INTERNATIONAL JOURNAL OF ORAL-MEDICAL SCIENCES

Vol. 6 No. 2      DECEMBER - 2007

ISSN: 1347-9733      UBIC: 136-M

Abstract

Today, direct composite fillings have reached a satisfactory level, aesthetically and functionally, to replace decayed or lost tooth tissue. However, as the bond degrades with time, the restoration lifetime is limited, depending largely on the type of adhesive used. This review examines the processes involved in the adhesion of biomaterials to enamel and dentin. Contemporary adhesives are categorized upon ultra morphological, chemical and mechanical features, as well as clinical parameters. Apart from these properties, special attention is given to one step (self etch) adhesives, as they are aggressively marketed as the most user friendly adhesives. Nevertheless, in vitro research has revealed considerable shortcomings related to many of these simplified adhesives. Notwithstanding the amount of in vitro data available, non carious class V clinical trials remain the ultimate test method to assess clinical success. In combination with the prior in vitro assessment, the following conclusions were drawn: 1) At present, the three step etch&rinse approach remains the 'golden standard' in terms of bonding effectiveness; 2) Any kind of simplification in the application procedure results in loss of bonding effectiveness; 3) The today most acceptable trade-off between bonding effectiveness and case of use is a 'mild' two step self- etch approach that combines micro mechanical interlocking with additional chemical interaction, the latter definitely contributing to the bond stability on the long term. Keywords: dentin bonding, composite resin, glass ionomer, self-etching adhesive, one step adhesive.

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