CONTENTS

 Introduction

 Definitions

 Mechanisms of adhesion

 Acid etching technique

 Dentin Bonding Agents ( DBA)

 Applications
 Introduction
• Research into bonding agents for attachment of the resin
restorations to the tooth structure –1950’s by Hagger

• In 1955 Buonocore showed that there is increase in the

surface area due to etching-this was the great landmark
in adhesive dentistry.

• Now after 40 years of long march the esthetic restorative

dentistry is practiced
 Definitions
• Adhesion –When two substances are brought into
intimate contact with each other the molecules of one
adhere to the molecules of other substance. This force is
called Adhesion
• Adhesive – substance that promotes adhesion of one
substance or material to another
• Adhesive Bonding – Process of joining two materials by
means of an adhesive agent that solidifies during the
bonding process
• Dentin Bonding – The process of bonding a resin to
conditioned dentin.
• Dentin Bonding Agent – A thin layer of resin between
conditioned dentin and the resin matrix of composite.
• Dentin conditioner – An acidic agent that dissolves the
inorganic structure in dentin, resulting in a collagen mesh
that allows resin infiltration into the conditioned dentin.
• Hybrid Layer – An intermediate layer of resin,
collagen and dentin produced by acid etching of
dentin and resin infiltration into the conditioned
dentin.
• Primer – A hydrophilic, low – viscosity resin that
promotes bonding to a substance, such as dentin.

• Resin tag – Extension of resin that has penetrated into

the etched enamel or dentin.

• Smear layer – poorly adherent layer of ground dentin

produced by cutting a dentin surface.
• True Adhesion has been the “holy grail” of
dental restorative materials.
• For true Adhesion , three conditions is to be
satisfied
 sound tooth structure must be conserved
 Optimal retention must be achieved
 Microleakage must be prevented
 Mechanisms of adhesion
• Factors that have a roll in achieving adhesive bonds
 Wetting
 Interpenetration
 Micromechanical interlocking
 Chemical bonding
Main theories for adhesion
 Mechanical theory (States that solidified
adhesive interlocks micro mechanically with the
roughness and irregularities of the adherend’s
surface)
 Adsorption Theory ( includes all chemical
bon, and secondary valence forces)
 Principles of adhesion.
• Surface energy / surface tension

• Wetting

• Contact angle.
 Surface energy
• For adhesion the surfaces must be attracted to
one another at their interface . The energy at the
surface is the surface energy, this is because at
the surface the atoms are not equally attracted
in all directions.
• The increase in surface energy per unit area of
the surface is referred as surface energy or
surface tension.
• When primary bonding is involved the adhesion
is called as chemisorption and when physical
forces are involved these are due to Vander
waals forces.
 Wetting
• It is difficult to force two solid surfaces to adhere when
placed in apposition if the surface molecules of the
attracting substances are separated by distances greater
than 0.7 nm then the adhesion is negligible.
• The method to overcome this is to use a fluid that flows
into the irregularities to provide contact. This is called as
wetting.
• Wetting is influenced by the cleanliness of the surface.
• The extent to which an adhesive wets the surface of an
adherend may be determined by contact angle between
the adhesive and the adherend.
Contact angle.
• A) when contact
angle is 0 the liquid
contacts the surface
completely and
spreads freely and
good adhesion.

