Professional Documents
Culture Documents
The Science of Bonding: From First To Sixth Generation
The Science of Bonding: From First To Sixth Generation
CON
IO
N
N
U
IN
G
ED
ARTICLE 2
Background. Adhesive dentistry has revolutionized restorative dental practice during the past
30 years. Improved adhesive materials have made
resin-based composite restorations more reliable and
long-standing.
for us to examine the past. The principles of adhesive dentistry date back to 1955 when Buonocore,
using techniques of industrial bonding, postulated
that acids could be used as a surface treatment
before application of the resins.1 He subsequently
found that etching enamel with phosphoric acid
increased the duration of adhesion under water.
In 1963, Buonocore demonstrated his insight into
adhesion dentistry when he discussed the difference in bonding to enamel and to dentin,2 particularly when he referred to Dr. Bowens attempts to
investigate substances that will displace water
from tooth surfaces3 with the idea that they could
be used as pretreatment for enamel or dentin.
Buonocore then stated that they could even be
incorporated into the adhesives.2
In the late 1960s, Buonocore suggested that it
was the formation of resin tags that caused the
principal adhesion of the resins to acid-etched
enamel.4 The idea that resin penetrates the
microporosities of etched enamel and results in a
micromechanical bond is well-accepted today.
As time went on, variations in duration of the
20S
As dentin bonding
improved, removal
of the smear layer
became necessary,
but not without
controversy.
son to fifth- and sixth-generation systems) but they were a
significant improvement over
first-generation systems.
One major concern with
these systems was that the
phosphate bond to calcium in
the dentin was not strong
enough to resist the hydrolysis
resulting from water immersion. This hydrolysis, resulting
from either saliva exposure or
moisture from the dentin itself,
could result in composite resin
debonding from the dentin and
causing microleakage.
Since dentin was not etched
in these early bonding systems,
21S
characteristics
of fourth-generation bonding
systems.19,20 The
total-etch technique permits
the etching of
enamel and
dentin simultaneously using
phosphoric acid
for 15 to 20 seconds. The surface must be
Figure 3. Resin tags and adhesive lateral branches
left moist (wet contribute to micromechanical bonding formation
bonding), how- (scanning electron microscopy 2,000).
ever, in order to
avoid collagen collapse (Figure
dissolved by the acidic action;
1); the application of a
the initial surface penetration
hydrophilic primer solution can
exposes the collagen fibers. In
infiltrate the exposed collagen
this area, for a depth of 2 to 4
network forming the hybrid
micrometers, hybridization
layer (Figure 2).21,22 Unfortakes place, and resin tags can
seal the tubule orifices
tunately, moist dentin is not
firmly.16,26
easily defined clinically and
may lead to less-than-ideal
FIFTH GENERATION
bonds if the dentin is excessively wet23 or dried.16
To simplify the clinical proceThe formation of resin tags
dure by reducing the bonding
and adhesive lateral branches
steps and thus, the working
complete the bonding mechatime, a better system was neednism between the adhesive
ed. Also, clinicians needed a
material and etched dentin sub- better way to prevent collagen
strate (Figure 3).22,24,25 The mincollapse of demineralized
eralized tissues of the peritubudentin. The fifth generation of
lar and intertubular dentin are
bonding systems was developed
Figure 4. Enamel surface after etching with a selfetching primer solution; the enamel surface is less
retentive than that obtained with phosphoric acid
(scanning electron microscopy 1,500).
Figure 5. Laminate veneers of maxillary central incisors; the porcelain restorations are luted thanks to
the adhesive technique.
Recently, several bonding systems were developed and proposed as the sixth generation of
adhesive materials. These bonding systems are characterized
by the possibility to achieve a
proper bond to enamel and
dentin using only one solution.
These materials should really
be a one-step bonding system.
Unfortunately, the first evaluations of these new systems
showed a sufficient bond to conditioned dentin while the bond
with enamel was less effective.
This may be due to the fact that
the sixth-generation systems
are composed of an acidic solution that cannot be kept in
place, must be refreshed continuously and have a pK that is
not enough to properly etch
enamel.34
However, any improvement
in the direction of clinical simplification of bonding procedures can bring us closer to
achieving an ideal bonding
system.
23S
DISCUSSION
The mechanical
properties of the
bonding mechanism
achieved with
hybrid layer and
resin tag formation
can be greater than
the forces of
polymerization
contraction.
to reproduce the natural
appearance of natural teeth
with direct and/or indirect
esthetic restorations. Esthetic
techniques involve a bonding
step to ensure durability and
reliability. Thus, the ideal bonding system should be biocompatible, bond indifferently to enamel and dentin, have sufficient
strength to resist failure as a
result of masticatory forces,
wet phenomenon: an optical, micromorphological study of surface moisture in acid-conditioned, resin-dentin interface. Am J Dent
1996;9(1):43-8.
24. Chappel RP, Cobb CM, Spencer P, Eick
JD. Dentinal tubule anastomosis: a potential
factor in adhesive bonding? J Prosthet Dent
1994:72:183-8.
25. Mjor IA, Nordhal I. The density and
branching of dentinal tubules in human
teeth. Arch Oral Biol 1996;41:401-12.
26. Titley K, Chercnecky R, Chan A, Smith
DC. The composition and ultrastructure of
resin tags in etched dentin. Am J Dent
1995;8:224-30.
27. Ferrari M, Goracci G, Garcia-Godoy F.
Bonding mechanism of three one-bottle systems to conditioned and unconditioned enamel and dentin. Am J Dent 1997;10:224-30.
28. Tay FR, Gwinnett AJ, Wei SHY.
Structural evidence of a sealed tissue interface with total etch wet bonding technique, in
vivo. J Dent Res 1994;73:629-36.
29. Mason PN, Calabrese M, Graif L.
Modified extrusion shear bond strength of the
new 3M adhesive (abstract 256). J Dent Res
1998;77:1239.
30. Watanabe I, Nakabayashi N. Bonding
durability of photocured Phenyl-P in
TEGDMA to smear layer-retained bovine
dentin. Quintessence Int 1993;24:335-42.
31. Ferrari M, Mannocci F, Vichi A,
Davidson CL. Effect of two etching times on
the sealing ability of Clearfil Liner Bond 2 in
Class V restorations. Am J Dent
1997;10(2):66-70.
32. Toida K, Watanabe A, Nakabayashi N.
Effect of smear layer on bonding to dentin
prepared with bur. J Jpn Dent Mater
1995;14:109-16.
25S