5 adhesion to dental tooth tissues 1
Operative dentistry
Egypt Cairo University
Palestine Gaza
Al Azhar University
Dr. Inas Alim
Uploaded by Dr. Lama El Banna
Recent advances have improved dental composite materials. Composites contain resin and inorganic fillers to increase strength while decreasing problems from resin such as shrinkage. Larger filler particles improve strength but smoothness while smaller fillers enhance esthetics. Novel composites aim to reduce shrinkage through techniques like silorane resin which uses a different polymerization or bulk fill which can be placed in 4mm layers. Other trends include nano-filled composites with ultra-small particles achieving high filler loading and strength, and smart composites which release ions to prevent decay. Indirect composites can be contoured outside the mouth but still experience shrinkage during cementation. Overall composites continue advancing but shrinkage remains a challenge.
7 adhesion to dental tooth tissue 3
Lecture number 6
Operative dentistry
Egypt Cairo University
Palestine Gaza
Al Azhar University
Dr. Inas Alim
Uploaded by Dr. Lama El Banna
This document discusses adhesion and bonding in dentistry. It begins by introducing the fundamental objective of creating adhesion between tooth structure and restorative materials. It then covers the principles of adhesion, including the different types of adhesion mechanisms. Some key factors and challenges that impact adhesion are surface energy, contact angle, wetting, surface contamination, and water content. The document reviews the history of bonding agents, from early experiments in the 1950s to the development of multi-step bonding systems. It also separates the discussion of enamel bonding agents from dentin bonding agents.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
This document provides an overview of dental adhesion and dentin bonding. It discusses the basic concepts and requirements of adhesion, applications of adhesive restorative techniques, enamel and dentin adhesion mechanisms, and challenges in dentin bonding. It also summarizes the generations of dentin bonding agents from the beginning in the 1950s to current techniques, noting limitations and improvements over time in bonding strength and stability of the bond. The goal has been to develop adhesive systems that can effectively bond to tooth structure, withstand stresses from polymerization, and resist degradation in the oral cavity.
This document provides information on the different generations of dentin bonding agents. It discusses the definitions and requirements of ideal bonding agents. It describes the mechanisms and challenges of bonding to enamel versus dentin. The development and limitations of first through seventh generation bonding agents are outlined, focusing on how newer generations aimed to simplify procedures and improve bond strength to dentin over time. The key aspects of enamel bonding, dentin bonding, and the role of the smear layer are summarized.
4th 5th 6th generation of bonding agentsIsraa Awadh
This document discusses the history and development of dental bonding techniques. It begins by defining bonding agents and outlining their components and ideal requirements. The challenges of bonding to dentin are then described. The document goes on to classify bonding techniques into generations from first to seventh generation, describing the characteristics of fourth, fifth and sixth generation bonding agents. Considerations for bonding to primary versus permanent dentin are also discussed, along with tips for optimizing bonding procedures. In conclusion, the document emphasizes that technique is more important than the specific bonding material used.
References
Clinical Applications For Dental assistants And Dental Hygienists ,3rd edition
Phillips’ Science of Dental Materials, 12th edition.
Sturdevant’s Art and Science of Operative Dentistry, 7th edition.
Dental Hard Tissues and Bonding Interfacial Phenomena and Related Properties , G. Eliades , D. C. Watts · T, Eliades (Eds.), 2005.
BASIC DENTAL MATERIALS, 3rd edition.
Textbook of OPERATIVE DENTISTRY By Nisha Garg & Amit Garg , 3rd edition , 2015.
Clinical Aspects Of Dental Materials Theory, Practice, and Cases
4th edition , 2013
Recent advances have improved dental composite materials. Composites contain resin and inorganic fillers to increase strength while decreasing problems from resin such as shrinkage. Larger filler particles improve strength but smoothness while smaller fillers enhance esthetics. Novel composites aim to reduce shrinkage through techniques like silorane resin which uses a different polymerization or bulk fill which can be placed in 4mm layers. Other trends include nano-filled composites with ultra-small particles achieving high filler loading and strength, and smart composites which release ions to prevent decay. Indirect composites can be contoured outside the mouth but still experience shrinkage during cementation. Overall composites continue advancing but shrinkage remains a challenge.
7 adhesion to dental tooth tissue 3
Lecture number 6
Operative dentistry
Egypt Cairo University
Palestine Gaza
Al Azhar University
Dr. Inas Alim
Uploaded by Dr. Lama El Banna
This document discusses adhesion and bonding in dentistry. It begins by introducing the fundamental objective of creating adhesion between tooth structure and restorative materials. It then covers the principles of adhesion, including the different types of adhesion mechanisms. Some key factors and challenges that impact adhesion are surface energy, contact angle, wetting, surface contamination, and water content. The document reviews the history of bonding agents, from early experiments in the 1950s to the development of multi-step bonding systems. It also separates the discussion of enamel bonding agents from dentin bonding agents.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
This document provides an overview of dental adhesion and dentin bonding. It discusses the basic concepts and requirements of adhesion, applications of adhesive restorative techniques, enamel and dentin adhesion mechanisms, and challenges in dentin bonding. It also summarizes the generations of dentin bonding agents from the beginning in the 1950s to current techniques, noting limitations and improvements over time in bonding strength and stability of the bond. The goal has been to develop adhesive systems that can effectively bond to tooth structure, withstand stresses from polymerization, and resist degradation in the oral cavity.
This document provides information on the different generations of dentin bonding agents. It discusses the definitions and requirements of ideal bonding agents. It describes the mechanisms and challenges of bonding to enamel versus dentin. The development and limitations of first through seventh generation bonding agents are outlined, focusing on how newer generations aimed to simplify procedures and improve bond strength to dentin over time. The key aspects of enamel bonding, dentin bonding, and the role of the smear layer are summarized.
4th 5th 6th generation of bonding agentsIsraa Awadh
This document discusses the history and development of dental bonding techniques. It begins by defining bonding agents and outlining their components and ideal requirements. The challenges of bonding to dentin are then described. The document goes on to classify bonding techniques into generations from first to seventh generation, describing the characteristics of fourth, fifth and sixth generation bonding agents. Considerations for bonding to primary versus permanent dentin are also discussed, along with tips for optimizing bonding procedures. In conclusion, the document emphasizes that technique is more important than the specific bonding material used.
