Based on the results of laboratory tests, the potential advantages of amalgam bonding agents are to reduce postoperative sensitivity and to strengthen the restored tooth. In the present study, the question we chose to answer was whether both of these two potential advantages would prevail in the clinical environment.
Because of the constraints on clinical studies with regard to the numbers of patients required, determining the relative merits of many available bonding agents simply would not be feasible. Rather, we selected a material having the best relevant properties based on our laboratory test results using a simulated Class I restoration.
This material proved to be Panavia 21, which exhibited zero microleakage and the highest bond strength of the seven materials we tested (J Dent Res 78, 532). Not incidentally, the primer used with Panavia 21 was developed to bond to both dentin and cut enamel, this quality being verified by the manufacturer’s scientific reports.
Although amalgam bonding agents may have merit in applications such as complex restorations, the results of our study failed to verify that these adhesives are necessary in traditional Class I and Class II restorations. The question of use in this application was what we posed as the original objective of this study.
We are aware of the anecdotal evidence that bonding agents do reduce postoperative sensitivity for some dentists. This is usually related to the use of spherical particle alloys, which have a greater propensity for sensitivity than admix alloys containing lathe-cut particles. In the discussion section of this article, this factor is addressed with some alternative solutions proposed.
