DENTIN BONDING AGENTS

Presented By
Dr. Sushmita Chakraborty
Dept. Of Conservative Dentistry And Endodontics
CONTENTS
 INTRODUCTION
 ROLE OF ADHESIVE DENTISTRY
 CONCEPT OF ADHESION
ENAMEL ADHESION
DENTINE ADHESION
CHALLENGES IN DENTINE ADHESION

 ENAMEL BONDING
STEPS FOR ENAMEL BONDING
MECHANISM INVOLVED
 DENTINE BONDING
CONDITIONING OF DENTINE
PRIMING OF DENTINE

 DENTINE BONDING AGENTS

CLASSIFICATION
GENERATIONS OF BONDING AGENTS
FIRST GENERATION
SECOND GENERATION
THIRD GENERATIONS
FOURTH GENERATION
FIFTH GENERATION
SIXTH GENERATION
SEVENTH GENERATION
 ROLE OF MICROLEAKAGE
 BIOCOMPATIBILITY
 ANTIBACTERIAL PROPERTY
 CLINICAL FACTORS IN DENTINE ADHESION
 NEWER CLINICAL INDICATIONS OF DENTINE
ADHESIVES
DESENSITISATION
ADHESIVE AMALGAM RESTORATIONS
INDIRECT ADHESIVE RESTORATIONS

 FAILURES IN DENTINE BONDING

 SUMMARY
 BIBLIOGRAPHY
 INTRODUCTION

 There is much interest and activity in dentistry today with dentin

bonding agents.
 In the modern society, aesthetics has become a major concern for
every individual .Thus most of us desire for a perfect set of teeth.

 Therefore, teeth that have been deformed or ravaged by dental

diseases need to be restored to their natural form and colour.
 Moreover, the classic concepts of tooth preparation advocated in the early
1900s have changed dramatically.
 Now more focus is laid upon conservative approach to the
tooth preparation.

 Therefore the introduction of adhesive restorative materials has

reduced
the need for an extensive tooth preparation.

 In order to successfully accomplish this, dentin bonding systems have

been introduced which bond the composite resin to the tooth structure.
 DEFINITION
 Adhesion is derived from Latin meaning "a state in which two surfaces
are held together by interfacial forces like valence forces or interlocking
forces or both".

(The American Society for Testing and Materials)

 Thus for the process of adhesion to occur , we need to understand the
role of following components:

 ADHESIVE

 ADHEREND

 ADHESIVE STRENGTH
 ADHESIVE is defined as a material , frequently a viscous
fluid that joins two substrates together by solidifying , resisting
separation & transferring a load from one surface to the other.

 ADHEREND is defined the surface to which an adhesive

adheres.
 ADHESIVE STRENGTH is the measure of the load-bearing capacity of
an adhesive joint.
 Therefore the development of resin based restorative material has
opened new direction to a more conservative approach to caries
management.
MECHANISM OF
ADHESION:

MECHANICAL

ADSORPTION
COMBINATION

DIFFUSION
INDICATIONS FOR ADHESIVE DENTISTRY

 Restoration of class 1,2,3,4,5,6 carious lesions

 Change the shape & colour of anterior teeth(using full or partial
veneer )
 Seal pits and fissures
 Bond orthodontic brackets
 Desensitize exposed root surfaces
 Bond amalgam restorations to tooth
 Bond fractured segments of anterior teeth.
 Bond pre-fabricated fibre or metal posts and cast posts.
 Seal root canals during endodontic therapy.
 ENAMEL

ADHESION
In 1955,Michael Buonocore described a clinical technique that used a diluted phosphoric
acid to etch the enamel surface to provide retention of unfilled, self-cured acrylic resins.

 The resin would mechanically lock to the microscopically roughened enamel surface,
forming small "tags" as it flowed into the 10-µm to 40-µm deep enamel microporosities and
then polymerized.

 The first clinical use of this technique was the placement of pit and fissure sealants.

