In Practice
focus on materials
Adhesives: Newer Is Not
Always Better—Part 1
Latest-generation adhesives often do not measure up to their predecessors
in bonding strength and durability.
By Leendert (Len) Boksman, DDS, BSc, FADI, FICD | Gregg Tousignant, CDT
I
Lee W. Boushell, DMD, MS | Gildo Coelho Santos, Jr., DDS, MSc, PhD
n most fields of modern tech-
nology, the latest version of a
product is usually an improve-
ment over the previous ones.
For example, smartphones,
hybrid cars, the Blu-Ray disk,
and high-definition television
represented significant advancements
over their predecessors. So why is this
continual advancement apparently not
the case when it comes to dental adhe-
sives? Over the last 25 years, dentistry
has seen significant generational chang-
es, new materials categories, new chem-
istries, and new clinical protocols with
dental adhesives—much of it driven by
an effort to simplify or to shorten the
bonding procedure. However, not all of
the newer materials have necessarily
offered improvements to the patient or
for the long-term viability/prognosis of
the restorations placed. How does the
clinician make a rational choice from
among more than 65 adhesives still on
the market today? Among the so-called
Leendert (Len)
Boksman, DDS, BSc,
FADI, FICD
Retired from Private Practice
London, Ontario, Canada
Gregg
Tousignant, CDT
Technical Support Manager
Clinical Research Dental
London, Ontario, Canada
94 inside dentistry | February 2012 | www.dentalaegis.com/id
technology | clinical brief | tech profile | practice essentials
fourth-, fifth-, sixth-, and seventh-gen-
eration adhesives— alternatively known
as the “etch-and-rinse” and “self-etch
bonding agents”—which system gives
the most consistent, long-term clinical
results and has the longest viable bond
strength over time? Which system re-
sists oral degradation and allows for the
integration of new methodology to treat
the hybrid layer for long-term stabil-
ity while addressing the inevitability of
the presence of bacteria and composite
polymerization and functional stress?
The current resin–dentin bonding
mechanism, whether using etch-and-
rinse or self-etch systems, relies on the
formation of a hybridized layer that
couples adhesives/resin-composites
with the underlying mineralized dentin.
With the exception of resin tags, which
extend down into the dentinal tubules,
only the collagen fibers offer physical
continuity between the hybrid layer1 (as
it is known after being infiltrated with
resin) and the underlying mineralized
Lee W. Boushell,
DMD, MS
Assistant Professor
Department of Operative
Dentistry
University of North Carolina
School of Dentistry
Chapel Hill, North Carolina
Gildo Coelho
Santos, Jr., DDS,
MSc, PhD
Assistant Professor and
Chair Division of
Restorative Dentistry
Schulich School of
Medicine and Dentistry
University of Western Ontario
London, Ontario, Canada
Private Practice
London, Ontario, Canada
dentin. The collagen fibers represent
millions of fibril anchors, which emerge
from the underlying mineralized dentin
matrix into the demineralized layer.
In an excellent overview of factors
that affect the bond strength of bonding
agents, Powers et al2 point out that the
type of substrate (ie, superficial dentin,
deep dentin, permanent/primary denti-
tion, carious dentin), phosphoric acid/
acidic primers, preparation by air abra-
sion and laser, moisture, contaminants,
desensitizing agents, and self-cured/
light-cured restorative materials all af-
fect the bond strength; bond strength is
reduced by more than 50% when bond-
ing conditions are not ideal. Further,
when lasers are used to prepare hard
tissues, studies show that bonding to
these surfaces may be more problem-
atic than bonding to conventionally
bur-prepared preparations.3 Rushing to
complete such procedures by reducing
the priming time from 20 to 5 seconds
can cause a 17% reduction in mean bond
strength.4 In contrast, using a 20-second
application time to agitate a self-etch ad-
hesive significantly improves the shear
bond strength to dentin.5 In addition to
agitation, rather than applying a single
coat of adhesive resin on dentin, up to
four additional coatings increase the
bond strength and decrease nanoleak-
age.6 Multiple research reports attest
to the existence of material incompat-
ibilities that depend on formulation, and
that bond strengths can be reduced by
45% to 90% or more when incompat-
ible combinations are applied clini-
cally.7-9 Acetone-based adhesives show
a high degree of technique sensitivity,10
and over- or under-drying the acid-
etched dentin compromises the bond.11
Simplification of the bonding procedure
does not necessarily lead to improved
bonding performance, especially in the
long term.12 Alex3 perhaps has stated it
best: “The bottom line is, it is incumbent
on every dentist to learn about their spe-
cific adhesive system, its idiosyncrasies,
its strengths and weaknesses, and how
to maximize its performance.”
