An analysis of the shear strength of the bond between enamel and porcelain laminate veneers with different etching systems: acid and Er,Cr:YSGG laser separately and combined

Conditioning of the enamel surface is now an accepted and widely applied technique used to improve retention in porcelain laminate veneer restorations. The aim of this study was to evaluate strength of the bond between porcelain laminate veneers and tooth surfaces etched with acid and laser, separately and together. The teeth studied comprised 60 incisors extracted for periodontal reasons. These were divided into four groups according to etching method: group 1, acid etching alone; group 2, acid etching followed by laser etching; group 3, laser etching followed by acid etching; group 4, laser etching alone. The teeth were etched with 37% phosphoric acid and a Er,Cr:YSGG laser system. In addition, 60 IPS Empress II cylindrical blocks 2 mm in height and 5 mm in diameter were also prepared for the etched tooth surface. These blocks were bonded to the teeth with dual cured resin cement and shear tests were then performed. After the shear tests, Scanning electron microscopy images of the tooth surfaces were obtained at a magnification of ×3,800. Etching with acid alone yielded the highest mean value of bond shear strength (15.4±3.8 MPa), while laser etching followed by acid etching gave the lowest mean value (11.5±4.6 MPa). The mean values of the bond shear strength for acid etching followed by laser etching and laser etching alone were 13.8±3.9 MPa and 12.8±4.6 MPa, respectively. Statistical analysis revealed no significant differences between the groups. The results suggest that laser etching is easy to apply and less time-consuming. They further suggest that the order in which the acid and laser are applied in combined treatments is important.