Report on Restorative Dentistry, Bonding System

1. CURRENT OPTIONS FOR
RESIN-DENTIN BONDING
Joseph Russell N. Gorda

2. ◻ Three-Step, Etch-and-Rinse Adhesives
◻ Two-Step Etch-and-Rinse Adhesives
◻ Two-Step Self-Etch Systems
◻ One-Step Self-Etch Adhesives

3. Three-Step, Etch-and-Rinse Adhesives

4. Three-Step, Etch-and-Rinse Adhesives
◻ This method is originally known as the total-etch
technique
◻ Now more commonly called Etch and rinse technique
◻ Three-Step, Total-Etch Adhesives.
◻ Fourth Generation Dentin Adhesives
◻ Etchant + Primer + Bonding

6. ◻ All-Bond 2 and All-Bond 3 (Bisco, Inc, Schaumburg,
Ill),
◻ OptiBond FL (Kerr Corporation, Orange, Calif),
◻ Scotchbond Multi-Purpose (3M ESPE, St. Paul, Minn)

7. ◻ Although the smear layer acts as a “diffusion
barrier” that reduces the permeability of dentin, it
also can be considered an obstacle that must be
removed to permit resin bonding to the underlying
dentin substrate.
◻ Removal of the smear layer via acid etching led to
significant improvements in the in vitro bond
strengths of resins to dentin.

12. ◻ Etching did not result in a significant improvement in
bond strengths, possibly as a result of the
hydrophobic nature of the phosphonated resin.
◻ In addition, in the mid-1970s, some researchers had
hypothesized that the application of acids to dentin
might trigger inflammatory pulpal responses
◻ Based on these concerns, acids were believed to be
contraindicated for direct application on dentin

13. ◻ Clinical retention rates was close to 100% compared
with a second-generation adhesive system having
retention rates in the 50% range.
◻ Laboratory shear bond strengths vary from 17 to 30
Mpa, which are close to the values generally
obtained on enamel

14. ◻ The three essential components are
• (1) a phosphoric acid etching gel that is rinsed off;
• (2) a primer containing reactive hydrophilic monomers in
ethanol, acetone, or water; and
• (3) an unfilled or filled resin bonding agent containing
hydrophobic monomers, such as Bis-GMA, frequently
combined with hydrophilic molecules, such as HEMA.

15. ◻ The acid-etching step not only alters the mineral
content of the dentin substrate, but also changes its
surface free energy.
◻ The latter is an undesirable effect, because for good
interfacial contact, any adhesive must have a low
surface tension, and the substrate must have a high
surface free energy.

16. ◻ Among dental materials, hydroxyapatite and glass
ionomer cement filler particles are high-energy
substrates,
◻ whereas collagen and composite have low energy
surfaces
◻ Consequently, dentin consists of two distinct
substrates, one of high surface energy
(hydroxyapatite) and one of low surface energy
(collagen).

17. ◻ When primer and bonding resins are applied to
etched dentin, they penetrate the intertubular dentin,
forming a resin-dentin interdiffusion zone, or hybrid
layer.
◻ They also penetrate and polymerize in the open
dentinal tubules, forming resin tags.

18. Two-Step Etch-and-Rinse Adhesives

19. Two-Step Etch-and-Rinse Adhesives
◻ One-Bottle, Total-Etch Adhesives.
◻ Fifth Generation Dentin Adhesives
◻ “onebottle” systems
◻ Etchant + [Primer, Bonding]

20. ◻ Much of the research and development is focused on
simplification of the bonding procedure.
◻ In vitro dentin bond strengths have improved so much
that they approach the levels of enamel bonding.

22. ◻ One-Step Plus (Bisco, Inc, Schaumburg, Ill),
◻ Prime & Bond NT, XP Bond (Dentsply Caulk, Milford, Del),
◻ Adper Single Bond Plus (3M ESPE, St. Paul, Minn),
◻ OptiBond SOLO Plus (Kerr Corporation, Orange, Calif),
◻ PQ1 (Ultradent Products, South Jordan, Utah),
◻ ExciTE (Ivoclar Vivadent, Schaan, Principality of
◻ Liechtenstein),
◻ Bond 1 (Pentron Clinical, Wallingford, Conn),
◻ One Coat Bond (Coltene/Whaledent Inc, Mahwah, NJ),
◻ Gluma Comfort Bond & Desensitizer (Heraeus Kulzer, South
Bend, Ind).

