MODERN ADHESIVE SYSTEMS IN DENTISTRY: CHEMISTRY, CLINICAL STRATEGIES, AND ADHESIVE BOND DURABILITY

Adhesive technologies are a key factor in the success of direct restorations, sealing fissures, fixing indirect structures, and treating non-carious lesions. In recent years, universal (multi-mode) adhesives have been most noticeably developed, allowing them to work in total-etch (etch-and-rinse), self-etch and selective etching of enamel. Their effectiveness is determined by a combination of functional monomers (in particular, 10-MDP), the composition of solvents, the presence / absence of HEMA, the water balance, as well as the application protocol and substrate features (enamel/dentin, degree of sclerosis, humidity). The purpose of this work is to systematize modern ideas about the structure and mechanisms of adhesive systems, compare clinical strategies for the use of universal adhesives and identify the factors determining the durability of the adhesive interface. The degradation processes of the hybrid layer, the role of the collagen matrix and enzymes, as well as practical approaches to reducing the sensitivity of technology and increasing the stability of the bond over time are considered. The review's conclusions emphasize that clinical success is determined not only by the "generation" of the adhesive, but also by compliance with the protocol: surface preparation, humidity control, rubbing time, correct polymerization, and a reasonable choice of adhesion regimen.