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UPDATE OF ORTHODONTICUPDATE OF ORTHODONTIC
ADHESIVESADHESIVES
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CONTENTSCONTENTS Introduction
 Historical view
 Development of epoxy resigns
 Current resin developments
 Development of polyelectrolyte cements and chemical
 Adhesion
 Some definitions
 Theories of adhesion
 Requirements of long lasting adhesion
 Materials used as adhesion
 Resins
 Cements
RMGIC
 Bonding systems
 Primers
 Bonding to non-enamel surfaces
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INTRODUCTIONINTRODUCTION
 The current trends in the development of
adhesives attempts to simplify bonding steps and
make them user friendly.Advances in different
scientific disciplines, will enrich the pool from
which ideas may be drawn in designing future
adhesives .
 It is probably on the molecule level that we
see the greatest expansion of horizons and
advances in biomimetics . Using the concept of
controlled release,future adhesives may contain
flourescent biosensitizers that can detect pH
changes .
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HISTORICAL OVERVIEWHISTORICAL OVERVIEW
 Research into bonding agents for
attachment of resins to tooth structure
was started in the early 1950s.
•Ist attempt to develop an adhesion system for
bonding acrylic resins to tooth structure was
made by Haggers ,a swiss chemist working for
the amalgamated dental company in London and
Zurich in 1947.
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1955 Buonocore conducted experiments on
enamel surfaces employing a 30 sec
treatment of 85% phosphoric acid to achieve
a simple acid decalcification and found
tremendous increase in surface area due to
acid etching action by exposing the organic
frame work of enamel
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In 1955 Buonocore and Brudevold
selected sevriton as one material that
seemed ideally suited for chemical
combination with constituents of
dentin but the role of methacrylic
acid in establishing adhesion could not
be continued
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 Further paper by Buonocore and Quigley in
1958 ,confirmed the earlier work of KRAMER and
MC LEAN .
 Hagger and mclean work remained dormant for a
long period .
 In 1961 work shop on adhesive restorative dental
materials ,which was organized by Philips and
which provide considerable impeus to future
research .
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EPOXY RESINSEPOXY RESINS
 Castain and Dr.Trey Freres ,Zurich ,made a major
break through in polymer chemistry in 1937 with
the invention of of epoxy resins made by
condensation alkaline oxides with anhydrides of
polybasic acids .
 Epoxy resigns has formed the basis for most of
the current composite resins in which vinyl groups
were attached to the end groups of epoxy resin
,converting epoxy resign to dimethacrylate
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CURRENT RESIN DEVELOPMENTCURRENT RESIN DEVELOPMENT
 In 1958 the first low shrinkag resin was produced
by schmitt and purrman in germany. It was a low
viscosiy epimine resins and marketed under trade
name pcadurit .
 In 1959 Bowen filed his first paten in the united
states on his famous bis-GMA resin ,based on he
epoxy molecule and produced a dental restorative
material containing vinyl silane treated fused silica
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 Recently urethane dimethacrylate
developed by knigh e tal for industrial
use.later Loster and Walker made urethane
dimethacrylate resin for use in resin -
composite dental material.
 Advantages of these new resins are ,higher
molecular weigh ,low viscosiy ,certain
degree of toughness in the urethane
moiety ,together with less staining bis-
GMA
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AdvantagesAdvantages
Higher molecular weigh .
low viscosiy .
certain degree of toughness in the
urethane moiety ,together with less
staining bis-GMA .
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POLYELECTROLYTE CEMENTS ANDPOLYELECTROLYTE CEMENTS AND
CHEMICAL ADHESIONCHEMICAL ADHESION
 It is Another advancement in bonding restorative
materials to tooth structure
 Long term adhesion possible with out any
preparation of tooth surface .
Ian 1968 smith described about dental cements in
which Zno powder could be reacted with poly
acrylic acid.
Zinc polycarboxylate cement were the first truly
adhesive cements that could form chemical bonds
with tooth structure,a major advance in dental
adhesive chemistry .
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 Research in this field continoues and lead
to production of first chemically adhesive
tooth –colored restorative .
 The GIC were initially described by Wilson
and kent in 1971-it became anoher land
mark in adhesive dentistry.
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DEFINATIONSDEFINATIONS
 Adhesion
"The state in which two surfaces are held
together by interfacial forces which may consist of
valence forces /interlocking forces or both.
 Adhesive
“Is a material frequently a viscous fluid that
joins two surfaces together solidifies and
therefore is able to transfer a load from one
surface to the other.”
Adherend
 “ Material to which an adhesive applied is called
Adherend “
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MECHANISMS OF ADHESIONMECHANISMS OF ADHESION
Mechanical adhesion
 Adsorption adhesion
 Electrostatic adhesion
 Diffusion adhesion
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 Mechanical:Interlocking of adhesive with
irregularities in the surface of the
adherend
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 Adsorption is nothing but Chemical
bonding between the adhesive and
adherend
 chemical bonding is of 2 types:
1.Primary chemical bonding
1. 2.Secondary chemical bonding
Adsorption adhesion
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Electrostatic: There is an electrical
double layer at the interface of a
metal and polymer that is part of the
total adhesive system
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Diffusion: Interlocking between mobile
molecules, such as the adhesion of two
polymers through diffusion of polymer
chain ends across an interface
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REQUIREMENT FOR ADHESIVEREQUIREMENT FOR ADHESIVE
SYSTEMSYSTEM
 Wetting: An adhesive must give good
wetting of the adherend.
 Thickness: Too great thickness can lead to
poor bond strength.
 Viscosity: Adhesive should have a suitable
viscosity to enable it to flow readily over
the surface of adherend.
 Strength: of the set adhesive must be
taken into consideration.
 Dimensional Stability: The setting time of
the adhesive should occur without
excessive dimensional changes i.e. little
expansion or contraction
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RANGE OF ORTHODONTICRANGE OF ORTHODONTIC
ADHESIVESADHESIVES
 RESINS
CEMENTS
RESIN IONOMER HYBRIDS
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COMPONENTS OF A COMPOSITECOMPONENTS OF A COMPOSITE
RESINRESIN
 Dental composite resins are complex materials :
1. organic resin component that forms matrix .
2. Inorganic filler.
3. coupling (interfacial) agent, to unite the resin
with the filler .
4. initiator system, to activate the setting
mechanism .
5. stabilisers (inhibitors ).
6. pigments .
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ORGANIC RESIN COMPONENTORGANIC RESIN COMPONENT
 Composite resins vary in their resin component but
all the variations are diacrylates.
 High­viscosity aromatic monomer:bis-GMA.
 The lengthy diacrylate chains of this monomer
minimise the polymerisation contraction.
• Some systems contain oligomeric compounds based
on urethane dimethacrylate to replace bis-GMA
either partially or completely..
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 Low-viscosity monomers:
 TEGDMA , EGDMA and HEMA to facilitate
clinical handling.
 There must be carbon-carbon double bonds
at each end of the monomer chain to allow
polymerisation and cross-linking.
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Silica used generallySilica used generally
Crystalline form
Hard
Stronger
Difficult to
finish
and polish.
Eg: crystobalite
Tridymite
Quartz.
Non-crystalline
Most popular
fillers.
Eg:silicate glass
made of Zn,Yt,Ba.
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MACRO FILLERSMACRO FILLERS
 Macrofiller – Made of glass, quartz or ceramic
by crushing, grinding and sieving to achieve
splinter-shaped particles.
 The average size -formulations is 5-30 um.
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MICRO FILLER PARTICLESMICRO FILLER PARTICLES
 Microfiller particles are amorphous silica
(Si02)
average diameter 0.0411-m
 prepared by hydrolysis and precipitation.
 They are radiolucent
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HYBRIDSHYBRIDS
• In thehybrid materials, the average size is
0.5-8I1-m.
 Barium (Ba), strontium (Sr) or lanthanum
(La) glasses are usually included to provide
radiopacity
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COUPLING AGENTCOUPLING AGENT
 coupling agent - silane coupling agents
 Composition:
y-methacryloxyproptrimethoxysilane.
 silane coupling affects: the durability of the
composite resin , loss of the coupling releases
particles and leads to surface breakdown.
 The filler particles are treated with a silane
coupling agent to produce a bond between the
particles and the resin matrix
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Initiator systemInitiator system
 light cure.
 Chemical cure.
