Effect of operator skill on the dentin bonding ability of a self-adhesive resin cement after different adhesive treatments.

This study evaluated the influence of operator skill on the shear bond strength of a self-adhesive resin cement to dentin after different adhesive treatments. Flat dentin surfaces were prepared on 160 extracted molars. The teeth were distributed evenly (n = 80) to 2 groups based on the operator's skill (undergraduate dental student vs operative dentistry specialist). The teeth in each operator group were distributed into 5 groups based on pretreatments used before they were cemented to indirect composite resin cylinders with Panavia SA Luting Plus resin cement. The operators prepared the dentin surfaces for bonding according to the following pretreatment groups: 1, no treatment; 2, phosphoric acid etching; 3, Clearfil Universal Bond in etch-and-rinse mode; 4, Clearfil Universal Bond in self-etching mode; and 5, Clearfil SE Bond 2-step adhesive. After cementation was performed by the 2 operator groups, shear bond strength testing was performed, and data were analyzed with 2-way analysis of variance. The effects of operator skill and surface pretreatment and their cumulative effect were statistically significant (P < 0.05). The shear bond strength of the control group in the student group was significantly greater than that of the specialist group (P = 0.02). In group 5 (2-step adhesive), the shear bond strength of the specialist group was significantly greater than that of the student group (P < 0.001). The use of acid etching and the 3 adhesive treatments improved the bonding ability of resin cement for the expert group. This positive effect was observed only in the etch-and-rinse and self-etching modes for the student group. Extensive clinical experience did not have a positive effect on the bonding effectiveness of resin cement with no pretreatment, while the expert group showed better results in applying this cement with a 2-step adhesive pretreatment.