Practitioners should be aware not
only of the immediate bond strengths—
whether shear or tensile (the immedi-
ate configuration factor [C-factor] po-
lymerization shrinkage stress is about
24 MPa in a Class I cavity prepara-
tion)13 but also, the long-term perfor-
mance or longevity (patency) of their
bonding agent in actual clinical perfor-
mance.14 Much of the bond testing has
been done in a laboratory under ideal
controlled conditions, which may not
be possible to replicate in a clinical en-
vironment, and results may vary de-
pending on the testing methods and
devices used.15 Some studies test im-
mediate or 24-hour bond strength only
on dentin just below the enamel surface,
where bonding is easiest and strongest;
and most of these studies have been
done in vitro on human or bovine teeth,
without positive fluid flow or the posi-
tive pressure that exists clinically—
both of which can drastically decrease
long-term performance. A
short, simplified overview
of the systems and their
clinical behavior follows.
To read a CE article on Adhesives, visit:
dentalaegis.com/go/id79
Fourth-Generation
Adhesives
Compared to current adhesives or
bonding agents, those still considered
to be the “gold standard” in long-term
durability are fourth-generation ad-
hesives (etch-rinse-prime-adhesive
resin) or multi-bottle systems (eg,
3M™ ESPE™ Scotchbond™ MP Multi-
Purpose Plus, 3M ESPE, www.3mespe.
com; ALL-BOND 2© and ALL-BOND
3©, Bisco, Inc., www.bisco.com; Perma
Quick, Ultradent Products, Inc., www.
ultradent.com; and OptiBond FL©,
Kerr Corporation, www.kerrdental.
com).16,17 These etch-and-rinse materi-
als still provide the deepest, strongest,
most predictable, and long-term bond
to enamel.18 This strong layer resists
microleakage and protects the dentin
bond from water degradation, which
may contribute to better long-term
clinical performance.19-23 Arrais24 has
reported that these three-step adhe-
sives also form the thickest hybrid
layer, followed by one-bottle adhe-
sives, with the self-etching adhesives
forming the thinnest hybrid layers. It
must be noted that strict adherence to
etching times is critical, as prolonged
phosphoric acid-etching can form a
deep demineralized dentin zone that
may not be fully impregnated by the
primer and adhesive, resulting in
low bond strength.25 These products,
which bond well to dentinal substrates,
have lost some of their popularity due
to the fact that they are multi-bottle,
multi-step systems, which require etch,
rinse, and application of hydrophilic
primers followed by a hydrophobic
adhesive layer. As such, these systems
can be very technique-sensitive, if the
sequencing and timing is not exactly ad-
hered to, with some having complicated
instructions on how to bond to tooth
structure and other dental materials.
The so-called fourth-generation bond-
ing agents have the major benefit of be-
ing effectively used with self-cure, dual-
cure, and light-cured composites as well
as indirect restorations without concern.
