Review Adhesive

d e n t a l m a t e r i a l s 2 8 ( 2 0 1 2 ) 7286

Available online at www.sciencedirect.com

jo ur n al homep age : w ww.int l .e lsev ierhea l th .com/ journa ls /dema

Review

Durability of bonds and clinical success of adhesiverestor

Ricardo David Ha DepartmenWesbrook Mb DepartmenUSAc Departmend Departmen

a r t i c

Article histor

Received 5 A

Received in

19 Septemb

Accepted 19

Keywords:

Dentin

Adhesives

Durability

Clinical out

CorresponE-mail a

0109-5641/$doi:10.1016/ations

M. Carvalhoa,, Adriana P. Mansoa, Saulo Geraldeli b, Franklin R. Tayc,. Pashleyd

t of Oral Biological and Medical Sciences, Division of Biomaterials, University of British Columbia, Faculty of Dentistry, 2199all, Vancouver, BC, V6T 1Z3, Canadat of Restorative Dental Sciences, Division of Operative Dentistry, University of Florida, College of Dentistry, Gainesville, FL,

t of Endodontics, Georgia Health Science University, School of Dentistry, Augusta, GA, USAt of Oral Biology and Maxillofacial Pathology, Georgia Health Science University, School of Dentistry, Augusta, GA, USA

l e i n f o

y:

ugust 2011

revised form

er 2011

September 2011

come

a b s t r a c t

Resindentin bond strength durability testing has been extensively used to evaluate the

effectiveness of adhesive systems and the applicability of new strategies to improve that

property. Clinical effectiveness is determined by the survival rates of restorations placed in

non-carious cervical lesions (NCCL). While there is evidence that the bond strength data

generated in laboratory studies somehow correlates with the clinical outcome of NCCL

restorations, it is questionable whether the knowledge of bonding mechanisms obtained

from laboratory testing can be used to justify clinical performance of resindentin bonds.

There are signicant morphological and structural differences between the bonding sub-

strate used in in vitro testing versus the substrate encountered in NCCL. These differences

qualify NCCL as a hostile substrate for bonding, yielding bond strengths that are usually

lower than those obtained in normal dentin. However, clinical survival time of NCCL restora-

tions often surpass the durability of normal dentin tested in the laboratory. Likewise, clinical

reports on the long-term survival rates of posterior composite restorations defy the relatively

rapid rate of degradation of adhesive interfaces reported in laboratory studies. This article

critically analyzes how the effectiveness of adhesive systems is currently measured, to iden-

tify gaps in knowledge where new research could be encouraged. The morphological and

chemical analysis of bonded interfaces of resin composite restorations in teeth that had

been in clinical service for many years, but were extracted for periodontal reasons, could be

a useful tool to observe the ultrastructural characteristics of restorations that are regarded

as clinically acceptable. This could help determine how much degradation is acceptable for

clinical success.

2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

ding author. Tel.: +55 14 81665150.ddresses: [email protected], [email protected] (R.M. Carvalho).

see front matter 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.j.dental.2011.09.011

d e n t a l m a t e r i a l s 2 8 ( 2 0 1 2 ) 7

Contents

1. Intro2. The C3. Effec4. The e5. Asse

inter6. Conc

AcknRefer

1. Int

Attempts tomust inclucore evaluasurvival tdentin [1,2]that becausethe reasons nding that as comparedditions for rthe value oimproved atechniques

The issurent researBecause bodurable [3],stand why of its neiggiven to exdespite of and advancerogeneity dentin surftreatmentsties of thethe currentlaboratory tory outcomclinical perrelationshiand clinica

While itthe bondinadhesion [5caries-affecdentin, magenerated fsand-papereffectiveneof restorati[10]. This aduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73lass V non-carious cervical lesions (NCCL): a clinical effectiveness paradigm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

tiveness of adhesives in supporting longevity of posterior composite restorations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76nigma of the protective enamel margins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

ssment of in vivo bonded interfaces: retrieval and analysis of clinically aged resinenamel and resindentinfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80luding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82owledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82ences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

roduction

determine the effectiveness of adhesive systemsde durability testing. The pioneer work of Buono-ted the quality of adhesion by determining theime of bonds of acrylic resin made to enamel and. As stated by Buonocore (1955), At this time we feel

evidence of this nature has not been previously reported,for the increased adhesion are less important than thethe adhesive bond attained on treated (i.e. acid-treated)

to untreated (i.e. control), surfaces survived oral con-elatively long periods of time, it became clear thatf the newly developed technique was because thedhesion was more durable than previous adhesion.e of bond durability has dominated most cur-

ch in both resin-enamel and resindentin bonding.nds made to enamel are regarded as reliable and

most of the attention has been devoted to under-bonding to dentin does not match the durabilityhboring hard tissue. Several reasons have beenplain why bonding to dentin is still a challenge,the improvements in dental adhesive technologyes in bonding knowledge. These include the het-of the structure and composition of dentin, theace characteristics after bur cutting and chemical; and bond strategy and physicochemical proper-

adhesives, among other variables [38]. Most of knowledge of bonded interfaces originated fromstudies. The question as to whether these labora-es are somehow related or can be predictive of

formance remains dubious. Except for a few weakps [7], most of the attempts to correlate laboratoryl data are inconclusive [7,9].

is widely recognized that the characteristics ofg substrate plays a major role on the quality of], and that clinically relevant substrates includeted, caries-infected, sclerotic, deep, and bur cutjor new insights in bonding mechanisms are oftenrom laboratory studies using sound, freshly cut and

abraded dentin as the testing substrate. Clinicalss of adhesives is assessed from the performanceons placed in Class V, non-carious cervical lesionspproach provides direct evidence of the ability of

the adhesive to effectively bond, because the restorations failby loss of retention. However, the type of sclerotic substrateencountered in such lesions is rather unique [11,12] and maynot reect how adhesives bond to other clinically availablesurfaces for bonding. Class II composite restorations fail fre-quently because of marginal leakage that leads to secondarycaries [13,14]. The breakdown of interfacial sealing poses achallenge to the longevity of restoration [15,16]. If longevityof these restorations are mainly affected by leakage of oraluids and bacteria along the interface [7], studies on thisphenomenon should be more clinically relevant to better pre-dict the clinical performance of adhesive restorations [7,17,18].Instead, bond strength data are generally used for such pre-dictive analysis, even though no correlation seems to existbetween bond strength and marginal leakage [19]. All this mayaccount for the difculties in establishing a reliable and pre-dictive relationship between durability of bonds measured inthe laboratory and clinical success of adhesive restorations.Several clinically possible adjunctive procedures have beensuggested to improve short-, and perhaps long-term adhe-sion to dentin. These include ethanol wet-bonding [20,21],extended adhesive application time [2224] use of warm airto accelerate solvent evaporation [24], use of protease enzymeinhibitors [2529], use of collagen cross-linkers [3032], andrubbing action during the adhesive application [33,34]. Whilethese strategies have been proved quite effective underlaboratory and short-term in vivo conditions [26,31,3538],only a few have been translated to a controlled clinicaltesting [3941].

While durability testing in the laboratory has consistentlydemonstrated bond degradation within a relatively shortperiod of time [42], clinical data indicate that resindentinbonds last much longer [7,4345]. This suggests that the mech-anisms involved in the degradation of bonds observed inlaboratory may not apply at the same rate clinically, or theeffects of the degradation of the bonds have a secondary rolein the clinical success of restorations.

This article will not provide an exhaustive review the topicon durability of bonds and the respective clinical outcome.Several excellent review articles have been published withinthe last 2 years that cover the current knowledge on that topicin detail [3,5,7]. Rather, this review intends to critically analyzesome of the approaches used to evaluate the effectiveness ofadhesive systems and, perhaps, stimulate new approaches tothis topic.286 73

74 d e n t a l m a t e r i a l s 2 8 ( 2 0 1 2 ) 7286

2. The Class V non-carious cervical lesions(NCCL): a

Clinical effein Class Vmended by[10]: (a) cercal retentioof the restand dentincal aspect oaccess for odirect visuare relativevariability; tiple teeth, and (f) the less importthe adhesiv

The devmultifactornation of echaracterizphysiologicor completence of scleareas, whictubules [50specic feaprobably nThese lesioability of tthe presen(Fig. 1), whbacteria (Fifound undeing as a sccross-bandthe hypermsclerotic deture also vaThicker andthe deepesgival walls,gingival waby which tunique mulocally andbond strenbeing reposound dentobstacles ption of adhea manner sdentin. As the hybrid ing with etdentin is suabraded de

remarkable, however, that this reduced bonding efcacy iscapable of retaining NCCL restorations in clinical service for

s mustra

[4,54ardinnam

gen enam

cons pe

ing n NCC

fromed thg sue co5]. W

appfrome in

ed tth ths weunatt adhw w

denns hoh funelf-eer ceadheoratikyo,0-Me thamproterislacelity oed frond t

of fuerfo

[7,8,4nds58,59

inteto N

actuestobilitred uch tion

degenoun

com clinical effectiveness paradigm

ctiveness of adhesive systems is ideally conducted non-carious cervical lesions (NCCL) as recom-

the ADA [46]. Such lesions are preferred becausevical lesions do not provide any macromechani-n, therefore ineffective bonding will result in lossoration; (b) the restoration contains both enamel

margins; (c) they are usually located on the buc-f anterior and premolar teeth, thus offering goodperative procedures and subsequent evaluation byalization or replication; (d) restorative proceduresly easy and minimal, thus reducing the operator(e) lesions are widely available and are seen in mul-thus facilitating patient selection and study design;mechanical properties of the composite resin areant to the outcome than the actual performance ofe [7].elopment of non-carious cervical lesions involvesial etiologies. They usually form due to a combi-rosion, abrasion and abfraction [4749]. They areed by the presence of sclerotic dentin that has beenally and pathologically altered, resulting in partiale obliteration of the dentinal tubules by the pres-rotic casts. Patency of tubules is found in sensitiveh are usually sparsely distributed among occluded]. The ultrastructural analysis of NCCL revealedtures that make this a unique bonding substrate,ot found anywhere else in the mouth [11,51,52].ns present a complex structure with high vari-ubule occlusion. The surface is characterized byce of a hypermineralized layer of varied thicknessich is invariably associated with the presence ofg. 2a and b). Denatured collagen brils have beenrneath the hypermineralized layer, probably serv-affold for mineral deposition. Apparently sound,ed collagen could only be observed at the base ofineralized layer where it transitions to underlyingntin. The thickness and composition of the struc-ries depending on the location in a NCCL (Fig. 1).

