Author
Bart Van Meerbeek
Other affiliations: Hokkaido University, The Catholic University of America, University of Texas Health Science Center at San Antonio ...read more
Bio: Bart Van Meerbeek is an academic researcher from Katholieke Universiteit Leuven. The author has contributed to research in topics: Dentin & Dental bonding. The author has an hindex of 67, co-authored 356 publications receiving 17042 citations. Previous affiliations of Bart Van Meerbeek include Hokkaido University & The Catholic University of America.
Topics: Dentin, Dental bonding, Bond strength, Adhesive, Enamel paint
Papers published on a yearly basis
Papers
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TL;DR: The basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions and confirms that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term.
Abstract: Bonding to tooth tissue can be achieved through an "etch&rinse," "self-etch" or "glass-ionomer" approach. In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore, bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine "bonding effectiveness" in the laboratory) are evaluated upon their value and relevance in predicting clinical performance. A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device. Eventually, today's adhesives will be critically weighted upon their performance in diverse laboratory studies and clinical trials. Special attention has been given to the benefits/drawbacks of an etch&rinse versus a self-etch approach and the long-term performance of these adhesives. Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness. Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term. Nevertheless, a self-etch approach may have the best future perspective. Clinically, when adhesives no longer require an "etch&rinse" step, the application time, and probably more importantly, the technique-sensitivity are substantially reduced. Especially "mild," two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional three-step systems in bonding performance.
1,721 citations
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TL;DR: The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients.
1,218 citations
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TL;DR: Morphological evaluation revealed that RelyX Unicem only superficially interacted with enamel and dentin, and that application using some pressure is required to ensure close adaptation of the cement to the cavity wall.
571 citations
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TL;DR: The higher shrinkage of flowable composites over that of hybrids may indicate a potential for higher interfacial stresses, however, their lower rigidity may be a counteracting factor.
Abstract: OBJECTIVES
The magnitude and kinetics of polymerization shrinkage, together with elastic modulus, may be potential predictors of bond failure of adhesive restorations. This study examined these properties in visible-light-cured resins, in particular new flowable composites and filled adhesives.
METHODS
Polymerization shrinkage values were obtained by digital video imaging before and after light-curing; shrinkage kinetics were obtained by the "deflecting disk" method and the elastic modulus by analysis of the fundamental period of vibration.
RESULTS
Flowable composites generally showed higher shrinkage than traditional non-flowable composites, while more densely filled adhesives presented lower shrinkage than lightly filled or unfilled resins. The elastic moduli of flowable composites were in the low-medium range, whilst the hybrid composites showed the highest values and the microfilled the lowest. More densely filled adhesives were more rigid than lightly filled and unfilled adhesives. The kinetics behavior was material dependent, mainly characterized by the coefficient of near-linear contraction between 10 and 40% of the final shrinkage and the time to reach 75% of the final shrinkage.
SIGNIFICANCE
The higher shrinkage of flowable composites over that of hybrids may indicate a potential for higher interfacial stresses. However, their lower rigidity may be a counteracting factor. The microfilled composite showed low shrinkage and low rigidity, a combination that may prove less damaging to the interface. As the kinetics parameters tended to be material specific, no specific class of materials should be seen as more stress inducing until studies determine the relative importance of each examined parameter. The performance of adhesive resins as stress buffers also remains unpredictable.
528 citations
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TL;DR: Besides micro-mechanical interlocking through hybrid-layer formation, self-etch adhesives may benefit from additional chemical interaction between the functional monomer and residual hydroxyapatite, which may account for their lower bonding effectiveness.
Abstract: Besides micro-mechanical interlocking through hybrid-layer formation, self-etch adhesives may benefit from additional chemical interaction between the functional monomer and residual hydroxyapatite. One-step adhesives are commonly associated with lower bonding effectiveness, which must be attributed in part to the dissolution of hydrophilic and hydrophobic monomers in a relatively highly concentrated solvent. In this 'difficult' mixture, also water is essential as ionization medium to enable self-etching activity. Due to the high hydrophilicity, one-step self-etch adhesives have been reported to behave as semi-permeable membranes, allowing fluids to pass through and seriously jeopardizing bond durability. Recent research has also revealed that HEMA-free one-step adhesives are prone to phase-separation, which may also account for their lower bonding effectiveness. Employing an appropriate air-drying technique may, however, improve the bonding effectiveness of such phase-separating adhesives by getting rid of substantially more interfacial water than HEMA-containing adhesives, of which water might be more difficult to remove from.
335 citations
Cited by
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TL;DR: This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements, to assess adhesion durability.
Abstract: The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
1,778 citations
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TL;DR: The basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions and confirms that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term.
Abstract: Bonding to tooth tissue can be achieved through an "etch&rinse," "self-etch" or "glass-ionomer" approach. In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore, bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine "bonding effectiveness" in the laboratory) are evaluated upon their value and relevance in predicting clinical performance. A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device. Eventually, today's adhesives will be critically weighted upon their performance in diverse laboratory studies and clinical trials. Special attention has been given to the benefits/drawbacks of an etch&rinse versus a self-etch approach and the long-term performance of these adhesives. Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness. Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch&rinse adhesives still perform most favorably and are most reliable in the long-term. Nevertheless, a self-etch approach may have the best future perspective. Clinically, when adhesives no longer require an "etch&rinse" step, the application time, and probably more importantly, the technique-sensitivity are substantially reduced. Especially "mild," two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional three-step systems in bonding performance.
1,721 citations
••
TL;DR: The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients.
1,218 citations
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TL;DR: This study critically discusses the latest peer-reviewed reports related to formation, aging and stability of resin bonding, focusing on the micro and nano-phenomena related to adhesive interface degradation.
1,086 citations
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TL;DR: The major shortcomings of the most simple-to-use one-step (self-etch) adhesives are addressed and special attention is devoted to the AD-concept and the benefit of chemical interfacial interaction with regard to bond durability.
1,059 citations