Does resin based dentine bonding work?

Since Buonocore, in the mid 1950s, introduced enamel etching to be used to bond resinous restorations to enamel, different resin based bonding procedures have continuously found their way into dental practise. Today, dentists bond materials not only to enamel, but also to dentine. Up until recently, the clinical success with dentine bonding agents had been unreliable at best, and many clinicians had become sceptical as to whether it would ever be possible to bond to dentine. In this paper, some of the important break-throughs in the field of dentinal adhesives are reviewed in an attempt to throw some light on the question, does resin based dentine bonding work? The technical procedure used to optimise dentine bonding is reviewed, emphasising the significance of etching dentine, placing the primer on a slightly moist dentine surface, avoiding oxygen inhibition of the bonding resin, and maximising the degree of cure. In addition, emphasis is also placed on the significance of variations in dentine structure, and how sclerotic dentine may make dentine bonding less efficient. The conclusion of the entire review is that although significant improvements have been made in the field of dentine bonding during the last few years, it is still too early to conclude that dentine bonding will survive several years of clinical service.