Journal of Adhesion Science and Technology
ISSN: 0169-4243 (Print) 1568-5616 (Online) Journal homepage: https://www.tandfonline.com/loi/tast20
Effects of silane treatment on salivary protein
contamination during the bonding of lithium
disilicate ceramic
Hyun-Jung Kim, Sehoon Kim, Seung-Hyun You, Sung-Geun Cho, Kyoung-Kyu
Choi & Duck-Su Kim
To cite this article: Hyun-Jung Kim, Sehoon Kim, Seung-Hyun You, Sung-Geun Cho, Kyoung-
Kyu Choi & Duck-Su Kim (2020): Effects of silane treatment on salivary protein contamination
during the bonding of lithium disilicate ceramic, Journal of Adhesion Science and Technology, DOI:
10.1080/01694243.2020.1733368
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Published online: 12 Mar 2020.
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JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY
https://doi.org/10.1080/01694243.2020.1733368
Effects of silane treatment on salivary protein
contamination during the bonding of lithium
disilicate ceramic
Hyun-Jung Kima , Sehoon Kimb, Seung-Hyun Youc, Sung-Geun Choc,
Kyoung-Kyu Choid and Duck-Su Kimd
a
Department of Conservative Dentistry, Kyung Hee University Dental Hospital, Seoul, Korea;
b
Department of Dentistry, Naval Medical Center, ROK Navy, Jinhae, Korea; cDepartment of
Conservative Dentistry, Graduate School, Kyung Hee University, Seoul, Korea; dDepartment of
Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
ABSTRACT ARTICLE HISTORY
In this study, the effect of saliva contamination and cleaning pro- Received 9 October 2019
cedures on the bond strength of lithium disilicate (LS2) ceramics Revised 15 February 2020
was investigated at different timings of silane treatment. Micro- Accepted 19 February 2020
tensile bond strength (lTBS) test using a universal testing
KEYWORDS
machine was performed (n ¼ 24). For analysis of adhesive surface Lithium disilicate; silane
characteristics, water contact angle was measured (n ¼ 3). After treatment; saliva
saliva contamination, the salivary protein level using the Bradford contamination; cleaning
assay was quantified (n ¼ 3). The pre-conditioned surfaces were procedure; salivary protein;
observed using a field emission-scanning electron microscope (FE- ceramic bonding
SEM). Saliva contamination and the silane treatment timing sig-
nificantly affected the lTBS of LS2 ceramics (p < 0.05). However,
cleaning methods did not show any significant differences in
lTBS (p > 0.05). Water contact angle increased after silane treat-
ment. High concentration of salivary protein was detected in the
group where saliva contamination occurred before silane treat-
ment (p < 0.05). FE-SEM analysis showed that the etched surfaces
of the contaminated LS2 specimens were covered with oral bac-
teria and other salivary components. It also showed that ultra-
sonic cleaning was effective in eliminating salivary contaminants
while air-water spray was not. Saliva contamination of the surface
of LS2 ceramics deteriorates lTBS. To minimize the effect of saliva
contamination, prompt silane treatment to etched surface of LS2
ceramic is recommended.
Introduction
In dentistry, all-ceramic restorations are gaining increased popularity amongst clinicians
and patients universally. Dental ceramics were historically regarded as brittle materials.
Even though early dental ceramics possessed limited mechanical strength, recent dental
ceramics have shown improved mechanical properties without hampering esthetics.
CONTACT Duck-Su Kim [email protected] Department of Conservative Dentistry, School of Dentistry,
Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
ß 2020 Informa UK Limited, trading as Taylor & Francis Group
2 H.-J. KIM ET AL.
There have been considerable advancements in the field of ceramic technology, which
include the highly advanced dental ceramic-lithium disilicate (LS2). It is composed of
approximately 70% needle-shaped LS2 crystals embedded in a glass matrix [1]. It consists
of numerous randomly oriented micro-interlocking plate-like crystals in a glass matrix.
This micro-structure provides increased fracture toughness, as the needle-like crystals
act by deflecting or interrupting crack propagation [2]. LS2 ceramics satisfy majority of
the biomechanical requirements of an ideal restorative material and provide enhanced
aesthetics and longevity compared to metal-ceramic restorations [3].