 The formation of resin micro tags within the enamel surface is the basis of RESIN-ENAMEL
ADHESION.
 The steps involved are:
 Acid etching transforms smooth enamel into an irregular surface & increases its free
surface
energy

 Application of a fluid resin based material to the irregular etched surface ,

facilitates penetration of the resin into the surface aided by capillary action

 Monomers in the material are polymerised and the material becomes interlocked with
the enamel surface.
 ETCH PATTERN

 Enamel etching leads to the following types of micro morphological

patterns:

 TYPE 1 ETCH PATTERN-dissolution of prism cores without involvement of

prism peripheries.
 TYPE 2 ETCH PATTERN-PERIPHERAL ENAMEL IS DISSOLVED , but
the cores are left intact.
 TYPE 3 ETCH PATTERN-it is less distinct than the other two patterns.
 ETCHANT CONCENTRATION
 Buonocore used 30-40% phosphoric acid.

 Currently,37% phosphoric acid in gel form is used.

 Silverstone found that the application of 30-40% phosphoric acid
resulted
in a very retentive enamel surface.
 >40% - Calcium salts are less dissolved - ETCH patterns with
poorer definition.

 <27% - Formation of dicalcium phosphate dihydrate -

cannot be easily removed by rinsing.
 ETCH TIME

 Currently, an etching time of 15 seconds is used.

 An etching time of 60 seconds originally was recommended for

permanent enamel using 30-40% phosphoric acid.

 However , studies show that a 15 second etch resulted in a

similar surface roughness as that provided by a 60 second etch.
Phosphoric acid is said to be a more aggressive acid,so alternative etchants have
been suggested:
 EDTA (24%; ph=7)
 Citric acid
 Tannic acid
 Maleic acid
 Polyacrylic acid

ALTERNATE ETCHANT SYSTEMS:

 Lasers
 Air abrasion-Al2O3 particles
BOND STRENGTH

 Shear bond strength of composite to phosphoric acid etched

enamel exceeded 20 Mpa.

 According to studies,a minimum of 17-21MPa of bond strength is

needed to prevent the disruption of the bond between the tooth and
composite.
 DENTIN
ADHESION
 Bonding to dentin is challenging & difficult.
 Adhesion to dentin occurs by mechanical method,chemical or both.

 But the main method is by penetration of adhesive monomers into

collagen
fibrils which are exposed post acid etching.
 Structural differences exist between enamel & dentin.

 Therefore the following reasons account for challenges faced in dentin

adhesion:
 STRUCTURE OF DENTIN
 SMEAR LAYER
 STRESSES AT RESIN-DENTIN INTERFACE
 STRUCTURE OF DENTIN

 Enamel contains 90% of hydroxyapatite crystals whereas dentin has only

50% and the rest is constituted by water(25%) and type I collagen(25%
by volume).

 Dentinal tubules exert pressure of 25-30mmHg, thus creating

decreased stability of bond between composite resin and dentin.

 The number of dentinal tubules decreases from about 45000 near the
pulp to 20000 near DEJ
 Also the tubule diameter decreases from 2.37µm to 0.63µm near DEJ.
 Adhesion can also be affected by remaining dentin thickness(RDT) as
bond strength is greater for superficial dentin and its lesser for deeper
dentin
WHAT IS SMEAR LAYER?

 It is the residual organic or inorganic components formed when a tooth

is prepared using a bur or other instrument.
(Sturdevant’s Art & Science of operative dentistry,4th edition)

 It is 1-10 µm thick .
 COMPOSITION OF SMEAR LAYER:

 According to SEM studies done by Shulien TM(1988),it consists of:

 Small particles of mineralized collagen matrix
 Inorganic tooth preparation
 Saliva
 Blood
 Bacteria

 According to branstroem,the organic component consisted of

coagulated proteins from collagen denatured by frictional heat of
cutting.
 Therefore optimal bonding can occur
by:

A. Removal of smear layer by using etch and rinse adhesives.

B. Incorporation of smear layer into bonding layer by self-etch adhesives

Complete removal of smear layer increases the dentin permeability by
90%.
 STRESSES AT THE RESIN-DENTIN INTERFACE:

