BONDING v BASES/ LININGS

Martin J Tyas AM
BDS, PhD, DDSc, GradDipHlthSc, FADM, FICD, FRACDS, FADI

Honorary Professorial Fellow

Melbourne Dental School
University of Melbourne
 ‘BONDING’ vs ‘BASING’
BONDING
•Large bulk  potential
polymerisation shrinkage
•Can be technique sensitive
•Simple technique
•Etching dentine (> 0.5 mm) may
stimulate reparative dentine
formation
•Variable adhesion to affected
dentine
•No remineralisation of affected
dentine
•No fluoride release
•Good clinical results
BASING/ LINING
•Minimises resin polymerisation
shrinkage
•Low technique sensitivity
•More complex technique
•No stimulation of reparative
dentine
•Satisfactory adhesion to affected
dentine
•Potential to remineralise affected
dentine
•Fluoride release
•Good clinical results
 ARE LININGS NEEDED?
⚫ Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA.
Longevity and reasons for failure of sandwich and total-etch posterior
composite resin restorations. J Adhes Dent 2007;9:469-475
➢ 458 approximal restorations; two dentists in one
practice; 9 years
➢ more frequent fractures with GIC lining (30%) than
without (12%)

⚫ van de Sande FH, Da Rosa Rodolpho PA, Basso GR, et al.

18-year survival of posterior composite resin restorations with and without glass
ionomer cement as base. Dent Mater 2015. Epub: 2015/04/13
➢ 632 approximal restorations; one practice; 18 years
➢ GIC base did not affect survival (~ 2% p.a.)
 ARE LININGS NEEDED?

⚫ systematic review and meta-analysis of antibacterial

effects of cavity liners
⚫ no liner/ Ca(OH)2/ MTA/ antibiotic-disinfectant/ Ca
phosphates/ ZOE/ black Cu cement/ GIC
➢ MTA greatest possibility of achieving sterile
cavities (73%); remainder  8%
⚫ based on anti-bacterial effects
➢ no evidence to recommend a cavity liner, or any
specific liner
➢ use of a liner not supported by clinical studies

Schwendicke et al., J Dent 2015;43:1298-1307)

 ARE LININGS NEEDED?

⚫ Blum IR, Wilson NHF. An end to linings under

posterior composites? J Am Dent Assoc 2018.
Epub: 2018/01/26
⚫ the evidence does not support the use of linings
➢ unless in deep cavities for therapeutic
reasons, e.g., Ca(OH)2, calcium silicate
cements (MTA, Biodentine, …)
⚫ no adverse effect on postoperative complications
⚫ possible improvements in clinical performance
⚫ efficiency savings in chairside time
 ARE LININGS NEEDED?
Schenkel AB, Veitz-Keenan A. Cochrane Database Syst Rev 2019;3:CD010526.

⚫ to assess the effects of cavity liners in Class I,

II composites
⚫ eight randomized controlled trials selected;
over 700 participants
⚫ inconsistent, low-quality evidence regarding
the difference in postoperative hypersensitivity
⚫ no evidence was found to demonstrate a
difference in the longevity