Cervical microleakage in MOD restorations: in vitro comparison of indirect and direct composite. Three-year clinical evaluation of the Clearfil Liner Bond system. Clinical evaluation of a dentinal adhesive system: three-year results. In situ anticariogenic effect of adhesive systems containing fluoride and MDPB. Indirect pulp treatment: in vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex. Clinical Status of Ten Dentin Adhesive Systems Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions. Total-etch versus self-etch adhesive: effect on postoperative sensitivity. A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. Influence of gaps in adhesive restorations in the development of secondary caries lesions: an in situ evaluation. In situ assessment of effects of the bromide- and fluoride-incorporating adhesive systems on biofilm and secondary caries. A practice-based research network on the survival of ceramic inlay/onlay restorations.
This study compared microleakage between  indirect composite inlays and direct composite restorations . Forty-eight st and ard inlay MOD cavities , with cervical margins located either in enamel or dentin , were prepared in extracted human third molars . The specimens were r and omly divided into 3 groups ( n=16 ) . In the control group , the cavities were restored with the composite Filtek Z250 ( 3 M ESPE ) . For the experimental groups , indirect restorations were made with the Artglass ( Heraeus-Kulzer ) or Belleglass HP ( Kerr Laboratories ) systems and cemented with the dual curing cement RelyX ARC ( 3 M ESPE ) . The adhesive system Single Bond ( 3 M ESPE ) was applied on all groups . The specimens were su bmi tted to thermolcycling , coated with nail varnish , then immersed in 2 % basic fuchsine aqueous solution for 24 hours . The teeth were then sectioned and leakage scores were evaluated ( 40x ) , based on a st and ard ranking . Data were su bmi tted to statistical analysis ( Mann-Whitney and Kruskal-Wallis tests ) with a 95 % confidence level . No statistical difference was found between substrates ( p=0.595 ) , and the material s performed similarly in dentin ( p=0.482 ) . Direct restorations showed higher leakage than indirect restorations at the enamel margins ( p=0.004 ) . Within the limitations of this experimental design , overall leakage was similar between both substrates , while the indirect systems provided a better sealing than direct composites only in enamel Modern dental adhesive systems have improved the bond of restorative material s to mineralized tooth structures . The purpose of this study was to evaluate the clinical performance of composite restorations placed in abrasion and erosion lesions using the Clearfil Liner Bond dental adhesive system . Following ADA clinical guidelines for dentin and enamel adhesive material s , 62 facial class 5 smooth surface erosion or abrasion lesions with no undercuts and involving primarily root surfaces were restored in 25 adult male and female patients . The teeth were restored without preparations using Clearfil Liner Bond and Clearfil Photo Anterior composite resin . The clinical performance of the restorations was assessed by two examiners at baseline , 6 months , 1 , 2 , and 3 years using the following evaluative parameters : color match , marginal discoloration , and marginal integrity according to modified Ryge criteria ; the presence or absence of recurrent decay ; pre- and postoperative sensitivity ; and restoration failure due to loss of retention or other causes . At the end of 3 years , four of the 55 restorations remaining in the study failed due to lack of retention ( 92.7 % retention rate ) . The evaluations of the other clinical parameters demonstrated excellent performance by this system The dentinal adhesive Scotchbond 2 was evaluated with the microfilled composite resin Silux in cervical and root caries lesions for up to 3 years . Clinical criteria evaluated included retention , marginal integrity , marginal discoloration , color match , anatomic form , recurrent caries , gingival response , and postoperative sensitivity . Overall , the adhesive demonstrated improved performance over earlier dentinal adhesive systems . Retention was greatest at 3 years when available enamel margins had been etched ( 93 % ) and when root caries lesions ( 97 % ) had been restored . Other criteria were reported as generally favorable . Early findings suggest that the level of development of sclerotic dentin may influence behavior of the adhesive . The greatest difficulty was noted in lesions presenting with heavy sclerotic dentin PURPOSE To evaluate in situ the anticariogenic effect of fluoride and MDPB containing adhesive systems at the restoration interface , by microhardness tests . METHODS 120 fragments containing preparations for resin composite restorations performed at the cemento-enamel junction were r and omly distributed among the adhesive systems to be tested . The adhesive systems were applied in accordance with the manufacturers ' instructions : Optibond FL , Adper Single Bond 2 , Prime & Bond 2.1 , Optibond Solo Plus , Adper Prompt , Clearfil Protect Bond and restored with the nanoparticulate resin composite Z350 .  