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      Adhesion to Primary and Permanent Dentin and a Simple Model Approach

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          Abstract

          Objectives

          First to compare different dentin bonding agents’ shear bond strength to primary and permanent dentin. Secondly to compare the fracture failure modes and making an attempt to develop a statistical model that could be helpful in predicting them.

          Methods

          Extracted human primary and permanent molars were used as substrates (dentin). The shear bond strength of composite to substrate was measured and fracture surfaces were evaluated visually and with stereomicroscope. Using the data obtained, a statistical model was built in order to predict the failure modes.

          Results

          Higher bond strength values were obtained for permanent dentin. Total-etch adhesives displayed higher shear bond strength values than the self-etch adhesive. Adhesive failures were more frequently seen in primary dentin. Self-etch adhesive system displayed more adhesive failures. Prepared model confirmed the negative relationship between shear bond strength and the probability of observing adhesive failure.

          Conclusions

          There should be an application protocol for the usage of dentin bonding agents in primary dentin. Further development of statistical and fuzzy models for failure modes can be supportive alternatives for microscopic evaluations and also be helpful in understanding and eliminating the factors which are responsible for the formation of adhesive failures and for achieving clinically more successful adhesive restorations.

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          Most cited references62

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          Applied Logistic Regression

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            A critical review of the durability of adhesion to tooth tissue: methods and results.

            The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
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              Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges.

              Bonding to tooth tissue can be achieved through an "etch&rinse," "self-etch" or "glass-ionomer" approach. In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore, bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine "bonding effectiveness" in the laboratory) are evaluated upon their value and relevance in predicting clinical performance. A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device. Eventually, today's adhesives will be critically weighted upon their performance in diverse laboratory studies and clinical trials. Special attention has been given to the benefits/drawbacks of an etch&rinse versus a self-etch approach and the long-term performance of these adhesives. Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness. Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term. Nevertheless, a self-etch approach may have the best future perspective. Clinically, when adhesives no longer require an "etch&rinse" step, the application time, and probably more importantly, the technique-sensitivity are substantially reduced. Especially "mild," two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional three-step systems in bonding performance.
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                Author and article information

                Journal
                Eur J Dent
                Eur J Dent
                European Journal of Dentistry
                Dental Investigations Society
                1305-7456
                1305-7464
                January 2009
                : 3
                : 1
                : 32-41
                Affiliations
                [a ] PhD, Department of Operative Dentistry, Faculty of Dentistry, Near East University, Mersin, Turkey
                [b ] Professor, Department of Pediatric Dentistry, Faculty of Dentistry, University of Ankara, Ankara, Turkey
                [c ] PhD, Department of Pediatric Dentistry, Faculty of Dentistry, University of Ankara, Ankara, Turkey
                [d ] Associate Professor, Department of Statistics, Art and Sciences Faculty, Middle East Technical University, Ankara, Turkey
                [e ] PhD, Department of Statistics, Art and Sciences Faculty, Middle East Technical University, Ankara, Turkey
                Author notes
                Corresponding author: Dr. Deniz C. Can-Karabulut, Department of Operative Dentistry, Faculty of Dentistry, Near East University, Mersin 10, Turkey. Phone:+90 392 680 20 30/2618, Fax: +90 392 680 20 25, E-mail: cdenizcank@ 123456yahoo.com
                Article
                0030032
                2647957
                19262729
                d89a3226-768a-4d82-adba-5f32438a5b2f
                Copyright 2009 European Journal of Dentistry. All rights reserved.
                History
                Categories
                Original Article

                Dentistry
                primary dentin,failure modes,adhesive restorations,shear bond strength test
                Dentistry
                primary dentin, failure modes, adhesive restorations, shear bond strength test

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