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Marginal adaptation and microtensile bond

strength of composite indirect restorations
bonded to dentin treated with adhesive and
low-viscosity composite

ARTICLE in DENTAL MATERIALS APRIL 2007

Impact Factor: 3.77 DOI: 10.1016/j.dental.2006.01.028 Source: PubMed

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Oswaldo Scopin de Andrade Mario Fernando de Goes

Senac So Paulo University of Campinas
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Universidade de Pernambuco
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 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287

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journal homepage: www.intl.elsevierhealth.com/journals/dema

Marginal adaptation and microtensile bond strength of

composite indirect restorations bonded to dentin treated
with adhesive and low-viscosity composite

Oswaldo S. de Andrade a , Mario F. de Goes a , Marcos A.J.R. Montes b,

aDepartment of Restorative Dentistry/Dental Materials, School of Dentistry of PiracicabaUNICAMP, Piracicaba, SP, Brazil
bDepartment of Restorative Dentistry /Dental Materials, School of Dentistry of PernambucoUPE, Av. Gen. Newton Cavalcanti,
1650 Camaragibe, PE 54753-220, Brazil

a r t i c l e i n f o a b s t r a c t

Article history: Objectives. This study evaluated the marginal adaptation of composite indirect restorations
Received 31 March 2005 bonded with dual curing resin cement after different strategies to seal dentin. Different
Received in revised form bonding techniques associated or not with a low-viscosity composite resin (LVCR) were
29 November 2005 utilized. In addition, the bond strength between composite resin and pre-sealed dentin was
Accepted 10 January 2006 evaluated in the buccal and pulpal walls of class I cavities, prepared for indirect restorations.
Methods. Thirty-three freshly extracted human molars were used for this study, divided
into three groups (n = 11) representing different techniques to seal dentin(Group 1) Con-
Keywords: ventional technique: the adhesive system was applied and polymerized just before the
Composite resin cementation of the indirect restoration; (Group 2) Dual bonding technique: a rst layer of
Adhesive resin the adhesive system was applied and polymerized just after preparation, and a second layer
Resin cement just before the nal cementation; (Group 3) Resin coating technique: a LVCR was applied and
Marginal adaptation polymerized after the rst layer of the adhesive system, and before the impression. A further
Bond strength application of the adhesive system was performed before the placement of the restoration.
The restorations were polished and a solution of acid red propyleneglycol was dropped on
each specimens occlusal surface for 10 s. The dye penetrations were captured under stereo-
scopic lens and the images were transferred to a computer with a measurement program,
in order to determine the extension of the dye penetration. The microtensile bond strength
test (TBS) was applied on pulpal (P) and buccal (B) walls of the restorations for Groups 13.
The subgroups for TBS were: Group 1P (n = 13); Group 1B (n = 7); Group 2P (n = 6); Group 2B
(n = 14); Group 3P (n = 14); Group 3B (n = 15). All specimens were sectioned to obtain an area
of 0.8 mm2 . The specimens were mounted on a microtensile device and fractured using a
universal testing machine at a cross-head speed of 1 mm/min. Failure modes were analyzed
by SEM. One-way ANOVA and multiple-comparison Tukeys test were used for statistical
analysis of the marginal adaptation scores and TBS test. Non-parametrical KruskalWallis
test was used for failure mode analysis.
Results. Group 3 showed a signicantly higher mean value of marginal dye penetration (45.59)
when compared to Groups 1 (8.44) and 2 (18.92). For pulpal walls, Group 1P showed signif-
icantly higher mean TBS (25.93 2.27) when compared to Groups 2P (14.71 1.78) and 3P
(16.07 2.81). There was no statistical difference between Groups 2P and 3P. For buccal walls,

Corresponding author. Tel.: +55 81 3458 1186; fax: +55 81 3458 1476.
E-mail address: majrm@uol.com.br (M.A.J.R. Montes).
0109-5641/$ see front matter 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.dental.2006.01.028
280 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287

