P. Kanumilli

Bio: P. Kanumilli is an academic researcher from Catholic University of Leuven. The author has contributed to research in topics: Enamel paint & Dentin. The author has an hindex of 6, co-authored 6 publications receiving 1424 citations.

Clinical effectiveness of contemporary adhesives: A systematic review of current clinical trials

Abstract: Objectives The purpose of this paper was to review current literature on the clinical effectiveness of contemporary adhesives when used to restore cervical non-carious class-V lesions. Restoration retention in function of time was recorded in order to find out if adhesives with a simplified application procedure are as clinically effective as conventional three-step adhesives. Data Sources Literature published from January 1998 up to May 2004 was reviewed for university-centred clinical trials that tested the clinical effectiveness of adhesives in non-carious class-V lesions. Restoration-retention rates per adhesive reported in peer-reviewed papers as well as IADR-AADR abstracts and ConsEuro abstracts were included and depicted as a function of time in graphs for each of the five adhesive classes (three- and two-step etch-and-rinse adhesives, two- and one-step self-etch adhesives, and glass ionomers). The guidelines for dentin and enamel adhesive materials advanced by the American Dental Association were used as a reference. Per class, the annual failure rate (%) was calculated. Kruskal–Wallis analysis and Dwass–Steel–Chritchlow–Fligner pairwise comparisons were used to determine statistical differences between the annual failure percentages of the five adhesive categories. Results Comparison of retention of class-V adhesive restorations as a measure to determine clinical bonding effectiveness of adhesives revealed that glass ionomers most effectively and durably bond to tooth tissue. Three-step etch-and-rinse adhesives and two-step self-etch adhesives showed a clinically reliable and predictably good clinical performance. The clinical effectiveness of two-step etch-and-rinse adhesives was less favourable, while an inefficient clinical performance was noted for the one-step self-etch adhesives. Significance Although there is a tendency toward adhesives with simplified application procedures, simplification so far appears to induce loss of effectiveness. Clinical performance can be correlated with, and predicted by, appropriate types of laboratory study.— Reprinted with permission of The Academy of Dental Materials.

A Critical Review of the Durability of Adhesion to Tooth Tissue: Methods and Results

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.