References
Clinical Applications For Dental assistants And Dental Hygienists ,3rd edition
Phillips’ Science of Dental Materials, 12th edition.
Sturdevant’s Art and Science of Operative Dentistry, 7th edition.
Dental Hard Tissues and Bonding Interfacial Phenomena and Related Properties , G. Eliades , D. C. Watts · T, Eliades (Eds.), 2005.
BASIC DENTAL MATERIALS, 3rd edition.
Textbook of OPERATIVE DENTISTRY By Nisha Garg & Amit Garg , 3rd edition , 2015.
Clinical Aspects Of Dental Materials Theory, Practice, and Cases
4th edition , 2013
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides an overview of recent advances in composite resins. It discusses the introduction and advantages of various types of composites developed over time, including packable composites in 1995, flowable composites in 1996, ormocers in 1998, and bulkfill composites in 2010. The document also summarizes different photoinitiators, self-healing composites, giomers, and various commercial composite materials like Tetric Evo Ceram Bulkfill, SonicFill, and Filtek BulkFill.
Adhesion in dentistry involves bonding dental materials such as composites to tooth structure. There are two main types of adhesion - chemical and micromechanical. Chemical adhesion involves bonding between tooth and material molecules while micromechanical adhesion uses surface irregularities created by etching to mechanically interlock the material. Factors like surface energy and cleanliness influence adhesion. Conditioning times for enamel and dentin can affect bond strength, with some studies finding extended times increase strength for dentin but not enamel. High quality adhesion improves restoration retention and resistance to leakage and fracture.
Bonding to Enamel and Dentin Bonding to Enamel and DentinStephanie Chahrouk
1. Bonding agents allow for placement of aesthetic restorations like composites by bonding to enamel and dentin. Developments in bonding agents and composite materials as well as increased focus on aesthetics have boosted adhesive dentistry.
2. Bonding techniques minimize removal of tooth structure, manage sensitivity, reduce microleakage, and expand aesthetic options. Conditioning enamel with phosphoric acid increases surface area for bonding through resin tags.
3. Dentin requires both acid conditioning to remove the smear layer and expose collagen and priming to promote resin infiltration into demineralized dentin. Maintaining a moist environment is important for optimal dentin bonding.
This document discusses dentin bonding agents. It begins with an introduction to adhesive dentistry and the importance of bonding to enamel and dentin. It then covers the basic concepts of adhesion, mechanisms of dental adhesion, and factors that affect bonding. The document discusses the evolution of dentin bonding agents through multiple generations as the technology advanced. It provides details on the components of dentin bonding agents including etchants, primers, and adhesives. In summary, this document provides a comprehensive overview of dentin bonding agents and the principles behind adhesive dentistry.
This document discusses dental adhesives and their evolution over several generations. It describes improvements in adhesion to dental structures and materials, including the development of self-etching adhesives and single-component adhesives. The document also covers adhesive components, properties, application techniques, advantages and disadvantages. Key adhesive types discussed include etch-and-rinse systems, self-etch adhesives, and light-cured or dual-cured formulations. Diagrams and tables supplement the text.
1. Modified composites include nano-hybrids, nano-fills, and silorane resins which are designed to reduce polymerization shrinkage.
2. Nano-hybrids contain filler particles ranging from 0.02-2.5 μm while nano-fills contain filler clusters of 0.06-1.4 μm made of particles as small as 5-20 nm.
3. Silorane resins use an alternative monomer system compared to traditional Bis-GMA or UDMA monomers to achieve minimal shrinkage.
1) The document discusses the history and evolution of dental adhesives from the 1960s to present. It describes the different generations of adhesives from 1st/2nd generation that only bonded to enamel to current 7th generation self-etch adhesives.
2) Principles of adhesion to tooth structures are described including requirements for bonding to enamel versus dentin. The concept of the hybrid layer which enhances bonding to dentin is introduced.
3) Factors that influence post-operative sensitivity with total-etch adhesives are examined including overdrying of etched dentin. Advantages of self-etch adhesives in reducing post-operative sensitivity are summarized.
Dentin bonding has progressed through several generations of adhesives to improve bond strength and reduce technique sensitivity. The 8th generation features all-in-one bottle adhesives containing nanosized fillers that increase resin penetration and bond strength while maintaining simplicity of use. Water-based adhesives are primarily self-etching systems suitable for porous substrates, while acetone/ethanol systems require separate acid-etching but maintain a drier surface. Fluoride-releasing adhesives can strengthen bonds through acid-resistant zone formation while protecting against recurrent decay.
7 adhesion to dental tooth tissue 3
Lecture number 7
Operative dentistry
Egypt Cairo University
Palestine Gaza
Al Azhar University
Dr. Inas Alim
Uploaded by Dr. Lama El Banna
This document discusses dentin bonding agents. It provides background on adhesion and the challenges of bonding to dentin compared to enamel. Key points discussed include:
- Conditioning of dentin is needed to remove the smear layer and expose collagen fibers. This can be done chemically using acids or chelators.
- Primers are then used which contain both hydrophilic and hydrophobic monomers. They displace water from the moist collagen network and allow resin infiltration.
- The concept of "wet bonding" was introduced, in which acid-etched dentin is kept moist during bonding to maintain the expanded collagen network for resin penetration.
The document discusses the hybrid layer, which is the zone where adhesive resin micromechanically interlocks with demineralized dentin. It provides a brief history of the hybrid layer concept and covers topics like the goals of hybridization, formation of the hybrid layer, etching effects, zones within the hybrid layer, and degradation of the hybrid layer over time. The summary focuses on the key aspects and does not include specifics or examples from the document.