Group 2B presented signicantly higher mean TBS (23.29 1.42), and Group 1B the lowest
mean values (11.37 1.14). The failure mode analysis presented a considerable variation,
according to the treatment and to the wall. The results of this study indicated that a pre-
vious sealing of dentin using the adhesive system, followed by a second application just
before the cementation, is an effective alternative technique, since it maintains the marginal
adaptation of indirect composite resin restorations, and improves the bond strength at the
interface on buccal walls, which are the most critical regions for the long-term durability of
these procedures.
2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

could arise, causing a disruption between the restoration and

1. Introduction
The modern concepts of direct or indirect restorative dentistry
have tried to acquire in esthetic restorative materials, tech-
niques to recover biomechanically teeth that have lost part
of their structure due to caries or trauma. Composite resin
has been the material of choice for this function, based on
the similarity of its elastic modulus with the dental struc-
tures, and due to its high potential to bond to enamel and
dentin [1].
These characteristics of composite resin, when associated
with adhesive systems, have created technical alternatives
that have increased the utilization of esthetic restorations.
The improvements in inorganic ller (amount, type and aver-
age size), and the molecular weight of monomers that com-
pose the organic phase, have made modern composite resins
easier to manipulate and apply. However, these materials
still present problems related to marginal integrity and leak-
age, mostly due to their inherent polymerization shrinkage
[25].
Generally, composite resins are applied by the direct tech-
nique, in placement of restorations in anterior and posterior
teeth. In the polymerization process, the chemical reaction
that occurs in the organic phase of the composite produces the
conversion of monomers into polymers, resulting in a molecu-
lar forthcoming with the consequent shrinkage [1]. The extent
of this shrinkage inuences the tension state generated at the
interface composite/dental structure and, commonly, com-
promises the bond integrity at this region. In addition, the
polymerization shrinkage of composites is also inuenced by
the geometric form of the cavity. When the ratio between the
bounded to unbounded surfaces is higher than two, the stress
generated by the composite shrinkage may exceed the bond
strength to the cavity walls and produce marginal gaps [6].
When these problems are added to an incorrect placement
technique and nishing mistakes, marginal leakage, inade-
quate anatomic form and proximal contacts occur clinically,
which lead to a consequent reduction in the longevity of the
restoration [7,8].
At the beginning of the 1990s, indirect composite restora-
tions were shown to present improved clinical conditions with
respect to proximal contact, occlusal anatomy and marginal
adaptation [9,10]. In these cases, all technical procedures of
manufacturing and polymerizing of the restorations were
performed externally and just a thin layer of a high ow
composite resin (so-called resin cement) was used to lute the
restorations [11]. It is important to highlight, however, that
during the polymerization of the resin cements, tensions
the cavity walls, leading to marginal leakage, mainly if the
margins are located in dentin [1217]. Thus, marginal integrity
is directly related to the bond strength between the dentin
surface and the adhesive system/resin cement indicated for
luting indirect restorations [18,19].
Tooth preparation for indirect restorations can induce sig-
