Do Dentin Bond Strength Tests Serve a

Useful Purpose?
Somsri SudsangiamVRichard van Noort''

Purpose: The publication of dentin bond strength data is prolific in the dental literature and will remain so
as more and more new dentin bonding agents are marketed. It is the purpose of this presentation to as-
sess the usefuiness of this information.

Methods: The limitations of dentir bond strength tests are examined in the contert of current knowledge
about the methods used.

Results: The evidence provided shows that dentin bond strength measurement techniques provide data
that \s not sbie to act as a consistent predictor of clinical performance. Fundamental fiaws in the most
popular methods adopted have been identified and alternative approaches need to be explored. Unfortu-
nately, we do not as yet have in place methodologies that siiow us to establish a reliabie link between iab-
oratory bond strength data and clinical performance.

Conclusion: For the present, oiinicslly based evidence remains the only reliabie means for the selection of
dentin bonding agents.
J Adhesive Dent 1999:1:57-67 SuOmitteû for putilicatlon: 13.08.98: accepted for publication: 28.09.98.

S a consequence of a growing demand for mate-
A rials that bond well to dentin, new and improved
versions of bonding systems are constantly being
marketed, making it difficult for dental practitioners
to choose the most appropriate materials for clini-
cal use. Since long-term clinical trials are costly and
time consuming, and manufacturers are not obliged
to carry out such studies prior to launching a new
product, laboratory bond strength test data are usu-
ally used to demonstrate the quality of a dentm
adhesive relative to its competitors. Many manufac-
turers promote their products on the basis of mean
values of shear bond strength measurements, im-
plying that high bond strength values are indicative
of good clinical performance. But has it been shown
that such measurements provide useful and reli-
^ Postgraduate student. Department of Restorative Dentistry, Uni-
versity of Sheffield, United Kingdom.
" Professor, Department of Restorative Dentistry, University of
Sheffield, United Kingdom.
Reprint requests: Prof R. van Noort, Department of Restorative Den- during both bonding and testing to avoid stress con-
tistry, University of Sheffield, Claremont Crescent, Sheffield SIO 2TA,
United Kingdom. E-mail: r.vannoortmheffieid.ac.uk.
able information relevant to clinical adhesive be-
havior? This paper reviews the validity of commonly
used methods of measuring dentin bond strengths
and their relevance to clinical performance.
BOND STRENGTH TESTS
In a tensile bond strength test using extracted
human or bovine teeth stored In a suitable medium,
a flat bonding site is prepared on a dentin surface
by wet grinding with silicone carbide paper. The pre-
pared bonding site is usually treated according to
manufacturers' instructions for the adhesive sys-
tem being evaluated. A cylindrical-shaped restora-
tive material is then bonded to the treated dentin
surface. After short- or long-term specimen storage,
possibly combined with cyclic fatigue or thermal
stress aging, the bonded specimen is placed in a
universal testing machine and subjected to tensile
force perpendicular to the tooth surface. The test
arrangement is shown in Eig 1. A major difficulty
with this type of test is maintaining the alignment
centrations due to incorrect interfacial geometry.

57
Vol 1, No L
Sudsangiam/van Noort

LOAD

ADHESIVE

DENTIN

I Tensile stress
f
[Compressive stress

(a)

Fig 1 Cross SGCtioh of a tensile bond test speoirnen (a) and non-uniform stress formation due to misalignment |b).

tooth surfaoe (Fig 2). The advantage ofthis method

LOAD
ADHERENDA
ADHEREND B
Fig 2 View of shear bond test arrangement.
Such problems as alignment are iargely over-
come in the shear bond strength test. Specimen
preparation is essentially the same as for the ten-
sile test, but in the shear bond strength test the
bond is broken by a force applied paraiiei to the
is that specimens and loading arrangements are
easy to produce, which makes it by far the most
popular measurement system used. However, this
test may easily transform to a bend or cleavage
type of test where tensile and not shear stresses
dominate (Fig 3).
It has been shown repeatediy that dentin bond
strength data suffer from considerabie scatter and
lack of consistency when results from different lab-
oratories are compared."^s Therefore, the compar-
ison of the reported bond strength values must be
treated with caution. Alternatively, ranking of bond
strength values has been claimed to be more
meaningfui than the absolute values obtained.^
While it may be the case in some studies that the
shear and tensile bond strength tests produce the
same ranking of the products,i^ aithough with
somewhat higher values in shear than in tension,
other studies^^ do not show this, as illustrated in
Fig 4.
An enormous number of variables can influence
the bond strength test. Broad categories of vari-
abies influencing the test resuits have been sum-
marized by Pashiey et al.^s Factors relating to the
selection, storage, and preparation ofthe substrate
for bond strength tests to tooth structure have aiso
been thoroughly reviewed by Rueggeberg.^^ poten-

