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journal of dentistry 37 (2009) 769–775

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Improving the effect of NaOCl pretreatment on bonding
to caries-affected dentin using self-etch adhesives
Gen Taniguchi a,*, Masatoshi Nakajima a, Keiichi Hosaka a, Nanako Iwamoto a,
Masaomi Ikeda b, Richard M. Foxton c, Junji Tagami a,d
a

Cariology and Operative Dentistry, Department of Restorative Science, Graduate School, Tokyo Medical and Dental University,
1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
b
Faculty of Dentistry, School for Dental Technology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
c
Department of Conservative Dentistry, King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals,
King’s College London, London Bridge, London SE1-9RT, UK
d
Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases at Tokyo
Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan

article info

abstract

Article history:

Objective: To evaluate the effect of sodium hypochlorite pretreatment on adhesion to

Received 28 January 2009

normal and caries-affected dentin using self-etch adhesives.

Received in revised form

Methods: Forty extracted human molars with coronal carious lesions were used in this

9 May 2009

experiment. The occlusal dentin surfaces including the caries-affected dentin in each group

Accepted 2 June 2009

were treated as follows: group 1, rinsed with water; group 2, treated with 6% NaOCl for 15 s;
group 3, treated with 6% NaOCl for 30 s; group 4, application with Accel for 30 s after NaOCl30 s pretreatment. After rinsing with water and air-drying, the treated dentin surfaces were

Keywords:

applied with self-etch systems (Bond Force and Clearfil Protect Bond) according to the

Smear layer

manufacturers’ instructions, and built-up with resin composite. After 37 8C water storage

Caries-affected dentin

for 24 h, the bonded normal or caries-affected dentin areas were isolated to create an

Dentin bonding

hourglass configuration with a cross-sectional area of approximately 1 mm2. The specimens

NaOCl

were subjected to tensile stress at a cross-head speed of 1.0 mm/min.

Antioxidant

Results: NaOCl-15 s pretreatment significantly improved the mTBS of both self-etch adhesives to caries-affected dentin, while the 30 s pretreatment did not affect them. For normal
dentin, NaOCl-30 s pretreatment significantly reduced the mTBS of both self-etch adhesives
although the 15 s pretreatment did not alter them. Furthermore, the application of Accel
with a reducing effect increased the mTBS to normal and caries-affected dentin treated with
NaOCl for 30 s.
Conclusions: The effects of NaOCl pretreatment on bonding of both self-etch adhesives were
dependent upon type of dentin (normal and caries-affected dentin) and the treatment time.
# 2009 Elsevier Ltd. All rights reserved.

1.

Introduction

Carious dentin consists of two distinct layers (caries-infected
dentin and caries-affected dentin), which have different

morphological and chemical structures. Caries-infected dentin is infected and quite demineralized, and must be removed.
On the other hand, caries-affected dentin is partially demineralized and should be preserved in clinical treatment

* Corresponding author. Tel.: +81 3 5803 5483; fax: +81 3 5803 0195.
E-mail address: genkainada31990326@yahoo.co.jp (G. Taniguchi).
0300-5712/$ – see front matter # 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2009.06.005