Representative bonding strengths for
products in this category are: OptiBond
FL, 39 MPa to dentin,26 and Scotchbond
MP, 45.6 MPa to dentin.19
Fifth-Generation Adhesives
Fifth-generation adhesives (etch-and-
rinse plus [primer and bond]) or the
single-bottle systems, such as MPa™
(CLINICIAN’S CHOICE®, www.
clinicianschoice.com); Sealbond
Ultima (RTD, Clinical Research Dental,
www.clinicalresearchdental.com);
OptiBond® Solo Plus (Kerr); Adper™
Single Bond Plus (3M ESPE); Prime &
Bond® NT™ (DENTSPLY Caulk, www.
caulk.com); PQ1 and Peak™ (Ultradent
Products); ExciTE® (Ivoclar Vivadent,
www.ivoclarvivadent.com); and One
Step Plus and ACE® ALL-BOND TE™
(Bisco), contain primers and adhesive in
a single bottle. This simplifies the bond-
ing technique by eliminating some of
the variables regarding the number of
bottles and steps required. This single-
bottle, etch-and-rinse adhesive type
shows the same effectiveness as the
fourth-generation systems in terms of
microleakage,27 and shows good dentin
bond strengths with excellent margin-
al seal in enamel.28-30 However, not all
fifth-generation adhesives are compat-
ible with dual- and self-cure composites
or core materials. The lower pH of the
oxygen-inhibited layer, or the acidic
monomers in some simplified products,
are too acidic and thereby de-activate
the tertiary amine in chemical-cured
composites. This results in no bonding,
or weak bonding, with a material such
“Multiple research
reports attest
to the existence
of material
incompatibilities
that depend on
formulation, and
that bond strengths
can be reduced by
45% to 90% or more
when incompatible
combinations are
applied clinically.”
as Prime & Bond NT in its light-cured
version showing a bond strength of 0
MPa.31 Some adhesive systems such
as OptiBond Solo Plus require a dual-
cure activator, which is a resin-free
benzene sulphinic-acid/sodium salt
solution, which will raise the acidic pH
of the oxygen-inhibited layer in order to
bond to self-cured/dual-cured products.
However, this additional step lowers
bond strengths because of the dilution
of the adhesive and the inherent perme-
ability of the polymerized adhesive.32
Other products, such as MPa, Sealbond
Ultima, and One Step Plus, do not re-
quire the use of a dual-cure activator.
With a self-cure composite, One Step
Plus shows bond strength of 21.4 MPa33
in one study and 19 MPa in another.34
In the later study, MPa showed a bond
strength of 18.5 MPa to the self- cure
composite; however, when the oxy-
gen-inhibited layer was removed with
alcohol, the bond strength more than
doubled to 38.9 MPa to the level ob-
tained using light-cured composite.34
The solvents in bonding agents can
be either ethanol-based, a nonvolatile
solvent, or acetone-based. Products
such as Sealbond Ultima and One
Step Plus contain acetone, a very vola-
tile solvent that should never be pre-
dispensed into a dappen dish before
the actual clinical bonding procedure,
because the evaporation of the solvent
will drastically reduce the patency of
the bonding agent. Products that use
ethanol or acetone need the proper
amount of moisture (a moist bonding
protocol), to prevent the collapse of
the exposed collagen network.35 The
amount of impregnation of the hybrid
layer can be reduced by 50% if the den-
tin is over dried.36 Ethanol-based ad-
hesives contained in products such as
MPa™, Peak™, and OptiBond Solo Plus
generally are more forgiving in clinical
application and show the highest micr-
otensile bond strengths.35,37,38 It must
be noted here that the 3 to 5 seconds
recommended by some manufacturers
for the evaporation of solvents is gener-
ally not enough to remove even half of
the solvent, and therefore extension of
this time is recommended.39
The clinician also needs to know
whether they are using a filled or un-
filled adhesive, as the inclusion of fillers
changes the viscosity and thickness of
the applied layer. As well, evidence in
the literature supports the concept that
filled resins provide stress relief at the
tooth–restoration interface.40 Not all
fifth-generation adhesives are the same
in regards to the number of applications
(unfilled need more applications), so it
is critical to follow the manufacturer’s
directions. Some products, such as One
Step Plus and Adper Single Bond Plus,
require two coats of the adhesive, while
others like MPa™ and PQ1 require only
one.41 Of course a single coat saves ma-
terial and time, because less of each is
required for bonding the restoration.
