Variable Smear Layer and Adhesive Application: The Pursuit of Clinical Relevance in Bond Strength Testing.

The removal or modification of smear layers that cover the dentin is critical to allow the penetration of adhesive molecules and to ensure a strong bond between resin and dentin. Aiming to establish a model for clinically-relevant dentin-bond testing, we evaluated the effects of smear layers created by abrasives having similar coarseness (180-grit SiC paper; fine-grit diamond bur) and application modes (single application; double application) on the microtensile bond strengths (µTBS) of two currently available universal adhesives (G-Premio Bond; Scotchbond Universal Adhesive) and a two-step self-etch adhesive (Clearfil Megabond 2). Sixty extracted human third molars were used for the μTBS test. Data were analyzed by three-way ANOVA and Tukey's test (α = 0.05). Fracture modes were determined using stereomicroscopy. An additional 24 third molars were prepared for observation of the resin-dentin interface by TEM and adhesive-smear layer interaction by SEM. μTBS was significantly affected by the adhesives and their application modes (p < 0.001), implying that the double application of universal adhesives should be recommended to improve their performance. The effect of smear layers was not significant (p > 0.05), indicating that 180-grit SiC papers could be used to prepare dentin as a substitute for fine-grit diamond burs for dentin-bond testing in laboratory settings.