more bacterially contaminated layers are found int regions of the lesion. Along the occlusal and gin-

the hypermineralized layers are thinner, and thell may be devoid of bacteria. The dynamic modelhese lesions are formed and develop results in altilayer structure that is in constant change both

over time [11]. Because of such characteristics,gths to naturally formed NCCL have systematicallyrted as being 2050% lower than bonds made toin. This reduced bonding efcacy is a result of theresent in NCCL that prevent the optimal interac-sive resins with this substrate [11,5153], at least inimilar to what has been demonstrated with soundthoroughly demonstrated by Tay and Pashley [11],layer morphology after self-etching or wet bond-ch-and-rinse adhesives in natural, intact scleroticbstantially different from that observed in sound,ntin created with the same C-factor (Fig. 1). It is

perioddemondentin

Regresinemostlysound[5,7]. Insystemals usabove,differsacceptbondinand thtems [readilynated outcomexploract wistudieunfortcurrento knoto theexplaithrougmild sionomthese of restInc., Totains 1assumsibly icharactions pdurabireportthat boactionto outpNCCL that bo[44,45,on theresins on thethese rical stameasuhow mrestora

Theendogcollageicantlych longer [3,7,10] than laboratory studies take tote signicant degradation of bonds made to sound,55].g effectiveness, the current knowledge about theel and resindentin bonding mechanisms waserated from laboratory studies generally using,el and dentin from extracted human third molarstrast, the current knowledge about how adhesiverform clinically was originated from clinical tri-on-carious cervical lesions (NCCL) [3,7]. As seenLs contain a unique dentin bonding substrate that

that of mid-coronal third molars. It is widelyat the chemical and structural characteristics of

bstrates highly inuence the bonding mechanismsnsequent bond strength outcome of adhesive sys-ithout challenging this premise, one could notly the knowledge in bonding mechanisms origi-

mid-crown third molar dentin to justify the clinical NCCL. Only a few studies are available that havehe mechanisms through which adhesives inter-e unique NCCL substrate [11,5153,56,57]. Thesere conducted approximately 715 years ago. It ise that more recent studies are not available usingesive systems. It would be desirable, for instance,hether the AD bonding concept [8] also appliestin substrate encountered in NCCL. This conceptw and why chemical bonding with hydroxyapatitectional monomers, such as 10-MDP and 4-MET, of

tch adhesives and the polyalkenoic acid of glass-ments enhances durability of bonds made withsives to sound dentin. Based on the survival ratesons placed on NCCL using Clearl SE Bond (Kuraray

Japan) [8,56,58], a mild-self etch adhesive that con-DP as the functional monomer, it is plausible tot chemical bonding not only occurs, but it is pos-ved in NCCL due to its hypermineralized surfacetics. The 8-year clinical survival of NCCL restora-d with Clearl SE Bond [58] largely surpasses thef bonds made with this adhesive to sound dentin asm laboratory studies [3,8]. Glass-ionomer cements

o both enamel and dentin largely by chemical inter-nctional polymers with hydroxyapatite, are knownrm resin adhesives in clinical trials using Class V5,59,60]. Recent long-term clinical trials indicate

made to NCCL can provide up to 13 years in service]. Unfortunately, no long-term laboratory studiesrfacial morphology and bond strength of adhesiveCCL are available. Such studies could help focusal mechanisms supporting the clinical success ofrations. If laboratory studies can reproduce the clin-y of the bonds and the actual bond strength can beover time, then one can have a better estimate ofbond strength is necessary to retain a Class V NCCL.radation of adhesive interfaces due the action ofs dentin proteolytic enzymes acting on exposedbrils is recognized as a mechanism that signif-promises the durability of bond strengths and

d e n t a l m a t e r i a l s 2 8 ( 2 0 1 2 ) 7286 75

Fig. 1 Schdentin of N

the integritknowledgesound dentthe authorsinvestigatedentin protmatic degrwith etch-thicker demincompletelagen bril(Fig. 1) wasof phosphoogy was sim[11]. Converof NCCL wthat did noWhen the hally covershypermineematic of potential deterrents to resin-inltration following totaCCL.

y of hybrid layers made to dentin [54,61,62]. This has also been mostly generated from coronal,in from molar and premolar teeth. To the best of knowledge, there are no studies available that hadd the presence, activity or the role of endogenouseases on resindentin bonds made to NCCLs. Enzy-adation of bonded interfaces are mainly observedand-rinse adhesives [6163] because they haveineralized zones that pose a higher risk of formingly resin-inltrated hybrid layers, thus leaving col-s exposed. Hybrid layer formation of about 5 m

observed along the occlusal and gingival wallsric acid-etched sclerotic NCCL, whose morphol-ilar to that observed in acid-etched sound dentinsely, hybrid layer morphology on the deepest partsas erratic in appearance and eccentric in shapet resembled that seen in sound dentin (Fig. 1).ypermineralized layer is present in NCCL, it usu-

a bed of denature collagen brils [11]. If theralized layer is so thick that acid-etching does not

dissolve it [bonded intmatrix protive. Althouto see in soufaces, no inare these hNCCL suffeas describeNCCLresinproteases rfor this speet al. [65]. Imid-coronaOne-Step (Bwere reducin 37 C watsticks was iSpecimensvals for upl-etching or self-etching in sound and sclerotic

11], then the collagen brils will remain within theerface. This hypermineralized layer may keep theteases covered with mineral crystallites and inac-gh hybrid layer morphology, as we are accustomednd dentin, may be observed in NCCL bonded inter-formation is available as to how well-inltratedybrid layers. If we assume that hybridization inrs from the same obstacles for resin inltrationd for sound dentin [6,64], the longer durability of

bonds may be due to the fact that the matrixemain mineralized and inactive. Indeed, supportculation can be found in a recent study by Kimn that study, resindentin bonds were created onl extracted third molars using the etch-and-rinse,isco) or Single Bond (3M-ESPE). The bonded teeth

ed to 0.9 mm 0.9 mm 6 mm sticks and incubateder for accelerated aging. A second group of bondedncubated in a biomimetic remineralizing solution.

were removed from both groups at regular inter- to 1 year to permit measurement of microtensile


Fig. 2 (A)wedge-shahyperminehyperminearrow). (B) etched witbeing abseeroded by

bond strenresindentiresindentiline to 21the bond sfall below 3in vitro incudegraded, wThus, remiprevented matic degrrarely consclinical failadhesive [3

Clearly, ther explomuch to lethat couldsystems. This demineralized TEM micrograph showed a hypermineralizeped lesion that was about 14 m thick. Bacteria colonies were trralized layer (pointer). Another species of bacteria (arrowhead) aralized layer. Dentinal tubules were not occluded with sclerotic cDemineralized TEM micrograph of an erratic hybrid layer fromh 40% phosphoric acid and bonded using Clearl Liner Bond 2V. nt (arrow) where a hypermineralized layer (HM) was present, to bacteria (B). A: adhesive; SD: sclerotic dentin.

gth and transmission electron microscopy of then bonded interface. In the control groups, then bond strengths fell from 3740 MPa at base-23 MPa after 1 year. In the remineralizing group,trength at time zero were 3942 MPa and did not839 MPa, a nonsignicant decrease over 1 year andbation. TEMs showed that the control hybrid layershile the remineralized hybrid layers did not [65].

neralization of resin-spare water-rich hybrid layersendogenous protease-induced degradation. Enzy-adation of collagen at NCCL bonded interfaces, isidered as a cause of failures in clinical trails. Rather,ures are generally attributed to the hydrolysis of the,7,44,58].more basic laboratory studies are needed to fur-re the bonding mechanisms to NCCL. There isarn from the unmatched durability of these bonds

translate to improved effectiveness of adhesive

3. Efflongevity

The qualityis usually eto as ModiRetention sively detecavity walis requireddivergent is largely ration andrestorationII resincomfaces, eventhe qualitytions is indd layer (HM) within the deepest part of aapped inside this layer (hollow arrow) by a thinccumulated along the surface of theasts and were also lled with bacteria (solid

the apex of a wedge-shaped lesion that wasThe thickness of the hybrid layer varied from5 m (Hd) where the latter was thin and was

ectiveness of adhesives in supporting of posterior composite restorations

of resin composite restorations in posterior teethvaluated by a system of clinical parameters referreded USPHS Criteria or USPHS/CDA Criteria [66,67].

