Histopathological pulp study is a routine procedure to evaluate possible pulp damage caused by the restorative material/procedure. During histological section preparation, extracted teeth are demineralized and restorations have to be removed from the preparations in order to cut thin sections. Adhesive resin restorations bonding to dentin sometimes make removal of fillings difficult due to strong adhesion to dentin even after demineralization of the teeth. The aim of the present study was to evaluate cohesive failure and cracks of dentinal cavity walls/floor produced during fillings removal using histological sections obtained in three studies.
Cohesive failures and cracks of dentin walls/floor were usually observed on the histological sections, but their magnitude and frequency depended on the adhesive system used and dwell time of the restorations. Panavia EX and Orthomite Super Bond placed in phosphoric acid etched cavities showed 40 to 60% cohesive failure and cracks of cavity walls initially, but they decreased gradually as dwell time increased. Clearfil Photo Posterior and Photo Bond placed in phosphoric acid etched cavities with and without SA primer showed 80 to 90% cohesive failure and cracks of the dentin, but showed no decrease of cohesive failure and cracks with time. Palfique inlays placed in 10-3 totally etched cavities showed the highest rate of cohesivefaliure of the dentin floor in the present study, but only enamel etching produced the highest rate of adhesive failure.

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“ISO/TR11405 Dental Materials Guidance on testing of adhesion to tooth structure” has been pblished in 1994. Working group 11 for adhesive test methods in ISO/TC106 Dentistry/SC1 Restorative materials had started in 1984 and continud to discuse for various adhesive test methods. This international technical report specifies test methods for evaluation of the adhesive bond between dental materials and tooth structure. It describes two bond strength measurement tests, i.e. tensile and shear, a test for measurement of marginal gaps around fillings, a microleakage test and gives guidance on clinical usage test for such materials.

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More than 10 years have passed since adhesive resin cements were developed and applied to daily clinic. But it seems that the information about the clinical application of these resins are not enough for general practitioners.
Earlier adhesive resins had excellent bond strength to the enamel, but it was a problem that these resins showed weaker bond strength with lower adhesive durability to dentin and precious dental alloy than to enamel. Therefore many studies were done, various primers for dentin or dental precious alloys were developed, and those problems were solved to a significant extent. But for clinical use, some problems remain unsolved.
In this symposium, manufacturers of adhesive resin cements and practitioners who use these in daily clinic will provide current information about newer adhesive resin cements.

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In order to develop a multi-purpose dental adhesive resin of “Imperva Dual/Bond System”, 4-acryloxyethyltrimellitic acid (4-AET), an initiator system of 5-monosubstituted barbituric acid (5-MSBA)/BPO/Amine and an adhesive primer composition have been newly invented. The purpose ofthis study was to evaluate the effect of 4-AET, the initiator system and the primer composition on bonding performance of Imperva Dual/Bond System to enamel, dentin, dental alloys and porcelains.

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The adhesive resin cement has been developed recently, and its clinical indication is widely spreading. These cements may give a benefit to conserve the sound tooth substance. These cements have relatively many clinical steps compared with zinc-phosphate cement and glass ionomer cement. There are several points for succeeding clinically, especially the removal of excess cement is important.

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BISTITE Resin Cement is designed to perform the neccessary characteristics as required by a luting cement.
BISTITE has the following characteristics:
1. It has a strong adhesion to teeth and various types of prosthetics by combining with the adhesive monomer “MAC-10”. The adhesive strength becomes higher than ever by the treatment with the Primer.
2. It contains a total of 77 wt% filler, which is a combination of 0.2um sized spherical filler and an irregular filler with an average size of 3um. As a result, the mechanical strength and abrasion resistance greatly increases, while at the same time it becomes less soluble and improves its durability.
3. It has a higher radiopacity than enamel as a result of its silica-zirconia filler.
4. It comes in apaste-paste type with the newly invented “Super Syringe”, thus, the placement and mixing of the pastes becomes quicker and easier. Its dual curing characteristic enables an efficient and perfect adhesion process.

