Most commercial dental composites contain liquid dimethacrylate monomers (including BIS-GMA or variations of it) and silica-containing compositions as inorganic reinforcing filler particles coated with methacrylate-functional silane coupling agents to bond the resin to the filler. They also contain initiators, accelerators, photo-initiators, photosensitizers, polymerization inhibitors, and UV absorbers. Durability is a major problem with posterior composites. The typical life-span of posterior composites is from three to 10 years, with large fillings usually fewer than five years. Polymerization shrinkage and inadequate adhesion to cavity walls are remaining problems. Some pulp irritation can occur if deep restorations are not placed over a protective film. Some have advocated the use of glass-ionomer cement as a lining under resin composite restorations in dentin. The concept of glass-ionomer cements (GICs) was introduced to the dental profession in the early 1970's. Current GICs may contain poly(acrylic acid) or a copolymer. Higher-molecular-weight copolymers may also be used to improve the physical properties of some GICs. Stronger and less-brittle hybrid materials have been produced by the addition of water-soluble compatible polymers to form light-curing GIC formulations. The ion-leachable aluminosilicate glass powder, in an aqueous solution of a polymer or copolymer of acrylic acid, is attacked by the hydrated protons of the acid, causing the release of aluminum and calcium ions. Salt bridges are formed, and a gel matrix surrounds the unreacted glass particles. The matrix is adhesive to mineralized tissues. Provisions must be made for maintenance of the water balance of restorations for the first 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

The development of an adhesion system for bonding dental composites to dentin and enamel is reviewed. Building on findings concerning adhesion to enamel, a field pioneered by Dr. Michael Buonocore and others, Dr. R.L. Bowen and his colleagues at the Paffenbarger Research Center, National Institute of Standards and Technology, began addressing and solving problems associated with (1) silicate cements and unfilled resins, (2) bonding in an aqueous environment, and (3) the development of an adhesion system for both dentin and enamel that could withstand various stresses. Although commercial products based on this adhesion system are currently available in the dental materials marketplace, experimentation continues, focusing on the synthesis of potentially better component analogs, the optimization of the individual components, and on improved storage stability and ease of synthesis.

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