 As composites polymerize,shrinkage occurs leading to stresses

upto 7MPa.
 When the composite is bonded only to one surface,stresses are
relieved by flow from the unbonded surface.
 Davidson et al. postulated that minimum bond strength of 17-20 MPa to
enamel and dentin is needed to resist contraction forces of resin
composite materials.
 In the present study, both the self-etching adhesives showed
optimal bond strength values greater than 20 MPa for both
uncontaminated and contaminated dentin.
 DENTINE BONDING
 ItAGENTS
is defined as ”a thin layer of resin applied between conditioned dentin and resin
matrix of a composite.”
 The term dentine bonding agents is no longer relevant as current bonding agents
bond to enamel and dentine.

 Due to the differences in the composition of enamel and dentine,developing

agents that will adhere to dentine was challenging due to the following reasons:

 The high water content interferes with bonding.

 Presence of a smear layer on the dentine surface.
 Therefore the bonding agent should be hydrophilic to displace the water
,permitting it to penetrate the porosities in dentine and react with
the inorganic/organic components.

 But, restorative resins are hydrophobic, therefore the bonding agent

should
contain both hydrophilic and hydrophobic components.

 The hydrophilic part bonds with either calcium or collagen whereas

the hydrophobic part bonds with the restorative resin.
 CLASSIFICATION
1. HISTORICAL STRATEGIES
 FIRST GENERATION(1965)
 SECOND
GENERATION(1978)
 THIRD
GENERATION(1984)
2. CURRENT STRATEGIES
 ETCH & RINSE ADESIVES
i. THREE STEP-ETCH
&RINSE
ADHESIVE(FOURTH
GENERATION)
ii. TWO STEP –ETCH &
RINSE ADHESIVE(FIFTH
GENERATION)
 SELF ETCH ADHESIVES
 TWO COMPONENT –
 BASED ON THE TREATMENT OF SMEAR LAYER:

 Smear layer modifying

 Smear layer removal
 Smear layer dissolving
 Most products use a three-component system consisting of a conditioner, primer, and
adhesive.

 1. CONDITIONER (CLEANSER, ETCHANT) –

 weak organic acid (e.g., maleic acid),
 a low concentration of a stronger inorganic acid (e.g., phosphoric or nitric
acid)
 a chelating agent (e.g., EDTA).
 MAIN ACTIONS:

 Alters or removes the smear layer.

 demineralizes peritubular and intertubular dentin

 exposes collagen fibrils --demineralizes up to a depth of 7.5

microns.

 peritubular dentin is etched more deeply than the intertubular

dentin increases dentin permeability.
 PRIMER

 bifunctional monomer in a volatile solvent such as acetone or

alcohol

 examples of HEMA (hydroxyethyl methacrylate),

NMSA (N-methacryloyl-5- aminosalicylic
acid), NPG (N-phenylglycine),
PMDM (pyromellitic diethylmethacrylate), and
4-META (4- methacryloxyethyl trimellitate
anhydride).
 MAIN ACTIONS:

 Links the hydrophilic dentin to the hydrophobic restorative resin

 Promotes infiltration of demineralized peritubular and intertubular

dentin

 increases wettability of the conditioned dentin surface

 ADHESIVE (Unfilled RESIN):

 It is an unfilled or partially-filled resin; may contain some component of the primer

(e.g., HEMA) in an attempt to promote increased bond strength.

 MAIN ACTIONS:

 Combines with the primer monomers to form a resin-reinforced hybrid layer

( resin-dentin
interdiffusion zone ) 1 to 5 microns thick.

 Forms resin tags to seal the dentin tubules

FIRST GENERATION DENTIN BONDING AGENT

 It consisted of surface active co-monomer NPG-GMA(N-

phenylglycine glycidyl methacrylate)

 MECHANISM OF ACTION:

 This co-monomer could chelate with calcium on the tooth surface

to generate chemical bonds of resin to calcium.

 Example:
 Cervident(S S White ,Lakewood,NJ)
 Clinical result:

 It had poor bond strength of 2-3MPa.