 Dual cure.
 light cure system:
LED
Plasma arc
xenon
uv-light
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Ortholux LED curing systemOrtholux LED curing system
Ortholux LED curing systemOrtholux LED curing system
emits light in the
430-480 nm range at
an intensity of 1000
mW/cm2
.
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Organ laser light for rapid photo
polymerization of resin composites-
jco 2000.
a statistically lower overall bond
failure rate was found for organ
laser(2.5%) curing ,when compared
with conventional light curing (5.7%)
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Plasma arc versus halogen light –curing of
adhesive precoated orthodontic brackes:A
12-month clinical sudy of bond failures.-AJO
DO 2004 Vittorio cacca festa e tal
Plasma arc lights can be considered an
advantageous alternative to conventional
light curing ,because they enable the
clinician to reduce the curing time of
adhesive precoated orthodontic brackets
with significantly affecting the bond failure
rate
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 Degree of conversion of 2 lingual retainer
adhesives cured with different light
sources-EJO 2005BY Serdar Usumez
The results suggest that a similar or
higher DC than the control values could be
achieved in 6-9 sec by plasma arc curing,in
10-15 second by fast halogen curing,or in
20 sec by LED curing
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(CLASSIFICATION OF COMPOSITE(CLASSIFICATION OF COMPOSITE
RESINSRESINS
Lutz and Phillips (1983),classification based
on the filler particle size and distribution.
 is simple and logical
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TypeType 1.1. Macrofilled compositeMacrofilled composite
resinresin
This type contains only macrofiller particles
and is usually referred to as 'conventional'
or 'traditional'.
 Largely because of the particle size, this
type exhibits a pattern of unacceptable
wear, both of itself and of the opposing
tooth.
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TypeType 2.2. Microjilled composite resinMicrojilled composite resin
The fillers in these composites are
amorphous silica particles of 0.0411-m
average diameter.
 Four different particle groupings have been
developed to maximise the filler loading
while retaining acceptable clinical handling
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Homogeneous - consists of directly
admixed microfillerparticles.
Splintered prepolymerised particles-
Size of prepolymerised particles or
filler blocks is 80l1micrinm in size.
Prepolymerised particle reduce
polymeristion contraction
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Spherical prepolymerised particles.
Particles of selected size allow optimal
packing together.
 Agglomerated microfiller complexes.
The Si02 micro­filler particles are
sintered to a porous mass and then ground
to form coarse particles of agglomerated
Si02 up to 2511-m in size. These are
incorporated, with additional microfiller
particles, into uncured resin.
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TypeType 3.3. Hybrid composite resinHybrid composite resin
Also often known as 'small-particle
composites'.
 combination of macrofiller particles with a
proportion of microfiller particles.
 probably the most commonly used
composite resins.
The main variation is in the proportion and
distribution of the various particles of
different sizes
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Visible-light-activated systemsVisible-light-activated systems
 Single paste visible light activated systems.
 2 component initiator system-di ketone and
tertiary amine.
 Di ketone is usually 0.2 -0.7% camphoroquinone.
absorbs the radiant energy or wavelength of
approximately 470 nm (blue light).
Activation of di ketone combines with the
amine to form a complex that breaks down to
release free radicals which then initiate
polymerization of the resin.
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Transbond XTTransbond XT
AdhesivKit in Syringes AdhesivKit in capsules
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Transbond™ XT Light CureTransbond™ XT Light Cure
AdhesiveAdhesive
 Bonds metal and ceramic brackets to tooth
surfaces.
 Available in both syringes and capsules,
 uses light cure adhesive technology.
 The viscosity of adhesive prevent adhesive run-on
and bracket skating that saves you money .
 reduces adhesive waste.
 easy application, increased control and convenience.
 A syringe delivery system is available too.
 Immediate archwire tie-in www.indiandentalacademy.com
Transbond LR AdhesiveAdhesive
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Transbond™ LR AdhesiveTransbond™ LR Adhesive
Developed specifically for bonding lingual
retainers.
 Easy to apply,
 optimal handling characteristics .
working time is extended so accurate
placement is enhanced
 product waste is minimized
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Chemically activated systemsChemically activated systems
 Two-paste or powder-liquid systems.
Initiator benzoyl peroxide, and tertiary
aromatic amine accelerator
 combination of the two parts will yield free
radicals.
 It is these radicals that will initiate
polymerisation of the resin
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Other systems
Dual-activated composites - both light-
activated and a chemically activated
initiation system .
 packaged as two pastes.
The light-activation mechanism is used to
initiate polymerisation and the chemical-
activation is relied upon to continue and
complete the setting reaction.
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Unfilled resin-bonding agentsUnfilled resin-bonding agents
 Advocated for improving adhesion
 chemistry similar to the composite resin.
 diluted by additional monomers to provide
lower viscosity .
 Mainly of 2 types:
1.enamel bonding agents
1. 2.dentin bonding agents
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EVOLVE
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EVOLVEEVOLVE
starts with blue color and changes to
natural shade after light cure
HELPS TO REMOVE EXCESS FLASH.
Color change compleats complete light
cure and bond strength.
Adhesive contain fluoride
Available in push syrenge and pre
loaded syrenge tips.
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ENAMEL BONDING AGENTSENAMEL BONDING AGENTS
 Consists of unfilled liquid acrylic monomer
placed on acid etched enamel.
 micromechanical retention by resin tag formation
on resin enamel interface.
 Micro tags and macro tags are basis for micro
mechanical retention.
 Micro tags are more important because of their
large number and great surface of contact.
 On other side bonding agent co-polymerises with
matrix phase of dental composite
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DENTIN BONDING AGENTSDENTIN BONDING AGENTS
 Unless we understand dentin bonding and certain
terminologies related to it we will not be able to
follow the update of adhesives.
 Disadvantages of Dentine Bonding:
Smear Layer .
Moist dentine.
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DENTIN BONDING AGENTSDENTIN BONDING AGENTS
Un filled ,liquid acrylic monomer mixture
placed onto acid conditioned and primed
dentin surface
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GENERATIONS OF BONDINGGENERATIONS OF BONDING
AGENTSAGENTS
 Generations are nothing but evolution of bonding
agents from 1955 to 2003.
 There are 7 generations.
 I - GENERATION Buonocore(1956) introduced.
 Resin containing glycerophosphoric acid
dimethacrylate.
 Bowen introduced N­Phenyl Glycine &
GlycidylMethacrylate (NPG-GMA)
 Bonding-is by chelation of bonding agent to calcium
of dentine
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Drawback:
 Poor dentine bonding .
Enamel bonding is good
 Examples-The first commercial system of
this type (Cervident, SS White).
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II - GENERATION (1978)
Bis-GMA (or) HEMA were introduced which are
unfilled resins which causes ionic bonding to the
calcium in dentine.
1. Bonding to smear layerDraw Backs
2.require mechanical preparation
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 III - GENERATION
 Principle: Partially removed (or) modified the
smear layer
 Etching opens dentinal tubules and primer META or
BPDM modifies smear layer and attaches to
composites.
 Drawbacks:
 Primer, does not penetrate the smear layer
 Adhesive retention decreases after some time
 Examples
 Mirage bond, Scotch bond 2
 Prisma Universal bond 2 and 3
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IV - GENERATION
 Complete removal of smear layer was attempted .
 Total - etch technique. In the total etch -
technique Orthophosphoric acid was used to etch
enamel and dentin, simultaneously for 15 - 20
seconds
 Moist - Dentine Concept. However, in order to
avoid collagen collapse, primer solution is applied
which can infiltrate the exposed collagen network
forming hybrid layer. This is called moist dentin
concept
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Hybridization: Replacement of hydroxy-
apatite and water in the surface dentin
with resin
Hybrid: resin in combination with
remaining collagen fibre
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 4th generation dentin bonding agents may be again
described as
 Etch (phosphoric acid) + Primer (NTG-GMA, N­
tolyglycine -glycidyl methacrylate) + Bond (Bis-
GMAj TEGDMA
 Examples
 All bound-2 (BISCO), Scotch bond
 Multipurpose (3M), Prime and bond
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v - GENERATION
1. One -Bottle System
Primer and adhesives are combined into one
solution.
Show high bond strength values both to the etched
enamel and dentin due to adhesive lateral branches
and hybrid layer formation
2. Self etching primers
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Contents
This system may be described as, E
(phosphoric acid) + PB (PENTA,
methacrylated phosphonates
Examples
One step (BiSCO), Single bond (3M),
Clearfil SE bond (J MORITA).
Opti bond solo (KERR
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 VI- GENERATION
VIEtchng was not required at least at the dentinal
interface.
