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agent
• Introduction
• History
• Adhesion • Wet/Moist bonding
• Classification • Over-wetting phenomenon
• Acid etching • Dry bonding
• Enamel etching • Hybrid layer
• Enamel etching patterns
• Fillers
• Water trees effect
• Etchants
• Chronological classification
• Hybridization layer • Total etch adhesives
• Criteria for bonding system • 3-step and 2-step total etch adhesive
• Problems faced in bonding to dentin • Self-etch adhesives
• Components • 2-step and 1-step self etch primer
• Conditioning • Amalgam bonding
• Primers • Ceramic bonding
• Mechanism of action of DBA • Failures in bonding
• Solvents used in primers • Literature review
• Conclusion
• References
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Introduction
Retention of restoration
Conservation of tooth structure
Elimination of marginal microleakage
Reinforcement of remaining tooth structure
Increasing the clinical life time of restorations
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HISTORY
1955-Buonocore
developed acid
etching with
phosphoric acid
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1997- 2003 -Ferrari et al -
Development of one bottle
bonding systems.Sixth and
Seventh generation bonding
1990s -Kanca- concept systems
of wet bonding
1982-Fusayama-
concept of total etching
and bonding
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Adhesion
• Adhesion is derived from the Latin (adhaerere) 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 materials)
• Adhesive - Substance that promotes adhesion of one substance or material to another
• Adherend - A material substrate that is bonded to another material by means of an
adhesive
ADHESIVE
ADHEREND
ADHESIVE
STRENGHTH
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Classification
Theories :
2. Adsorption –chemical bonding between adhesive and the adherent, forces involved are
primary(ionic and covalent) or secondary (Van derWaals forces, hydrogen bonds)
3.Diffusion – interlocking between mobile molecules, such as the adhesion of two polymers
through diffusion
4.Electrostatic – an electrical double layer at the interface of a metal with a polymer making
a certain/obscure contribution to the bond strength
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Factors Affecting Adhesion
• Wetting : Wetting is the ability of the liquid to flow easily over the entire surface and adhere to the
solid
• If the adhesive does not wet the surface of the adherend, adhesion between the adhesive and
adherend will be negligible or nonexistent
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Surface Energy
• The surface tension of the liquid and the surface energy of the adherend, ultimately
determine the degree of wetting that occurs
• Generally, the harder the surface , the higher the surface energy will be, which means that
adhesive properties of the material will be higher
• Hydroxyapatite(High surface energy);Collagen(low energy surfaces)
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• Acid etching : It is the process of increasing the surface reactivity by demineralizing the
superficial calcium layer and thus creating the enamel tags. These tags are responsible for
micromechanical bonding between tooth and restorative resin
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Compositional & structural aspects of enamel & dentin
• The inorganic content of mature enamel is 95%by wt% & 86% by vol%; the primary
component is hydroxyapatite
• The remainder consists of water & organic material
• Unlike enamel, dentin contains higher % of water and organic material(type I collagen) &70
wt % of hydroxyapatite
Mjor IA, Fegerskov o, eds. Human oral embryology & histology,1986 11
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• Numerous dentinal tubules radiate from pulp through out the entire thickness of
dentin(fan shaped), making dentin highly permeable tissue
• Near pulp peritubular dentin 66% & intertubular dentin only 12 %, while rest 22% by watar
. Hence, dentin is an intrinsically wet tissue
3) Tubular nature of dentin that permits fluid flow, adversely affects bonding
• Density of dentinal tubules - 20,000 to 50,000 tubules per square millimetre, at a level 2mm from the pulp it is
30,000 tubules per square millimetre with diameter of 1.1 microns
• Density is more towards pulp because tubules are radically concentric to pulp and tubules near pulp are less
narrow due to peritubular mineralization
• Water content of dentin is more towards pulp and diminishes significantly towards dentin–enamel junction
(DEJ)
• Suzuk et al;2000 - bond strengths in deep dentin are around 30–50% lower than in superficial dentin
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Enamel Etching