 Therefore when used to restore noncarious cervical lesions
without mechanical retention.
SECOND GENERATION DENTIN BONDING
AGENT:

 Introduced in 1978.
 They were based on phosphate ester material (Phenyl-P hydroxyethyl
methacrylate [HEMA] in ethanol).
 MECHANISM OF ACTION:

 Adhesion was by means of polar interaction between the negatively charged

phosphate groups in the resin & positively charged calcium in the smear layer
 Bond strength was 1-5 Mpa

 Disadvantage:
 Clinical failure due to the bonding instability in the wet oral environment & their
primary bonding to the smear layer and not the dentin.
 EXAMPLES:

 Clearfil Bond System(Kuraray,Japan)

 Scotchbond(3M ESPE)
 Bondlite(Kerr Corporation.CA)
 Prisma Universal Bond(Dentsply)
THIRD GENERATION BONDING AGENT:

 The concept of phosphoric acid etching of dentin before the application of a

phosphate ester type of bonding agent was put forward by FUSAYAMA et al in
1979

It was a phosphate based material containing HEMA and a 10-

carbon molecule 10-MDP(10-methacryloyloxy decyl dihydrogen
phosphate)
 These were introduced with Clearfil New Bond in 1984 by Kuraray.
 Mechanism Of Action

 Most of the other III generation bonding agents were designed not to
remove the smear layer but only to modify it and therefore allow the
penetration of acidic monomers like pheny-P or PENTA(dipentaerythritol
penta-acrylate monophosphate)

 EXAMPLES:

 Clearfil New
Bond(Kuraray)
 Scotchbond 2(3M ESPE)
CURRENT STRATEGIES FOR RESIN-DENTIN
BONDING

1. ETCH AND RINSE ADHESIVE:

The smear layer is considered to be an obstacle that must be removed
to permit resin bonding to dentin.
The next generation of dentin adhesives was introduced for use on
acid – etched dentin.

The clinical technique involves simultaneous application of an acid to

enamel
& dentin.This was called as total-etch technique.
 MECHANISM OF ACTION:
application of acid to dentin results in complete or partial removal of smear layer
and
demineralization of dentin

Intertubular & peritubular dentin are demineralised,thus exposing collagen fibres &
increasing
microporosity of intertubular dentin

7.5µm of dentin is demineralised

Primer increases the free surface energy of

dentin Formation of resin tags and hybrid

layer.
THREE STEP:ETCH&RINSE
ADHESIVES(FOURTH GENERATION)

IT CONSISTS OF

ETCHANT PRIMER ADHESIVE

 Here three components came into
being:
 Phosphoric acid etchant(in gel form)
 Primer –it consisted of hydrophilic monomers in ethanol , acetone or
water.
 Primer is a bifunctional molecule having a hydrophilic and a hydrophobic
part.the former attaches to tooth whereas the latter attaches to
composite resin.
 Examples:HEMA
NTG-GMA
PENTA
 Bonding agent:

 It consists of unfilled or filled resin which may be BisGMA(Bisphenol

glycidyl methacrylate),UDMA(urethane dimethacrylate) with TEGDMA
& HEMA(2-hydroxyethyl methacrylate).

 Thus after the application of primer and bonding agent to etched surface
aids in their penetration into intertubular dentin to form a resin-dentin
inter diffusion zone called HYBRID LAYER which was introduced by
Nakabayashi in 1982.
 ADVANTAGES:

 Higher bond strength of 17-30MPa.

 They show reliable and consistent results.

 DISADVANTAGES:

 Etching did not result inn significant

improvement of bond strength because of the
hydrophobic nature of the phosphonated resin
 Application of acid to dentin might trigger
inflammatory pulpal response
• BRAND NAMES-

• All Bond 2 & All Bond 3

• Optibond FL(Kerr Corporation)
• Scotchbond Multi-purpose(3M ESPE)
 CLINICAL STEPS INVOLVED:

 STEP1:application of etchant gel(37% phosphoric acid) for 15

seconds .
 STEP2:rinse the etchant thoroughly
 STEP3:application of primer on the substrate.
 STEP4:application of adhesive on the tooth substrate.
 STEP5: light cure .
 WHAT IS HYBRID LAYER?