This document provides an overview of composite resin materials used in dental restorations. It defines composite resin as a compound of two or more materials with superior properties to the individual components. Composite resins are classified based on filler size, percentage, resin type, viscosity, and curing method. The document outlines the composition of composite resins including resin matrix, filler particles, coupling agents, and initiators. It discusses advantages like esthetics and disadvantages like polymerization shrinkage. Properties like coefficient of thermal expansion, wear resistance, water absorption, and mechanical properties are also covered.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Physical and Mechanical Properties of CompositesHeatherSeghi
The document discusses various physical and mechanical properties of dental composites, including biocompatibility, strength, wear resistance, polymerization shrinkage, degree of conversion, thermal conductivity, coefficient of thermal expansion, elastic modulus, water sorption, and radiopacity. It describes how properties such as strength, wear, shrinkage, conversion and modulus are affected by the composite's filler content and composition. Strategies for reducing shrinkage like incremental layering and use of prepolymerized filler are also covered.
Resin based composites(Recent Advances)Taduri Vivek
This document provides an overview of dental composites, including their history, classification, composition, properties, and recent developments. It discusses the key components of composites such as the resin matrix, fillers, coupling agents, and photoinitiators. It also summarizes the different types of composites based on particle size, polymerization method, and other characteristics. Recent innovations in composites include antibacterial, flowable, packable, compomers, and fiber-reinforced formulations.
This document discusses the history and evolution of dental adhesives from the first generation developed in the 1950s to the latest universal adhesive systems. It covers the various classifications of adhesives based on generation and mechanism of adhesion. The key mechanisms of adhesion to enamel and dentin are described, including the etch and rinse approach and self-etch adhesives. Factors affecting the bonding process and bond strength are also summarized.
Fundamental concepts of enamel and dentin adhesionRicha Singh
1. The document discusses the fundamental concepts of enamel and dentin adhesion, including the mechanisms of adhesion and classifications of dental adhesives.
2. It describes Buonocore's acid etch technique for bonding to enamel and the challenges of bonding to dentin, such as its structure, the smear layer, and stresses at the resin-dentin interface.
3. Current strategies for resin-dentin bonding are discussed, including etch-and-rinse adhesives and self-etch adhesives. Etch-and-rinse adhesives involve removing the smear layer with acid before bonding, while self-etch adhesives combine etching and priming into one step.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides an overview of recent advances in composite resins. It discusses the introduction and advantages of various types of composites developed over time, including packable composites in 1995, flowable composites in 1996, ormocers in 1998, and bulkfill composites in 2010. The document also summarizes different photoinitiators, self-healing composites, giomers, and various commercial composite materials like Tetric Evo Ceram Bulkfill, SonicFill, and Filtek BulkFill.
Adhesion in dentistry involves bonding dental materials such as composites to tooth structure. There are two main types of adhesion - chemical and micromechanical. Chemical adhesion involves bonding between tooth and material molecules while micromechanical adhesion uses surface irregularities created by etching to mechanically interlock the material. Factors like surface energy and cleanliness influence adhesion. Conditioning times for enamel and dentin can affect bond strength, with some studies finding extended times increase strength for dentin but not enamel. High quality adhesion improves restoration retention and resistance to leakage and fracture.
Bonding to Enamel and Dentin Bonding to Enamel and DentinStephanie Chahrouk
1. Bonding agents allow for placement of aesthetic restorations like composites by bonding to enamel and dentin. Developments in bonding agents and composite materials as well as increased focus on aesthetics have boosted adhesive dentistry.
2. Bonding techniques minimize removal of tooth structure, manage sensitivity, reduce microleakage, and expand aesthetic options. Conditioning enamel with phosphoric acid increases surface area for bonding through resin tags.
3. Dentin requires both acid conditioning to remove the smear layer and expose collagen and priming to promote resin infiltration into demineralized dentin. Maintaining a moist environment is important for optimal dentin bonding.
This document discusses dentin bonding agents. It begins with an introduction to adhesive dentistry and the importance of bonding to enamel and dentin. It then covers the basic concepts of adhesion, mechanisms of dental adhesion, and factors that affect bonding. The document discusses the evolution of dentin bonding agents through multiple generations as the technology advanced. It provides details on the components of dentin bonding agents including etchants, primers, and adhesives. In summary, this document provides a comprehensive overview of dentin bonding agents and the principles behind adhesive dentistry.
This document discusses dental adhesives and their evolution over several generations. It describes improvements in adhesion to dental structures and materials, including the development of self-etching adhesives and single-component adhesives. The document also covers adhesive components, properties, application techniques, advantages and disadvantages. Key adhesive types discussed include etch-and-rinse systems, self-etch adhesives, and light-cured or dual-cured formulations. Diagrams and tables supplement the text.
1. Modified composites include nano-hybrids, nano-fills, and silorane resins which are designed to reduce polymerization shrinkage.
2. Nano-hybrids contain filler particles ranging from 0.02-2.5 μm while nano-fills contain filler clusters of 0.06-1.4 μm made of particles as small as 5-20 nm.
3. Silorane resins use an alternative monomer system compared to traditional Bis-GMA or UDMA monomers to achieve minimal shrinkage.
1) The document discusses the history and evolution of dental adhesives from the 1960s to present. It describes the different generations of adhesives from 1st/2nd generation that only bonded to enamel to current 7th generation self-etch adhesives.
2) Principles of adhesion to tooth structures are described including requirements for bonding to enamel versus dentin. The concept of the hybrid layer which enhances bonding to dentin is introduced.
3) Factors that influence post-operative sensitivity with total-etch adhesives are examined including overdrying of etched dentin. Advantages of self-etch adhesives in reducing post-operative sensitivity are summarized.
Dentin bonding has progressed through several generations of adhesives to improve bond strength and reduce technique sensitivity. The 8th generation features all-in-one bottle adhesives containing nanosized fillers that increase resin penetration and bond strength while maintaining simplicity of use. Water-based adhesives are primarily self-etching systems suitable for porous substrates, while acetone/ethanol systems require separate acid-etching but maintain a drier surface. Fluoride-releasing adhesives can strengthen bonds through acid-resistant zone formation while protecting against recurrent decay.
7 adhesion to dental tooth tissue 3
Lecture number 7
Operative dentistry
Egypt Cairo University
Palestine Gaza
Al Azhar University
Dr. Inas Alim
Uploaded by Dr. Lama El Banna
This document discusses dentin bonding agents. It provides background on adhesion and the challenges of bonding to dentin compared to enamel. Key points discussed include:
- Conditioning of dentin is needed to remove the smear layer and expose collagen fibers. This can be done chemically using acids or chelators.
