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This article reviews the current concepts for operatively managing carious lesions extending into dentine with minimal removal of tooth structure and restoring with dentine adhesives and direct composite resin. It looks sequentially at the operative steps involved including remineralisation with bioactive cements, bonding to caries-affected dentine including smear-layer modification using HOCl, creation of an acid-base resistance zone,steps to optimise the performance of all-in-one adhesives, and incremental placement of direct composite resin to improve bond strengths to cavity floor dentine. It explores how understanding the phenomenon of colour-shifting at the composite resin-enamel/dentine restoration borders can help in creating near “invisible” restoration margins through a “chameleon” effect. With the increased risks of transmission of Covid-19 when aerosol generating procedures are carried out in Dentistry, following a minimally invasive approach to managing dental caries should be given serious consideration.

It has been proposed that a resin coating can serve as a means to protect dental structure after preparation of the tooth for indirect restorations, sealing the exposed dentin. The resin coating is applied on the cut surfaces immediately after tooth preparation and before making an impression by assembling a dentin bonding system and a flowable composite. Resin coatings minimize pulp irritation and improve the bond strength between a resin cement and tooth when bonding the restoration to tooth. Recently, thin-film coating dental materials based on all-in-one adhesive technology were introduced for resin coating of indirect restorations. The thin coating materials are applied in a single clinical step and create a barrier-like film layer on the prepared dentin. The thin coatings play an important role in protecting the dentin from physical, chemical, and biological irritation. In addition, these thin-film coating materials reportedly prevent marginal leakage beneath inlays or crown restorations. In light of the many benefits provided by such a protective layer, these all-in-one adhesive materials may therefore also have the potential to cover exposed root dentin surfaces and prevent caries formation. In this paper, recent progress of the dental coating materials and their clinical applications are reviewed.

Summary Dentin bonding systems have been dramatically simplified and improved during the recent decades. Monomer penetration into dentin and its polymerization in situ creates a hybrid layer, which is essential to obtain good bonding to dentin. Moreover, the presence of an acid–base resistant zone below the hybrid layer has been documented with self-etching adhesive systems in an artificial secondary caries attack. When ultrastructure of the acid–base resistant zone is assessed by SEM and TEM observations, formation of the acid–base resistant zone is considered to be due to the monomer penetration potential and fluoride release in the adhesive systems. Natural dentin has a limited potential to resist an acid attack of secondary caries; however, the acid–base resistant zone does not purely consist of dentin in morphology, it is rather a combination of dentin and the adjacent hybrid layer. Therefore, the reinforced dentin has been called "Super Dentin" bearing the ability to prevent primary and secondary caries. Prospectively, the great potential of adhesive technology in creation of the "Super Dentin" would lead to the development of new materials for mechanical, chemical and biological protection of the dental structures.