Kar Yung
authors.initials: CK
authors.lastname: Yiu
authors.forename: Michael Frances
authors.initials: MF
authors.lastname: Burrow
mesh_terms: D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003731:Dental Caries / Q000473:pathology*; D003737:Dental Cavity Preparation / Q000295:instrumentation / Q000379:methods*; D003763:Dental Leakage / Q000145:classification; D003764:Dental Materials / Q000737:chemistry; D003793:Dental Restoration, Permanent / Q000379:methods; D003804:Dentin / Q000648:ultrastructure*; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D004867:Equipment Design; D018698:Glutamic Acid / Q000627:therapeutic use; D006801:Humans; D007930:Leucine / Q000627:therapeutic use; D008239:Lysine / Q000627:therapeutic use; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D008963:Molar / Q000648:ultrastructure; D010206:Papain / Q000627:therapeutic use; D019279:Resin Cements / Q000737:chemistry; D016622:Silver Staining; D013314:Stress, Mechanical; D013718:Tensile Strength
chemical_list: C119934:Carisolv; C505694:Clearfil S3 Bond; C438313:Clearfil SE Bond; D003188:Composite Resins; D003764:Dental Materials; D017220:Dentin-Bonding Agents; C509557:Papacarie; D019279:Resin Cements; D018698:Glutamic Acid; D010206:Papain; D007930:Leucine; D008239:Lysine