Effect of a bonding agent on in vitro biochemical activities of remineralizing resin-based calcium phosphate cements

OBJECTIVES: To test whether fluoride in a resin-based Ca-PO4 ion releasing cement or coating with an acidic bonding agent for improved adhesion compromised the cement remineralization potential. METHODS: Cements were formulated without fluoride (Cement A) or with fluoride (Cement B). The treatment groups were A=Cement A; A2=Cement A+bonding agent; B=Cement B; B2=Cement B+bonding agent. The calcium, phosphate, and fluoride ion release in saliva-like solution (SLS) was determined from hardened cement disks without or with a coating of bonding agent. For the remineralization, two cavities were prepared in dentin of extracted human molars and demineralized. One cavity received composite resin (control); the other received treatment A, A2, B or B2. After 6 week incubation in SLS, 180 microm cross-sections were cut. The percentage remineralization was determined by transverse microradiography comparing the dentin mineral density under the cement to that under the control. RESULTS: The percentage of remineralization (mean+/-S.D.) was A (39+/-14)=B (37+/-18), A2 (23+/-13), B2 (14+/-7). Two-way analysis of variance (ANOVA) and Holm-Sidak test showed a significant effect from the presence of bonding agent (p<0.05), but not from fluoride (p>0.05). The ion solution concentrations of all groups showed undersaturation with respect to dicalcium phosphate dihydrate and calcium fluoride and supersaturation for fluorapatite and hydroxyapatite suggesting a positive remineralization potential. SIGNIFICANCE: Compared to the control all treatments resulted in mineral increase. The remineralization was negatively affected by the presence of the bonding agent.