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Adhesive/Dentin Interface: The Weak Link in the Composite Restoration

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Abstract

Results from clinical studies suggest that more than half of the 166 million dental restorations that were placed in the United States in 2005 were replacements for failed restorations. This emphasis on replacement therapy is expected to grow as dentists use composite as opposed to dental amalgam to restore moderate to large posterior lesions. Composite restorations have higher failure rates, more recurrent caries, and increased frequency of replacement as compared to amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and premature failure. Under in vivo conditions the bond formed at the adhesive/dentin interface can be the first defense against these noxious, damaging substances. The intent of this article is to review structural aspects of the clinical substrate that impact bond formation at the adhesive/dentin interface; to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface.

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Acknowledgments

The authors gratefully acknowledge research support from NIDCR grants DE14392 (PS) and K23DE/HD00468 (BSB).

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Authors and Affiliations

  1. Department of Mechanical Engineering, University of Kansas, 1530 W. 15th St., Lawrence, KS, 66045, USA

    Paulette Spencer & Viraj Singh

  2. Bioengineering Research Center, University of Kansas, Lawrence, KS, USA

    Paulette Spencer, Qiang Ye, Jonggu Park, Anil Misra, John Eslick & J. Lawrence Katz

  3. Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN, USA

    Elizabeth M. Topp

  4. Department of Civil Engineering, University of Kansas, Lawrence, KS, USA

    Anil Misra & Orestes Marangos

  5. Department of Oral Biology, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA

    Yong Wang

  6. Department of Pediatric Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA

    Brenda S. Bohaty

  7. Department of Restorative Dentistry, State University of Londrina, School of Dentistry, Londrina, Brazil

    Fabio Sene

  8. Department of Chemical Engineering, University of Kansas, Lawrence, KS, USA

    Kyle Camarda

  9. School of Engineering, Case Western Reserve University, Cleveland, OH, USA

    J. Lawrence Katz

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  1. Paulette Spencer
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Correspondence to Paulette Spencer.

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Associate Editor Michael S. Detamore oversaw the review of this article.

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Spencer, P., Ye, Q., Park, J. et al. Adhesive/Dentin Interface: The Weak Link in the Composite Restoration. Ann Biomed Eng 38, 1989–2003 (2010). https://doi.org/10.1007/s10439-010-9969-6

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