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. 2012 Jan;15(1):4-18.
doi: 10.14295/bds.2012.v15i1.790.

Durable bonds at the adhesive/dentin interface: an impossible mission or simply a moving target?

Paulette Spencer  1 , Qiang Ye Jonggu Park  2 , Anil Misra  3 , Brenda S Bohaty  4 , Viraj Singh  1 , Ranga Parthasarathy  2 , Fábio Sene  5 , Sérgio Eduardo de Paiva Gonçalves  6 , Jennifer Laurence  7
Affiliations

Durable bonds at the adhesive/dentin interface: an impossible mission or simply a moving target?

Paulette Spencer et al. Braz Dent Sci. 2012 Jan.

Abstract

Composite restorations have higher failure rates, more recurrent caries and increased frequency of replacement as compared to dental amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and failure. The gingival margin of composite restora tions is particularly vulnerable to decay and at this margin, the adhesive and its seal to dentin provides the primary barrier between the prepared tooth and the environment. The intent of this article is to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface.

Keywords: Literature review; bonding; durability; integrity; interface dentin/restoration.

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Figures

Figure 1
Figure 1
Radiographic image of primary teeth on right side. a) The arrow denotes carious lesion on the proximal surface of mandibular right first primary molar. b) The arrow denotes the composite restoration on first primary molar. c) Radiographic image of primary teeth on right side, 2 years after figure 1b. The arrow denotes the failed class II composite restoration because of extensive decay.
Figure 2
Figure 2
Primary molar restored with posterior composite. Note staining at gingival margin indicating recurrent decay. Tooth was collected through protocol approved by the appropriate health sciences institutional review board.
Figure 3
Figure 3
X-ray micro-CT image of molar restored with composite restoration. Note dark region in proximity of gingival margin suggesting gap formation.
Figure 4
Figure 4
Three-dimensional plot of pH vs 13C NMR chemical shift (ppm) of the carbonyl group (C=O) from lactic acid (LA) in solutions titrated with increasing concentrations of HEMA or DMAEMA monomers. HEMA does not alter the pH of the 0.1 M LA solution, whereas increasing amounts of DMAEMA demonstrate obvious buffering and neutralization.
See this image and copyright information in PMC

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