Biomedical subjects

J Perdigão

Publications and source records attributed to J Perdigão.

At least 37 records · Page 2Linked to original sources

PubMed2000

Bond strengths of nonrinsing adhesives.

OBJECTIVE: The purpose of this study was to determine enamel and dentin bond strengths of a nonrinsing "all-in-one" adhesive and of a nonrinsing conditioner combined with a 1-bottle adhesive. METHOD AND MATERIALS: Specimens were obtained from 240 bovine teeth ground to expose enamel or dentin surfaces. Ten enamel and 10 dentin specimens were randomly assigned to each of 12 different combinations of adhesive system (Prompt L-Pop; no etch + Prime & Bond NT; NRC + Prime & Bond NT; 36% phosphoric acid + Prime & Bond NT; no etch + Prime & Bond 2.1; 36% phosphoric acid + Prime & Bond 2.1) and restorative material (resin composite; polyacid-modified resin composite ["compomer"]). After the application of the adhesive system, a No. 5 gelatin capsule filled with the restorative material was seated against the enamel or dentin surface. After 24 hours in distilled water at 37 degrees C, the specimens were thermocycled and the shear bond strengths were measured. RESULTS: For resin composite, etching with phosphoric acid resulted in the highest bond strengths to enamel. For compomer, the highest enamel bond strengths were achieved with both phosphoric acid and Prompt L-Pop. Treating dentin with Prime & Bond NT without etching provided the highest mean bond strength for composite. For compomer, treating dentin with Prime & Bond NT resulted in the highest mean bond strengths, regardless of the conditioner. CONCLUSION: Compomer and resin composite exhibited statistically similar bond strengths. Bond strengths to dentin were significantly lower than those to enamel.

Acid Etching, Dental↗

PubMed2000

New trends in dentin/enamel adhesion.

The acid-etch-technique has provided an ideal surface for bonding to enamel by using 30-40% phosphoric acid. The resulting etch pattern is characterized by the profuse formation of microporosities which allow the penetration of monomers into those porosities to form resin tags that provide micromechanical retention. Successful attempts of bonding to dentin in a similar fashion have been reported more recently. Due to the specific properties of dentin, such as its tubular structure and its intrinsic wetness, bonding to dentin has not yet reached the ideal characteristics. In spite of the existing deficiencies in dentin adhesion, the increasing demand for esthetic restorations has generated intensive research on new esthetic materials with special focus on amalgam alternatives. The bonding mechanism of recent dentin bonding agents is based on the penetration of ambiphilic molecules into acid-etched dentin to form a lacework of dentin collagen and polymerized monomers. Dentin adhesive systems that contain a multitude of different bottles of different colors and shapes belong to the past. Because clinicians are increasingly eager to try new materials, the actual tendency calls for simplification of the bonding procedure e.g. one-bottle adhesive systems and all-in-one no-bottle materials. In spite of simpler materials, a separate etching step is still needed for one-bottle systems. Nevertheless, manufacturers of these simplified one-bottle materials recommend their use to bond polyacid-modified composites (compomers) without a separate etching step. The most recent addition to the group of simplified adhesives is the all-in-one no-bottle adhesives; one of these all-in-one systems, Prompt L-Pop (ESPE) has resulted in very promising laboratory results when used on enamel. In spite of the uncertainty about the capacity of all-in-one adhesives to etch enamel adequately in vivo, scanning electron microscopy studies have resulted in an enamel-etching pattern morphologically similar to that corresponding to phosphoric acid-etched enamel. While all-in-one adhesive systems have been reported to result in very satisfactory dentin bond strengths, results from other laboratories suggest that bonding to dentin with all-in-one adhesive systems will need to be somewhat improved. Clinical studies, which are the ultimate test for the acceptance of dentin adhesives, are now underway in several centers. Six-month data showed a very good clinical performance for this ultra-simplified all-in-one adhesive system.

Acid Etching, Dental↗

PubMed2000

Microscopy investigations. Techniques, results, limitations.

This paper critically reviews current microscopy techniques that are used to image resin-dentin interfaces and more in particular to investigate the process of hybridization and resin-tag formation. A short description of the four most commonly used microscopy techniques with their necessary specimen-preparation methodology is provided along with a discussion of their possibilities, limitations and potential artifact formation. With this critical appraisal on microscopy techniques available to study adhesive interfaces, it is hoped to encourage the use of high-resolution analytical tools to further elucidate the mechanisms of bonding at the ultra-structural level. Besides ultra-morphologic characterization, more research should be devoted to study the chemical and physical properties of resin-dentin bonds. The final objective of such fundamental research should be to establish a more durable and reliable adhesive restorative technique.

