Clinical Relevance: A self-etching primer adhesive system, Clearfil SE Bond, may be able to prevent secondary caries around composite restorations in which an acid-base resistant zone was observed beneath the hybrid layer after acid-base challenge.

An acid-base resistant zone has been found to exist after acid-base challenge adjacent to the hybrid layer using SEM. The aim of this study was to examine the acid-base resistant zone using three different bonding systems. Dentin disks were applied with three different bonding systems, and then a resin composite was light-cured to make dentin disk sandwiches. After acid-base challenge, the polished surfaces were observed using SEM. For both one- and two-step self-etching primer systems, an acid-base resistant zone was clearly observed adjacent to the hybrid layer — but with differing appearances. For the wet bonding system, the presence of an acid-base resistant zone was unclear. This was because the self-etching primer systems etched the dentin surface mildly, such that the remaining mineral phase of dentin and the bonding agent yielded clear acid-base resistant zones. In conclusion, the acid-base resistant zone was clearly observed when self-etching primer systems were used, but not so for the wet bonding system.

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SummaryDentin bonding systems have been dramatically simplified and improved during the recent decades. Monomer penetration into dentin and its polymerization in situ creates a hybrid layer, which is essential to obtain good bonding to dentin. Moreover, the presence of an acid–base resistant zone below the hybrid layer has been documented with self-etching adhesive systems in an artificial secondary caries attack. When ultrastructure of the acid–base resistant zone is assessed by SEM and TEM observations, formation of the acid–base resistant zone is considered to be due to the monomer penetration potential and fluoride release in the adhesive systems. Natural dentin has a limited potential to resist an acid attack of secondary caries; however, the acid–base resistant zone does not purely consist of dentin in morphology, it is rather a combination of dentin and the adjacent hybrid layer. Therefore, the reinforced dentin has been called “Super Dentin” bearing the ability to prevent primary and secondary caries. Prospectively, the great potential of adhesive technology in creation of the “Super Dentin” would lead to the development of new materials for mechanical, chemical and biological protection of the dental structures

This study evaluated the effect of two hemostatic agents on bond strength of resin-modified glass ionomer cement (RMGIC) to root dentin after using different pretreatment solutions compared to resin composite with a 2-step self-etch adhesive. Dentin specimens were either uncontaminated or contaminated with a ferric sulphate or aluminum chloride astringent, RMGIC was applied after conditioning with; Cavity Conditioner, Self Conditioner or Clearfil SE Primer, while a resin composite was bonded using Clearfil SE Bond. Microtensile bond strength (mu TBS) values and failure modes were determined. Two-way ANOVA revealed that hemostatic agents did not significantly affect the RMGIC bond strength with any conditioning material (p>0.05). SE Primer pretreatment provided the highest mu TBS values among RMGIC groups. For the resin composite, ferric sulphate astringent significantly reduced mu TBS value (p <= 0.001). Scanning electron micrographs of representative dentin surfaces contaminated with the hemostatic agents showed effects on smear layer removal and dentinal tubule occlusion.