- Primers are then used which contain both hydrophilic and hydrophobic monomers. They displace water from the moist collagen network and allow resin infiltration.
- The concept of "wet bonding" was introduced, in which acid-etched dentin is kept moist during bonding to maintain the expanded collagen network for resin penetration.
The document discusses the hybrid layer, which is the zone where adhesive resin micromechanically interlocks with demineralized dentin. It provides a brief history of the hybrid layer concept and covers topics like the goals of hybridization, formation of the hybrid layer, etching effects, zones within the hybrid layer, and degradation of the hybrid layer over time. The summary focuses on the key aspects and does not include specifics or examples from the document.
This document provides an overview of composite resin materials used in dental restorations. It defines composite resin as a compound of two or more materials with superior properties to the individual components. Composite resins are classified based on filler size, percentage, resin type, viscosity, and curing method. The document outlines the composition of composite resins including resin matrix, filler particles, coupling agents, and initiators. It discusses advantages like esthetics and disadvantages like polymerization shrinkage. Properties like coefficient of thermal expansion, wear resistance, water absorption, and mechanical properties are also covered.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Physical and Mechanical Properties of CompositesHeatherSeghi
The document discusses various physical and mechanical properties of dental composites, including biocompatibility, strength, wear resistance, polymerization shrinkage, degree of conversion, thermal conductivity, coefficient of thermal expansion, elastic modulus, water sorption, and radiopacity. It describes how properties such as strength, wear, shrinkage, conversion and modulus are affected by the composite's filler content and composition. Strategies for reducing shrinkage like incremental layering and use of prepolymerized filler are also covered.
Resin based composites(Recent Advances)Taduri Vivek
This document provides an overview of dental composites, including their history, classification, composition, properties, and recent developments. It discusses the key components of composites such as the resin matrix, fillers, coupling agents, and photoinitiators. It also summarizes the different types of composites based on particle size, polymerization method, and other characteristics. Recent innovations in composites include antibacterial, flowable, packable, compomers, and fiber-reinforced formulations.
This document discusses the history and evolution of dental adhesives from the first generation developed in the 1950s to the latest universal adhesive systems. It covers the various classifications of adhesives based on generation and mechanism of adhesion. The key mechanisms of adhesion to enamel and dentin are described, including the etch and rinse approach and self-etch adhesives. Factors affecting the bonding process and bond strength are also summarized.
Fundamental concepts of enamel and dentin adhesionRicha Singh
1. The document discusses the fundamental concepts of enamel and dentin adhesion, including the mechanisms of adhesion and classifications of dental adhesives.
2. It describes Buonocore's acid etch technique for bonding to enamel and the challenges of bonding to dentin, such as its structure, the smear layer, and stresses at the resin-dentin interface.
3. Current strategies for resin-dentin bonding are discussed, including etch-and-rinse adhesives and self-etch adhesives. Etch-and-rinse adhesives involve removing the smear layer with acid before bonding, while self-etch adhesives combine etching and priming into one step.
The endo restorative interface, dcna 2010, ree & schwartzOpenWideGroup
This document summarizes current concepts regarding the endodontic-restorative interface. It discusses the importance of the coronal restoration for endodontic treatment success and how endodontic treatment impacts restorative outcomes. Key points covered include the limitations of bonding within the root canal system due to its unfavorable geometry for adhesion. Principles for restoring endodontically treated teeth emphasize cuspal coverage, preservation of tooth structure, and achieving an adequate ferrule effect. Posts are indicated when substantial coronal structure is lost and retention/resistance of a core buildup is compromised.
This document provides information on bonding in operative dentistry and enamel and dentin adhesion. It discusses the history and development of dental bonding agents from the 1950s to present. Key topics covered include the mechanism of adhesion, factors affecting adhesion to enamel and dentin, wet versus dry adhesion techniques, challenges with bonding, and the requirements for an ideal bonding agent. The document also defines important terms, discusses the components and removal of the smear layer, and compares adhesion to enamel versus dentin.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Bonding agents and its application in prosthodontics / dental implant coursesIndian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This study evaluated the clinical performance of a self-etching adhesive system (Clearfil SE Bond) and a one-bottle adhesive system (Prime&Bond NT) in non-carious Class V restorations over 2 years. 98 restorations were placed in 32 patients using the two adhesive systems. At 2 years, the retention rates were 93% for Clearfil SE Bond and 91% for Prime&Bond NT, showing very good clinical performance for both systems with no statistically significant differences in failure rates. A few restorations showed slight marginal discoloration or adaptation issues, but no restorations exhibited postoperative sensitivity, recurrent caries or changes in anatomical form.
The document discusses the history and development of dental bonding systems. It describes the key differences between first, second, and third generation bonding agents. First generation agents from the 1960s produced weak bonds of 2-3 MPa and had high failure rates. Second generation agents from the 1970s-1980s left the smear layer intact and achieved bonds of 4.5-6 MPa. Third generation "total-etch" systems from the 1990s removed the smear layer prior to bonding and produced stronger bonds of 16-26 MPa approaching that of enamel. The three-step approach of conditioning, priming, and applying adhesive resin was developed to strongly bond to both enamel and dentin.
This document discusses compatibility and clinical application of bonding systems. It notes that:
- 4th generation bonding systems are compatible with light, self, and dual-cure composites, while 5th generation systems require an activator to be compatible with self and dual-cure composites.
- Compatibility of bonding systems depends on whether they are total-etch or self-etch, and what generation they are.
- Bonding systems are used clinically for restorations, repairs, orthodontics, and more. Proper isolation, surface preparation, and application are important for success.
The document discusses the principles and evolution of adhesive dentistry. It explains that adhesive dentistry aims to create adhesion between tooth structure and restorative materials. Historically, acid etching of enamel by Buonocore in 1955 improved adhesion of acrylic resin to enamel and marked the beginning of adhesive dentistry. The document covers topics such as the principles of adhesion, mechanisms of adhesion, factors affecting adhesion, dentin bonding systems, classification of bonding agents, and challenges in adhesion.
