Adhesion and

Dentin bonding
agents
 Contents
History
Adhesion - types
- factors affecting
Ideal requirements
Adhesion to enamel
Bonding to dentin and its problems
Conditioning of dentin
Primers
Smear layer
Hybrid layer
Classification of dentin bonding agents
Conclusion
Introduction
 History –

1955 - Buonocore acid etching with phosphoric acid

1956 - Buonocore developed the first dentin bonding agents.

1957 - Bowen gave BISGMA resin system

1982 - Bowen, Cobb and Rapson developed multilayer adhesive
system

Nakabayashi reported the presence of hybrid layer

 Adhesion – latin - to stick
s the force or the intermolecular attraction that exists between molecules of
nlike substances when placed in intimate contact with each other.

Adhesive Adherend

of adhesion –

emical - based on primary valence forces – covalent, ionic, metallic bonds

ysical - based on secondary forces – Van der Waals forces,
hydrogen bonds, dispersion forces
( specially when surfaces are smooth and polished )
chanical - based on penetration of one material into another at
microscopic level. ( when surfaces are rough )
Factors affecting adhesion –

1. Surface energy –

2. Wetting -

3. Contact angle -
Adhesion to enamel – mainly by micromechanical method

Acid etching
The procedure that leads to removal of smear layer and increase
the microscopic roughness by removal of prismatic and the
interprismatic mineral crystals.

Effects of acid etching –

1. Removes residual pellicle

2. Creates a porous layer of depth 5 – 10 microns
3. Increases wettability
4. Increases surface area
5. Increases surface energy

Bond strength to acid conditioned enamel 16 – 21 M Pa.

 Various etchants used –
1. Phosphoric acid – as liquid or gel
)

2. Sulphuric acid 2 %
3. Phosphoric acid 10 %
4. Maleic acid 10 %
5. Nitric acid 2.5 %
6. Oxalic acid
7. Citric acid

Teeth requiring longer application - acid resistant teeth

( with high F content)
primary teeth.
( more aprismatic )
 Patterns of etching –
Type 1 – Most common. Preferential removal of enamel prism cores
& periphery intact.
Type 2 - Reverse of type 1. Periphery removed and cores intact.
Type 3 – Etching pattern less distinct. Both types 1 & 2 present.

Macrotags – resin tags formed at periphery of enamel rods ( between prisms

Microtags - smaller tags formed at end of rod where individual

hydroxyapatite crystal has been dissolved.
More important because of greater number and surface area.
 Problems in bonding to dentin –
Presence of 30% organic material

Random arrangement of hydroxyapatite crystals in the organic

matrix.

Tubular nature of dentin that permits fluid flow, adversely

affects bonding.

Sclerosed dentin is difficult to penetrate as peritubular dentin

becomes and wider.

Permeability of dentin differs at various sites.

Variation in arrangement of tubules & their shape.

 Ideal requirements of dentin bonding agents:

1. Provide high bond strength to dentin that should be present

immediately after placement and that should be permanent.
2. Provide bond strength to dentin similar to that of enamel.
3. Show biocompatibility to dental tissue including the pulp.
4. Minimize microleakage at the margins of the restorations.
5. Prevent recurrent caries and marginal staining.
6. Be easy to use and minimally technique sensitive.
7. Possess a good shelf life.
8. Be compatible with a wide range of resins.
9. In addition it should be non toxic and non sensitizing
to the operators or patients.
10. Bonding agents should seal the tooth surfaces from oral fluids.
 SMEAR LAYER

Suggested by Skinner (1961)

Coined by Boyde et al (1963)

It is a thin layer of grinded debris left on
tooth during tooth preparation.
Thickness – 12 micron meters
Composition
Denatured collagen
Hydroxyapetite & cutting debris.

Of 2 types :
- Superficial – loosely adherent
smear layer
- Deep – tightly packed smear
plug
Smear plugs-
Thickness 1-5 microns meters
Prevents bacterial invasion but does not prevent
diffusion of bacterial toxins into the pulp .
Decreases dentinal permeability
Composition of dentin bonding
agents

Conditioners
Primers
Adhesives
Initiators and accelerators
Fillers
Other ingredients.
 Conditioning of the dentin
Defined as alteration done after the creation of dentin cutting
debris, termed the smear layer, to create a surface, capable of
micromechanical and chemical bonding to dentin bonding agent.

