Effect of Casein Phosphopeptide Amorphous Calcium Phosphate Conditioning on Microtensile Bond Strength of Three Adhesive Systems to Deep Dentin

  • Mohammad Ali Mohammadi Torkani ORCID Department of Restorative Dentistry, Faculty of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
  • Sepideh Mesbahi Dentistry student, Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
  • Amir Ardalan Abdollahi ORCID Mail Department of Endodontics, School of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
Casein Phosphopeptide-Amorphous Calcium Phosphate Nanocomplex, Clearfil Bonding Agent, Dentin, Tooth Remineralization


Objectives: This study aimed to assess the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on microtensile bond strength of three adhesive systems to deep dentin.
Materials and Methods: In this in vitro study, the occlusal surface of 30 sound human third molars was sectioned at 2 mm below and above the cementoenamel junction. The samples were randomly divided into three groups of OptiBond Solo Plus, G-Bond, and Clearfil SE Bond. Before composite resin bonding, each group was divided into two subgroups with and without dentin preparation with CPP-ACP. The teeth were then sectioned into 1 mm rods (n=15), and their microtensile bond strength was measured at a crosshead speed of 0.5 mm/min. Data were analyzed using two-way ANOVA and post-hoc Bonferroni test.
Results: There was no significant difference in bond strength of OptiBond Solo Plus (P=0.44) and Clearfil SE Bond (P=0.67) with/without CPP-ACP. A significant difference was found between the two subgroups of G-Bond in this respect (P<0.001). The differences in microtensile bond strength among all subgroups were significant (P<0.05).
Conclusion: The microtensile bond strength in use of G-Bond is significantly higher following dentin treatment with CPP-ACP compared with no use of CPP-ACP.


1. Bahari M, Savadi Oskoee S, Kimyai S, Pouralibaba F, Farhadi F, Norouzi M. Effect of Casein Phosphopeptide-amorphous Calcium Phosphate Treatment on Microtensile Bond Strength to Carious Affected Dentin Using Two Adhesive Strategies. J Dent Res Dent Clin Dent Prospects.2014 Summer;8(3):141-7.
2. Van Meerbeek B, Yoshihara K, Yoshida Y, Mine A, De Munck J, Van Landuyt KL. State of the art of self-etch adhesives. Dent Mater. 2011 Jan;27(1):17-28.
3. Miyazaki M, Iwasaki K, Onose H. Adhesion of single application bonding systems to bovine enamel and dentin. Oper Dent. 2002 Jan-Feb;27(1):88-94.
4. Deepa VL, Damaraju B, Priyadharsini BI, Subbarao VV, Raju KR. Comparative evaluation of microshear bond strength of 5(th), 6(th) and 7(th) generation bonding agents to coronal dentin versus dentin at floor of pulp chamber: An in vitro study. J Int Oral Health. 2014 Sep;6(5):72-6.
5. Prati C, Chersoni S, Mongiorgi R, Pashley DH. Resin-infiltrated dentin layer formation of new bonding systems. Oper Dent. 1998 Jul-Aug;23(4):185-94.
6. Mitchem JC, Gronas DG. Effects of time after extraction and depth of dentin on resin dentin adhesives. J Am Dent Assoc. 1986 Aug;113(2):285-7.
7. Toba S, Veerapravati W, Shimada Y, Nikaido T, Tagami J. Micro-shear bond strengths of adhesive resins to coronal dentin versus the floor of the pulp chamber. Am J Dent. 2003 Sep;16:51A-6A.
8. Kijsamanmith K, Timpawat S, Harnirattisai C, Messer HH. Micro-tensile bond strengths of bonding agents to pulpal floor dentine. Int Endod J.2002 Oct;35(10):833-9.
9. Iida Y, Nikaido T, Kitayama S, Takagaki T, Inoue G, Ikeda M, et al. Evaluation of dentin bonding performance and acid-base resistance of the interface of two-step self-etching adhesive systems. Dent Mater J. 2009 Jul;28(4):493-500.
10. Usha H, Kumari A, Mehta D, Kaiwar A, Jain N. Comparing microleakage and layering methods of silorane-based resin composite in class V cavities using confocal microscopy: An in vitro study. J Conserv Dent. 2011 Apr;14(2):164-8.
