Cervical Sclerotic Dentin: Resin Bonding

Abstract

Many reports have indicated that resin bond strengths to noncarious sclerotic cervical dentin are lower than bonds made to normal dentin. This is thought to be due to tubule occlusion by acid-resistant mineral salts, preventing resin tag formation following acid etching. The purpose of this review was to critically examine what is known about the structure of this type of dentin. Recent transmission electron microscopy revealed that in addition to occlusion of the tubules by mineral crystals, many parts of wedge-shaped cervical lesions contain a hypermineralized surface that resists the etching action of both self-etching primers and phosphoric acid. This layer prevents hybridization of the underlying sclerotic dentin. In addition, bacteria are often detected on top of the hypermineralized layer. Sometimes the bacteria were embedded in a partially mineralized matrix. Acidic conditioners and resins penetrate variable distances into these multilayered structures. Examination of both sides of the failed bonds revealed a wide variation in fracture patterns that involved all of these structures. Microtensile bond strengths to the occlusal, gingival, and deepest portions of these wedge-shaped lesions are signifi cantly lower than similar areas artifi cially prepared in normal teeth. When resin bonds to sclerotic dentin are extended to include peripheral sound dentin, their bond strengths are probably high enough to permit retention of class V restorations by adhesion, without additional retention.

Effects of age on secondary dentine mineralization and resin bonding capacity

“…The statistically signi cant negative correlation between SBS and M indicate that the increase in secondary dentine mineralization may signi cantly reduce the bonding capacity. The percentage difference in SBS between III-C and III-R groups of the present study (46%), was within the range of the differences reported between normal and sclerotic dentine of non-carious cervical lesions bonded with a self-etch adhesive (45%) [23,24,51]. Although the biosynthesis and structure of sclerotic are different from secondary dentine, they both show increased mineralization in older patients.…”

“…The increase of primary dentine mineralization reduces the bond strength with resin composites mediated with etch and rinse or self-etch adhesives [19,22,23]. A typical example is bonding to sclerotic dentine, where the more aggressive etch and rinse adhesives demonstrated higher bond strength compared to self-etch products [24]. Secondary dentine may emerge as a small area surrounded by primary dentine in deep cavity preparations.…”

Effect of Different Desensitizers on Shear Bond Strength of Self-Adhesive Resin Cements to Dentin

“…It has been previously reported that the SBS of resin cements depends on several factors, such as the type of dentin (coronal, apical, caries-affected, and sclerotic), preparation depth (superficial or close to the pulp), and tooth surface management [ 20 , 21 , 22 , 23 ]. For SARCs, no conditioning of dentin with a bonding agent is needed.…”

A Comparative Study of Frequency of Retention of Flowable Nanocluster Composite and Resin Modified Glass Ionomers in Non Carious Cervical Lesions in Maxillary Molars

“…The bonding capacity of the present time adhesives to the non-carious cervical lesions with sclerosed dentine was accounted to 20-45% lesser than those attached to self-made similarly shaped cavities created in healthy tooth structure. This disparity is due to the thin hybrid layers in the former, and the complex structure of the resin-bonded interface 6,7 .…”

“…Due to the improved esthetics and adhesion, composites are also alternative material for restoration of NCCL. Short comings of composite restorations in cervical areas have been associated with stress generation on the tooth restoration interface due to polymerization shrinkage, and tensile stress caused by oblique occlusal loading causing debonding 6,8 . Flowable composites with low viscosities provided excellent handling characteristics with syringe delivery system.…”