Dentin: a dynamic substrate--a review.

Abstract

The structure of dentin is unusual in that the number and size of its tubules changes as one moves from the periphery toward the pulp chamber. Near the pulp, the tubules are very close together and the water content of this deep dentin is high. Near the enamel, the tubules are far apart, occupying less than 1% of the surface area. When enamel or dentin is cut, the surface becomes covered by an adherent layer of cutting debris called the smear layer. Its composition presumably reflects the composition of the underlying dentin. It is only about 1 micron thick but its presence modifies the function of the dentin a great deal. It lowers dentin permeability and therefore can be regarded as protective. However, it masks the underlying dentin and hence interferes with attempts to bond dental materials directly to dentin. If it is removed, the dentin becomes much more permeable and fluid shifts across the open tubules can cause sensitivity in vivo. As smear layers are very acid-labile, they often dissolve in oral fluids. Several attempts have been made to replace smear layers with acid resistant structures that accomplish the same function. Smear layer structure is being studied by using both scanning electron microscopy as well as electronic particle sizing equipment. The close adaptation of dental materials to smear layers and to underlying dentin is currently an area of very active research. Removal of smear layers increases adaptation and bonding strength but may increase the incidence of pulpal inflammation if the bonding is not uniform or permanent. The dynamics of dentin are just beginning to be understood.