This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.

The limited durability of resin-dentin bonds severely compromises the longevity of composite resin restorations. Resin-dentin bond degradation might occur via degradation of water-rich and resin sparse collagen matrices by host-derived matrix metalloproteinases (MMPs). This review article provides overview of current knowledge of the role of MMPs in dentin matrix degradation and four experimental strategies for extending the longevity of resin-dentin bonds. They include: (1) the use of broad-spectrum inhibitors of MMPs, (2) the use of cross-linking agents for silencing the activities of MMPs, (3) ethanol wet-bonding with hydrophobic resin, (4) biomimetic remineralization of water-filled collagen matrix. A combination of these strategies will be able to overcome the limitations in resin-dentin adhesion.

During a composite resin restoration, an anticipating contraction gap is usually tried to seal with low-viscosity resin after successive polishing, etching, rinsing and drying steps, which as a whole is called rebonding procedure. However, the gap might already have been filled with water or debris before applying the sealing resin. We hypothesized that microleakage would decrease if the rebonding agent was applied before the polishing step, i.e., immediately after curing composite resin. On the buccal and lingual surfaces of 35 extracted human molar teeth, class V cavities were prepared withthe occlusal margin in enamel and the gingival margin in dentin. They were restored with a hybrid composite resin Z250 (3M ESPE, USA) using an adhesive AdperTM Single Bond 2 (3M ESPE). As rebonding agents, BisCover LV (Bisco, USA), ScotchBond Multi-Purpose adhesive (3M ESPE) and an experimental adhesive were applied on the restoration margins before polishing step or after successive polishing and etching steps. The infiltration depth of 2% methylene blue into the margin was measured using an optical stereomicroscope. The correlation between viscosity of rebonding agents and mciroleakage was also evaluated. There were no statistically significant differences in the microleakage within the rebonding procedures, within the rebonding agents, and within the margins. However, when the restorations were not rebonded, the microleakage at gingival margin was significantly higher than those groups rebonded with 3 agents (p < 0.05). The difference was not observed at the occlusal margin. No significant correlation was found between viscosity of rebonding agents and microleakage, except very weak correlation in case of rebonding after polishing and etching at gingival margin (r = -0.326, p = 0.041).

The purpose of this study was to evaluate the effect of film thickness of various resin cements on bonding efficiency in indirect composite restoration by measurement of microtensile bond strength, polymerization shrinkage, flexural strength and modulus, fractographic FE-SEM analysis. Experimental groups were divided according to film thickness (< 50 µm-control, 50 µm-T50, 100 µm-T100, 150 µm-T150) using composite-based resin cements (Variolink II, Duo-Link) and adhesive-based resin cements (Panavia F, Rely X Unicem). The data was analyzed using ANOVA and Duncan's multiple comparison test (p < 0.05).

The results were as follows;

Variolink II showed higher microtensile bond strength than that of adhesive-based resin cements in all film thickness (p < 0.05) but Duo-Link did not show significant difference except control group (p < 0.05).

This study evaluated the influence of the type of restoration and the amount of interdental spacing on the stress distribution in maxillary central incisors restored by means of porcelain laminate veneers and direct composite resin restorations.

Three-dimensional finite element models were fabricated to represent different types of restorations. Four clinical situations were considered. Type I, closing diastema using composite resin. Labial border of composite resin was extended just enough to cover the interdental space; Type II, closing diastema using composite resin without reduction of labial surface. Labial border of composite resin was extended distally to cover the half of the total labial surface; Type III, closing diastema using composite resin with reduction of labial surface. Labial border of the preparation and restored composite resin was extended distally two-thirds of the total labial surface; Type IV, closing diastema using porcelain laminate veneer with a feathered-edge preparation technique. Four different interdental spaces (1.0, 2.0, 3.0, 4.0 mm) were applied for each type of restorations.

For all types of restoration, adding the width of free extension of the porcelain laminate veneer and composite resin increased the stress occurred at the bonding layer. The maximum stress values observed at the bonding layer of Type IV were higher than that of Type I, II and III. However, the increasing rate of maximum stress value of Type IV was lower than that of Type I, II and III.