• Enamel adhesion-micromechanical retention
Resin tags
• Macrotags: -Form between the enamel rod
peripheries
- 2-5 Microns
• Microtags - Across the end of each rod where
hydroxyapatite crystals have been dissolved
• Bond strength to acid conditioned enamel :16 – 21
M Pa
• Type 1 – Most common. Preferential removal of enamel prism cores & periphery intact
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Etchants
1. Phosphoric acid – as liquid or gel
• Conc 30 – 40 % - for 15 sec - ideal. (Silverstone et al 1975)
• Conc more than 50 % - monocalcium phosphate monohydrate precipitate
• Conc less than 30% - dicalcium phosphate dihydrate precipitate( cannot be easily
removed )
• Higher conc - deeper tags, break away easily
2. Sulphuric acid 2 %
3. Maleic acid 10 %
4. Nitric acid 2.5 %
5. Oxalic acid
6. Citric acid
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CLINICAL USES
Ideal Characteristics OF DENTIN
of Dentin BONDING
Bonding AgentsSYSTEMS:
1. Bonding of directly placed resin based restorative materials
2. Bonding of indirectly placed restorative materials
3.1.Bonding of ceramic
Bond to dentin restorations
with a strength equal to or greater than that of a composite resin bonded to etched enamel
4.2.Bonding of amalgam
Rapidly (within a few minutes) restorations
attain maximum bond strength to permit finishing and polishing procedures and
5. Bonding of prefabricated
postoperative and acast
patient functioning within poststime frame
reasonable
6.3.Bonding orthodontic
Be biocompatible brackets
and nonirritating to the pulp
7.4.Bonding periodontal splints
Prevent micro-leakage, recurrent caries and marginal staining
8. Repair existing restorations
5. Exhibit long-term stability in the oral environment
9. Sealing of pits and fissures of posterior teeth
6. Be easy to apply and clinically forgiving
10. Treatment of cervical sensitive dentine
7. Reattachment
11. Possess a good shelf of
life fractured tooth fragments
8. Pulp
12. capping
Be compatible with a wide range of resins
13.
9. Reinforce
System shouldfragile roots
not be toxic internally
or sensitizing to the operators and patients
14.
10.Seal apical
Should seal therestorations
tooth surface fromplaced
oral fluids.during endodontic surgery
• Conditioning (cleaning)
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Conditioning
“Alteration done after the creation of dentin cutting debris(smear layer), to create a surface,
capable of micromechanical and chemical bonding to dentin bonding agent”
Can be done by -
Chemicals ( Acids, Calcium chelators )
Thermal (lasers)
Mechanical (abrasion)
• Maleic acid: 10%
- Removes only smear layer, not plugs
- Hybrid layer formed is thin.
• Polyacrylic acid:
- 40% solution is used
- A 10 second application opens up the dentinal tubules but does not effect pulp as the
particle size is greater than diameter of dentinal tubules
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• Phosphoric acid : First dentin conditioner
37% H3PO4 is used
• Nitric acid : - Stronger than H3PO4
- Concentration of 2.5%
• Citric acid :
- 10% citric acid is recommended
- 10% citric acid + 3% ferric chloride was recommended by Nakabayashi
- Kurray proposed a combination of 10% citric acid and 20% CaCl2 to stabilize collagen during
etching
• Pyruvic acid: - Pyruvic acid buffered with glycine is used to facilitate polymerization reactions
and adjust the pH
• EDTA:
- Commercially available as “Tublicid”
- It contains 0.1% EDTA and 0.15% Benzalkonium chloride
- Removes smear layer, not plugs
- It is scrubbed on the surface of the smear layer for a few seconds, then left passively
for another 60 seconds followed by additional scrubbing
Removes small amount of Ca, thus causing fall in the bond strength
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• Thermal conditioners:
- Lasers: Nd:YAG laser used at 10 to 30 pulses per second
- The mechanism of action is through microscopic explosions
• Laser causes
- Desensitization of dentin
- Decrease microorganisms
- Creates micromechanical retention
• Mechanical conditioners:
- Abrasion:Al2O3 is used for micro abrasion
0.5 μ particles are used
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Primers
Agents that promote wetting of the dentin with the bonding agent and increase the
penetration of the bonding agent into the dentin
• Surface tension - less than the surface free energy of the acid etched dentin
• Solvent- water or water miscible
• Monomer - hydrophilic because they must compete with water and diffuse through water
in the depths of demineralized zone
• HEMA: 2-HydroxyethylMethacrylate
• R- Spacer
Is responsible for making the molecule large enough to keep methacrylate groups
spatially located for optimal chemical reaction with the composites
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Solvents used in Primers