This document discusses minimum thickness porcelain laminate veneers (PLVs). It provides a history of PLVs, beginning with the early "Hollywood Veneers" made of acrylic in the 1920s. In the 1980s, PLVs made of porcelain bonded to etched enamel became popular due to their esthetic and noninvasive nature. The document explores advances in materials, including pressed ceramics introduced in the 1990s. It recommends a minimal 0.5mm preparation and 0.5mm thick porcelain to be the most conservative and esthetic approach. Key factors in case selection and success of PLVs are also discussed.
Pulp protection in operative dentistry Nivedha Tina
This document discusses various materials used for pulp protection and their properties. It describes how remaining dentin thickness, depth of preparation, and prevention of bacterial microleakage are important factors for pulp health. Common pulp protection materials discussed include bases, liners, varnishes, and sealers. Calcium hydroxide and glass ionomer cements are highlighted as they promote reparative dentin formation, adhere to dentin, and release fluoride. The document emphasizes that proper isolation and sealing of restorations is key to preventing pulpal injury from bacteria and toxins.
Biomimic Dentistry in modern dentistry and dental materialsalinoori55
Biomimetic dentistry aims to preserve natural tooth structure and function by mimicking the properties and biomechanics of natural teeth. It emphasizes using techniques and materials that maximize adhesion while minimizing residual stress. In contrast to traditional dentistry which often requires more tooth preparation, biomimetic procedures preserve intact tooth structure through thin composite layers and indirect restorations. The goal is to restore teeth in a way that is biomechanically and aesthetically similar to natural teeth.
An interim prosthesis is a temporary dental restoration used while determining the effectiveness of a treatment plan or design of a definitive prosthesis. It must satisfy patient and dentist needs by protecting pulp, maintaining oral health, and establishing proper occlusion. Interim restorations can be custom made using impressions or prefabricated shells that are later adjusted. The direct technique forms the restoration directly in the mouth while indirect techniques use models to improve fit and reduce risks.
This document discusses adhesion and bonding in dentistry. It provides background on the history of adhesion, definitions of key terms, and the principles of adhesion. Specifically, it describes how adhesion is achieved through mechanical interlocking and various adhesion mechanisms for bonding dental materials to tooth structures like enamel and dentin. It discusses the role of surface properties, bonding agents, and clinical factors that influence adhesion. Methods for bonding various restorative materials like glass ionomers, amalgam, and ceramics are also covered.
Similar to 5 adhesion to dental tooth tissues 1 (20)
This document provides tips for creating successful content on TikTok. It discusses that raw, authentic content focused on providing value works best on TikTok rather than overly produced content. It recommends creating video series rather than focusing on trends. It also provides tips for using hashtags, posting regularly, engaging with your audience, and using hooks and titles to capture viewers' attention. The key takeaway is that TikTok rewards content that provides genuine value to viewers.
This document provides guidelines for preparing an investment proposal (PIN) to present to the Management Investment Committee (MIC) for evaluation. The PIN should address: 1) the profitability of the investment based on internal rate of return estimates, 2) available competitive strategies and the recommended strategy, 3) what must be done well to succeed, and 4) risks and opportunities and their potential impacts. If approved, the assumptions in the PIN will become the objectives for the business. Actual performance will later be compared to targets in a post-audit review at exit. Overhead and depreciation estimates are provided to aid financial evaluations.
The document outlines the key elements that make up a good project funding proposal, including an introduction describing the project aim and qualifications, a need statement, measurable objectives and goals, an evaluation plan, a budget summary and detailed budget, and plans for follow-up funding. A good proposal provides all necessary information on these elements to convince the funding agency to support the project.
The document discusses principles of oral surgery including access, visibility, and flap design. It states that adequate access requires wide mouth opening and retraction of tissues away from the surgical field. Improved access can be gained by creating surgical flaps using incisions. Key principles of incisions and flap design are outlined such as using a sharp blade, firm strokes, avoiding vital structures, and designing flaps to ensure adequate blood supply and healing. Common flap types including triangular, trapezoidal, envelope, and semilunar flaps are described. Careful handling of tissues is also emphasized to minimize damage.
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https://twitter.com/lama_k_banna
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Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name Correction of dentofacial deformities Part 2
Lecture 7
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Lecture 8 management of patients with orofacial cleftsLama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name management of patients with orofacial clefts
Lecture 8
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Lecture 5 Diagnosis and management of salivary gland disorders Part 2Lama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name Salivary gland 2
Diagnosis and management of salivary gland disorders Part 2
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Lecture 6 correction of dentofacial deformitiesLama K Banna
The document discusses epidemiological studies that estimate the prevalence of malocclusion and dentofacial deformities in the United States population. The National Health and Nutrition Examination Survey found that approximately 2% of the US population has severe mandibular deficiency or vertical maxillary excess, while other abnormalities such as mandibular excess or open bite affect about 0.3-0.1% of the population. Overall, about 2.7% of Americans may have dentofacial deformities severe enough to require surgical treatment along with orthodontics.
lecture 4 Diagnosis and management of salivary gland disordersLama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name Salivary gland
Diagnosis and management of salivary gland disorders
Al Azhar University Gaza Palestine
Dr. Lama El Banna
This document discusses principles of managing panfacial fractures, including anatomic considerations of the craniofacial skeleton and buttresses. It describes two main theories for management: bottom up/inside out and top down/outside in. Reduction, fixation, immobilization and early return of function are discussed. Closed reduction uses manipulation without visualization, while open reduction allows visualization but requires surgery. Various fixation methods are outlined, including arch bars, wiring techniques, and maxillomandibular fixation.
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name maxillofacial trauma part 2
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
3. Adhesive Dentistry is a, relatively, new field that has
totally revolutionized the face of dentistry.
It is based on the concept of adhesion and totally covers
the areas of anterior & posterior cosmetic restorations
3
4. Innovations in dentistry have always been related to the
development of new materials , techniques &equipments
and thus , were always subject to changing and
disappearing with the evolution of newer ones.
For the first time, the innovation related to adhesion is
concept related , whereas the materials & techniques are
revolving and changing around this concept to satisfy it
and improve it without changing it .
