A review of dentine-bonding agents and an account of clinical applications in paediatric dentistry

Abstract

The need for dental materials which bond to all hard tissues of the tooth is an obvious one. The technique of enamel acid etching has made adhesion to enamel possible. In addition, extensive research has allowed the development of dentine-bonding agents, materials that are claimed to bond to dentine. The first and second generation of these products, despite their early success and popularity, pose several problems, including a weak and unstable bond in the oral environment. During the last decade, a number of systems, known as the third generation of dentine-bonding agents, have been marketed. They base their bonding ability on the utilization of the organic part of a pre-treated dentine. In vitro studies have reported significantly higher bond strength, and reduced microleakage and marginal gap formation. Biocompatibility and toxicity studies have demonstrated no direct harmful effect on the pulp. Clinical trials have shown promising clinical performance. These products can offer treatment alternatives in paediatric dentistry; for example, for teeth affected by amelogenesis imperfecta or local hypoplasia, for anterior teeth extensively damaged by decay or trauma, and for teeth with hypersensitive dentine. However, the dentist should be cautious using these systems because, for most of the products, the permanence of the bond in the oral environment has not been extensively studied.