of posterior composite restorations is not exclu-rmined by the ability of adhesives to bond to thels. Except in cases where minimal intervention

and the resultant preparation is shallow withwalls, retention in composite resin restorationsdetermined by the self-retentive cavity congu-

friction to opposing cavity walls. In contrast tos of NCCL, one would not expect Class I or Classposite restorations to fall off their restored sur-

in total absence of adhesion. Because of that, of adhesion in posterior resincomposite restora-irectly evaluated by parameters such as marginal


integrity (presence of ditching and/or gaps), marginal stainingor discolortiguous witas secondaing and thof clinical fSecondary the major dite restoratregarded auids alonand dentalof the inabstudies havdefects anIn vivo stuleakage or minants oThe relatioand develoinvestigate[77,8082]. studies to bonds [83,8

Althougagreement ing [19], thpreferred msystems ancomposite associationformance oparametersmarketed lower bondassociated versely, supadhesive sfrom Kerr from Kurarand clinica

In contrdata produteeth encouin posterioies aimingdurability treductions time (ca. 6[42]. Becausof the bondsive restoraobtain suppformance oresindentithen one wsible for anhas not beeuation perithe major c

associated with patients considered at high risk for caries. This implies that the clinical effectiveness of theve sntainves wted suivouireable

studver nly bs whare ave

ing sith ay borach ah th

witommentlompd (Ktivel

for ], whher s. Ace ok cacomp, a th. All een rct corecen

give

cleastemve sye lik

is se efftienturab

careve re

Thins

beene anl suc

sealation, and ultimately, the presence of caries con-h the margin of the restoration, usually referredry caries [6668]. Advanced ditching and stain-e presence of secondary caries are determinantsailure and replacement of the restoration [67,69].caries has consistently been identied as one ofeterrents of longevity in posterior resin compos-ions [7072]. Secondary caries has therefore beens a clinical failure resulting from leakage of oralg the interface between the restorative material

hard tissues [7275]. Leakage, in turn, is a resultility of the adhesive to seal the interface. In vitroe shown a clear relationship between marginal

d microleakage with secondary caries [74,76,77].dies, however, have failed to demonstrate thatmarginal gaps smaller than 250400 m are deter-f demineralization beneath restorations [78,79].nship between marginal gap size and geometrypment of secondary caries have been extensivelyd in cariology using microcosm biolm modelsSuch models could be used in resindentin bondsinvestigate how biolm affects the durability of4].h it has been shown that there is no correlation orbetween marginal leakage and bond strength test-e latter has been systematically employed as theethod to evaluate bond effectiveness of adhesived infer associations with clinical performance ofrestorations [3,7]. It is noteworthy, however, thats between bond strength data and clinical per-f resin composite restorations, established valid

to qualify the effectiveness of several availableadhesive systems [7]. For instance, consistently

strengths of single-step self-etch adhesives, waswith poorer clinical performance in NCCL. Con-erior performance of the so-called gold standard

ystems (ca. three-step etch & rinse Optibond FL,Inc.; and the two-step self-etch Clearl Bond SE,ay Inc.) was found in both laboratory bond strengthl trials [3,7].ast to NCCL (see above), in vitro bond strengthced in extracted normal molar and premolarnter more similarities with the substrate availabler resin composite restorations. Laboratory stud-

to evaluate effectiveness of adhesives throughests have consistently demonstrated signicantin bond strength within relatively short periods of12 m) after immersion in water or articial salivae of that, it has been inferred that such degradations may lead to premature clinical failures of adhe-tions. This causal relationship, however, does notort from the clinical literature available on the per-f resin composite restorations in posterior teeth. Ifn bond strengths decrease irreversibly over time,ould expect that secondary caries would be respon-

increasing rate of clinical failures. This, however,n the case in clinical trials with the longest eval-ods [43,72,85]. Secondary caries is indeed one ofauses of restoration replacement, but it is largely

[72,85]adhesito maiadhesipresenthe eqare reqand strecentsives ohave o2 yearbonds sives hincludsives wtime mof a lathat suals witresultsstudy cthe recresin cXR Bonrespecdentin[8890are ratsystemformanlow-risof the primerJapan)have bno diremore wouldsives.

It issive syadhesiis morvice, itprovidrisk pabond dhealthadhesi

4.marg

It hasreliablclinicassureystem does not exclusively depend on its ability reliable bond strengths over time. The fact thatith high bond strength in laboratory studies alsouperior clinical performance in NCCL has created

cal concept that high and durable bond strengthsd for long-lasting restorations. Adhesives with highbond strengths over time are lacking. Apart from ay that has demonstrate stable bonds for two adhe-a period of 10 years of water storage [86], otherseen able to demonstrated stable bonds for up toen strategies for increasing the durability of theused [42]. Even the so-called gold standard adhe-shown inconsistent results in different studies,ome from the same laboratory [55,63,87]. Adhe-initial low and/or unstable bond strengths overbe considered ineffective under the parameterstory study. However, this is not direct evidencedhesive will perform poorly clinically. Clinical tri-e longest evaluation period have shown excellenth adhesives that were available at the time theenced, which means 1222 years ago. For instance,

y published 22-year clinical evaluation of posteriorosite restorations used Scotchbond 2 (3M ESPE) anderr) to bond P-50 (3M ESPE) and Herculite XR (Kerr),y. The reported shear or tensile bond strengths tothese adhesives were in the range of 415 MPaich despite of limitations in direct comparison,lower values than one could expect from currentnother 12-year clinical trial reported superior per-f resin composites over amalgam restorations inries patients [85]. The adhesive system used in 93%osite restorations in that study was PhotoBond/SAree-step etch & rinse system (Kuraray Inc., Tokyo,these adhesives are no longer on the market andeplaced by improved versions. Although there aremparisons of their laboratory bond strength witht and current systems, it is probable that they

lower bond strengths than contemporary adhe-

r that laboratory and clinical effectiveness of adhe-s are judged by different criteria. While an effectivestem as measured by in vitro bond strength testingely to offer improved performance in clinical ser-triking that deceptive laboratory results may stillective clinical performance in well-motivated, lows [43,85]. The combination of strategies to improveility of adhesive systems [42] with improved oral

and patient motivation is the key for success ofstorations (Fig. 3).

e enigma of the protective enamel

widely accepted that resinenamel bonds ared durable [3,9193]. Indeed, restorations whosecess relies mostly on enamel bonds (e.g. pit-and-ants, laminate veneers) may be found in excellent


Fig. 3 Clinillustrate thlow risk papre-molar XR (Kerr) reobserved. Tresin comp2.1 (Dentspon the occla mesio-ocafter 7 yeaNo signs o

clinical conof this, theat the marfect sealingthus protec[55,9496]. to enamel,this has beto at denpaper [55,9transversalical aspect of resin composite restorations after several years ine satisfactory clinical outcome of earlier adhesives, composite rtients. A, B and C correspond to a mesio-occluso-distal resin comafter 18 years of clinical service. Materials used were ScotchBondsin composite. Generalized wear (B) and marginal staining on thhere were no clinical or radiographic signs of secondary caries; osite restoration in the rst left lower molar after 14 years of clinly) adhesive and resin composite Charisma (Heraeus-Kulzer). Alusal aspect, no signs of secondary caries were detected both radclusal restoration in the rst right lower molar and an occlusal rrs of clinical service. Materials applied were Single Bond (3M ESPf failure due to bond degradation, both radiographically (F) and c

dition after many years of service (Fig. 4). Becausere is a common belief that the presence of enamelgins of a cavity offers the opportunity for a per-

against the ingression of oral uids and bacteria,ting the more vulnerable bonds to adjacent dentinIn other words, when cavity margins are bonded

bonds made to dentin are more durable. Indeed,en demonstrated in vitro when bonds are madetin surfaces further prepared with ne grit sand4]. In those studies, human third molars werely sectioned to expose at dentin surfaces, all

surroundeddifferent agies. Bondeafter beingbonded intthat way, to the watface of thealso used medium fo[94]. Bonde function, placed by the same operator. Theyesins and bond techniques in well-motivated,posite restoration in the rst upper left

Multi Purpose (3M ESPE) adhesive and Herculitee distal, cervical dentin margin (C) can be(D) and (E) correspond to a mesio-occlusal-buccalical service. Materials used were Prime&Bondthough signicant wear with marginal exposureiographically (D) and clinically (E); (F) and (G) areestoration in the second right lower molar, bothE) adhesive and resin composite P60 (3M ESPE).linically (G).

by enamel. The entire surface was bonded withdhesive systems using different bonding strate-d teeth were then either stored as whole teeth or

longitudinally sectioned in two halves to exposeerface with dentin along the crown diameter. Inone group had only the enamel bond exposeder storage medium and the other had one sur-

dentin bond exposed to the medium. One studyoil to replace water as an experimental storager the teeth with exposed resindentin interfacesd specimens were stored for 1 year [94] or up to


Fig. 4 Radtransversa(Dentsply, (Johnson &X-ray wereservice for enamel mathe restoraPavarini, Dat Bauru ScSP, Brazil.)

