Abstract
Despite their popularity, resin composite restorations fail earlier and at higher rates than comparable amalgam restorations. One of the reasons for these rates of failure are the properties of current dental bonding agents. Modern bonding agents are vulnerable to gradual chemical and mechanical degradation from a number of avenues such as daily use in chewing, catalytic hydrolysis facilitated by salivary or bacterial enzymes, and thermal fluctuations. These stressors have been found to work synergistically, all contributing to the deterioration and eventual failure of the hybrid layer. Due to the expense and difficulty in conducting in vivo experiments, in vitro protocols meant to accurately simulate the oral environment’s stressors are important in the development of bonding agents and materials that are more resistant to these processes of degradation. This narrative review serves to summarize the currently employed methods of aging dental materials and critically appraise them in the context of our knowledge of the oral environment’s parameters.
Highlights
Dental caries are one of the most common maladies in the human population today, affecting 35% of the global population across all ages in 2010 [1], with peaks of cavitated dental caries incidence at the ages of 6, 26, and 70 years old [2]
Assuming an adequate application of the bonding agent, bonding agents are well suited to withstanding the mechanical stresses of the oral environment in the short term [18]; it is long term processes of fatigue and degradation that cause failure
One of the most common ways to detect the chemical degradation of a dental bonding agent is the use of liquid chromatography, at times in combination with mass spectrometry to measure the release of biodegradation by products such as BisHPPP from a sample [18]
Summary
Dental caries are one of the most common maladies in the human population today, affecting 35% of the global population across all ages in 2010 [1], with peaks of cavitated dental caries incidence at the ages of 6, 26, and 70 years old [2] This presents a significant burden on the healthcare system, and barring prevention or early detection, treatment is required to remove the decayed tissue and restore the lost tooth structure with a restorative material. Differences in the curing method significantly affect marginal adaptation, bacterial biofilm microleakage, and caries formation and/or detachment of the restoration [9] These possible vulnerabilities have driven research and innovation to develop resin composite materials with improved properties, but these need to be assessed in a laboratory setting before their clinical assessment and applications are considered. This polymerization is usually triggered by a photochemical initiation system activated by blue light (468 nm) [16], or a chemical initiation system, either of which is incorporated into the material [19]
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