Net expansion of dried demineralized dentin matrix produced by monomer/alcohol saturation and solvent evaporation

Enhancing dentin bonding quality through Acetone wet-bonding technique: a promising approach

Objective: This paper aimed to assess the impact of the acetone wet-bonding (AWB) technique on dentin bonding and to investigate its potential underlying mechanisms. Materials and Methods: Caries-free third molars were sliced, ground, etched, water-rinsed. Then the specimens were randomly allocated to four groups according to the following pretreatments: 1. water wet-bonding (WWB); 2. ethanol wet-bonding (EWB); 3. 50% (v/v) acetone aqueous solution (50%AWB); 4. 100% acetone solution (AWB). Singlebond universal adhesive was then applied and composite buildups were constructed. The microtensile bond strength (MTBS), failure modes and interface nanoleakage were respectively evaluated after 24 h of water storage, 10,000 times of thermocycling or 1-month collagenase ageing. In situ zymography and contact angle were also investigated. Results: Acetone pretreatment preserved MTBS after thermocycling or collagenase ageing (p < 0.05) without affecting the immediate MTBS (p > 0.05). Furthermore, AWB group manifested fewer nanoleakage than WWB group. More importantly, the contact angle of the dentin surfaces decreased significantly and collagenolytic activities within the hybrid layer were suppressed in AWB group. Conclusion: This study suggested that the AWB technique was effective in enhancing the dentin bond durability by increasing the wettability of dentin surface to dental adhesives, removing residual water in the hybrid layer, improving the penetration of adhesive monomer, and inhibiting the collagenolytic activities. Clinical significance: The lifespan of adhesive restorations would be increased by utilization of acetone wet-bonding technique.

Activation of matrix-bound endogenous proteases by self-etch adhesives

The study evaluated changes in total enzymatic activity and degradation of demineralized dentin following the application of universal or self-etch adhesives. The universal adhesives -Scotchbond Universal (SU) and All-Bond Universal (ABU) and self-etch adhesives -Adper Easy Bond (EB) and G-aenial Bond (GB) were used for 2 min pretreatment of the dentin beams. Phosphoric acid (PA) treatment as well as no treatment served as controls. Total enzymatic activity was analyzed before and after treatment, collagen degradation was assessed using mass loss, C-terminal telopeptide (CTX) and C-terminal-telopeptide of type I collagen (ICTP) release (24 h, 3-day, 3-week). Over three weeks of incubation, ICTP release of ABU treated beams was significantly higher than other groups (p<0.05), except for SU treated beams (p>0.05) and CTX release of GB treated beams was the highest among the groups with statistically significant difference (p<0.05). The results confirm that the universal adhesives tested have also potential to increase the enzymatic activity in dentin.

Bonding BisGMA to Dentin—a Proof of Concept for Hydrophobic Dentin Bonding

The use of TEGDMA as a diluent comonomer in the formulation of hydrophobic adhesives for ethanol wet-bonding is a concern, due to its leaching potential, higher water sorption, and bio-incompatibility. This study tested the hypothesis that hydrophobic bonding to acid-etched dentin may be accomplished with the use of ethanol-solvated BisGMA only. Phosphoric-acid-etched, oxalate-occluded, deep coronal dentin bonded under 20 cm water pressure with experimental BisGMA adhesives by ethanol wet-bonding exhibited tensile strengths that were not significantly different from that achieved with OptiBond FL bonded according to the manufacturer-recommended protocol, with similar acid-/base-resistant hybrid layers, resin tags, and nanoleakage distribution. Ethanol replacement of water-saturated dentin produced wider interfibrillar spaces, more extensive shrinkage of the collagen fibrils, and narrower hybrid layers. Experimental BisGMA adhesives provide the proof of concept that relatively hydrophobic resins may be coupled to acid-etched dentin by increasing its hydrophobic characteristics via ethanol replacement. They should be further optimized before clinical application.

Dental adhesives and strategies for displacement of water/solvents from collagen fibrils

OBJECTIVES

To evaluate the influence of temperature of evaporation in adhesive systems with different solvents on the apparent modulus of elasticity and mass change of macro-hybrid layers modified by proanthocyanidins (PACs).