The aim of this study was to measure the dentinal tubular fluid flow (DFF) during and after amalgam and composite restorations. A newly designed fluid flow measurement instrument was made. A third molar cut at 3 mm apical from the CEJ was connected to the flow measuring device under a hydrostatic pressure of 15 cmH₂O. Class I cavity was prepared and restored with either amalgam (Copalite varnish and Bestaloy) or composite (Z-250 with ScotchBond MultiPurpose: MP, Single Bond 2: SB, Clearfil SE Bond: CE and Easy Bond: EB as bonding systems). The DFF was measured from the intact tooth state through restoration procedures to 30 minutes after restoration, and re-measured at 3 and 7days after restoration.

Inward fluid flow (IF) during cavity preparation was followed by outward flow (OF) after preparation. In amalgam restoration, the OF changed to IF during amalgam filling and slight OF followed after finishing.

In composite restoration, application CE and EB showed a continuous OF and air-dry increased rapidly the OF until light-curing, whereas in MP and SB, rinse and dry caused IF and OF, respectively. Application of hydrophobic bonding resin in MP and CE caused a decrease in flow rate or even slight IF. Light-curing of adhesive and composite showed an abrupt IF. There was no statistically significant difference in the reduction of DFF among the materials at 30 min, 3 and 7 days after restoration (P > 0.05).

The aim of this study was to examine that thick dentin bonding agent application or low modulus composite restoration could reduce stresses on dentin bonding agent layer.

A mandibular first premolar with abfraction lesion was modeled by finite element method. The lesion was restored by different composite resins with variable dentin bonding agent thickness (50µm, 100µm, 150µm). 170N of occlusal loading was applied buccally or lingually. Von Mises stress on dentin bonding agent layer were measured.

When thickness of dentin bonding agent was increased von Mises stresses at dentin bonding agent were decreased in both composites. Lower elastic modulus composite restoration showed decreased von Mises stresses. On root dentin margin more stresses were generated than enamel margin.

For occlusal stress relief at dentin boning agent layer to applicate thick dentin bonding agent or to choose low elastic modulus composite is recommended.

This study compared the effect of an activator, intermediate bonding resin and low-viscosity flowable resin on the microtensile bond strength of a self-curing composite resin used with two-step total etching adhesives. Twenty extracted permanent molars were used. The teeth were assigned randomly to nine groups (n=10) according to the adhesive system and application of additional methods (activator, intermediate adhesive, flowable resin). The bonding agents and additional applications of each group were applied to the dentin surfaces. Self-curing composite resin buildups were made for each tooth to form a core, 5mm in height. The restored teeth were then stored in distilled water at room temperature for 24h before sectioning. The microtensile bond strength of all specimens was examined. The data was analyzed statistically by one-way ANOVA and a Scheffe's test. The application of an intermediate bonding resin (Optibond FL adhesive) and low-viscosity flowable resin (Tetric N-flow) produced higher bond strength than that with the activator in all groups. Regardless of the method selected, Optibond solo plus produced the lowest µTBS to dentin. The failure modes of the tested dentin bonding agents were mostly adhesive failure but there were some cases showed cohesive failure in the resin.

Bond strength depends on characteristics of bonding surface and restorative technique. The majority of studies dealing with dentin bond strength were carried out on flat bonding surface, therefore, difference of bond strength between axial wall and pulpal wall is not clear yet. This study evaluated bonding difference between cavity walls in class I composite resin restoration with different filling techniques.

Twenty extracted caries-free human third molars were used. Cavities were prepared in 6 × 4 × 3 mm box-type and divided into four groups according to filling technique and bonding surface: Group I; bulk filling - pulpal wall, Group II; bulk filling - axial wall, Group III; incremental filling - pulpal wall, Group IV; incremental filling - axial wall.

Cavities were filled with Filtek Z250®(3M/ESPE., USA) and Clearfill SE bond®(Kuraray, Japan). After 24 hour-storage in 37℃ water, the resin bonded teeth were sectioned bucco-lingualy at the center of cavity.