 DEFINITION
 “The structure formed in the dental hard tissue by demineralization of
the surface and the sub-surface followed by infiltration of monomers &
subsequent polymerization.”
( Nakabayashi,1982)

 It is a hybrid combination of the above two. It is a process which creates

a
molecular level interfacebetween dentin and composite resin.
 ZONES

TOP LAYER MIDDLE LAYER BASE

TOP LAYER :loosely arranged collagen fibrils directed towards adhesive resin.
MIDDLE LAYER: collagen fibrils separated by electron lucent spaces(10-20nm)
represent areas in which HA crystals have been replaced by resin due to
hybridization.
BASE : partially demineralized dentin.
TWO STEP :ETCH & RINSE ADHESIVES (FIFTH
GENERATION)

 This was developed to simplify the procedures involved in bonding.

 Therefore , the primer and the bonding agent is present in a single

bottle,so called as ‘One Bottle’ systems
 COMPONENTS:

 ETCHANT GEL + PRIMER & ADHESIVE

 STEPS INVOLED
ARE:
 STEP1:application of etchant gel.
 STEP2:rinse the etchant thoroughly
 STEP3:application of primer and adhesive (single bottle)
 STEP4:light cure .

 BRAND NAMES:
 One step plus
 Adper single bond Plus
 Bond 1
 One coat Bond
 SELF-ETCH ADHESIVES
 These acidic primer include a phosphonated resin molecule that performs
two functions simultaneously-etching and primig of dentin and enamel.

 No separate etching step is needed.

 ADVANTAGES:

 Decrease in the number of steps

 Less technique sensitive.
  The bonding mechanism of SEPs is based on the simulatanoeous
etching and priming of enamel and dentin,forming a continuum in the
substrate and incorporating smear plugs into the resin tags.

 The elimination of rinsing and drying steps reduce the possibility of overwetting or overdrying,
either of which can affect adhesion adversely

 Water is always a component of SEPs because it is needed for the acidic monomers to ionize
and trigger demineralization of hard dental tissues this makes SEPs less susceptible to variations in
the degree of substrate moisture
 Disadvntage
 They do not etch enamel as well as phosphoric acid,particularly if the enamel has not been instrumented
 The seal of enamel margins in vivo might be compromised

 Because they are user friendly and do not reqire the etching and rinsing step, SEPs such as Clearfil SE Bond
Is popular
 Clearfil SE Bond contains an aquous mixture of a phosphoric acid ester monomer (10-MDP) with a ph
relatively higher than that of phosphoric acid etching gels(1.9-2).
 SEPs classified in three categories-mild ,moderate and aggressive,Clearfil SE Bond neing a mild SEP
 Mild SEPs tend to provede excellent dentin bond strength and poorer enamel bonds
whereas more aggressive self etch systems provide the reverse.

 SEPs are more accurately called as nonrinsing conditioners or self priming etchants and
are used with a one bottle adhesive as the bonding agent
 Ex- NRC(Non Rinse Conditioner and Tyran SPE and require the subsequent application of a separate adhesive
The same used with total etch technique
 SELF-ETCH ADHESIVES

2 COMPONENT SELF-ETCH 1 COMPONENT SELF-ETCH

ADHESIVES ADHESIVES
(VIGENERATI (VII GENERATION)
ON)

2 STEP & 2 COMPONENT I STEP BUT 2 COMPONENT

2 STEP & 2 COMPONENT

 Steps involved are:

 Application of bottle I(etchant +primer)

 After 10 s, application of bottle2 on tooth
surface
 Light cure

 BRAND NAMES:

 Clearfil SE Bond(Kuraray,Japan)
 AdheSE(Ivoclar-Vivadent)
 Optibond Solo Plus Self-etch(Kerr Corp)
2. ONE STEP:TWO COMPONENT-SELF-ETCH
ADHESIVE:

 consists of- BottleI +Bottle II

 Bottle I:conditioner +primer

 Bottle II: adhesive resin

 Both have to be mixed prior to application on tooth surface.