METHODS

Adhesive resin beams (A) from Single Bond Plus (SB), Excite (EX) and One Step Plus (OS) were prepared after solvent evaporation at 23°C or 40°C (n=12). Macro-hybrid layers (M) (n=12) were prepared using demineralized dentin beams sectioned from extracted human third molars. The demineralized dentin specimens were infiltrated with each one of the three adhesive systems at 23°C or 40°C; with or without prior dentin treatment with PACs for 10min. The apparent modulus of elasticity (E) and mass change (Wmc, %) of adhesives beams and resin-infiltrated specimens were assessed in dry and wet conditions after immersion in water (24h, 1, 3 and 6 months). The E was statistically analyzed by Tukey-Kramer test and the Wmc, % by Kruskal Wallis, and Dunn (α=0.05).

RESULTS

Solvent evaporation at 40°C resulted in higher E values for adhesive resin beams at all storage conditions, regardless of the adhesive system (p<0.05). Increased mass loss (3 months: -0.01%; 6 months: -0.05%) was observed in One Step resin beams (p≤0.05). In the macro-hybrid layer models the pretreatment with PACs along with solvent evaporation at 40°C increased E and decreased the Wmc, % (3 months: -2.5; 6 months: 2.75%) for adhesives evaluated over time (p<0.05). No significant differences in ratio (resin/dentin) were found for the macro-hybrid layers (p>0.05).

SIGNIFICANCE

Improved solvent evaporation at higher temperature, and increased collagen cross-linking induced by PACs, enhanced the mechanical properties resulting in highly stable macro-hybrid layers over 6 months storage.

Can 1% chlorhexidine diacetate and ethanol stabilize resin-dentin bonds?

OBJECTIVES

To examine the effects of the combined use of chlorhexidine and ethanol on the durability of resin-dentin bonds.

METHODS

Forty-eight flat dentin surfaces were etched (32% phosphoric acid), rinsed (15 s) and kept wet until bonding procedures. Dentin surfaces were blot-dried with absorbent paper and re-wetted with water (water, control), 1% chlorhexidine diacetate in water (CHD/water), 100% ethanol (ethanol), or 1% chlorhexidine diacetate in ethanol (CHD/ethanol) solutions for 30 s. They were then bonded with All Bond 3 (AB3, Bisco) or Excite (EX, Ivoclar-Vivadent) using a smooth, continuous rubbing application (10 s), followed by 15 s gentle air stream to evaporate solvents. The adhesives were light-cured (20 s) and resin composite build-ups constructed for the microtensile method. Bonded beams were obtained and tested after 24-h, 6-months and 15-months of water storage at 37°C. Storage water was changed every month. Effects of treatment and testing periods were analyzed (ANOVA, Holm-Sidak, p<0.05) for each adhesive.

RESULTS

There were no interactions between factors for both etch-and-rinse adhesives. AB3 was significantly affected only by storage (p=0.003). Excite was significantly affected only by treatments (p=0.048). AB3 treated either with ethanol or CHD/ethanol resulted in reduced bond strengths after 15 months. The use of CHD/ethanol resulted in higher bond strengths values for Excite.

CONCLUSIONS

Combined use of ethanol/1% chlorhexidine diacetate did not stabilize bond strengths after 15 months.

Inhibition of MMPs by alcohols

OBJECTIVES

While screening the activity of potential inhibitors of matrix metalloproteinases (MMPs), due to the limited water solubility of some of the compounds, they had to be solubilized in ethanol. When ethanol solvent controls were run, they were found to partially inhibit MMPs. Thus, the purpose of this study was to compare the MMP-inhibitory activity of a series of alcohols.

METHODS

The possible inhibitory activity of a series of alcohols was measured against soluble rhMMP-9 and insoluble matrix-bound endogenous MMPs of dentin in completely demineralized dentin. Increasing concentrations (0.17, 0.86, 1.71 and 4.28 mol/L) of a homologous series of alcohols (i.e. methanol, ethanol, propanols, butanols, pentanols, hexanols, the ethanol ester of methacrylic acid, heptanols and octanol) were compared to ethanediol, and propanediol by regression analysis to calculate the molar concentration required to inhibit MMPs by 50% (i.e. the IC(50)).

