10.59987/ads/2014.1.15-22
Aim. The aim of this in vitro study was to evaluate the effect of different surface treatments on shear bond strength of a conventional glass-ionomer cement (GIC) and a resin-modified glass-ionomer cement (RMGIC) to dentin.
Materials and methods. 80 bovine permanent incisors were used. 40 cylindrical specimens of a GIC (Fuji IX GP Extra) and 40 cylindrical specimens of a RMGIC (Fuji II LC) were attached to the dentin. The teeth were then randomly assigned to 8 groups of equal size (n=10), 4 for every type of glass-ionomer cement, corresponding to type of dentin surface treatments. Group 1: GC Cavity Conditioner; Group 2: 37% phosphoric acid gel; Group 3: Clearfil SE Bond; Group 4: no dentin conditioning (control). The specimens were placed in a universal testing machine (Model 3343, Instron Corp., Canton, Mass., USA) and subsequently tested for shear bond strength (MPa).
Results. ANOVA showed the presence of significant differences among the various groups. Post hoc Tukey test showed different values of shear bond strength for Fuji IX GP Extra and for Fuji II LC. The different conditioners variably influence the adhesion of the glass-ionomer cements tested.
Conclusions. RMGIC shear bond to dentin was higher than GIC. The use of a Self-etch adhesive system improved the shear bond strength values of RMGIC and lowered the shear bond strength values of GIC significantly.
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M. Lombardini 
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Annali di stomatologia
shear bond strength test
Effects of dentin surface treatments on shear bond strength of glass-ionomer cements
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Original Article
2022-08-16
2022-08-16
2014-03-01
2023-12-04
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Ann Stomatol (Roma)
M. Lombardini 
2014
10.59987/ads/2014.1.15-22
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1971-1441
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shear bond strength test
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Effects of dentin surface treatments on shear bond strength of glass-ionomer cements
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                                                                                                Original article



    Effects of dentin surface treatments on shear bond
    strength of glass-ionomer cements




                                                                                                                 li
                                                                na
    Claudio Poggio, MD, DDS1                               values of RMGIC and lowered the shear bond
    Riccardo Beltrami, DMD, PhD2                           strength values of GIC significantly.




                                                              io
    Andrea Scribante, DMD, PhD2
    Marco Colombo, DMD, PhD1                               Key words: conventional glass-ionomer cement,
    Marco Lombardini, DMD, PhD1                            resin-modified glass-ionomer cement, dentin pre-
                                                           treatment, phosphoric acid, polyacrylic acid, self-




                                                           az
                                                           etch adhesives, shear bond strength test.
    1 Department of Clinical-Surgical, Diagnostic and
      Paediatric Science, University of Pavia, Italy
    2 Department of Brain and Behavioural Sciences,        Introduction




                                                        rn
      Section of Statistics, University of Pavia, Italy
                                                           Glass-ionomer cements (GICs) were developed and
                                                           first presented by Wilson and Kent (1) in 1972: the
    Corresponding author:                                  goal was finding an ideal restorative material with




                                                     te
    Claudio Poggio                                         physical properties similar to tooth structure, with ad-
    Department of Clinical-Surgical, Diagnostic and Pae-   hesion to dentine/enamel, with resistance to degrada-
    diatric Science, University of Pavia, Italy            tion in the oral cavity (2) and with ability to release
    Piazzale Golgi, 1
    27100 Pavia, Italy
                                                  In       fluoride (3). GICs are able to bond chemically to
                                                           enamel, dentin, plastics, and non-precious metals (4,
    E-mail: c.poggio@unipv.it                              5); other potential advantages of GICs are adhesion
                                                           in a wet substrate and the release of fluoride ions
                                                           over long periods (6). Previous studies showed that
                                                ni
    Summary                                                enamel adjacent to glass-ionomer cements was less
                                                           deeply and less frequently demineralised compared
    Aim. The aim of this in vitro study was to evaluate    with that adjacent to non fluoridated materials (7, 8).
    the effect of different surface treatments on shear    Moreover, glass-ionomer cements were shown to re-
                              o

