The success of adhesive restorations relies on managing polymerization shrinkage stress to achieve a reliable adhesive bond. The effect of these stresses leads to signs and symptoms including microleakage, post-operative sensitivity, marginal-breakdown, recurrent decay, cuspal deformation, and cracks. These effects are not visible immediately, but it is of utmost importance to understand and manage the forces that are responsible in order to achieve long-lasting success with adhesive restorations. A strong understanding of these concepts will help practitioners select ideal restorative techniques for various clinical scenarios. A simple and intuitive new method is described for visualizing both polymerization shrinkage and stress. This method will help in selecting the ideal restorative technique to best minimize undesirable effects caused by polymerization shrinkage stress.
- Origin of resin polymerization shrinkage
- The relationship between bond strength and shrinkage stress
- Consequences of residual stress
- Consequences of stress greater than the bond strength
- The relationship between time and bond/stress development
- Low-shrinkage materials – Do they work well? How do they work?
- Comparison of various stress reduction methods
- Correlation of residual stress, bond strength, and clinical performance of various adhesive restorative techniques