Adhesive dentistry: the development of immediate dentin sealing/selective etching bonding technique

A major objective of dental research over the past 60 years has been a search for the "dream-team" of dental adhesives. In fact, a recent Medline search produced more than 6,500 papers on dentin bonding and its techniques. Adhesive systems are designed to retain direct and indirect restorations, minimize leakage at the margin, and be simple to place while producing consistent results. The development of materials and techniques has an interesting history; some have recirculated from the past and are being used in some form today. Buonocore used the etchant phosphoric acid at the beginning of the adhesive revolution. Though not accepted for many years it eventually became the "gold standard" for etching enamel. Technique sensitivity moved it out of favor and, through the development of self-etching acidic primers, was eliminated from some adhesive systems. Although these primers may have successfully addressed postoperative sensitivity, adhesion was compromised. The bond strength of these systems has now been improved with the incorporation of phosphoric acid-etch to condition enamel prior to using the adhesive system. This article will trace the history of adhesive techniques and materials and how it has led to the creation of a new technique that combines two bonding methods.