58 The Journal of Adhesive Dentistry

 Sudsangiam/van Noort

DISTRIBUTED LOAD INTERRACIAL LOAD

- • /
SUBSTRATE ADHEREND SUBSTRATE ADHEREND

ADHE SIVE ADHESIVE

Ben ding Cleavage

Fig 3 Bending and cleavage arising in the shear bond strength test.

^Tensile ^ Tensile
• Shear • Shear

Fig 4 Comparison of bond strength vaiues from tensile and stiear bond strength testing. Left: From Kitasai^o et al,is Right: From
iVlay et ai,^3

59
 Sudsangiam/van Moort
TB5 (MPal
^Scotchbond 2
Ö Gluma
Fig 5 Comparison of bond strength vaiues with smaii modifications to the methods. Left; From Oiio et ai.2' Right: From van Noort
et al.^e
tially of much greater influence and significance is
that different methods or smaii modifications of the
same method can give two- to four-fold differences
in bond strength values for one and the same prod-
uct. This has been shov^n to be the case by Oilo et
a\^^ and van Noort et al,''^ as illustrated in Fig 5.
The lack of consistency in the use of dentin bond
strength measurement techniques has novj
reached the stage that editoriais requesting devel-
opment of a standardized bonding test are being
written.39 A group of experts working for the Inter-
national Organization for Standardization (ISO) have
developed guidelines [CD TR 11405, Dental Materi-
als "Guidance on testing of adhesion to tooth struc-
ture"] Viiith the intention to standardize the bond
testing procedures as much as possible.^^ Both ten-
sile and shear tests are described in the ISO docu-
ment. However, this standard has not been given
much recognition and has been harshiy criticized.^^
Inherent in the process of standardization is the be-
lief that the results derived from the bond strength
test wili have some vaiidity and meaning as long as
bond strength can be measured consistently. This
is highly questionable, as discussed beiow, be-
cause no amount of standardization will overcome
inconsistency problems if a test is fundamentaliy
flawed.
60
TBS (MPa)
with flash
without flash
Adhesive application meltiod
Aithough a strict standardization scheme may
soive part of the inconsistency of the test resuits,
there are more fundamental concerns with regard
to the mechanics of the test method. Severai re-
searchers have shown that a non-uniform stress
distribution is generated aiong the bonded inter-
face in both the tensile and shear bond strength
tests.'•"Ë'''^ The occurrence of prominent stress con-
centrations is in conflict with the underlying as-
sumption o f t h e nominal bond strength, which is
defined as the average stress value of the cross
section. Van Noort et al^^.J? used finite element
stress analysis (FEA) to demonstrate that the maxi-
mum stresses generated in tensiie and shear bond
strength measurements are at the edge ofthe inter-
face and far exceed the nominal bond strength.
This was confirmed in a more detailed 3-D FFA
analysis by DeHoff et al.? Fracture is probably initi-
ated from some point around the circumference of
the bonded interface where there is a flaw of a criti-
cal size, coincident with the high localized tensile
stress, and then propagates aiong the interface. In
these anaiyses,^•''S''^? the interfacial stress distribu-
tion in both tests was found to be highly dependent
on the geometry of the test arrangement, the na-
ture of the load application, the presence or ab-
sence of adhesive f i a s h , and the physical
The Journal of Adhesive Dentistry
 Table 1 Strength of dentin
Source Cohesive strength (MPa) Type of hoiid strength test
Mineralized dentin
Bowen et a 1,61962 51.7±10,3 Tensiie
Smith et ai,3äl97S 103,0 ± 135,0 Shear (micropunch)
Sano et al,331994 93,8±11,1 Tensiie
Watahabeetal,i3i996 7S,4±13,3 Shear
Demineralized dentin
Sano et a 1,331994 29,6±5,9 Tensiie
Resin-infiltrated demineraiizerl rlpntm
Sano et a 1,351995 121,6±20-3 (AB] Tensiie
111,5±14,5 (MP)
117,6±12,2 (SB ]
102,6+3,7 (CL)
57,6±16.4 (PB)

