Super dentin formation : a new concept in Adhesive dentistry



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Super dentin formation :A new concept in Adhesive dentistry

Super dentin maybe defines as a reinforced and modified dentin with superior resistance against caries activity.

The reinforcement may be achieved by remineralization using calcium-phosphates, increased acid-resistance of Hydroxyapatite by fluoride, protection of HAP crystals against acid.

Super dentin is considered essential for minimal invasive treatments.

Much has been contributed to the concept of adhesion in the past decade, in terms of chemical reactions where exchange of ions occur between the adhesive and substrate at the bonding interface.

More recent developments suggest that in self-etching primer adhesive systems, a mineral-rich acid-base resistant zone may form under the classic hybrid layer of resin impregnated hypomineralized dentin.

It has been suggested that resin monomers may penetrate and wrap hydroxyapatite particles below the hybrid layer.

Tsuchiya et al. (2004) used scanning electron microscopy (SEM) to analyze the ultrastructure of the adhesive-dentin interface after acid-base challenge.


They demonstrated formation of an acid-base resistant zone (ABRZ) adjacent to the hybrid layer, which was influenced by adhesive material composition.

The ABRZ was observed in the self-etching adhesive systems, but not in acid etching systems.


It has been shown that thickness of ABRZ is between 500 -1000 nm and is thicker in Caries -affected dentin than Sound dentin.
Hypothetically, “super dentin”, a modified dentin with superior resistance against caries activity, could be created by the use of self-etching adhesive resins.

Such structure should be able to prevent occurrence or recurrence of caries.

Conceptually, novel strategies should be developed for dental caries treatment where the preserved caries-affected dentin and even inactivated infected parts could be transformed “reinforced” into super dentin. In this regard, the formation of an outer lesion around such a restoration involving this dentin would not be referred to as secondary caries, but as primary caries.

Such a reinforced dentin is Super dentin and such a tooth is Super Tooth.



Super dentin formation is a new approach in caries prevention in Restorative dentistry .


 
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