    bond strength of a conventional glass-ionomer          lease fluoride longer and at higher levels than fluo-
    cement (GIC) and a resin-modified glass-ionomer        ride-containing composites (9). The concept that
                          izi


    cement (RMGIC) to dentin.                              glass-ionomers can act as rechargeable fluoride re-
    Materials and methods. 80 bovine permanent in-         lease devices has been proposed (10). Studies re-
    cisors were used. 40 cylindrical specimens of a        ported that the regular use of fluoride toothpastes can
    GIC (Fuji IX GP Extra) and 40 cylindrical speci-       result in the absorption of fluoride into the glass-
           Ed




    mens of a RMGIC (Fuji II LC) were attached to the      ionomer and that this fluoride can subsequently be
    dentin. The teeth were then randomly assigned to       released into the adjacent tooth structure (11, 12).
    8 groups of equal size (n=10), 4 for every type of     Initial formulation of GICs underwent several modifi-
    glass-ionomer cement, corresponding to type of         cations with the intent to improve handling and physi-
    dentin surface treatments. Group 1: GC Cavity          cal properties. A remarkable improvement of this
    Conditioner; Group 2: 37% phosphoric acid gel;         class of material occurred with the introduction of the
    C




    Group 3: Clearfil SE Bond; Group 4: no dentin          resin-modified glass-ionomer cement (RMGIC). This
    conditioning (control). The specimens were             material is characterised by the addition of photo-acti-
CI




    placed in a universal testing machine (Model           vated metacrilate, and a small amount of resin, such
    3343, Instron Corp., Canton, Mass., USA) and           as 2-HEMA or Bis-GMA, to the conventional glass-
    subsequently tested for shear bond strength            ionomer cement (GIC) (13, 14). Over the years many
    (MPa).                                                 studies have been carried out to demonstrate that
    Results. ANOVA showed the presence of signifi-         GICs and RMGICs bond naturally to the tooth surface
    cant differences among the various groups. Post        (15, 16). Bond strengths are lower than composite
©




    hoc Tukey test showed different values of shear        resins bonded with appropriate bonding agents, but
    bond strength for Fuji IX GP Extra and for Fuji II     the durability of the bond appears greater (17). This
    LC. The different conditioners variably influence      may be attributed to the bioactive nature of the inter-
    the adhesion of the glass-ionomer cements test-        face between the cement and the tooth (15, 18),
    ed. Conclusions. RMGIC shear bond to dentin            which leads over time to a strong, durable bond
    was higher than GIC. The use of a Self-etch adhe-      formed by an ion-diffusion process (19). Many condi-
    sive system improved the shear bond strength           tioning solutions, such as polyacrylic acid and phos-

    Annali di Stomatologia 2014; V (1): 15-22                                                                   15
    C. Poggio et al.


    phoric acid in different concentrations have been in-             placed on the cut surface of the tooth, and packing
    vestigated as a pre-treatment to GICs and RMGICs,                 them until they were full. In GIC specimens, there
    in order to improve their adhesion to the dentin sur-             was a 6-min interval from the start of mixing to com-
    face (20-23). Dentin conditioning can act differently             plete curing of the cement, but in RMGIC the speci-
    on GICs and RMGICs due to the presence of resin                   mens were immediately cured using a LED curing




                                                                                                                               li
    components that can infiltrate into the demineralised             light in softstart-polymerisation mode (Celalux 2 High-
    dentin and after polymerisation result in microme-                Power LED curing-light, Voco GmbH, Cuxhaven, Ger-




                                                                     na
    chanical retention (24).                                          many) for 10 seconds at a light intensity of 1000
    The purpose of the present in vitro study was to eval-            mW/cm2. The tip of the light-curing unit was placed
    uate the effect of different surface treatments on                1 mm above the surface of the cement. The teeth
    shear bond strength of a conventional glass-ionomer               were then randomly assigned to 8 groups of equal




                                                                   io
    cement and a resin-modified glass-ionomer cement                  size (n=10) corresponding to the type of dentin sur-
    to dentin.                                                        face treatments and to the cylindrical specimen at-
                                                                      tached. Group 1: GC Cavity Conditioner (20% poly-