4
5. The dream of restorative dentistry has always been to
develop a material that would totally bond to tooth
structure in such a way that , both the tooth and
material, would act & react as being one single unit .
5
6. The concept of adhesion and its application in
dentistry has made this dream become, relatively
very close , but it has to be understood that , in
spite of all the advancements that were achieved in
this field, it still is in an infant stage .
Thus , in all adhesive dental systems , one should
still expect islands of attachments separated by
areas of non-attachment .
6
7. Historical breakthroughs in adhesive dentistry
1- Experiments on bonding acrylic resin to enamel & dentin
began in the early fifties with Dr. Oscar Hugger in
England who developed a monomer based on
glycerophosphoric acid .
7
8. Historical breakthroughs in adhesive dentistry
2- In 1955 , Dr.Michael Buonocore in usa, made the most
important advance in this field by identifying the
occurrence of micromechanical adhesion to enamel
through acid etching .
Buonocore is considered to be the father of adhesive
dentistry . This innovation was not fully recognized in our
profession until the early 70’s .
8
9. Historical breakthroughs in adhesive dentistry
3- In 1979 , Dr.Fusayama in Japan advocated etching and
conditioning of dentin using phosphoric acid , starting a
new era in this fascinating field .
9
10. Terminology
Adhesion is the bonding of dissimilar materials by the
attraction of atoms or molecules.
Adhesive is the material used to produce adhesion ,
and is always a liquid.
Adherend is the surface to which the adhesive is applied,
and is always a solid.
The components of an adhesive system are present in the
process of restoring teeth ,i.e, the tooth tissues ( enamel
& dentin ) represent the adherend while the adhesive
restorative material represents the adhesive .
10
11. Wetting
It is very difficult to make two solid surfaces to adhere
completely, Regardless of how smooth their surfaces
appear to be, they are likely to be rough when
considered on a microscopic level.
When they are placed in apposition, only the high spots
will be in contact.
One method to overcome this , is to place a fluid between
them which will flow into the irregularities and provide
for a wider area of contact between the two solid
surfaces.
11
12. So, wetting is the degree of spreading of one drop
of liquid on a solid surface, and is measured by
the contact angle.
12
13. Contact angle is the angle formed by the adhesive with the
adherend at their interface.
It may be 0 or 180 degrees = maximum adhesion
less than 90 degrees = moderate adhesion
more than 90 degrees = poor adhesion
13
14. Mechanisms of adhesion in restorative dentistry:
1- Chemical or true adhesion where there is bonding at
the atomic or molecular level.
2- Mechanical attachment based on the old mechanical
retention concept . The adhesive flows into the pores of
the adherend where it hardens and interlocks.
14
15. Retention of adhesive restorations in cavities have not
shifted from the old Black's retention principle, which
relies on interlocking of restorative materials in
undercuts created inside the cavity .
Retention of adhesive restorations relies upon the same
mechanical principle , but on a microscopic level
(micro-retention) , aided by some degree of chemical
attachment which is present with the new adhesive
systems.
So , retention of adhesive restorations in our modern
practice is mechanico-chemical in nature .
15
16. A reliable and durable adhesive junction between the tooth
tissues and the adhesive restorative material is mandatory
for the successful clinical performance of the restoration,
in terms of retention, cosmetics and proper marginal seal .
Furthermore, the longevity of this reliable junction under
the destructive rigors which are present inside the oral
cavity represents the greatest challenge that faces our
adhesive practice .
16
17. Clinical significance of adhesion ( benefits )
1- Inhibition of marginal leakage which refers the ingress
of
saliva ,food debris , microorganisms and stains at the
tooth-restoration interface with its sequelae of recurrent
caries , hypersensitivity , discoloration , looseness of the
restoration and possible pulp involvement.
2- Re-inforcement of the tooth since adhesion bonds the
restorative material to the remaining tooth structure,
making them to behave clinically as one single structural
entity in sustaining and distributing the forces of
mastication . 17
18. 3- Solving the problem of retention especially in anterior
teeth, where trying to establish adequate mechanical
retentive features through undercutting would involve
more destruction & weakening of the tooth, if not
impossible at all &/or would not be sufficient to retain
the restorative material securely in place .
4- Adjusting esthetic defects without the need to grossly
reduce the teeth for crowning ( anterior cavities ,
minor discolorations , diastemas , malformed teeth ,
facings…)
5- Fulfilling the requisite of the modern esthetic practice
in placing successful posterior cosmetic restorations.
18
19. Requirements of a successful adhesive bond:
1- High bond strength values
- Bond strength to enamel should be equal or very close
to that to dentin, otherwise stresses might concentrate
at the interface with subsequent debonding and failure
- Bond strength values of 17-20 Mpa are required to
counteract the shrinkage stresses of composites during
polymerization , and even higher values are required
to resist mastication forces without failure .
- Recent adhesive systems have reached bond strength
values of 34-45 Mpa and even more as claimed by
some products.
19
20. 2- Elimination of voids at the interface
- The presence of voids at the interface, even in small &
separate areas, would disturb the structural continuity
of the tooth-restoration system, inviting leakage,
stress concentration, cracks formation and their
propagation with eventual debonding and failure.
- Voids are , unavoidably , present in all adhesive resin
systems, due to the polymerization shrinkage of the
material its incomplete polymerization , as well as
because of the inconsistent demineralization of the tooth
tissues.
20
21. 3- Stability and longevity
- The adhesive joint should be free from any dimensional
changes due to hardening or thermal changes, should
remain hydrolytically stable and should resist
biodegradation in the oral cavity.
- The long-term stability and longevity of an efficient
adhesive junction in the oral cavity is still very much
questionable and full of speculations because of the
complex interacting damaging rigors which are present
in the mouth ( stresses, temperature & PH fluctuations,
saliva, microorganisms as well as the heterogenicity of
the tooth tissues…) .
21
22. Properties that should be present in the tooth tissues
(adherend) and in the adhesive in order to provide for
a successful adhesive system
1- The tooth tissues should have a high surface energy to be
able to attract the atoms of the adhesive.
2- The tooth tissues should be clean and dry to provide for
direct apposition of the adhesive against these tissues.
3- The adhesive should have a low surface tension and low
viscosity to be able to properly wet the tooth tissues.
