Comparison of shear bond strength of calcium-enriched mixture cement and mineral trioxide aggregate to composite resin

Abstract

Aim: Adhesion of composite resin and pulp capping biomaterials remarkably influences treatment outcomes. This in vitro study aimed to compare the shear bond strength of composite resin to calcium enriched mixture (CEM) cement, mineral trioxide aggregate (MTA) and resin modified glass ionomer (RMGI) with or without acid etching.

Materials and methods: A total of 90 cylindrical acrylic blocks containing a central hole, measuring 4 mm diameter and 2 mm height were prepared. The blocks were randomly divided into three experimental groups based on being filled with CEM, MTA or RMGI. Samples in each group were then randomly divided into two subgroups, i.e. with or without phosphoric acid etching. Placing composite resin cylinders on the samples, shear bond strengths were measured using a universal testing machine. Failure modes of the samples were evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA and Tukey tests.

Results: Shear bond strengths in the etched and nonetched samples were not significantly different (p = 0.60). There was a significant difference in shear bond strength values of the three experimental materials (p < 0.001) and RMGI showed the highest strength values (p < 0.001); no significant difference was observed between MTA and CEM (p = 0.51). The interaction of the type of material and surface etching was statistically significant (p < 0.001). All of the samples showed cohesive failure mode.

Conclusion: Acid etching of MTA, CEM and RMGI do not improve the shear bond strength of these materials to composite resin. Besides, shear bond strength values of MTA and CEM to composite resin, are favorable due to their cohesive mode of failure.

Clinical significance: When MTA and CEM biomaterials are used in vital pulp therapy, it is advisable to cover these materials with RMGI. In addition, if it is not possible to use RMGI, the surface etching of MTA and CEM biomaterials is not necessary prior to composite restoration using total-etch adhesive resin.