Principles of bonding and

adhesives in dentistry
Dental materials
What is adhesion?

● The force that binds two dissimilar materials

together when they are brought into intimate
contact
● In dentistry, bonding refers to the process of
attaching a restorative material to tooth
structure by adhesion
Basic principles in the bonding
process
● Surface preparation to remove plaque & debris
● Acid etching with phosphoric acid, to remove
mineral, create porosity, wettability
● Bonding agent applied and flows to fill the
porosities and create resin tags
(micromechanical retention)
● Resin applied and bonds chemically to
underlying bonding agent (primary bonding)
Adhesion
● For proper adhesion to occur, intimate
contact between the adhesive and the
substrate is needed. This intimate contact is
affected by:
● Wettability of the substrate surface
● The viscosity of adhesive
● The morphology or surface roughness,
Factors affecting adhesion

1. Wettability and surface energy

High surface energy low surface energy (solid)

Low surface tension

liquid
θ liquid θ

solid solid

● Surface energy: the attraction of atoms to a surface

(directed inward). In liquids, it is called surface tension
Continue,

1. Viscosity of bonding agent

2. Interpenetration (formation of hybrid zone)

3. Micromechanical interlocking

4. Chemical bonding
Enamel etching

● Introduced by Michael Buonocore in 1950s

● Etching time: 10-30 seconds (around 15
seconds)
● Primary teeth and fluoride treated teeth
require more time
● Etched enamel looks frosty white when dried
● Etching produces a rough surface (pits) into
which resin flows and forms resin tags =
micromechanical retention
Enamel etching

● Resin tags may penetrate to a depth of 10-20

microns in etched enamel
● The depth of penetration depends on:
○ Etching time
○ Rinsing time
● These two actors determine how effective
etching was, and how well debris were
removed from enamel surface
Enamel etching

● Liquid or gel (the gel

is made by adding
colloidal silica to the
acid) phosphoric acid
30-50% (usually
37%).
Procedure

● Acid etch is applied, how ?

● Etchant is applied for 15 seconds, or longer
as mentioned previously
● Rinsing for 20 seconds then drying.
Appearance of enamel?
● Enamel should be kept clean and
contaminant free (saliva, blood, etc)
● If contamination occurs? Re-etch.
Enamel bonding

● In the past, etching and bonding involved

only enamel. Currently, total etch technique is
done, and bonding agents are applied to both
enamel and dentine.
● Bonding agents used for enamel bonding
were made from resin combined with diluents
to lower viscosity. (Bis-GMA + TEGDMA)
Dentine etching and bonding

● What makes dentine a challenge when it

comes to adhesive bonding:
○ Dentine is a living tissue (50% HA, 30% collagen,
20% fluid)
○ Tubular nature of dentine (dentinal fluid)
○ Branching patterns in tubules, may enhance
retention
○ Smear layer presence
○ Possible side effects on the pulp
Dentine etching
● 1979 etching was done for dentine as well as
enamel using 37% phosphoric acid. Research
proved enhanced bonding
● Over etching, effects on dentine structure and pulp?
● Over etching dentine leads to weaker bond and
sensitivity
● Over drying should be avoided to prevent collapse
of collagen and occluding tubules
Continue,

● Another study showed how resin tags from

bonding agents in dentine infiltrated a
surface layer of collagen in demineralized
dentine to form the HYBRID LAYER
Bonding agents

● Several years ago, it was believed that bonding to

dentine can be achieved by chemical bonding
between resin and either collagen or mineral content
of dentine. Molecules designed for these purposes
had the following presentation: M-R-X: M is a
methacrylate group, R is a spacer such as
hydrocarbon chain (ensure mobility of M group when
X is immobilized), an X is a functional group that can
bond to calcium in HA (usually an acidic group)
Generations of bonding agents

● First generation (1950s): based on silane

coupling agents model. Based on M-R-X
model:
○ M=methacrylate group
○ R= hydrocarbon group
○ X= glycerolphosphoric acid dimethacrylate
● Success rate was low, due to high
polymerization shrinkage and high CTE in
unfilled resins used in those time
Bonding agents