nicant dentin exposures and, consequently, sensitivity. The
conventional technique for indirect restorations consists in
molding the cavity immediately after preparation and pro-
tecting temporarily the teeth for the patients functional
and esthetic needs. Then, after the fabrication of the indi-
rect restoration, the provisional cement is removed and the
adhesive/luting procedures are performed. It is important to
emphasize that freshly cut dentin has been demonstrated to
be the ideal substrate for bonding, therefore, dentin contami-
nation due to provisional cements could reduce the potential
for dentin bonding, leading to lower bond strengths, failure
in the hybridization process and post-operative sensitivity
[2022]. Alternative techniques have been suggested to over-
come these problems; it has been reported that it is possi-
ble to considerably augment bond strength values when the
dentin surface is sealed with an adhesive system, prior to
molding procedures and before the application of temporary
materials, and when a new layer of adhesive is applied at
the moment of the nal luting of the restoration, the so-
called dual bonding or immediate dentin sealing tech-
nique [20,21,23]. The reasons supporting this technique are
the increase in bond strength over time, since dentin bond
can develop without stress, resulting in improved adaptation
[24,25], and the protection of dentin against bacterial leakage
and sensitivity during provisionalization and after nal luting
[26].
The application of a LVCR on the adhesive layer has also
been suggested immediately after cavity preparation [27].
This technical procedure seems to reduce gap formation at
the interface dentin/resin cement [28,29], and improve bond
strength. Moreover, it could serve as a resilient layer between
the restorative composite resin and dentin, absorbing the ten-
sions generated by the polymerization shrinkage of the resin
cement and mastication efforts [5,25,30].
Thus, the aim of the present investigation was to eval-
uate the marginal adaptation of indirect composite resin
restorations luted with resin cement, after sealing dentin
with an adhesive system associated, or not, with LVCR.
Additionally, the study aimed to evaluate the bond strength
between composite resin and pre-sealed dentin, in buccal
and pulpal walls of Class I cavities, congured for indirect
restorations.
 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287
2. Materials and methods
The materials, manufacturers, compositions and batch num-
bers for this study are listed in Table 1.
2.1. Marginal adaptation test
Thirty-three freshly extracted caries-free human molars,
stored in distilled water at 4 C, were used for the marginal
adaptation test. The teeth roots were embedded in plas-
tic cylinders with acrylic resin, leaving the crown totally
exposed and projected beyond the cylinders edge. The teeth
were ground on their occlusal surfaces with a water-irrigated
grinding wheel using 320-grit silicone carbide (SiC) paper to
obtain at dentin surfaces and then nished with 600-grit SiC.
Standardized cavities with margins totally located in dentin
(4 1 mm diameter and 2.5 0.5 mm deep) lightly expulsive
to occlusal, were made using diamond burs, nos. 30006-31-131
025 and 845KR 31 025, and nished with steel multi-laminated
burs, H339-014 (Brasseler, Savannah, GA, USA). The teeth were
then ultrasonically cleaned for 10 min.
The teeth were randomly divided into three groups of
eleven specimens each. For Group 1, the cavities were imme-
diately molded with a polyvinyl siloxane material (Express
3M/ESPE, Dental Products Division, St. Paul, MN, USA), using
a twin-mix technique. The molds were poured with a type IV
dental stone (Vel-MixKerr Co., Orange, CA, USA). After mold-
