KCI등재
Current Status of Dentin Bonding System
저자
Rawls,H.R. (Division of Biomaterials, School of Dentistry, The University of Texas) ; Lee,Y-R (Department of Dental Materials, College of Dentistry, Chonnam National University) ; Park,Y-J (Department of Dental Materials, College of Dentistry, Chonnam National University) ; Song,J-E (Department of Dental Materials, College of Dentistry, Chonnam National University) ; Hwang,K-S (Department of Dental Materials, College of Dentistry, Chonnam National University)
발행기관
학술지명
대한치과재료학회지(THE JOURNAL OF THE KOREA RESEARCH SOCIETY FOR DENTAL MATREIALS)
권호사항
발행연도
2000
작성언어
English
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515.12
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Advances in adhesive technology have occurred at a remarkable pace over the past few years. It seems as though every month brings a "new" and "better" bonding system onto the market. Clinical protocols are constantly changing. Just when clinicians have mastered one technique, they find it has been supplanted by another. A wide variety of bonding materials are currently available and many more will no doubt follow shortly. Practitioners are therefore faced with an extremely confusing and frequently frustrating situation when making a choice among bonding materials.
There are, however, some fundamental concepts applicable to almost all adhesive systems.
Multiple component systems comprising at least two or even more parts were developed making the application procedure rather complex and susceptible to mistakes. In the multi-component dentin bonding adhesives, there is a basic 3-step procedure in treatment of the dentin surface prior to the application of viscous dental composite restoratives or luting materials ; i.e., 1) surface conditioning, 2) surface priming, and 3) intermediary layering of fluid bonding resins. Recently, many companies introduced adhesive bonding systems that incorporate primer and bonding resin into one bottle. These have the advantages of being less complicated to use, and reducing chair time, confusion for dental personnel during application, and technique sensitivity. Most simplify the two-step method of "priming and bonding resin" into a one step procedure, making it simpler and faster to use. These products still companies have introduced self-etching primers, which have mild acid conditioning combined with the ability to promote chemical bonding. These do not require rinsing after applying the self-etching primer. Instead, one can go directly to the bonding resin application step.
Successful bonding of resin-based filling materials to tooth structure can only happen when the adhesive fulfills the following properties. It should 1) wet the substrate. and 2) infiltrate the porous structure of the dentin. The clinical success of current adhesive systems has been attributed to their primer's ability to infiltrate the dentinal tubules and diffuse into exposed collagen fibers of the demineralized dentin and subsequent polymerization therein producing what has been referred to as the 'resin-impregnated' zone or 'hybrid layer'. Thus, every primer has its priming agent dissolved in some kind of solvent. Acetone enhances good penetrability into dentin surfaces. Acetone also acts as a solvent and carrier for the resins, and displaces the water on dentin surfaces. If left over-dry or over-wet after the rinsed dentin surface is dried following acid conditioning, the bond quality will suffer. Therefore, many companies replace acetone with ethanol/acetone or ethanol or even water. Once the conditioned surface is completely saturated, any remaining solvent should be dried thoroughly. If all the acetone does not completely evaporate, primer will not polymerize completely resulting in low bond strength and post-operative sensitivity.
To promote adhesion to tooth surfaces, the bonding agent should contain some ingredient that will complement the adhesion mechanism by developing chemical bonds to the dentin substrate. More importantly, there should be mechanical interlocking. The polymerized adhesive must interlock closely with the irregularities of the conditioned enamel surface and should penetrate into the spaces between collagen meshes left after the conditioning treatment. Finally, 3) a bonding agent also needs the ability to absorb energy, in order to provide stress resistance and long-term performance. Shrinkage upon polymerization of the resin-based restorative, and mastication forces, both generate stress within the adhesive layer, which it must resist in order to retain the restoration and to continue to provide excellent marginal integrity. For this, several dentin bonding agents were recently introduced with nano-particles in the adhesive resins. 4) Easy placement and lack of technique sensitivity are also very important for the successful DBA.
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