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8/13/2019 Cons (Adhesive System)
1/12
Adhesion:attachment of one substance to another.
Adhesive system (bonding agent): 2 materials or 2 surfaces and you apply a material in
between which can:
Join the 2 materials or surfaces together.
Persist their separation.
___?Capacity (00:00:35) :: will act like shock absorber by strength the link between
teeth structure.
Requirement of adhesion:
Intimate contact between the 2 surfaces.
Sufficient wettability:
Angle forming between the droplet and the surface:
Smaller the angle better spreading better, wettability
Good surface energy to absorb and make the droplet flow.
High surface energy ,low tension:
The surface is hydrophilic which mean it loves water.
8/13/2019 Cons (Adhesive System)
2/12
Poor wetting high contact angle+ low surface energy.
Good wettinglow contact angle+ high surface energy.
Perfect wetting the angle equal zero.
Which is better adhesion to enamel or dentine?
Enamel: better and much easier because it has higher surface energy.
It contains more inorganic material (hydroxyapatite crystals) high surface energy).
On the other side, Dentine composes of inorganic (hydroxyapatite) +organic (collagen)
lower surface energy than enamel.
8/13/2019 Cons (Adhesive System)
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In the oral environment we have organic pollutants like the saliva, proteins... Etc.
Which has Low surface tension; it will impair the adhesion as
well, and decrease the bond and compromise the adhesion to the tooth structure.
Smear layer:
Calcific debris formed within instrumentation and preparation of the tooth, they have
low surface energy as well.
So we have 2 problems:
One related to teeth structure:: Dentine which has low surface tension.
The other related to the smear layer we produced within instrumentation.
Both will compromise the bond.
8/13/2019 Cons (Adhesive System)
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I have to have an isolated field and clean tooth which should to conditioned by applying
acid etching.
You apply acid etching to modify teeth structure and the smear layer after isolation and
cleaning the tooth.
Dr. Michael Buonocore has best credit for adhesive dentistry. He suggested and did
many studies about the effect of acid etching on tooth structure.
If we have Very good bonding it will improve your work (long standing restorations (good
durability)).
Adhesive technique advantages:
Conservative and preservation of tooth structure: we dont remove a lot
from the tooth structure.
Homogeneous distribution of tensions throughout the union allowing the
elimination of stress concentrations.
Esthetic: like veneers.
Reduce micro leakage.
Easier to repair.
What are the subsequences of reducing micro-leakage?
Improving the postoperative sensitivity.
Decrease marginal staining.
Decrease recurrent caries.
What are the indications of adhesive dentistry?
Restoration of carious and fractured teeth.
Correction of shape, position, size and color (veneers like composite or
porcelain).
Core builds up.
Extra coronal restoration like onlay, crowns and veneers.
8/13/2019 Cons (Adhesive System)
5/12
Orthodontics and periodontal splints.
Orthodontics bands.
Dental hypersensitivity.
Repair fractured composite.
Pit and fissure sealant.
Bonding to amalgam restorations.
Bonding agent:low viscosity material thats applied to the tooth surface (thin film
thick layer will affect the bond appears in radiograph as radiolucent line underneath
that will induce recurrent caries).
Dont spread it with air only by brush.
After applying, you have to light cure it for 20 seconds.
Bi-functional molecule which will attach to the teeth surface and resin
Low viscosity resin attaches to micro porosity created by the reaction.
Major role is to stabilize the hybrid layer.
Resin tags: resin extensions closer to composite resin, formed inside micro porosity,
when the bonding agent penetrates the resin tags the composite will hold!!
To have an interlocking bond(good bonding strength) you should have:
Good isolation
Good etching
Good bonding
Enamel bonding: micromechanical.
Dentine bonding: micromechanical+ chemical.
8/13/2019 Cons (Adhesive System)
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Ideal properties of bonding agent:
Biocompatible.
Low film thickness.
Low viscosity.
Strong bond.
Good dimensional stability.
Good shelf life.
Compatible coefficient of thermal expansion??( The cte of the restoration should be
similar to that of the tooth .. So when the pt drink cold water for eg the restration and
the tooth will shrink in the same rate or when he drink hot drinks both will expand inthe same manner so there'll be no microleakage nore fractures of the tooth due to the
pressure from the restoeation )
Clinical steps for bonding:
Proper isolation and
Pulp protection in deep cavities.