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Wet bonding/ Moist bonding
• Refers to bonding in which acid etched dentin is moist and hence, acetone based
primers are used, which have water chasing capacity
• Azeotrophism:
In acetone containg primers, when acetone comes in contact with water, the boiling
point of acetone is raised &the boiling point of water is lowered causing evaporation of
both water and acetone and the resin is left behind
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Dry Bonding
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Internal and external dentinal wetness
• Occlusal dentin is more permeable over the pulp horns than at the center of occlusal
surface; proximal dentin > occlusal dentin & coronal> root
Pashley DH, Pashley EL, Am J Dent, 1991
• The variability in dentin permeability makes dentin more difficult substrate for bonding
than enamel
Douglas WH, J Dent, 1989
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• Earlier dentin adhesives were too hydrophobic to be successful, recent adhesives tend to
be overly hydrophillic , also impairing adhesion
• Recently, the so called all-in-one adhesive have been reported to behave as
semipermeable membranes and to absorb moisture from “ the outside” as well as the
tooth itself Tay FR, J Adhes Dent, 2002
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Hybrid layer
• Resin reinforced zone, or resin infiltrated layer
• Structure formed in dental hard tissues by demineralisation of the surface and subsurface,
followed by infiltration of monomers and subsequent polymerisation
- The combined mechanical and chemical action of rubbing the acid etched dentin with an
acidic primer dissolves additional mineral salts while fluffing and separating the entangled
collagen at the surface
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Fillers
• May contain inorganic fillers 0. 5% to 40% by wt. microfillers, or nanofillers, and submicron glass.
• Advantages of nanofillers:
-Prevents nanoleakage
-Causes uniform thickness of adhesive layer
-Better flexibility to adhesives
-Better dissipation of forces
-Scatter of light is prevented
-Provides radio opacity
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Water Trees Effect
• Water can pass from dentin around resin tags & form water filled channels that project from
the hybrid layer into the overlying adhesives
• When these water filled channels are stained with silver, they often look like microscopic
trees
• These are called water trees by Tay & Pashley
• They suggested that they might act as potential sites for hydrolytic degradation of resin
&also may be the cause of nanoleakage
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Chronological Classification
• Early 1978
Low bond strength (1-3MPa)
• Agents used: Hydrolysis of phosphate - Ca++ bond.
- Phosphate ester material HEMA in ethanol Bonding obtained to the smear layer,
- Polyurethane based compounds not to the dentin itself
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Third Generation-1984
• Negative effect of smear layer known by then. Thus
additional step of conditioning and priming to Bond strength: 9-15 Mpa.
remove smear layer
modify smear layer
More number of steps, thus complex
Technique sensitive
• Mechanism of adhesion:
Retention decreased with time (
Conditioner removes smear layer and opens up the
tubule longevity questionable )
Primer having both hydrophilic and hydrophobic
groups were used which facilitates bonding with the Eg: Clearfill new bond
adhesive Scotchbond new
• Mechanism of action
-Etching removes smear layer, opens the tubules upto 7.5 microns and increases the
permeability.
- Primer wets & penetrates the collagen meshwork and increases its surface energy and
wettability into which the resin flows.
- Based on diffusion and impregnation of resin into partially decalcified dentin followed by
polymerisation creating a resin reinforced layer-Hybrid layer
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• Advantages
- Less technique sensitivity
- Similar bond strengths to both enamel and dentin
- can bond to other surfaces like metals, amalgam, porcelain
• Disadvantages
- Unless the primer and adhesive are applied, the overlying composite resin will not bond to
the surface
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Fifth generation
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• Advantages –
Good bond strength
Very rare post operative sensitivity
Less no of applications -easy to use
• Some agents have flouride and elastomeric components incorporated for better marginal integrity
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Sixth generation
• Here the primer and etchant are combined in one step.( Self etching primers).
