9 ACID-BASE RESISTANCE ZONE - PG SEMINAR.pptx

In 2004, a zone located directly under the hybrid layer (HL) was described when investigating the dentin/SEA interface.
Further research works showed that this zone was characterized by its resistance against acids ; therefore, it was named the "acid-base resistant zone" (ABRZ)

1. ACID-BASE RESISTANCE ZONE PRESENTED BY : VAIDEHI JOSHI GUIDED BY : DR ROOPA BABANNAVAR 1

2. CONTENTS 2

3. INTRODUCTION Perdigão J. Current perspectives on dental adhesion:(1) Dentin adhesion–not there yet. Japanese Dental Science Review. 2020 Nov 1;56(1):190-207. 3

4. INTRODUCTION Perdigão J. Current perspectives on dental adhesion:(1) Dentin adhesion–not there yet. Japanese Dental Science Review. 2020 Nov 1;56(1):190-207 Substrates DENTINE ENAMEL 4

5. INTRODUCTION Phosphoric acid Etchng to Enamel Perdigão J. Current perspectives on dental adhesion:(1) Dentin adhesion–not there yet. Japanese Dental Science Review. 2020 Nov 1;56(1):190-207 Durability of Adhesive Restorative Procedure Dynamic Compositional Differences & Complex Histology Buonocore (1955) 5

6. INTRODUCTION HYBRID LAYER Nakabayashi, 1985 Inoue G, Tsuchiya S, Nikaido T, Foxton RM, Tagami J. Morphological and mechanical characterization of the acid-base resistant zone at the adhesive-dentin interface of intact and caries-affected dentin. Operative Dentistry. 2006 Jul 1;31(4):466-72. Confocal micrograph 6

7. INTRODUCTION Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. 7

8. INTRODUCTION Also Discovered in ENAMEL Different Mechanisms of Formation Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. 8

9. HYBRID LAYER Nakabayashi et al ( 1985 ) Nakabayashi N, Nakamura M, Yasuda M. Hybrid layer as a dentine bonding mechanism. J Esthet Rest Dent 1991;3:133 138. 9

10. Salvio LA, Di Hipólito V, Martins AL, de Goes MF. Hybridization quality and bond strength of adhesive systems according to interaction with dentin. Eur J Dent. 2013 Jul;7(3):315-326. 10

11. HYBRID LAYER Source of ABRZ Formation Release of functional monomers Formation of stable, insoluble salts Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190 . 11

12. HYBRID LAYER Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20 . 12

13. ADHESION-DECALCIFICATION CONCEPT Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20. 13

14. Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20. 14

15. Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20. 10 MDP Calcium-phosphate Polyalkeonic acid Calcium-carboxylate 15

16. Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20. 16

17. FORMATION OF THE ACID-BASE RESISTANCE ZONE ABRZ Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatriae Clínica Integrada . 2023 Oct 20;23:e210190. 17

18. SIGNIFICANCE OF ABRZ Nikaido T, Takahashi R, Ariyoshi M, Sadr A, Tagami J. Protection and reinforcement of tooth structures by dental coating materials. Coatings. 2012 Oct 8;2(4):210-20. IMPROVES BOND STABILITY 18

19. EVALUATION METHODS FOR ASSESSMENT OF DEMINERALIZED LESIONS AND INHIBITION ZONES IN ENAMEL AND DENTINE Insufficient magnification to obtain sufficient information at interface Nikaido T, Weerasinghe DD, Waidyasekera K, Inoue G, Foxton RM, Tagami J. Assessment of the nanostructure of acid–base resistant zone by the application of all-in-one adhesive systems: Super dentin formation. Bio-medical materials and engineering. 2009 Jan 1;19(2-3):163-71. 19

20. SPECIMEN PREPARATION OF SAMPLES FOR VISUALIZATION OF ABRZ Nanoindentation test Inoue G, Tsuchiya S, Nikaido T, Foxton RM, Tagami J. Morphological and mechanical characterization of the acid-base resistant zone at the adhesive-dentin interface of intact and caries-affected dentin. Operative Dentistry. 2006 Jul 1;31(4):466-72 20

21. FACTORS AFFECTING FORMATON OF ABRZ Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. Tsujimoto et al 21

22. Salvio LA, Di Hipólito V, Martins AL, de Goes MF. Hybridization quality and bond strength of adhesive systems according to interaction with dentin. Eur J Dent. 2013 Jul;7(3):315-326 . ADJESIVE SYSTEMS’ INTERACTION WITH SUBSTRATE 22