RESULTS

Using two different MMP models, alcohols were shown to inhibit rhMMP-9 and the endogenous proteases of dentin matrix in a dose-dependent manner. The degree of MMP inhibition by alcohols increased with chain length up to 4 methylene groups. Based on the molar concentration required to inhibit rhMMP-9 fifty percent, 2-hydroxyethylmethacrylate (HEMA), 3-hexanol, 3-heptanol and 1-octanol gave the strongest inhibition.

SIGNIFICANCE

The results indicate that alcohols with 4 methylene groups inhibit MMPs more effectively than methanol or ethanol. MMP inhibition was inversely related to the Hoy's solubility parameter for hydrogen bonding forces of the alcohols (i.e. to their hydrophilicity).

Resin-dentin bonds to EDTA-treated vs. acid-etched dentin using ethanol wet-bonding. Part II: Effects of mechanical cycling load on microtensile bond strengths

OBJECTIVE

To compare microtensile bond strengths (MTBS) subsequent to load cycling of resin bonded acid-etched or EDTA-treated dentin using a modified ethanol wet-bonding technique.

METHODS

Flat dentin surfaces were obtained from extracted human molars and conditioned using 37% H(3)PO(4) (PA) (15s) or 0.1M EDTA (60s). Five experimental adhesives and one commercial bonding agent were applied to the dentin and light-cured. Solvated experimental resins (50% ethanol/50% comonomers) were used as primers and their respective neat resins were used as the adhesives. The resin-bonded teeth were stored in distilled water (24h) or submitted to 5000 loading cycles of 90N. The bonded teeth were then sectioned in beams for MTBS. Modes of failure were examined by scanning electron microscopy.

RESULTS

The most hydrophobic resin 1 gave the lowest bond strength values to both acid and EDTA-treated dentin. The hydrophobic resin 2 applied to EDTA-treated dentin showed lower bond strengths after cycling load but this did not occur when it was bonded to PA-etched dentin. Resins 3 and 4, which contained hydrophilic monomers, gave higher bond strengths to both EDTA-treated or acid-etched dentin and showed no significant difference after load cycling. The most hydrophilic resin 5 showed no significant difference in bond strengths after cycling loading when bonded to EDTA or phosphoric acid treated dentin but exhibited low bond strengths.

SIGNIFICANCE

The presence of different functional monomers influences the MTBS of the adhesive systems when submitted to cyclic loads. Adhesives containing hydrophilic comonomers are not affected by cycling load challenge especially when applied on EDTA-treated dentin followed by ethanol wet bonding.

The inhibitory effects of quaternary ammonium methacrylates on soluble and matrix-bound MMPs

Matrix metalloproteinases (MMPs) bound to dentin contribute to the progressive degradation of collagen fibrils in hybrid layers created by dentin adhesives. This study evaluated the MMP-inhibiting potential of quaternary ammonium methacrylates (QAMs), with soluble rhMMP-9 and a matrix-bound endogenous MMP model. Six different QAMs were initially screened by a rhMMP-9 colorimetric assay. For the matrix-bound endogenous MMPs, we aged demineralized dentin beams for 30 days in calcium- and zinc-containing media (CM; control), chlorhexidine, or QAMs in CM to determine the changes in dry mass loss and solubilization of collagen peptides against baseline levels. The inhibitory effects of QAMs on soluble rhMMP-9 varied between 34 and 100%. Beams incubated in CM showed a 29% decrease in dry mass (p < 0.05), whereas beams incubated with QAMs showed only 0.2%-6% loss of dry mass. Significantly more solubilized collagen was detected from beams incubated in CM (p < 0.05). It is concluded that QAMs exhibited dentin MMP inhibition comparable with that of chlorhexidine, but required higher concentrations.

The anti-MMP activity of benzalkonium chloride

OBJECTIVE

This study evaluated the ability of benzalkonium chloride (BAC) to bind to dentine and to inhibit soluble recombinant MMPs and bound dentine matrix metalloproteinases (MMPs).

