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History of Dental Adhesives
Transcript of History of Dental Adhesives
WHY DO WE CARE?
First introduced about 45 years ago
At first, it was only recommended for etching/bonding of the enamel
Over time, allowed bonding to dentin as well
Today, there are a variety of materials to choose from
All direct resin restorations require bonding
We are always looking for the best product, quick, simple and effective.
Late 1990s, early 2000s (6th generation)
“Self” etching primers
Reduced incidence of post treatment sensitivity
Bond strengths lower than fourth and fifth generation due to higher pH
Hydrolytic degradation of bonds
Prompt L Pop
ACE All Bond SE
Introduction of bonding
First systems were introduced by Buonocore in 1955 and Bowen in 1965
history of dental adhesives
Dr. Michael Buonocore wrote a paper on the benefits of acid etching
Since then – adhesives have evolved from no-etch to total etch to self etch
Improved in physical properties and convenience
1960s – 1970s
(1st and 2nd Generation)
Did not recommend dentin etching
Relied on adhesion to smear layer
Weak bond strength – allowed dentin leakage with clinical margin stain
Cervident (SS White)
Scotchbond (3M dental)
Clearfil bond system
Acid etching of dentin
Increased bond strength
Margin staining caused clinical failure over time
Universal bond 2
Early 1990s (4th Generation)
Acid etching of dentin and enamel
Increased bond strength
Margin staining clinical failure over time
Concept of “wet bonding” introduced.
Technique sensitive – complexity of multiple bottles and steps
All Bond 2,3
Mid 1990s (5th generation)
Combined primer and adhesive in one bottle
Maintained high bond strengths
Unit-dose packaging introduced
Controlled etching, surface wetness and resin placement continued to be a clinical challenge for some clinicians.
Prime and bond
OptiBond Solo Plus
Late 2002 (7th generation)
Combines etching, priming and bonding
Good bond strength and margin sealing
Virtually eliminates post-op sensitivity
Generally not compatible with dual and self cure products
BONDING DATA BY GENERATION
What is Ideal?
High bond strength
Thin film thickness
Suitable for both moist and dry environments
XP Bond-Universal total-etch adhesive (Dentsply)
One-step-universal Dental Adhesive (Bisco)
G-aenial Bonding -Universal bonding agent
Self Etch Dentin Adhesives
USES OF ADHESIVES
Retention of composites
Reduction of Micro-leakage
Reduction of re-current caries
Can be used to attach orthodontic brackets
Types of Etching
Total -etching (3-step process)
Self-etching (2-step process)
Make sure that tooth is dry and clean
If there is biofilm on the tooth, the adhesive might adhere to it rather than the tooth surface.
The use of rubber dam would be necessary to avoid any biofilm from saliva touching the tooth and keeping the area clean.
Acid –etching is a bonding technique most commonly used.
Before starting the process, it is important to clean the enamel surface with pumice or similar abrasive, rinse away the dirt and pumice with water, and dry the surface with air compression
Acid etching, with Orthophosphoric acid at 37% ( or 3/8) concentration, creates a microscopically rough enamel by dissolving the enamel rods
The recommended time for etching enamel is 15-30 seconds
Acid -Etching Technique
Deciduous teeth require more time because enamel rods are less regularly arranged.
If the enamel is properly etched it should occur as chalky white.
Resin systems were used in conjunction with acid-etching technique.
The low-viscosity resin systems wet the etched surface and flow into the microscopic irregularities.
All resin systems are set by polymerization, which can be initiated by light or chemical reaction.
After the resin is applied, the composite material can be added and is set by the same process as that of the low-viscosity resin to bond onto the resin
Dentinal Bonding System
Developed to have adhesives bond to dentin rather than only enamel
Dentin is composed of inter-tubular dentin, intra-tubular dentin and dentinal tubules filled with odontoblastic processes.
Different types of dentin also exist such as primary, secondary, reparative, sclerotic and dead tracts
Dentinal Bonding System
The second step is to apply the primer. Primers have low viscosity and are much more hydrophilic compared to resins used in enamel bonding.
Primers contain solvents such as acetone or ethanol. They flow into the surface irregularities of the etched enamel and dentin and the surface should appear shiny after its application.
Then the adhesive is applied which is low-viscosity resin and is hydrophilic.
After that the composite placement is performed.
The two-step dentinal bonding system is a newer version.
In this system the first step is etching the enamel and dentin; the second is applying the adhesive, which is light cured and the composite restorative material is placed.
Two-step systems with self-etching primers are also available in which there is one bottle that contains the etch and primer.
The adhesive is applied as a second step. The one-step self-etching adhesives are another choice for dentinal bonding.
Relevance to Dental Hygiene
In our scope of practice we can apply pit and fissure sealants.
Therefore, should know the type, duration, and steps of etching material before applying sealant to avoid any microleakage that may cause recurrent decay.
It is also important to make sure there is no biofilm or contamination formation on the tooth surface after it is etched for optimal bond strength.
Dental hygienists may also be required to bond orthodontic brackets to tooth surfaces