4 years [55microtensil24 h after bindicated ttection to tresindentistorage, sigfor most othe resultsfrom the msives, whicstrengths [6seal of enainterfaces aadhesives, time. Not sbic adhesivuse solvendation evenfact that thinterfaces estorage in

water on the adhesives was the leading cause of bonds degra- over time. Indeed, methacrylate-based adhesives aretible

uirongentie orar, ttrense insteracialagen

enzce. He of r

an el of a

wertione throtef anme pdationsuscepin oralArmstresindesterasor 1 yebond sdecreaterol ein artiof collgenaseinterfasurfac

Fordationresultsrestorabecausbond pence othe saiograph, close and wide view of a Class IVl fracture restored with UV-cured Nuval-FilCaulk) resin composite and using Adaptic ARM

Johnson) bonding agent. The photographs and taken on June 2011. The restoration was in35 years. The presence of acid-etched bondedrgin ensured retention and marginal integrity oftion for many years. (Case treated by Dr. AymarDS, PhD, retired Professor of Pediatric Dentistryhool of Dentistry, University of So Paulo, Bauru,

] before being sectioned into beams and tested ine bond strength. Control specimens were testedeing bonded. General results of both in vitro studieshat the presence of resinenamel bond offers pro-he adjacent resindentin bonds. Conversely, whenn bonded interfaces were exposed to water duringnicant reductions in bond strength were observedf the adhesives tested. General explanations for

focused on the effects of the water sorptionedia on the mechanical properties of the adhe-

h are known to cause reductions in of interfacial,97]. Presumably, without the protective peripheralmel bond, water more easily reached resindentinnd promoted degradation of the structure of thethus resulting in reduced bond strengths withurprisingly, bonds made with the more hydropho-es, i.e., the three-step etch & rinse systems thatt-free adhesives, were more resistant to degra-

when dentin interfaces were exposed [55]. Thee bond strength of specimens with resindentinxposed were either maintained or increased afteroil [94] reinforces the concept that the effects of

ties cut in C-factor catraction strlayers thatence of a tsummate tregardless gins [87,107increases thif not all fand have tresin dentiknowledgehost-derivethe degradahybridizatiresindentitive bondedin these sta Class I cexpose midformed. Beincluded athe marginenamel bonof externaldegradationsion strengrather thanIn other wdentin promajor role Moreover, ssive degradbe observemonths). to the attack by chemicals and enzymes presentds and are biodegradable [98104]. However, both

et al. [105] and Toledano et al. [106] incubatedn sticks in Clostridium collagenase and cholesterol

in bacterial collagenase, respectively for 12 weeko determine if enzymes could lower resindentingths. While Armstrong et al. [105] found a slight

bond strength after 12 weeks incubation in choles-se, collagenase had no more effect than did storage

saliva. Toledano et al. [106] also found no effectase. They concluded that these exogenous colla-ymes were too large to diffuse into the bondedowever, these enzymes are known to attack theesin-composites [99,102].egant description of events that leads to the degra-dhesives, please refer to Spencer et al. [6]. Thesee interpreted as indicating that resin composites with enamel margins are more likely to survive,e more reliable and durable surrounding enamelcts the bond to dentin. Unfortunately, the pres-

enamel bonded margin did not seem to producerotection when bonds were made in Class I cavi-extracted teeth with diamond burs [87]. In a highvity conguration, with high polymerization con-esses, pooling of the adhesive resulting in thicker

compromise solvent evaporation, and the pres-hick smear layer due to bur cutting, all seem too reduce the durability of the bonds to dentin,of the presence of a resin-enamel sealed mar-110]. The concept that a bonded enamel margine durability of bonds to dentin assumes that most,

actors that cause bond degradation are externalo break the marginal seal and diffuse along then interface to affect the bond. In light of current, this assumption does not apply. The activity ofd enzymes (ca. MMPs and cysteine-cathepsins) intion of exposed collagen brils due to incomplete

on has been extensively demonstrated to occur inn bonds, even when there is a so-called protec-

enamel margin [2527,111,112]. A common featureudies is the experimental design. All employedavity prepared in occlusal surfaces using burs todle to deep dentin, on which bonding was per-

cause of this experimental design, all preparations sound acid-etched enamel cavosurface angle ats of the restorations. By assuming that marginalding offered adequate sealing against ingression

uids, the results suggested that the observed of hybrid layers and consequent loss of adhe-th were more due to elements conned in dentin

those originated from oral uids or storage media.ords, it suggests that the action of endogenousteases attacking unprotected collagen played aon the degradation of the bonds made to dentin.ignicant decreases in bond strength and exten-ation of collagen brils in those studies could

d within relatively short periods of time (ca. 614


The apparent controversy regarding the protective effectof enamel bond adjacent to dentin bond deserves furtheranalysis. Ddures (ca. dwhenever adhesive rdentin appgin of enamat and byand a relatcoat of hyapplied to ewater, somthis scenarhydrophilictective effeacross the demineralithus dimininduced desurface elimallows for evaporationactivity [12and becausface damaguids are lfrom beingabove, in cness will bto deal wita problem strated thaby acid etcis denatureand forms tration. Thresults in tmore difcpolymerizasorption anerties [6]. Twhen dealtions in deto dentin din dentin, ethe interfacreach the aoffers the osive interfacollagenolya faster degevents procavities prereduced boregardless t

In a stutry on secoGonzalz-Ca custom-m

4 experimental groups: a 30-m gap throughout both enameland dentin (group 1); a 30-m enamel gap and 530-m dentinal

oup 525-onda

andted bce ot aff

enal gapition

devf thel anntina

the g carsenndarat w

ut tht beerinces creast womodgatessioneemoraticent

min studccept-opl mae a

xiste the ouldsindratiorspec

the surte thes dcerneted t adh

Asval ena

ists haentin proteases are activated by the bonding proce-emineralization) [54,113] and will degrade collagenit is left exposed, unprotected by the inltratingesins. Long-term durability of bond strength toears attainable when there is an adequate mar-el bond, the surface is sound, prepared in vitro,

ne grit sand paper (ca. 600 grit SiC or ner),ively hydrophobic adhesive (ca. with an additionaldrophobic resin) [114119] is used and properlynsure optimal inltration, and the storage media isetimes containing antibacterial agents [55]. Whenio is present, even a simplied, relatively more

adhesive may survive, mostly because of the pro-ct of bonded enamel against the diffusion of waterbonded interface [55]. In the ideal scenario above,zed collagen brils are less likely to be left exposed,ishing the overall effects of dentin proteases-gradation on the stability of the interface. A atinates challenging stresses of curing contraction,

a uniform adhesive layer and improved solvent, and water storage may underestimate enzymatic

0]. Additionally, the enamel margin is always sounde it is also prepared by ne grit, wet sand paper, sur-es and cracks that could facilitate the ingression ofess likely to occur [87]. Conversely, this ideal is far

attainable in most clinical situations. As describedavities prepared by burs the adhesive effective-e challenged by contraction stresses and will haveh thicker smear layers. Although this may not befor etch-and-rinse adhesives, it has been demon-t the collagen of the smear layer is not removedhing [121,122]. Instead, this disorganized collagend by shear stresses associated with bur cutting

a gelatinous coat that compromises adhesive inl-e pooling of the adhesive in internal line angleshicker layers, from which solvent evaporation isult. Excess residual solvent compromises adhesivetion and makes them more susceptible to waterd its negative consequences on mechanical prop-hese unfavorable inuences summate even moreing with bur-created cavities in vital teeth. Varia-ntin wetness [123] affect sensitivity of adhesivesepth [5]. As cavity preparations are made deeperxternal uids have a longer path to diffuse alonge, but more uid from shorter dentinal tubules candhesive interface [124]. The presence of a vital pulppportunity for pulpal MMPs to diffuse to the adhe-ce via dentinal uid and perhaps enhance localtic and gelatinolytic activity [125], thus leading toradation of the unprotected collagen brils. Thesebably explain why bonds made in vivo in Class Isented a rapid rate of degradation as measured bynd strength and disappearance of the hybrid layershe presence of bonded enamel margins [26,27,111].dy designed to evaluate the effect of gap geome-ndary caries wall lesion development, Nassar andabezas [80] mounted prepared tooth specimens inade gap stage that created 4 different sized gaps in

gap (gr3); or a4). Secmodelevaluapresendid noas theenameof addin theparts oenamethe desize ofondarythe preof secogaps thetry, bhad noConsidinterfaand in[127], icaries investiprogre

It sof restof adjabear inin vivocally aor posenameoutcomThe eretardthat wthe rea restothe petive ofhigherindicaof cariis conmotivaprotec

5. retrieresin

Scienthistory2); a 525-m gap in both enamel and dentin (groupm enamel gap and 1,025-m gap in dentin (groupry caries was induced by a cycling microbial caries

the outcomes of enamel and dentin wall-lesionsy confocal microscopy. They concluded that the

f additional space at the dentinal cavity wall areaect the development of secondary caries as longmel gap was small (group 2). However, when the

increased to approximately 500 m, the presenceal space at the dentinal wall (group 4) resultedelopment of dentinal wall lesions in the deeper

cavity model. When gaps were uniform along thed dentinal interfaces (groups 1 and 3), the size ofl walls lesions was positively correlated with theaps. Unfortunately, studies on simulation of a sec-ies model contribute little to discussions on howce of a bonded interface would affect the outcomey caries progression [77,80,82]. Rather, they employere purposely created in different sizes and geom-e exposed enamel and dentin walls along the gapsen previously bonded with and adhesive system.g that marginal gaps are likely to occur in bondeddue to polymerization contraction stresses [126],e in extension and size due to functional stressesuld be desirable to combine simulated secondaryels with simulated functional stresses to further

how enamel and dentin bonds affect the overall of interfacial lesions.s that the presence of enamel-bonded marginsons cannot per se protect the long-term integrity

resindentin bonds. It is important, however, tod that the degradation of bonds observed in theies discussed above, were associated with clini-

table restorations, with no signs of marginal failureerative sensitivity. When restoring a cavity withrgins, clinicians should expect a more favorablend predict improved durability of the treatment.nce of a peripheral resinenamel seal seems toingression of external uids and oral bacteria

certainly accelerate the rate of degradation ofentin interface. The most favorable prognosis ofn with enamel margins could also be viewed fromtive that cavities with enamel margins are indica-ir smaller size and, therefore, tend to present avival rate [43]. Additionally, smaller size cavitiesat the patient sought treatment at an early stageevelopment, which is suggestive that the patientd about his/her oral health, and probably better

for oral hygiene habits. All this works in concert toesive bonds.

