Breschi Lorenzo, Maravic Tatjana, Mazzitelli Claudia, Josic Uros, Mancuso Edoardo, Cadenaro Milena, Pfeifer Carmem S, Mazzoni Annalisa
Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy.
Dent Mater. 2025 Feb;41(2):141-158. doi: 10.1016/j.dental.2024.11.011. Epub 2024 Dec 4.
This review aimed at presenting the mechanisms and pitfalls of adhesion to enamel and dentin, advances in the materials science and in the development of strategies to improve hybrid layer (HL) longevity.
Search of the literature was performed on PubMed, Scopus and Web of Science with keywords related to the structure of the dental substrate, HL degradation mechanisms and strategies to contrast them.
Albeit the advances in the dental materials' properties, HL degradation is still a relevant and current issue in adhesive dentistry. However, adhesive materials have become more resistant and less operator sensitive, and good adhesion is currently in the hands of every practitioner. Numerous novel strategies are being developed, able to improve the resistance of adhesive resins to degradation, their ability to infiltrate and chemically bond to dentin, to remove the unbound/residual water within the HL, reinforce the dentin collagen matrix, and inhibit endogenous metalloproteinases. Many of the strategies have turned to nature in search for powerful biomodifying compounds, and for the inspiration as to mimic naturally occurring regenerative processes.
Extensive knowledge on the structure of the dental substrate and the complexity of adhesion to dentin has led to the development of improved formulations of dental adhesives and numerous valid strategies to improve the strength and longevity of the HL. Nevertheless, for many of them the road from bench to chairside still seems long. We encourage practitioners to know their materials well and use the strategies readily available to them.
本综述旨在阐述牙釉质和牙本质黏附的机制及陷阱、材料科学的进展以及提高混合层（HL）耐久性的策略发展情况。
在PubMed、Scopus和Web of Science上检索与牙体组织基质结构、HL降解机制及对抗这些机制的策略相关的文献。
尽管牙科材料性能有所进步，但HL降解仍是牙体黏附修复领域一个重要且亟待解决的问题。然而，黏结材料已变得更具耐受性且对操作人员的依赖性降低，如今每位从业者都能实现良好的黏附效果。目前正在开发众多新策略，这些策略能够提高黏结树脂的抗降解性、其渗透并与牙本质化学结合的能力、去除HL内未结合/残留水分的能力、增强牙本质胶原基质以及抑制内源性金属蛋白酶。许多策略都从自然界寻求强大的生物改性化合物，并从模仿自然发生的再生过程中获取灵感。
对牙体组织基质结构及牙本质黏附复杂性的广泛了解，促使人们开发出改良的牙科黏结剂配方以及众多有效的策略，以提高HL的强度和耐久性。然而，对其中许多策略而言，从实验室到临床应用的道路似乎仍很漫长。我们鼓励从业者充分了解其使用的材料，并随时运用现有的策略。
