Adhesion
Adhesion
Adhesion
Roughness of surface: Measurements of contact angle for evaluation of wettability of certain liquid on certain surface is based
on assumption that the surface is perfectly flat & smooth. However, on a microscopic level, we always will find roughness in
varying dimensions. This is advantage causing increase of surface area & area of bonding. Irregularities at the surface
additionally can create capillary forces that support diffusion of adhesive into rough surface.
Adhesion promoters: Whenever 2 materials that should be bonded do not have any particular affinity to each other, special
adhesion-promoting agents have to be used. These agents can react with both materials to establish the bond. They
also can be used as primers because they modify surface of substrate to enable wetting of subsequently applied adhesive.
These promoters are essential to create bond to dentin.
Mechanisms of adhesion:
- Chemical: bonding at the atom or molecular level.
- Mechanical: interlocking or penetration of 1 phase into the surface of other.
Principles of adhesion:
- close & intimate contact
- surface wettability
- contact angle
- surface energy and surface tension
Surface energy (surface tension) - inward attractive forces of molecule of liquid or solid.
Ideal adhesive: Contact angle ↓; Wettability ↑; Surface energy ↓
Factors affecting adhesion to tooth: wetting of adhesive, composition & structure of enamel and dentin; internal & external
dentin wetness; smear layer; polymerization contraction (shrinkage), initial polymerization; thermal expansion coefficient and
thermal conduction; stress transmission across interface
Bonding/Adhesion to enamel
Structure of enamel: almost homogeneous, low water content [hydrophobic], enamel prism/rod; contain Hydroxyapatite
crystals
Microstructure of enamel: DEJ, enamel prisms (rods formed from tightly packed crystals, mineralization front (nucleation &
growth of crystals), cellular excretion zone; ameloblasts moving away from DEJ
Geometry and dimensions of apatite crystal: regular hexagonal prism; length=1600 A(0,05-0,1μm)
Bonding to enamel: Untreated enamel surface is smooth (i.e. not retentive) & covered by plaque, which prevents close contact
of any material with tooth surface. Therefore, enamel has to be conditioned. Adhesive technique started in 1955 when
Buonocore first applied phosphoric acid to enamel & proved that this procedure resulted in altered surface that increased
bonding of acrylic material to human teeth. Etching enamel with use of 30-40% phosphoric acid provides repeatable etching
pattern of enamel („honeycomb’). Acid etching of enamel results in rough & enlarged surface, which promotes wettability &
improved micromechanical retention needed to effective adhesion.
Characteristics of etched enamel: honeycomb pattern; “Frosty appearance”, high surface energy; more than twice unetched
enamel. Enamel rods which are unetched provide less effective bonding between tooth surface & composite material. Etched
surface producing microundercuts which provides more effective bonding
Effect of acid etching depends on: kind of acid, acid concentration, etch time, rinse time, form of etchant (gel, semigel,
aqueous solution), enamel structure & composition: (primary or permanent teeth/ prism-structure or prismless enamel/
fluoridated or demineralized enamel)
Resin-enamel interface: resin can wet surface & penetrate to microporosity; resin is polymerized to form 10-20 μm “resin
tags”
Bonding to enamel - Formation of micromechanical retention by 1st step: Acid etching 2nd step: Apply resin adhesive: unfilled
resin or containing small fillers or low viscosity resin
Bonding/Adhesion to dentin:
Structure of dentin:
- Vital & dynamic tissue
- Dentinal tubules: large near the pulp but small near the enamel
- More organic and water content than enamel [more hydrophilic]
- Low surface energy
Comparison of enamel & dentin composition: Enamel: 86% hydroxyapatite, 12% water, 2% organic compound. Dentin:
45% hydroxyapatite, 25% water, 30% organic compound. Because of its high inorganic content, enamel is more difficult to
etch than dentin.
Structure of dentin: Dentin consists of two differently composed mineralized substrates - intertubular dentin with lesser
amount of mineralization compared to peritubular dentin with higher amount of minerals. Dentinal tubules filled with
odontoblastic processes & dentinal fluid make up main part of dentin. Dentin has intrinsic wetness. Number of tubules
decreases from about 45,000 per mm2 close to the pulp to 20,000 per mm2 at DEJ. The closer to pulp, the more fluid from the
tubules is expected. Complex of dentin structure makes difficulty to establish long-lasting bonds to this substrate. Intratubular:
odontoblastic process, fluid Peritubular: hypermineralized dentin Intertubular: more organic and collagen fibrils.
Enamel Dentin
Homogeneous in composition (almost) 95% Heterogeneous in composition 70% hydroxyapatite
hydroxyapatite.
Homogeneous in structure; prisms uniform despite Heterogeneous in structure; more tubules in the deeper dentin (double)
the depth. dentinal fluid in the deeper 1/3
Solid crystallites and non-dynamic Permeable and dynamic (secondary, tertiary - reactive & reparative,
dentinal sclerosis)
High surface energy; aids better wetting. Lower surface energy, less spreading of adhesives.