23. BONDING SYSTEMS Salvio LA, Di Hipólito V, Martins AL, de Goes MF. Hybridization quality and bond strength of adhesive systems according to interaction with dentin. Eur J Dent. 2013 Jul;7(3):315-326. GENERATONS 23

24. INCREASES WIDTH OF ABRZ IN ENAMEL Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. ADHESIVE SYSTEM 24

25. Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. 1 Step SEA 2 step SEA ADHESIVE SYSTEMS Inouoe et al 25

26. Sato et al Area vulnerable to Acid-Base attacks Nikaido T, Takagaki T, Sato T, Burrow MF, Tagami J. The concept of super enamel formation—Relationship between chemical interaction and enamel acid-base resistant zone at the self-etch adhesive/enamel interface. Dental materials journal. 2020 Jul 30;39(4):534-8. ABRZ AT ENAMEL-ADHESIVE INTERFACE 26

27. SUPER ENAMEL Nikaido T, Takagaki T, Sato T, Burrow MF, Tagami J. The concept of super enamel formation—Relationship between chemical interaction and enamel acid-base resistant zone at the self-etch adhesive/enamel interface. Dental materials journal. 2020 Jul 30;39(4):534-8. 27

28. Formation of Super Enamel Nikaido T, Takagaki T, Sato T, Burrow MF, Tagami J. The concept of super enamel formation—Relationship between chemical interaction and enamel acid-base resistant zone at the self-etch adhesive/enamel interface. Dental materials journal. 2020 Jul 30;39(4):534-8. 28

29. THICKNESS ABRZ IN ENAMEL IN VARIOUS STUDIES Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. 29

30. CLINICAL IMPLICATION 30

31. ABRZ IN DENTINE HYBRID LAYER Nikaido T, Takagaki T, Sato T, Burrow MF, Tagami J. The concept of super enamel formation—Relationship between chemical interaction and enamel acid-base resistant zone at the self-etch adhesive/enamel interface. Dental materials journal. 2020 Jul 30;39(4):534-8 . ADHESIVE SYSTEM 31

32. ABRZ IN DENTINE SUPER DENTINE Super dentin is modified dentin of combination of dentin and the adjacent hybrid layer with superior resistance against caries activity created by the use of self etching adhesive resins . Nikaido et al Jana S, Desai PD, Das D, Pal S, Shil R, Mazumdar P. ‘‘SUPER DENTIN’’: Reinforcement Of Adhesive-dentin Interface And Protection Of Tooth Structures.World Journal of Pharmaceutical Research,2020;10(1):368-79. 32

33. Formation of Super Dentine IONIC BOND Jana S, Desai PD, Das D, Pal S, Shil R, Mazumdar P. ‘‘SUPER DENTIN’’: Reinforcement Of Adhesive-dentin Interface And Protection Of Tooth Structures.World Journal of Pharmaceutical Research,2020;10(1):368-79. 33

34. SAED pattern obtained for the apatite crystallites in the acid—base resistant zone of dentin treated with Clearfil SE Bond ( Waidyasekera et al.). The peak positions (d-spacing) 0 0 2 and 2 1 1 were identical, which suggested the presence of hydroxyapatite in the ABRZ. Densely arranged apatite crystals Nikaido T, Inoue G, Takagaki T, Waidyasekera K, Iida Y, Shinohara MS, Sadr A, Tagami J. New strategy to create “Super Dentin” using adhesive technology: reinforcement of adhesive–dentin interface and protection of tooth structures. Japanese Dental Science Review. 2011 Feb 1;47(1):31-42. 34

35. 2 Step SEA 1 Step SEA Stable Zone with Butt Joint 1 micron Funnel shaper erosion noted 0.27 – 0.5 microns Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. 35

36. 2 Step SEA 1 Step SEA Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. Nikaido T, Inoue G, Takagaki T, Waidyasekera K, Iida Y, Shinohara MS, Sadr A, Tagami J. New strategy to create “Super Dentin” using adhesive technology: reinforcement of adhesive–dentin interface and protection of tooth structures. Japanese Dental Science Review. 2011 Feb 1;47(1):31-42 36

37. Leaves Residual Hydroxyapatite for Chemical bonding Removes smear layer but does not remove dissolved calcium phosphates which have low hydrolytic stability Van Meerbeek B, Yoshihara K, Yoshida Y, Mine AJ, De Munck J, Van Landuyt KL. State of the art of self-etch adhesives. Dental materials.2011 Jan 1;27(1):17 28. SEA CLASSIFICATION BASED pH Expose superficially dentin collagen, producing a nanometer interaction zone Hybrid layer with demineralized top layer and partially demineralized base 37