Etching, inorganic acid phosphoric acid 37%\\ the gel is better bcz its easier to
manipulate .liquid will dry easily
primer
adhesive
Acid etching:Application of chemical (acid etching) to alter the surface configuration.
(Hydroxyapatite and smear layer modification)
Purpose of acid etching:
8/13/2019 Cons (Adhesive System)
7/12
Protection of substrate that capable of micromechanical: prepare the tooth structure to
receive the bonding and restoration by changing the micro structure of enamel, dentine
and smear layer.
We accomplish two goals by etching the dentin. First we remove the smear layer anddebris present from tooth preparation. The dentinal tubules become clogged with cut
tooth structure, saliva, red blood cells and other contaminates like oil from our hand
piece. The etching process effectively removes all of this to expose open dentinal
tubules which can be filled with resin. Secondly, the acid etch demineralizes a layer of
the dentin, exposing the collagen fibers, allowing the resin to penetrate into the dentin
structure. We carefully manage the chemicals and timing during etching (total etchor
self-etch) in order to effectively remove the smear layer, open the tubules and create
an adequate demineralized zone that resin can infiltrate.
Again, the Smear layer is calcific debris formed within instrumentation and preparation
of the tooth; they have low surface energy as well.
Benefits of smear layer:
Reduces dentinal permeability.
Limits out flow of pulpal fluid
Natural barrier to the pulp.
http://leeannbrady.com/restorative-dentistry/restorative-techniques/total-etch-technique-dentinhttp://leeannbrady.com/restorative-dentistry/restorative-techniques/total-etch-technique-dentinhttp://leeannbrady.com/restorative-dentistry/restorative-techniques/total-etch-technique-dentinhttp://leeannbrady.com/restorative-dentistry/restorative-techniques/total-etch-technique-dentin8/13/2019 Cons (Adhesive System)
8/12
Etched enamel:dissolved hydroxyapatite crystals give new micro structure like honey
camp
Average of penetration: 10-25
Enamel surface etched with 35% and 10% phosphoric acid gels for 15
and 60 seconds. Areas with preferential removal of prism core material and the prism
peripheries relatively intact
Clinical description of etched enamel: frosty.
Factors effecting acid etching of enamel:
Types of acids(phosphoric acid 37%, inorganic)
Duration (15 seconds). The prisms (bevel: you expose more surface area to enhance the bond).
8/13/2019 Cons (Adhesive System)
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Un-etched enamel (left), etched enamel at 500x magnification (middle), etched enamel at
5000x magnification (right).
Etched dentine: dissolution of the smear layer and demineralizing dental surface
Changing the micro structure, u will be able to see the collagen fibers. The collagen
fibers will remain.
8/13/2019 Cons (Adhesive System)
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Dentinal surface etched with 35% phosphoric acid gel for 15 and 60 seconds. The acid has removed
the smear layer and opened the dentinal tubule orifices.
Etched and un-etched dentin (500x) (left),
Etched dentin (500x) (smear layer removed) (right).
Shrinkage of collagen fibers within the dentin caused by over drying during acid - etch procedure (E:
acid-etched dentin, W: water)
Over drying will cause collagen collapse so there wont be enough spacefor the resin tags. So avoid
over drying.
8/13/2019 Cons (Adhesive System)
11/12
The hydrodynamic theory:the mechanism by which atoothperceives
sensation. It states that the flow of fluid in dentinal tubules trigger receptors within the
tooth. It is the most widely accepted theory explaining tooth sensitivity
http://en.wikipedia.org/wiki/Toothhttp://en.wikipedia.org/wiki/Toothhttp://en.wikipedia.org/wiki/Toothhttp://en.wikipedia.org/wiki/Tooth8/13/2019 Cons (Adhesive System)
12/12
Cutting in tooth structure will cause Vibration it will move the dentinal fluid toward the
pulp stimulating the nerve ending, thats why after each operation and when u reach
dentine you have to inform your patients that the might have sensitivity because of this
.
The end
Done by: Amal Ameer