Specimens were vertically sectioned into 1.0 × 1.0 mm thick serial sticks perpendicular to the bond surface using a low-speed diamond saw (Accutom 50, Struers, Copenhagen, Denmark) under water cooling. The trimmed specimens were then attached to the testing device and in turn, was placed in a universal testing machine (EZ test, Shimadzu Co., Kyoto, Japan) for micro-tensile testing at a cross-head speed of 1 mm/min. The results obtained were statistically analyzed using 2-way ANOVA and t-test at a significance level of 95%.

The results were as follows:

1. There was no significant difference between bulk filling and incremental filling.

2. There was no significant difference between pulpal wall and axial wall, either.

Within the limit of this study, it was concluded that microtensile bond strength was not affected by the filling technique and the site of cavity walls.

The purpose of this study was to compare the effect of various dentin bonding systems on microtensile bond strength of immediate dentin sealing (IDS) and delayed dentin sealing (DDS). Eighteen extracted permanent molars were used in this study. The teeth for DDS group were restored with a provisional restorations, and immersed in saline solution for 1 week, and divided into 3 subgroups according to various dentin bonding adhesives; SB subgroup (3 step total-etch adhesive), SE subgroup (2 step self-etch adhesive), XE subgroup (1 step self-etch adhesive). In IDS group, the teeth were divided into 3 subgroups, and applied with bonding adhesives as in DDS group. The teeth were restored with provisional restorations, and immersed in saline solution for 1 week. Indirect composite disc was cemented with resin cement, and all specimens were subjected to microtensile bond strength. The data were statistically analyzed with one-way ANOVA and Student t-test.

The results were as follows:

The IDS group showed significantly higher µTBS than DDS group in 3 step total-etch and 2 step self-etch adhesive (p < 0.05).

This study was conducted to evaluate the influence of the C-factor on the bond strength of a 6th generation self-etching system by measuring the microtensile bond strength of four types of restorations classified by different C-factors with an identical depth of dentin.

Eighty human molars were divided into four experimental groups, each of which had a C-factor of 0.25, 2, 3 or 4. Each group was then further divided into four subgroups based on the adhesive and composite resin used. The adhesives used for this study were AQ Bond Plus (Sun Medical, Japan) and Xeno III (DENTSPLY, Germany). And composite resins used were Fantasista (Sun Medical, Japan) and Ceram-X mono (DENTSPLY, Germany).

The results were then analyzed using one-way ANOVA, a Tukey's test, and a Pearson's correlation test and were as follows.

There was no significant difference among C-factor groups with the exception of groups of Xeno III and Ceram-X mono (p < 0.05).

It was concluded that the C-factor of cavities does not have a significant effect on the microtensile bond strength of the restorations when cavities of the same depth of dentin are restored using composite resin in conjunction with the 6th generation self-etching system.

This study analyzed the influence of dental adhesive/primer on the bond strength between indirect resin composite and the resin cement.

Seventy disc specimens of indirect resin composite (Tescera Dentin, Bisco) were fabricated. And bonding area of all specimens were sandblasted and silane treated for one minute. The resin cements were used with or without application of adhesive/primer to bonding area of indirect resin restoration: Variolink-II (Ivoclar-Vivadent): Exite DSC, Panavia-F (Kuraray): ED-Primer, RelyX Unicem (3M ESPE): Single-Bond, Duolink (Bisco): One-step, Mulitlink (Ivoclar-Vivadent): Multilinh Primer.

Shear bond strength was measured by Instron universal testing machine.

Adhesive application improved shear bond strength (p < 0.05). But Variolink II and Panavia-F showed no statistically significant difference according to the adhesive application.

With the above results, when resin inlay is luted by resin cement it seems that application of dental adhesive/primer is necessary in order to improve the bond strength.

This study was aimed to investigate whether an oxygen inhibition layer (OIL) is essential for the interfacial bonding between resin composite layers or not.