• B) small contact
angle

• C) large contact angle

hence poor wetting
and poor adhesion.
 Acid Etching Technique
• Before the introduction of acid etching the use of
bonding agents and leakage of oral fluids within the
microscopic space between the prepared teeth and
restorative materials was of greater concern for resin
composites.
• The first meaningful proof of intra-oral adhesion was
reported in 1955 by MICHEAL BUONOCORE, who
etched the enamel with acids and then placed the
restorative resin which formed resin tags when
penetrated into the roughened surface created by the
acid.
• This was the effective method to improve the mechanical
bonding and to ensure sealed interfacial gaps.
• Phosphoric acid 30-50% (most commonly used at a
conc. Of 37% )
• Citirc acid
• Maleic acid
• Oxalic acid
• Polyacrylic acid.
• Pyruvic acid
 Procedure –Available as gel ( colloidical silica is added)
or liquid form.
 Applied onto the tooth surface with brushes or when
available in the form syringe it is expressed onto surface.
 Etching time is -15 sec.
 Rinse the tooth. If any contamination occurs procedure is
to be repeated.
• TYPE 1--Etch pits result form selective dissolution of
either the enamel rod cores
• TYPE 2 –Peripheral areas dissolution

Even with the etching procedure it cannot be relied

solely on this procedure for the retention. However
conditioned enamel is essential
to ensure a marginal seal.
Etching Patterns and resin tags
• Before the advent of total etch for enamel and dentin,
enamel bonding agents were used,. These agents had o
potential for adhesion, but they improved the mechanical
bonding by optimum formation of resin tags within
enamel.
• These agents were made by combining different
dimethacrylates such as BIS-GMA and TEGDMA. These
resins were hydrophobic.
• Dentin possess greater obstacles as it is a living tissue
consisting if dentinal fluid within the tubules which can
flow and adversely affect the adhesion.
• An important breakthrough in DBA occurred when
FUSAYAMA et al in 1979 used phosphoric acid on both
dentin and enamel.
• In 1982 NAKABAYASHI revealed hydrophilic resins
infiltrate a surface layer of collagen in dimineralized
dentin to form HYBRID LAYER.
 Generations of dentin bonding agents
• First Generation --Contained acidic groups to react
with the mineral content of the tooth
• The first product marketed in 1950’s containing the
active agent glycerol phosphoric acid dimethacrylate.
• This material achieved little success for the same
reasons that plagued the enamel etching applications
(high polymerization shrinkage and high coefficient of
thermal expansion )
• Second Generation —This included NPG-GMA (N-
phenyl glycine and glycidyl methacrylate ) and phenyl-
p,2-methacryloxy phenyl phosphoric acid
• No evidence is significant for these adhesive in bonding
to the tooth structure.
• Third Generation –Also based on the use of acid group
to react with ca2+ ions and a methacrylate gp to
copolymerize with unfilled resin
• This adhesive system involved two approaches
 Modification of the smear layer to improve properties
 Removal of the smear layer without disturbing the plugs that
occluded the dentinal tubules.
• Four steps involved are
 Application of a dentin conditioner( HEMA ).solution
of maleic acid or 2 % aq nitric acid.
 Application of the primer
 Application of the adhesive , typically an unfilled
resin
 Placement of resin based composite.
• Fourth Generation--It was a result of major thinking as
an advance in materials. It was thought that etching
would cause pulpal irritation. Hence materials that could
remove the smear layer and smear plugs completely
were developed.
• Steps for its applications.
 Etch dentin and enamel simultaneously for 15 sec
and then rinsed.
 Dry with air.
 Slightly moisten the surface,
 Apply primer ( infiltrates the collagen and optimizes
the bonding).
 Dry thoroughly
 Apply adhesive to enamel and dentin and cure for 20
sec.
 Apply composite incrementally and cure.
• Fifth Generation –This system was developed with a
thought that clinical success would be more consistent if
fewer steps were involved.
• Current DBA rely on a complex combination of
micromechanical retention by
 Penetration into partially opened dentinal tubules
 Formation of a hybrid layer in which hydrophilic
monomers penetrate and polymerize to form an
interpenetrating network
 Chemical interactions involving first and second
order bonds.
• The number of procedural steps reduced by combining
the conditioner and primer (self etching primer ) or
primer and adhesive (self priming adhesive or one bottle
system). This single step is sometimes referred to as a
sixth generation system.
 Applications
• To seal pit and fissures
• For bonding orthodontic brackets.
• For bonding restorations to the tooth
structure (amalgam and composite).
• For veneers