Enzymatic Pretreatment Of Enamel And Dentin As A Stage In Optimizing The Adhesive Protocol For Esthetic Restoration
Abstract
Modern esthetic dentistry is based on the principles of minimally invasive preparation, preservation of hard dental tissues, and the use of adhesive technologies that provide a strong bond between restorative material and enamel and dentin. Despite substantial advances in adhesive systems, the problem of adhesive interface durability remains relevant, especially in the restoration of anterior teeth, where mechanical stability, marginal adaptation, color integration, and prevention of postoperative sensitivity are simultaneously important. One of the factors limiting the effectiveness of the adhesive protocol is the presence of the smear layer, organic residues, collagen matrix, and surface contaminants that can impair the penetration of adhesive monomers and the formation of a complete hybrid layer. In recent years, enzymatic pretreatment of enamel and dentin using proteolytic enzymes, particularly bromelain and papain, has attracted increasing interest. Data from international studies show that bromelain, at certain concentrations, can increase the strength of the adhesive bond and improve the marginal adaptation of restorative material, whereas the results of papain application remain more variable and depend on concentration, type of adhesive system, dentin depth, and the sequence of clinical steps.