11. Vinay S, Shivanna V. Comparative evaluation of microleakage of fifth, sixth, and seventh generation dentin bonding agents: An in vitro study. J Conserv Dent. 2010 Jul;13(3):136-40.
12. De Munck J, Van Landuyt K, Peumans M, Poitevin A, Lambrechts P, Braem M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results. J Dent Res. 2005 Feb;84(2):118-32.
13. Adebayo OA, Burrow MF, Tyas MJ. Dentine bonding after CPP-ACP paste treatment with and without conditioning. J Dent. 2008 Dec;36(12):1013-24.
14. Oshiro M, Yamaguchi K, Takamizawa T, Inage H, Watanabe T, Irokawa A, et al. Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study. J Oral Sci. 2007 Jun;49(2):115-20.
15. Borges BC, Catelan A, Sasaki RT, Ambrosano GM, Reis AF, Aguiar FH. Effect of the application of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste and adhesive systems on bond durability of a fissure sealant. Odontology. 2013 Jan;101(1):52-9.
16. Kamozaki MB, Prakki A, Perote LC, Gutierrez NC, Pagani C. The effect of CPP-ACP and Nd:YAG laser on the bond strength of softened dentin. Braz Oral Res. 2015;29(1):1-7.
17. Agob JN, Aref NS, Al-Wakeel EES. Effect of casein phosphopeptide-amorphous calcium phosphate on fluoride release and micro-shear bond strength of resin-modified glass ionomer cement in caries-affected dentin. Restor Dent Endod. 2018 Nov;43(4):e45.
18. Xuan W, Hou BX, Lu YL. Bond strength of different adhesives to normal and caries-affected dentins. Chin Med J (Engl).2010 Feb;123(3):332-6.
19. Sharafeddin F, Salehi R, Feizi N. Effect of dimethyl sulfoxide on bond strength of a self-etch primer and an etch and rinse adhesive to surface and deep dentin. J Dent (Shiraz). 2016;17(3 Suppl):242-9.
20. Liu Y, Tjaderhane L, Breschi L, Mazzoni A, Li N, Mao J, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011 Aug;90(8):953-68.
21. Wang Y, Spencer P. Evaluation of the interface between one-bottle adhesive systems and dentin by Goldner's trichrome. Am J Dent. 2005 Feb;18(1):66-72.
22. Hashimoto M, Fujita S, Endo K, Ohno H. Effect of dentinal water on bonding of self-etching adhesives. Dent Mater J. 2009 Sep;28(5):634-41.
23. Pashley DH. Dentin: a dynamic substrate--a review. Scanning Microsc.1989 Mar;3(1):161-74.
24. Wang Y, Spencer P. Interfacial chemistry of class II composite restoration: structure analysis. J Biomed Mater Res A. 2005 Dec;75(3):580-7.
25. Wang Y, Spencer P, Hager C, Bohaty B. Comparison of interfacial characteristics of adhesive bonding to superficial versus deep dentine using SEM and staining techniques. J Dent.2006 Jan;34(1):26-34.
26. Wang Y, Spencer P, Yao X, Brenda B. Effect of solvent content on resin hybridization in wet dentin bonding. J Biomed Mater Res A. 2007 Sep;82(4):975-83.
27. Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist. 1998 Jan-Feb;18(1):8-16.
28. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009;67(6):321-32.
29. Borges BC, Souza-Junior EJ, da Costa Gde F, Pinheiro IV, Sinhoreti MA, Braz R, et al. Effect of dentin pre-treatment with a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on dentin bond strength in tridimensional cavities. Acta Odontol Scand. 2013 Jan;71(1):271-7.
30. Bouillaguet S, Ciucchi B, Jacoby T, Wataha JC, Pashley D. Bonding characteristics to dentin walls of class II cavities, in vitro. Dent Mater. 2001 Jul;17(4):316-21.
31. Pashley DH, Sano H, Ciucchi B, Yoshiyama M, Carvalho RM. Adhesion testing of dentin bonding agents: a review. Dent Mater. 1995 Mar;11(2):117-25.
32. Shafiei F, Derafshi R, Memarpour M. Bond strength of self-adhering materials: Effect of dentin-desensitizing treatment with a CPP-ACP paste. Int J Periodontics Restorative Dent. 2017 Nov-Dec;37(6):e337-e43.