AB = All Bond 2, MP ^ ScotcliBond MultipjrDOse, SB = SuperBonfl C&3, CL = Clearfil Liner Bond 2,

PB = Clearfil Phoiobnnd.

properties o f t h e materials involved. The sensitivity
lo the loading geometry is particularly acute in
shear type tests. Shearing force can be applied with
a wide variety of configurations, including loops,
points, and knife edges. Clearly differing configura-
tions of ioad application will lead to differing stress
distributions. Moreover, in the shear test the true
shear stresses at the interface were invariabiy over-
shadowed by high tensile stresses.
Versluis et ai,"^ using a failure accumuiation sim-
ulation program to determine iocaiized failure inter-
activeiy with a f i n i t e e l e m e n t solver, was in
agreement with van Noort et al,''^"^ They confirmed
that dentin pull-out in the shear bond strength
test was, in part, due to the mechanics of the test
set-up, such as crosshead speed, load application
offsets, and adhesive layer thickness. They aiso
noted that failure in dentin did not mean that the
adhesive strength exceeded the cohesive strength
of the d e n t i n , as c o n c l u d e d by many re-
sea rc hers, ^^'^^ but is a consequence o f t h e experi-
mental design.
The mode of failure is another important aspect
of bond strength tests, although not reported on as
often as it shouid. A detailed inspection of the frac-
tured surfaces can indicate the failure mode of a
bonded assembly. The failure mode can be adhe-
sive [located in the adhesive interface), cohesive (a
fracture in one ofthe materials on either side ofthe
interface), or a mixture of the two. As reported by
severai investigators, a high percentage of fractures
in dentin are observed at bond strengths over 15 to
20 MPa when using current adhesive systems,^^'^^
However, the ultimate tensile strengtii of human
dentin has been consistently reported to be in a
range of 50 to 138 MPa (Table i).6,33,35,38,49 j h e ex-
planation for this discrepancy, with identin fractures
occurring at seemingly iower stresses in the shear
bond strength test, is simple. Due to uneven stress
distributions deveioped during the test, the calcu-
lated nominai stresses are far beiow the actual
stress experienced at the adhesive interface. This
explanation can also be applied when cohesive fail-
ure occurs within the restorative materials. For ex-
ampie, the bond strength of glass-ionomer cements,
typically 1 to 5 MPa'^ and with largely cohesive fail-
ures within the cement, are lower than those re-
ported for resin-modified giass-ionomer cements
and resin composites,^•^•*'° However, their low bond
strength vaiue is primariiy due to the iack of tensile
strength of the materials themselves" rather than
any inability to bond to the dentin. The higher bond
strength of resin-modified glass-ionomer cements
compared with conventionai glass-ionomer ce-