Tokyo.12 However. However. In order to obtain caries-affected dentin. The dentin surfaces of the specimens in group 4. roughness. biochemical and mechanical characteristics between normal and caries-affected dentin. since remnants of super-oxide radicals generated by NaOCl within the dentin surface inhibit polymerization of resin monomers. followed by water rinsing. Japan) for 15 or 30 s.11 Self-etch adhesives are widely used for bonding to enamel and dentin. NaOCl treatment significantly reduces the bond strength to dentin.6 It was speculated that this was the result of differences in morphological. If. because the composition of smear layer is similar to the underlying dentin substrates. Tokyo.7-mm thick slabs using a lowspeed diamond saw (Isomet. Japan) to a height of 4–5 mm and each layer was light cured for 20 s. Japan) or onestep self-etch adhesive system (Bond Force. BF. The inclusion criteria were that the caries be limited to the occlusal face. which were served as the control group. After grinding. Kyoto. Kyoto. Japan) was applied to both normal and cariesaffected dentin according to the manufacturers’ instructions (Table 1). Kuraray Medical.10 It is speculated that there would be differences in the morphological and chemical structures of the smear layer created on normal and cariesaffected dentin. After pretreatment. were treated with 6% NaOCl for 30 s as previously described.23.25. grinding was performed with #600 silicon carbide (SiC) paper under running water using the combined criteria of visual examination and staining with a caries-detector solution (Kuraray Medical. the characteristics of smear layer covering the caries-affected dentin might be one reason why self-etch adhesives exhibit reduced adhesion to caries-affected dentin compared with normal dentin. However. which contains p-toluenesulfinic acid sodium salt. Then.17 Some researchers have reported that. while simultaneously allowing resin monomers to penetrate into the demineralized zone. Tokyo Medical and Dental University. Materials and methods Forty extracted human molars with coronal carious lesions. has been introduced for reducing agent. this compromised bonding ability can be reversed by the application of an antioxidant/reducing agent prior to the bonding procedures. because of the simplified bonding procedures and reduced technique sensitivity. after being bonded and sectioned. a two-step self-etch adhesive system (Clearfil Protect Bond. 2. the product. it has been reported that the characteristics of the smear layer variously affect the bond strength of self-etch adhesives to dentin. the teeth were divided into four groups. stored frozen. Lake Bluff.18. which has a reducing effect. and then treated with Accel (Sun Medical. Japan.19 On the other hand. Japan). Buehler Ltd. Tokuyama Dental. Dental adhesives are routinely applied to caries-affected dentin after removal of caries-infected dentin in clinical practice. when NaOCl was applied to smear layer-covered dentin. were used in this study. a smear layer is created on the surface. Tokyo. and that there is enough surrounding normal dentin to serve as a control bonding site. Tokyo. All the slabs were hand-trimmed to an hourglass shape with approximately 1 mm2 cross-sectional areas isolated by normal or caries-affected dentin using a fine diamond bur for the microtensile bond strength test as previously described.and two-step self-etch adhesives to normal and caries- affected dentin and to observe the morphological alterations of smear layer-covered normal and caries-affected dentin surfaces after treatment with NaOCl solution.20.8 Dentin smear layer is composed mostly of submicron particles of mineralized collagen debris. The null hypothesis tested was that NaOCl pretreatment does not affect the bond strength to normal and caries-affected dentin and morphological characteristics of their smear layercovered surfaces. Two or three slabs of bonded normal dentin and two or three slabs of bonded caries-affected dentin were prepared from per tooth. density and degree of attachment of the smear layer to the underlying tooth structure. the dentin surfaces were treated with 6% NaOCl (Jiaen 6%. the carious lesion was found to be too shallow or too deep.9. followed by water rinsing for 10 s. Surface preparation methods have been shown to vary the thickness. For the specimens in Groups 2 and 3. Following application of the adhesives. Accel (Sun Medical. Yoshida Co. Japan). The slight discolored dentin was classified as caries-affected dentin and the surrounding yellow dentin was classified as normal dentin with lateral view. Kyoto. The dentin surfaces of the specimens in group 1 were rinsed with water. IL) under water lubrication.4. Sodium hypochlorite (NaOCl) solutions are widely used in the chemomechanical treatment of root canals due to their antibacterial properties and effective dissolution of organic substances from biological materials. that it extends at least half the distance from the enamel–dentin junction to the pulp chamber. Japan) for 30 s.26 The final width and thickness of the bonded area were . the mineral to matrix ratio at dentin surface increased and the smear layer was thinned due to dissolution of the organic phase. The occlusal enamel was ground perpendicular to the long axis of the tooth to expose flat surfaces of normal and cariesaffected dentin. there is little published information available on the effect of pretreatment with NaOCl and reducing agent with regards to the adhesion of self-etch adhesives to caries-affected dentin.13–16 Therefore.. as a pretreatment before a NaOCl-irrigated root canal is filled with an adhesive root canal sealer (Super Bond Sealer. after storage in tap water at 37 8C for 24 h. Sun Medical. PB.770 journal of dentistry 37 (2009) 769–775 because it is uninfected and remineralizable.20–22 In addition. the tooth was excluded from this study.1.12 Self-etch adhesives are able to demineralize the smear layer and underlying dentin. previous studies have reported that bond strengths to caries-affected dentin were significantly lower than those to normal dentin1–6 and the hybrid layer created with caries-affected dentin was thicker and more porous compared with that with normal dentin. Japan). according to a protocol approved by the Human Research Ethics Committee. The purpose of this study was to evaluate the effect of pretreatment with NaOCl aqueous solution with or without a subsequent application of a reducing agent on the adhesion of one. which results in the creation of a hybrid layer. the bonded teeth were vertically sectioned into four or five 0. Tokyo.7 When the tooth structure is cut.24 Recently. a resin composite crown was built up using three layers of Clearfil AP-X (Kuraray Medical.