ing, the teeth were stored in distilled water at 4 C.
For Group 2, the cavity wall surfaces were etched with 35%
phosphoric acid for 15 s, rinsed with running water for 30 s
and the excess water removed by blotting with tissue paper,
leaving the dentin visibly moist. Adhesive single bond (SB) was
applied using a saturated disposable brush, gently air dried
with oil-free compressed air from a syringe for 5 s, keeping
the tip 2 cm from the surface and light cured for 10 s. With
the cavity walls sealed, the molding/pouring processes were
the same as for Group 1. The teeth were stored in distilled
water at 4 C. All light-curing procedures used a 3M XL 3000
(3M Dental Products Division, St. Paul, MN, USA) curing unit
with a light intensity of 500 mW/cm2 . The light intensity was
measured with a radiometer (Curing Radiometer, model 100,
Demetron/Kerr, Danbury, CT, USA).
Table 1 Materials used in this study
Materials Composition
Targis Dentin-220 Bis-GMA, UDMA, Copolymers of Bis-GMA,
Barium glass, colloidal silica
Rely X ARC Paste A: Bis-GMA, TEGDMA, Zirconia/silica
ller, photoinitiators, Amine, pigments;
paste B: Bis-GMA, TEGDMA, benzoyl
peroxide, zirconia/silica ller
Single Bond HEMA, Bis-GMA, dimethacrylates, Ethanol,
water, polyalkenoic acid, copolymer,
initiator
Protect Liner F Bis-GMA, TEGDMA, uoride-methyl
methacrylate, camphorquinone, silanized
colloidal silica, pre-polymerized organic
ller
281
For Group 3, adhesive SB was applied as for Group 2. Fol-
lowing SB application, a layer of LVCR Protect Liner F was
applied on the SB surface and light-cured for 20 s. The mold-
ing/pouring processes that followed were the same as for
Groups 1 and 2. The teeth were stored in distilled water at
4 C.
The restorations were made in the stone dies, using the
composite resin of the Targis system, according to the follow-
ing steps: (1) isolation of the dies with the spacer/separator
recommended by the manufacturer; (2) application of the resin
in incremental layers of 1 mm, and polymerization in the light-
curing unit Targis Quick (Ivoclar/Vivadent, Schaan, Liechten-
stein) for 10 s each layer. All the restorations were then submit-
ted to the Targis Power Curing Unit (Ivoclar/Vivadent, Schaan,
Liechtenstein), which combines a light and heat polymeriza-
tion for 20 min, according to the manufacturers instructions.
The restorations were luted in the respective cavities using
resin cement Rely X ARC (RX) associated to SB. For Group 1,
SB was then applied on cavity surface, as previously described
for Group 2, just before the luting of the restoration. Then,
equal portions of RX were mixed during 20 s and applied in
internal cavity walls and the restoration was positioned and
adapted to the cavity, kept under a pressure of 500 g for 10 min.
Additionally, the cavity margins were light-cured for 40 s from
three directions. No excess of RX was removed during this
step.
For Groups 2 and 3, 35% phosphoric acid and SB were also
applied on the pre-sealed cavities, as previously described,
before luting the restorations with RX as described for Group 1.
The specimens were stored for 24 h in distilled water at
37 C, nished with 320, 400, 600 and 1000-grit SiC under water
and ultrasonically cleaned for 10 min between the grits.
The specimens were then thermocycled at 555 C for 1200
cycles, lasting 30 s at each temperature.
On each restoration surface a solution of propylene-glycol
and acid red 52 (Caries Detector, Kuraray Co., Tokyo, Japan),
used for caries detection, was applied for 10 s, rinsed with run-
ning water and dried with tissue paper. Each restoration was
positioned in a Leica MZ6 stereomicroscope (Switzerland) in
which the image of the restoration was captured and trans-
ferred to a computer equipped with the image program Pro-