                                                                az
                                                                      acrylic acid and 3% aluminum chloride hexahydrate)
    Materials and methods                                             for 20 seconds, rinsed and gently air-dried plus Fuji
                                                                      IX GP Extra. Group 2: 37% phosphoric acid gel (Total
    In the present in vitro study, 80 bovine mandibular in-           Etch; Ivoclar Vivadent AG, Schaan, Liechtenstein) for




                                                             rn
    cisor were collected and randomly divided into 8                  15 seconds, rinsed and gently air-dried plus Fuji IX
    groups (n=10). Tissue remnants and debris were re-                GP Extra. Group 3: Clearfil SE Bond (Kuraray) ap-
    moved with periodontal curettes. The teeth were                   plied according the Instruction for use plus Fuji IX GP
    stored in 0.5% chloramine solution for one week and               Extra. Group 4: no dentin conditioning (control) plus




                                                          te
    later in distilled water at 4º C. The teeth were embed-           Fuji IX GP Extra. Group 5: GC Cavity Conditioner
    ded in self-cured acrylic resin, obtaining 2.0 cm large           (20% polyacrylic acid and 3% aluminum chloride
    x 2.0 cm thick specimens. The teeth were randomly                 hexahydrate) for 20 seconds, rinsed and gently air-
    assigned to 8 groups (n=10) according to the dentin               dried plus Fuji II LC. Group 6: 37% phosphoric acid
    treatment received. The vestibular enamel was re-
                                                       In             gel (Total Etch; Ivoclar Vivadent AG, Schaan, Liecht-
    moved to obtain a flat surface of dentin. In all groups,          enstein) for 15 seconds, rinsed and gently air-dried
    a high-speed turbine attached to a device was used                plus Fuji II LC. Group 7: Clearfil SE Bond (Kuraray)
    for standardised dentin preparation. The lingual                  plus Fuji II LC. Group 8: no dentin conditioning (con-
    dentin surface was exposed using a high-speed car-                trol) plus Fuji II LC. Details of materials employed are
                                         ni

    bide rotary instrument (# H21L.314.014; Komet, Ger-               presented in Table 1 and in Table 2.
    many) under copious water irrigation. The surface
    was rinsed with water and gently air dried. Different
                             o

    types of surface treatments were employed: GC Cavi-               Shear Bond Strength Testing
    ty Conditioner, 37% phosphoric acid gel, Clearfil SE
                         izi


    Bond, no dentin conditioning. 40 cylindrical speci-               Specimens were stored in a solution of 0,1%
    mens (4 mm diameter × 4 mm height) of a conven-                   (weight/volume) thymol for 24 hours and then were
    tional glass-ionomer cement (Fuji IX GP Extra) and                placed in a universal testing machine (Model 3343,
    40 cylindrical specimens (4 mm diameter × 4 mm                    Instron Corporation, Norwood, MA, USA) (Fig. 1).
           Ed




    height) of resin-modified glass-ionomer cement (Fuji              Specimens were secured in the lower jaw of the ma-
    II LC) were attached to the dentin. The capsules of               chine so that the bonded cylinder base was parallel to
    glass-ionomer cements were activated and mixed ac-                the shear force direction (Fig. 2). The shear bond
    cording to the manufacturer’s instructions. The pre-              strength was performed at 0.5 mm/minute until the
    pared mixture was packed into a cylindrical plastic               sample ruptured. Specimens were stressed in an oc-
    moulds (a diameter of 4 mm and a height of 4 mm)                  cluso-gingival direction at a crosshead speed of 1
    C
CI




    Table 1. Glass-ionomer cements employed in the study.

    Material             Type        Composition                             Manufacturer                        Batch Number
    Fuji IX GP Extra     GIC         Polyacrylic acid,                       GC Corporation, Tokyo, Japan        1102214
    in caps                          Fluoro-alumino-silicate glass,
©




                                     Distilled water
    Fuji II LC in caps   RMGIC       2-hydroxyethyl                          GC Corporation, Tokyo, Japan        1103127
                                     methacrylate (HEMA),
                                     Urethane Dimethacrylate (UDMA),
                                     Polyacrylic acid,
                                     Fluoro alumino-silicate glass,
                                     Distilled water


    16                                                                                   Annali di Stomatologia 2014; V (1): 15-22
    Effects of dentin surface treatments on shear bond strength of glass-ionomer cements


    Table 2. Conditioners employed in the study.