p < 0. In addition. the smear layer of normal dentin exhibited a smooth texture with a compact crust of Table 2 – On TBS to normal and caries-affected dentin. After testing. silanated colloidal silica Bond Force (BF.6)ac. 3. After treatment with or without NaOCl for 15 and 30 s.01 mm using a digital micrometer. hydrophobicdimethacrylate. Japan). NS 029.4)bc.002).9 41. photo-initiator.3 39. Kuraray Medical) pH.4 (7. An application of Accel increased the mTBS to caries-affected dentin treated with NaOCl for 30 s. Examination of the failure modes of the all groups revealed that these were mostly mixed failures in the interface and cohesive in the adhesive layer and/or dentin (Table 3).0 (4.05). while there were no significant differences in mTBS between the control and NaOCl-30 s pretreatment groups ( p > 0.001) and there was a SEM observation In the case of the control group.7 (9. surface-treated sodium fluoride crystals.05. the dentin surfaces were gold-sputter-coated and observed with a Scanning Electron Microscope (JXA-840.0 (3. Glass fillers. Results The mTBS bond strengths of protect bond (PB) and bond force (BF) to normal and caries-affected dentin are shown in Table 2.3 Methacryloyloxyalkyl acid phosphate. 50% for 20 min. 95% for 30 min and 100% for 60 min.27 Subsequently. while there were no significant differences in mTBS between the control and NaOCl-15 s pretreatment groups ( p > 0.9 (6.05).6) B (5. the mTBS of PB and BF after NaOCl pretreatment for 15 s were significantly higher than those of the no treatment control group ( p < 0. Japan) and subjected to microtensile testing at a cross-head speed of 1 mm/min. light cure for 10 s Bond: MDP. Material Clearfil Protect Bond (PB. pretreatment methods and type of dentin (normal dentin or caries-affected dentin).05). The Bonferroni and t-test were used for post hoc multiple comparisons at a = 0. NaOCl pretreatment for 30 s significantly reduced the mTBS of PB and BF ( p < 0.2) A (6. water Apply Primer for 20 s.5 (4.9 (6.05). Kyoto. NS Group 4 37.7)e. Further eight teeth were used for SEM observation. water Apply Bond for 20 s. The specimens were fixed with cyanoacrylate adhesive (Zapit. apply Bond.05 Group 2 43. 4. . for caries-affected dentin. Camphorquinone.7) D (8.6 031. NS = no significant difference. the mTBS to cariesaffected dentin were significantly lower than those to normal dentin ( p < 0. MDPB. TEGDMA: triethyleneglycol dimethacrylate.8 (3. HEMA.6 33. For both PB and BF. MDPB: 12-methacryloy-loxydodecylpyridinum bromide.. n = 12 Normal dentin Caries-affected dentin Protect bond: Mpa mean (SD) Group 1 40. 2. Tokuyama Dental) pH. Shimadzu Co. CA. and dried by placement on filter paper inside a covered glass vial at room temperature for 24 h.5) C (9. Tokyo.1) CD Same letters indicate statistically no significant differences ( p > 0. Isopropyl alcohol.7) B Bond force: Mpa mean (SD) Group 1 44. the dentin surface was rinsed off with water and then dehydrated in ascending concentrations of ethanol in the following steps: 25% ethanol for 20 min. NS Group 3 30. After the final ethanol step.001: BF. For normal dentin. water Accel (Sun Medical) p-Toluenesulfinic acid sodium salt ethanol. 75% for 20 min. HEMA: 2-hydroxyethyl methacrylate. HEMA. 5. TEGDMA.4 (3. ANOVA analysis revealed that there was no significant difference among the materials ( p = 0. p = 0. air dry. Bis-GMA: Bis-phenol A diglydidylmethacrylate. a subsequent application of Accel reversed the compromised bond strengths to NaOCl-30 s treated dentin. JEOL.0 (Primer) Composition Procedures Primer: MDP. Statistical analysis The microtensile bond strengths (mTBS) obtained in this study were analyzed by three-way ANOVA to test the effect of materials. Bis-GMA.6) C (7.771 journal of dentistry 37 (2009) 769–775 Table 1 – Chemical composition and application mode of the materials used in the study.001) and type of dentin ( p < 0. HEMA.6 (4. NS Group 4 36.2) A (6.0)ac. photo-initiators. statistically significant interaction between the type of dentin and the pretreatment method on each adhesive system (PB. Anaheim. p < 0. gentle air-dry and then moderate air-dry more than 5 s.9)d.9)de.5)b. the modes of failure of the de-bonded specimens were determined by means of an optical microscope at 10 and 40 magnifications. p < 0. NS 27. USA) onto a flat Ciucchi’s jig attached to a table-top testing machine (EZ-test. 2.32) and there was significant difference among the pretreatment methods ( p < 0. DVA.05 Group 2 42. Bis-GMA. dimethacrylates.05). SEM observation of normal and cariesaffected dentin surface after NaOCl pretreatment 6.05). NS Group 3 34.0)d. measured to the nearest 0.19. light cure for 10 s Abbreviations: MDP: 10-methacryloyloxydecamethylene phosphoric acid. the specimens were immersed in hexamethyldisilazane (HMDS) for 10 min.8 040. On the other hand.4 035.