Vol 1, No 1, 1999 61
Sudsangiam/uan Noort
mehts can be attributed to the improved oohesive
strength of the resin-modified cements.is There-
fore, It Is questionable what is being measured in
these tests; it certainly is not the adhesive strength
ofthe cements.
Thus, variations in test results can be easily in-
troduced by the design of the experimental set-up.
This means that relying solely on bond strength
data is not a reliable method of material selection.
Furthermore, the conventional bond strength tests
may no longer be able to measure the adhesive
properties of the dentin adhesive. The popularity of
these tests, especially the shear type, can be ex-
plained by their relative simplicity. However, this is
not a good reason for their continued use.
The non-uniformity of the stress distribution gen-
erated during the conventional tensile and shear
bond strength tests will create areas of high local
stress, and fracture will be initiated from flaws at
the interface or in the substrate in these areas of
high local stress. The local stress at which failure
occurs cannot easily be calculated and is not repre-
sented by the average stress quoted in most arti-
cles. A new approach for the evaluation of biologic
interfaces is clearly needed to provide a better in-
terpretation of the dentin adhesive properties.
There are a number of ways this could be dealt
with. One possibility is to design a test configura-
tion that is more akin to the clinical situation—what
one might consider a usage test. An example of
such an approach is the push-out test used by
Krämer et al^o and Frankenburger et al^o providing
a measure of the retention of an inlay in dentin.
However, there is no doubt that the interfacial
stresses in such an experimental design will again
be highly non-uniform and potentially influenced by
the stiffness characteristics of the materials, the
design of the plunger, and the exact geometry and
dimensions of the test arrangement. Thus, as a test
for in-house comparison, it will serve a useful pur-
pose but will be difficult to duplicate elsewhere.
Also, the data obtained should not be expressed in
terms of the extrusion stress, ie, MPa, but should
be reported simply as the extrusion force. The ratio-
nale for this recommendation is that the interfacial
stresses are highly complex and non-uniform, mak-
ing the average value of stress calculated of little
value as a measurement ofthe actual stresses ex-
perienced at the adhesive interfaoe. This will have
no effect on the relative ranking of the data as long
as the dimensions are standardized. It will also
avoid any tendency on the part of others to carry
62
out what would be an invalid comparison with the
equally incorrect stresses calculated from shear
bond strength experiments.
An alternative approach is to design an experi-
meht in which the interfacial stresses will be as uni-
form as possible to achieve, so that the true in-
terfaoial stresses can be readily calculated. Sano et
al^" developed a bond test that sought to eliminate
the non-uniform stress distribution at the adhesive
interface by reverting to the more traditional dumb-
bell-shaped specimen design. The so-called "mi-
crotensile" method involves bonding adhesive
resins to the entire flat occlusal surface of the
tooth, which is then covered with a resin composite.
After curing and storage, the specimen is vertically
sectioned into multiple serial sections. The trimmed
section is then attached to microgrips and sub-
jected to a tensile force (Eig 6). By this method, the
authors found that bond strengths to dentin were
inversely related to the bonding surface areas. The
larger surface areas showed lower tensile bond
strengths, whereas the smaller surface areas were
associated with higher tensile bond strengths. At a
bonded surface area below 2.0 mm^, the bond
strength values showed minimum scatter, and all of
the failures were adhesive in nature even though
the bond strengths increased to 50 to 60 MPa. This
phenomenon is due to a reduction of the number
and size of flaws, which is a consequence ofthe re-
duction in specimen size. It follows the same pat-
tern observed many years ago by Griffith wheh
changing from low-strength glass sheets to high
strength glass fibers.^3 These results provide addi-
tional evidence that the cohesive strength of dentin
is much higher than the values measured in shear
bond testing when dentin fails cohesively. The
higher bond strength values obtained with the mi-
crotensile method are also consistent with the finite
element analysis prediction of van Noort et al,''^
which suggested that the actual tensile stresses ex-
perienced under the loading point in the shear test
can be as much as a factor of three higher than the
nominal bond strength values. Schreiner et al^s
compared the microtensile bond strength test with
the shear bond strength test, and found that signifi-
cantly more failures In dentln and composite were
seen in the shear test. Thus, the results obtained
from the microtensile testing method may better re-
flect the actual interfaoial bond strengths to dentin.
Another experimental approach for evaluation of
the adhesion of dentin-bonded interfaces is the
fracture toughness test.^i The fracture toughness
The Journai of Adhesive Dentistry
 PMMA ^^T^t\

Composite
Dentin

Composite
Dentin

Fig 6 Bonding procedure ahd specimen preparation for the miorotensiie bond strength test. A,B: Preparation of tooth for bonding.
C: Composite crown bonded to dentin, D: Preparation of bonded specimen for sectioning. E: Serial seotioning of specimen. F: Indi-
vidual slab shown in profile and full view. G: Slab trimmed at bonded interface. H: Trimmed slab in special grips. (Adapted from
Saho et al.s")