38. Van Meerbeek B, Yoshihara K, Yoshida Y, Mine AJ, De Munck J, Van Landuyt KL. State of the art of self-etch adhesives. Dental materials.2011 Jan 1;27(1):17 28. FUNCTIONAL MONOMERS 38

39. FUNCTIONAL MONOMER Lower Dissolution of Calcium Salts Yoshihara et al Stability of Bond 10 MDP > 4-META > PHENYL-P Yoshihara K, Yoshida Y, Nagaoka N, Fukegawa D, Hayakawa S, Mine A, Nakamura M, Minagi S, Osaka A, Suzuki K, Van Meerbeek B. Nano-controlled molecular interaction at adhesive interfaces for hard tissue reconstruction. Acta Biomater 2010; 6: 3573-3582. 39

40. FUNCTIONAL MONOMER & ABRZ IN ENAMEL ABRZ SEEN Li N, Nikaido T, Takagaki T, Sadr A, Makishi P, Chen J, Tagami J. The role of functional monomers in bonding to enamel: acid-base resistant zone and bonding performance. J Dent. 2010 Sep;38(9):722-30 NO ABRZ SEEN 10 MDP Primer & Adhesive Phenyl-P Primer & Adhesive Funnel shaped erosion 40

41. 2 Other Groups Li N, Nikaido T, Takagaki T, Sadr A, Makishi P, Chen J, Tagami J. The role of functional monomers in bonding to enamel: acid-base resistant zone and bonding performance. J Dent. 2010 Sep;38(9):722-30 Li et al 1 mm 0.2 mm 41

42. pH Li N, Nikaido T, Takagaki T, Sadr A, Makishi P, Chen J, Tagami J. The role of functional monomers in bonding to enamel: acid-base resistant zone and bonding performance. J Dent. 2010 Sep;38(9):722-30 CONCLUSIONS- Li et al 42

43. 1 Step SEA Nikaido T, Ichikawa C, Li N, Takagaki T, Sadr A, Yoshida Y, Suzuki K, Tagami J. Effect of functional monomers in all-in-one adhesive systems on formation of enamel/dentin acid-base resistant zone. Dental Materials Journal. 2011;30(5):576-82. pH values 4-META > 3D-SR > 10 MDP 2.2 2.0 1.9 Nikaido et al MDP SDR 4-META 43

44. FUNCTIONAL MONOMER AND ABRZ IN DENTINE 1 Step SEA Nikaido T, Ichikawa C, Li N, Takagaki T, Sadr A, Yoshida Y, Suzuki K, Tagami J. Effect of functional monomers in all-in-one adhesive systems on formation of enamel/dentin acid-base resistant zone. Dental Materials Journal. 2011;30(5):576-82. pH values 4-META > 3D-SR > 10 MDP 2.2 2.0 1.9 Nikaido et al 0.8-1 µm - MDP 0.6-0.7 µm - 4META 0.7-1 µm – 3D-SR 44

45. Nikaido T, Ichikawa C, Li N, Takagaki T, Sadr A, Yoshida Y, Suzuki K, Tagami J. Effect of functional monomers in all-in-one adhesive systems on formation of enamel/dentin acid-base resistant zone. Dental Materials Journal. 2011;30(5):576-82 45

46. 46

47. Nikaido T, Weerasinghe DD, Waidyasekera K, Inoue G, Foxton RM, Tagami J. Assessment of the nanostructure of acid–base resistant zone by the application of all-in-one adhesive systems: Super dentin formation. Bio-medical materials and engineering. 2009 Jan 1;19(2-3):163-71. ABRZ LESS THAN 1 μm HARDLY DETECTED BENEATH THE HYBRID LAYER 47

48. 1 Step SEA TEM IMAGING Clearfil Tri-S Bond G Bond Nikaido T, Weerasinghe DD, Waidyasekera K, Inoue G, Foxton RM, Tagami J. Assessment of the nanostructure of acid–base resistant zone by the application of all-in-one adhesive systems: Super dentin formation. Bio-medical materials and engineering. 2009 Jan 1;19(2-3):163-71. ELECTRON DENSE AREA AROUND 100-300 nm 48

49. 4-MET and a phosphoric ester monomer to gain strong chemical adhesion to hydroxyapatite https://www.gc.dental/australasia/sites/australasia.gc.dental/files/products/downloads/gbond/brochure/brochure-g-bond.pdf 49

50. EFFECT OF FLUORIDE CONTAINING ADHESIVES Slope Formation -Shinohara et al Thicker ABRZ Densely arranged crystallites Kirihara M, Inoue G, Nikaido T, Ikeda M, Sadr A, Tagami J. Effect of fluoride concentration in adhesives on morphology of acid-base resistant zones. Dent Mater J 2013; 32(4):578-84 Stable interface –Ichikawa et al De Carvalho et al Clearfil Protect Bond 50