2b and c). For both normal and caries-affected dentin. the smear layer was eroded and thinned and fibril-like structures were not observed (Fig. Smear layer was smooth and compact. while the caries-affected dentin was covered with a thicker and irregular smear layer with sludgelike formation. b cutting debris (Fig. 1a). (d) Treated with 6% NaOCl for 30 s. when the caries-affected dentin was treated with NaOCl for 15 and 30 s. Mixed = interfacial failure and cohesive failure in the adhesive resin and/or dentin. there were no significant alterations in surface morphology between NaOCl-30 s pretreatment groups and Accel treatment after NaOCl-30 s pretreatment groups (Fig. (a) No treatment. 1b and c). 1c and d.772 journal of dentistry 37 (2009) 769–775 Table 3 – Failure modes.10 and differs little Fig. (b) Treated with 6% NaOCl for 15 s. 1 – Scanning electron micrographs of normal dentin surface. There were no significant alterations in surface morphology from (a). 2a). 7. alteration in the surface morphology and smear layer thickness of normal dentin after 15 and 30 s treatment of NaOCl was unclear (Fig. 2c and d). Fig. Dentin Inrerfaciala Mixedb Cohesive In dentinc Protect Bond Normal Group 1 Group 2 Group 3 Group 4 Caries-affected Group 1 Group 2 Group 3 Group 4 Bond force Normal Group 1 Group 2 Group 3 Group 4 Caries-affected Group 1 Group 2 Group 3 Group 4 In resind 0 0 1 0 10 11 11 10 2 1 0 1 0 0 0 1 1 0 0 0 10 11 10 10 1 1 1 2 0 0 1 0 1 0 1 0 9 10 10 11 0 1 0 0 2 1 1 1 1 0 0 0 9 11 10 10 1 0 1 0 1 1 1 2 a Interfacial = 80–100% failure occurred between resin and dentin. d Cohesive failure in resin = 80–100% of the failure occurred in the adhesive resin and/or overlying composite. (b) and (c). c Cohesive failure in dentin = 80–100% of the failure occurred in the underlying dentin. There were no significant alterations in surface morphology from (a). D = dentin. When NaOCl was applied to the smear layer-covered normal dentin for 15 and 30 s. There were no significant alterations in surface morphology from (a) and (b). S = smear layer. . On the other hand. and then treated with Accel for 30 s. Discussion The smear layer on dentin is composed of disorganized collagen debris binding mineral particles. in which fibril-like structures were observed (Fig. (c) Treated with 6% NaOCl for 30 s.9.