4- The adhesive should be biocompatible with the
dentin-pulp organ .
22
23. 5- The adhesive should contain both, hydrophilic
components to displace water and properly penetrate the
tooth surface ,and hydrophobic components to co-
polymerize with the composite resin material .
6- The adhesive should provide for some degree of
chemical bond with the tooth tissues , although the
longevity of this bond in the oral cavity is still not reliable
23
24. Bonding to tooth tissues
- Bonding to enamel & dentin is basically mechanical in
nature , and depends on the interlocking of an
intermediate adhesive layer ( bonding agent ) inside the
micro-pores created inside enamel and dentin through
etching and conditioning.
- An impregnated hybrid layer is thus formed from resin
and tooth tissues and co-polymerizes with the composite
material .
24
25. Bonding to tooth tissues
- Recent adhesive systems provide for some degree of
chemical attachment to tooth substrate through chelation
of Ca ions of the tooth tissues ( bonding to Ca in the
hydroxyapatite crystals ), or through bonding to the
collagen of dentin trough cross-linking .
25
27. Bonding to dentin is more difficult,complicated and less
reliable than bonding to enamel due to the following
facts :
1- Dentin contains a much lower percentage of inorganic
components ( 65% as compared to 95% in enamel )
which provides for less micro-pores formation with
surface conditioning and decalcification.
2- The surface energy of conditioned dentin surface is
much lower than that of enamel, and hence its capability
to attract molecules of the adhesive is weaker.
3- The presence of the smear layer on the surface of cut
dentin significantly reduces adhesion, unless it is dealt
with and removed .
27
28. 4- The structure of dentin is heterogenous ( less
homogenous than that of enamel,) because it contains
a much more significant amount of water , which
requires a bonding agent than can compete with
water and remove it to properly wet the surface .
5- This is further complicated by the inter-tubular
dentinal fluid that runs inside the dentinal tubules
under a constant positive pressure of 25-30 mm Hg .
6- The dentinal tubules are not regular nor consistent in
their number nor sizes , as they vary with alterations
in location and depth within the same tooth as well as
from one tooth to the other .
28
30. Development of dentin bonding agents
1-First generation bonding agents
- A co-monomer was used ( primer ) to react chemically
with the inorganic Ca hydroxyapatite &/ or with the
collagen of dentin , e.g. NPG-GMA
( N-phenylglycineglycidylmethacrtlate )
- This system was not successful as it provided for low
bond strength values ( 2-3 Mpa ) .
2-Second generation bonding systems ( phosphate
bonding agents )
- Phosphate esters were added to the BIS-GMA resins in
an attempt to bond chemically with the phosphate and
calcium of dentin .
- This system was hydrolytically unstable and provided
for low bond strength values ( 2-7 Mpa )
30
31. 3- Third generation bonding agents
- These are the first systems that advocated conditioning of
dentin with acids to modify or remove the smear layer .
- This generation represents one of the major breakthroughs
in adhesives and bonding. After the primer was added, an
unfilled resin was placed on both dentin and enamel.
- The weak link with this generation was the unfilled resins
that simply did not penetrate the smear layer effectively.
- 4- Fourth generation bonding agents
- This generation of bonding agents introduced the wet
bonding technique ( bonding to moist dentin.)
- It is considered to be the basis for all the recent dentin
bonding systems as it provided for much higher bond
strength values ( up to 27 Mpa ) and exhibited a fairly good
durability . 31
32. 5-Fifth generations dentin bonding agents
introduced to minimize the clinical steps of
bonding by amalgamating more than one step together,
e.g., etching followed by one single agent containing
both the primer and the adhesive .
6. sixth generation dentin bonding agents
sought to eliminate the etching step, or to include it
chemically in one of the other steps: (self-etching primer
+ adhesive) acidic primer applied to tooth first, followed
by adhesive or (self-etching adhesive) two bottles or unit
dose containing acidic primer and adhesive.
32
33. 7.The seventh generation or all-in-one-bottle:
It’s a self-etching system represents the latest simplification
of adhesive systems. With these systems, all the ingredients
required for bonding are placed in and delivered from a
single bottle
8. Eighth Generation dentine bonding agents:
Self etch which contains nanosized fillers by the addition
of nano-fillers with an average particle size of 12 nm that
increases the penetration of resin monomers and the hybrid
layer thickness, which in turn improves the mechanical
properties of the bonding systems.
Nano-bonding agents are solutions of nano-fillers, which
produce better enamel and dentin bond strength, stress
absorption, and longer shelf life
33
34. Classification of dental adhesives(according to clinical
application steps)
- Contemporary adhesives exhibit an common adhesion
mechanism of hybridization ( a process of micro-
mechanical interlocking occurring by the infiltration of
resin into demineralized substrate , creating a resin-
infiltrated hybrid layer) .
- This classification was described , in 2001 , by Van
Meerbeek and was based on the clinical steps of
application.
34
36. - Types of adhesives
1-Etch & rinse adhesives(smear layer removing)
a- three steps : etching , priming and bonding are done
in 3 separate steps.
b- two steps : etching is in one step and primer and
bonding in one step ( incorporated in
one bottle ) .
Etch& rinse adhesives represent the golden standards for
adhesives with proven long-term success.
2- Self-etch adhesives (smear layer dissolving)
No separate etching step.
a- two steps : acidic primer in one bottle and an
adhesive in another bottle .
b- all-in-one : acid , primer and adhesive in one
single bottle .
36
41. The nanoleakage
phenomenon, which is
basically the presence of
submicrometer-sized gaps
within the hybrid layer.
it is considered as a
manifestation of incomplete
resin infiltration of the
hybrid layer and of a
discrepancy between the
depth of demineralization
and the depth of resin
infiltration.
Or due to poor adaptation
and envelopment of the
resin to the collagen ,fibrils,
leaving microscopic gaps.
41
42. Self-etch adhesives are further classified according to their
acidity or aggressiveness into mild (pH more than 2),
intermediate (pH = 1.5) & strong (pH less than 1) .
Self-etch adhesives simplify the clinical steps , reduce post-
operative sensitivity( do not increase dentin permeability),
but exhibit lower bond strength values .
