The bonding effect of adhesive systems and bulk-fill composites to sound and caries-affected dentine

Purpose: To investigate the influence of adhesive type and increment thickness on shear bond strength of flowable bulk-fill resin composites compared with a flowable conventional resin composite, in both sound and caries-affected dentine.Methods: Shear bond strength was tested in 100 extracted human molars with coronal dentine caries. Half of the teeth were restored with Adper™ Easy Bond and the other half with Adper™ Single Bond Plus. Bonded surfaces were restored with Filtek™ Ultimate Flow and two bulk-fill composites (SDR and X-tra base) (n = 10 teeth for each subgroup). Restorations of 4 mm were performed with incremental or bulk-fill technique. The shear bond was determined and statistically analysed using three-way ANOVA and Bonferroni multiple comparison post hoc tests (p ≤ 0.05). Dentine–resin interfaces were evaluated by scanning electron microscopy.Results: For both adhesives, the highest shear bond strength values were obtained for sound dentine. In sound dentine, the highest bond strength observed with Easy Bond when used in 2-mm increments of SDR. In caries-affected dentine, Single Bond in combination with SDR displayed significantly lower bond strength.Conclusion: There was no significant difference in shear bond strength between the incremental and bulk-fill groups for molars with sound dentine when the etch-and-rinse adhesive system was used; however, for the self-etch adhesive system, incremental application caused higher bond strength than bulk application.