Artifacts↗

PubMed2000

Effect of conditioner and restorative resin on enamel bond strengths.

PURPOSE: To evaluate the effect of three enamel conditioners and four restorative materials on enamel shear bond strengths. MATERIALS AND METHODS: 120 bovine incisors were polished to 600-grit and randomly assigned to three enamel adhesive systems (n=40): Syntac Single Component with phosphoric acid etching (PA-SSC), Syntac Single Component without phosphoric acid etching (SSC), and Experimental Prompt L-Pop (LPI), a self-etching adhesive. The specimens were restored with one of four resin restorative materials (n=10): (1) Compoglass F, a high-viscosity compomer; (2) Compoglass Flow, a low-viscosity compomer; (3) Tetric Ceram, a high-viscosity resin-based composite (RBC); and (4) Tetric Flow, a low-viscosity RBC. After thermocycling, shear tests were carried out with an Instron Universal Testing Machine. Mean enamel bond strengths were analyzed with ANOVA and Duncan post hoc test at P < or = 0.05. RESULTS: PA-SSC resulted in higher mean bond strengths than LP1, but the difference was not statistically significant. Both PA-SSC and LP1 resulted in statistically higher mean bond strengths than SSC at P < or = 0.0001. The lowest mean bond strengths of all the groups were obtained when SSC was used with an RBC (Tetric Ceram or Tetric Flow). SSC and PA-SSC resulted in statistically higher mean bond strengths when used with a compomer than when used with an RBC, regardless of the viscosity. Although recommended to be used only with compomers, LP1 resulted in statistically similar enamel bond strengths when used with the composite of corresponding viscosity (Tetric Ceram vs. Compoglass F; Tetric Flow vs. Compoglass Flow). LP1, however, resulted in higher enamel bond strengths when combined with Tetric Ceram than when combined with Tetric Flow. When the results were pooled for "viscosity", high-viscosity restorative materials resulted in higher bond strengths than low-viscosity materials at P < or = 0.041. When the data were pooled for "restorative material", compomers resulted in higher bond strengths than composites at P < or = 0.0001.

Acid Etching, Dental↗

PubMed1999

The effect of a re-wetting agent on dentin bonding.

OBJECTIVES: Recently, a new generation of simplified one-bottle dentin bonding systems, sensitive to variations in the degree of substrate moisture, was introduced. This in vitro project compared the dentin bond strengths and interfacial ultra-morphology formed by three one-bottle bonding systems [OptiBond SOLO (ethanol-based), Prime&Bond 2.1 (acetone-based), and Single Bond (ethanol- and water-based)]. The null hypothesis tested was that re-wetting a dried dentin surface with a HEMA aqueous solution would not result in bond strengths, and resin impregnation into demineralized dentin, comparable to those obtained for moist dentin. METHODS: Dentin specimens were assigned to the following three etched surface conditions: moist dentin-control group; dentin dried for 5 s; and dentin dried for 5 s and re-moistened with a commercial 35% HEMA aqueous solution. Mean shear bond strengths were calculated and analyzed with one- and two-way ANOVA. Dentin discs treated with the same combination of surface condition/adhesive were processed and observed under both transmission and scanning electron microscopes. RESULTS: For moist dentin, the morphology of the resin-dentin interfaces showed penetration of the dentin adhesives to the depth of the transition between demineralized and unaffected dentin. Drying dentin for 5 s resulted in a significant decrease in mean bond strengths and an incompletely infiltrated collagen structure with areas of unveiled collagen fibers, regardless of the solvent. Re-wetting dentin with the aqueous HEMA solution re-established the level of bond strengths obtained to moist dentin and resulted in a raise of the fiber network with simultaneous increase in interfibrillar space dimensions. SIGNIFICANCE: The results suggest that the use of an aqueous HEMA solution might compensate for the dryness induced on dentin surfaces by using air blasts from an air syringe, after rinsing off the etchant. As the behavior of the material that contained water was also affected by surface dryness, the percentage of water included in the composition of current ethanol- and water-based adhesives, such as Single Bond, may not be enough to compensate for the collapse of the collagen filigree upon drying.

Analysis of Variance↗

PubMed1999

Molecular cloning, developmental expression, and cellular localization of the 70-kDa RPA-1 subunit of Drosophila melanogaster.