resulting in it being softer and more porous. it might contain acid-resistant minerals. D = dentin. for self-etch adhesives. Furthermore. Although dentinal tubules in caries-affected dentin are occluded by acid-resistant minerals4.1.10.30 the intertubular dentin is partially demineralized. would result in the creation of a poorer quality hybrid layer that is thick. it forms a gelatinous matrix around the mineral. (a) No treatment. and incorporate it into the hybrid layer. Dentin surface was covered with a thick and irregular smear layer in which a sludge-like formation and fibril like structures were seen (arrow). (b) Treated with 6% NaOCl for 15 s. There were no significant alterations in surface morphology from (b). Several previous studies have demonstrated that pretreatment of smear layer-covered dentin with NaOCl for 60 s or a few minutes has a negative effect on bonding. and then treated with Accel for 30 s.and twostep self-etching adhesive systems (Bond Force and Clearfil Protect Bond) to caries-affected dentin were lower than those to normal dentin. In this study. S = smear layer. in which fibril-like structures could not be observed. The smear layer was eroded and thinned.20–22 It has been speculated that reactive residual free-radicals are present on the NaOCl-treated dentin surface that have been produced by the oxidizing effect of NaOCl and these compete with the propagation of vinyl free-radicals generated during light-activation of the adhesive. acid-resistance minerals in the smear layer on the caries-affected dentin might prevent proper infiltration of self-etch adhesive into underlying dentin. resulting in premature chain Fig. There were no significant alterations in surface morphology from (b) and (c). (c) Treated with 6% NaOCl for 30 s. there is a lower possibility of smear layer removal because they are less acidic and have a reduced demineralizing action compared to phosphoric acid. the smear layer on normal dentin was compact with a smooth surface.11 The disorganized collagen within the smear layer is not denatured. (d) Treated with 6% NaOCl for 30 s.28 The disorganized collagen and the gelatinous layer within the smear layer may prevent resin monomer infiltration and prevent a perfect seal at the resin–dentin interface. but gives rise to reduced bond strengths. the water content of caries-affected dentin increases as mineral is lost. which has a higher water content.29 and are likely to be impermeable to water.2. it would be more difficult to remove the thick and organic-enriched smear layer on the caries-affected dentin and their organic phase would interfere with the infiltration of the self-etch adhesive into the underlying dentin. the bond strengths of the tested one.31 From these results. however after acidic exposure. Fibril-like structures were not seen. Moreover.6 With self-etch adhesives. On the other hand.10 The disorganized collagen and/or the mineral trapped within the gelatinized collagen cannot be easily removed even when etched with phosphoric acid. and the porous intertubular dentin. the smear layer of caries-affected dentin seems to be enriched with organic components compared with that of normal dentin.32 Therefore. the smear layer on caries-affected dentin was thick and irregular with fibril-like structures. These results were in agreement with previous studies. 2 – Scanning electron micrographs of caries-affected dentin surface. Moreover. .28 In this study.journal of dentistry 37 (2009) 769–775 773 in composition from the underlying dentin substrate.