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I daily use BISTITE RESIN CEMENT manufactured by Tokuyama Corp. in my clinic and would like to report my finding based on its handling and properties at chariside.
My initial impressions after first using the products are as follows,
1) Its two paste system delivery enables one to easily measure and uniformly mix them quickly.
2) The newly developed Super Syringe allows one to remove an equal amount of the two pastes at the same time and the opening and closing of the cap is simple.
3) It has dual (chemically and photo chemically) curing characteristics and, if necessary, quick curing is possible by light irradiation.
4) Because the fine filler and high fluidity results in a thin film thickness, we need not worry about producing space between the teeth and the prosthetics during the luting process.
5) Its radiopacity enables us to check for any residure cement at the contact point or in the gingival pocket.

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Today, we can be recognized that adhesive resin cements play very important roles in conservative and prosthetic restorations, since the resin cements show excellent bond strength to dentin and preferable physical properties.
A new adhesive resin cement “Panavia 21”(manufactured by KURARAY Co., Ltd.) was developed on september in 1993 and which is accompanied by self etching primer “ED Primer” to enhance the bond strength to dentin and minimize the micro leakage. The new paste/paste type cement provides easy manipulation and acculate mixing. In this article, adhesion techniques using “Panavia 21” are described in consideration for its characteristics.

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Adhesive resins provide for the advance of recent restoration techniques. However, adhesive resin cements showed less adhesion strength to dentin in early stage and these were resulted in some pulp irritation. Then, the adhesion was a matter of great concerning by many dentists.
Recently, adhesive resin cements was improved in adhesion strength to dentin and the results of clinical and histopathological aspects indicated minimum pulp irritation and allowed almost no immersion of bacteria. Then, adhesion techniques are becoming widely used in many restorations and are indispensable for requiring reliable restorations. In this background, adhesive techniques using an advanced adhesive resin cement “Panavia 21” (manufacatured by KURARAY Co., Ltd.) was described.

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4-META/MMA-TBB resin, known as SUPERBOND C & B, the multipurpose adhesive resin cement, has been applied in extensive areas of the dental treatment, and with the clinical achiecements over a decade, it has received a good reputation for its safety to the pulp.
This time SUPERBOND C &B CEMENTING KIT AND V-PRIMER is released on the maeket. This component is easy to use, mainly for the cementing purpose by mixing method, and it incorporated the newly developed V-PRIMER for precious metal use which is easy to handle and approved to use in the oral cavity.
Its basic performance follows SUPERBOND C & B, and its characterisitics and point to note in operating are mentioned. It is a resin of MMA system, and its characteristics compared with other kinds of resin cements are: excellent dentin adhesion by forming hybrid layer; very little irritation to the pulp; drastically improved adhesive durability to precious metals and the approved use in the oral cavity by introducing V-PRIMER.

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SuperBond C & B, the 4-META/MMATBB system, has been used as the multipurpose adhesive resin which does very little harm to the pulp with the clinical achievements over a decade.
The introduction of V-Primer for precious metal bonding use has this time drastically improved adhesive durability to the goldsilver-palladium alloys which are frequently used for dental use. This requires no necessity of tin plating, and handling has been facilitated quite a deal. This has made it easier to put SuperBond C & B on an inlay, onlay and a crown with lesser removal of the healthy tooth.
The following operational factors and points to note for its clinical use are discussed:
1) cool the mixing dish
2) apply the separating agent to the necessary part
3) wait for the prepared mixture to be the appropriate flow, and brush it quickly to heap it up with a fairly thick brush
4) remove the residual resin efficiently.
As a multipurpose adhesive resin which forms a hybrid layer to the dentin to be the protective film of acid-resistant, and protects the pulp and dentin from the outside stimuli, SuperBond C & B's further spread will be expected.

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Luting cements have widely been used for over one century by reason of their good handling characteristics and fairly acceptable physical properties. But they are soluble in saliva and oral fluid, which may result in the creation of secondary caries. Four adhesive resin cements were developed in Japan, one of which is based on 4-META/MMA-TBB and the other of which are based on composite resin. Their low solubility and ability to create the hybrid layer in dentin are thought to protect the dental pulp and to prevent the formation of secondary caries. Moreover, their good adhesive properties upgraded the reliability of the restoration where the retention form and the resistance form are regarded to be insufficient if it had been restored by conventional luting cements. However the expertness of handling the adhesive resin cements is required to maximize the innate advantages, resin cements is required to maximize the innate advantages, because they are thought to be easily affected by the influences of humidity in the oral cavity and the contaminants such as saliva or blood. The adhesive resin cements acquired greater importance in the updated clinical dentistry, especially when the esthetic restoration is required.

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