    Material               Composition                                 Manufacturer                       Batch Number
    GC Cavity              20% polyacrylic acid, 3% aluminum           GC Corporation, Tokyo, Japan       1102171
    Conditioner            chloride hexahydrate,distilled water




                                                                                                                         li
    Total Etch             phosphoric acid (37 % in H2O),              Ivoclar Vivadent AG, Schaan,       P35844




                                                                        na
                           thickeners and pigments                     Liechtenstein
    Clearfil SE Bond       Primer: 10-MDP, HEMA,                       Kuraray Medical, Sakazu,           Primer: 01040AA
                           Hydrophilic dimethacrylate, CQ,             Okayama, Japan
                           N,N-Diethanol-p-toluidine, water.
                           Bond: 10-MDP, Bis-GMA,                                                         Bond: 01556AA




                                                                      io
                           Hydrophilic dimethacrylate, HEMA, CQ,
                           N,N-Diethanol-p-toluidine,
                           silanated colloidal silica.




                                                                   az
                                                                rn
                                                             te
                                                          In
                              o                 ni
                          izi
           Ed
    C




    Figure 1. Universal testing machine Model 3343, Istrom         Figure 2. Universal testing machine Model 3343, Istrom
    (Universal testing machine, Model 3343, Instron Corpora-       (Universal testing machine, Model 3343, Instron Corpora-
CI




    tion, Norwood, MA, USA).                                       tion, Norwood, MA, USA). The bonded cylinder base was
                                                                   parallel to the shear force direction.


    mm/min (16-18). The maximum load necessary to                  within the tooth (19). The adhesive remnant index
    debond was recorded in Newton (N) and calculated in            (ARI) was used to assess the amount of adhesive left
©




    MPa as a ratio of Newton to surface area of the cylin-         on the enamel surface (20). This scale ranges from 0
    der. After the testing procedure, the fractured sur-           to 3. A score of 0 indicates no adhesive remaining on
    faces were examined with an optical microscope                 the tooth in the bonding area; 1 indicates mixed fail-
    (Stereomicroscope SR, Zeiss, Oberkochen, Ger-                  ure with less than half of the adhesive remaining on
    many) at a magnification of 10x to determine failure           the tooth; 2 indicates mixed failure with more than
    modes and classified as adhesive failures, cohesive            half of the adhesive remaining on the tooth; and 3 in-
    failures within the composite, or cohesive failures            dicates all adhesive remaining on the tooth. The ARI

    Annali di Stomatologia 2014; V (1): 15-22                                                                           17
    C. Poggio et al.


    scores were used as a more complex method of                       of variance (ANOVA) was applied to determine
    defining bond failure site among the enamel, the ad-               whether significant differences in debond values ex-
    hesive, and the composite (25). Samples were ther-                 isted among the groups. The Tukey test was used as
    mocycled and debonded using a shear force with a                   post-hoc. The chi-squared test was used to deter-
    crosshead speed of 0.5 mm/min. Shear bond                          mine significant differences in the ARI scores among




                                                                                                                                li
    strengths were determined using a Hounsfield Uni-                  the different groups. Significance for all statistical
    versal Testing machine, at a loading rate of                       tests was predetermined at P<0.05.




                                                                          na
    1 mm/min, using a knife edge placed 1 mm away
    from the interface. Loads at failure were converted to
    bond strengths by dividing by the contact areas of the             Results
    cylinders. After mechanical failure, the fracture




                                                                        io
    modes in all the specimens were evaluated under a                  Descriptive statistics of the shear bond strength
    stereomicroscope (Nikon; Japan) at ×20.                            (MPa) of the different groups are illustrated in Table 3
                                                                       and in Figure. 3. ANOVA showed the presence of sig-




                                                                     az
                                                                       nificant differences among the various groups
    Statistical analysis                                               (P<0.0001). Post hoc Tukey test showed that when
                                                                       testing Fuji IX GP Extra the application of cavity con-
    Statistical analysis was performed with Stata 9.0 soft-            ditioner (Group 1) showed significantly higher shear