Replication protein A (RPA) is a highly conserved multifunctional heterotrimeric complex, involved in DNA replication, repair, recombination, and possibly transcription. Here, we report the cloning of the gene that codes for the largest subunit of the Drosophila melanogaster RPA homolog, dmRPA70. In situ hybridization showed that dmRPA70 RNA is present in developing embryos during the first 16 cycles. After this point, dm-RPA70 expression is downregulated in cells that enter a G1 phase and exit the mitotic cycle, becoming restricted to brief bursts of accumulation from late G1 to S phase. This pattern of regulated expression is also observed in the developing eye imaginal disc. In addition, we have shown that the presence of cyclin E is necessary and sufficient to drive the expression of dmRPA70 in embryonic cells arrested in G1 but is not required in tissues undergoing endoreduplication. Immunolocalization showed that in early developing embryos, the dmRPA70 protein associates with chromatin from the end of mitosis until the beginning of the next prophase in a dynamic speckled pattern that is strongly suggestive of its association with replication foci.

Amino Acid Sequence↗

PubMed1999

Laboratory evaluation and clinical application of a new one-bottle adhesive.

PURPOSE: The purposes of this project were to compare the enamel and dentin bond strengths of a new nanofilled one-coat adhesive system with its predecessor, an unfilled two-coat adhesive system; to analyze the dentin interfacial ultramorphology, using scanning and transmission electron microscopy (SEM and TEM); and to illustrate the clinical technique associated with the use of the new nanofilled one-coat adhesive system. MATERIAL AND METHODS: Twenty flat dentin surfaces and 20 flat enamel surfaces were polished on the labial surface of bovine incisors mounted in acrylic resin. The specimens were equally and randomly assigned to four bonding groups: (1) dentin with Prime & Bond 2.1; (2) dentin with Prime & Bond NT; (3) enamel with Prime & Bond 2.1; and (4) enamel with Prime & Bond NT. A composite post was then adapted to the treated area and light-cured. After thermocycling, shear bond strengths were determined by testing the shear strength of the specimens. The data were analyzed using one-way analysis of variance (ANOVA) and Student's t-test. For SEM and TEM, six dentin disks were obtained from middle dentin of human third molars and assigned equally to each adhesive. The adhesives were applied to dentin according to manufacturer's directions. The hybrid layer and resin penetration into dentin tubules were analyzed at an ultramorphologic level, and the observations were compared. RESULTS: Shear bond strengths were as follows: group 1: 17.8 +/- 4.1 MPa; group 2: 20.5 +/- 3.5 MPa; group 3: 24.7 +/- 6.7 MPa; and group 4; 27.0 +/- 5.4 MPa. Electron microscopy showed that both adhesives penetrated the dentin tubules and formed a fully infiltrated hybrid layer. The nanofiller included in the new one-application adhesive penetrated the dentin tubules and infiltrated the microspaces between the collagen fibers within the hybrid layer. CLINICAL SIGNIFICANCE: The new one-application nanofilled adhesive tested in this study resulted in bond strengths and dentin hybridization comparable to those obtained with the corresponding two-application system. The clinical sequences presented illustrate the ease of use of the newest simplified adhesives.

Adhesives↗

PubMed1999

Shear bond strengths of one-bottle adhesives to moist enamel.

PURPOSE: This study evaluated bond strengths of six one-bottle bonding agents and a control (primer plus unfilled resin) to moist enamel. MATERIALS AND METHODS: One-hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts). RESULTS: Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives. CLINICAL SIGNIFICANCE: The results of this study suggest that all of the one-bottle systems tested should provide clinically acceptable bonding to moist enamel.

Animals↗

PubMed1999

Fluoride release from restorative materials and its effects on dentin demineralization.