METHODS

Dentine powder was prepared from extracted human molars. Half was left mineralized; the other half was completely demineralized. The binding of BAC to dentine powder was followed by measuring changes in the supernatant concentration using UV spectrometry. The inhibitory effects of BAC on rhMMP-2, -8 and -9 were followed using a commercially available in vitro proteolytic assay. Matrix-bound endogenous MMP-activity was evaluated in completely demineralized beams. Each beam was either dipped into BAC and then dropped into 1 mL of a complete medium (CM) or they were placed in 1 mL of CM containing BAC for 30 days. After 30 days, changes in the dry mass of the beams or in the hydroxyproline (HYP) content of hydrolysates of the media were quantitated as indirect measures of matrix collagen hydrolysis by MMPs.

RESULTS

Demineralized dentine powder took up 10-times more BAC than did mineralized powder. Water rinsing removed about 50% of the bound BAC, whilst rinsing with 0.5M NaCl removed more than 90% of the bound BAC. BAC concentrations 0.5wt% produced 100% inhibition of soluble recombinant MMP-2, -8 or -9, and inhibited matrix-bound MMPs between 55 and 66% when measured as mass loss or 76-81% when measured as solubilization of collagen peptide fragments.

CONCLUSIONS

BAC is effective at inhibiting both soluble recombinant MMPs and matrix-bound dentine MMPs in the absence of resins.

Chlorhexidine binding to mineralized versus demineralized dentin powder

OBJECTIVES

The purposes of this work were to quantitate the affinity and binding capacity of chlorhexidine (CHX) digluconate to mineralized versus demineralized dentin powder and to determine how much debinding would result from rinsing with water, ethanol, hydroxyethylmethacrylate (HEMA) or 0.5M NaCl in water.

METHODS

Dentin powder was made from coronal dentin of extracted human third molars. Standard amounts of dentin powder were tumbled with increasing concentrations of CHX (0-30 mM) for 30 min at 37 degrees C. After centrifuging the tubes, the supernatant was removed and the decrease in CHX concentration quantitated by UV-spectroscopy. CHX-treated dentin powder was resuspended in one of the four debinding solutions for 3 min. The amount of debound CHX in the solvents was also quantitated by UV-spectroscopy.

RESULTS

As the CHX concentration in the medium increased, the CHX binding to mineralized dentin powder also increased up to 6.8 micromol/g of dry dentin powder. Demineralized dentin powder took up significantly (p<0.01) more CHX, reaching 30.1 micromol CHX/g of dry dentin powder. Debinding of CHX was in the order: HEMA

SIGNIFICANCE

As CHX is not debound by HEMA, it may remain bound to demineralized dentin during resin-dentin bonding. This may be responsible for the long-term efficacy of CHX as an MMP inhibitor in resin-dentin bonds.

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Key Words

• chlorhexidine
• binding
• debinding
• dentin bonding

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MESH Headings

• Anti-Infective Agents, Local/pharmacokinetics
• Anti-Infective Agents, Local/pharmacology
• Chlorhexidine/analogs & derivatives
• Chlorhexidine/pharmacokinetics
• Chlorhexidine/pharmacology
• Collagen/metabolism
• Dental Bonding
• Dentin/metabolism
• Durapatite
• Ethanol
• Humans
• Hydrogen Bonding
• Linear Models
• Matrix Metalloproteinase Inhibitors
• Methacrylates
• Protease Inhibitors/pharmacology
• Protein Binding
• Resin Cements/chemistry
• Sodium Chloride
• Solubility
• Spectroscopy, Fourier Transform Infrared
• Tooth Demineralization/metabolism
• Water

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Grants

• R01 DE015306 NIDCR NIH HHS
• R01 DE015306-06A1 NIDCR NIH HHS
• R01 DE015306-06 NIDCR NIH HHS

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Affiliation(s)