Twenty volunteers used a palatal appliance containing fragments restored with each adhesive system for 21 days , and applied 20 % sucrose on them eight times a day to simulate a high cariogenic challenge . Microhardness tests were performed at different depths ( 20 microm , 40 microm and 60 microm from the occlusal margin of the restoration ) and at different distances ( 100 microm , 200 microm and 300 microm from the adhesive interface ) . RESULTS ANOVA showed that for enamel , there was significant difference between the adhesive systems ( P=0.0106 ) ; the interaction adhesive system*distance was a significant ( P=0.0006 ) , and the one-step self-etching adhesive system containing fluoride ( Adper Prompt ) presented a higher anticariogenic effect . However , for dentin , the adhesive system used did not interfere in decreasing the severity of caries formation PURPOSE The purpose of this prospect i ve and r and omized in vivo study was to compare the clinical and radiographic outcomes of an adhesive resin system vs a calcium hydroxide liner for protection of the dentin-pulp complex of primary molars treated with indirect pulp treatment . METHODS Forty-eight primary molars with deep occlusal caries , but without preoperative signs and symptoms of irreversible pulpitis , received indirect pulp treatment and were restored with a composite resin ( Z100 ) . The teeth were r and omly divided into 2 groups according to the material used for protection of the dentin-pulp complex : ( 1 ) adhesive resin system ( Scotchbond Multi Purpose ) ; and ( 2 ) calcium hydroxide liner ( Dycal ) . These teeth were evaluated clinical ly and radiographicaly for 2 years . RESULTS After 2 years , 83 % ( 19/23 ) of the teeth treated with calcium hydroxide and 96 % ( 24/25 ) of teeth treated with only the adhesive resin system presented a successful outcome , as determined by clinical and radiographic examination . Interradicular and /or periapical lesions were the most predominant signs of treatment failure , since 3 out of 23 teeth treated with calcium hydroxide and 1 out of 25 teeth treated with only adhesive resin presented this outcome . One tooth treated with the calcium hydroxide liner was diagnosed with internal root resorption at the 18-month examination . Of the 5 teeth diagnosed from radiographs as a failure of the indirect pulp treatment , none presented clinical signs/symptoms of pulpitis or necrosis such as the presence of fistula , enhanced tooth mobility , or pain . CONCLUSIONS This study demonstrates that protection of the dentin-pulp complex of primary molars with an adhesive resin system results in similar clinical and radiographic 2-year outcomes as compared to calcium hydroxide when indirect pulp treatment is performed in Class I composite restorations Laboratory testing of dentin adhesive systems still requires corroboration by long-term clinical trials for their ultimate clinical effectiveness to be vali date d. The objective of this clinical investigation was to evaluate , retrospectively , the clinical effectiveness of earlier-investigated dentin adhesive systems ( Scotchbond , Gluma , Clearf il New Bond , Scotchbond 2 , Tenure , and Tripton ) , and to compare their clinical results with those obtained with four modern total-etch adhesive systems ( Bayer exp . 1 and 2 , Clearfil Liner Bond System , and Scotchbond Multi- Purpose ) . In total , 1177 Class V cervical lesions in the teeth of 346 patients were restored following two cavity design s : In Group A , enamel was neither beveled nor intentionally etched , as per ADA guidelines ; in Group B , adjacent enamel was beveled and conditioned . Clinical retention rates definitely indicated the improved clinical efficacy of the newest dentin adhesives over the earlier systems . With regard to adhesion strategy , adhesive systems that removed the smear layer and concurrently demineralized the dentin surface layer performed clinical ly better than systems that modified the disorderly layer of smear debris without complete removal . Hybridization by resin interdiffusion into the exposed dentinal collagen layer , combined with attachment of resin tags into the opened dentin tubules , appeared to be essential for reliable dentin bonding but might be insufficient by itself . The additional formation of an elastic bonding area as a polymerization shrinkage absorber and the use of a microfine restorative composite apparently guaranteed an efficient clinical result . The perfect one-year retention recorded for Clearfil Liner Bond System and Scotchbond Multi- Purpose must be confirmed at later recalls OBJECTIVES The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems . METHODS A total of 270 Class V restorations of four etch- and -rinse , one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement . The restorations were evaluated at baseline , 6 , 12 , 18 , and 24 months and then every year during a 13-year follow-up . Dentin bonding efficiency was determined by the percentage of lost restorations . RESULTS During the 13 years , 215 restorations could be evaluated . The cumulative loss rate at 13 years was 53.0 % , with significant different failures rates for the different systems varying between 35.6 and 86.8 % . Four systems fulfilled the ADA 18-month full acceptance retention criteria . Two systems showed at 18 months and earlier high debonding rates . The annual failure rates for the etch- and -rinse systems were Optibond 3.1 % , Permagen 13.0 % , Scotchbond MP 4.8 % , Syntac classic 2.8 % ; for the self-etch system P&S 4.4 % ; and the resin-modified glass ionomer cement Vitremer 2.7 % . CONCLUSION It can be concluded that all systems showed a continuous degradation of the bond with a wide variation , which was independent of the adhesion strategy . Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41 % with the best retention for the resin-modified glass ionomer cement and a four-step etch- and -rinse system BACKGROUND Self-etching adhesives are believed to prevent postoperative sensitivity when used under posterior resin-based composite restorations . The authors tested a twofold hypothesis : a self-etch , or SE , adhesive would result in less postoperative sensitivity than a total-etch , or TE , adhesive ; an SE adhesive would result in poorer enamel marginal integrity than a TE adhesive . METHODS Patients were selected on the basis of requiring Class I and II restorations in molars and premolars . The authors placed 30 restorations with the SE material ( Clearfil SE Bond , Kuraray America , New York ) and 36 restorations with Prime & Bond NT ( Dentsply Caulk , Milford , Del. ) , which uses 34 percent phosphoric acid to etch enamel and dentin simultaneously . Preparations were of st and ard design , with all margins in enamel without beveling . Upon rubber dam isolation , the authors conditioned the enamel and dentin walls with the self-etching primer ( for Clearfil SE Bond ) or etched with the proprietary 34 percent phosphoric acid ( for Prime & Bond NT ) , followed by application of the corresponding dentin adhesive . Teeth were restored with the proprietary hybrid resin-based composite indicated for posterior restorations : Clearfil AP-X for Clearfil SE Bond or Esthet-X Micro Matrix Restorative for Prime & Bond NT . The restored teeth were evaluated preoperatively and at two weeks , eight weeks and six months postoperatively for sensitivity to cold ( ice ) , air and masticatory forces , as well as for marginal discoloration . RESULTS Analysis of variance revealed no statistically significant differences in postoperative sensitivity between the SE and TE material s at any recall time . Marginal discoloration was rated as " absent " for all restorations at six months . Only one tooth displayed sensitivity to occlusal forces at six months . CONCLUSION The SE adhesive did not differ from the TE adhesive in regard to sensitivity and marginal discoloration . CLINICAL IMPLICATION S Postoperative sensitivity may depend on the restorative technique rather than on the type of dentin adhesive used OBJECTIVE The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo . METHOD AND MATERIAL S Forty-eight primary molars with carious lesions were r and omly assigned to 2 different treatments : group 1 ( control , n = 24)--All identifiable , irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material ; group 2 ( experimental , n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material . The control and experimental teeth were clinical ly monitored every 3 months and evaluated 12 months after restoration . The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy . RESULTS Retention rate , marginal integrity , and pulpal symptoms were identical in both groups . Radiographically , the radiolucent area associated with the experimental restorations did not increase with time in 75 % of the cases . For the control group , the adhesive system formed a hybrid layer . In the experimental group , there was morphologic evidence of the formation of an acid-resistant " altered hybrid layer . " An acid-resistant tissue , result ing from the interdiffusion of adhesive resin within the area of carious dentin , was observed adjacent to and under the altered hybrid layer . CONCLUSION Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration PURPOSE To investigate in situ the influence of gaps in the development of secondary caries lesion in adhesive restorations . METHODS 10 volunteers utilized intra-oral appliances , containing three human dental blocks ( enamel and dentin ) , representing the three different groups ( two restored , one sound ) : ( 1 ) restored with resin composite using the total acid etch adhesive technique ( 37 % H3PO4 + Single Bond + Z250 ) ; ( 2 ) restored with resin composite but without acid etching ( Single Bond + Z250 ) ; ( 3 ) and sound blocks ( control group ) . The dental blocks ( n=30 ) were r and omly positioned inside the intra-oral appliances , and covered by a porous tissue ( gabardine base ) to induce a cariogenic biofilm . The volunteers used the appliances 24 hours daily for a 28-day period , removing just during meals and oral hygiene . Eight times a day , a 20 % sucrose solution was dripped onto the blocks . Five minutes later , the appliance was washed with distilled water and replaced in the oral environment . After the experimental period , the dental blocks were removed from the appliance and examined by visual examination to detect the presence or the absence of an active carious lesion ( kappa= 0.89 ) . Posteriorly , they were