They contained dentin conditioning agent as one of
their components.
Described as EPB(METHACRYLAED PHOSPHATES)
Drawbacks: Multiple components and multiple steps
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VII - GENERATION
I-bond.
Etching, priming, bonding all were
combined into one step.
 Shear bond strength not affected-any
type of curing light .
 Similar adhesion to prepared and
unprepared enamel.
 Desensitizers were added.
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CEMENTSCEMENTS
 GLASS IONOMER CEMENTS
 Invented -1969 reported in 1971 by WILSON AND
KENT
POWDER ; Flouroalumino silicate glass
Liquid: Poly alkenoic acid (Carboxyl containing acid )
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 Setting Reaction: The hydrogen ions of the acid
attack the glass particles in the presence of
water releasing calcium, strontium, and aluminium
ions .
 The metal ions combine with the carboxylic group
of the polyacid to form the polyacid salts matrix
and the glass surface is changed to a silica
hydrogel.
 Advantages
 Fluoride release
 Hydrogel phases
 Moisture tolerance
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 Advantages
 Fluoride release
 Hydrogel phases
 Moisture tolerance
 Disadvantages
 Bond strength less than that of composite
Hydrogel phase: Responsible for the uptake and
release of added environmental fluoride from topical
gels, rinses & dentifrices
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Gic's used for bonding toGic's used for bonding to
ceramic bracketsceramic brackets
Cacciafesta et al (1998) (European journal of
orthodontics)
The lower bond strength of glass ionomer
cements might be advantageous with ceramic
brackets where high bond strengths have
been associated with enamel damage
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RMGIC'SRMGIC'S
Orthodontic use of GIC increased
with development of resin modified
GIC.
+
+10-20% resin monomers
GIC
RMGIC'SRMGIC'S
LIGHT OR CHEMICAL
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RMGIC'SRMGIC'S
Composition:
Polyacid +fluroalumino silicate Glass particles
Monomer+photoinitiator +light .
Monomer+initiator+ catalyst.
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Reaction TypeReaction Type
 Reaction Type - acid –base reaction
 polymerization (light –initiated)
 polymerization (chemical initiator )
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ADVANTAGESADVANTAGES
 Improved physical properties especially fracture
resistance.
 Stable hydrogels when compared with GIC.
 Capsulation helps in mixing with a trichurator.
 Polymerization proceeds faster than acid-base
reaction
 RMGIC-tolerates moisture similar to GIC's
 Maturation hardeming.
 Sustained fluoride release and caries inhibition
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Effect of brushing on fluoride
release from 3 bracket adhesives-
AJO DO Staley e tal.
Resin modified GIC bracketed
groups released morefluoride han the
other groups over the 93 days of
study.
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Silver et al AJO (1995) Found excellent long
term adhesion with such materials in the
absence of enamel etching .
Bishata et al: AJO (1999) Advised etching of
enamel for sufficient bond strength.
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Multicure GICMulticure GIC
Ortholux XT
GIC
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Multicure GICMulticure GIC
Manufactured by –3M- UNITEK
Features-slight blue tint of the cement for
easy clean up
Cherry flavour for pt acceptance
Adequate strength with in 40 sec of curing
with ortholux -XT .
Advantages-adhers to regular etched or
enhanced bands
Minimizing wash out by filling voids.
Sustained fluoride release.www.indiandentalacademy.com
CURRENT CATEGORIES OF ADHESIVECURRENT CATEGORIES OF ADHESIVE
BONDINGBONDING
1. Total etch adhesive bonding
2. Self - etch adhesive bonding
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Total- etch Adhesive bondingTotal- etch Adhesive bonding
Bonding or adhesion to the enamel is
done in the following procedure:
 1) Cleansing
2) Enamel conditioning or acid etching
 3) Priming
4) Bonding
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cleansingcleansing
To remove saliva,acquired pellicle,
different organic and inorganic
components of enamel and dentin.
Also improves wetting.
Pumice used
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Acid etchingAcid etching
Types of etchants :
Strong acids–37% phosphoric acid fpr 15sec
Weak acids -2.5% nitric acid (or) 7% maleic acid for
30­
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Etching in fluoridated teeth
Fluoride ion is incorporated into hydroxy-
apatite crystals and is resistant to acid-
dissolution which aids in prevention of
caries
Hence fluoridated teeth requires longer etching time
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Primers: Primers were invented to deal
with moist dentine problem.
They are difunctional .
 one end has affinity for hydrophilic
dentine and the other for hydrophobic
resin.
e. g HEM A (Hydroxy ethyl methacrylate)
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A Self etching primerA Self etching primer
A Self etching primer combines etchant
and primer in one chemical compound
 Contains bifunctional methacrylate base .
 Primers - penetrates into the exposed
rods .
Less evoparation,more stable viscosity,and
wetting capability due o unit dose package.
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Trans plus SEPTrans plus SEP
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Composition.Composition.
 Trans bond plus SEP CONSISTS OF 3
COMPARTMENTS.
 First compartment:methacrylated
phosphoric acid
esters,photosensitizers,stabilizers
 Second compartment:water & soluble
fluoride
 Third compart ment:Applicator microbrush.
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Chemical comparison of phosphoric acidChemical comparison of phosphoric acid
to self-etching primerto self-etching primer
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Trans bond plus & APCTrans bond plus & APC
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ArmamentariumArmamentarium
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PROCEDUREPROCEDURE
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procedureprocedure
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Scanning electron microscopeScanning electron microscope
observationobservation
Irregular but smooth hybrid layer,3-
4 mm thick irregular tag formation
with no apparent in dentations of
enamel prisms.
Minimal etching with SEP indicates
majority of bond may be more of a
chemical bond with calcium in the
enamel than mechanical bond.
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Scanning electron microscopeScanning electron microscope
observationobservation
Phosphoric acid etch Transbond plus
www.indiandentalacademy.com
Effects of blood contamination on the
shear bond strenghs of conventional and
hydro philic primers-AJO DO-2004
Vittorioo cacaiafesta e tal
Blood contamination of enamel during he
bonding procedure of conventional and
hydrophilic primers significantly lowers
their bond strength values and mig produce
a bond strength that not clinically adequate
www.indiandentalacademy.com
MIP,s - MOISTUREMIP,s - MOISTURE
INSENSITIVE PRIMERINSENSITIVE PRIMER
Arndt kloche et. al. Angle
orthodontist 2003 August.)
Hydrophilic primer - from 3rd
generation
Bonding can be
 Requires moisture for the initiation
of polymerization
www.indiandentalacademy.com
Commercially used MIPs
transbond
2. Assure
Ethyl alcohol 30-40% (Solvent) , Bis-GMA ,
- HEMA - Hydroxy ethyl methacrylate
(main Hydrophilic component) - CDMA -
Citric acid (allows greater cross linking) -
GDMA - Diluent + hydrophilic monomer
Same function as CDMA
 / The Hydrophilic monomer takes Oral
fluid & so fluoride uptake
- Acidic Co-polymer Greater cross linking
CPQ / Amine H2O - Solventwww.indiandentalacademy.com
Transbond™ MIP
Moisture Insensitive Primer
Transbond MIP primer offers bond strength in a
moist environment comparable to a conventional
primer in a dry environment
www.indiandentalacademy.com
www.indiandentalacademy.com
Adhesion promoters forAdhesion promoters for
orthodontic bondinqorthodontic bondinq
Adhesion promoters-are chemical
substances introduced to enhance the
bond with resin.
Used for increasing bond streangths.
Adhesion promotors used in case of
porcelain or gold resoratins.
Adhesion promoors are teremed as
MEGABOND 1,2,and 3(M-1,M-2,M-3)
www.indiandentalacademy.com
Adhesion promotorsAdhesion promotors
M-1:NTG – GMA -Magnesium Salt of N -
Tolylglycineglycidyl Methacrylate in acetone
and inhibitors.
M-2:PMGDM -Adiadduct of Glyercol
Dimethacrylate ­and pyrromellitic anhydride
In acetone.
M-3:Dimethyl paratoluidine in acetone.
M-1 & M-2 are used primarily for tooth
enamel surface where as M-3 & M-4 are used
for coaing mesh meal brackets
www.indiandentalacademy.com
The shear bond streangth was
increased from 9.0Mpa for the
control to 13.3Mpa(an increase of
48%) when adhesion promotors used.
