Dentin bonding: what is the state of the art?

Currently, two approaches are available for bonding resin-based materials to dentin--total-etch and self-etch. The total-etch approach, using either a three-step or a two-step method, has been available for several years. Clinical studies have demonstrated excellent success rates for total-etch adhesives, but many clinicians report problems with postoperative sensitivity. The self-etch approach, which is relatively new to the US market, reduces the incidence of postoperative sensitivity. However, the long-term clinical performance of self-etch materials--particularly those that use a single solution to etch, prime, and bond--is not yet proven. This article provides an overview of the current options for bonding resin to dentin.