51. EFFECT OF FLUORIDE CONTAINING ADHESIVES Kirihara M, Inoue G, Nikaido T, Ikeda M, Sadr A, Tagami J. Effect of fluoride concentration in adhesives on morphology of acid-base resistant zones. Dent Mater J 2013; 32(4):578-84 Released from filler particles Enter Calcium Phosphate Rich Spaces To Form Fluorapatite 51

52. EFFECT OF FLUORIDE CONTAINING ADHESIVES Iida Y, Nikaido T, Kitayama S, Takagaki T, Inoue G, Ikeda M, Foxton RM, Tagami J. Evaluation of dentin bonding performance and acid-base resistance of the interface of twostep self-etching adhesive systems. Dent Mater J 2009; 28: 493-500. Kirihara M, Inoue G, Nikaido T, Ikeda M, Sadr A, Tagami J. Effect of fluoride concentration in adhesives on morphology of acid-base resistant zones. Dent Mater J 2013; 32(4):578-84 Kirihara et al 52

53. EFFECT OF PRE-CONDITIONING WITH FLUORIDE Clearfil SE Bond 3.8% SDF 38% SDF 0 TC 5000 TC 10,000 TC Morphologies similar Ko AK, Matsui N, Nakamoto A, Ikeda M, Nikaido T, Burrow MF, Tagami J. Effect of silver diammine fluoride application on dentin bonding performance. Dental Materials Journal. 2020 May 27;39(3):407-14. 53

54. Guan R, Takagaki T, Matsui N, Sato T, Burrow MF, Palamara J, et al. Dentin bonding performance using Weibull statistics and evaluation of acid-base resistant zone formation of recently introduced adhesives. Dent Mater J 2016; 35(4):684-93. Fluoride Releasing Adhesive 54

55. Guan R, Takagaki T, Matsui N, Sato T, Burrow MF, Palamara J, et al. Dentin bonding performance using Weibull statistics and evaluation of acid-base resistant zone formation of recently introduced adhesives. Dent Mater J 2016; 35(4):684-93 . SE BOND 2 OPTIBOND XTR SBU 0.5 µm 0.1 µm 0.5 µm 55

56. Guan R, Takagaki T, Matsui N, Sato T, Burrow MF, Palamara J, et al. Dentin bonding performance using Weibull statistics and evaluation of acid-base resistant zone formation of recently introduced adhesives. Dent Mater J 2016; 35(4):684-93 Strong Self-etch Van Meerbeek et al 56

57. Clinical Implication 57

58. CARIES AFFECTED DENTINE Inoue et al 2 Step SEA( Clearfil SE Bond) Inoue G, Tsuchiya S, Nikaido T, Foxton RM, Tagami J. Morphological and mechanical characterization of the acid-base resistant zone at the adhesive-dentin interface of intact and caries-affected dentin. Operative Dentistry. 2006 Jul 1;31(4):466-72. 58

59. DEGRADATION AND FAILURE AT ABRZ Nikaido T, Nurrohman H, Takagaki T, Sadr A, Ichinose S, Tagami J. Nanoleakage in hybrid layer and acid base resistant zone at the adhesive/dentin interface. Microscopy and Microanalysis. 2015 Oct 1;21(5):1271 . 59

60. Nikaido T, Nurrohman H, Takagaki T, Sadr A, Ichinose S, Tagami J. Nanoleakage in hybrid layer and acid base resistant zone at the adhesive/dentin interface. Microscopy and Microanalysis. 2015 Oct 1;21(5):1271. 60

