Specific aspects of adhesive system application in restoration of teeth with cervical enamel loss: a review

The clinical course of root caries is largely determined by the structural characteristics of dental tissues: cementum and dentin contain fewer inorganic components than enamel and are therefore more susceptible to demineralization. This results in more aggressive carious progression, formation of deep defects, and increased complexity of restoration, making the selection of appropriate restorative materials a relevant and important issue in contemporary dentistry. This review analyzes the publications on the use of various adhesive protocols for the restoration of defects involving the hard tissues of the tooth root. Publications from the past 10 years were identified through searches of PubMed, eLIBRARY.RU, Google Scholar, and The National Library of Medicine. English-language articles from peer-reviewed journals were reviewed using electronic searches and manual screening with the following keywords: кариес корня (root caries), реставрация (restoration), адгезивная система (adhesive system), адгезивный протокол (adhesive protocol), кариес цемента (cementum caries), обзор (review). Publications dated from September 2016 to January 2026 were included; duplicate articles were excluded. Anatomical features of the tooth root, such as sclerotic dentin, reduced thickness of dental hard tissues, and increased moisture in the operative field, necessitate reliable bonding to dentin and long-term restoration stability. Modern adhesive systems exhibit high performance characteristics, including resistance to oral moisture, the ability to form durable bonds with sclerotic dentin, increased bond strength to underlying tissues, and fluoride-releasing capability. In addition, seventh- and eighth-generation adhesive systems contain mildly acidic monomers such as 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), which have low molecular weight and the ability to form hydrogen bonds with calcium ions. These properties ensure strong dentin bonding and restoration stability under conditions of moisture and mechanical loading. Contemporary 10-MDP–containing adhesive systems exhibit moisture tolerance and reliable bonding to sclerotic dentin, making them materials of choice for predictable and durable adhesion in the treatment of root caries. However, no single adhesive protocol is universally applicable; root anatomy and the degree of dentin sclerosis require an individualized approach. Effective restoration of root carious lesions is achieved through selection of an adhesive system based on clinical indications and specific operative conditions.