prepared for the polarized light microscopy examination , which was performed to describe enamel surface characteristics on the restored and unrestored blocks with active caries lesion ( kappa= 1 ) . RESULTS The visual examination demonstrated that almost all ( 29/30 ) of the blocks showed non-cavitated active caries lesion on the enamel surface . The microscopic evaluation showed non-cavitated caries lesions on enamel surfaces for all groups . In the restored blocks ( with and without the total etch technique ) , the demineralization was first identified as an outer lesion that follows the enamel prism directions , and in some cases , reached the cavity walls . The results showed that caries lesion development adjacent to the restoration was determined by the cariogenic challenge of the oral environment , instead of the restoration adhesive quality , and the wall lesion was determined by the prism orientation , regardless of the presence of gaps AIM This in situ study assessed the effects of adhesive systems containing or not fluoride and /or the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide ( MDPB ) on the microbiological composition of dental biofilm and enamel demineralization . MATERIAL S AND METHODS During two phases of 14 days , ten volunteers wore intraoral palatal appliances containing two slabs of human enamel according to a double-blind , crossover design . The slabs were r and omly restored using a composite resin and one of the following adhesive systems : All-Bond SE(TM ) ( self-etch , fluoride/MDPB free adhesive , AB ) and Clearfl Protect Bond ( self-etch containing fluoride and MDPB adhesive , CB ) . The biofilm formed on the slabs was analyzed with regard to total and mutans streptococci and lactobacilli counts . Demineralization represented by integrated area of hardness × lesion depth Delta S ( ΔS ) was determined on enamel by analysis of cross-sectional microhardness , at 20 and 70 μm from the restoration margin . Data were analyzed by ANOVA . RESULTS No statistically significant difference was found either in enamel demineralization or in the microbiological composition of dental biofilm . CONCLUSION All adhesive systems containing or not fluoride and /or MDPB tested were unable to inhibit secondary caries in the in situ model used in the present research OBJECTIVE To evaluate prospect ively the longevity of  ceramic inlay/onlay restorations  placed in a web-based practice -based research network and to investigate risk factors associated with restoration failures . MATERIAL S AND METHODS Data were collected by a practice -based research network called Ceramic Success Analysis ( CSA ) . 5791 inlay/onlay ceramic restorations were placed in 5523 patients by 167 dentists between 1994 and 2014 in their dental practice s. For each restoration specific information related to the tooth , procedures and material s used were recorded . Annual failure rates ( AFRs ) were calculated and variables associated with failure were assessed by a multivariate Cox-regression analysis with shared frailty . RESULTS The mean observation time was 3 years ( maximum 15 years ) of clinical service , and AFRs at 3 and 10 years follow up were calculated as 1.0 % and 1.6 % . Restorations with cervical outline in dentin showed a 78 % higher risk for failure compared to restorations with margins in enamel . The presence of a liner or base of glass-ionomer cement result ed in a risk for failure twice as large as that of restorations without liner or base material . Restorations performed with simplified adhesive systems ( 2-step etch- and -rinse and 1-step self-etch ) presented a risk of failure 142 % higher than restorations performed with adhesives with bonding resin as a separate step ( 3-step etch- and -rinse and 2-step self-etch ) . 220 failures were recorded and the most predominant reason for failure was fracture of the restoration or tooth ( 44.5 % ) . CONCLUSIONS Ceramic inlay/onlay restorations made from several glass ceramic material s and applied by a large number of dentists showed a good survival . Deep cervical cavity outline , presence of a glass ionomer lining cement , and use of simplified adhesive systems were risk factors for survival
According to this review , the 3-step adhesive systems were the best performing and still are the gold st and ard for the cementing of indirect restorations .
In addition , it can be concluded that self-etched adhesive systems reduce the time spent in clinical practice , however at the interface level they behave as permeable membranes more susceptible to degradation
New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians .
Different interactions between restorations , adhesive systems components , enamel and dentin require having criteria based on the selection of the adhesive system , ensuring the longevity of the restorations and the preservation of the biological remnant .
The adhesion force to the dental tissue is one of the indicatives of the behavior of the adhesive systems and influences the behavior of the treatments with direct and indirect restorations .
The objective of this search was to find the adhesive systems with the best results in terms of the adhesion strength of indirect restorations  on the dental tissues .