                                                                  rn
    ware (Stata, College Station, Tex). Descriptive statis-            bond strength than all other surface treatments
    tics, including the mean, standard deviation, median,              (P<0.05). Moreover phosphoric acid gel application
    and minimum and maximum values were calculated                     (Group 2) showed no significant difference in shear
    for all groups. Kolmogorov and Smirnov test was ap-                strength values than no conditioning control group




                                                               te
    plied to assess normality of distributions. An analysis            (Group 4). Lowest values were reported when Clearfil



    Table 3. Descriptive statistics of the different groups tested.
                                                            In
    Groups      Material                 Enamel pre-treatment          Mean       SD       Min        Mdn       Max       Tukey *
    1           Fuji IX GP Extra         Cavity Conditioner            3.51       1.22     1.51       3.34      5.34      A
    2           Fuji IX GP Extra         Ortophosphoric acid           1.86       1.10     0.18       1.11      5.02      B
                                             ni

    3           Fuji IX GP Extra         Clearfil SE Bond              0.00       0.00     0.00       0.00      0.00      C
    4           Fuji IX GP Extra         No conditioning               1.94       0.96     0.84       1.92      3.36      B
                                 o

    5           Fuji II LC               Cavity Conditioner            10.24      2.20     5.10       11.09     14.28     D
    6           Fuji II LC               Ortophosphoric acid           6.53       1.90     2.08       6.30      11.23     E
                             izi


    7           Fuji II LC               Clearfil SE Bond              15.88      4.40     7.03       15.69     26.29     F
    8           Fuji II LC               No conditioning               5.72       2.82     2.46       5.17      11.66     E
    *: Tukey post hoc: Means with the same letters are not significantly different.
           Ed




                                                                                                  Figure 3. Mean shear bond
                                                                                                  strength and standard deviation
                                                                                                  of the different groups tested.
    C
CI
©




    18                                                                                    Annali di Stomatologia 2014; V (1): 15-22
    Effects of dentin surface treatments on shear bond strength of glass-ionomer cements


    SE Bond was applied (Group 3). On the other hand,              as higher than that of conventional GICs (32). Howev-
    when testing Fuji II LC the highest shear bond                 er, the exact mechanism of adhesion of this material
    strength values (P<0.001) were reported when                   is not completely established. Some SEM studies re-
    Clearfil SE Bond was applied (Group 7). Significantly          vealed the formation of tags at the dentin-cement in-
    lower (P<0.05) values were reported when Cavity                terface resultant from the RMGIC polymer penetration




                                                                                                                            li
    conditioner was applied (Group 5). Lowest shear                into the dentinal tubules (21, 28, 33).
    strength values (P<0.01) were reported both when               The application of surface-altering solutions to dentin




                                                                      na
    enamel was pretreated with phosphoric acid gel                 prior to bonding with glass-ionomer cements has a
    (Group 6) and when no conditioner was applied                  long history (34, 35). The purpose of applying these
    (Group 8). Overall, Fuji II LC showed significantly            solutions has been to increase the strength of the
    higher shear bond strength values than Fuji IX GP              bond formed between the dentin surface and cement.




                                                                    io
    Extra (P<0.0001). When comparing ARI Score results             For chemically-cured glass-ionomer cements, one of
    of the different groups, no statistical difference was         these first solutions used for this purpose was citric
    found in frequency distribution among various groups,          acid (36). Although 50% citric acid was commonly




                                                                 az
    that all showed a significant prevalence of ARI Score          used as a dentin conditioning agent, it fell out of
    of “0” (Fig. 4).                                               favour because it lacked biocompatibility (37), opened
                                                                   dentin tubules (38), and produced either no increase
                                                                   or decrease in bond strength (38, 39). Polyacrylic acid




                                                              rn
    Discussion                                                     in various concentrations has also been suggested as
                                                                   a dentin conditioner prior to placement of chemically
    The adhesion of dental materials to dentin has been            set glass-ionomer cement because Powis et al. (38)
    extensively investigated in the last decades in order to       believed that it increases wettability of dentin surface