sessment of in vivo bonded interfaces:and analysis of clinically agedmel and resindentin interfaces

around the world have long shown how humans been unfolded by retrieving aged entombed


Fig. 5 SEM sineafter 10 plu reaservice in t sive (RBC) leavin le lo

bodies, sunand evaluaedge. Theirdata collecbelieve it isthe developInterestingretrieved ovbility testinmedia. Afteor part of prepared fosis of the bmany studfaces over how such idesirable ifThe abilitymechanicain functionevidence oneeded. Thdoes not allobviously, ceptable. Inare extractclinical rearestorationisfactory orextracted tethe bondedtion. If apprresin compinformation

Failuresfor changesticularly woccurrencea suitable itigations oenvironmeanswer thebacteria ca

[13nicalic cruce

callyhe sal ap[27,1ch.ew eant ve inf clitify

the Sve wlongporos th

er paecenere ole antreny coutu zyscop

the i micrographs of laboratory polished/acid demineralized res years of clinical service. The adhesive joint (AJ) presents ahe mouth. Note the loss of silica nanollers above the adheg porosities in the adhesive joint; open arrows = ller partic

ken ships, fossils, deep layers of earth crust, etc.,ting them using current technologies and knowl-

meticulous observations as well as their retrievedtion from those entities brought us to what we

our background and are the basis for establishingment of our knowledge regarding our existence.

ly, the two main items from which data can beer millenia are teeth and bone. In laboratory dura-g, teeth are bonded and stored in some agingr pre-determined periods of time, tooth specimensthe specimens are retrieved from the media andr bond strength tests and morphological analy-onded interface. This approach has been used inies to evaluate the status of resindentin inter-time, and form the basis of our knowledge onnterfaces degrade with time [7]. It would be highly

the same approach could be applied clinically. to follow up the morphological, chemical andl changes that an adhesive joint undergoes when

in the mouth would certainly provide denitiven their behavior and permit improvements wheree intra-oral imaging technology currently availableow for such microscopic evaluations required, and,extraction and/or destructive methods are unac-

real-life, however, it is not uncommon that teethed for periodontal, prosthetic or other justiablesons. Some of these teeth include resin composites that, regardless of their clinical judgment as sat-

lesionsthe cliceramto prodgraphiFrom tretrievtions approa

A fimportadhesiyears oto idenused, adhesitions asmall It seemthe llhave rhere wavailabbond sactivitby in sispectrotent of not, were in service until being extracted. Theseeth probably carry important information on how

interface performed in real life service and func-opriate records of what adhesive, bonding strategy,osite, etc., can also be retrieved, the relevance of the

increases signicantly. can provide a tremendous wealth of information

in the quality of bonded interfaces over time, par-hen one analyzes in depth the reasons for their

[128]. Retrieved primary molars offer, for instance,n situ test model for macro and microscopic inves-f the restorations after several years in the oralnt [129]. A retrieval study model was used to help

highly relevant clinical question as to whethern grow underneath sealed carious pit and ssure

status of thcomparison

AnotherMechanicatechnique bonded intage and loimages. Thwater is idmodulus zunderstandquality of t

As mendone in labresindentinamel interface of a retrieved restored toothsonable quality even after such a long period ofjoint detachment in the resin-based compositess.

0]. A similar approach has been used to evaluate performance of ceramic crowns. Failed, fracturedowns were taken for optical and SEM evaluation

images of the fragments that were further fracto- analyzed to determine the causes of failures [131].tudies above and few others that have used theproach to investigate clinically serviced restora-

32134] it is clear the potential benets of this

xamples on how the retrieval method can bringinformation about the clinical performance ofterfaces can be seen in Figs. 5 and 6 after 10 plusnical service. Although no records were available

the bonding strategy and the type of adhesiveEM images suggest a gradual dissolution of theith partial disruption of the joint in several loca-

the interface. The adhesive layer presents multiplesities, and so does the adjacent restorative resin.at the silane coupling of the resin matrix withrticles has disappeared. Similar loss of nanollerstly been reported [135,136]. The images presentedbtained using SEM only. Once the retrieved tooth isd its records audited, SEM, TEM and microtensile

gth test can be applied to the interface. Enzymaticld be investigated immunohistochemically and/ormography [137,138]. New, laser-induced breakdowny could also be used to analyze the mineral con-

nterface in a non-destructive way [139]. The clinical

e marginal integrity could be directly evaluated in

with the conditions of the interface. interesting approach is the use of nanoDynamicl Analysis of aged bonded interfaces [140]. Thisscans the mechanical properties across sectionederfaces to provide images of the complex, stor-ss moduli of interfacial structures as color-codedus, any loss of hybrid layers and replacement withentied in such images as a very low complexone. These new techniques may provide a bettering of how bond degradation relates to clinicalhe restoration.tioned before, thousands of studies have beenoratory settings searching for evidence on hown interfaces could behave clinically in bonded


Fig. 6 SEM hesi10 plus yea ood debonded cts aof the adhe s bobelow it. In e. (Bhigher mag he adadhesive m explainterfacial maindue to a th ile ap

restorationdirectly appdentin to wretrieval ofhas a greadata is acturestorative

6. Co

Recent revbonds and tions have advanced stems and htesting in cthe interfaof adhesivresindentibonds is mThere are of the inteteeth versugests that shortcominratory datastudies hava much faThis implieplay only ations. Whilfor optimabond strention in funrestorationrently bein

comtren

to sis ofimpnderhich

will

owl

ork wDHPand tefu micrographs of laboratory polished/acid demineralized adrs of clinical service. (A) Adhesivedentin interface shows ginterface at the bottom of the AJ. It is possible that such defesive into dentinal tubules is seen by the present of resin tag

this specimen, the tubules can parallel to the dentin surfacnication showing large interfacial voids at the middle of taterial attached to the underlying sound dentin. This may

failures there is no dentin sensitivity because the tubules reick adhesive joint formed or poor operator performance wh

s. However, there are important limitations toly what is learned from laboratory-studied soundhat is encountered in the clinical setting. That way,

information from aged, extracted restored teetht potential for shedding light on how laboratoryally representative of the clinical performance of

dental materials.

ncluding remarks

iews on the topic of durability of resindentinthe respective clinical outcome of adhesive restora-gathered a wealth of information that reects thetatus of the current knowledge of adhesive sys-ow improvements may be made. Bond strength

luting bond scientanalysreveal help uand warticle

Ackn

This w08 (PI: RMC), are graombination with micromorphological analysis ofce have been used to measure the effectivenesses and of strategies to increase the durability ofn bonds. The clinical effectiveness of resindentineasured by the retention rate of NCCL restorations.tremendous differences between the morphologyrfaces produced on dentin from sound extracteds that produced on natural NCCL, which sug-

their bonding mechanisms may be different. Thisg has to be taken into account when using labo-

to justify clinical outcomes. Laboratory durabilitye suggested that resindentin bonds degrade atster rate than clinical restorations take to fail.s that the durability of the bonded interface may

secondary role on the clinical survival of restora-e achieving high bond strength is a requirementl performance in laboratory studies, much lowergth might be required to retain a NCCL restora-ction and to seal interfaces in posterior composites. Self-adhesive lling resin composites are cur-g developed [141,142]. Similarly to self-adhesive

r e f e r e n

[1] BuonoadhesDent

[2] BrudecompJ Dent

[3] CardoLandueffectJ 2011

[4] PashleCarrilDent

[5] Perdigsituat2010;2

[6] SpencAdhesrestorve dentin joint of a retrieved restored tooth afteroverall morphology with relative small,re artifacts of specimen preparation. Inltrationth at the adhesive interface and dentinal tubules) SEM micrograph of another tooth taken athesive joint layer but leaving part of the resinin why even in the presence of subclinical

sealed with adhesive. The void may be in partplying the adhesive system.

posites, these materials are likely to produce lowgths to both enamel and dentin, but probably suf-atisfy the clinical needs as discussed above. The

in vivo interfaces of retrieved restored teeth mayortant features of the degraded interface that willstand which aspects are determinants of failure

are not. It is hoped that the issues raised in thisstimulate future research in the eld.

edgements

as funded, in part, by NIDCR grant #R01 DE015306-), R21 DE019213 (PI: FRT), CNPq # 307510/2010-7 (PI:UFCD Seed Program #090483 (PI: SG). The authorsl to Mrs. Michelle Barnes for secretarial assistance. c e s

core MG. A simple method of increasing theion of acrylic lling materials to enamel surfaces. JRes 1955;34:84953.vold F, Buonocore M, Wileman W. A report on a resinosition capable of bonding to human dentin surfaces.

Res 1956;35:84651.so MV, de Almeida Neves A, Mine A, Coutinho E, Vanyt K, De Munck J, et al. Current aspects on bondingiveness and stability in adhesive dentistry. Aust Dent;56(Suppl. 1):3144.y DH, Tay FR, Breschi L, Tjaderhane L, Carvalho RM,ho M, et al. State of the art etch-and-rinse adhesives.Mater 2011;27:116.ao J. Dentin bonding-variables related to the clinicalion and the substrate treatment. Dent Mater6:e2437.er P, Ye Q, Park J, Topp EM, Misra A, Marangos O, et al.ive/dentin interface: the weak link in the compositeation. Ann Biomed Eng 2010;38:19892003.


[7] Van Meerbeek B, Peumans M, Poitevin A, Mine A, Van EndeA, Nevand cl21.

