III Congreso Internacional de Biomateriales BIOMAT03

PRACTICAL ASPECTS ON ADHESION TO DENTIN. MANAGEMENT OF COLLAGEN M. TOLEDANO Facultad de Odontologa, Universidad de Granada, Espaa. toledano@urg.es Acid etching of dentin is used as a surface preparation step to improve adhesion for a variety of procedures in restorative and preventive dentistry. The adhesive principle of most dentin bonding systems is the micromechanical interlocking of unfilled bonding resin withing collagen network of the decalcified dentin surface. This demineralized dentin surface sometimes presents several characteristics that may play a negative role in dentin adhesion. The dense web of collagen fibrils becomes a low-energy surface substrate, collagen fibrils undergo structural changes that affect the extent of resin infiltration, part of acid demineralized dentin collagen remains in a de-stabilized state which is susceptible to hydrolysis and enzymatic degradation, and the incomplete resin infiltration within the demineralized dentin results in a weak collagen-rich zone susceptible to microleakage or nanoleakage. The prevention of collagen denaturation following acid etching is of utmost importance in optimizing adhesion to dentin. Therefore, our investigations have centered on removal of demineralized collagen web and, application of other systems that do not require acid etching of dentin as the use of ErYag or self-etching dental adhesive systems. The removal of collagen fibers with a deproteinizing agent would facilitate the access of the adhesive resins to a substrate which is more permeable or penetrable; this substrate is rich in hydroxyapatite crystals and may result in a stable interface over time because it is essentially composed of mineral phases. Meanwhile, the existence of a most favorable chemical interaction has also been hypothesized. Previous reports claimed that there are certain advantages in bonding to lased dentin. The microexplosions of dentin attained by the ErYAG laser produces its thermomechanical ablation and protrud dentinal tubules with a cuff-like appearance. This may, apparently, contribute to an increase in the adhesive area and, in higher bond strenth than those achieved with acid etching. Patent tubules and absence of smear layer are additional factors that might enhance bonding to lasertreated dentin. When the dentin is acid etched, the depth of demineralization and completeness of monomer diffusion/impregnation into this calcium depleted zone are two factors believed to affect the quality of dentin bonds. When the former (depth of dentin demineralization) exceeds the latter (depth of dentin diffusion/impregnation), a zone of hydroxyapatite-depleted collagen fibers is left exposed, i.e., not resin infiltrated and nonhybridized. Dentin bonding systems which do not require smear layer removal by acidic conditioners are being developed because there is no discrepancy between the depth of demineralization and the depth of resin infiltration, since both processes occur simultaneously. If this is the main concern, systems based on self-etching primers might be considered more effective than either onebottle or conventional, three-step adhesives. Self-etching agents eliminate the conditioning, rinsing, and drying steps that may be critical and difficult to standardize in operative conditions because of the instability of demineralized matrix. REFERENCES
Toledano, M., Perdigao, J., Osorio, R., Osorio, E., Operative Dentistry, 25(2000) 496