Vol 1, N o . 63
Sudsangiam/van Noort
value (Kic) reflects the ability of a materiai to resist
crack initiation and unstable propagation, Tam and
Pilliar'^i compared a fracture toughness test of
dentin-resin interfaces with a tensiie bond strength
test. Although the relative rankings of the grouped
means for the dentin bonding agents were the
same for both tests, light microscopy examination
revealed a greater number of total or partial cohe-
sive fractures after the tensile bond strength test-
ing compared with fracture toughness testing. They
concluded that the fracture toughness test provided
a vaiid method of characterizing the fracture resis-
tance of the denttn-resin interface both quanti-
tatively, with respect to the Kic results, and qua-
litativeiy, with respect to the fracture surfaces.
Both the microtensile test and the fracture me-
chanics approach show promise in improving our
understanding of the properties of the adhesive in-
terface. Despite this, the acceptance of these ap-
proaches by the wider research community will
probabiy be poor because they are much more diffi-
cuit to do.
CLINICAL VALUE OF BOND STRENGTH TESTS
As discussed above, bond strength vaiues depend
on the method used, and thus it is advisable not to
directly compare the reported values. The purpose
of breaking apart a bonded assembly is to try to es-
tablish how strong the bond is and where there are
weaknesses in the system. Identification of these
weaknesses and their eiiminetion ieads to improve-
ments, in engineering appiications it is often reia-
tiveiy straightforward to design bond strength
experiments that are exactly the same as the bond-
ed assembly to be used in service, eg, lap joints or
butt joints. However, given the complexity of adhe-
sively retained restorations in dentistry, this is not
possible. The most popular methods to evaiuate
bond strengths to enamei and dentin cleariy bear
no relationship to the ciinicai situation. This in itself
should not present a problem, as long as the infor-
mation obtained in the laboratory has value in as-
sessing the merits of the bonding system being
evaiuated, which is a matter of interpretation and
use of the data. Ideally the data gathered can sub-
sequently be used to determine the potential per-
formance of the adhesive in service. This is how an
engineer wiil use fundamental properties (eg, elas-
tic modulus, yield strength, and fracture toughness)
of a material such as high tensile steel to deter-
64
mine if it wiii perform its intended function as part
of a structurai unit, be it a bridge, boat, or car. At no
stage is the materiai judged for its suitabiiity for a
particular purpose solely on the data gathered in
iaboratory experiments on the material. In dentistry
this seems to be what we are trying to do. It should
therefore come as no surprise that this naive ap-
proach does not work,
if bond strength data are to be of enduring value,
a number of things will need to happen. First, the
data obtained must be transferabie from one situa-
tion to another. The microtensiie test data appear
promising in this respect, and the fracture tough-
ness approach may aiso be the way to gain greater
insight to what is actuaiiy happening at the adhe-
sive interface. Second, the means by which this
transfer is to be achieved needs to be explored. The
engineer has the advantage in that the process of
designing a suspension bridge, for example, iends
itself to an analytical soiution of the stresses and
strains the bridge components wili be required to
support. Thus it is possible to teli from its funda-
mental properties, obtained from laboratory experi-
ments, if a material has adequate strength and
stiffness for its intended purpose. When the struc-
ture to be built does not lend itself to a simple ana-
lytical solution, the engineer calls upon other
techniques, such as photoelasticity or finite ele-
ment modeling of the structure. In engineering
these are tried and trusted procedures; however, in
dentistry the use of such techniques is new and
much needs to be learned before they can be used
with any degree of confidence. We can take
courage from the fact that the worid of industrial
adhesives is not much ahead of dentistry and they
are also still working to understand what is happen-
ing atthe adhesive interface.^^
While this situation remains, clinical evidence
will continue to be the only conclusive measure of
adhesive performance, despite its own inherent
problems. The clinical evaluation of dentin adhe-
sive materials is based primarily on the retention of
the restorations. Few studies have attempted to cor-
relate laboratory bond strength measurements di-
rectiy with the clinical performance of the ad-
hesives used. This may be partiy because of the
iarge number of dentin adhesive materials on the
market, and partly because of the changes in prod-