[8] Van MJ, VanDent M

[9] HeintCorreclinica2011;2

[10] PeumLambconteclinica

[11] Tay FRdentin

[12] Aw TCnoncaDent A

[13] GaengMicrorestor2004;3

[14] OpdamFive-yrestor2004;3

[15] Anderof extresin-Dent 2

[16] Roulealtern

[17] RaskinReliabJ Adhe

[18] de AlmEckertmicrorestor

[19] Guzmbetwethe re606.

[20] PashleCarrilethandentinthe hy

[21] Tay FRLV, et hydro9.

[22] CardoEffectstreng

[23] Reis AGrandtimes2008;2

[24] Klein-StanisEvapoadhesJ Dent

[25] CarrilGeraldbond

[26] Carrilho MR, Geraldeli S, Tay F, de Goes MF, Carvalho RM,jadey chleblinrrestivo. Jtaniseis Aondiper DezveA, Cenzal-Amollagtreng009;9os Sano-nterfedrantunatricta Bal-Bogueubbintrengeis Aoguery deent 2osakW, Aater009;8adekashlereateechnreschjadenterficci Heblinesinoguemaron-cdhes011;1rackwo-yn resper Dtanisvaluaurab.iu Y, imitatrate011;9a RoD, Mvaluaith deumambes A, et al. Relationship between bond-strength testsinical outcomes. Dent Mater 2010;26:e100

eerbeek B, Yoshihara K, Yoshida Y, Mine A, De Munck Landuyt KL. State of the art of self-etch adhesives.

ater 2011;27:1728.ze SD, Thunpithayakul C, Armstrong SR, Rousson V.lation between microtensile bond strength data andl outcome of Class V restorations. Dent Mater7:11425.ans M, Kanumilli P, De Munck J, Van Landuyt K,rechts P, Van Meerbeek B. Clinical effectiveness ofmporary adhesives: a systematic review of currentl trials. Dent Mater 2005;21:86481., Pashley DH. Resin bonding to cervical sclerotic: a review. J Dent 2004;32:17396., Lepe X, Johnson GH, Mancl L. Characteristics ofrious cervical lesions: a clinical investigation. J Amssoc 2002;133:72533.ler P, Hoyer I, Montag R, Gaebler P.morphological evaluation of posterior compositeations a 10-year report. J Oral Rehabil1:9911000.

NJ, Loomans BA, Roeters FJ, Bronkhorst EM.ear clinical performance of posterior resin compositeations placed by dental students. J Dent2:37983.sson-Wenckert IE, van Dijken JW, Kieri C. Durabilityensive Class II open-sandwich restorations with amodied glass ionomer cement after 6 years. Am J004;17:4350.

t JF. Benets and disadvantages of tooth-colouredatives to amalgam. J Dent 1997;25:45973.

A, DHoore W, Gonthier S, Degrange M, Dejou J.ility of in vitro microleakage tests: a literature review.s Dent 2001;3:295308.eida JB, Platt JA, Oshida Y, Moore BK, Cochran MA,

GJ. Three different methods to evaluateleakage of packable composites in Class IIations. Oper Dent 2003;28:45360.an-Armstrong S, Armstrong SR, Qian F. Relationshipen nanoleakage and microtensile bond strength atsindentin interface. Oper Dent 2003;28:

y DH, Tay FR, Carvalho RM, Rueggeberg FA, Agee KA,ho M, et al. From dry bonding to water-wet bonding tool-wet bonding. A review of the interactions between

matrix and solvated resins using a macromodel ofbrid layer. Am J Dent 2007;20:720., Pashley DH, Kapur RR, Carrilho MR, Hur YB, Garrettal. Bonding BisGMA to dentina proof of concept forphobic dentin bonding. J Dent Res 2007;86:1034

so Pde C, Loguercio AD, Vieira LC, Baratieri LN, Reis A. of prolonged application times on resindentin bondths. J Adhes Dent 2005;7:1439., de Carvalho Cardoso P, Vieira LC, Baratieri LN,e RH, Loguercio AD. Effect of prolonged application

on the durability of resindentin bonds. Dent Mater4:63944.Junior CA, Zander-Grande C, Amaral R,lawczuk R, Garcia EJ, Baumhardt-Neto R, et al.rating solvents with a warm air-stream: effects onive layer properties and resindentin bond strengths.

2008;36:61825.ho MR, Carvalho RM, de Goes MF, di Hipolito V,eli S, Tay FR, et al. Chlorhexidine preserves dentin

in vitro. J Dent Res 2007;86:904.

Tb

[27] Hav

[28] SRcO

[29] TKb

[30] Acs2

[31] Dni

[32] BAmA

[33] DLrs

[34] RLdD

[35] HWw2

[36] SPct

[37] BTi

[38] RHr

[39] LAna2

[40] BTiO

[41] Sed7

[42] LLs2

[43] DAew

[44] PLrhane L, et al. In vivo preservation of the hybrid layerorhexidine. J Dent Res 2007;86:52933.g J, Pashley DH, Tjaderhane L, Tay FR. Chlorhexidines subclinical degradation of dentin hybrid layers in

Dent Res 2005;84:7416.lawczuk R, Amaral RC, Zander-Grande C, Gagler D,, Loguercio AD. Chlorhexidine-containing acidtioner preserves the longevity of resindentin bonds.ent 2009;34:48190.

rgil-Mutluay A, Mutluay MM, Gu LS, Zhang K, Ageearvalho RM, et al. The anti-MMP activity oflkonium chloride. J Dent 2011;39:5764.mar A, Drummond JL, Bedran-Russo AK. The use ofen cross-linking agents to enhance dentin bondth. J Biomed Mater Res B: Appl Biomater1:41924.antos PH, Karol S, Bedran-Russo AK. Long-termmechanical properties of biomodied dentinresinace components. J Biomech 2011;44:16914.n-Russo AK, Castellan CS, Shinohara MS, Hassan L,es A. Characterization of biomodied dentinces for potential preventive and reparative therapies.iomater 2011;7:173541.

ianco K, Pellizzaro A, Patzlaft R, de Oliveira Bauer JR,rcio AD, Reis A. Effects of moisture degree andg action on the immediate resindentin bondth. Dent Mater 2006;22:11506., Pellizzaro A, Dal-Bianco K, Gones OM, Patzlaff R,rcio AD. Impact of adhesive application to wet andntin on long-term resindentin bond strengths. Oper007;32:3807.a K, Nishitani Y, Tagami J, Yoshiyama M, Brackettgee KA, et al. Durability of resindentin bonds to

- vs. ethanol-saturated dentin. J Dent Res8:14651.

FT, Castellan CS, Braga RR, Mai S, Tjaderhane L,y DH, et al. One-year stability of resindentin bondsd with a hydrophobic ethanol-wet bondingique. Dent Mater 2010;26:3806.i L, Mazzoni A, Nato F, Carrilho M, Visintini E,

rhane L, et al. Chlorhexidine stabilizes the adhesiveace: a 2-year in vitro study. Dent Mater 2010;26:3205.A, Sanabe ME, de Souza Costa CA, Pashley DH,g J. Chlorhexidine increases the longevity of in vivodentin bonds. Eur J Oral Sci 2010;118:4116.rcio AD, Raffo J, Bassani F, Balestrini H, Santo D, doal RC, et al. 24-month clinical evaluation inarious cervical lesions of a two-step etch-and-rinseive applied using a rubbing motion. Clin Oral Investig5:58996.ett MG, Dib A, Franco G, Estrada BE, Brackett WW.ear clinical performance of Clearl SE and Clearl S3toration of unabraded non-carious Class V lesions.ent 2010;35:2738.lawczuk R, Reis A, Loguercio AD. A 2-year in vitrotion of a chlorhexidine-containing acid on theility of resindentin interfaces. J Dent 2011;39:40

Tjaderhane L, Breschi L, Mazzoni A, Li N, Mao J, et al.tions in bonding to dentin and experimentalgies to prevent bond degradation. J Dent Res0:95368.sa Rodolpho PA, Donassollo TA, Cenci MS, Loguerciooraes RR, Bronkhorst EM, et al. 22-Year clinicaltion of the performance of two posterior compositesifferent ller characteristics. Dent Mater 2011.ans M, De Munck J, Van Landuyt KL, Poitevin A,rechts P, Van Meerbeek B. A 13-year clinical


evaluation of two three-step etch-and-rinse adhesives innon-carious Class-V lesions. Clin Oral Investig 2010.