Adhesion promoters ,their
effect on the bond strength of metal
brackets-AJO 1995
www.indiandentalacademy.com
BONDING TO GOLDBONDING TO GOLD
Until recently, bonding to gold and other
metals was considered difficult.
In the 1980's some adhesives - (Enamelite
500, Goldlink) etc and primers (fusion) -
were designed to allow such bonding.
 However, published reports and clinical
experience do not support their
effectiveness.
www.indiandentalacademy.com
There are 2 types of AdhesionThere are 2 types of Adhesion
promoters for goldpromoters for gold
 Resins with adhesive promotors .
eg-super bond c and b
-

Geristore
Super bond C & B is a metal bonding
adhesive and contains 4 – META 10-
MDP
www.indiandentalacademy.com
Intermediate primers:
eg. All bond 2 (Primers A & B)
and scotch bond multipurpose adhesive
system.
All bond 2 contains an organosilane agent -
BPDBM - Biphenyl dimethacrylate and NTC -
GMA bond accelerator
www.indiandentalacademy.com
Bonding to porcelainBonding to porcelain
Bonding to porcelain is also enhanced by the
use of adhesion promotors, principally organo
silanes.
 One difference from Gold is that an etching
process is used similar to conventional
etching.
 The etchant used is 2.5% Hydrofluoric acid
etch (porcelock).
The etching time in 90 secs.
 Hf acid dissolves the crystalline and glassy
phases of porcelain thus enhancing the
surface area and energy. www.indiandentalacademy.com
Chemistry of silane couplinqChemistry of silane couplinq
www.indiandentalacademy.com
Chemistry of silane couplinqChemistry of silane couplinq
Stage 1 Stage 2
Stage 3 www.indiandentalacademy.com
COMERCIALLY AVAILABLE ORGANOCOMERCIALLY AVAILABLE ORGANO
SILANESSILANES
Supplied in prehydrolysed form& hydrolysed
form
Pre hydrolysed form:eg scotch prime
hydrolysed form:eg ormo porcelain primer.
The pre hydrolysed form is unstable and has
a very short shelf life
www.indiandentalacademy.com
Bonding to amalgam restorationsBonding to amalgam restorations
 Micro-etching is essential for bonding to
amalgam and other non­precious metals.
 Small amalgam restorations no sand
blasting to be done
 Large amalgams should be sandblasted for
about 3 sec to provide an improved surface
for bonding.
www.indiandentalacademy.com
Bonding to acrylic and compositeBonding to acrylic and composite
restorationsrestorations
 An acrylic adhesive resin is preferred for
bonding Metal, plastic or ceramic brackets to
acrylic crowns.
The bond strength obtained, with the
addition of new composite to Mature
composite, is substantially less than the
cohesive strength of the Material.
www.indiandentalacademy.com
Fluoride releasing adhesivesFluoride releasing adhesives
Fluoride releasing adhesives is a relatively
recent advancement.Fluoride release:
Wiltshire et al have reported on the fluoride
release characteristics of various resins.
Most resins show an immediate release of
fluoride following bonding and thereafter
the levels of release decreases sharply and
levels of off
www.indiandentalacademy.com
Clinical comparision of the bond failure
rates between the fluoride releasing and
non- fluoride releasing composite resins-
JCO 2000 CHUN-HIS CHUNG,DMD,MS
This study demonstrates that a
fluoride –exchanging composite resin
such as phase II is clinically enough for
use as an orthodontic bonding.
www.indiandentalacademy.com
APC PLUS ADHESIVE SYSTEMAPC PLUS ADHESIVE SYSTEM
www.indiandentalacademy.com
APC plus adhesive systemAPC plus adhesive system
REDUCE BONDING STEPS.
COLOR CODED TO REMOVE EXCESS
FLASH.
MOISTURE TOLERENCE AND
FLUORIDE RELEASE
MORE STABILITY AND SHELF LIFE
CUTING BY ORTHOLUX.
www.indiandentalacademy.com
ConclusionConclusion
The future of adhesive dentistry is bright.The
scope for deepening in this pool is still
tremendous.This will require for more collabaration
between molecular biologists and polymer chemists
that has previously occurred
Commercialization of such technology can only
be done by large corporations that have both type
of scientists in their research and development
divisions.
www.indiandentalacademy.com
DR.TRIVENI MADAM
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Transbond XTTransbond XT
AdhesivKit in Syringes AdhesivKit in capsules
www.indiandentalacademy.com
Transbond™ XT Light CureTransbond™ XT Light Cure
AdhesiveAdhesive
 Bonds metal and ceramic brackets to tooth
surfaces.
 Available in both syringes and capsules,
 uses light cure adhesive technology.
 The viscosity of adhesive prevent adhesive run-on
and bracket skating that saves you money .
 reduces adhesive waste.
 easy application, increased control and convenience.
 A syringe delivery system is available too.
 Immediate archwire tie-inwww.indiandentalacademy.com
Transbond LR AdhesiveAdhesive
www.indiandentalacademy.com
Transbond™ LR AdhesiveTransbond™ LR Adhesive
Developed specifically for bonding lingual
retainers.
 Easy to apply,
 optimal handling characteristics .
working time is extended so accurate
placement is enhanced
 product waste is minimized
www.indiandentalacademy.com
Indirect Bonding AdhesiveIndirect Bonding Adhesive
The Sondhi™ Rapid-Set Indirect
Bonding Adhesive is revolutionary
from every angle. This lightly filled
resin cures in half the time (2
minutes vs. 4 minutes) of other
indirect adhesives, while achieving
two thirds of its bond strength within
the first five minutes
www.indiandentalacademy.com
 Designed to complement our APC™
Adhesive Coated Appliances, the Sondhi
Rapid-Set Indirect Bonding Adhesive
allows you to take full advantage of the
benefits of indirect bonding. More
accurate bracket placement; less bracket
repositioning; maximization of doctor time;
and compared to direct bonding, decreased
chair time and patient discomfort from
simultaneous bonding of all brackets
www.indiandentalacademy.com
From the doctor's angle, it means
less wasted time per patient and less
stress. It also means more control
over bracket placement second molar
to second molar, and a higher level of
precision, accuracy and strength. This
instills added confidence that the
doctor's goal, straight teeth, will be
accomplished.
www.indiandentalacademy.com
 From the patient's angle, it means a
faster, more comfortable, more
confident bonding experience. From the
business angle, it means more cost
effective use of doctor time.
Any way you look at it, indirect bonding
is superior with the Sondhi Rapid-Set
Indirect Bonding Adhesive
www.indiandentalacademy.com
 For fast orthodontic curing times andthe
convenience of untethered portability, your
best choice today is the Ortholux™ LED
Curing Light from 3M Unitek.
With the Ortholux LED light, there’s no
cord connecting the handpiece to a light
source. There’s no bulky equipment to get
in the way or impede chairside mobility.
And yet, with a small handheld unit, you
have curing times for orthodontic bonds
that are typically twice as fast as www.indiandentalacademy.com
 Advanced LED Technology is the Key
The Ortholux LED curing light uses one
blue LED (Light Emitting Diode) that emits
light in the 430-480 nm range at an
intensity of 1000 mW/cm2
. The light is
optimized specifically for the
polymerization of materials used in
orthodontic bonding. With LED technology,
there is no bulb to lose intensity or wear
out. Heat build-up is minimal, so there is no
need for a fan which uses battery power
and adds weight. Microprocessor-based
www.indiandentalacademy.com
 Convenience for You and the Patient
The Ortholux LED light is remarkably easy
to handle and use. The handpiece is
compact, sleek and weighs less than eight
ounces. The light guide rotates 360
degrees, making positioning easy for you,
and quick curing times enhance patient
comfort and shorten chair time.