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Seventh Generation
• Fluoride releasing
• Self etching type
• Characterized by etching, priming and bonding in a simple application with no rinsing or drying
• All in one system
• Disadvantages:
- prone to phase seperation
- adhesive layer can act as semi-permeable membrane
- low bond strength
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IBond
➢ Etch
➢ Disinfect
➢ Desensitize
➢ Prime
➢ Bond
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G bond
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Total etch adhesives
• Total etching is the simultaneous etching of enamel and dentin
• Mechanism of action –
Smear layer removed by etch and rinse phase,
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3 step Total etch
• Conditioning
Priming
Application of adhesive resin Etchant
• Amalgam- bond
• Clearfil Liner Bond Primer
• Imperva Bond
• Optibond
• Scotch bond multipurpose
Adhesive
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Advantages Disadvantages
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2 Step total etch
• Conditioning
• Primer and adhesive
Etchant
• Eg:
Gluma comfort bond
Prime and bond NT
Primer
Prime and bond 2.1
and
Adhesive
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Advantages Disadvantages
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Self etch adhesives
• These adhesive systems are based on the use of non rinse acidic monomers that simultaneously
condition and prime dentin and enamel.
• Features :
Here the conc of acidic monomers was increased from 5-10% wt to 30-40% wt
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Two step self etching primer
• Ex -
Clearfil SE Bond Self –Etching
Primer
Clearfil Liner Bond IIV.
Simplicity
UniFil Bond
Adhesive
AdheSE
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Advantages Disadvantages
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Single step self etching primer
• Ex -
Prompt L Pop
Touch and Bond
Brush and Bond All in
Xeno III one
adhesive
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Advantages Disadvantages
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Futurabond DC- 8th Generation
•It is dual-cured and works with all light, self or dualcured resins
•Nanosized cross linking agents with fused silica particles
•It works in a self-cured mode without any light – great for endo
• It takes only 35 sec. from start to finish.
• It needs only one coat.
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Surpass: A Universal Eighth Generation
Bonding System
• Has the best attributes of the fourth generation and the ease of the sixth-generation
bonding systems
• Consists of three bottles: an etchant/conditioner, a primer, and a separate hydrophobic
bonding resin
• Etchant/conditioner is not rinsed from the tooth.
• Bond Strength: 50 Mpa
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Effect of Cyclic Loading on the Microtensile Bond Strengths of Total-etch and Self-etch
Adhesives
M. Toledano, R. Osorio, A. Albaladejo, F. S. Aguilera, F. R. Tay, and M. Ferrari
• Clearfil SE Bond and Single Bond attained higher MTBS than the other three adhesives.
• Prime&Bond NT and Prime&Bond XP performed equally, and Etch&Prime 3.0 resulted in the lowest
MTBS.
• After mechanical loading, MTBS decreased in all groups except Prime&Bond XP
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Bonding of Self-etch and Total-etch Adhesives to Carious Dentin M. Yoshiyama, F.R. Tay
• Microtensile bond strength of a total-etch adhesive and an experimental self-etching adhesive (ABF)
to caries-infected, caries-affected, and sound dentin
• The bond strengths of both adhesives to sound dentin were significantly (p < 0.05) higher than those
to caries-affected dentin, which, in turn were significantly (p < 0.05) higher than those to caries-
infected dentin
• For both adhesives, hybrid layers in caries-affected dentin were thicker but more porous than those
in sound dentin
• The lower bond strengths may be due to the lower tensile strength of caries-affected dentin
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Amalgam Bonding
• Bond strengths have been reported to range from 2 to 20 MPa, with higher bond strengths
reported for filled adhesives
• Benefits include decreased microleakage between the cavity wall and the restorative material.