Representative dentin bond strengths
reported in this category are
42 MPa to dentin for Adper
Single Bond Plus25 and 41
MPa for MPa™.34
For product information about
Adhesives, visit:
dentalaegis.com/go/id80
Postoperative sensitivity can be in-
duced with the etch-and-rinse tech-
nique when exacting protocols are
not followed. This is more prevalent
in deeper dentin preparations and in
high C-factor cavity preparations.42
Simplification by combining the primer
www.dentalaegis.com/id | February 2012 | inside dentistry
and adhesive into one bottle, which
also applies to the so-called seventh-
generation or self-etch all-in-one ad-
hesives, increases the hydrophilicity
and permeability of the bond, making
them more likely to undergo hydrolysis.
This is especially true for the unfilled
bonding agents, as they create a thinner
hybrid layer.43
Conclusion
Part II of this article discusses two
techniques to minimize, if not totally
eliminate, postoperative sensitivity
with etch-and-rinse adhesives using
glutaraldehyde/HEMA combinations,
as well as a hydrophobic radiopaque
liner to decrease the permeability of
the bond and thereby increase long-
term performance. Part II will also
examine the current status of the self-
etch adhesives, their categories, and
the role of matrix metalloproteinases
in the lack of longevity of bonding to
dentin. In the future, research data on
increasing the longevity of the bond
by inhibiting the activity of these pro-
teinases may alter current approaches
to bonding and newer products may
emerge as a result.
Disclosure
Dr. Boksman was previously a part-time paid
consultant to Clinician’s Choice and Clinical
Research Dental, holding the title of Director
of Clinical Affairs. Dr. Santos is a consultant
for R&D to Clinical Research Dental and
Clinician’s Choice.
References
1. Nakabayashi N, Pashley DH. Hybridization
of Dental Hard Tissues. Chicago, Illinois:
Quintessence Publishing Co., Ltd; 1998.
2. Powers JM, O’Keefe KL, Pinzon LM.
Factors affecting in vitro bond strength of
bonding agents to human dentin. Odontology.
2003;91(1):1-6.
3. Alex G. Adhesive dentistry: the good, the
bad, and the ugly. Compend Contin Educ Dent.
2009;30(8)553-568.
4. El-Badrawy W. Kozovski L, Nathan G,
Roperto RC. 1490 Bond strength of dentin
as a function of priming time Seq #180 Bond
Strength of Composites to Enamel and
Dentin—Application Technique [abstract].
IADR/AADR/CADR 85 th General Session
and Exhibition. March 21-24, 2007. Available
at: http://iadr.confex.com/iadr/2007orleans/
techprogram/abstract_89827.htm. Accessed
October 11, 2011.
5. Velasquez LM, Sergent RS, Burgess JO,
Mecante DE. Effect of placement agitation
95
 In Practice materials
and placement time on the shear bond strength
of 3 self-etching adhesives. Oper Dent.
2006;31(4):426-430.
6. Hashimoto M, Sano H, Yoshida E, et al.
Effects of multiple adhesive coatings on dentin
bonding. Oper Dent. 2004;29(4):416-423.
7. Hagge MS, Lindemuth JS. Shear bond
strength of an auto-polymerizing core
build-up composite bonded to dentin 81 st General Session of the International
with 9 adhesive systems. J Prosthet Dent. Association for Dental Research. June 25-
2001;86(6):620-623. 28, 2003. Available at: http://iadr.confex.
8. Jung H, Friedl KH, Hiller KA, Schmalz G. com/iadr/2003Goteborg/techprogram/ab-
0341 Bond strength of composite resins using stract_31644.htm. Accessed October 11, 2011.
a new one-step adhesive system [abstract]. 9. Carvalho RM, Garcia FC, E Silva SM, et
Seq #49 Self-etching Adhesive Systems 3, al. Critical appraisal: adhesive-composite
Adhesion Composite Bond Strength Program. incompatibility, part 1. J Esthet Restor Dent.