www.indiandentalacademy.com

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update of orthodontic adhesives

  • 1. UPDATE OF ORTHODONTICUPDATE OF ORTHODONTIC ADHESIVESADHESIVES www.indiandentalacademy.com
  • 2. CONTENTSCONTENTS Introduction  Historical view  Development of epoxy resigns  Current resin developments  Development of polyelectrolyte cements and chemical  Adhesion  Some definitions  Theories of adhesion  Requirements of long lasting adhesion  Materials used as adhesion  Resins  Cements RMGIC  Bonding systems  Primers  Bonding to non-enamel surfaces www.indiandentalacademy.com
  • 3. INTRODUCTIONINTRODUCTION  The current trends in the development of adhesives attempts to simplify bonding steps and make them user friendly.Advances in different scientific disciplines, will enrich the pool from which ideas may be drawn in designing future adhesives .  It is probably on the molecule level that we see the greatest expansion of horizons and advances in biomimetics . Using the concept of controlled release,future adhesives may contain flourescent biosensitizers that can detect pH changes . www.indiandentalacademy.com
  • 4. HISTORICAL OVERVIEWHISTORICAL OVERVIEW  Research into bonding agents for attachment of resins to tooth structure was started in the early 1950s. •Ist attempt to develop an adhesion system for bonding acrylic resins to tooth structure was made by Haggers ,a swiss chemist working for the amalgamated dental company in London and Zurich in 1947. www.indiandentalacademy.com
  • 5. 1955 Buonocore conducted experiments on enamel surfaces employing a 30 sec treatment of 85% phosphoric acid to achieve a simple acid decalcification and found tremendous increase in surface area due to acid etching action by exposing the organic frame work of enamel www.indiandentalacademy.com
  • 6. In 1955 Buonocore and Brudevold selected sevriton as one material that seemed ideally suited for chemical combination with constituents of dentin but the role of methacrylic acid in establishing adhesion could not be continued www.indiandentalacademy.com
  • 7.  Further paper by Buonocore and Quigley in 1958 ,confirmed the earlier work of KRAMER and MC LEAN .  Hagger and mclean work remained dormant for a long period .  In 1961 work shop on adhesive restorative dental materials ,which was organized by Philips and which provide considerable impeus to future research . www.indiandentalacademy.com
  • 8. EPOXY RESINSEPOXY RESINS  Castain and Dr.Trey Freres ,Zurich ,made a major break through in polymer chemistry in 1937 with the invention of of epoxy resins made by condensation alkaline oxides with anhydrides of polybasic acids .  Epoxy resigns has formed the basis for most of the current composite resins in which vinyl groups were attached to the end groups of epoxy resin ,converting epoxy resign to dimethacrylate www.indiandentalacademy.com
  • 9. CURRENT RESIN DEVELOPMENTCURRENT RESIN DEVELOPMENT  In 1958 the first low shrinkag resin was produced by schmitt and purrman in germany. It was a low viscosiy epimine resins and marketed under trade name pcadurit .  In 1959 Bowen filed his first paten in the united states on his famous bis-GMA resin ,based on he epoxy molecule and produced a dental restorative material containing vinyl silane treated fused silica www.indiandentalacademy.com
  • 10.  Recently urethane dimethacrylate developed by knigh e tal for industrial use.later Loster and Walker made urethane dimethacrylate resin for use in resin - composite dental material.  Advantages of these new resins are ,higher molecular weigh ,low viscosiy ,certain degree of toughness in the urethane moiety ,together with less staining bis- GMA www.indiandentalacademy.com
  • 11. AdvantagesAdvantages Higher molecular weigh . low viscosiy . certain degree of toughness in the urethane moiety ,together with less staining bis-GMA . www.indiandentalacademy.com
  • 12. POLYELECTROLYTE CEMENTS ANDPOLYELECTROLYTE CEMENTS AND CHEMICAL ADHESIONCHEMICAL ADHESION  It is Another advancement in bonding restorative materials to tooth structure  Long term adhesion possible with out any preparation of tooth surface . Ian 1968 smith described about dental cements in which Zno powder could be reacted with poly acrylic acid. Zinc polycarboxylate cement were the first truly adhesive cements that could form chemical bonds with tooth structure,a major advance in dental adhesive chemistry . www.indiandentalacademy.com
  • 13.  Research in this field continoues and lead to production of first chemically adhesive tooth –colored restorative .  The GIC were initially described by Wilson and kent in 1971-it became anoher land mark in adhesive dentistry. www.indiandentalacademy.com
  • 14. DEFINATIONSDEFINATIONS  Adhesion "The state in which two surfaces are held together by interfacial forces which may consist of valence forces /interlocking forces or both.  Adhesive “Is a material frequently a viscous fluid that joins two surfaces together solidifies and therefore is able to transfer a load from one surface to the other.” Adherend  “ Material to which an adhesive applied is called Adherend “ www.indiandentalacademy.com
  • 15. MECHANISMS OF ADHESIONMECHANISMS OF ADHESION Mechanical adhesion  Adsorption adhesion  Electrostatic adhesion  Diffusion adhesion www.indiandentalacademy.com
  • 16.  Mechanical:Interlocking of adhesive with irregularities in the surface of the adherend www.indiandentalacademy.com
  • 17.  Adsorption is nothing but Chemical bonding between the adhesive and adherend  chemical bonding is of 2 types: 1.Primary chemical bonding 1. 2.Secondary chemical bonding Adsorption adhesion www.indiandentalacademy.com
  • 18. Electrostatic: There is an electrical double layer at the interface of a metal and polymer that is part of the total adhesive system www.indiandentalacademy.com
  • 19. Diffusion: Interlocking between mobile molecules, such as the adhesion of two polymers through diffusion of polymer chain ends across an interface www.indiandentalacademy.com
  • 20. REQUIREMENT FOR ADHESIVEREQUIREMENT FOR ADHESIVE SYSTEMSYSTEM  Wetting: An adhesive must give good wetting of the adherend.  Thickness: Too great thickness can lead to poor bond strength.  Viscosity: Adhesive should have a suitable viscosity to enable it to flow readily over the surface of adherend.  Strength: of the set adhesive must be taken into consideration.  Dimensional Stability: The setting time of the adhesive should occur without excessive dimensional changes i.e. little expansion or contraction www.indiandentalacademy.com
  • 21. RANGE OF ORTHODONTICRANGE OF ORTHODONTIC ADHESIVESADHESIVES  RESINS CEMENTS RESIN IONOMER HYBRIDS www.indiandentalacademy.com
  • 22. COMPONENTS OF A COMPOSITECOMPONENTS OF A COMPOSITE RESINRESIN  Dental composite resins are complex materials : 1. organic resin component that forms matrix . 2. Inorganic filler. 3. coupling (interfacial) agent, to unite the resin with the filler . 4. initiator system, to activate the setting mechanism . 5. stabilisers (inhibitors ). 6. pigments . www.indiandentalacademy.com
  • 23. ORGANIC RESIN COMPONENTORGANIC RESIN COMPONENT  Composite resins vary in their resin component but all the variations are diacrylates.  High­viscosity aromatic monomer:bis-GMA.  The lengthy diacrylate chains of this monomer minimise the polymerisation contraction. • Some systems contain oligomeric compounds based on urethane dimethacrylate to replace bis-GMA either partially or completely.. www.indiandentalacademy.com
  • 24.  Low-viscosity monomers:  TEGDMA , EGDMA and HEMA to facilitate clinical handling.  There must be carbon-carbon double bonds at each end of the monomer chain to allow polymerisation and cross-linking. www.indiandentalacademy.com
  • 25. Silica used generallySilica used generally Crystalline form Hard Stronger Difficult to finish and polish. Eg: crystobalite Tridymite Quartz. Non-crystalline Most popular fillers. Eg:silicate glass made of Zn,Yt,Ba. www.indiandentalacademy.com
  • 26. MACRO FILLERSMACRO FILLERS  Macrofiller – Made of glass, quartz or ceramic by crushing, grinding and sieving to achieve splinter-shaped particles.  The average size -formulations is 5-30 um. www.indiandentalacademy.com
  • 27. MICRO FILLER PARTICLESMICRO FILLER PARTICLES  Microfiller particles are amorphous silica (Si02) average diameter 0.0411-m  prepared by hydrolysis and precipitation.  They are radiolucent www.indiandentalacademy.com
  • 28. HYBRIDSHYBRIDS • In thehybrid materials, the average size is 0.5-8I1-m.  Barium (Ba), strontium (Sr) or lanthanum (La) glasses are usually included to provide radiopacity www.indiandentalacademy.com