                                                           te
    make it effective and durable, but due to dentin com-          and improves ion exchange with the cement. Al-
    plexity this is an arduous procedure (26). Unlike              though researchers have recommended its use in an
    enamel, dentin is a live, dynamic tissue that contains         attempt to maximise bond strength, suggested con-
    greater portion of water and organic material. It is con-      centrations and application times have varied. Berry
                                                        In
    nected to the pulp through the dentinal tubules, which         et al. (40) used SEM to evaluate dentin surfaces treat-
    extend from the pulp to the dentin-enamel junction.            ed with number of conditioning solutions and conclud-
    These tubules contain dentinal fluid that is responsible       ed that a 5 second application of 40% polyacrylic acid
    for the intrinsic humidity of this structure (26, 27). Dif-    produced the most ideal surface for bonding. Howev-
    ferent mechanical tests have been proposed to as-              er, Long et al. (41) found that a 30 second treatment
                                                ni
    sess the bonding performance of restorative materi-            with either 30% or 35% polyacrylic acid produced
    als. Although it suffers criticism, shear testing has          bond strengths that were significantly higher than
    been widely used to evaluate the bonding ability of ad-        those produced using 15%, 20%, 25% and 40% solu-
                              o

    hesive materials to dental structure (22, 28). Particu-        tions. Although differences in opinion remain concern-
    larly regarding GICs, which present low bond strength,         ing application times and concentrations for poly-
                          izi


    other tests may be difficult to apply (29). Previous           acrylic acid, researchers continue to recommend its
    studies have shown that typical shear bond strengths           use as a dentin pre-treatment with chemically set
    of glass-ionomer cements to dentine lie in the range           glass-ionomer products. Polyacrylic acid is the most
    1–3 MPa, and rarely exceed 5 MPa (30, 31). The                 commonly used conditioner for conventional GICs be-
           Ed




    bond strength RMGICs to dentin have been reported              cause it is capable of cleansing the dentin surface


                                                                                           Figure 4. ARI Scores percentages of
                                                                                           the different groups tested.
    C
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©




    Annali di Stomatologia 2014; V (1): 15-22                                                                              19
    C. Poggio et al.


    without completely unplugging the dentinal tubules.        dentin treatment with polyacrylic acid is recommend-
    The increase in bonding efficiency resulting from con-     ed by the manufacturer of Fuji II LC considering the
    ditioning can be attributed to: a cleansing effect which   fact that the liquid of Fuji II LC contains approximately
    removes loose cutting debris following cavity prepara-     35% hydroxyethyl methacrylate (HEMA) (manufactur-
    tion, a partial demineralisation effect which increases    er’s data).




                                                                                                                         li
    the surface area and creates microporosities and a         Previous studies demonstrated a significant improve-
    chemical interaction of the polyalkenoic acid with         ment in the bond strength of Fuji II LC after condition-




                                                                    na
    residual hydroxyapatite. The auto-adhesion of glass-       ing with polyacrylic acid (43-45). Pereira et al. (28)
    ionomer cements to tooth tissue has recently been          observed resin tag formation in dentin specimens
    elucidated to be two-fold in nature. Micromechanical       pretreated with polyacrylic acid and restored with Fuji
    interlocking is achieved by shallow hybridisation of       II LC. Fuji II LC contains HEMA which can facilitate




                                                                  io
    the micro-porous, hydroxyapatite-coated collagen net-      an improvement in the wetting ability as well as suit-
    work . In this respect, glass-ionomer cements can be       able bonding (46). A hybrid-like layer was reported to
    considered as adhering to tooth tissue through a kind      form at the Fuji II LC/dentin interface when condition-




                                                               az
    of self-etch approach. As the second part of self-ad-      ing was carried out prior to application of this cement
    hesion mechanism, true primary chemical bonding oc-        (44). According to many Authors phosphoric acid
    curs through the formation of ionic bonds between the      conditioning prior to RMGIC application was able to
    carboxyl groups of the polyalkenoic acid and calcium       improve adhesion to dentin. The effective removal of