For the cementation of LS2 ceramic restorations, internal surface pre-conditioning
of the restoration is required to attain a stable adhesion. It includes internal surface
etching with hydrofluoric (HF) acid followed by silane treatment. HF acid dissolves the
glass phase of the ceramic, creating micro-porosities on the surface [4,5]. The silane-
coupling agent forms siloxane bonds between the silica of the glass matrix and the
methacrylate groups of the resin cement [6,7].
In clinical situations, the internal surface of the ceramic restoration may be contami-
nated with saliva during the try-in procedure. Saliva contamination may negatively
affect bond strength of LS2 ceramic [8,9]. HF acid etching and silane treatment may be
one of the proper options that can prevent reduction in bond strength caused by saliva
contamination [10]. However, HF acid etching is usually performed in the dental
laboratory, thus saliva contamination may occur during try-in procedure. Although,
the effect of saliva contamination and cleaning procedures on the bond strength of LS2
ceramics has been studied in some studies [9–12], the intriguing question whether sal-
ivary proteins attach to the ceramic surface after contamination, and if so, do the inter-
posed their levels change after various cleaning procedures has not been addressed
as well.
Therefore, the aim of this study was to investigate the effect of silane treatment on
the bond strength of saliva-contaminated LS2 ceramic by measuring the micro-tensile
bond strength (lTBS), contact angle, and interposed salivary protein level and to sug-
gest a proper cleaning method that will enhance the bond strength. The null hypothesis
in this study was that silane treatment timing and cleaning methods could affect the
bond strength of saliva-contaminated LS2.
Materials and methods
Materials
The specimens were fabricated with IPS e.max Press (A2-shade, high-translucency;
Ivoclar Vivadent, Schaan, Liechtenstein). Duo-Link (Bisco, Schaumburg, IL, USA) was
used as the resin cement, 9.5% hydrofluoric acid (Bisco) as the etchant, and
Monobond-S (Ivoclar Vivadent) as the silane-coupling agent. Materials used in this
study are listed in Table 1.
Specimen preparation and experimental groups
Ten specimens were fabricated using the hot-pressing technique with LS2 ingots (IPS
e.max Press, Ivoclar Vivadent). The specimens with the volume of
JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY 3
Table 1. Materials used in this study.
Material Brand Composition Manufacturer
Lithium disilicate ceramic IPS e.max Press Silicon dioxide, lithium oxide, Ivoclar Vivadent, Schaan,
potassium oxide, phosphorus Liechtenstein
pentoxide, zirconium dioxide,
zinc oxide
Hydrofluoric acid Porcelain etchant 9.5 % buffered hydrofluoric acid Bisco, Schaumburg,
IL, USA
Silane coupling agent Monobond-S Silane, acetic acid, Ivoclar Vivadent, Schaan,
ethanol, water Liechtenstein
Dual-cure resin cement Duo-Link Powder: glass powder, silica, Bisco, Schaumburg,
calcium hydroxide, pigment, IL, USA
substituted pyrimidine,
peroxy compound, initiator
Liquid: methacrylated
phosphoric ester,
dimethacrylate, acetate,
stabilizer, initiator
10.0 7.0 10.0 mm3 were prepared in the dental laboratory. The top surfaces of the
specimens were serially polished with 320, 400, and 600-grit silicon carbide (SiC)
paper. Subsequently, they were etched with 9.5% HF acid for 20 s, rinsed for 30 s with a
water spray, and air-dried for 15 s. They were randomly classified into five experimen-
tal groups (n ¼ 2) according to the cleaning procedures and the timing of silane treat-
ment as shown in Figure 1.
1. Group S: silane treatment (control group).
2. Group SCU: silane treatment, saliva contamination, and ultrasonic cleaning.
3. Group SCA: silane treatment, saliva contamination, and air-water spray cleaning.
4. Group CUS: saliva contamination, ultrasonic cleaning, and silane treatment.
5. Group CAS: saliva contamination, air-water spray cleaning, and silane treatment.
Human saliva was collected from a single donor. Before collecting the saliva, the
teeth were brushed and rinsed with water. The donor was refrained from eating and
drinking for 2 h prior to saliva collection [13]. The donor was asked to chew wax to
stimulate salivation, and saliva was collected in a disposable test tube. The procedure
for cementation is outlined below:
1. Saliva contamination: all specimens except those of group S (control) were
immersed in the collected saliva for 60 s.