33. Barbosa-Martins LF, de Sousa JP, de Castilho ARF, Puppin-Rontani J, Davies RPW, Puppin-Rontani RM. Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents. J Mech Behav Biomed Mater. 2018 May;81:214-21.
34. Lin J, Zheng WY, Liu PR, Zhang N, Lin HP, Fan YJ, et al. Influence of casein phosphopeptide-amorphous calcium phosphate application, smear layer removal, and storage time on resin-dentin bonding. J Zhejiang Univ Sci B. 2014 Jul;15(7):649-60.
35. Yoshida Y, Nagakane K, Fukuda R, Nakayama Y, Okazaki M, Shintani H, et al. Comparative study on adhesive performance of functional monomers. J Dent Res. 2004 Jun;83(6):454-8.
36. Sattabanasuk V, Burrow M, Shimada Y, Sadr A, Tagami J. Resin bonding to dentine after casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatments. J Adhes Sci Technol. 2009 Nov-Dec;23(7-8):1149-61.
37. Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent. 2007 Aug;35(8):695-8.
38. Tantbirojn D, Huang A, Ericson MD, Poolthong S. Change in surface hardness of enamel by a cola drink and a CPP-ACP paste. J Dent. 2008 Jan;36(1):74-9.
39. Adebayo OA, Burrow MF, Tyas MJ. Effects of conditioners on microshear bond strength to enamel after carbamide peroxide bleaching and/or casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatment. J Dent. 2007 Nov;35(11):862-70.
40. Moule CA, Angelis F, Kim GH, Le S, Malipatil S, Foo MS, et al. Resin bonding using an all-etch or self-etch adhesive to enamel after carbamide peroxide and/or CPP-ACP treatment. Aust Dent J. 2007 Jun;52(2):133-7.
41. Yamaguchi K, Miyazaki M, Takamizawa T, Inage H, Kurokawa H. Ultrasonic determination of the effect of casein phosphopeptide-amorphous calcium phosphate paste on the demineralization of bovine dentin. Caries Res. 2007;41(3):204-7.
42. Fu B, Sun X, Qian W, Shen Y, Chen R, Hannig M. Evidence of chemical bonding to hydroxyapatite by phosphoric acid esters. Biomaterials. 2005 Sep;26(25):5104-10.
43. Tsuchimoto Y, Yoshida Y, Mine A, Nakamura M, Nishiyama N, Van Meerbeek B, et al. Effect of 4-MET- and 10-MDP-based primers on resin bonding to titanium. Dent Mater J. 2006;25(1):120-4.
44. Iwai H, Fujita K, Ikemi T, Goto H, Aida M, Nishiyama N. Development of MDP-based one-step self-etch adhesive--effect of additional 4-META on bonding performance. Dent Mater J. 2013;32(1):1-9.
45. Adebayo OA, Burrow MF, Tyas MJ. Resin-dentine interfacial morphology following CPP-ACP treatment. J Dent. 2010 Feb;38(2):96-105.
46. Jacobsen T, Soderholm KJ. Some effects of water on dentin bonding. Dent Mater. 1995 Mar;11(2):132-6.
47. Milia E, Lallai MR, Garcia-Godoy F. In vivo effect of a self-etching primer on dentin. Am J Dent. 1999 Aug;12(4):167-71.
48. Maciel KT, Carvalho RM, Ringle RD, Preston CD, Russell CM, Pashley DH. The effects of acetone, ethanol, HEMA, and air on the stiffness of human decalcified dentin matrix. J Dent Res. 1996 Nov;75(11):1851-8.
49. Pashley DH, Carvalho RM. Dentine permeability and dentine adhesion. J Dent. 1997 Sep;25(5):355-72.
50. Sano H, Takatsu T, Ciucchi B, Horner J, Matthews W, Pashley D. Nanoleakage: Leakage within the hybrid layer. Oper Dent. 1994 Mar-Apr;20(1):18-25.
51. Nakajima M, Ogata M, Okuda M, Tagami J, Sano H, Pashley DH. Bonding to caries-affected dentin using self-etching primers. Am J Dent. 1999 Dec;12(6):309-14.
How to Cite
Mohammadi Torkani MA, Mesbahi S, Abdollahi AA. Effect of Casein Phosphopeptide Amorphous Calcium Phosphate Conditioning on Microtensile Bond Strength of Three Adhesive Systems to Deep Dentin. Front Dent. 17.
Original Article