                                                            rn
    of hydroxyapatite that remained around the exposed         the smear layer, exposure of collagen and opening of
    surface collagen. The polyacrylic acid pre-treatment is    dentinal tubules promoted a better resin monomer
    much milder than a traditional phosphoric acid treat-      (HEMA) penetration within the underlying dentin, thus
    ment, and the exposed collagen fibrils are not com-        creating a hybrid layer. Hybrid layer increases the




                                                         te
    pletely denuded of hydroxyapatite. The phosphoric          surface energy and contributes to provide a better
    acid treatment demineralised superficial dentin to a       moisture of the dentin surface creating an interdiffu-
    variable thickness of the order of several microns (de-    sion zone between the cement and dentin matrix,
    pending on time of application) and the hydroxyap-         which contributes to micromechanical retention, in
                                                      In
    atite removal prevented formation of ion exchange in       addition to chemical adhesion to dentin (21, 22, 48).
    which the carboxyl groups of the cement interacted         According to the previous research this study demon-
    with calcium ions and phosphate from hydroxyapatite.       strated the dentin bond strength of Fuji II LC using
    Our research shows that the use of polyacrylic acid        Clearfil SE Bond (contain hydrophilic monomers) was
    on dentin increases shear strength value of GIC            statistically higher than other treatments or no treat-
                                         ni

    whilst the use of another system for pre-treatment,        ments (in the present study unconditioned specimens
    phosphoric acid, shows no significant difference in        showed significantly lower bond strength results than
    shear strength values.                                     all conditioned specimens). The better bonding per-
                            o

    Dentin surface treatment remains a topic of research       formance of RMGICs compared to conventional GICs
    as new, resin-containing glass-ionomer products like       could be due to their expected dual mechanism of ad-
                        izi


    visible light activated liners/ bases are introduced to    hesion (32). Resin cements are composites of a resin
    the market. Prati et al. (23) evaluated the effects of     matrix, such as Bis-GMA or urethane dimethacrylate,
    nine different dentin surface treatments on the shear      and fine inorganic particles as filler (48). HEMA is an
    bond strength of Vitrabond to human dentin. They           example of a hydrophilic primer, used to improve the
           Ed




    found that although many of the treatments signifi-        infiltration of adhesive monomers into demineralised
    cantly altered the dentin as observed using scanning       dentin by wetting the surface of collagen fibres and
    electron microscopy, only neutral and acidic oxalate       maintaining the collagen network in an expanded
    solutions significantly increased the bond strength.       state by stiffening the collagen fibres (49, 50). In ad-
    This finding implies that glass-ionomer products           dition, the increase in the bond strength can be attrib-
    which contain resin may require dentin treatments          uted to the polymerisation of HEMA leaving of a film
    C




    that differ from those used with traditional glass-        of polymerised material on the dentin surface (51,
    ionomer cements. It should not be surprising then          52). Also, HEMA increases the infusion and impreg-
CI




    that the dentin treatment used with recently devel-        nation of resin monomers into demineralised dentinal
    oped visible light activated glass-ionomer restorative     matrix. Thus, the interfacial hybrid zone formed by
    materials differs from those recommended for use           polymerized resins, including HEMA must have
    with chemically set glass-ionomers forms. This is          played an important role in enhancing the bonding of
    probably due to the liquid component that contains         resin materials (53).
    acrylic monomers: dentin treatment with dentin bond-
©




    ing primers rather than polyacrylic acid may be effec-
    tive in maximising bond strengths. Prisma Universal        Conclusions
    Bond (30% hydroxyethyl methacrylate, 6% phospho-
    nated penta-acrylate ester in ethanol) and similar         Within the limitations of this study and according to
    primers that contain hydrophilic monomers facilitate       the methodology used in our study and the statistical
    wetting of dentin and enhance bonding between              analysis obtained, the following conclusions can be
    dentin and resin-containing materials (42). However,       drawn:

    20                                                                             Annali di Stomatologia 2014; V (1): 15-22
    Effects of dentin surface treatments on shear bond strength of glass-ionomer cements


    ·   RMGIC showed significantly higher shear bond                       19. Ngo H, Mount GJ, Peters MC. A study of glass-ionomer ce-
        strength to dentin than GIC; this can be attributed                    ment and its interface with enamel and dentin using a low-
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