2. Air-water spray: saliva-contaminated surfaces of specimens of group SCA and
CAS were washed with water using a three-way syringe for 20 s.
3. Ultrasonic cleaning: saliva-contaminated surfaces of specimens of group SCU and
CUS were cleaned with 70% ethanol for 1 min in an ultrasonic bath (Soniclean
160HT; Soniclean Pty Ltd., Thebarton, Australia).
4. Silane treatment: silane-coupling agent was applied using a microbrush for 60 s
and dried for 10 s with warm air in all experimental groups.
The resin cement was manipulated according to the manufacturer’s instructions,
applied to the silane-treated ceramic surface using silicon mold. The thickness of each
4 H.-J. KIM ET AL.
Figure 1. Classification of experimental groups. Each upper-case letter in the group name is the
abbreviation of the following. S: silane-coupling agent; C: contamination with saliva; U: ultrasonic
cleaning; A: air-water spray cleaning.
increment was about 2 mm, and a total of 10 mm thickness resin cement layer was
formed. Each increment was light-cured for 20 s using a light-curing unit (Bluephase;
Ivoclar Vivadent) with an intensity of 1100 mW/cm2. The specimens were stored in
distilled water at 37 C for 24 h.
Micro-tensile bond strength (lTBS) test
Each ceramic-resin cement bonded specimen was sectioned perpendicular to the
bonded surface to obtain ceramic-resin beams with a surface area of 1 1 mm2 using
high-speed diamond saw (IsoMet 5000; Buehler, Lake Bluff, IL, USA) under continu-
ous water cooling. The sectioned specimens (n ¼ 24) in each group were immersed in
distilled water at 37 C for 24 h. Each beam was fixed to the lTBS jig with cyanoacryl-
ate adhesive (Zapit; Dental Ventures of America, Corona, CA, USA). lTBS was meas-
ured using a universal testing machine (AGS-X; Shimadzu, Tokyo, Japan) at a
crosshead speed of 1 mm/min until bond failure. The obtained data were converted to
MPa using Trapezium-X software (Shimadzu).
Failure mode analysis
The debonded surfaces of specimens were examined under an optical microscope
(Sunny, Shanghai, China) at 40 magnification to determine the failure mode. Each
sample was classified into one of the three failure modes: adhesive failure that occurred
JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY 5
at the interface between the ceramic and the resin cement; cohesive failure that frac-
tured the ceramic or the resin cement; and mixed failure, which involved both adhesive
and cohesive failure [9].
Contact angle measurement
Three LS2 discs with the volume of 10.0 7.0 2.0 mm3 were fabricated (IPS e.max
Press) in the dental laboratory, and serially polished with 320, 400, and 600-grit SiC
papers for each experimental group. Additionally, two groups were added: non-treated
(positive control) and HF acid etch (negative control). The same procedures were per-
formed as for the lTBS test. Distilled water of 10 lL was applied to the prepared sur-
face of the specimens. Followed by equilibration, the contact angle was measured using
a contact angle meter (Phoenix 10 Contact Angle Tester; SEO, Suwon, Korea) and the
Surfaceware 8 software. The contact angle of the water droplet was calculated by aver-
aging the contact angles of the left and right sides.
Spectrometry for salivary protein quantification
Three LS2 discs were fabricated in each group by following the same procedure as for
the lTBS test. The top surfaces of the specimens were treated as per the respective pro-
tocols for each experimental group. They were stored in distilled water at 37 C for
24 h. Specimens were incubated in 1 mL of 1 TBST buffer (20 mM Tris, pH 8.0,
170 mM NaCl, and 0.05% Tween-20) overnight with continuous rocking. Samples were
vigorously mixed for 1 min, the supernatants were collected, and 200 lL of the super-
natant material was added to 800 lL of the Bradford reagent to detect the proteins.
Surface-attached salivary protein concentration was determined using the Bradford
assay (BioRad, Hercules, CA, USA).
Field emission-scanning electron microscope (FE-SEM) analysis of the LS2 surface
Twelve LS2 discs with the volume of 10.0 10.0 4.0 mm3 were fabricated in the den-
tal laboratory, and serially polished with 320, 400, and 600-grit SiC papers. These
discs were divided into six groups according to different methods of treatment; (1) no-
treatment, (2) HF acid etch, (3) HF acid etch and silane treatment, (4) HF acid etch
and saliva contamination, (5) HF acid etch, saliva contamination, and ultrasonic clean-
ing, and (6) HF acid etch, saliva contamination, and air-water spray cleaning. For FE-
SEM analysis, all the specimens were treated according to the method suggested by
Perdigao et al. [14] and were examined using the FE-SEM (S-4800; Hitachi High
Technologies Co., Tokyo, Japan).
