Effect of enzymatic chemo-mechanical agents on adhesion of composite resin to dentin of permanent teeth: an in vitro study.

Purpose: To evaluate and compare the effect of two enzymatic chemo-mechanical caries removal agents with conventional caries removal using rotatory instruments on the adhesion of composite resin to dentin of permanent teeth.

Methods: The sample comprised 30 permanent molars with caries lesions extending to the dentin, randomly distributed into three groups (n = 10 each): 1-Caries removal with rotary instruments (control group); 2-Caries removal with Papacárie Duo (F&A Laboratório Farmacêutico, São Paulo, Brazil); 3-Caries removal with Brix 3000™ (Brix S.R.L., Carcarañá, Argentina). After caries removal, the specimens were rinsed and dried. Scotchbond Universal™ adhesive (3 M, Saint Paul, Minnesota, USA) was actively applied in self-etch mode and light-cured. Resin composite increments were applied using a silicone mold (3 × 3 × 2 mm) and light-cured. Shear bond strength (MPa), work-to-debonding (J/m), and shear modulus (kPa) were evaluated. For statistical analysis, the level of significance was set at 5%.

Results: The control group presented significantly higher shear bond strength values (8.50 ± 2.69 MPa) compared to the Brix 3000™ group (5.72 ± 1.55 MPa, p = 0.008). There were no significant differences between Papacárie Duo (6.66 ± 0.86 MPa) and the other groups (p > 0.05). Regarding work-to-debonding, the Papacárie Duo group had a significantly higher result (2944.41 ± 450.21 J/m) than the Brix 3000™ group (1189.41 ± 504.13 J/m, p < 0.001) and the control group (967.10 ± 270.01 J/m, p < 0.001). Concerning shear modulus, the control group showed a significantly higher result (558.67 ± 168.96 kPa) than the Brix 3000™ group (339.79 ± 143.78 kPa, p = 0.008) and the Papacárie Duo group (223.04 ± 127.30 kPa, p < 0.001).

Conclusion: While the application of Papacárie Duo did not negatively affect composite resin adhesion to dentin of permanent teeth, the application of Brix 3000™ reduced adhesive forces, potentially limiting its clinical use. Further investigations are warranted to elucidate the effects of these materials on dentin substrate, particularly through clinical studies.