Bonding efficiency and durability: current possibilities.

Bonding plays a major role in dentistry nowadays. Dental adhesives are used in association with composites to solve many restorative issues. However, the wide variety of bonding agents currently available makes it difficult for clinicians to choose the best alternative in terms of material and technique, especially when different clinical situations are considered. Moreover, although bonding agents allow for a more conservative restorative approach, achieving a durable adhesive interface remains a matter of concern, and this mainly due to degradation of the bonding complex in the challenging oral environment. This review aims to present strategies that are being used or those still in development which may help to prevent degradation. It is fundamental that professionals are aware of these strategies to counteract degradation as much as possible. None of them are efficient to completely solve this problem, but they certainly represent reasonable alternatives to increase the lifetime of adhesive restorations.

Bonding efficiency and durability: current possibilities

Abstract Bonding plays a major role in dentistry nowadays. Dental adhesives are used in association with composites to solve many restorative issues. However, the wide variety of bonding agents currently available makes it difficult for clinicians to choose the best alternative in terms of material and technique, especially when different clinical situations are considered. Moreover, although bonding agents allow for a more conservative restorative approach, achieving a durable adhesive interface remains a matter of concern, and this mainly due to degradation of the bonding complex in the challenging oral environment. This review aims to present strategies that are being used or those still in development which may help to prevent degradation. It is fundamental that professionals are aware of these strategies to counteract degradation as much as possible. None of them are efficient to completely solve this problem, but they certainly represent reasonable alternatives to increase the lifetime of adhesive restorations.

Orthodontic material applications over the past century: Evolution of research methods to address clinical queries.

The advances in the field of materials as they relate to orthodontics can be divided into the actual evolution of materials applied to daily practice and the changes in research methods to study the performance and the biologic properties of the materials. Although it is evident that new materials have saturated the market during the past century, the basic concepts of attaching one appliance to the enamel to use as a grip and inserting wires into that to control the spatial orientation of a tooth are identical to the original concepts. In contrast to that, the numbers of treatises about those subjects and the complexity of instrumentation and analytic tools used in published research have advanced tremendously and at a frenetic pace. This highly specialized pattern of research may effectively raise boundaries across research areas, since the complexity of the issues allows researchers to comprehend the content of journal articles in a narrow spectrum of disciplines. The purposes of this article were to review the advances in the research methods for investigating the various properties of orthodontic materials and to assist the reader in navigating this topic. A synopsis of the materials is also provided, listing future applications that already exist at the experimental stage or are yet unavailable but with the relevant technology already presented in broader scientific disciplines.

Universal adhesives: the next evolution in adhesive dentistry?

Every so often a new material, technique, or technological breakthrough spurs a paradigm shift in the way dentistry is practiced. The development and evolution of reliable enamel and dentin bonding agents is one such example. Indeed, the so-called "cosmetic revolution" in dentistry blossomed in large part due to dramatic advances in adhesive technology. It is the ability to bond various materials in a reasonably predictable fashion to both enamel and dentin substrates that enables dentists to routinely place porcelain veneers, direct and indirect composites, and a plethora of other restorative and esthetic materials. In fact, the longevity and predictability of many (if not most) current restorative procedures is wholly predicated on the dentist's ability to bond various materials to tooth tissues. Adhesive systems have progressed from the largely ineffective systems of the 1970s and early 1980s to the relatively successful total- and self-etching systems of today. The latest players in the adhesive marketplace are the so-called "universal adhesives." In theory, these systems have the potential to significantly simplify and expedite adhesive protocols and may indeed represent the next evolution in adhesive dentistry. But what defines a universal system, and are all these new systems truly "universal" and everything they are claimed to be? This article will examine the origin, chemistry, strengths, weaknesses, and clinical relevance of this new genre of dental adhesives.

History and current state of metal adhesion systems used in prosthesis fabrication and placement.

The adhesion techniques used in prosthetic dentistry have substantially improved with respect to retention of veneering resin to the metal framework of resin-veneered restorations and the bonding of resin-bonded fixed partial dentures (RBFPDs) to abutment teeth. In the early 1970s, prostheses relied on macromechanical retention for veneering surfaces and the retention holes of retainers. Later, retention was achieved by using small spherical particles. In addition, the use of small pits created by electrochemical corrosion was tested in resin-veneered restorations and RBFPDs. Thus, micromechanical retention gradually supplanted macromechanical retention. First-generation adhesive monomers were introduced at the end of the 1970s and were succeeded in the early 1980s by the marketing of adhesive resin cements, which were effective for use with non-noble alloys when surface oxidation procedures were used. In 1994, a second-generation adhesive primer for noble alloys was introduced, which prompted development of other adhesive primers. These primers were applied mainly to silver-palladium-copper-gold and type IV gold alloys and improved the reliability of RBFPDs. Recent studies have confirmed the effectiveness of such primers when used with high-gold-content metal ceramic alloys. Due to these developments, RBFPDs now have excellent esthetic characteristics.