Statistical analysis
The results of lTBS test and contact angle measurements were analyzed with Kruskal-
Wallis analysis and Bonferroni correction (a ¼ 0.05). Weibull statistical analysis (R software
3.6.2) was used to describe the result of lTBS test. Results of salivary protein quantification
6 H.-J. KIM ET AL.
Figure 2. Micro-tensile bond strength of the experimental groups. p < 0.05 compared to the
S group; †p < 0.05 compared to the SCU group.
were analyzed with Kruskal-Wallis analysis. The statistical analysis was performed using
SPSS software ver. 19.0.0 (IBM Corp., Armonk, NY, USA) and R software ver. 3.6.2.
Results
Micro-tensile bond strength (lTBS) test
Figure 2 shows the lTBS values of all the experimental groups. There were 4, 6, 6, and
5 pre-testing failures during specimen cutting in the group SCU, SCA, CUS, and CAS,
respectively. Both saliva contamination and silane treatment timing significantly
affected the bond strength (p < 0.05). Group S showed the highest bond strength
among all the experimental groups (p < 0.05). Group SCU showed a significantly
higher bond strength than group CUS and CAS (p < 0.05). However, cleaning methods
did not significantly affect the bond strengths (p > 0.05). According to the Weibull dis-
tribution analysis, survival plot of lTBS test is presented at Figure 3.
Failure mode analysis
Failure mode distributions of all the experimental groups are shown in Figure 4. Group
S and SCU revealed predominant cohesive failures in the resin cement, while the other
experimental groups revealed predominant adhesive and cohesive failures in the
resin cement.
The contact angle measurement
Figure 5 shows contact angle values of all the experimental groups. The contact angle
of the ceramic surface significantly decreased after HF acid etch (p < 0.05). Silane treat-
ment significantly increased the contact angle (p < 0.05). However, there was no
JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY 7
Figure 3. Survival plot of different silane treatment time and cleaning methods. The points in
graph mean empirical cumulative distribution and the lines mean the fit Weibull distribution.
Figure 4. Distribution of failure modes.
significant difference among saliva contamination, silane treatment timing, and clean-
ing method (p > 0.05).
Spectrometry for salivary protein quantification
The amounts of salivary proteins in all the experimental groups are shown in Figure 6.
Group CAS showed the highest amount of protein on the LS2 surface (p < 0.05). There
were no significant differences among the other four groups (p > 0.05).
8 H.-J. KIM ET AL.
Figure 5. Evaluation of contact angle measurement. p < 0.05 compared to the control group
without HF acid etch (e.max); p < 0.05 compared to the control group without HF acid etch
(e.max) and the group with HF acid etch (e.max þ HF).
FE-SEM analysis of the LS2 surface
The representative FE-SEM images of the LS2 surfaces are shown in Figure 7. The
untreated LS2 surface was covered with smear layer (Figure 7(A,B)). After HF acid
etch, the LS2 matrix dissolved and distinct sharp crystals were exposed (Figure
7(C,D)). Silane treatment partly covered the LS2 surface, and the sharp crystals were
not visible (Figure 7(E,F)). After saliva contamination, some cocci-like bacteria and
other precipitates were observed [15] (Figure 7(G,H)). They were almost completely
removed after ultrasonic cleaning (Figure 7(I,J)). However, air-water spray cleaning
was less effective than ultrasonic cleaning, and some bacteria and precipitates remained
on the LS2 surface (Figure 7(K,L)).
Discussion
Contamination by saliva, blood, and gingival fluid is a major concern during the
cementation of ceramic restorations, particularly when the margin of the restoration is
close to the gingiva. Such contamination could adversely affect the bonding of restora-
tions, which might result in micro-leakage and ultimately, loss of the restoration [8,16].
This study evaluated the effect of silane treatment timing on the lTBS to saliva conta-
minated LS2 ceramic. Silane treatment timing affected lTBS, but cleaning methods did
not. Thus, null hypothesis was partlay rejected.
