Effect of the demineralisation efficacy of MDP utilized on the bonding performance of MDP-based all-in-one adhesives

Objectives: The amounts of calcium salt of 10-methacryloyloxydecyl dihydrogen phosphate (MDP-Ca salt) and dicalcium phosphate dihydride (DCPD) with an amorphous phase produced by the demineralisation of enamel and dentin were determined using commercial MDP-based 2-hydroxyethyl methacrylate (HEMA)-containing and HEMA-free all-in-one adhesives. The effect of the amount of MDP-Ca salt produced on bonding performance to enamel and dentin was then characterized. Methods: Three types of commercial HEMA-containing adhesives (Scotchbond Universal Adhesive, Clearfil Tri-S Bond ND, Clearfil Tri-S Bond ND Quick), a commercial HEMA-free adhesive (G-Bond Plus) and an experimental HEMA-free adhesive were used. The reactant residues of each adhesive were prepared after interacting with enamel and dentin samples for 60 s. The amounts of MDP-Ca salt and amorphous DCPD produced were determined using a phosphorous-31 nuclear magnetic resonance technique. Enamel and dentin bond strengths were measured for each adhesive, with and without thermocycling. Results: The amounts of MDP-Ca salt and amorphous DCPD formed after interacting with enamel and dentin differed among the five adhesives and were independent of their pH values. Enamel showed a strong positive-correlation of the bond strength of the all-in-one adhesives to the amount of MDP-Ca salt produced, however, the dentin showed a weak negative-correlation. Conclusion: The HEMA-free all-in-one adhesives showed a greater efficacy to demineralise the enamel and dentin than the HEMA-containing all-in-one adhesives. The dentin showed a different effect of the amount of MDP-Ca salt produced on the bonding performance compared with enamel. Clinical significance: The enamel bond strength of MDP-based all-in-one adhesives strongly contributes to the demineralisation efficacy by the incorporation of MDP, in contrast to the dentin bond strength. However, the efficacy of MDP-based all-in-one adhesives to demineralise the enamel and dentin is not directly related to the pH value of the MDP-based all-in-one adhesive.