Continuing the trend toward simplification, no-rinse, self-etching materials that incorporate the classic steps of etching, priming,

and bonding into one solution have become increasingly popular. In contrast to sonventional adhesive system that contain an intermediate light-cure, low-viscosity bonding resin to join the primed dentin/enamel substrate to the composite restorative material, allin-one adhesive contain uncured ionic monomers that contact the composite restorative material directly. Their acidic unreacted monomers are responsible in part for the incompability between these all-in-one adhesive and self-cured composite. Additionally, all-in-one adhesive tend to behave as semipermeable membranes, resulting in a hydrolytic degradation of the resin-dentin interface. Because all-in-one adhesive must be acidic enough to be able to demineralize enamel and penetrate dentin smear layer, the hydrophilicity of their resin monomers, usually organophosphates and carboxyloates, also is high. Some of these resin monomers might be too hydrophilic, which makes them liable to water degradation. Several all-in-one adhesive with etching, priiming, and bonding functions delivered in a single solution are now available, including Adper Prompt L-Pop (3M ESPE).......... As with SEP system, the pH of an all-in-one, self etching adhesive affects its clinical properties. Although Prompt L-Pop (3M ESPE) provides enamel bond strength similar to those obtained with a separate phosphoric acidetching step, some in vitro studies suggest that dentin bond strengths are significantly lower than those obtained with total-etch, one-bottle adhesive. The application of four consecutive coats for Xeno III (Densply DeTrey) and five consecutive coats for iBond (Hareaus Kulzer) significantly increases dentin bond strength and decrease nanoleakage, suggesting that some of the all-in-one adhesive might not coat the dentin surface uniformly. The bond strengths of One-Up Bond F (Tokuyama Dental) to intact enamel have been reported to be virtually zero. A clinical study of Prompt L-Pop reported a 35% failure rate at 1 year in Class V restoration, although the material used in this study was an earlierversion.

Polimerization shrinkage Composite materials shrink while hardening. This is reffered to as polymerization shrinkage. This phenomenon cannot be avoided, and important clinical procedural techniques must be incorporated to help offset the potential problems associated with a material pulling away from the preparation walls as it hardens. Careful control of the amount and insertion point of the material and appropriate placement of etchant, primer, and adhesive on the prepared tooth structure to improve bonding reduce these problems. Polimerization shrinkage usually does not cause significant prolems with restorations cured in preparation having all-enamel margins. When a tooth prepration has extended onto a root survace, however, polymerizationshrinkage can (and usually does) cause a gap formation at the junction of the composite and root surface. This problem can be minimized with appropriate techniques, but probably not eliminated. The clinical significance of the gap is not fully known. The V-shaped gap occurs because the force of polymerization of the composite is greater than the initial bond strength of the composite to the dentin of the root. The V-shaped gap is probably composed of composite on the restoration side and hybridized dentin on the root side. If extending onto the root surface, there

may be benefits to placing a RMGI first in the gingival portion on the preparation on the root followed by the composites.this approach may reduce the microleakage and gap formation potential and render the surrounding tooth structure more resistant to reccurent caries. Another important clinical consideration regarding the effects of polymerization shrinkage is the configuration factor (Cfactor). The C-factor is the ratio of bonded surface to the unbonded, or free, surfaces in a tooth preparation. The higher the C-factor, the greater is the potential for bond disruption from polimerization effects. A class IV restoration (one bonded surface and four unbonded surfaces) with a C-factor of 0,25 is at low risk for adverse polimerization shrinkage efects. A class I restoration with a C-factors of 5 (five bonded surface, one unbonded surface) is much higher risk of bond disruption associated with polimerizationshrinkage, particularly along the pulpal floor. Internal stress can be reduced in restorations subject to potentially high disruptive contraction forces (e.g., class I preparation with a high C-factor) by using (1) soft-start polimerization instead of high-intensity light curing (2) incremental additions to reduce the effects of polimerization shrinkage, and (3) a stress-breaking liner, such as a filled dentinal adhesive, flowable composite, or RMGI