Jongryul Kim Department of Conservative Dentistry, School of Dentistry, Kyung Hee National University, Seoul, Republic of Korea
Toshikazu Uchiyama Department of Regenerative Dentistry, Nihon University School of Dentistry at Matsuso, Chiba, Japan
Marcela Carrilho GEO/UNIBAN, Health Institute, Bandeirante University of São Paulo, Brazil and Department of Dental Materials and Oral Biochemistry, University of São Paulo, School of Dentistry, São Paulo/SP, Brazil
Kelli A. Agee Medical College of Georgia, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA
Annalisa Mazzoni Department of SAU & FAL, University of Bologna, Bologna, Italy
Lorenzo Breschi Department of Biomedicine, University of Trieste + IGM-CNR, Unit of Bologna, c/o IOR, Bologna, Italy
Ricardo M. Carvalho Department of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, Florida, USA
Leo Tjäderhane Institute of Dentistry, University of Oulu and Oulu University Hospital, Oulu, Finland
Stephen Looney Department of Biostatistics, Medical College of Georgia, Augusta, Georgia, USA
Courtney Wimmer Department of Biostatistics, Medical College of Georgia, Augusta, Georgia, USA
Arzu Tezvergil-Mutluay Department of Prosthodontics, School of Dentistry, University of Turku, Turku, Finland
Franklin R. Tay Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA
David H. Pashley Medical College of Georgia, School of Dentistry, Medical College of Georgia, Augusta, Georgia, USA

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Resin-dentin bonds to EDTA-treated vs. acid-etched dentin using ethanol wet-bonding

OBJECTIVE

To compare resin-dentin bond strengths and the micropermeability of hydrophobic vs. hydrophilic resins bonded to acid-etched or EDTA-treated dentin, using the ethanol wet-bonding technique.

METHODS

Flat dentin surfaces from extracted human third molars were conditioned before bonding with: 37% H(3)PO(4) (15s) or 0.1M EDTA (60s). Five experimental resin blends of different hydrophilicities and one commercial adhesive (SBMP: Scotchbond Multi-Purpose) were applied to ethanol wet-dentin (1 min) and light-cured (20s). The solvated resins were used as primers (50% ethanol/50% comonomers) and their respective neat resins were used as the adhesive. The resin-bonded teeth were stored in distilled water (24h) and sectioned in beams for microtensile bond strength testing. Modes of failure were examined by stereoscopic light microscopy and SEM. Confocal tandem scanning microscopy (TSM) interfacial characterization and micropermeability were also performed after filling the pulp chamber with 1 wt% aqueous rhodamine-B.

RESULTS

The most hydrophobic resin 1 gave the lowest bond strength values to acid-etched dentin and all beams failed prematurely when the resin was applied to EDTA-treated dentin. Resins 2 and 3 gave intermediate bond strengths to both conditioned substrates. Resin 4, an acidic hydrophilic resin, gave the highest bond strengths to both EDTA-treated and acid-etched dentin. Resin 5 was the only hydrophilic resin showing poor resin infiltration when applied on acid-etched dentin.

SIGNIFICANCE

The ethanol wet-bonding technique may improve the infiltration of most of the adhesives used in this study into dentin, especially when applied to EDTA-treated dentin. The chemical composition of the resin blends was a determining factor influencing the ability of adhesives to bond to EDTA-treated or 37% H(3)PO(4) acid-etched dentin, when using the ethanol wet-bonding technique in a clinically relevant time period.

Two-photon laser confocal microscopy of micropermeability of resin-dentin bonds made with water or ethanol wet bonding

This study evaluated the micropermeability of six etch-and-rinse adhesives bonded to dentin. There were two principal groups: wet bonding with water or wet bonding with absolute ethyl alcohol. After bonding and the creation of composite build-ups, the pulp chambers were filled with 0.1% lucifer yellow. The contents of the pulp chamber were kept under 20 cm H(2)O pressure to simulate pulpal pressure for 3 h. The specimens were vertically sectioned into multiple 0.5-mm thick slabs that were polished and then examined using a two-photon confocal laser scanning microscope (TPCLSM). The results showed that specimens bonded with adhesives using the water wet-bonding condition all showed tracer taken up uniformly by the hybrid layer. This uptake of fluorescent tracer into the hybrid layer was quantified by computer software. The most hydrophobic experimental resins showed the highest fluorescent tracer uptake (ca. 1800 +/- 160 arbitrary fluorescent units/std. surface area). The most hydrophilic experimental resins showed the lowest tracer uptake into water-saturated hybrid layers. When ethanol wet-bonding was used, significantly less fluorescent tracer was seen in hybrid layers. The most hydrophilic experimental resins and Single Bond Plus showed little micropermeability. Clearly, ethanol wet-bonding seals dentin significantly better than water-wet dentin regardless of the adhesive in etch-and-rinse systems.