This, in turn, may decrease post-operative sensitivity, pulpal inflammation and the incidence of
recurrent caries
• In vitro studies have reported one potential problem in the incorporation of resin into
amalgam, which may cause a decrease in strength of the restoration
• The glassy matrix is selectively removed, and crystalline structures are exposed
• HF solutions between 2.5% and 10% applied for 2 to 3 minutes seem to be most successful
• Silane coupling agent is applied on the etched surface and air dried
• Coupling agent acts as a primer and makes the inorganic substrate more receptive to organic
surface
• They can also increase the bond strength between the restoration and tooth
Resin-ceramic bonding:JPD 2003 67
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Failures in bonding
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Recent Advances in Dentin Bonding Systems –
Literature Review
The objectives of this study were to incorporate nanoparticles of silver (NAg) and nanoparticles
of amorphous calcium phosphate (NACP) into adhesive for the first time, and to investigate
the effects on dentin bond strength and plaque microcosm biofilms
Significance Dental plaque microcosm biofilm viability and acid production - greatly reduced on
bonding agents containing NAg and NACP, without compromising dentin bond strength. The
novel method of incorporating dual agents (remineralizing agent NACP and antibacterial agent
NAg) may have wide applicability to other dental bonding systems
This study evaluates the hypothesis that the incorporation of fibrous hydroxyapatite
nanoparticles with high crystallinity and high aspect ratio, synthesized by hydrothermal
Significance:
method,Hydroxyapatite-based
into an experimental composites have
ethanol-based shown promising
one-bottle bioactivity.
dentin adhesive, improves the
However,the
mechanicalknowledge
propertiesabout
of thethe influence
adhesive of the
layer, andnano-sized
accordinglyHAp on thethe
increases properties of the to
bond strength
dental dentin
materials, especially dentin bonding adhesives, is yet insufficient. The nanorod containing
adhesive system presented here might be considered to have practical applications in dental
clinics.
• Several doping compounds - biologically active agents have been incorporated into dental
adhesives
Manuel Toledano et al; New Advanced Materials for High Performance at the Resin-Dentine Interface; Biomaterials for Oral
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and Craniomaxillofacial Applications; Karger, 2015, vol 17, 39–48
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• Zinc has been proposed as a doping agent in dental adhesives
• Zn is a cofactor of many enzymes and is essential for DNA replication - potent inhibitory
effect on osteoblastic bone resorption and can modify the production of cytokines
• Zinc ions inhibit MMPs and reduce collagen degradation in demineralised dentine
• Zinc has been shown to promote binding between collagen and other oligomeric matrix
proteins
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Comparative evaluation of microleakage of fifth, sixth, and seventh generation
dentin bonding agents: An in vitro study
Objectives: To determine the microleakage in the 5th and 6th generation bonding agents with that
compared with the newly introduced 7th generation bonding agents using three bonding agents
Results: This study showed that at the coronal margin and the apical margins, the preparations treated
with Clearfil S3 showed significantly less leakage than the other groups. Enamel margins provided
better marginal sealing than dentin/ cementum margins
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Effect of UVA-activated Riboflavin on Dentin Bonding
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References
• CURRENT CONCEPTS ON ADHESION TO DENTIN-J.D. Eick
• Adhesion to Enamel and Dentin: Current Status and Future Challenges- B Van Meerbeek
• Water treeing-a potential mechanism for degradation of dentin adhesives- Tay FR,Pashley
• Effects of dentin permeability on restorative dentistry –Dent clin N Am 46 2002
• Hybridization of dental hard tissues – Nakabayashi ,David pashley
• Dental adhesion review: Aging and stability of the bonded interface Lorenzo Breschi
• Effects of water on dentin bonding Thomas Jacobsenl, Karl-Johan Siiderholm
• The smear layer in endodontics – a review D. R. Violich1 & N. P. Chandler
• Operative Dentistry 2000 mar-apr25(2)
• Dental update 2011 may38(4)
• Resin-ceramic bonding:JPD 2003
• Effect of Cyclic Loading on the Microtensile Bond Strengths of Total-etch and Self-etch Adhesives
M. Toledano, R. Osorio, A. Albaladejo, F. S. Aguilera, F. R. Tay, and M. Ferrari
• Bonding of Self-etch and Total-etch Adhesives to Carious Dentin M. Yoshiyama, F.R. Tay
• Fundamentals of Operative Dentistry: A Contemporary Approach-James B. Summitt
• Phillips' Science of Dental Materials-By Kenneth J. Anusavice
• Sturdevant's Art & Science of Operative Dentistry
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