Plus 4.1 (Media Cybernetic, Silver Springs, MD, USA) where the
marginal adaptation of the restorations was evaluated [31].
Batch Manufacturer
D09938 Ivoclar/Vivadent, Schaan, Liechtenstein
CACA 3M Dental Products Division, St. Paul, MN, USA
1FM 3M Dental Products Division, St. Paul, MN, USA
0050 Kuraray Co. Ltd., Osaka, Japan
282 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287
Fig. 1 Image obtained in a stereomicroscope (40)
illustrating the dye penetration along the margin of the
restoration (arrows). D: dentin; R: restoration.
The dye penetration in the margins of each restoration was
calculated as a percentage of the cavity perimeter for each
specimen (Fig. 1).
The results were subjected to one-way analysis of variance
ANOVA (p < 0.05) and Tukeys test ( = 0.05).
2.2. Microtensile bond testing
The same specimens used in the marginal adaptation test
were used for the TBS test. The occlusal surface of each
specimen was acid-etched, followed by application of SB and
4 mm layer of composite resin (Z1003M/ESPE, Dental Prod-
ucts Division, St. Paul, MN, USA), in increments of 2 mm each.
The specimens were then sectioned perpendicular to the
pulpal wall with the Isomet low speed wheel saw under water,
in order to obtain slabs of approximately 0.8 mm thick (Fig. 2).
To obtain slabs of buccal region, a 4 mm layer of composite
resin Z100 was placed as previously described on the buc-
cal enamel. The lingual half of the specimen was removed,
and the internal exposed surface of the indirect restoration
received a 4 mm layer of composite resin Z100 (Fig. 3).
Another 15 teeth were prepared, restored and submitted
to the same experimental conditions, in order to obtain at
least 10 sections to the microtensile bond test, specic for each
group and region.
Fig. 2 Specimens preparation for TBS test for pulpal walls.
Each slab was individually secured with sticky wax and
further sectioned into an approximately 0.8 mm2 slice in its
narrowest part, located at the interface SB-dentin or SB/LVCR-
dentin.
The slabs to be tested were xed to a modied
BencorMulti t-testing assembly using cyanoacrylate adhe-
sive. The specimens were pulled to failure under tension using
a universal testing machine (Model 4411; Instron Inc., Canton,
MA, USA) at a crosshead speed of 1 mm/min.
After testing, TBS values were recorded, the halves of
the fractured specimens were paired, positioned in alu-
minum stubs and gold-sputter coated with gold/palladium,
and observed by SEM (JEOL, JSM-5600VP, scanning electron
microscope, Japan) for evaluation of the fracture pattern.
During the removal from the testing machine, some speci-
mens fractured in fragments, making analysis of these spec-
imens impossible. Thus, the number of specimens analyzed
for each group and region are described with the results in
Table 4.
Fracture modes were classied into one of three types:
Type 1 (cohesive failure in hybrid layer). When the fracture
occurred within or at the base of the hybrid layer.
Type 2 (cohesive in composite resin). When the fracture
occurred within the composite resin, either for xation or
LVCR.
Type 3 (mixed). When both types of fracture were present
within the same specimen, in approximately 50% of the
area.
The results of SEM-analysis were subjected to non-
parametrical multiple comparison KruskalWallis test
(p < 0.05).
3. Results
3.1. Marginal adaptation
Table 2 summarizes the results for marginal adaptation. Group
3 showed the highest average values (43.59%) for dye penetra-
tion at the cavity margins, which were statistically different
(p < 0.05) from Groups 1 (8.44%) and 2 (18.92%). There was no
signicant difference between Groups 1 and 2.
 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287 283