Changes after conditioning:

Removal or modification of smear layer
Opening of dentinal tubule orifices.
Modifications in organic matter
Decalcification of inorganic portion.

Can be done by -
Chemicals Thermal Mechanical
Acids Lasers Abrasion
Calcium chelators
 Mechanism of dentine bonding

Acid washing / rinsing

Removes smear layer
Dissolves HA

Drying shrinks remaining

Collagen polymer molecules
Rehydration / priming
Swells collagen
Mechanism of dentine bonding
Monomer polymerisation
And collagen entanglement

Monomer penetration
1. Phosphoric acid : First dentin conditioner
37% H3PO4 should be used. Use of more than 50% results in
the formation of monocalcium phosphate monohydrate that
is not readily soluble and would not be completely washed
away.
Calcium chelators:
Chelators are used to remove the smear layer without
decalcification or significant physical changes to the underlying
substrate as opposed to strong acid etchants.

EDTA:
- Removes smear layer, not plugs.
- It is scrubbed on the surface of the smear layer for a few
seconds, then left passively for another 60 seconds
followed by additional scrubbing.
Disadvantage:
- Removes small amount of Ca, thus causing fall in the bond
strength.
Primers

Adhesion promoting agents

Contains monomers with HYDROPHILIC properties which

have affinity for exposed collagen fibrils &HYDROPHOBIC
properties for copolymerization with the adhesive resin.

Monomers used are : HEMA, NPG-GMA.

PRIMER FORMULA :

M R X

Hydrophilic part: (REACTIVE GROUP)

Hydrophobic part: (Methacrylate group)
R- Spacer
Adhesive molecule is bifunctional
X  enters into chemical union with the tooth structure
M  Co-polymerizes to the resin through the double bond of
methacrylate
R- spacer group responsible for making the molecule large enough
to keep the methacrylate groups spatially located for optimal
chemical reaction with composite
 The solvents used in primers
1. Acetone based primers –
Advantages :
Excellent water chaser,
Dries quickly
2. Ethanol based primers –
Advantages :
Evaporates less quickly
Less sensitive to wetness of dentin.
Good surface energy and good penetration.
3. Water based primers –
Advantages :
Slow evaporation
Not sensitive to wetness of dentin.
Have capacity to raise collapsed fibers.
(9%-50%)
Hybrid layer :
Nakabashi -1982
Resin reinforced zone, or resin infiltrated
layer
Hybrid layer is the structure formed in dental hard
tissues by demineralisation of the surface and subsurface,
followed by infiltration of monomers and subsequent
polymerisation.
The resulting structure is neither resin or tooth but a hybrid of
both.
Shag carpet appearance
Appears when dentin surface after being acid etched is
actively scrubbed with an acidic primer solution.
The combined mechanical and chemical action of
rubbing the acid etched dentin with an acidic primer dissolves
additional mineral salts while fluffing and separating the
Fillers:
Most of the bonding agents are unfilled

May contain inorganic fillers 0. 5% to 40% by wt.

microfillers, or nanofillers, and submicron glass.

Advantages of nanofillers:
Prevents nanoleakage.
Causes uniform thickness of adhesive layer
Better flexibility to adhesives
Better dissipation of forces
Scatter of light is prevented.
Provides radio opacity
 Classification of Dentin bonding agents
1. According to generation
2. According to adhesion strategy (number of clinical applications)
3. According to treatment of smear layer.
4. According to mode of curing
5. According to Ph
I. On the basis of generations:
First Generation: By Bowen in 1965
Agents used: NPG GMA

Mechanism of adhesion:
Chelation of NPG GMA with calcium on the tooth
surface to generate water resistant chemical bonds
of resin to dentinal calcium.

Bond strength : 2 – 3 MPa

 Second Generation: Early 1980s

Agents used: BIS-GMA / HEMA

Polyurethane based compounds

Interaction b/w negatively charged phosphate grps in the resin with

positively charged calcium ions in the smear layer.

Bond strength: 1- 5 Mpa

 Third Generation: Mid 1980s
Negative effect of smear layer known by then. Thus
additional step of conditioning and priming to -
remove smear layer
modify smear layer

Mechanism of adhesion:
Conditioner removes smear layer and opens up the
tubules.