application of the reducing agent. Since p-toluenesulfinic acid sodium salt solution has a reducing action. an improvement in monomer infiltration into dentin due to dissolution of the organic component in the smear layer and an interference in resin polymerization due to remaining oxidizing products. The effects of NaOCl pretreatment on the adhesion of both self-etch adhesives were dependent upon the type of dentin (normal and caries-affected dentin) and the treatment time. applying Accel after NaOCl treatment for 30 s increased the mTBS of both self-etch adhesives compared with the no treatment groups. These results indicate that after Accel application. Journal of Dental Research 1995. 8. Tensile bond strength and SEM evaluation of caries-affected dentin using dentin adhesives. NaOCl pretreatment for 15 s significantly increased the mTBS of both self-etch adhesives compared with those of the no treatment groups of caries-affected dentin. On the other hand. However. the bond strengths of the tested one. but could not completely remove the smear layer although it was left thinner. NaOCl treatment of smear layer-covered caries-affected dentin eroded and thinned the smear layer due to dissolution of superficial organic components of smear layer. while there were no significant differences in mTBS to normal dentin between the control and NaOCl-15 s treated groups. which was thick and irregular with fibril-like structures. while 30 s pretreatment did not affect them. Ebisu S. reported that the mineral to matrix ratio of smear layer-covered dentin surface significantly increased following NaOCl treatment for 0. the smear layer on caries-affected dentin layer exhibited a different morphology. For normal dentin. there might be remnants of oxidized products on the dentin surface after rinsing off with water for 10 s. in the case of the NaOCl-15 s treated surface.774 journal of dentistry 37 (2009) 769–775 termination and incomplete polymerization. which had a compact surface.5. Sano H. NaOCl pretreatment for 15 s significantly improved the mTBS of both self-etch adhesives to caries-affected dentin. were significantly lower to caries-affected dentin than normal dentin. rinsing off with water for 10 s could remove the oxidized products from the dentin surface because there were fewer products and/or a lesser diffusion depth due to the shorter treatment time.18. and to evaluate the micromorphologcal structures of the bonded interface to NaOCl treated caries-affected dentin. Recently.34 Erhardt et al. resulting in no adverse effects on adhesion to dentin. and SEM observations clearly indicated that NaOCl pretreatment could dissolve superficial collagen within the smear layer of caries-affected dentin. Accel contains p-toluenesulfinic acid sodium salt. it is possible to reverse the residual oxidizing effects on a NaOCl-treated dentin surface. the mTBS of both self-etch adhesives to caries-affected dentin did not improve and were similar to those of the no treatment groups of caries-affected dentin. in the case caries-affected dentin. sodium ascorbate. Nakajima M. Global Center of Excellence (GCOE) Program.34 reported that resin bonded interfaces to caries-affected dentin were more susceptible to water degradation when directly exposed than normal dentin over time. Durability studies on adhesion to caries-affected dentin are still limited. resulting in the restoration of the altered redox potential..33 In this study. The results require rejection of the null hypothesis. using FTIR microspectroscopy. NaOCl pretreatment might improve the quality of the hybrid layer of caries-affected dentin using self-etch adhesives due to more infiltration of resin monomer. These results indicate that there were the negative and positive effects of NaOCl treatment on bonding to dentin. NaOCl pretreatment for 30 s significantly reduced the mTBS of both self-etch adhesives although the 15 s pretreatment did not alter them. Tagami J. 40 and 120 s. Burrow MF. while the morphological alterations of normal dentin-smear layer were unclear using scanning electron microscopy. Further research is required to determine the effect of NaOCl pretreatment on the bonding durability of caries-affected dentin. When NaOCl was applied for 30 s. . it has been reported that applying an antioxidant agent/reducing agent (e. it was not clear if there were any morphological alterations of the smear layer-covered dentin surfaces after NaOCl treatment for 15 and 30 s when the specimens were observed with the SEM. Conclusions Within the limitations of this study. Accel. Acknowledgement This work was supported by the grant from the Japanese Ministry of Education. Presumably. the negative effect of the oxidizing effects of NaOCl on polymerization was reversed and there was a positive effect on monomer infiltration into caries-affected dentin due to dissolution of the organic components in the smear layer by NaOCl. 20. In addition. ‘‘International Research Center for Molecular Science in Tooth and Bone Diseases’’.20 In the case of caries-affected dentin. A thinner smear layer on cariesaffected dentin with a reduced organic component might promote the infiltration self-etch adhesives into the smear layer and the underlying dentin. applying Accel improved the compromised bonding of both self-etch adhesives to normal dentin treated with NaOCl for 30 s. Mountouris et al. in the case of NaOCl treatment for 30 s. Therefore. compared to the smear layer on normal dentin. references 1. increased the mTBS to normal and cariesaffected dentin treated with NaOCl for 30 s. et al. However.74:1679–88. in which there were no significant differences between the adhesive materials.and two-step self-etch adhesive systems (Bond Force and Clearfil Protect Bond). NaOCl pretreatment for 30 s significantly reduced the bond strengths of both self-etch adhesive systems to normal dentin. However. Yoshiyama M.20 In this study. leading to more stable bonding to caries-affected dentin.g. sodium thiosulfate solution) resulted in a positive effect when adhesion to dentin had been compromised by NaOCl. the 15 and 30 s treatment time of NaOCl used in this study seems to be enough to cause an oxidizing effect on a NaOCl treated-dentin surface. Furthermore. leading to higher bond strengths to caries-affected dentin.

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