  • 29. COUPLING AGENTCOUPLING AGENT  coupling agent - silane coupling agents  Composition: y-methacryloxyproptrimethoxysilane.  silane coupling affects: the durability of the composite resin , loss of the coupling releases particles and leads to surface breakdown.  The filler particles are treated with a silane coupling agent to produce a bond between the particles and the resin matrix www.indiandentalacademy.com
  • 30. Initiator systemInitiator system  light cure.  Chemical cure.  Dual cure.  light cure system: LED Plasma arc xenon uv-light www.indiandentalacademy.com
  • 31. Ortholux LED curing systemOrtholux LED curing system Ortholux LED curing systemOrtholux LED curing system emits light in the 430-480 nm range at an intensity of 1000 mW/cm2 . www.indiandentalacademy.com
  • 32. Organ laser light for rapid photo polymerization of resin composites- jco 2000. a statistically lower overall bond failure rate was found for organ laser(2.5%) curing ,when compared with conventional light curing (5.7%) www.indiandentalacademy.com
  • 33. Plasma arc versus halogen light –curing of adhesive precoated orthodontic brackes:A 12-month clinical sudy of bond failures.-AJO DO 2004 Vittorio cacca festa e tal Plasma arc lights can be considered an advantageous alternative to conventional light curing ,because they enable the clinician to reduce the curing time of adhesive precoated orthodontic brackets with significantly affecting the bond failure rate www.indiandentalacademy.com
  • 34.  Degree of conversion of 2 lingual retainer adhesives cured with different light sources-EJO 2005BY Serdar Usumez The results suggest that a similar or higher DC than the control values could be achieved in 6-9 sec by plasma arc curing,in 10-15 second by fast halogen curing,or in 20 sec by LED curing www.indiandentalacademy.com
  • 35. (CLASSIFICATION OF COMPOSITE(CLASSIFICATION OF COMPOSITE RESINSRESINS Lutz and Phillips (1983),classification based on the filler particle size and distribution.  is simple and logical www.indiandentalacademy.com
  • 36. TypeType 1.1. Macrofilled compositeMacrofilled composite resinresin This type contains only macrofiller particles and is usually referred to as 'conventional' or 'traditional'.  Largely because of the particle size, this type exhibits a pattern of unacceptable wear, both of itself and of the opposing tooth. www.indiandentalacademy.com
  • 37. TypeType 2.2. Microjilled composite resinMicrojilled composite resin The fillers in these composites are amorphous silica particles of 0.0411-m average diameter.  Four different particle groupings have been developed to maximise the filler loading while retaining acceptable clinical handling www.indiandentalacademy.com
  • 38. Homogeneous - consists of directly admixed microfillerparticles. Splintered prepolymerised particles- Size of prepolymerised particles or filler blocks is 80l1micrinm in size. Prepolymerised particle reduce polymeristion contraction www.indiandentalacademy.com
  • 39. Spherical prepolymerised particles. Particles of selected size allow optimal packing together.  Agglomerated microfiller complexes. The Si02 micro­filler particles are sintered to a porous mass and then ground to form coarse particles of agglomerated Si02 up to 2511-m in size. These are incorporated, with additional microfiller particles, into uncured resin. www.indiandentalacademy.com
  • 40. TypeType 3.3. Hybrid composite resinHybrid composite resin Also often known as 'small-particle composites'.  combination of macrofiller particles with a proportion of microfiller particles.  probably the most commonly used composite resins. The main variation is in the proportion and distribution of the various particles of different sizes www.indiandentalacademy.com
  • 41. Visible-light-activated systemsVisible-light-activated systems  Single paste visible light activated systems.  2 component initiator system-di ketone and tertiary amine.  Di ketone is usually 0.2 -0.7% camphoroquinone. absorbs the radiant energy or wavelength of approximately 470 nm (blue light). Activation of di ketone combines with the amine to form a complex that breaks down to release free radicals which then initiate polymerization of the resin. www.indiandentalacademy.com
  • 42. Transbond XTTransbond XT AdhesivKit in Syringes AdhesivKit in capsules www.indiandentalacademy.com
  • 43. Transbond™ XT Light CureTransbond™ XT Light Cure AdhesiveAdhesive  Bonds metal and ceramic brackets to tooth surfaces.  Available in both syringes and capsules,  uses light cure adhesive technology.  The viscosity of adhesive prevent adhesive run-on and bracket skating that saves you money .  reduces adhesive waste.  easy application, increased control and convenience.  A syringe delivery system is available too.  Immediate archwire tie-in www.indiandentalacademy.com
  • 45. Transbond™ LR AdhesiveTransbond™ LR Adhesive Developed specifically for bonding lingual retainers.  Easy to apply,  optimal handling characteristics . working time is extended so accurate placement is enhanced  product waste is minimized www.indiandentalacademy.com
  • 46. Chemically activated systemsChemically activated systems  Two-paste or powder-liquid systems. Initiator benzoyl peroxide, and tertiary aromatic amine accelerator  combination of the two parts will yield free radicals.  It is these radicals that will initiate polymerisation of the resin www.indiandentalacademy.com
  • 47. Other systems Dual-activated composites - both light- activated and a chemically activated initiation system .  packaged as two pastes. The light-activation mechanism is used to initiate polymerisation and the chemical- activation is relied upon to continue and complete the setting reaction. www.indiandentalacademy.com
  • 48. Unfilled resin-bonding agentsUnfilled resin-bonding agents  Advocated for improving adhesion  chemistry similar to the composite resin.  diluted by additional monomers to provide lower viscosity .  Mainly of 2 types: 1.enamel bonding agents 1. 2.dentin bonding agents www.indiandentalacademy.com
  • 50. EVOLVEEVOLVE starts with blue color and changes to natural shade after light cure HELPS TO REMOVE EXCESS FLASH. Color change compleats complete light cure and bond strength. Adhesive contain fluoride Available in push syrenge and pre loaded syrenge tips. www.indiandentalacademy.com
  • 51. ENAMEL BONDING AGENTSENAMEL BONDING AGENTS  Consists of unfilled liquid acrylic monomer placed on acid etched enamel.  micromechanical retention by resin tag formation on resin enamel interface.  Micro tags and macro tags are basis for micro mechanical retention.  Micro tags are more important because of their large number and great surface of contact.  On other side bonding agent co-polymerises with matrix phase of dental composite www.indiandentalacademy.com
  • 52. DENTIN BONDING AGENTSDENTIN BONDING AGENTS  Unless we understand dentin bonding and certain terminologies related to it we will not be able to follow the update of adhesives.  Disadvantages of Dentine Bonding: Smear Layer . Moist dentine. www.indiandentalacademy.com
  • 53. DENTIN BONDING AGENTSDENTIN BONDING AGENTS Un filled ,liquid acrylic monomer mixture placed onto acid conditioned and primed dentin surface www.indiandentalacademy.com
  • 54. GENERATIONS OF BONDINGGENERATIONS OF BONDING AGENTSAGENTS  Generations are nothing but evolution of bonding agents from 1955 to 2003.  There are 7 generations.  I - GENERATION Buonocore(1956) introduced.  Resin containing glycerophosphoric acid dimethacrylate.  Bowen introduced N­Phenyl Glycine & GlycidylMethacrylate (NPG-GMA)  Bonding-is by chelation of bonding agent to calcium of dentine www.indiandentalacademy.com
  • 55. Drawback:  Poor dentine bonding . Enamel bonding is good  Examples-The first commercial system of this type (Cervident, SS White). www.indiandentalacademy.com
  • 56. II - GENERATION (1978) Bis-GMA (or) HEMA were introduced which are unfilled resins which causes ionic bonding to the calcium in dentine. 1. Bonding to smear layerDraw Backs 2.require mechanical preparation www.indiandentalacademy.com
  • 57.  III - GENERATION  Principle: Partially removed (or) modified the smear layer  Etching opens dentinal tubules and primer META or BPDM modifies smear layer and attaches to composites.  Drawbacks:  Primer, does not penetrate the smear layer  Adhesive retention decreases after some time  Examples  Mirage bond, Scotch bond 2  Prisma Universal bond 2 and 3 www.indiandentalacademy.com
  • 58. IV - GENERATION  Complete removal of smear layer was attempted .  Total - etch technique. In the total etch - technique Orthophosphoric acid was used to etch enamel and dentin, simultaneously for 15 - 20 seconds  Moist - Dentine Concept. However, in order to avoid collagen collapse, primer solution is applied which can infiltrate the exposed collagen network forming hybrid layer. This is called moist dentin concept www.indiandentalacademy.com
