Enhancing adhesive restoration effectiveness

In the current era, with anxieties over aerosol generating procedures (AGPs), it has been suggested¹ that the use of adhesive (and, by inference, minimally invasive) procedures could facilitate a majority of dental treatments, with crown preparations, removal (rather than repair) of large restorations, and the opening of access cavities being notable exceptions. It therefore follows that the processes by which the performance of adhesive restorations can be maximized should be examined.

A general, if obvious, thought is: materials used in the mouth should have a robust evidence base, which rules out those which do not – generally the own label, ‘me too’ products, to which some practitioners may be attracted because of their (often lower) price. The provenance of these materials is usually not known and their batch to batch variation can be high,² possibly indicating that they are manufactured by one company one year and another the following year. That these own label materials should be treated with some suspicion has been mentioned in this column over the years, and is backed up by research.^3,4 Moreover, patients care about the quality of the materials that we use in their teeth!⁵ The cost of one prematurely failed restoration is arguably more than the saving accrued by using a cheap, untested alternative material.