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Effect of smear layer deproteinization with chemo-mechanical caries removal agents on sealing performances of self-etch adhesives

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Citra Kusumasari, Ahmed Abdou, Antonin Tichy, Takashi Hatayama, Keiichi Hosaka, Richard M. Foxton, Takahiro Wada, Yasunori Sumi, Masatoshi Nakajima, Junji Tagami

Original languageEnglish
Article number103300
JournalJournal of Dentistry
Volume94
DOIs
Publication statusPublished - Mar 2020

King's Authors

Abstract

Objectives: To evaluate the sealing performance of self-etch adhesives (SEA) after smear layer deproteinization with chemo-mechanical caries removal agents (CRA) to enamel and dentin cavity walls in comparison with 6% NaOCl smear layer deproteinizing. Methods: Eighty extracted bovine incisors with tapered cylindrical cavities (2.5 mm upper diameter, 1.5 mm lower diameter, 2 mm depth) at the cemento-enamel junction were randomly divided into four pre-treatment groups; no treatment (control), Papacarie (papain enzyme-based CRA), Carisolv (NaOCl-based CRA), and 6% NaOCl. After pretreatment, G-Bond Plus (GBP, one-step SEA) or Clearfil SE Bond 2 (CSE, two-step SEA) was applied to the pre-treated cavity, and then filled with a flowable resin composite (Clearfil Majesty ES Flow). Gap formations at the enamel and dentin lateral walls, and on the dentin cavity floor were investigated using swept-source optical coherence tomography (SS-OCT) after 24-h water storage at 37 °C. Deproteinizing effects of the tested agents on smear layer-covered enamel and dentin were quantified by changes in the amide:phosphate ratio using ATR-FTIR analysis. Results: Papacarie significantly reduced gap formation with both self-etch adhesives at all locations, compared to the control group (p < 0.05). In contrast, increased gap formation was observed with Carisolv and NaOCl. In most groups, CSE exhibited significantly lower gap formation than GBP (p < 0.05). ATR-FTIR revealed a significant decrease in the amide:phosphate ratio for all the deproteinizing agents (p < 0.05). Conclusions: Chemo-mechanical CRAs could effectively remove the organic phase of enamel and dentin smear layer. The papain enzyme-based gel Papacarie could improve the sealing performance of the self-etch adhesives to both enamel and dentin.

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