As the use of adhesive restorative materials has increased during the last several years, interest in adhesive materials that release fluoride has also grown. The purpose of this study was to measure fluoride release from several adhesive restorative materials and to evaluate its effect on dentin resistance to demineralization and on bacterial metabolism in a modified in vitro system. Standardized cavities (1.8 mm in diameter) were prepared in bovine teeth that had been ground to dentin. One cavity in each tooth was restored with one of the following restorative systems: (a) Single Bond and Z100; (b) Single Bond and Tetric Ceram; (c) Fuji Bond LC and Z100; (d) Fuji Bond LC and Tetric Ceram; (e) Fuji II LC; or (f) Fuji IX GP. The other cavity in each tooth was "restored" with wax as a control. For each restorative system, 12 specimens were evaluated for fluoride release during the first 24 hrs after restoration placement. Dentin adjacent to the restored sites was subjected to lactic acid challenge (pH 4.3) for 3 hrs, after which calcium release was measured. Another 12 specimens in each group were stored for 24 hrs in de-ionized water, and were exposed to an S. mutans suspension (1:1 THB/de-ionized water and 50 mM glucose, A660 = 0.2) for 6 hrs, followed by calcium release and pH measurement. Bulk specimens of each material were also made and stored in water. Fluoride released from Fuji Bond LC, Fuji IX GP, and Fuji II LC in bulk was significantly greater than from the other materials. In the restored dentin specimens, increased resistance to demineralization from a lactic acid challenge was directly related to fluoride release. The same effects were seen as a result of the S. mutans challenge. While fluoride release from restorative materials increased the resistance of dentin to demineralization in this system, the clinical relevance of the findings is not known.

Animals↗

PubMed1999

An ultra-morphological characterization of collagen-depleted etched dentin.

PURPOSE: To evaluate the ultramorphology of superficial and deep dentin after etching with 35% phosphoric acid (H3PO4) and after etching with 35% H3PO4 followed by deproteinization with 5% sodium hypochlorite (NaOCl). MATERIALS AND METHODS: Two dentin disks (superficial and deep dentin) were obtained from each of 10 extracted human third molars by slow-speed sectioning. Dentin was polished with wet 600-grit SiC abrasive paper for 1 min to provide smooth surfaces. The occlusal surface of each disk was etched with 35% H3PO4 for 15 s and thoroughly rinsed. The specimens were kept moist and analyzed using Atomic Force Microscopy (AFM). Half of the specimens were deproteinized by rubbing with 5% NaOCl for 2 min, followed by a 30 s rinse with deionized water. After AFM analysis of the deproteinized specimens, all disks were fixed in a solution of glutaraldehyde and paraformaldehyde, dehydrated in ethanol and dried in hexamethyldisilazane. The dentin disks were then mounted on aluminum stubs for field-emission scanning electron microscope (FESEM) observation. RESULTS: The surface of etched dentin displayed a granular layer of silica, which did not reach the peritubular collagen area. The silica was more uniformly distributed in superficial dentin than in deep dentin. In spite of the silica deposition, the intertubular porosity remained unobstructed when observed at high magnification. Under a lateral view, intertubular dentin was demineralized to a depth of 2.0 to 2.5 microns for superficial dentin, and 2.5 to 3.0 microns for deep dentin. Deproteinization with 5% NaOCl removed the exposed collagen both for superficial and deep dentin. The number of open tubules was greater for deep dentin. Deproteinization of superficial dentin revealed an extensive labyrinth of lateral secondary tubules and anastomoses, which opened on the intertubular region and on the peritubular area close to the surface. This phenomenon decreased the area of exposed intertubular dentin as compared to etched specimens. In deproteinized deep dentin, the lateral anastomotic tubules were not consistently observed on the intertubular area, but were easily depicted on the peritubular area.

Acid Etching, Dental↗

PubMed1999

Effects of repeated use on bond strengths of one-bottle adhesives.

OBJECTIVE: Most one-bottle adhesives contain organic solvents (acetone or ethanol) that displace the water entrapped within the network of collagen fibers in etched dentin. Acetone and ethanol are volatile substances that could easily evaporate from bottles during use. The objective of this in vitro study was to assess the effects of repeated opening of bottles on dentin shear bond strengths of 4 adhesives. METHOD AND MATERIALS: Eighty freshly extracted bovine incisors were mounted, polished to 600 grit, and randomly assigned to 8 groups (n = 10). After the application of the materials to 40 specimens at baseline, adhesive use was simulated by opening bottles for 1 minute, 2 times a day, for 3 weeks, except during weekends, when the bottles were kept refrigerated. After 3 weeks of simulated use, the same adhesives were applied to 40 additional specimens. Resin composite was applied to dentin in a No. 5 gelatin capsule and was light-cured. After 500 thermal cycles (5 degrees C to 55 degrees C), shear bond strength testing was performed with a universal testing machine at 0.5 cm/min. RESULTS: Adhesives containing ethanol or water had similar mean bond strengths at baseline and at 3 weeks. The acetone-based material had a significantly lower mean bond strength at 3 weeks than at baseline. CONCLUSION: Acetone-based adhesives may have a shorter useful life than ethanol- and water-based adhesives.

