Biodegradation of Resin-Dentin Bonds: a Clinical Problem?

Abstract

Biodegradation of the resin-dentin interfaces has been a focus of research over the last decade. Most studies show that degradation of both the collagen and the adhesive take place within short periods of time after bonding, and claim that such loss of structure at the interface opens opportunity for secondary caries initiation and progression thus leading to failure of the restoration. Open margins are further compromised by thermo-mechanical loading and enzymes produced by local bacteria. While marginal gaps appear to be unavoidable, it is remarkable that resin composite restorations can deliver successful clinical service for many years provided preventive and conservative measures to reduce the caries-risk of the patient are applied along with the restorative treatment. This review will look into the evidence from laboratory studies that investigated degradation of bonds and the consequences leading to clinical failure and balance that against the results of clinical trials that evidence the factors associated with the durability and clinical success of resin composite restorations.