uct chemistry that occur periodicaily, Platt et al^^
conducted both a shear bond strength test and ciin-
icai evaiuation of four dentin adhesive materials.
They concluded that the popuiar laboratory test
The Journai of Adhesive Dentistry
 Rétention rats 1%)
inn —
90
BO
/O
40
30
Fig 7 Comparison of 3-year clinical re-
tention rate of two different adhesive 20
restorative materiais, reported by Po- ID
well et al,30 and their bond strength
values published by severai laborato- •4
may not be a good means of predicting ciinicai per-
formance ofthe materiais.
Given the differences in clinioal results with
many systems, such as Scotchbond Muitipurpose
and Prisma Universai Bond 3 dentin bonding sys-
tems,^'3.*3,45 ¡I; ¡5 apparent that various factors may
alter the apparent clinioai efficacy of adhesives.
Some of these factors could be tooth preparation,
operator, patient, material, and intraoral location.""
Figure 7 illustrates the results of a recently pub-
lished study on the 3-year clinicai retention rate of
two different adhesive restorative materials.3° Also
included are the bond strength values of each ma-
terial as reported from several laboratories.^-ii'^i"^
Glass-ionomer cements consistently produce excel-
ient retention rates, yet their bond strengths are ai-
ways very low; dentin bonding agents produce
much higher bond strengths but have poorer reten-
tion rates. The impression this creates is that the
laboratory bond strength values of dentin adhesive
systems have little correlation with clinical retention
rates. Neither the bond strength values nor their
ranking appear able to predict the longevity of
dentin-bonded restorations. As already noted, one
conspicuous exampie of this is giass-ionomer ce-
ment {eg, Ketac-Fil), which has been shown to have
a favorable clinical retention rate up to 10 years^^
but very low bond strength values."*" Neo et al^s
noted that Imperva Bond had high loss rate (35%)
in their clinioal trial despite its high shear bond
strength.^3
Vnl 1 No L 1999
Bond ali-angth (MPa|
S7
12
s • Retention rats
6 g Bond slrangth
1
Ketac-Fil ^ * - Scotchbond Z/Sllux-^
CONCLUSION
Adhesion tests, while not perfect, have enabied the
development of improved bonding systems and
techniques. The shear bond strength test has been
of vaiue in differentiating between materials that
have littie or no adhesion to dentin and those that
show good promise as a dentin adhesive. However,
it must be recognized that bond strength values de-
pend on the method used, should be carefully inter-
preted, and that comparison of the results from
different laboratories is not possible. In terms of
new information it can provide, the shear bond
strength test has reached the end ofthe road. New
testing methods need to be developed to provide
researchers with the tools needed to make further
advances in adhesion to dentin.
Research is based on experimentation and iogic
such that the empirical method stresses the facts
and at the same time chaiienges the theoreticaliy
minded to make deductions from them. Most publi-
cations on bond strength tests provide what are
perceived as facts-that is, bond strength data. At
first sight this appears to be adequate, but the du-
bious validity of these data makes the job of the
theoretical thinker, who seeks an expianation of the
facts, difficult if not impossible. Thus we need first
to establish the truth behind the facts if we are ever
to make sense of the data being generated.
The abiiity of the bonded interface between tooth
and restoration to resist fracture is complex and
cannot be simply correlated with laboratory bond
strength values. We need to learn to make the link
between laboratory-generated data on dental mate-
65
 udsangiam/van hJoort
rials and their ciinical appiication. We have dental
materials scientists and we have dental clinicians;
perhaps we need more dental engineers. Until such
time that we know how to produce the missing link,
dentin bond strength data may be of some use in
the laboratory duringthe development of new adhe-
sives but cannot and should not be used as a
means of predicting clinicai performance, whether
directly or by inference.
For the present, therefore, the oniy reliable
source of information for the seiection of dentin ad-
hesives remains comparison of clinicai perfor-
mance of different products over a significant
period of time.
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200 pp (soltcover): 96
¡lljslratinns {15 color):
ISBN 0-86715-310-5;
US$42

Contents I Acute Inflammatory Process

Vascular Response to ln|ury
Chemical Mediators of the Vascular
Response
The Blood Leukocytes
Sysleniio Manitestations of infiammation
II Immunity
The Immune System
Hypersensilivity Reactions
Chronic Inflammatory Processes
III Repair of Host Tissues
Healing
IV Application of Basic Principles
Clinical Connections

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