The effect of structural abnormalities on dental substrates adhesion: A systematic literature review

Abstract

Introduction: During the odontogenesis, structure abnormalities could occur within dental hard tissues. These primary or aqcuired structural malformations bring major therapeutic challenges, notably while performing adhesive dentistry. Aim: Through the present systematic review, we intent to assess the adhesive interface, between abnormal dental structure and restoration materials, in order to identify the techniques that can improve its quality. Methods: The systematic search was undergone in three electronic databases : PubMed, ScienceDirect and Google Scholar, using the following key words: teeth abnormalities, Dental enamel, Enamel defect, fluorosis, amelogenesis imperfecta, Acid etching, Bonding, ultrastructure. A manual search was performed based on the electronic search bilbiography. Published articles, after 2000, were identified by reading titles and abstracts. Their critical analysis was done based on the reading grid (Audet N. Ledère H, Pédagogie médicale) and the literature analysis guide (approved by the Agence Nationale d’accréditation et d’évaluation en santé ANAES/HAS). Results: Among the 400 articles initially found, 110 were selected and 31 english articles were retained, after full reading. Prospective studies and systematic reviews have been conducted on four structural anomalies : amelogenesis imperfecta, fluorosis, Molar Incisor Hypomineralization and dentinogenesis imperfecta. Discussion: According to the found data, and in comparison with healthy dental tissues, lower adhesive bonding of filling materials have been noticed, on teeth with structural abnormalities. To overcome this problem, various techniques have been suggested, such as the deproteinization using the sodium hypochlorite solution, the micro abrasion, the prolonged etching, or the use of adhesion promoters. Conclusion: The quality of adhesive bonding to enamel and dentine is decreased in case of sutructural abnormalities, which is a real clinical challenge in dental practice. Phosphoric acid etching, without prolonged application, is recommended for damaged teeth with amelogenesis imperfecta. In the case of fluorosis, micro abrasion treatment, as well as prolonged etching, have been proven useful to the bonding protocol. More clinical trials with long term follow-up are required, in order to improve the adhesion quality in presence of the several structural abnormalities. *Correspondence to: Meriem AMINE, Associate Professor, Fixed Prosthesis Department, Faculty of Dentistry of Casablanca, University Hassan 2 of Casablanca, Morocco, Tel: 00212 665 012 021; E-mail: meriemamine@hotmail.com