Can we trust the success of adhesive restorations to the bonded interface?

Abstract: Biodegradation of the resin-dentin interfaces has been a focus of research over the last decade. Most studies show that degradation of both the collagen and the adhesive take place within short periods of time after bonding, and claim that such loss of structure at the interface opens opportunity for secondary caries initiation and progression, thus leading to failure of the restoration. Open margins are further compromised by thermo-mechanical loading and enzymes produced by local bacteria. While marginal gaps appear to be unavoidable, it is remarkable that resin composite restorations can deliver successful clinical service for many years provided preventive and conservative measures to reduce the caries-risk of the patient are applied along with the restorative treatment. The presentation will open a dialogue to discuss how laboratory data confronts with clinical reality, and critically review the mechanisms of degradation in light of new information on the degradation of collagen and adhesives.