Dental adhesion: mechanism, techniques and durability

Abstract

Contemporary dental adhesives show favorable immediate results in terms of bonding effectiveness. However, the durability of resin-dentin bonds is their major problem. It appears that simplification of adhesive techniques is rather detrimental to the long-term stability of resin-tooth interface. The hydrostatic pulpal pressure, the dentinal fluid flow and the increased dentinal wetness in vital dentin can affect the intimate interaction of certain dentin adhesives with dentinal tissue. Bond degradation occurs via water sorption, hydrolysis of ester linkages of methacrylate resins, and activation of endogenous dentin matrix metalloproteinases. The three-step etch-and-rinse adhesives still remain the gold standard in terms of durability. This review discusses the fundamental process of adhesion to enamel and dentin with different adhesive techniques, factors affecting the long-term bonding performance of modern adhesives and addresses the current perspectives for improving bond durability.