Microtensile bond strength of universal adhesives to flat versus Class I cavity dentin with pulpal pressure simulation

Abstract Objectives The aim of this study was to test long‐term microtensile bond strength (µTBS) of 2 universal adhesives applied to dentin following “total‐etch” (TE) or “self‐etch” (SE) protocols and aged by direct or indirect water exposure using simulated pulpal pressure. Materials and methods Single Bond Universal (SBU, 3M ESPE) or Ipera Bond (IP, Itena) were applied to mid‐coronal dentin (“flat dentin”) or Class I cavity (“cavity dentin”) following TE or SE protocols in 112 extracted human third molars. Sixteen groups (n = 7 per group) were prepared, 8 groups for µTBS measurements after 24 hours, and further 8 groups for measurements after 6 months storage. “Cavity dentin” groups were subjected to simulated hydrostatic pulpal pressure of 15 cm H 2 O using a custom‐made device before cutting 1 × 1 mm sticks while “flat dentin” groups were cut into sticks and directly exposed to deionized water. Results Generally, the TE protocol resulted in highest µTBS values on flat dentin initially for both adhesives (general linear model, P < .05). Long‐term storage resulted in significantly lower µTBS values for the TE protocol ( P < .05) while the SE protocol showed comparable values after 6 months ( P > .05). “Cavity dentin” with simulated pulpal pressure resulted in lower µTBS than “flat dentin” ( P < .05). For both adhesives, µTBS was in the range of 19‐42 MPa initially and 16‐36 MPa after 6 months storage. Conclusions µTBS to dentin of universal adhesives is more stable in the long term following the SE than TE protocol. Simulated pulpal pressure and cavity‐type sample preparation may be recommended for µTBS testing as a more clinically relevant strategy. Clinical Significance Microtensile bond strength to dentin of universal adhesives appears more stable following the “self‐etch” than “total‐etch” protocol after long‐term degradation. More clinically relevant data may be obtained using simulated pulpal pressure and cavity‐type sample preparation in the study design.