Deproteinization of primary enamel: fundamental step in the adhesion protocol.

Abstract

Introduction : The acid etching technique was introduced in 1955 by Buonocore , to increase micromechanical adhesion. However, acid etching alone does not produce full adhesion of the enamel surface. Primary enamel has high amounts of organic material and a lower thickness, as a result of amelogenesis, resulting in less retention. Thus, the need arises to modify the inorganic content of the primary enamel through the process called deproteinization, which removes the surface proteins of the enamel. Sodium hypochlorite has shown the ability to remove these proteins efficiently, improving adhesion. Objective: To know the deproteinization process in primary enamel as part of the adhesion protocol. Literature review: Sodium hypochlorite is known to be an excellent proteolytic denaturing agent that effectively removes organic material, acts by saponification reducing the surface tension of fatty acids, and inhibits enzymatic action by denaturing protein formation. The use of 5% sodium hypochlorite improves retention, in contrast, using only etching acid acts on the inorganic material and not on the organic. Conclusions: Deproteinization with 5% sodium hypochlorite before acid etching has become a non-invasive, efficient and accessible method that improves adhesion to the primary enamel surface. Recommendations: The use of 5% sodium hypochlorite is recommended as part of the bonding protocol