● Second generation ( late 60s early 70s):

similar concept to first generation agents.
Low success rate. Attempts were made to
deal with the smear layer
● Third generation agents: same as the
previous generation, however attempts were
made to modify or remove the smear layer
which consists of:
Bonding agents

● Smear layer: it is weakly bonded to dentine

○ Dentine particles
○ Bacteria
○ Salivary constituents.
● Procedure in 3rd generation agents:
○ Application of dentine conditioner (HEMA, or 2% nitric acid,
or maleic acid)
○ Application of primer (dentine bonding agent based on
M-R-X)
○ Application of adhesive (unfilled resin)
○ Placement of resin composite
Bonding agents

● Fourth generation: procedure,

○ Total etch technique for enamel and dentine, dentine
conditioned for 15 seconds.
○ Rinse and dry but do not over dry to prevent collapse of
collagen fibers
○ Slightly moisten dentine
○ Absorb excess water with cotton
○ Apply hydrophilic primer (contains resin that polymerizes
within collagen and a solvent that evaporates to ensure
drying of tooth surface).
○ Apply adhesive (bonding resin) then cure
○ Composite applied and cured
Bonding agents

● Fifth generation agents: fewer steps, better

results. Rely on micromechanical retention
involving:
○ Penetration into partially opened dentinal tubules
○ Formation of hybrid layer (hydrophilic monomer
penetrate and polymerize to form interpenetrating
network with collagen fibrils
○ Chemical interactions involving 1st and 2nd order
bonds
Continue,

● Self-etching primers
○ Acidic groups are added to etch tooth surface
○ No need for rinsing and drying
○ May not be effective on unprepared enamel
● Self priming adhesive: most commonly used
now
 th
5 generation
Continue,

● Sixth generation
systems
(all-in-one)
Microleakage

● Occurs when the restoration does not

completely seal the surrounding margins of
the cavity preparation

● Possible outcomes of microleakage?

● What contributes to microleakage?
Factors that prevent good bonding
Measurements of bond strength

● Tests used:
○ Shear bond strength
○ Tensile bond strength
● Data were variable due to variability of tooth
surface, and different testing methods
○ Microtensile and microshear bond strength: less
variability.
● Current bonding agents shifted the bonding
failure from cohesive to adhesive
Amalgam bonding

● Older amalgam restorations leak less due to

corrosion products
● Technique:
○ Cavity preparation then isolation
○ Etching of enamel and dentine to remove smear
layer
○ Primer applied and cured
○ Self-cure or dual cure bonding resin applied then
amalgam is applied
Clinical applications of bonding

● Porcelain bonding and repair involves:

○ Sandblasting
○ Special etchant (hydrofluoric acid)
○ Silane applied for 30 seconds then dried to
evaporate solvent (leaving a layer of vinyl that
bonds resin to adhesive)
○ Bonding agent applied
○ Composite applied
Continue,

● Metal bonding:
○ PFM
○ Resin bonded bridges (Maryland)
● Lab. And clinical techniques for bonding:
○ Sandblasting for micromechanical retention
○ Electrochemical etching or placing a layer of tin by
electroplater
○ Surface cleaned and dried, then coated with
bonding resin and cemented
Metal bonding continue,

● For repair of fractured porcelain on a PFM or

bridge:
○ Porcelain and metal are prepared as described
previously
○ Bonding resin applied and cured for 20 seconds
○ An opaque masking resin applied, cured 20
seconds
○ Proper shaded composite applied and cured 20
seconds
Pit and fissure sealants

● Filled and unfilled resins

● GIC
● Success depends on good wetting, intimate
contact through etching which will also
ensure longevity of the sealant.
● PRR: minimal cavity preparation, resin
composite placement, sealant placement on
top.
Thank you

● Reference,
1. Philips science of dental materials,
Chapter 14
2. Dental materials, clinical application for dental
assistants and dental hygienists,
Chapter 5