24. Two-Step Self-Etch Systems

25. Two-Step Self-Etch Systems
◻ Self-Etching Primer Systems.
◻ Two-bottle Self-Etch
◻ Sixth Generation Dentin Adhesives
◻ [Etchant, Primer] + Bonding

28. ◻ Some SEPs are more accurately called nonrinsing
conditioners or self-priming etchants and are used with
a one-bottle adhesive as the bonding agent.
◻ NRC Non-Rinse Conditioner (Dentsply DeTrey,
Konstanz, Germany)
◻ Tyrian SPE (Bisco, Inc, Schaumburg, Ill).
◻ Clearfil SE Bond (Kuraray)

29. ◻ NRC and Tyrian SPE require the subsequent
application of a separate adhesive, the same used
with the total-etch technique
• (Prime & Bond NT [Dentsply Caulk, Milford, Del] with
NRC, and
• One-Step Plus [Bisco, Inc] with Tyrian SPE).

31. ◻ Nonrinsing conditioners do not provide higher bond
strengths or better clinical performance than
phosphoric acid etchants.
◻ NRC does not etch enamel to the same depth as
phosphoric acid.

32. ◻ The elimination of rinsing and drying steps reduces
the possibility of overwetting or overdrying, either
of which can affect adhesion adversely.
◻ Water is always a component of SEPs because it
needed for the acidic monomers to ionize and
trigger demineralization of hard dental tissues; this
makes SEPs less susceptible to variations in the degree
of substrate moisture but more susceptible to chemical
instability due to hydrolytic degradation.

33. ◻ Disadvantage: They do not etch enamel as well as
phosphoric acid, particularly if the enamel has not been
instrumented. The seal of enamel margins in vivo might be
compromised.
◻ SEPs are more likely than total-etch systems to undergo
deterioration through thermal cycling.
◻ The enamel bond strengths of some newer self-etching,
self-priming adhesive systems approach the enamel bond
strengths of phosphoric acid–based adhesives, however,
suggesting that self-etch adhesives are gradually being
developed to replace total-etch adhesives.

34. ◻ Mild SEPs tend to provide excellent dentin bond
strengths and poorer enamel bonds, whereas more
aggressive self-etch systems provide the reverse.
◻ SEPs are less technique-sensitive than total-etch
adhesives.
◻ SEPs demineralize and infiltrate dentin
simultaneously.

35. ◻ SEPs do not remove the smear layer from dentin
completely, which is the main reason that they might
result in less postoperative sensitivity than total-etch
adhesives
◻ One clinical study found no differences in
postoperative sensitivity from two weeks to six
months between a total-etch adhesive and a SEP.
◻ These results suggest that the restorative technique is
more important than the material itself.

36. One-Step Self-Etch Adhesives

37. One-Step Self-Etch Adhesives
◻ Self-Etching Adhesives (All-in-One)
◻ Seventh Generation Dentin Adhesives
◻ [Etchant, Primer, Bonding]

40. ◻ Additionally, all-in-one adhesives tend to behave as
semipermeable membranes, resulting in a hydrolytic
degradation of the resin-dentin interface.
◻ The hydrophilicity of their resin monomers, usually
organophosphates and carboxylates, also is high.
◻ Simplified self-etch adhesives do not provide
hermetic seal for vital deep dentin.

41. ◻ AdheSE One F (Ivoclar Vivadent)
◻ Adper Prompt L-Pop (3M ESPE, St. Paul, Minn),
◻ All-Bond SE (Bisco Inc.)
◻ Brush & Bond (Parkell Inc, Farmingdale, NY),
◻ iBond Self-Etch (Heraeus Kulzer, South Bend, Ind),
◻ One-Up Bond F, Bond Force (Tokuyama Dental, Tsukuba,
Japan),
◻ Clearfill S3 Bond (Kuraray)
◻ Xeno III, Xeno V+ (Dentsply DeTrey, Konstanz, Germany)
◻ OptiBond All-in-One (Kerr Corporation)