Acetone↗

PubMed1999

A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth.

OBJECTIVE: The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo. METHOD AND MATERIALS: Forty-eight primary molars with carious lesions were randomly assigned to 2 different treatments: group 1 (control, n = 24)--All identifiable, irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material; group 2 (experimental, n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material. The control and experimental teeth were clinically monitored every 3 months and evaluated 12 months after restoration. The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy. RESULTS: Retention rate, marginal integrity, and pulpal symptoms were identical in both groups. Radiographically, the radiolucent area associated with the experimental restorations did not increase with time in 75% of the cases. For the control group, the adhesive system formed a hybrid layer. In the experimental group, there was morphologic evidence of the formation of an acid-resistant "altered hybrid layer." An acid-resistant tissue, resulting from the interdiffusion of adhesive resin within the area of carious dentin, was observed adjacent to and under the altered hybrid layer. CONCLUSION: Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration.

Child↗

PubMed1999

Bond strengths of new simplified dentin-enamel adhesives.

PURPOSE: To compare the in vitro shear bond strengths (SBS) of five simplified dentin adhesives. The tested hypothesis was that the recently introduced simplified adhesive systems would have similar or higher SBS than an existing simplified acetone-based adhesive used as a control. MATERIALS AND METHODS: 100 flat bonding sites were polished to 600-grit on the labial surface of bovine incisors mounted in acrylic resin. 50 teeth were ground to expose enamel, while the remaining 50 specimens were prepared to expose middle dentin. The specimens were randomly divided into five equal groups to be treated with simplified dentin adhesives: Dentastic Uno, EasyBond, Gluma One Bond, One Coat Bond, and One-Step (control). A composite post was bonded to each treatment area. After thermo-cycling, enamel and dentin shear bond strengths were determined using an Instron testing machine and the data were submitted to statistical analyses. RESULTS: Mean enamel bond strengths ranged from 14.6-28.4 MPa. One Coat Bond had the highest mean enamel SBS, but it was not significantly higher than those of Gluma One Bond and Dentastic Uno. EasyBond and One-Step had statistically similar mean enamel SBS and these were significantly lower than the mean enamel SBS of the other three adhesives. For dentin, mean SBS ranged from 14.8-21.7 MPa. Dentastic Uno had the highest mean dentin SBS, but it was not significantly greater than those of One Coat Bond and Gluma One Bond. Although One Step had the lowest mean dentin SBS, it was not significantly different from those of either EasyBond or Gluma One Bond.

Analysis of Variance↗

PubMed1999

Microleakage of Class V resin-based composite restorations using five simplified adhesive systems.

PURPOSE: To evaluate microleakage at enamel and dentin margins of Class V resin-based composite (RBC) restorations using five simplified adhesive systems, one self-etching adhesive, three commercial one-bottle adhesives and one experimental one-bottle adhesive. MATERIALS AND METHODS: Class V cavities (3 mm x 2 mm x 2 mm) were prepared in sound human molars with occlusal margins in enamel and gingival margins in dentin/cementum. Etch & Prime 3.0 (Degussa), Single Bond (3M), PQ1 (Ultradent), Prime & Bond NT (Dentsply) and Experimental BEH (Dentsply DeTrey) were applied strictly according to manufacturers instructions. All adhesive systems were applied on etched substrates, except for the self-etching adhesive Etch & Prime 3.0. Cavities were restored with Z100 RBC. After finishing and polishing, teeth were thermo-cycled (x 700, 5-55 degrees C, 60 s dwell time). Specimens were coated with nail varnish, immersed in silver nitrate for 2 hours and sectioned longitudinally with a diamond disc. The extent of leakage was measured and ranked using a 0-4 scale. RESULTS: Statistical analysis using Kruskal-Wallis test revealed significantly higher leakage scores (P < 0.001) for Etch & Prime 3.0 on enamel when compared to all other adhesive systems. Regarding dentin margins none of the systems completely eliminated microleakage. PQ1 had significantly lower scores (P < 0.05) when compared to Etch & Prime 3.0 and Single Bond. No statistically significant difference was observed for the other groups.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1999

Dentin bonding--state of the art 1999.

