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Dental Assistant Dental Liners, Bases, and Bonding Agents

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Rachael Wiebe

on 11 October 2015

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Transcript of Dental Assistant Dental Liners, Bases, and Bonding Agents

Dental Liners, Dental Bases, and Bonding Agents
Protective by providing thermal protection
Acidic to pulp, must be used with a cavity liner
.
Zinc Phosphate
Zinc Oxide Eugenol
Zinc Oxphosphate
Zinc Polycarboxylate
Glass Ionomers
Dental Materials uses
for Dental Bases
Used when the cavity preparation is moderately deep or as an additional layer for pulpal protection.
Mixed to a secondary consistency
The material can be rolled into a ball or rope

Dental Bases
Two paste (base and catalyst) or Light cured
The materials is prepare prior to application
With use of syringe tip or dycal applicator, the material is applied to the deepest portions of the cavity prep.

Application of a Dental liner

Calcium Hydroxide is the most frequently used dental liner
Protects the pulp from chemical irritants
Stimulates the production of tertiary dentin
Compatible with all dental materials

Calcium Hydroxide
Direct Pulp Capping: The pulp of the tooth is exposed

Indirect Pulp Capping: The pulp of the tooth is nearly exposed


Pulp Capping
Utilized to save a pulp and prevent a endodontic therapy (a root canal) by placing a calcium hydroxide agent over the nearly exposed or exposed pulp to encourage the formation of tertiary dentin.

Pulp Capping
A thin layer of material placed on deep portions of the cavity preparation.
May be utilized when pulpal exposure occurs. Called indirect or direct pulp capping
Utilized to stimulate the development of tertiary (reparative) dentin because

Dental Liners

Dental Liners
Varnishes
Desensitizer
(discuss later in the semester)
Dental Bases
Types of Pulpal Protection

Protective and insulating
Nonirratating
May be placed under all restoratives, direct or indirect
.
Polycarbonate
AKA: ZOE
Used insulation and sedation of the pulp
Eugenol is soothing
ZOE cannot be used with resins, glass ionomers, and resins
Works well with amalgam
Zinc Oxide Eugenol
Protective Bases: place prior to the restoration to protect the pulp.
Insulating Bases: place to insulate pulp from thermal irritants, usually associated with deep cavity preparations
Sedative Bases: soothes a pulp when irritation occurs.
How do Dental Bases Protect the Pulp?
Consist of one or more resins. Place within the entire preparation of the tooth.
Seal the dentin tubules
Reduce microleakage
Acts as a barrier to protect the tooth from highly acidic cements such as zinc phosphate.

Varnishes
Varnishes
Calcium Hydroxide
Zinc Oxide
Glass Ionomers
Resin
Types of Dental Liners
Types of irritation may be due to normal attrition, bruxism, erosion, dental caries, dental treatment, etc.
Tertiary Dentin
Physical: thermal or electrical

Mechanical: Vibration for the cavity preparation, occlusal trauma when the occlusion is not correct on an occlusal restoration

Chemical: Acidic dental materials affecting the pulp

Biological: Bacteria from saliva or the dental caries.


Types of Pulpal Stimuli

A dentist cannot always be 100% certain as to the extent of the dental caries. Sometimes the restoration may become deeper or larger than planned.

This is when pulp capping, dental liners, and bases are required.
Introduction
Forms a in response to irritation and appears as a localized deposit of dentin.
Tertiary Dentin

#14 and #15 has an exposed pulp. Note the bleeding.

Direct Pulp Capping

#6 pulp is nearly exposed.

Indirect Pulp Capping

Lime-Lite
Dycal
Hydrox
IRM

Names Bands
Bonding of resins permits restorative materials to stick to tooth structure
Etchant increases surface energy and removes smear layer
Phosphoric acid is used on both enamel and dentin
Enamel is etched longer
Tooth sensitivity may occur
Summary
Composites
Porcelain
Metal
Amalgam
Orthodontic Bonding
Endodontic Posts
Clinical Application of Bonding
Hypersensitivity
Microleakage
Clinical Considerations
with Bonding
A layer of uncured resin.
Oxygen-Inhibited Layer
Etching dentin with phosphoric acid dissolves the smear layer first
This opens the collogen fibrils of dentinal tubules
Dentin has a lower mineral content and needs to be etched for
only
about 10 seconds. Over-etching leaves a weaker bond.

Dentin Etching
Always ready Manufactures Recommendations
Typically 20-30 secs
Available in liquid or gel.
After etching the tooth is rinsed for approx. 10 seconds.
Application for enamel and dentin with a 20 sec etchant process: apply to enamel surface first for 10 secs, then dentin for remainder of 20 sec etching, 10 secs.
Etching
Etching enamel: takes approx 20 secs, removes smear layer, then hydroxyapatite crystals from enamel rods
Etching dentin: Takes approx 10 secs, removes smear layer, then exposes collogen fibrils
Etching increases the ability of the bonding material to wet the tooth surface by creating a high surface energy
Good surface wetting increases integrate of bonding agent into tooth's surface.
For this reason, bonding agents are typically made of a low-viscosity material.
Etching
Bonding agents for dentin are viewed as two types:
Primer
Bond
Bonding Agents

What is Bond or Bonding?????
Basic Principles
of Bonding
The tooth is treated with the prime and resin bonding agent for enamel and dentin bonding or just bonding agent for enamel bonding.
Dentin bonding: avoid desiccation!
4th Step in Bonding
Smear Layer
Etching of the enamel removes a small portion of the surface and opens porosities among the rods. It removes hydroxyapatite crystals from enamel rods.
Enamel Etching
The tooth is etched/conditioned with a 37% solution of phosphoric acid for (20-30 secs).
3rd Step to Bonding
Tooth is prepped/ scared/ roughened by the dental bur.


1st Steps of Bonding
Three modes of curing are used for resin bonding agents:
Self cure
Light cure
Dual cure
Modes of Cure
Principles of Bonding
The surface is dried to a frosty finish.
Enamel Etching
The tooth must be free of decay, plaque, and debris.
2nd Step to Bonding
Other than an actually bonding agent when can this term be used!
Bonding agents for Enamel:
Bond
Oxygen-inhibited lay is the layer of bonding agent which has mixed with oxygen and now cannot fully cure. This is a characteristic of all resin materials: bonding agents, sealants, composites, compomers, etc.
Primer
Bond
an unfilled resin which penetrates etched tooth surface.
Creating mechanical and chemical retention (materials applied to bond is chemically retained by bonding to etchant)
Total Etchant System
Requires seperate application and rinsing or phosporic acid application.
Dentin must be left slightly moist (dentin fibers will collapse it dessicated)
4th and 5th Generation systems
1 (ethant, primer, and bond in same bottle) or 2 (etchant/primer seperate from bonding agent) bottle systems
Self Etchant System
Bonding agent will etch enamel and dentin while resin is penetrating tooth structure.
6th and 7th generation
1 (ethant, primer, and bond in same bottle) or 2 (etchant/primer seperate from bonding agent) bottle systems
Take away message: KNOW THE SYSTEM YOU ARE USING, READ DIRECTIONS
Only necessary for dentin bonding,
Can be used for enamel bonding.
Hydrophilic to penetrate wet, etched dentin
Contains solvants which disolve water as it penetrates collogen fibrils,
Solvants: Acetone, ethenol or combination of both
Primer is not rinsed off
Primers are typically dried for approx. 5 secs prior to application of bonding agent
Primer is not light cured
Bonding agent bonds to primer
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