Can the method of primer application influence adhesion to Er:YAG-laser irradiated dentin?

Aim: The aim of this study was to evaluate how cavity preparation and primer application methods influence the adhesion of composite resin to dentin using a self-etching system.
Methods and Materials: Forty-eight extracted, sound human molars were divided into six groups (n=8) according to the method used for the surface preparation of the teeth (#600-grit paper disc, diamond bur, and Er:YAG laser) and the primer application method utilized (active or passive). Following the adhesive procedure using a self-etching system, 5 mm high composite buildups were created with Z-250 composite resin. After storage in water at 37 degrees C for 24 hours, the specimens were vertically sectioned into serial 1 mm2 sticks and tested for microtensile strength (micro-TBS). Nine additional molars were prepared for morphological analysis using scanning electron microscopy (SEM).
Results: Statistical analysis showed surface preparation technique (p < 0.00) and primer application methods (p < 0.001) do influence bond strength of the self-etching system tested. The best adhesion was achieved with specimens having the dentin ground with sandpaper followed by those ground with diamond burs. The worst bonding was obtained with Er:YAG laser ablated dentin. The active primer application method increased bonding performance compared to the passive method.
Conclusions: Within the limitations of the study, it can be stated surface treatment can influence the bond strength of the self-etching system tested and the active primer application method is more effective in achieving success in bonding to dentin compared with the passive application method.
Clinical Significance: Clinicians should use the active application method to apply a mild acidic self-etching primer along with an appropriate tooth surface preparation to facilitate the bond strength between dentin and composite resin.