The adhesion of restorative materials to the hard components of tooth structure has been a goal pursued by many researchers ever since Buonocore established the foundation for adhesive and preventive dentistry. Based on the industrial use of phosphoric acid to obtain better adhesion of paints and resin coatings to metal surfaces, Buonocore proposed that phosphoric acid could be used to transform the surface of enamel to "render it more receptive to adhesion." Subsequent research indicated that the formation of taglike resin prolongations into the enamel microporosities was the leading bonding mechanism of resin to phosphoric acid-etched enamel. The enamel bonding agents of the 1960s and 1970s progressively evolved into complex multibottle or universal adhesives in the early 1990s, which were designed to bond to enamel, dentin, composite, amalgam, porcelain, and non-precious metal. Although bonding to enamel has been a dependable technique, bonding to dentin still represents an overwhelming task because dentin is a naturally wet organic tissue penetrated by a tubular maze containing the odontoblastic process, which communicates with the pulp. This intrinsic moisture may actually benefit the chemistry of the newest adhesive systems, which must be applied on moist dentin to be effective. In fact, the collapse of the collagen that occurs on air-drying may prevent the adhesive monomers from penetrating the network of nano-channels formed by the dissolution of hydroxyapatite crystals between collagen fibrils. In view of the complexity of the mechanisms associated with these mechanisms, the objective of this review article is to summarize the most recent concepts in dentin bonding.

Acid Etching, Dental↗

PubMed1999

Dentin bonding--questions for the new millennium.

PURPOSE: The objective of this review article is to summarize the most recent concepts in dentin bonding and, simultaneously, challenge some convictions that have not been backed up by sound, convincing research. After the introduction of the enamel acid-etch technique by Dr. Buonocore in 1955, the increasing demand for restorative and non-restorative esthetic treatments, as well as the refinement in the utilization of fluoride-containing products, have totally transformed the practice of operative dentistry. While bonding to enamel is a reliable technique, bonding to dentin represents a greater challenge: dentin is an intrinsically wet organic tissue penetrated by a tubular labyrinth containing the odontoblastic process, which communicates with the pulp. The manufacturers of new adhesive systems recommend the application of their adhesive materials on moist dentin. The main reason is that the spatial alteration that occurs upon drying demineralized dentin may prevent the monomers from penetrating the labyrinth of nano-channels formed by dissolution of hydroxyapatite crystals between collagen fibrils. Several of the current concepts in dentin bonding have been built from the observation of clinical studies, which measure retention rates, and from laboratory bond strength studies, which measure the force needed to debond a composite post from a flat dentin area. Although their utility is doubtful as far as clinical performance is concerned, bond strength studies are still necessary in order to compare similar parameters among materials. However, both clinical and laboratory studies lack information on the dynamic behavior of the substrate in a vital environment. For example, the changes induced by adhesive systems in the resin-infiltrated demineralized dentin have not been fully characterized. Also, the role of collagenous and non-collagenous proteins in dentin bonding has been generally overlooked.

Acid Etching, Dental↗

PubMed1998

The clinical performance of adhesives.

OBJECTIVES: Traditional mechanical methods of retaining restorative materials have been replaced to a large extent by tooth conserving adhesive restorative techniques. Because adhesives have been evolving so rapidly for the last few years, the timing is right for evaluating the clinical status of present day adhesives. DATA SOURCES: Current literature with regard to the clinical performance of adhesives has been reviewed. An overview of currently available adhesive systems is provided and a categorization of these adhesives according to their clinical application procedure and their intended mechanism of adhesion is proposed. Parameters of direct relevance to the clinical effectiveness of adhesives are discussed in relation to the clinical effectiveness of today's adhesives. CONCLUSIONS: The clinical performance of present day adhesives has significantly improved, allowing adhesive restorations to be placed with a high predictable level of clinical success. Most modern adhesive systems are superior to their predecessors, especially in terms of retention that is no longer the main cause of premature clinical failure. Recent adhesives also appear less sensitive to substrate and other clinical co-variables. As the remaining major shortcoming of modern adhesives, none of these modern systems however appears yet to be able to guarantee hermetically sealed restorations with margins free of discoloration for a long time.

Adhesiveness↗

PubMed1998

Direct posterior composite resin restorations: current concepts for the technique.

Due to the development of sound clinical procedures and evolution of advanced restorative materials, composite resins are being used with increasing frequency for direct posterior applications. When the clinical protocol for the use of composite resin is performed properly, this material can be utilized with success and predictability. This article presents the advantages and limitations of this restorative modality. It also reviews the characteristics of contemporary composite resin materials and demonstrates the treatment protocol that is utilized to achieve aesthetic restorations in the posterior segment.

Acid Etching, Dental↗