Saliva is composed of a variety of electrolytes, immunoglobulins, proteins, and
enzymes [17]. These components generally exist in small amounts, because saliva is a
very dilute fluid that is composed of more than 99% water. Saliva contamination of the
restoration during try-in procedure might form a protein layer on its surface.
JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY 9
Figure 6. Bradford assay for protein quantification on the surface of lithium disilicate ceramics of
the experimental groups. p < 0.05 compared to the other groups.
Figure 7. Representative FE-SEM images of LS2 surfaces. (A) 5000, (B) 15,000 with no-treat-
ment; (C) 5000, (D) 15,000 with HF acid etch; (E) 5000, (F) 15,000 with HF acid etch and
silane treatment; (G) 5000, (H) 15,000 with HF acid etch and saliva contamination; (I) 5000,
(J) 15,000 with HF acid etch, saliva contamination, and ultrasonic cleaning; (K) 5000, (L)
15,000 with HF acid etch, saliva contamination, and air-water spray cleaning.
Physicochemical interactions between a solid substrate (such as a ceramic restoration)
and saliva can cause the deposition of a supra-molecular protein assembly (proline-rich
protein) on the substrate [18,19].
Various cleaning methods have been introduced to remove saliva components from
LS2 surface. A recently developed universal cleaning paste, Ivoclean (Ivoclar Vivadent),
is reported as an effective agent for decontamination of ceramics [20]. It mainly con-
tains alkaline suspension of zirconium oxide particles and 70% isopropanol. Its efficacy
in cleaning saliva-contaminated zirconia ceramics has been proved [21], although its
effect on bond strength of LS2 is not entirely clear [22,23].
HF acid etch of LS2 increases the surface energy and hydrophilicity. Hence, a simple
cleaning process (e.g. using an air-water spray) might not be sufficient to remove saliv-
ary proteins [16], which was also confirmed in the FE-SEM analysis (Figure 7(K,L)). In
this study, the lTBS between LS2 and resin cement was affected by the silane treatment
10 H.-J. KIM ET AL.
timing. Group SCU and SCA showed higher bond strength than group CUS and CAS.
It implies that silane treatment immediately after HF acid etch is the most important
step in achieving optimum bond strengths.
Silane is commonly used to enhance the strength of the resin-ceramic bond [24].
Silane treatment leads to formation of covalent and hydrogen bonds on the surface of
HF acid-etched ceramic, which enhances the bond strength of the silica-based ceramic
[25,26]. In this study, silane treatment prior to saliva contamination resulted in a sig-
nificant higher bond strength than that after saliva contamination did, irrespective of
the cleaning methods. This result suggests that silane treatment reduces the risk of sal-
iva contamination by increasing hydrophobicity. However, when saliva contamination
occurs before silane treatment, the salivary proteins may adhere to the ceramic surface,
which adversely affects formation of bonds between the silane and ceramic [27].
There have been some studies that evaluated the effect of saliva contamination
and cleaning methods of LS2 ceramic. One study evaluated three cleaning methods
(water spray, sodium hypochlorite, and cleaning paste) after saliva contamination
and reported that all the methods were not effective to increase bond strength
[11]. The results are consistent with those of our study, considering that micro-
tensile bond strength of group CUS and CAS was not significantly different.
Lyann et al. reported that HF acid and silane treatment produced high bond
strength of LS2 regardless of saliva contamination [9]. This result is also similar
to this study. Lapinska et al. reported that HF acid re-etching after saliva treat-
ment was most effective method [10]. They also used TOF-SIMS to evaluate
chemical composition of the saliva-contaminated LS2 surface. However, its results
did not directly related to bond strengths. Yoshida K reported similar findings to
this study [12]. Besides water-spray treatment, most of surface treatment methods
were effective after saliva contamination in his study. An interesting finding was
that there was an experimental group in which specimens were treated with silane
before saliva contamination and just dried with air after contamination. It did not
show significant result compared with other treatments after saliva contamination.
In our study, saliva contamination after silane treatment was less effective in bond
strength reduction than before silane treatment. It was reported that silane layer
to HF acid-etched ceramic have a resistance to saliva contamination [16].