Fig. 3 Specimens preparation for TBS for buccal walls.

3.3. Fracture mode

Table 2 Mean values (%) for dye penetrations at the
cavity margins
Fracture pattern observations showed considerable variation
Group Repetitions Mean among the groups. These results are summarized in Table 4.
valuesa
The use of one SB layer in the pulpal wall, Group 1P, resulted
Group 1: one layer adhesive 11 8.44 b in a prevalence of Type 1 failure (n = 9), cohesive in hybrid layer,
Group 2: two layers adhesive 11 18.92 b with a signicant difference for Group 2P (n = 1) and Group 2B
Group 3: adhesive/LVCR/adhesive 11 43.59 a (n = 4), where two layers of SB were applied, and also for Group
a
Same letters indicate no statistical difference (p < 0.05).
3B (n = 0), where the LVCR was applied. There was no statistical
difference among the other groups. Type 2 failure, cohesive
in composite resin, was remarkably prevalent for Group 3B
3.2. Microtensile bond testing (n = 11), where Protect Liner F was applied.

Table 3 summarizes the TBS values and standard deviations

for all groups. The mean values ranged from 25.92 2.27 MPa
for Group 1P to 11.37 1.14 MPa for Group 1B.
For pulpal wall, the values of TBS were higher and statis-
tically different for Group 1P (25.92 2.27 MPa), where SB was
applied just before the luting of the restoration, when com-
pared to Groups 2P (14.71 1.78 MPa) and 3P (16.07 2.81 MPa),
where dentin was pre-sealed, which were not signicantly dif-
ferent to each other. For buccal wall, the highest values were
presented by Group 2B (23.29 1.42 MPa) which were signi-
cantly different to those of Groups 1B (11.37 1.14 MPa) and
3B (17.54 2.20 MPa). A statistical difference between Groups
1B and 3B was observed.
When pulpal and buccal walls were compared for TBS val-
ues, a higher mean value for pulpal wall was observed in Group
1, which was statistically different to that of the buccal wall.
The converse was observed for Group 2, where the mean value
for the buccal wall was higher and statistically different to that
of the pulpal wall. For Group 3 the mean values for the pulpal
and buccal walls did not differ statistically.
Table 3 Microtensile bond strength at buccal and pulpal
walls (MPa)
Group Pulpala Buccala
Group 1: one layer adhesive 25.92 (2.27) aA 11.37 (1.14) cB
Group 2: two layers adhesive 14.71 (1.78) bB 23.29 (1.42) aA
Group 3: adhesive/LVCR/adhesive 16.07 (2.81) bA 17.54 (2.20) bA
a
Mean values (S.D.). Same letters in uppercase indicate no statisti-
cal difference on columns, and in lowercase indicate no statistical
difference on lines (p < 0.05).
4. Discussion
The critical moment for the restorative technique, associat-
ing composite resin and adhesive systems, is the application
and polymerization of the adhesive layer and the stress gen-
erated by the shrinkage of the rst increment of composite
resin, placed on the adhesive surface, using either a direct or
an indirect technique [25]. In indirect restorations, the stress
produced by the composite resin used for luting, the so-called
resin cements, may disrupt the hybrid layer and open micro-
scopic spaces that could induce post-operative sensitivity
[18,32]. The application of an adhesive layer to seal dentin prior
to molding and temporary luting, followed by another adhe-
sive layer application at the moment of the nal luting of the
restoration, has been demonstrated to reduce marginal leak-
age, to improve the dentinadhesivecomposite resin bond
strength values and also to be effective in reducing the post-
operative sensitivity [20,21].
This study employed an adhesive layer (Group 2) and a low
elastic modulus LVCR placed on the adhesive layer (Group 3),
using the technical procedure of sealing dentin prior to the
nal luting of the indirect restoration, before the molding pro-
cedures. This method was used to evaluate the effect of the
internal cavity walls on bond strength, and was compared
with the conventional technique for luting an indirect restora-
tion (Group 1).
The evaluation of the results for marginal adaptation
showed a higher dye penetration in margins of Group 3
restorations, which were statistically signicant when com-
pared to Groups 1 and 2 (Table 2). Possibly, the presence of
four different materials composing the bonded interface at
the cave-surface margin provoked higher irregularity on the
284 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287

Table 4 Failure modes: same letters indicate no statistical difference

Groupsa Type Ib Type IIc Type IIId Specimens KruskalWallis
p < 0.05

G1P 9 3 1 13 B
G2P 1 2 3 6 A
G3P 8 2 4 14 AB
G1B 4 1 2 7 AB
G2B 4 5 5 14 A
G3B 0 11 4 15 A

a
P: pulpal wall; B: buccal wall.
b
Type I: cohesive in hybrid layer.
c
Type II: cohesive in composite resin.
d
Type III: mixed.