Changes in resin-infiltrated dentin stiffness after water storage

Plasticization of polymers by water sorption lowers their mechanical properties in a manner that is predictable by the polarity of their component resins. This study tested the hypothesis that when adhesive resins were used to create resin-infiltrated dentin, the reductions in their flexural moduli after water storage would be lowered proportional to their hydrophilic characteristics. Three increasingly hydrophilic resin blends were used to fabricate polymer beams and macro-hybrid layer models of resin-infiltrated dentin for testing with a miniature three-point flexure device, before and after 1-4 weeks of water storage. Flexural modulus reductions in macro-hybrid layers were related to, and more extensive than, reductions in the corresponding polymer beams. Macro-hybrid layers that were more hydrophilic exhibited higher percent reductions in flexural modulus, with the rate of reduction proportional to the Hoy's solubility parameters for total intermolecular attraction forces (delta(t)) and polar forces (delta(p)) of the macro-hybrid layers.

Effects of polar solvents and adhesive resin on the denaturation temperatures of demineralised dentine matrices

OBJECTIVES

To measure the denaturation temperature (Td) of demineralised dentine matrix as a function of infiltration with water vs. polar solvents vs. adhesive resins.

METHODS

Small discs of normal dentine were completely demineralised in 0.5M EDTA. Dried demineralised specimens were placed in water, methanol, ethanol, acetone, eta-butanol or HEMA. Additional specimens were infiltrated with Prime&Bond NT and polymerised. All specimens sealed in high-pressure pans and scanned using differential scanning calorimetry (DSC).

RESULTS

Demineralised dentine saturated with water showed a Td of 65.6 degrees C that increased with saturation by methanol, ethanol, acetone, eta-butanol or HEMA to 148.5 degrees C. These increases in Td were inversely related to the molar concentration of the solvents and to their Hoy's solubility parameter for hydrogen bonding (delta h, p<0.01), as well as directly related to the cube root of their molecular weights (p<0.001). The presence of adhesive resins also increased the Td of demineralised matrices to even higher values depending if the resin bonded dentine was measured after 24h of water storage (166.8 degrees C) or dry (172.7 degrees C) storage.

CONCLUSIONS

Solvents and monomers with low delta(h) values (i.e., 100% HEMA) increase the Td of demineralised dentine above that produced by solvents with higher delta h values such as methanol and water.

Use of Hoy's solubility parameters to predict water sorption/solubility of experimental primers and adhesives

Self-etching primers and adhesives contain very hydrophilic acidic monomers that result in high water sorption/solubilities of their polymers. However, the chemical composition of these products varies widely. The purpose of this work was to vary the chemical composition of experimental self-etching primers and adhesives to determine if the water sorption/solubility of the polymers were affected in a predictable manner. The Hoy's solubility parameters of these mixtures were calculated to permit ranking of the degree of hydrophilicity of the polymers. Water sorption/solubility was measured according to ISO 4049. The results showed highly significant (R(2) = 0.86, P < 0.001) correlations between water sorption and Hoy's solubility parameter for polar forces (delta(p)) of the polymers. Similar correlations were obtained between polymer solubility and delta(p). When these results were compared with previously published results obtained with more hydrophobic resins, excellent correlations were obtained, indicating that Hoy's delta(p) values may be used to predict the water sorption behavior of methylmethacrylate polymers.

Effects of resin hydrophilicity on dentin bond strength

The purpose of this study was to determine if hydrophobic resins can be coaxed into dentin wet with ethanol instead of water. The test hypothesis was that dentin wet with ethanol would produce higher bond strengths for hydrophobic resins than would dentin wet with water. This study examined the microtensile bond strength of 5 experimental adhesives (50 wt% ethanol/50% comonomers) of various degrees of hydrophilicity to acid-etched dentin that was left moist with water, moist with ethanol, or air-dried. Following composite buildups, hourglass-shaped slabs were prepared from the bonded teeth for microtensile testing. For all 3 types of dentin surfaces, higher bond strengths were achieved with increased resin hydrophilicity. The lowest bond strengths were obtained on dried dentin, while the highest bond strengths were achieved when dentin was bonded moist with ethanol. Wet-bonding with ethanol achieved higher bond strengths with hydrophobic resins than were possible with water-saturated matrices.