 BRAND NAMES:
 Xeno III(Dentsply)
 One up bond(Tokuyama)
 Prompt L bond(3M ESPE)
SEVENTH GENERATION(early 2000s):
(SELF-ETCHING ADHESIVES)

 Here the etchant, primer and the adhesive resin are combined into
one bottle .

 All In One adhesive contains uncured ionic material that contact the
composite restorative material directly.
 Their acidic unreacted monomers are responsible in part for the
incompatibility between these all in one adhesive and self cured
composite .
 All in one adhesive behave as semipermeable membranes resulting in
a hydrolytic degradation of the resin dentin interface
 ADVANTAGES OF VII GENERATION DENTIN BONDING AGENTS:

 Lesser application time

 Decrease in errors with each step.
 Examples
are:

 iBond(Heraeus
kulzer)
 G bond(GC)
 XenoIV(Dentsply)
 Clearfil S3(Curare)
 XenoV+
 iBond
COMPONENT FUNCTION

UDMA MATRIX COMPONENT

(urethane dimethacrylate) ETCHING & CONDITIONING OF ENAMEL & DENTIN
BONDING TO COLLAGEN VIA HYDROGEN
BONDING
BONDING TO CALCIUM IONS VIA CHELATION
COMPLEXES

4-META MATRIX COMPONENT

(4-methyloxyethyl trimellitic acid) CROSS-LINKING

WATER SOLVENT FOR MONOMERS

PROVIDES WATER FOR ETCHING

CAMPHORQUINONE PHOTOINITIATORS

GLUTARALDEHYDE DISINFECTANT/DESENSITIZER

STABILIZERS
How is iBond applied?

1. Isolate tooth from saliva contamination during adhesive procedure

2. Clean the tooth prepation,removing all debris with water.
3. Saturate the microbrush with iBond liquidfrom the bottle or single
dose
vial.
4. Apply 3 consecutive coats of iBond to enamel & dentin
5. Use gentle air pressure to remove excess solvent
6. Cure for 20s with curing light
7. Place the composite resin.
 Both the hydrophilic and the hydrophobic components are mixed in this system.
 Though this simplifies the clinical steps,it has following shortcomings:

 Due to the complex nature of this solution,they are more prone to phase separation.
 It forms droplets within the adhesive layer.
 This adhesive layer acts as a semi-permeable membrane permitting bi-directional
water
currents.

 Thus these bonding agents show much reduced bond strength when compared to
the fourth,fifth,and sixth generation of bonding agents.
 Advantages:

 Most time efficient application procedure.

 Unidose application,which prevents cross-
contamination.
 Simultaneous demineralisation & resin penetration.
 Less sensitivity to dentin wetness conditions.

 Disadvantages:

 Reduced shelf life.

 Less sealing capacity.
 Least bond strength.
 Incompatibility with auto/chemical curing composites.
 BASED ON THE TREATMENT OF SMEAR LAYER

SMEAR LAYER SMEAR LAYER SMEAR LAYER

MODIFYING REMOVAL DISSOLVING
 SMEAR LAYER

 It was first suggested by Skinner in

1961.

 Coined by Boyde in 1963.

 0.5-2µm thick, granular

 Smear plugs…1-10µm
WHY IS THE PRESENCE OF SMEAR LAYER
DETRIMENTAL TO BONDING?

 It is a weak attachment to dentin and is

brittle

 so it can be easily dislodged & prone to cohesive failure.

 Therefore to overcome this, etch & rinse adhesive was

developed.
 SMEAR LAYER REMOVAL

 DRAWBACK OF COMPLETE REMOVAL OF SMEAR LAYER:

Increases dentin permeability and flow of the dentinal

fluid

Thus diluting the bonding agent

 Examples:

 IV & V generation dentin bonding agents.