occlusal surface. For this technique, dentin was acid-etched,

followed by the application of the adhesive and LVCR prior to
molding procedures. For the luting procedures of the restora-
tion another layer of the adhesive was applied and followed by
the resin cement. This sequence of different materials thick-
ened the bonded interface and resulted in more irregularities
at the cave-surface region enabling a higher dye impregnation.
Conversely, the SEM analysis of fractured specimens of
Group 3 showed a prevalence of Type 1 fracture (n = 8), cohe-
sive within the hybrid layer, for the pulpal wall (G3P) and Type
2 fracture (n = 11), cohesive in composite resin, for the buccal
wall (G3B). Although not statistically signicant (Table 4), it
may be speculated that an improved conversion of the adhe-
sive monomers inside the demineralized dentin, guided the
fracture within the hybrid layer in pulpal walls (Fig. 4) and
within the composite resin in buccal walls (Fig. 5). In pulpal
walls, the effect of an improved polymerization of the adhesive Fig. 5 SEM photomicrograph (1500) illustrating a Type II
can be observed in Fig. 4, where portions of dentin are bonded failure, cohesive in composite resin, prevalent in Group 3
to the base of the resin tags and even after the TBS test it pulpal wall (G3P). The sequence of arrows shows the
is possible to visualize intact anastomoses among the resin interface of the fractured areas occurred between
tags. The presence of a layer of LVCR covering the thin layer of LVCR/resin cement (A), and resin cement/adhesive layer (B).
adhesive neutralized the effect of the exposition to oxygen,
leading to a higher conversion of the monomers [33,34]. In

addition, the orientation of the dentin tubules in buccal region

Fig. 4 SEM photomicrograph (4000) illustrating a Type I
failure in a specimen of Group 3 pulpal wall (G3P). Note the
resin tags connected by the adhesive through the
anastomoses of the dentin tubules (arrows).
provided a more mineralized area for diffusion of the adhe-
sive monomers, in the body of the longitudinally cut dentin
tubules, as is shown in Fig. 6, and as reported by Marshall et
al. [35]. Thus, the area for bonding was larger and the disrup-
tion occurred cohesively in the body of low modulus LVCR.
Consistent with these characteristics in the fracture pat-
tern, the mean values of TBS between the two regions
(pulpal and buccal) did not present any statistical differ-
ence (Table 3). Probably, the application of the adhesive and
LVCR, which have low elastic modulus, is responsible for this
physicalmechanical behavior due to the formation of a higher
thickness resilient bonded interface, created by the sequence
of materials with low elastic modulus. Thus, the LVCR Pro-
tect Liner F, a low modulus composite resin, absorbed part
of the tensile stress produced by the shrinkage of the resin
cement during its polymerization and the axial stress during
the test. This characteristic reinforces the concept of an elas-
tic stress breaker along the cavity wall [36], and the thickness
of this layer reaches 200 m. Thus, the low elastic modulus
associated to the higher thickness of the layer determined the
 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287 285

Fig. 6 SEM photomicrograph illustrates a fractured
specimen of Group 3 buccal wall (G3B), Type I failure,
cohesive in hybrid layer (3500). Note the fragment of the
disrupted peritubular dentin (white arrows). It can be
observed, in the circled areas, the impression of the
collagen structure on the resin tag. Note also the disrupted
resin tags (T).
Fig. 7 SEM photomicrographs (1500) illustrating a
specimen of Group 1 pulpal wall (G1P), with cohesive
failure in the hybrid layer, Type I. Note the dentin tubules
lled with resin tags (white arrows). The limit between the
two levels of fracture within the hybrid layer (black arrows).