Orthodontic materials research and applications: part 1. Current status and projected future developments in bonding and adhesives.

The purpose of this opinion article, to be presented in 2 parts, is to project immediate future developments expected in orthodontic materials research and applications. Analysis of the material is structured around 2axes: presentation of evidence summarizing the current status in various fields, and formulation of a hypothesis for short-term future developments. This first part of the article deals with advances and developments in bonding to enamel. Projected adhesive developments include greater use of high-energy lamps for polymerization in light-cured systems, universal application of molar tube bonding, widespread use of self-etching primers, broader acceptance of glass ionomers in their conventional and modified modes, and elimination of 2-phase adhesives in favor of no-mix and light-cured adhesives. Long-term future adhesive applications might also include biomimetic approaches, adopting mechanisms used by living organisms to adhere to surfaces.

25 years of veneering: what have we learned?

This is a review of the research completed over the 25 years in which dentists have been veneering teeth. Recommendations are made relative to the tooth preparation design for composite resin veneers and porcelain veneers. Material differences in a variety of applications are discussed together with recommended applications, indications and contraindications. From the research that has been reviewed, a series of best practices in the application of veneering materials and techniques is listed.

Dental biomaterials and the healing of dental tissue.

This paper addresses the application of new adhesive technologies to dentistry. The bonding of synthetic polymers to dentin is difficult and it has taken a long time to produce reliable methods. Success has been achieved suing a 4-methacryloyloxyethyltrimellitate anhydride/methyl methacrylate-tri-n-butyl borane system which allows the generation of a layer of hybridised dentin. This provides a pseudo-wound-healing layer that resists demineralisation and degradation, is impermeable and inhibits secondary caries and hypersensitivity.

Dental adhesives of the future.

The current trend in the development of dentin adhesives attempts to simplify bonding steps and make them more user-friendly. However, optimizing speed and efficiency should be accomplished without major tradeoffs in the quality or durability of resin bonds. Although dentin adhesives have improved tremendously over the past decade, postoperative sensitivity, incomplete marginal seal, premature bond degradation, biocompatibility, and compromised bonding to abnormal substrates are still considered potential problems associated with their use. Advances in different scientific disciplines will enrich the pool from which ideas may be drawn in designing future dentin adhesives. It is probably on the molecular level that we will see the greatest expansion of horizons. With the advances in biomimetics, future dentin adhesive monomers may contain domains derived from protein-based, underwater bioadhesives secreted by aquatic animals such as mussels and barnacles, making them less dependent on the surface energy of the bonding substrates as well as less susceptible to hydrolytic degradation. As adhesive joints produced by contemporary adhesives are brittle in nature, future adhesive design may incorporate biomimetic intermediate-strength domains that can undergo stepwise reversible unfolding in response to varying functional stress levels before ultimate catastrophic failure of the adhesive joint occurs. These domains may also re-establish folded configurations on stress relaxation, making the adhesive both strong and tough. Using the concept of controlled release, future adhesives may contain fluorescent biosensors that can detect pH changes around leaking restorations. They may even have the capacity to heal autonomously, in response to microcracks formed by functional stresses within the adhesive joint. The ability to self-diagnose and self-repair will increase the life expectancy of adhesive restorations. Future dentin adhesives may also assume a more instrumental role in therapeutics apart from caries prevention. These features may include the controlled release of noncollagenous proteins to promote remineralization of collagen matrices in sound and caries affected dentin, and growth factors to induce controlled formation of reparative dentin.

[Perspectives of dentistry in the 21st century]. / A fogászat perspektívái a 21. században.

The topics reviewed are based on those published in a recent USA journal, including the following: demographic trends of oral diseases, changes in the trends of oral diseases, minimally invasive dentistry, the development of bond-systems, endodontics in the 21st century, trends in surgical and non-surgical periodontal treatments, esthetic ceramics in the 21st century, total dentures: present trends. The author is attaching comments to each of the topics on the present situation in Hungary, hoping to challenge a debate in the following numbers of Fogorvosi Szemle.

Prosthodontic and restorative care in the 21st century.

In a recent report on oral health, Surgeon General Satcher reminded us of the need to change the attitudes of families concerning the importance of oral health. In prosthodontics and restorative dentistry, remarkable developments are occurring daily. Specialties are changing, and different types of dental practices are emerging. The introduction of computer technology has greatly affected the way the restorative dentist practices, and the evolution of cyberschools are no longer a fantasy. Adhesive dentistry has replaced the manner in which we prepare, restore, and bond restorations to teeth. The entire field of ceramics and methods of fabricating esthetic restorations are entering a new era. The exceptional prognosis of various implant systems has changed the way we think about maintaining hopeless teeth. Through tissue engineering, the 21st century may be revolutionary in the way we replace missing teeth and lost tooth structure.