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2005;17(2):131.
10. Van Meerbeek B, Vargas S, Inoue S, et al.
Adhesives and cements to promote preser-
vation dentistry. Oper Dent. 26;S119-S144.
11. Kanca J. Effect of resin primer solvents
and surface wetness on resin compos-
ite bond strength to dentin. Am J Dent.
1992;5:213-215.
12. Shirai K, De Munck JD, Yoshida Y, et al.
Effect of cavity configuration and aging on
the bonding effectiveness of six adhesives
to dentin. Dent Mat. 2005;21(2):110-124.
13. Asmussen E, Munksgaard EC. Adhesion
of restorative resins to dentinal tissues.
In: Vanherle G, Smith DC, eds. Posterior
Composite Restorative Materials. Amsterdam:
Peter Szule Publishing Co.; 1985:228.
14. Hashimoto M, Ohno H, Kaga M, et al.
In vivo degradation of resin-dentin bonds
in humans over 1-3 years. J Dent Res.
2000:79(6):1385-1391.
15. Pecora N, Yaman P, Dennison J, Herrero
A. Comparison of shear bond strength rela-
tive to two testing devices. J Prosthet Dent.
2002;88(5):511-515.
16. De Munck J, Van Landuyt K, Peumans
M, et al. A critical review of the durability
of adhesion to tooth tissue: Methods and
results. J Dent Res. 2005;84(2):118-132.
17. Thunpithayakul C, Cobb DS, Denehy
G, et al. 0346 In vitro microtensile dentin
bond strength of adhesives by classifica-
tion. Seq #70 Bond strength of composites
to enamel and dentin with self-etching
adhesives [abstract]. IADR/AADR/CADR
85th General session and exhibition. March
21-24, 2007. Available at: http://iadr.con-
fex.com/iadr/2007orleans/techprogram/
abstract_90534.htm. Accessed October
13, 2011.
18. Hashimoto M, Ohno H, Yoshida E, et al.
Resin-enamel bonds made with self-etching
primers on ground enamel. Eur J Oral Sci.
2003;111(5):447-453.
19. De Munck J, Van Meerbeek B, Yoshida Y,
et al. Four year water degradation of total-
etch adhesives bonded to dentin. J Dent Res.
2003;82(2):136-140.
20. May KN, Swift EJ, Wilder AD, Futrell
SC. Effect of surface sealant on microleak-
age of Class V restorations. Am J Dent.
1996;9:133-136.
21. Abdalla AI, Feilzer AJ. Four year
water storage of a total-etch and two self-
etching adhesives bonded to dentin. J Dent.
2008;26:611-617.
22. Gamborgi GP, Loguercio A, Reis A.
Influence of enamel border and regional
variability on durability of resin-dentin
bonds. J Dent. 2007;35(5):371-376.
23. Frankenberger R, Strobel WO, Lohbauer
U, et al. The effect of six years of water
storage on resin composite bonding to
human dentin. J Biomed Mater Res B Appl
Biomater. 2004;15;69(1):25-32.
24. Arrais CA, Giannini M. Morphology
and thickness of the diffusion of resin
through demineralized or unconditioned
dentinal matrix. Pesqui. Odontol Bras.
2002;16(2):115-120.
25. Hashimoto M, Ohno H, Endo K, et
al. The effect of hybrid layer thickness
on bond strength: demineralized dentin
zone of the hybrid layer. Dent Mater.
2000;16(6):406-411.
26. Christensen GJ. Bonding agents: Is con-
venience overriding strength? Clinician’s
Report reprint from June 2010. Dental
Economics. 2010;3(6):1-3.
27. Schmitt DC, Lee J. Microleakage of
adhesive resin systems in the primary
and permanent dentitions. Pediatr Dent.
2002;24(6):587-593.