  • 59. Hybridization: Replacement of hydroxy- apatite and water in the surface dentin with resin Hybrid: resin in combination with remaining collagen fibre www.indiandentalacademy.com
  • 60.  4th generation dentin bonding agents may be again described as  Etch (phosphoric acid) + Primer (NTG-GMA, N­ tolyglycine -glycidyl methacrylate) + Bond (Bis- GMAj TEGDMA  Examples  All bound-2 (BISCO), Scotch bond  Multipurpose (3M), Prime and bond www.indiandentalacademy.com
  • 61. v - GENERATION 1. One -Bottle System Primer and adhesives are combined into one solution. Show high bond strength values both to the etched enamel and dentin due to adhesive lateral branches and hybrid layer formation 2. Self etching primers www.indiandentalacademy.com
  • 62. Contents This system may be described as, E (phosphoric acid) + PB (PENTA, methacrylated phosphonates Examples One step (BiSCO), Single bond (3M), Clearfil SE bond (J MORITA). Opti bond solo (KERR www.indiandentalacademy.com
  • 63.  VI- GENERATION VIEtchng was not required at least at the dentinal interface. They contained dentin conditioning agent as one of their components. Described as EPB(METHACRYLAED PHOSPHATES) Drawbacks: Multiple components and multiple steps www.indiandentalacademy.com
  • 64. VII - GENERATION I-bond. Etching, priming, bonding all were combined into one step.  Shear bond strength not affected-any type of curing light .  Similar adhesion to prepared and unprepared enamel.  Desensitizers were added. www.indiandentalacademy.com
  • 65. CEMENTSCEMENTS  GLASS IONOMER CEMENTS  Invented -1969 reported in 1971 by WILSON AND KENT POWDER ; Flouroalumino silicate glass Liquid: Poly alkenoic acid (Carboxyl containing acid ) www.indiandentalacademy.com
  • 66.  Setting Reaction: The hydrogen ions of the acid attack the glass particles in the presence of water releasing calcium, strontium, and aluminium ions .  The metal ions combine with the carboxylic group of the polyacid to form the polyacid salts matrix and the glass surface is changed to a silica hydrogel.  Advantages  Fluoride release  Hydrogel phases  Moisture tolerance www.indiandentalacademy.com
  • 67.  Advantages  Fluoride release  Hydrogel phases  Moisture tolerance  Disadvantages  Bond strength less than that of composite Hydrogel phase: Responsible for the uptake and release of added environmental fluoride from topical gels, rinses & dentifrices www.indiandentalacademy.com
  • 68. Gic's used for bonding toGic's used for bonding to ceramic bracketsceramic brackets Cacciafesta et al (1998) (European journal of orthodontics) The lower bond strength of glass ionomer cements might be advantageous with ceramic brackets where high bond strengths have been associated with enamel damage www.indiandentalacademy.com
  • 69. RMGIC'SRMGIC'S Orthodontic use of GIC increased with development of resin modified GIC. + +10-20% resin monomers GIC RMGIC'SRMGIC'S LIGHT OR CHEMICAL www.indiandentalacademy.com
  • 70. RMGIC'SRMGIC'S Composition: Polyacid +fluroalumino silicate Glass particles Monomer+photoinitiator +light . Monomer+initiator+ catalyst. www.indiandentalacademy.com
  • 71. Reaction TypeReaction Type  Reaction Type - acid –base reaction  polymerization (light –initiated)  polymerization (chemical initiator ) www.indiandentalacademy.com
  • 72. ADVANTAGESADVANTAGES  Improved physical properties especially fracture resistance.  Stable hydrogels when compared with GIC.  Capsulation helps in mixing with a trichurator.  Polymerization proceeds faster than acid-base reaction  RMGIC-tolerates moisture similar to GIC's  Maturation hardeming.  Sustained fluoride release and caries inhibition www.indiandentalacademy.com
  • 73. Effect of brushing on fluoride release from 3 bracket adhesives- AJO DO Staley e tal. Resin modified GIC bracketed groups released morefluoride han the other groups over the 93 days of study. www.indiandentalacademy.com
  • 74. Silver et al AJO (1995) Found excellent long term adhesion with such materials in the absence of enamel etching . Bishata et al: AJO (1999) Advised etching of enamel for sufficient bond strength. www.indiandentalacademy.com
  • 75. Multicure GICMulticure GIC Ortholux XT GIC www.indiandentalacademy.com
  • 76. Multicure GICMulticure GIC Manufactured by –3M- UNITEK Features-slight blue tint of the cement for easy clean up Cherry flavour for pt acceptance Adequate strength with in 40 sec of curing with ortholux -XT . Advantages-adhers to regular etched or enhanced bands Minimizing wash out by filling voids. Sustained fluoride release.www.indiandentalacademy.com
  • 77. CURRENT CATEGORIES OF ADHESIVECURRENT CATEGORIES OF ADHESIVE BONDINGBONDING 1. Total etch adhesive bonding 2. Self - etch adhesive bonding www.indiandentalacademy.com
  • 78. Total- etch Adhesive bondingTotal- etch Adhesive bonding Bonding or adhesion to the enamel is done in the following procedure:  1) Cleansing 2) Enamel conditioning or acid etching  3) Priming 4) Bonding www.indiandentalacademy.com
  • 79. cleansingcleansing To remove saliva,acquired pellicle, different organic and inorganic components of enamel and dentin. Also improves wetting. Pumice used www.indiandentalacademy.com
  • 80. Acid etchingAcid etching Types of etchants : Strong acids–37% phosphoric acid fpr 15sec Weak acids -2.5% nitric acid (or) 7% maleic acid for 30­ www.indiandentalacademy.com
  • 81. Etching in fluoridated teeth Fluoride ion is incorporated into hydroxy- apatite crystals and is resistant to acid- dissolution which aids in prevention of caries Hence fluoridated teeth requires longer etching time www.indiandentalacademy.com
  • 82. Primers: Primers were invented to deal with moist dentine problem. They are difunctional .  one end has affinity for hydrophilic dentine and the other for hydrophobic resin. e. g HEM A (Hydroxy ethyl methacrylate) www.indiandentalacademy.com
  • 83. A Self etching primerA Self etching primer A Self etching primer combines etchant and primer in one chemical compound  Contains bifunctional methacrylate base .  Primers - penetrates into the exposed rods . Less evoparation,more stable viscosity,and wetting capability due o unit dose package. www.indiandentalacademy.com
  • 84. Trans plus SEPTrans plus SEP www.indiandentalacademy.com
  • 85. Composition.Composition.  Trans bond plus SEP CONSISTS OF 3 COMPARTMENTS.  First compartment:methacrylated phosphoric acid esters,photosensitizers,stabilizers  Second compartment:water & soluble fluoride  Third compart ment:Applicator microbrush. www.indiandentalacademy.com
  • 86. Chemical comparison of phosphoric acidChemical comparison of phosphoric acid to self-etching primerto self-etching primer www.indiandentalacademy.com
  • 88. Trans bond plus & APCTrans bond plus & APC www.indiandentalacademy.com
  • 92. Scanning electron microscopeScanning electron microscope observationobservation Irregular but smooth hybrid layer,3- 4 mm thick irregular tag formation with no apparent in dentations of enamel prisms. Minimal etching with SEP indicates majority of bond may be more of a chemical bond with calcium in the enamel than mechanical bond. www.indiandentalacademy.com
  • 93. Scanning electron microscopeScanning electron microscope observationobservation Phosphoric acid etch Transbond plus www.indiandentalacademy.com
  • 94. Effects of blood contamination on the shear bond strenghs of conventional and hydro philic primers-AJO DO-2004 Vittorioo cacaiafesta e tal Blood contamination of enamel during he bonding procedure of conventional and hydrophilic primers significantly lowers their bond strength values and mig produce a bond strength that not clinically adequate www.indiandentalacademy.com
  • 95. MIP,s - MOISTUREMIP,s - MOISTURE INSENSITIVE PRIMERINSENSITIVE PRIMER Arndt kloche et. al. Angle orthodontist 2003 August.) Hydrophilic primer - from 3rd generation Bonding can be  Requires moisture for the initiation of polymerization www.indiandentalacademy.com
  • 96. Commercially used MIPs transbond 2. Assure Ethyl alcohol 30-40% (Solvent) , Bis-GMA , - HEMA - Hydroxy ethyl methacrylate (main Hydrophilic component) - CDMA - Citric acid (allows greater cross linking) - GDMA - Diluent + hydrophilic monomer Same function as CDMA  / The Hydrophilic monomer takes Oral fluid & so fluoride uptake - Acidic Co-polymer Greater cross linking CPQ / Amine H2O - Solventwww.indiandentalacademy.com
  • 97. Transbond™ MIP Moisture Insensitive Primer Transbond MIP primer offers bond strength in a moist environment comparable to a conventional primer in a dry environment www.indiandentalacademy.com
