Restoration of decayed teeth with tooth-colored materials that can be bonded to tooth tissue has been a highly desirable property in restorative dentistry for many years. Advantages of such an adhesive restorative technique over conventional techniques using non-adhesive metal-based restoratives include improved restoration retention with minimal sacrifice of sound tooth tissue for retention purposes, superior adaptation and sealing of the restoration margins in prevention of caries recurrence, improved stress distribution across the tooth-restoration interface throughout the whole tooth, and even reinforcement of weakened tooth structures. The dental adhesive technology is rapidly changing. An efficient resin bond to enamel has already long been achieved. Its bonding mechanism has been fully elucidated and has proven to be a durable and reliable clinical treatment. However, bonding to dentin represents a greater challenge. After the failures of a dentin acid-etch technique in imitation of the enamel phosphoric-acid-etch technique and a bonding procedure based on chemical adhesion, modern dentin adhesives are currently believed to bond to dentin by a micromechanical hybridization process. This process is developed by an initial demineralization of the dentin surface layer with acid etchants exposing a collagen fibril arrangement with interfibrillar microporosities that subsequently become impregnated by low-viscosity monomers. Although the development of such a hybridization process has well been documented in the literature, questions remain with respect to parameters of-primary importance to adhesive efficacy.