Failure mode analysis also proved the importance of silane treatment timing. Group
S and SCU showed predominant cohesive failure in the resin cement. It indicates that
the chemical interaction between LS2 and silane was more stable than that between
silane and resin cement. On the contrary, adhesive and cohesive failures in the resin
cement were predominant in groups SCA, CUS, and CAS. It implies that saliva con-
tamination before silane treatment adversely affects the chemical interaction between
silane and LS2, thus reducing bond strength.
Contact angle measurement revealed that HF acid etch and silane treatment influ-
enced the contact angle, which were in agreements with previous studies [7,28]. The
contact angle drastically decreased after HF acid etch. In contrast, saliva contamination,
the timing of silane treatment, and the cleaning method did not significantly affect the
contact angle. These results suggest that the effect of saliva contamination on the con-
tact angle is negligible because silane treatment renders the surface hydrophobic,
JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY 11
irrespective of the presence of contamination. Yoshida et al. reported similar results to
this study [28]. In their study, water rinsing of saliva-contaminated LS2 showed lower
surface energy than non-contaminated LS2.
To quantify protein level on the saliva-contaminated LS2 surface, the Bradford assay
was used in this study. Overnight incubation method was utilized to increase the pro-
tein recovery rate because the amount of salivary proteins in the normal saliva is less
than 0.5% [29]. To detach salivary proteins from LS2 specimens, acetone precipitation
and mechanical rocking were utilized. The attached salivary protein level was highest
in group CAS and lowest in group SCU. Contaminated ceramic surface might retain
more salivary proteins on the surface, which can also result in a reduction in bond
strength. Previous two studies have tried to identify the salivary proteins with X-Ray
photoelectron spectroscopy (XPS) [9] and time-of-flight secondary ion-mass spectros-
copy (TOF-SIMS) [10]. XPS can usually reveal the intensity of specific atoms, which
are a component of salivary protein but cannot quantify these atoms. However, TOF-
SIMS can quantify specific chemical structures regarded as salivary protein compo-
nents. It is more accurate than XPS, wherein analytic errors, the so-called artifacts that
can cause misunderstanding of analysis might occur due to several reasons.
In FE-SEM analysis, glass matrix was removed from the LS2 surface by HF acid etch.
The surface of LS2 becomes hydrophilic , so that it is susceptible to saliva contamin-
ation. Once it is contaminated by saliva, salivary components partly cover its surface
and adversely affect adhesion. Other cleaning methods are necessary for their efficient
removal. Ultrasonic cleaning was more effective in contaminant removal than air-water
spray cleaning. It is due to the fact that the effect of tremendous, high-frequency vibra-
tions is enough to detach salivary contaminants from LS2 surface. The result of FE-SEM
was identical to that of salivary protein quantification. However, there was no signifi-
cant difference in lTBS between the two cleaning methods (group CUS and CAS). A
possible explanation could be that another factor that could adversely affect bond
strength after contaminant removal existed, although it was not revealed in this study.
This study confirmed that saliva contamination prior to silane treatment on LS2 cer-
amics could result in increased salivary contaminant adsorption and decreased bond
strength. Within the limitation of this study, cleaning methods produced different
results according to the surface conditions of LS2. Silane treatment before saliva con-
tamination could reduce the effect of saliva contamination regardless of cleaning meth-
ods. Although this study evaluated these two cleaning methods, further researches
should focus on evaluating other cleaning methods for more stable adhesion between
ceramic and resin cement.
Clinical relevance
Considering the increasing popularity of all-ceramic restorations, more so LS2 restorations,
appropriate surface treatment is important for achieving stable bond strength. This study sug-
gests the ideal methods of minimizing saliva contamination that should be undertaken clinic-
ally. The results of this study will enhance the prognoses of LS2 restorations and extend their
longevity in the oral environment.
12 H.-J. KIM ET AL.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author contributions
All authors contributed to the study conception and design. Material preparation, data collec-
tion, and analysis were performed by Hyun-Jung Kim and Sehoon Kim. The first draft of the
manuscript was written by Hyun-Jung Kim, and all authors commented on the previous ver-
sions of the manuscript. All authors have read and approved the final manuscript.
Funding
This work was supported by the National Research Foundation of Korea (NRF) under Grant
[No. 2019R1F1A1057615] funded by the Korea government (MSIT).
ORCID
Hyun-Jung Kim http://orcid.org/0000-0002-7674-9363
Duck-Su Kim http://orcid.org/0000-0001-9386-6062
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