Adhesion to Enamel and Dentin: Current Status and Future Challenges
SUMMARY
Bonding to tooth tissue can be achieved through an “etch&rinse,” “self-etch” or “glass-ionomer” approach.
In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological
and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore,
bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine “bonding effectiveness”
in the laboratory) are evaluated upon their value and relevance in predicting clinical performance.
A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device.
Eventually, today’s adhesives will be critically weightedupon their performance in diverse laboratory studies and clinical trials.
Special attention has been given to the benefits/drawbacks of an etch&rinse versus a
self-etch approach and the long-term performance of these adhesives.
Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness.
Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term.
Nevertheless, a self-etch approach may have the best
future perspective.
Clinically, when adhesives no longer require an “etch&rinse” step, the application
time, and probably more importantly, the techniquesensitivity are substantially reduced. Especially “mild,” two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional threestep systems in bonding performance.
Adhesion to Enamel and Dentin: Current Status and Future Challenges
SUMMARY
Bonding to tooth tissue can be achieved through an “etch&rinse,” “self-etch” or “glass-ionomer” approach.
In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological
and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore,
bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine “bonding effectiveness”
in the laboratory) are evaluated upon their value and relevance in predicting clinical performance.
A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device.
Eventually, today’s adhesives will be critically weightedupon their performance in diverse laboratory studies and clinical trials.
Special attention has been given to the benefits/drawbacks of an etch&rinse versus a
self-etch approach and the long-term performance of these adhesives.
Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness.
Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term.
Nevertheless, a self-etch approach may have the best
future perspective.
Clinically, when adhesives no longer require an “etch&rinse” step, the application
time, and probably more importantly, the techniquesensitivity are substantially reduced. Especially “mild,” two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional threestep systems in bonding performance.
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