ASK THE EXPERT
BMC : Prof. Van Meerbeek, how have bonding agents changed and advanced since you first began studying them?
Prof. Van Meerbeek : I believe that the great progress dental adhesive technology underwent in the last thirty years, and bonding agents in particular, have had a large impact on the field of dentistry, particularly restorative dentistry, of course. Many of the current restorative dental procedures make use of adhesive materials and techniques, and have advanced greatly as compared to when I wrote my PhD dissertation more than two decades ago on the topic of adhesion to dentin. Adhesion to enamel is, of course, relatively easy to achieve in comparison to adhesion to dentin, and when I first started researching this topic, I was limited to conducting clinical trials in which we were confronted with a relatively high number of restoration losses at short term. I was lucky to have been able to follow from the first row the fast advancement dental bonding has made, as having conducted research in this field now for nearly thirty years.
At a certain point, the research community started to realise that there is a smear layer in between that is created through cavity preparation, and that this layer interferes with bonding; if you want to achieve successful micromechanical and chemical bonding to the substrate, you first need to do something with this bond-interfering smear layer.
After this, we entered the era of conditioners and primers. In the past, the restorative community had been a little bit afraid of using phosphoric acid due to its potential for pulp irritation. More and more, however, dental professionals began to use etchants with this chemical in them, as well as primers that effectively promoted bonding between the adhesive resin and dentin. While having reached excellent bonding performance with multi-step adhesives in the laboratory, as also was later confirmed in clinical studies, further design and development of adhesive materials…