28. Gallo JR, Comeaux R, Haines B, et al.
Shear bond strength of four filled bonding
systems. Oper Dent. 2001;26:44-47.
29. El-Kalla IH, Garcia- Godoy F. Saliva
contamination and bond strength of single
bottle adhesives to enamel and dentin. Am
J Dent. 1997;10:83-87.
3 0. C a s t e l n u o v o J, T j a n A H , L i u P.
Microleakage of multi-step and simpli-
fied-step bonding systems. Am J Dent.
1996;9:245-248.
31. O’Keefe KL, Powers JM. Adhesion of
resin composite core materials to dentin.
Int J Prosthodont. 2001;14(5):451-456.
32. Tay FR, Suh BI, Pashley DH, et al.
Factors contributing to the incompatibil-
ity between simplified-step adhesives and
self-cured or dual-cured composite. Part II.
Single bottle total etch adhesive. J Adhes
Dent. 2003;5(2):91-105.
33. Swift EJ Jr, Perdigão J, Combe EC, et al.
Effects of restorative and adhesive curing
methods on dentin bond strengths. Am J
Dent. 2001;14(3):137-140.
34. Walter R, Swift EJ Jr., Ritter AV, et al.
Dentin bonding of an etch-and-rinse adhes-
ive using self-and light-cured composites.
Am J Dent. 2009;22(4):215-218.
35. Lopes GC, Cardoso PC, Vieira LC, et
al. Shear bond strength of acetone-based
one-bottle adhesive systems. Br Dent J.
2006;17(1):39-43.
36. Hashimoto M, Ohno H, Kaga M, et al.
The extent to which resin can infiltrate
dentin by acetone-based adhesives. J Dent
Res. 2002;81(1):74-78.
37. Nunes MF, Swift EJ, Perdigão J. Effects
of adhesive composition on microtensile
bond strength to human dentin. Am J Dent.
2001;14(6):340-343.
38. Cardoso Pde C, Lopes GC, Vieira LC,
Baratieri LN. Effect of solvent type on adhesives: Their current status. Oral Health.
microtensile bond strength of a total-etch 2009;12-22.
one-bottle adhesive system to moist or dry 41. Montes MA, de Goes MF, da Cunha MR,
dentin. Oper Dent. 2005;30(3):376-781. Soares AB. A morphological and tensile
39. Pashley DH, Tay FR, Breshi L, et al. bond strength evaluation of an unfilled
State of the art etch-and-rinse adhesives. adhesive with low-viscosity composited
Dent Mater. 2011;27(1):1-16. and a filled adhesive in one and two coats.
40. Swift EJ Jr, Vargas MA. Dentin/enamel J Dent. 2001;29(6):435-441.
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42. Opdam NJ, Feilzer AJ, Roeters JJ, Smale
I. Class I occlusal composite restorations:
In vivo post-operative sensitivity, wall
adaptation, and microleakage. Am J Dent.
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Dental Dynamics Laboratory Inc. ...............Arlington ...................TX .... 800-640-8112
Oral Designs Dental Laboratory, Inc. ..........San Antonio ...............TX .... 800-292-5516
PCB Dental Lab ...........................................Richardson .................TX .... 672-671-3894
Broadway Dental Lab .................................Taylorsville .................UT .... 801-955-4878
Treasure Dental Studio ...............................Salt Lake City ............UT .... 800-358-6444
Art Dental Lab .............................................Chantilly ....................VA .... 888-645-7541
NexTek Dental Studios ...............................Manassas ..................VA .... 800-678-7354
The Point Dental Studio, LLC .......................West Point .................VA .... 804-337-5477
Ziemek Aesthetic Dental Lab.......................Olympia ..................... WA ... 866-943-6367
INTERNATIONAL SERVICING THE U.S.
Smith-Sterling Dental Laboratories ...........Cartago ........ Costa Rica ..... 800-479-5203
Smile Designs.............................................Guelph .......... ON, Canada .... 519-836-1100
| February 2012 |
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