The role of adhesive materials and oral biofilm in the failure of adhesive resin restorations

Roberto Pinna, Paolo Usai, Enrica Filigheddu, Franklin Garcia-Godoy, Egle Milia

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Purpose: To critically discuss adhesive materials and oral cariogenic biofilm in terms of their potential relevance to the failures of adhesive restorations in the oral environment. Methods: The literature regarding adhesive restoration failures was reviewed with particular emphasis on the chemistry of adhesive resins, weakness in dentin bonding, water fluids, cariogenic oral biofilm and the relations that influence failures. Particular attention was paid to evidence derived from clinical studies. Results: There was much evidence that polymerization shrinkage is one of the main drawbacks of composite formulations. Stress results in debonding and marginal leakage into gaps with deleterious effects in bond strength, mechanical properties and the whole stability of restorations. Changes in resins permit passage of fluids and salivary proteins with a biological breakdown of the restorations. Esterases enzymes in human saliva catalyze exposed ester groups in composite producing monomer by-products, which can favor biofilm accumulation and secondary caries. Adhesive systems may not produce a dense hybrid layer in dentin. Very often this is related to the high viscous solubility and low wettability in dentin of the hydrophobic BisGMA monomer. Thus, dentin hybrid layer may suffer from hydrolysis using both the Etch&Rinse and Self-Etching adhesive systems. In addition, exposed and non-resin enveloped collagen fibers may be degraded by activation of the host-derived matrix metalloproteinase. Plaque accumulation is significantly influenced by the surface properties of the restorations. Biofilm at the contraction gap has demonstrated increased growth of Streptococcus mutans motivated by the chemical hydrolysis of the adhesive monomers at the margins. Streptococcus mutans is able to utilize some polysaccharides from the biofilm to increase the amount of acid in dental plaque with an increase in virulence and destruction of restorations. Stability of resin restorations in the oral environment is highly dependent on the structure of the monomers used in composite and adhesive systems. Still, the issues related to microleakage of fluids into the gap and bacteria leaching from the surface of composites represent the main causes of failure of adhesive restorations. (Am J Dent 2017;30:285-292). Clinical significance: Modifications of adhesive materials are necessary to address their instability in the oral environment.

Original languageEnglish (US)
Pages (from-to)285-292
Number of pages8
JournalAmerican Journal of Dentistry
Volume30
Issue number5
StatePublished - Oct 1 2017

Fingerprint

Biofilms
Adhesives
Dentin
Streptococcus mutans
Hydrolysis
Salivary Proteins and Peptides
Wettability
Dental Plaque
Surface Properties
Esterases
Matrix Metalloproteinases
Saliva
Polymerization
Solubility
Polysaccharides
Virulence
Esters
Collagen
Bacteria
Acids

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

The role of adhesive materials and oral biofilm in the failure of adhesive resin restorations. / Pinna, Roberto; Usai, Paolo; Filigheddu, Enrica; Garcia-Godoy, Franklin; Milia, Egle.

In: American Journal of Dentistry, Vol. 30, No. 5, 01.10.2017, p. 285-292.

Research output: Contribution to journalReview article

Pinna, Roberto ; Usai, Paolo ; Filigheddu, Enrica ; Garcia-Godoy, Franklin ; Milia, Egle. / The role of adhesive materials and oral biofilm in the failure of adhesive resin restorations. In: American Journal of Dentistry. 2017 ; Vol. 30, No. 5. pp. 285-292.
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