Smear layer: Whenever tooth surface is cut with hand or rotary instruments, it causes small particles of cut tooth surface to
tooth producing smear layer. Smear layer - any debris, calcific in nature, produced by reduction or instrumentation of enamel,
or dentin or cementum
Dentinal smear layer - - porous layer of about 1-7 μm composed of hydroxyapatite & altered collagen; its morphology &
thickness depends on type of instrument, the way it is used & on site of dentin; keeps any material from direct contact to solid
dentin; should be removed before bonding process; cutting of dentin during cavity preparation produces microcrystalline
grinding debris that coats dentin & clogs orifices of dentinal tubules; poorly adherent layer of ground dentin produced by
cutting of dentin surface; forms after each instrumentation; lowers dentin permeability by 86%.It has two phases Solid phase -
made up of cutting debris, primarily denaturated collagen & mineral Liquid phase - made up of tortuous fluid filled channels
around cutting debris. Bacteria entrapped in smear layer can survive & multiply beneath restoration
Difficulties in long-lasting bonding to dentin: complex of dentin structure; physiologic alternation (dentin ageing);
pathologic alternation (sclerotic dentin, hypersensitive dentin with its open tubules, caries-affected areas)
Different approaches to handle dentinal smear layer: can be used as substrate (impregnation), it means that the adhesive
makes use of porosities within smear layer; can be modified (partial dissolution) in being partly dissolved; can be totally
removed. Impregnation of smear layer - bonding to smear layer provides only low bond strength values. Partly dissolved smear
layer - it provides some higher bond strength values. Totally removed smear layer - provides higher bond strength values.
Totally removal of smear layer - total etch technique: Depth of decalcification of about 3 to 10 µm depends on type &
concentration of acid & etching time. Interaction of acids with dentin is limited by buffer capacity of hydroxyapatite. Etching
procedure not only dissolves smear layer but also removes superficial part of dentin, opens dentinal tubules to funnel-like
shape & demineralizes dentin surface. After etching dentin & rinsing the acid from cavity, demineralized dentin remains as
collagen network since it lost the support from hydroxyapatite. Space between fibres previously filled with hydroxyapatite now
contain water. Water has to be replaced by monomer. Any drying of dentine would result in a loss of water with collapse of
collagen fibres, hindering resin monomers from penetrating decalcified dentin. Therefore, it is recommended to keep
demineralized dentin wet or moist. It is a challenge for practicioner to keep dentin in correct degree of moisture after
demineralization wet bonding technique.
Role of water in bonding process: Water acts as plasticizer for collagen & keeps it in soft state. If dentin is excessively dried
it will lead to collapse of collagen network. Critical amount of water is essential for bonding but over wet condition decreases
bond strength & formation of blister like structures at interface.
Dentin wetness - Etch & Rinse: After etching (conditioning) dentin - dentin must be wet to prevent collagen collapse. To
little water causes - collagen collapse giving ineffective resin penetration that leads to nanoleakage.
Smear layer dentin etching (removal of smear layer & exposure of collagen net) overdrying collapse of collagen net
re-wetting
Overwet phenomena: Too much water - not completely displaced. Phase separation - blister & globule formation
Adhesion-promoting agents - Hydrophilic primer is used, which is able to change surface properties to promote diffusion of
adhesive into collagen network & into opened tubules. Penetration into collagen network results in mixed zone called the
„hybrid layer” or „resin-dentin interdiffusion zone”. Priming process has to produce efficient wetting of exposed collagen
fibrils, which displaces any residual surface moisture, transform hydrophilic into hydrophobic surface condition & sufficiently
carries monomers into interfibrilar channels of demineralized dentin.
Hybrid layer: zone where adhesive resin of dentin bonding agent micromechanically interlocks within intertubular dentin &
surronding collagen fibres. Hybrid layer formation: (1) etching removes smear layer & exposes collagen fibres; it also removes
hydroxyapatite with intertubular dentin (2) primers penetrate collagen network (3) adhesive resin along with primers form
resin microtags within intertubular dentin
6) Follow sound principles of cavity design: For direct composite restorations, regardless of cavity class, sharp vertical
walls and line angles are not needed, and rounded internal line angles are actually preferred because it is easier to adapt
resin restoratives without voids to rounded surfaces. Cavity design should be dictated by access to achieve complete
removal of carious hard tissue and access to place the adhesive system and assure proper adaptation of the restorative
material to the cavity wall. While minimally invasive cavity preparations can be used, care must be taken to gain enough
visibility to determine if caries is completely removed. It is also important that all unsupported enamel be removed to prevent
marginal fractures from the polymerization shrinkage inherent in the composite-curing process. Proper preparation of enamel
margins, especially with self-etching adhesive systems, will maximize bond strength and improve marginal integrity.