Advantages:
Increased bond strength
Improved clinical performance
Reduced microleakage relied on mechanical means of
bonding as opposed to the less reliable chemical
adhesion.
Bond strength: 9-15 Mpa.

Disadvantages:
More number of steps, thus complex
Technique sensitive
Retention decreased with time ( longevity
questionable )
Fourth generation – Universal bonding systems

Characterized by Complete removal of smear layer

Total etch technique
( simultaneous etching of enamel and dentin. )

Mechanism of action
Etching removes smear layer, opens the tubules upto 7.5 microns
and increases the permeability.
Primer wets & penetrates the collagen meshwork and increases its
surface energy and wettability into which the resin flows.

Based on diffusion and impregnation of resin into partially

decalcified dentin followed by polymerisation creating a resin reinforced lay
Hybrid layer
Advantages
Less technique sensitivity
similar bond strengths to both enamel and dentin

Bond strength: 18 Mpa

Fifth generation
Developed with aim towards reducing the total number of clinical ste
 Characterized by combinations of primer and adhesive in one step.
( One bottle adhesive systems )

Mechanism of action : complex combination of micromechanical retention


Bond strength 17 – 24 MPa.
 Sixth generation: Introduced in the late 1990s.

Here the primer and etchant are combined in one step.( Self etching
primers).

Available in two types –

two step self etching primers
single step self etching primers ( all in one systems )
Seventh Generation:
One up Bond F
 Fluoride releasing
 Self etching type
 Colour changing capacity (visual confirmation of complete
curing)
 Characterized by etching, priming and bonding in a simple
application with no rinsing or drying.
 Available in two bottles, which have to be mixed and applied
to the Yellow cavity. Pink White

(A & B mixed) (Completely cured)

II. Classification based on the number of clinical application
steps
and how they interact with tooth structure

Total etch adhesives:

3 step
2 step

Self etch adhesives:

2 step
1 step

Resin modified glass ionomer adhesives

Total etch adhesives - Fusayama

Total etching is the simultaneous etching of enamel and

dentin.
The ph of these formulations is between 2.5 to 4.5
to demineralise smear layers and etch dentin.
Hence a separate etch and rinse phase involved

Mechanism of action – ( hybrid layer formation )

Smear layer removed by etch and rinse phase,

3-5micron deep demineralization of the dentin surface.

Collagen fibrils are completely removed from hydroxyapatite

a microretentive network for micromechanical interlocking of

3 step Total etch: ( Fourth generation of dentin bonding agent )
Conditioning
Priming
Application of adhesive resin

Etchant Primer Adhesive

2 Step total etch ( Fifth generation of dentin bonding agent. )

Conditioning
Primer and adhesive
Etchant

Primer Adhesive Primer

and
adhesive
Self etch adhesives -

These adhesive systems are based on the use of non rinse

acidic monomers that simultaneously condition and prime dentin and
enamel.
Two step self etching primer - ( sixth generation )

Etchant
Primer Self
etching
primer

Adhesive
Advantages : .
 The self etching primers are designed to be used on dry dentin.
 Avoids the removal of smear plugs in the dentinal tubules and
the dentin bond strengths is comparatively high.
Disadvantages :
 Less effective bonding of enamel.
 Initial bond might deteriorate with ageing, which could lead to
premature failures.
 Bonding to sclerotic and caries affected dentin might be
problematic
 Single step self etching primer

Etchant
Primer Adhesive

All in one
adhesive
Clinical uses of dentin bonding systems:

 Bonding of directly placed resin based restorative materials.

 Bonding of indirectly placed restorative materials.
 Bonding of ceramic restorations.
 Bonding of amalgam restorations.
 Repair existing restorations.
 Sealing of pits and fissures of posterior teeth.
 Treatment of cervical sensitive dentine.
 Reattachment of fractured tooth fragment
Advantage of single step SEPs :
Fast and easy to use.

Disadvantages:
Marginal staining and debonding may occur in some of the
Systems.
May not bond durably to enamel.
Lack of polymerization..
VII. According to their mode of curing:

Chemical cure:
Amalgabond plus

Light cure:
One bond
Gluma comfort bond

Dual cure:
Clearfil liner bond 2V
Prime and Bond NT dual cure.
Failures in bonding :

Can occur at various levels

between mineralised and demineralised dentin
between demineralised dentin and bonding agent
within layer of bonding agent
between bonding agent and composite resin.
Thank you !!