  • 99. Adhesion promoters forAdhesion promoters for orthodontic bondinqorthodontic bondinq Adhesion promoters-are chemical substances introduced to enhance the bond with resin. Used for increasing bond streangths. Adhesion promotors used in case of porcelain or gold resoratins. Adhesion promoors are teremed as MEGABOND 1,2,and 3(M-1,M-2,M-3) www.indiandentalacademy.com
  • 100. Adhesion promotorsAdhesion promotors M-1:NTG – GMA -Magnesium Salt of N - Tolylglycineglycidyl Methacrylate in acetone and inhibitors. M-2:PMGDM -Adiadduct of Glyercol Dimethacrylate ­and pyrromellitic anhydride In acetone. M-3:Dimethyl paratoluidine in acetone. M-1 & M-2 are used primarily for tooth enamel surface where as M-3 & M-4 are used for coaing mesh meal brackets www.indiandentalacademy.com
  • 101. The shear bond streangth was increased from 9.0Mpa for the control to 13.3Mpa(an increase of 48%) when adhesion promotors used. Adhesion promoters ,their effect on the bond strength of metal brackets-AJO 1995 www.indiandentalacademy.com
  • 102. BONDING TO GOLDBONDING TO GOLD Until recently, bonding to gold and other metals was considered difficult. In the 1980's some adhesives - (Enamelite 500, Goldlink) etc and primers (fusion) - were designed to allow such bonding.  However, published reports and clinical experience do not support their effectiveness. www.indiandentalacademy.com
  • 103. There are 2 types of AdhesionThere are 2 types of Adhesion promoters for goldpromoters for gold  Resins with adhesive promotors . eg-super bond c and b -  Geristore Super bond C & B is a metal bonding adhesive and contains 4 – META 10- MDP www.indiandentalacademy.com
  • 104. Intermediate primers: eg. All bond 2 (Primers A & B) and scotch bond multipurpose adhesive system. All bond 2 contains an organosilane agent - BPDBM - Biphenyl dimethacrylate and NTC - GMA bond accelerator www.indiandentalacademy.com
  • 105. Bonding to porcelainBonding to porcelain Bonding to porcelain is also enhanced by the use of adhesion promotors, principally organo silanes.  One difference from Gold is that an etching process is used similar to conventional etching.  The etchant used is 2.5% Hydrofluoric acid etch (porcelock). The etching time in 90 secs.  Hf acid dissolves the crystalline and glassy phases of porcelain thus enhancing the surface area and energy. www.indiandentalacademy.com
  • 106. Chemistry of silane couplinqChemistry of silane couplinq www.indiandentalacademy.com
  • 107. Chemistry of silane couplinqChemistry of silane couplinq Stage 1 Stage 2 Stage 3 www.indiandentalacademy.com
  • 108. COMERCIALLY AVAILABLE ORGANOCOMERCIALLY AVAILABLE ORGANO SILANESSILANES Supplied in prehydrolysed form& hydrolysed form Pre hydrolysed form:eg scotch prime hydrolysed form:eg ormo porcelain primer. The pre hydrolysed form is unstable and has a very short shelf life www.indiandentalacademy.com
  • 109. Bonding to amalgam restorationsBonding to amalgam restorations  Micro-etching is essential for bonding to amalgam and other non­precious metals.  Small amalgam restorations no sand blasting to be done  Large amalgams should be sandblasted for about 3 sec to provide an improved surface for bonding. www.indiandentalacademy.com
  • 110. Bonding to acrylic and compositeBonding to acrylic and composite restorationsrestorations  An acrylic adhesive resin is preferred for bonding Metal, plastic or ceramic brackets to acrylic crowns. The bond strength obtained, with the addition of new composite to Mature composite, is substantially less than the cohesive strength of the Material. www.indiandentalacademy.com
  • 111. Fluoride releasing adhesivesFluoride releasing adhesives Fluoride releasing adhesives is a relatively recent advancement.Fluoride release: Wiltshire et al have reported on the fluoride release characteristics of various resins. Most resins show an immediate release of fluoride following bonding and thereafter the levels of release decreases sharply and levels of off www.indiandentalacademy.com
  • 112. Clinical comparision of the bond failure rates between the fluoride releasing and non- fluoride releasing composite resins- JCO 2000 CHUN-HIS CHUNG,DMD,MS This study demonstrates that a fluoride –exchanging composite resin such as phase II is clinically enough for use as an orthodontic bonding. www.indiandentalacademy.com
  • 113. APC PLUS ADHESIVE SYSTEMAPC PLUS ADHESIVE SYSTEM www.indiandentalacademy.com
  • 114. APC plus adhesive systemAPC plus adhesive system REDUCE BONDING STEPS. COLOR CODED TO REMOVE EXCESS FLASH. MOISTURE TOLERENCE AND FLUORIDE RELEASE MORE STABILITY AND SHELF LIFE CUTING BY ORTHOLUX. www.indiandentalacademy.com
  • 115. ConclusionConclusion The future of adhesive dentistry is bright.The scope for deepening in this pool is still tremendous.This will require for more collabaration between molecular biologists and polymer chemists that has previously occurred Commercialization of such technology can only be done by large corporations that have both type of scientists in their research and development divisions. www.indiandentalacademy.com
  • 123. Transbond XTTransbond XT AdhesivKit in Syringes AdhesivKit in capsules www.indiandentalacademy.com
  • 124. Transbond™ XT Light CureTransbond™ XT Light Cure AdhesiveAdhesive  Bonds metal and ceramic brackets to tooth surfaces.  Available in both syringes and capsules,  uses light cure adhesive technology.  The viscosity of adhesive prevent adhesive run-on and bracket skating that saves you money .  reduces adhesive waste.  easy application, increased control and convenience.  A syringe delivery system is available too.  Immediate archwire tie-inwww.indiandentalacademy.com
  • 126. Transbond™ LR AdhesiveTransbond™ LR Adhesive Developed specifically for bonding lingual retainers.  Easy to apply,  optimal handling characteristics . working time is extended so accurate placement is enhanced  product waste is minimized www.indiandentalacademy.com
  • 127. Indirect Bonding AdhesiveIndirect Bonding Adhesive The Sondhi™ Rapid-Set Indirect Bonding Adhesive is revolutionary from every angle. This lightly filled resin cures in half the time (2 minutes vs. 4 minutes) of other indirect adhesives, while achieving two thirds of its bond strength within the first five minutes www.indiandentalacademy.com
  • 128.  Designed to complement our APC™ Adhesive Coated Appliances, the Sondhi Rapid-Set Indirect Bonding Adhesive allows you to take full advantage of the benefits of indirect bonding. More accurate bracket placement; less bracket repositioning; maximization of doctor time; and compared to direct bonding, decreased chair time and patient discomfort from simultaneous bonding of all brackets www.indiandentalacademy.com
  • 129. From the doctor's angle, it means less wasted time per patient and less stress. It also means more control over bracket placement second molar to second molar, and a higher level of precision, accuracy and strength. This instills added confidence that the doctor's goal, straight teeth, will be accomplished. www.indiandentalacademy.com
  • 130.  From the patient's angle, it means a faster, more comfortable, more confident bonding experience. From the business angle, it means more cost effective use of doctor time. Any way you look at it, indirect bonding is superior with the Sondhi Rapid-Set Indirect Bonding Adhesive www.indiandentalacademy.com
  • 131.  For fast orthodontic curing times andthe convenience of untethered portability, your best choice today is the Ortholux™ LED Curing Light from 3M Unitek. With the Ortholux LED light, there’s no cord connecting the handpiece to a light source. There’s no bulky equipment to get in the way or impede chairside mobility. And yet, with a small handheld unit, you have curing times for orthodontic bonds that are typically twice as fast as www.indiandentalacademy.com
  • 132.  Advanced LED Technology is the Key The Ortholux LED curing light uses one blue LED (Light Emitting Diode) that emits light in the 430-480 nm range at an intensity of 1000 mW/cm2 . The light is optimized specifically for the polymerization of materials used in orthodontic bonding. With LED technology, there is no bulb to lose intensity or wear out. Heat build-up is minimal, so there is no need for a fan which uses battery power and adds weight. Microprocessor-based www.indiandentalacademy.com
  • 133.  Convenience for You and the Patient The Ortholux LED light is remarkably easy to handle and use. The handpiece is compact, sleek and weighs less than eight ounces. The light guide rotates 360 degrees, making positioning easy for you, and quick curing times enhance patient comfort and shorten chair time. www.indiandentalacademy.com