A composite (Z-250, 3M ESPE) was filled in two layers using two aluminum plate molds with a hole of 3.7 mm diameter. The surface of first layer of cured composite was prepared by one of five methods as followings, thereafter second layer of composite was filled and cured: Group 1 - OIL is allowed to remain on the surface of cured composite; Group 2 - OIL was removed by rubbing with acetone-soaked cotton; Group 3 - formation of the OIL was inhibited using a Mylar strip; Group 4 - OIL was covered with glycerin and light-cured; Group 5 (control) - composite was bulk-filled in a layer. The interfacial shear bond strength between two layers was tested and the fracture modes were observed. To investigate the propagation of polymerization reaction from active area having a photo-initiator to inactive area without the initiator, a flowable composite (Aelite Flow) or an adhesive resin (Adhesive of ScotchBond Multipurpose) was placed over an experimental composite (Exp_Com) which does not include a photoinitiator and light-cured. After sectioning the specimen, the cured thickness of the Exp_Com was measured.

The bond strength of group 2, 3 and 4 did not show statistically significant difference with group 1. Groups 3 and 4 were not statistically significant different with control group 5. The cured thicknesses of Exp_Com under the flowable resin and adhesive resin were 20.95 (0.90) um and 42.13 (2.09), respectively.

The objective of this study was to compare dentin shear bond strength (DSBS) of dentin bonding agents (DBAs) cured with a plasma arc (PAC) light curing unit (LCU) and those cured with a light emitting diode (LED) LCU. Optical properties were also analyzed for Elipar freelight 2 (3M ESPE); LED LCU, Apollo 95E (DMT Systems); PAC LCU and VIP Junior (Bisco); Halogen LCU. The DBAs used for DSBS test were Scotchbond Multipurpose (3M ESPE), Singlebond 2 (3M ESPE) and Clearfil SE Bond (Kuraray). After DSBS testing, fractured specimens were analyzed for failure modes with SEM.

The total irradiance and irradiance between 450 nm and 490 nm of the LCUs were different. LED LCU showed narrow spectral distribution around its peak at 462 nm whereas PAC and Halogen LCU showed a broad spectrum. There were no significant differences in mean shear bond strength among different LCUs (P > 0.05) but were significant differences among different DBAs (P < 0.001)

The purpose of this study is to compare the shear bond strength of repaired composite resin with different bonding agents and evaluate the effect of bonding agents on composite repair strength. Forty composite specimens (Z-250) were prepared and aged for 1week by thermocycling between 5 and 55℃ with a dwell time of 30s. After air abrasion with 50 µm aluminum oxide, following different bonding agents were applied (n = 10); SB group: Scotchbond multipurpose adhesive (3 step Total-Etch system); SE group: Clearfil SE bond (2 step Self-Etch system); XP group: XP bond (2 step Total-Etch system); XE group: XenoIII (1 step Self-Etch system). After bonding procedure was completed, new composite resin (Z-250) was applied to the mold and cured. For control group, 10 specimens were prepared. Seven days after repair, shear bond strength was measured. Data was statistically analyzed using one-way ANOVA and Tukey's test (p < 0.05). The means and standard deviations of shear bond strength (MPa ± S.D.) per group were as follows: SB group: 17.06; SE group: 19.10; XP group: 14.44; XE group: 13.57; Control Group: 19.40. No significant difference found in each group. Within the limit of this study, it was concluded that the different type of bonding system was not affect on the shear bond strength of repaired composite resin.

The purpose of this study was to evaluate the effect of additional etching procedure prior to Maxcem resin cement application in indirect restoration cementation using push-out bonding strength.

One hundred and two extracted human molars were used to make indirect resin restorations of gold inlay and Synfony. These restorations were cemented using Maxcem and Variolink II. Additional etching procedures were done for one group with Maxcem. Three groups have 17 specimens in both restoration types. Push-out bond strength was measured using multi-purpose tester and calculated for bonding strength per sqaure-millimeter area. The mean bonding strength values were compared using SPSS 12.0K program for one-way ANOVA and Scheffe's Test with 95% significance.

Under the condition of this study, the additional etching procedure prior to usage of Maxcem resulted in reduced bond strength for both of restoration types.