Extrafibrillar demineralization: Yes or no?

Objective Extrafibrillar demineralization is considered to be an ideal solution for addressing the durability of resin-dentin bonding interfaces. However, its theoretical basis is contradictory to ionization equilibrium of hydroxyapatite dissolution. In this study, various calcium chelators were selected as dentin conditioners to explore the essence of dentin demineralization with chelators and its effect on resin-dentin adhesion. Methods Polyethyleneimine grafted with EDTA and polyacrylic acid sodium (PAAN 450k ) larger than 40 kDa, as well as PAAN (PAAN 3k ) and EDTA smaller than 6 kDa, were prepared as dentin conditioners. The dentin powder was designed to characterize whether it would demineralize without contact with PAAN 450k . Dentin demineralization effect with four conditioners was evaluated with field emission scanning electron microscopy, transmission electron microscopy, X-ray photoelectron spectroscopy, atomic force microscopy and quantification of hydroxyproline concentration after enzymatic degradation. Micro-tensile bond strength (µTBS) test and failure mode analysis were employed to assess the bonding effect of the four chelators in both wet and dry bonding, with H 3 PO 4 wet bonding serving as the control group. Results Demineralization occurs when PAAN 450k was not in direct contact with the dentin powder. The extrafibrillar demineralization cannot be induced by any chelator regardless of its molecular weight. Complete demineralization including extrafibrillar and intrafibrillar demineralization would occur with sufficient interaction time. Moreover, chelators could not provide a reliable dentin bonding effect under a short interaction time. Significance From the perspective of theory and application, extrafibrillar demineralization is not a reliable strategy, which provides a reminder for exploring new strategies in the future.