Bonding of restorative materials to dentine: the present status in Japan.

Monomers which promote adhesion not only to enamel but also to dentine have been prepared. They have both hydrophilic and hydrophobic groups. The monomers are 2-hydroxy-3-beta-naphthoxypropyl methacrylate, 2-methacryloxyethyl phenyl hydrogen phosphoric acid and 4-methacryloxyethyl trimellitate anhydride. Chemical reaction between monomers and tooth substrates did not lead to adhesion. Cleaning of the ground tooth surface to remove the smeared layer with aqueous 10 per cent citric acid and 3 per cent ferric chloride solution prior to adhesion is recommended. Then, the lipophilic monomers will promote the inter-penetration of monomers into the hard tissues. The infiltrated methacrylates polymerize there and good adhesion takes place. The layer has good resistance against acid and is, in effect, a resin reinforced dentine and enamel as demonstrated by SEM and TEM. The tensile adhesive strength to the cleaned dentine was 18 MN/m2 and to the enamel 14 MN/m2. On the other hand, the value was reduced to 6 MN/m2 when the dentine had been etched by phosphoric acid or citric acid. The ferric chloride added to the citric acid protected dentinal collagen during demineralization. However, the ferric chloride provided ineffective protection against an acid as strong as phosphoric acid. The high bond strength was not dependent upon interlocking at the dentinal tubules as had been considered previously. The resin reinforced dentine and enamel is a hybrid of natural tissue and artificial material and is valuable in the prevention of secondary caries after restoration.