SMEAR LAYER MODIFYING

 Examples:

 II & III generation dentin bonding agents.

 Incorporation of smear layer inhibited proper bonding and resulted in

loss of bond strength.
 SMEAR LAYER DISSOLVING

 Self-etching adhesives dissolve and include the smear layer in

the hybridization process.
 MICROLEAKAGE

 DEFINITION
 It is the passage of bacteria and their toxins between
restoration margins and tooth preparation walls

 MECHANISM OF ACTION:

 The presence of gaps at the resin-dentin interface leads to

ingress of
bacteria.
 Therefore bonding the resin to a preparation with cavosurface margins
in enamel is the best way to prevent microleakage.

 Bacteria are able to survive & proliferate within the fluid filled marginal
gaps, thus leading to secondary caries.
 NANOLEAKAGE

 It is the small porosities in the hybrid layer or at the transition between

the hybrid layer and the dentin that allow the passage of particles of
silver nitrate dye.

 Penetration of ammoniacal silver nitrate results in two patterns:

 Spotted pattern-in the hybrid layer of self-etch adhesives due to

incomplete resin infiltration.
 Reticular pattern-that occurs in the adhesive layer due to incomplete
removal of water from the bonding area.
 NANOLEAKAGE UNDER ELECTRON MICROSCOPE.

Spotted pattern in the hybrid layer formed by one-step self-etch adhesive

Reticular pattern and water trees in adhesive layer formed by self etch
adhesive
ANTIBACTERIAL PROPERTY OF
DENTIN BONDING AGENTS

 The development of adhesive systems have enabled variable cavity

designs to preserve tooth structure and treatment of dental caries
has shifted from the traditional method to that with downsized
cavities.

 Inspite of considerable improvement in the recent years ,

polymerization shrinkage & the resultant contraction gaps in tooth
restoration interface continue to be a significant problem associated
with composite resin restorations.
 Thus cariogenic bacteria like Streptococcus mutans,Lactobacillus
acidophilus,Lactobacillus casei and Streptococcus salivarius can
invade along the microgaps and lead to secondary caries.

 Therefore it is imperial to provide resin based materials with

antibacterial activity.

 Also, acidic monomers like 10-MDP(10-methacryloyloxy decyl

dihydrogen phosphate) due to its inherent acidity has antibacterial
property.
BIOCOMPATIBILITY

 Biological testing of DBA is a delicate and complex process.

 Unlike most dental materials, many dentin bonding systems are made
up
of more than one material e.g. cleanser , primer , bonding resin etc.
1st generation.
• A very limited number of reports have been published on the
biocompatibility of the first generation. Which may be due to their
inferior physical properties.
• Van Leeuwen et al showed no severe reactions even in extremely
deep caries in their study.

2nd generation.
• Most studies are carried out using Scotch Bond.
• It might have a adverse effect on pulp tissue when placed
in contact with vital tooth and proper pulpal protection
was recommended.

3rd generation.
• Tests showed that the bonding material as well as the
individual components were toxic.
 CLINICAL FACTORS AFFECTING ADHESION

 Flow of saliva and/or blood contamination

 Moisture contamination from handpiece or air water
syringe
 Oil contamination of handpieces or air-water syringes
 Fluoride content of teeth
 Location and size of dentinal tubules
 Presence of plaque,calculus,extrinsic stains or debris
 Presence of bases or liners on prepared teeth
 Tooth dehydration
 Presence of residual intermediary cements
 CONCLUSION

 Intoday’s era, numerous improvements in materials and

procedures have been made to meet the growing aesthetic
demands of the patients.
 In all the aesthetic restorations a bonding step is
involved to ensure durability and reliability.
 Thus the ideal bonding system should be biocompatible,
bond perfectly to enamel and dentin, have sufficient
strength to resist to failure as a result of masticatory forces,
have mechanical properties close to those of tooth, and be
resistant to degradation in oral environment and easy to
use.
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 TEXTBOOK OF OPERATIVE DENTISTRY-SUMEETHA

SANDHU..1ST EDITION
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