tion effect on its surface, preventing its adequate polymeriza-

tion, which resulted in lower bond strength for Group 1B. In
lack of statistical difference between the TBS values of pulpal pulpal walls, adhesive thickness seems to be adequate, since
(16.07 2.81 MPa) and buccal (17.54 2.20) walls for Group 3. it resulted in high bond strength values. According to Zheng
For Group 2, dentin was sealed prior to molding and lut- et al. [37] higher bond strength values were obtained when
ing of the restoration with resin cement. The values for the adhesive layer thickness ranged between 25 and 50 m. The
marginal adaptation test referent to dye penetration in the evaluation of the fracture pattern did not demonstrate any
margins were not statistically different between Groups 1 and statistical differences and both in the pulpal and buccal walls
2. It is possible to conclude that the interface formed by one or there was a prevalence of Type 1 fractures, cohesive within the
two layers of adhesive and resin cement was more uniform, hybrid layer, as illustrated in Figs. 7 and 8. It may be specu-
with fewer irregularities when compared to the restorations lated that the adhesive layer thickness on the pulpal wall may
of Group 3. This result corroborates the study of Montes et have ranged between 25 and 50 m, an adequate thickness for
al. [5] that used the association of an adhesive and a LVCR higher bond strengths [37], but also that the penetration of
in Class I cavities with margins totally located in dentin, for the adhesive within the acid-etched dentin was incomplete,
direct restorations with composite resin. beneath the demineralize area. Thus, the most susceptible
In this study, the Class I cavity preparation was also totally
in dentin, but with lateral walls lightly divergent to occlusal to
enable the insertion of the indirect restoration. In this situa-
tion, the dentin tubules in lateral walls are almost parallel to
the cut surface, while in pulpal wall the dentin tubules are cut
perpendicular to the surface. This morphological difference in
tubules orientation was an important factor that inuenced
the bond strength between resin and dentin. The other factor
is related to the thickness of the interface, due to the appli-
cation of the LVCR on the adhesive surface. Both conditions
could be evaluated in this study.
For the buccal wall, Group 2B had a statistically higher
mean value of bond strength to those of Groups 1B and 3B,
which were also statistically different to each other. In con-
trast, the pulpal wall bond strength was higher for Group 1P,
and statistically different when compared to Groups 2P and
3P, which did not differ from each other (Table 3). Probably,
when the adhesive was applied on lateral cavity walls, it nat-
urally owed towards pulpal walls, with an accumulation in Fig. 8 SEM photomicrograph (800) illustrating a Type I
the cavity deeper angles. Thus, the adhesive layer in buccal failure of Group 1 buccal wall (G1B). Note the resin tags in
walls becomes thinner and facilitates the oxygen concentra- the longitudinal section of the dentin tubules (arrows).
286 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 279287
Fig. 9 SEM photomicrograph (2500) illustrating a
specimen of Group 2 buccal wall (G2B). Note the dentin
impregnated by the adhesive. Note the structure of the tags
formed by the adhesive and the irregularities due to the
impression of collagen brils from inside the tubules (black
arrows). Note also parts of etched but not hybridized dentin
(white arrows). T: resin tags.
area for failure was located at the base of the hybrid layer,
as shown in Table 4 and Figs. 7 and 8.
When the second layer of adhesive or the LVCR layer
was applied (Groups 2 and 3), the ow phenomenon also
occurred towards the pulpal wall, and the addition of suc-
cessive layers resulted in a higher thickness on the pulpal
wall surface, which probably compromised the bond strength
in this region. On the other hand, for the buccal wall, the
second layer of adhesive (Group 2) may have achieved an
adequate thickness and provided a higher bond strength
(Table 3). Another situation may have caused these higher
bond strength values in buccal walls. The orientation of almost
parallel tubules may have facilitated the adhesive penetra-
tion in peritubular dentin, creating a larger bonding area
(Fig. 9), that resulted in higher bond strength for this area,
corroborating Ogata et al. [38]. In the fracture pattern eval-
uation, the inuence of the adhesive layer thickness could
be observed. Although bond strength values were lower in
the pulpal wall, the fracture pattern was not statistically
different when compared to the buccal wall. There was a
slight prevalence of Type 3 failure (mixed) in Group 2P, and
a uniform distribution among the three fracture patterns for
Group 2B.
Thus, prior sealing of dentin using adhesive, followed by
another application at the moment of luting of the restoration
was seen, in this study, to be an effective alternative technique
with regards to marginal adaptation of indirect composite
resin restorations and bond strength at the interface in buc-
cal wall. These are, in fact, the most critical regions for the
longevity of restorations. However, the structural variability
due to the orientation of the dentin tubules in cavity walls,
and the thickness of the adhesive layer or another low elas-
tic modulus resinous material, are factors that determine the
physical properties of the resin layer on the dentin surface.
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