From Risk to Predictability:
The Auditable Protocol in
"Adhesive Dentistry"
Scientifically Validated
20-Year follow-up
Claims-Avoidance
Embedded Files
“Rule #1 in operative dentistry is that no treatment should ever cause harm to the patient. The dentist’s primary responsibility is to preserve health, function, and comfort while restoring form.”
Ritter, A.V., Boushell, L.W., Walter, R., Sturdevant’s Art and Science of Operative Dentistry, 8th Edition, Elsevier, 2025, p. 3–4
Why Adhesive Restorations Fail: 🤔
Polymerization Shrinkage
Widely documented as a major cause of marginal gap formation, postoperative sensitivity, and secondary caries.
Shrinkage stresses can lead to debonding at the tooth-restoration interface.
2. Marginal Moisture During Bonding
Moisture contamination during bonding, especially from blood or saliva, compromises adhesive performance, leading to micro-leakage and reduced bond strength.
This is particularly critical in posterior restorations and sub-gingival margins.
3. Remaining Caries
Incomplete caries removal is a common clinical error, especially in deep lesions or when relying solely on tactile feedback.
Residual infected dentin can undermine the restoration and promote recurrent decay.
4. Plaque on Cavosurface
Plaque presence at margins contributes to biofilm-induced secondary caries and discoloration.
5. Operator Technique
Inadequate isolation, poor layering, or improper curing technique are frequent contributors to failure.
Overheating during polishing or under-curing can compromise longevity.
6. Material Selection
Using composites with low wear resistance or poor mechanical properties in high-stress areas increases fracture risk.
7. Occlusal Stress
Bruxism or high occlusal loads can cause bulk fracture or marginal breakdown, especially in large restorations.
8. Inadequate Finishing and Polishing
Leads to rough margins, plaque accumulation, and poor esthetics.
9. Poor Adhesive Protocol
Errors in etching, priming, or curing sequence can result in poor hybrid layer formation and early debonding.
10. Patient Factors
High caries risk, poor oral hygiene, and dietary habits (acidic foods, frequent snacking) accelerate failure.
Evidence & References:
- https://ijrti.org/papers/IJRTI2002019.pdf
- https://journalgrid.com/view/article/rjds/29
- https://opendentistryjournal.com/VOLUME/17/ELOCATOR/e187421062304181/FULLTEXT/
- https://rjs.com.ro/articles/2023.2/RJS_2023_2_Art-01.pdf
- https://norvasen.com/restoration-failures-common-pitfalls-and-how-to-avoid-them/
- https://www.gardenbrookedental.com/dental-adhesive-failures/
- https://pubs.rsc.org/en/content/articlehtml/2023/py/d3py00261f
- https://link.springer.com/article/10.1007/s10266-016-0264-3
- https://www.mdpi.com/2313-7673/9/12/753
- https://www.mdpi.com/2673-6373/5/3/63
- https://www.jstage.jst.go.jp/article/odep/1/1/1_2021-007/_pdf/-char/en
- https://pdfs.semanticscholar.org/4803/8450a75f88b51179ac180b2da11e6678beae.pdf
- https://www.nature.com/articles/s41432-024-01095-3
- https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0041-1736332.pdf
- https://library.search.stmarys-ca.edu/discovery/fulldisplay/cdi_crossref_primary_10_1016_j_ijadhadh_2025_104048/01STMARYSCA_INST:BASELINE
- https://researchprofiles.ku.dk/en/publications/longevity-of-posterior-composite-restorations-a-systematic-review/
- https://cris.unibo.it/bitstream/11585/956076/1/Article%20Dent%20Mater.pdf
- https://operative-dentistry.kglmeridian.com/view/journals/odnt/50/4/article-pE30.xml
The C-FIT™ Methodology is a patent-pending "low-cost and fast" clinical protocol that eliminates the Weakest Link in Bonding, converting unpredictable procedures into auditable, predictable outcomes.
The Science: Developed over 20 years of clinical practice and materials insight, C-FIT principles have resulted in high-risk, sub-crestal composite restoration remaining sound and problem-free and benign to periodontium for over 20 years.
The Solution (Claims Avoidance): C-FIT introduces the Reproducible Clinical Protocol that addresses the weakest link in the bonding chain:
The Haptic Check: A Quantifiable Standard for contaminant control, providing an immediate, verifiable signal to the clinician when contamination is present.
The Stress Relief Mechanism: A patented technique for mechanical decoupling that significantly mitigates polymerization shrinkage stress at the critical gingival margin interface.
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