3-Glass ionomer adhesives (smear layer modifying)
Based on the glass ionomer self adhesive capacity technology.
Conditioning of dentin with weak acids ( 10-20% polyacrylic
acid) removes the smear layer and leaves the smear plugs.
These adhesives are simple to apply but exhibit low bond
strength values .
42
45. In particular, the high concentrations of water have
raised questions about potentially harmful effects
on polymerization, given that incomplete water
removal can cause water trees.
This also applies for the high concentrations of
solvent that may cause incomplete resin
polymerization in case of incomplete evaporation.
45
49. Universal adhesive
systems/“multi-mode″ or ″multi-
purpose″ adhesives:
they may be used as self-etch
(SE) adhesives, etch-and-rinse
(ER) adhesives, or as SE
adhesives on dentin and ER
adhesives on enamel (a technique
commonly referred to as
“selective enamel etching)
49
50. The composition of universal adhesive differs from the current
SE systems by the incorporation of monomers that are capable
of producing chemical and micromechanical bond adhesion to
the dental substrates
It contains specific carboxylate and/or phosphate monomers
that bond ionically to calcium found in hydroxyapatite. For
example, Methacryloyloxydecyl Dihydrogen phosphate (MDP)
is a functional monomer found in certain new adhesives that
helps promote strong adhesion to the tooth surface via
formation of non-soluble Ca2salts.
50
51. Steps of bonding
A- Selective acid demineralization (etching , conditioning)
- Aiming at decalcifying & removing part of the inorganic content in
order to create microscopic undercuts where the adhesive material
can flow & at cleaning the enamel and dentin walls from
any contaminants that might , adversely , affect bonding .
- In enamel , it selectively decalcifies the enamel rods ,creating
interprismatic pores. Properly etched enamel looks chalky white
in appearance.
- In dentin , it removes the smear layer , creates inter-tubular &
peri-tubular pores and exposes the dentin collagen , to chemically
aid in bonding .
- Both enamel & dentin are etched with the same etchant in one
single step “ whole-etch technique” .
51
54. SEM micrograph of a resin-
dentin interface
A, Adhesive; D, residual dentin;
H, hybrid layer; T, resin tag.
54
55. - Types of acids most commonly used are phosphoric acid (10-37%)
and maleic acid (10%) .
- The acid is supplied in the liquid or gel forms with different colors.
- It is applied with a small brush, a small piece of sponge or with the
disposable tip of an injectable syringe for a length of time of approx.
15-30 sec.
- The etchant must be thoroughly washed away with water to remove
all the etched products , then enamel and dentin are dried with oil-free
compressed air .
B- Priming
- Aiming at increasing the wettability of enamel & dentin.
- Primers are adhesion promoting monomers (HEMA) containing
both hydrophilic & hydrophobic molecules.
- The hydrophilic part increases the wettability & permeability of the
demineralized enamel and dentin, while the hydrophobic part
55
56. penetrates inside the created pores where it polymerizes forming
retention tags inside them from the tooth-tissue side , and
co-polymerizes with the subsequently applied bonding agent from
the outer side .
- Acid- etched enamel has high surface energy , whereas etching of
dentin decreases its surface energy because of the high protein
content after etching (exposed collagen) , in addition to the fact
that its permeability and wetness increase, which hinder
adhesion furthermore.
- So , the primer is essential to ensure sufficient wetting of dentin,
displace residual water and carry the monomer inside the created
micro-porosities.
- The primer , usually, contains organic solvents (acetone or
ethanol) which act as water chasers , displacing water from
dentinal surfaces ,thus promoting the infiltration of monomers
through the exposed collagen .
56
57. - The primer is applied with small brushes or sponges ,is subjected
to a light stream of air to spread it(not the extent of removing it
or to cause collapse of the collagen bundles) , and is then left
undisturbed for at least 15 sec. ( enamel & dentin must appear
glossy after air spraying of the primer ) .
C- Bonding agent (adhesive resin)
- Is a solvent-free ,low viscosity filled or unfilled solution
containing mainly, hydrophobic monomers.
- It co-polymerizes with the primer that has penetrated the
undercuts from one side and with the subsequently applied
composite resin from the other side .
- It is applied with a brush or small sponge , gently air-thinned and
light cured .
- This is the final step in bonding , and is followed by the
application of the composite resin .
57
58. E. & D. etching Chalky white appearance
of Enamel
Priming
Glossy surface
58
60. Smear layer
- Following cutting of dentin with rotary tools, a layer 2-5 microns
in thickness is formed on the surface of dentin . This layer is
loosely attached to dentin , but is burnished on the cut dentin
surface by the effect of heat and pressure during cutting and
cannot be removed by rinsing .
- It is formed of cut dentin chips , hydroxyapatite crystals,
collagen , saliva & blood and it incorporates microorganisms .
- Advantages of this layer is that it plugs the dentinal tubules and
reduces the flow of dentinal fluids(reduces dentin permeability),
thus providing for a drier surface for bonding and minimizing
post-operative hypersensitivity .
- Disadvantages of this layer is that it is loosely attached to the
underlying dentin providing for weak bonding and it
incorporates microorganisms .
60
61. - Adhesive systems should totally remove this smear layer ,or
penetrate through it to provide for efficient bonding .
- Etch-and-rinse adhesives totally remove the smear layer .
- Self-etch-adhesives dissolve the smear layer and incorporate it into
the hybrid layer .
- Glass ionomer-adhesives remove the smear layer and leaves the
smear plugs .
61
62. Wet bonding versus dry bonding
- Following etching & rinsing , enamel and dentin present different
conditions for priming & bonding .
- Whereas enamel should be dry to provide for good bonding ,
dentin should be a little wet to prevent collapse of its collagen
bundles , representing two totally opposing clinical conditions .
- Two approaches can be followed, depending on the type of
adhesive system used :
a- dry bonding technique which involves air drying of enamel
& dentin and applying a water-based primer capable of re-
expanding the collapsed collagen network .
b- wet bonding technique which leaves dentin a little moist to
prevent collapse of the collagen and use a solvent-containing
primer to chase water from both dentin and enamel .
- Wet bonding technique is more consistent and reliable .
62