61. TAKE HOME MESSAGE 61 EVIDENCE – SUPERIOR ABRZ

62. CONCLUSION 62

63. REFERENCES Nikaido T, Nurrohman H, Takagaki T, Sadr A, Ichinose S, Tagami J. Nanoleakage in hybrid layer and acid base resistant zone at the adhesive/dentin interface. Microscopy and Microanalysis. 2015 Oct 1;21(5):1271. Inoue G, Tsuchiya S, Nikaido T, Foxton RM, Tagami J. Morphological and mechanical characterization of the acid-base resistant zone at the adhesive-dentin interface of intact and caries-affected dentin. Operative Dentistry. 2006 Jul 1;31(4):466-72. Guan R, Takagaki T, Matsui N, Sato T, Burrow MF, Palamara J, et al. Dentin bonding performance using Weibull statistics and evaluation of acid-base resistant zone formation of recently introduced adhesives. Dent Mater J 2016; 35(4):684-93. Ko AK, Matsui N, Nakamoto A, Ikeda M, Nikaido T, Burrow MF, Tagami J. Effect of silver diammine fluoride application on dentin bonding performance. Dental Materials Journal. 2020 May 27;39(3):407-14. Iida Y, Nikaido T, Kitayama S, Takagaki T, Inoue G, Ikeda M, Foxton RM, Tagami J. Evaluation of dentin bonding performance and acid-base resistance of the interface of twostep self-etching adhesive systems. Dent Mater J 2009; 28: 493-500. Kirihara M, Inoue G, Nikaido T, Ikeda M, Sadr A, Tagami J. Effect of fluoride concentration in adhesives on morphology of acid-base resistant zones. Dent Mater J 2013; 32(4):578-84. Nikaido T, Weerasinghe DD, Waidyasekera K, Inoue G, Foxton RM, Tagami J. Assessment of the nanostructure of acid–base resistant zone by the application of all-in-one adhesive systems: Super dentin formation. Bio-medical materials and engineering. 2009 Jan 1;19(2-3):163-71. 63

64. REFERENCES https://www.gc.dental/australasia/sites/australasia.gc.dental/files/products/downloads/gbond/brochure/brochure-g-bond.pdf . Nikaido T, Ichikawa C, Li N, Takagaki T, Sadr A, Yoshida Y, Suzuki K, Tagami J. Effect of functional monomers in all-in-one adhesive systems on formation of enamel/dentin acid-base resistant zone. Dental Materials Journal. 2011;30(5):576-82 Li N, Nikaido T, Takagaki T, Sadr A, Makishi P, Chen J, Tagami J. The role of functional monomers in bonding to enamel: acid-base resistant zone and bonding performance. J Dent. 2010 Sep;38(9):722-30. Yoshihara K, Yoshida Y, Nagaoka N, Fukegawa D, Hayakawa S, Mine A, Nakamura M, Minagi S, Osaka A, Suzuki K, Van Meerbeek B. Nano-controlled molecular interaction at adhesive interfaces for hard tissue reconstruction. Acta Biomater 2010; 6: 3573-3582. Van Meerbeek B, Yoshihara K, Yoshida Y, Mine AJ, De Munck J, Van Landuyt KL. State of the art of self-etch adhesives. Dental materials.2011 Jan 1;27(1):17 28. Khabadze Z, Shilyaeva E, Kotelnikova A, Todua D, Bakaev Y, Abdulkerimova S, Mordanov O. Acid-Base Resistant Zone in Teeth with the Direct Restoration Using Different Adhesive System Generations: A Systematic Review. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2023 Oct 20;23:e210190. Nikaido T, Inoue G, Takagaki T, Waidyasekera K, Iida Y, Shinohara MS, Sadr A, Tagami J. New strategy to create “Super Dentin” using adhesive technology: reinforcement of adhesive–dentin interface and protection of tooth structures. Japanese Dental Science Review. 2011 Feb 1;47(1):31-42 64

65. REFERENCES Jana S, Desai PD, Das D, Pal S, Shil R, Mazumdar P. ‘‘SUPER DENTIN’’: Reinforcement Of Adhesive-dentin Interface And Protection Of Tooth Structures.World Journal of Pharmaceutical Research,2020;10(1):368-79. Nikaido T, Takagaki T, Sato T, Burrow MF, Tagami J. The concept of super enamel formation—Relationship between chemical interaction and enamel acid-base resistant zone at the self-etch adhesive/enamel interface. Dental materials journal. 2020 Jul 30;39(4):534-8. Salvio LA, Di Hipólito V, Martins AL, de Goes MF. Hybridization quality and bond strength of adhesive systems according to interaction with dentin. Eur J Dent. 2013 Jul;7(3):315-326. Meyer- Lueckel H. Caries management: science and clinical practice. Paris S, Ekstrand KR, Effenberger S, editors. Stuttgart: Thieme ; 2013 Mar 20. Nakabayashi N, Nakamura M, Yasuda M. Hybrid layer as a dentine bonding mechanism. J Esthet Rest Dent 1991;3:133 138. Perdigão J. Current perspectives on dental adhesion:(1) Dentin adhesion–not there yet. Japanese Dental Science Review. 2020 Nov 1;56(1):190-207 65

66. THANK YOU ! 66

67. ACID-BASE RESISTANCE ZONE PRESENTED BY : VAIDEHI JOSHI GUIDED BY : DR ROOPA BABANNAVAR Confocal image of a resin-dentine interface 67