[45] van DClinicself-eA 13 y

[46] ADA Cand E

[47] LevitcNon-c1952

[48] Lee Wof adv1996;7

[49] Rees JProsth

[50] YoshistrengDent

[51] KwonFR, etusingMater

[52] Tay FRMouldnon-cultrasAdhes

[53] Yoshicharaand thocclus

[54] BreschDe Stestabil2008;2

[55] De MuSuzukadhes

[56] Van MBraemadhes

[57] YoshiCarvacervic

[58] PeumLambevaluselect

[59] van Dtwo-setch-aDent

[60] van Detch-aresin-cervic

[61] NasciPashlecariou

[62] PashleCarvaenzym

[63] De MuPoitevdegra2009;8

[64] Vaidyanathan TK, Vaidyanathan J. Recent advances in thetheory and mechanism of adhesive resin bonding toentiniomaim Yakahrogreatricta Bvar Jestorrintiarretaterateryge estorijkmentinicrourkeongeeplacractiuintjor I

estornt Depdametrosomp007;2idd Eomp976;1rosseconehabjor Iith codgeidthargi

pideotiamn vitreconjor Issochomppro

n situassaecon011;4ezwaariesomp131encielatiariesariesramb, Stroestorm J Dijken JW, Sunnegardh-Gronberg K, Lindberg A.al long-term retention of etch-and-rinse andtch adhesive systems in non-carious cervical lesions.ears evaluation. Dent Mater 2007;23:11017.ouncil on Acceptance Program Guidelines: Dentin

namel Adhesive Materials. J Am Dent Assoc 2001:12.h LC, Bader JD, Shugars DA, Heymann HO.arious cervical lesions. J Dent 1994;22:07.C, Eakle WS. Stress-induced cervical lesions: reviewances in the past 10 years. J Prosthet Dent5:48794.S. A review of the biomechanics of abfraction. Eur Jodont Restor Dent 2000;8:13944.

yama M, Matsuo T, Ebisu S, Pashley D. Regional bondths of self-etching/self-priming adhesive systems. J

1998;26:60916.g SM, Cheung GS, Kei LH, Itthagarun A, Smales RJ, Tay

al. Micro-tensile bond strengths to sclerotic dentin a self-etching and a total-etching technique. Dent

2002;18:35969., Kwong SM, Itthagarun A, King NM, Yip HK,ing KM, et al. Bonding of a self-etching primer toarious cervical sclerotic dentin: interfacialtructure and microtensile bond strength evaluation. J

Dent 2000;2:928.yama M, Ozaki K, Ebisu S. Morphologicalcterization of hypersensitive human radicular dentine effect of a light-curing resin liner on tubularion. Proc Finn Dent Soc 1992;88(Suppl. 1):33744.i L, Mazzoni A, Ruggeri A, Cadenaro M, Di Lenarda R,fano Dorigo E. Dental adhesion review: aging and

ity of the bonded interface. Dent Mater4:90101.nck J, Van Meerbeek B, Yoshida Y, Inoue S, Vargas M,i K, et al. Four-year water degradation of total-etchives bonded to dentin. J Dent Res 2003;82:13640.eerbeek B, Peumans M, Verschueren M, Gladys S,

M, Lambrechts P, et al. Clinical status of ten dentinive systems. J Dent Res 1994;73:1690702.yama M, Sano H, Ebisu S, Tagami J, Ciucchi B,lho RM, et al. Regional strengths of bonding agents toal sclerotic root dentin. J Dent Res 1996;75:140413.ans M, De Munck J, Van Landuyt KL, Poitevin A,rechts P, Van Meerbeek B. Eight-year clinicalation of a 2-step self-etch adhesive with and withoutive enamel etching. Dent Mater 2010;26:117684.ijken JW. A prospective 8-year evaluation of a mildtep self-etching adhesive and a heavily lled two-stepnd-rinse system in non-carious cervical lesions.

Mater 2010;26:9406.ijken JW, Pallesen U. Long-term dentin retention ofnd-rinse and self-etch adhesives and amodied glass ionomer cement in non-cariousal lesions. Dent Mater 2008;24:91522.mento FD, Minciotti CL, Geraldeli S, Carrilho MR,y DH, Tay FR, et al. Cysteine cathepsins in humans dentin. J Dent Res 2011;90:50611.y DH, Tay FR, Yiu C, Hashimoto M, Breschi L,lho RM, et al. Collagen degradation by host-derivedes during aging. J Dent Res 2004;83:21621.nck J, Van den Steen PE, Mine A, Van Landuyt KL,in A, Opdenakker G, et al. Inhibition of enzymaticdation of adhesivedentin interfaces. J Dent Res8:11016.

dB

[65] KTpmA

[66] CrP

[67] SmM

[68] Rr

[69] Ddm

[70] BlrpQ

[71] MrI

[72] Orc2

[73] Kc1

[74] GsR

[75] Mw

[76] HwmE

[77] Tis

[78] MA

[79] TAi

[80] Ns2

[81] Rcc1

[82] CRcC

[83] BFrA: a critical review. J Biomed Mater Res B: Applter 2009;88:55878.K, Mai S, Mazzoni A, Liu Y, Tezvergil-Mutluay A,ashi K, et al. Biomimetic remineralization as assive dehydration mechanism of collagen

cesimplications in the aging of resindentin bonds.iomater 2010;6:372939., Ryge G. Criteria for the clinical evaluation of dentalative materials. San Francisco: US Governmentng Ofce; 1971. USPHS Publ. No. 790-240.t DC. Clinical challenges and the relevance ofials testing for posterior composite restorations. Dent

2005;21:920.G, Snyder M. Evaluating the clinical quality ofations. J Am Dent Assoc 1973;87:36977.an GE, de Vries J, Arends J. Secondary caries ine around composites: a wavelength-independentradiographical study. Caries Res 1994;28:8793.

FJ, Cheung SW, Mjor IA, Wilson NH. Restorationvity and analysis of reasons for the placement andement of restorations provided by vocational dentaltioners and their trainers in the United Kingdom.essence Int 1999;30:23442.A, Moorhead JE, Dahl JE. Reasons for replacement ofations in permanent teeth in general dental practice.nt J 2000;50:3616.

NJ, Bronkhorst EM, Roeters JM, Loomans BA. Apective clinical study on longevity of posteriorosite and amalgam restorations. Dent Mater3:28.A. Microleakage in relation to amalgam andosite restorations. A laboratory study. Br Dent J41:30510.man ES, Matejka JM. Histological features of articialdary caries adjacent to amalgam restorations. J Oralil 1999;26:73744.A, Toffenetti F. Secondary caries: a literature reviewase reports. Quintessence Int 2000;31:16579.s DJ, Mangum FI, Ward MT. Relationship between gap

and recurrent dental caries beneath occlusalns of amalgam restorations. Commun Dent Oralmiol 1995;23:2004.

P, Gonzalz-Cabezas C, Fontana MR, Zero DT. A newo model to study the relationship of gap size anddary caries. Caries Res 2007;41:46773.A. Clinical diagnosis of recurrent caries. J Am Dent

2005;136:142633.as RZ, Ruben JL, ten Bosch JJ, Fidler V, Huysmans MC.ximal secondary caries lesion progression, a 20-week

study. Caries Res 2007;41:399405.r HM, Gonzalz-Cabezas C. Effect of gap geometry ondary caries wall lesion development. Caries Res5:34652.ni-Kaminski T, Kamann W, Gaengler P. Secondary

susceptibility of teeth with long-term performingosite restorations. J Oral Rehabil 2002;29:8.

MS, Pereira-Cenci T, Cury JA, Ten Cate JM.onship between gap size and dentine secondary

formation assessed in a microcosm biolm model. Res 2009;43:97102.illa E, Cagetti MG, Gagliani M, Fadini L, Garcia-Godoyhmenger L. Inuence of different adhesiveative materials on mutans streptococci colonization.ent 2005;18:1736.


[84] Brambilla E, Gagliani M, Ionescu A, Fadini L, Garcia-GodoyF. The inuence of light-curing time on the bacterialcolon2009;2

[85] Opdam12-yeaDent R

[86] HashiTen-y2010;1

[87] De MuLambeffectDent 2

[88] HoltanDouglDent 1

[89] StaninstrenganalyProsth

[90] Retiefrequirinterf

[91] Barkmenam2009;2

[92] Reis AAM, Lone-senam

[93] LogueRT, Grtwo-senam

[94] Reis AenambondiRes B:

[95] Abdaltotal-edentin

[96] Gambbordebonds

[97] CarrilDurabstorag

[98] Bean of estin an biocom5963

[99] Finer assocDent R

[100] Lin BAenzymto den2005;2

[101] Munk(di)me1990;9

[102] SantecommDent R

[103] Wangpoly(e

and identication of principal biodegradation products. JBiomed Mater Res 1997;36:40717.ou Yiodeiomermstampholesond.oledaashleesin007;1rmsttoragicrolled 001;1hiraiuzukhe boateroshiffecttrenghengelationd rackt al. In ace009;3rackH. Tivo. Oishitannelatielf-erackicroffect338ashi, et aondito S, W, e

dhesing NW, e

dhesm J Deis Aranddhesayer an Lan Mnto a334ezvereschalciuentinpencnterfes 20ization of resin composite surfaces. Dent Mater5:106772.

NJ, Bronkhorst EM, Loomans BA, Huysmans MC.r survival of composite vs. amalgam restorations. Jes 2010;89:10637.

moto M, Fujita S, Nagano F, Ohno H, Endo K.ears degradation of resindentin bonds. Eur J Oral Sci18:40410.nck J, Shirai K, Yoshida Y, Inoue S, Van Landuyt K,

rechts P, et al. Effect of water storage on the bondingiveness of 6 adhesives to Class I cavity dentin. Oper006;31:45665.

JR, Nystrom GP, Olin PS, Phelps 2nd RA, Phillips JJ,as WH. Bond strength of six dentinal adhesives. J994;22:926.ec M, Marshall Jr GW, Kawakami M, Lowe A. Bondth, interfacial characterization, and fracture surfacesis for a new stress-breaking bonding agent. Jet Dent 1995;74:46975.

