Evidence From the Experts
Throughout the progression of adhesive dentistry, which has spanned several "generations" of materials, clinical evidence has continued to be of paramount importance in confirming which are the most effective, what selection criteria and protocols should be used, and where improvement is still needed. The state of the art currently includes eighth-generation self-etch systems and universal adhesives. Although both were introduced approximately a decade ago,1,2 the specific protocols and methods used to place them are still being validated by research to determine best practices.
In the interest of providing the latest, most credible information available, Inside Dentistry turned to five experts who specialize in conducting research to address pressing questions about the nuances of adhesion, including those involving immediate dentin sealing, bonding to zirconia, universal adhesives, stabilizing the hybrid layer, and etching dentin.
1. Sofan E et al. Classification review of dental adhesive systems: from the IV generation to the universal type. Ann Stomatol (Roma). 2017;8(1):1-17.
2. Kazak M and Dönmez N. Development of dentin bonding systems from past to present. Bezmialem Science. 2019;7(4):322-330.
Expert: Augusto Robles, DDS, MS, DMD
Augusto Robles, DDS, MS, DMD, is an associate professor at the University of Alabama at Birmingham School of Dentistry. He has presented research on adhesive dentistry at the meetings of both the International Association for Dental Research (IADR) and the American Association for Dental Research (AADR)
as well as in several publications.
Expert: Markus Blatz, DMD, PhD
Markus Blatz, DMD, PhD, is a professor of restorative dentistry and chairman of the Department of Preventive and Restorative Sciences at the University of Pennsylvania School of Dental Medicine and the editor-in-chief of Compendium of Continuing Education in Dentistry. He has authored multiple articles on zirconia bonding techniques and materials, and he co-developed the APC zirconia-bonding concept.
Expert: Nathaniel Lawson, DMD, PhD
Nathaniel Lawson, DMD, PhD, is an associate professor and the director of the Division of Biomaterials at the University of Alabama at Birmingham School of Dentistry. He has presented multiyear clinical data on universal adhesives at a meeting of the IADR and the AADR and published research in multiple journals.
Expert: Bart Van Meerbeek, DDS, PhD
Bart Van Meerbeek, DDS, PhD, is a professor in the Department of Oral health Sciences and the founder and head of the BIOMAT (Biomaterials Research Group) at KU Leuven (University of Leuven) in Leuven, Belgium and co-editor-in-chief of the Journal of Adhesive Dentistry. His research work has been published in more than 400 international peer-reviewed journals.
Expert: Lorenzo Breschi, DDS, PhD
Lorenzo Breschi, DDS, PhD, is a full professor and chair of restorative dentistry and dental materials in the Department of Biomedical and Neuromotor Sciences and the director of the Master in Aesthetic Restorative Dentistry program at the University of Bologna in Bologna, Italy. He is also associate editor of the Journal of Adhesive Dentistryand has published more than 250 original papers and review articles about adhesion and restorative materials.