DH, Mandras RS, Russell CM. Shear bond strengthed to prevent microleakage of the dentin/restorationace. Am J Dent 1994;7:446.eier WW, Erickson RL, Latta MA. Fatigue limits of

el bonds with moist and dry techniques. Dent Mater5:152731., Moura K, Pellizzaro A, Dal-Bianco K, de Andradeoguercio AD. Durability of enamel bonding usingtep self-etch systems on ground and ungroundel. Oper Dent 2009;34:18191.rcio AD, Moura SK, Pellizzaro A, Dal-Bianco K, Patzlaffande RH, et al. Durability of enamel bonding usingtep self-etch systems on ground and ungroundel. Oper Dent 2008;33:7988.F, Giannini M, Pereira PN. Effects of a peripheralel bond on the long-term effectiveness of dentinng agents exposed to water in vitro. J Biomed Mater

Appl Biomater 2008;85:107.la AI, Feilzer AJ. Four-year water degradation of atch and two self-etching adhesives bonded to. J Dent 2008;36:6117.orgi GP, Loguercio AD, Reis A. Inuence of enamelr and regional variability on durability of resindentin. J Dent 2007;35:3716.ho MR, Carvalho RM, Tay FR, Yiu C, Pashley DH.ility of resindentin bonds related to water and oile. Am J Dent 2005;18:3159.TA, Zhuang WC, Tong PY, Eick JD, Yourtee DM. Effecterase on methacrylates and methacrylate polymersenzyme simulator for biodurability and

patibility testing. J Biomed Mater Res 1994;28:.Y, Santerre JP. Salivary esterase activity and itsiation with the biodegradation of dental composites. Jes 2004;83:226., Jaffer F, Duff MD, Tang YW, Santerre JP. Identifyinge activities within human saliva which are relevanttal resin composite biodegradation. Biomaterials6:425964.sgaard EC, Freund M. Enzymatic hydrolysis ofthacrylates and their polymers. Scand J Dent Res8:2617.rre JP, Shajii L, Tsang H. Biodegradation ofercial dental composites by cholesterol esterase. Jes 1999;78:145968.

GB, Labow RS, Santerre JP. Biodegradation of aster)urea-urethane by cholesterol esterase: isolation

[104] ZbB

[105] ACcb

[106] TPr2

[107] Asm2

[108] SStM

[109] YEs

[110] ZRb

[111] Bea2

[112] BDv

[113] NMgs

[114] BMe7

[115] HHb

[116] IWa

[117] KWaA

[118] RGal

[119] VVi5

[120] TBcd

[121] SIR, Jessop JL, Armstrong SR. In vitro enzymaticgradation of adhesive resin in the hybrid layer. Jd Mater Res A 2010;94:18792.rong SR, Jessop JL, Vargas MA, Zou Y, Qian F,bell JA, et al. Effects of exogenous collagenase andterol esterase on the durability of the resindentin

J Adhes Dent 2006;8:15160.no M, Osorio R, Osorio E, Aguilera FS, Yamauti M,y DH, et al. Effect of bacterial collagenase ondentin bonds degradation. J Mater Sci Mater Med8:235561.rong SR, Keller JC, Boyer DB. The inuence of watere and C-factor on the dentinresin compositetensile bond strength and debond pathway utilizing aand unlled adhesive resin. Dent Mater7:26876.

K, De Munck J, Yoshida Y, Inoue S, Lambrechts P,i K, et al. Effect of cavity conguration and aging onnding effectiveness of six adhesives to dentin. Dent

2005;21:11024.kawa T, Sano H, Burrow MF, Tagami J, Pashley DH.s of dentin depth and cavity conguration on bondth. J Dent Res 1999;78:898905.

L, Pereira PN, Nakajima M, Sano H, Tagami J.onship between adhesive thickness and microtensilestrength. Oper Dent 2001;26:97104.ett MG, Tay FR, Brackett WW, Dib A, Dipp FA, Mai S,n vivo chlorhexidine stabilization of hybrid layers oftone-based dentin adhesive. Oper Dent4:37983.ett WW, Tay FR, Brackett MG, Dib A, Sword RJ, Pashleyhe effect of chlorhexidine on dentin hybrid layers inper Dent 2007;32:10711.ani Y, Yoshiyama M, Wadgaonkar B, Breschi L,ello F, Mazzoni A, et al. Activation ofnolytic/collagenolytic activity in dentin bytching adhesives. Eur J Oral Sci 2006;114:1606.ett WW, Ito S, Tay FR, Haisch LD, Pashley DH.tensile dentin bond strength of self-etching resins:

of a hydrophobic layer. Oper Dent 2005;30:.moto M, Sano H, Yoshida E, Hori M, Kaga M, Oguchil. Effects of multiple adhesive coatings on dentinng. Oper Dent 2004;29:41623.Tay FR, Hashimoto M, Yoshiyama M, Saito T, Brackettt al. Effects of multiple coatings of two all-in-oneives on dentin bonding. J Adhes Dent 2005;7:13341.M, Tay FR, Pashley DH, Hashimoto M, Ito S, Brackettt al. Conversion of one-step to two-step self-etchives for improved efcacy and extended application.ent 2005;18:12634., Albuquerque M, Pegoraro M, Mattei G, Bauer JR,e RH, et al. Can the durability of one-step self-etchives be improved by double application or by an extraof hydrophobic resin? J Dent 2008;36:30915.anduyt KL, Peumans M, De Munck J, Lambrechts P,eerbeek B. Extension of a one-step self-etch adhesive

multi-step adhesive. Dent Mater 2006;22:4.rgil-Mutluay A, Agee KA, Hoshika T, Carrilho M,i L, Tjaderhane L, et al. The requirement of zinc andm ions for functional MMP activity in demineralized

matrices. Dent Mater 2010;26:105967.er P, Wang Y, Walker MP, Wieliczka DM, Swafford JR.acial chemistry of the dentin/adhesive bond. J Dent00;79:145863.


[122] Wang Y, Spencer P. Analysis of acid-treated dentin smeardebris and smear layers using confocal Ramanmicrospectroscopy. J Biomed Mater Res 2002;60:3008.

[123] Prati C, Pashley DH. Dentin wetness, permeability andthickness and bond strength of adhesive systems. Am JDent 1992;5:338.

[124] DAlpino PH, Pereira JC, Svizero NR, Rueggeberg FA, PashleyDH. Use of uorescent compounds in assessing bondedresin-based restorations: a literature review. J Dent2006;34:62334.

[125] Lehmann N, Debret R, Romeas A, Magloire H, Degrange M,Bleicher F, et al. Self-etching increases matrixmetalloproteinase expression in the dentinpulp complex.J Dent Res 2009;88:7782.

[126] Irie M, Suzuki K, Watts DC. Marginal gap formation oflight-activated restorative materials: effects of immediatesetting shrinkage and bond strength. Dent Mater2002;18:20310.

[127] Frankenberger R, Tay FR. Self-etch vs etch-and-rinseadhesives: effect of thermo-mechanical fatigue loading onmarginal quality of bonded resin composite restorations.Dent Mater 2005;21:397412.

[128] Medina J. Reections on effective teaching of operativedentistry. Oper Dent 1989;14:445.

[129] Varpio M, Warfvinge J, Noren JG. Proximo-occlusalcomposite restorations in primary molars: marginaladaptation, bacterial penetration, and pulpal reactions.Acta Odontol Scand 1990;48:1617.

[130] Mertz-Fairhurst EJ, Schuster GS, Williams JE, Fairhurst CW.Clinical progress of sealed and unsealed caries. Part I.Depth changes and bacterial counts. J Prosthet Dent1979;42:5216.

[131] Quinn JB, Quinn GD, Kelly JR, Scherrer SS. Fractographicanalyses of three ceramic whole crown restoration failures.Dent Mater 2005;21:9209.

[132] Fuks AB, Chosack A, Eidelman E. Assessment of marginalleakage around Class II composite restorations in retrievedprimary molars. Pediatr Dent 1990;12:247.

[133] Donly KJ, Segura A, Kanellis M, Erickson RL. Clinicalperformance and caries inhibition of resin-modied glassionomer cement and amalgam restorations. J Am DentAssoc 1999;130:145966.

[134] Fox K, Wood DJ, Youngson CC. A clinical report of 85fractured metallic post-retained crowns. Int Endod J2004;37:56173.

[135] Brackett MG, Li N, Brackett WW, Sword RJ, Qi YP, Niu LN,et al. The critical barrier to progress in dentine bondingwith the etch-and-rinse technique. J Dent 2011;39:23848.

[136] Fukuoka A, Koshiro K, Inoue S, Yoshida Y, Tanaka T, IkedaT, et al. Hydrolytic stability of one-step self-etchingadhesives bonded to dentin. J Adhes Dent 2011;13:2438.

[137] Mazzoni A, Papa V, Nato F, Carrilho M, Tjaderhane L,Ruggeri Jr A, et al. Immunohistochemical and biochemicalassay of MMP-3 in human dentine. J Dent 2011;39:2317.

[138] Mazzoni A, Nascimento FD, Carrilho MRO, Geraldeli S,Tjaderhane L, Mazzoti G, et al. In situ zymography of thehybrid layer. J Dent Res 2011;90(Spec Iss A), abstract 3052.

[139] Alvira FC, Ramirez Rozzi F, Bilmes GM. Laser-inducedbreakdown spectroscopy microanalysis of trace elementsin Homo sapiens teeth. Appl Spectrosc 2010;64:3139.

[140] Rhou H, Niu LN, Dai L, Pucci C, Arola D, Pashley DH, et al.Effect of biomimetic remineralization on the dynamicnanomechanical properties of dentin hybrid layers. J DentRes, in press.

[141] Ferracane JL. Resin compositestate of the art. Dent Mater2011;27:2938.

[142] Hanabusa M, Mine A, Kuboki T, Momoi Y, Van Landuyt KL,Van Meerbeek B, et al. TEM interfacial characterization ofan experimental self-adhesive lling material bonded toenamel/dentin. Dent Mater 2011;27:81824.

Durability of bonds and clinical success of adhesive restorations1 Introduction2 The Class V non-carious cervical lesions (NCCL): a clinical effectiveness paradigm3 Effectiveness of adhesives in supporting longevity of posterior composite restorations4 The enigma of the protective enamel margins5 Assessment of in vivo bonded interfaces: retrieval and analysis of clinically aged resinenamel and resindentin interfaces6 Concluding remarksAcknowledgementsReferences

Documents

Review Adhesive