An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
Colour and Shade Selection in dental practiseSNEHA RATNANI
Shade selection is an extremely important aspect of aesthetic dentistry.One must have thorough knowledge of colour and shade selection before carrying out any restorative procedures in patients mouth. A brief seminar on colour and shade selection has been penned down here. Hope it helps u fetch some information regarding shade selection and colour in dentistry.
The presentation depicts in a very simplified manner the steps of cavity preparation and restoration of class 3 and class 5 composite restoration. It is well supported with illustrations that further provide a better understanding of the topic.
Colour and Shade Selection in dental practiseSNEHA RATNANI
Shade selection is an extremely important aspect of aesthetic dentistry.One must have thorough knowledge of colour and shade selection before carrying out any restorative procedures in patients mouth. A brief seminar on colour and shade selection has been penned down here. Hope it helps u fetch some information regarding shade selection and colour in dentistry.
The presentation depicts in a very simplified manner the steps of cavity preparation and restoration of class 3 and class 5 composite restoration. It is well supported with illustrations that further provide a better understanding of the topic.
The simplicity of bonding can be misleading. The technique undoubtedly can be misused, not only by an inexperienced clinician but also by more experienced orthodontists who do not perform procedures with care.
Success in bonding requires understanding of and adherence to accepted orthodontic and preventive dentistry principles.
The advantages and disadvantages of bonding versus banding of different teeth must be weighed according to each practitioner’s preferences, skill, and experience.
Bonding should be considered as part of a modern preventive package that also includes a strict oral hygiene program, fluoride supplementation, and the use of simple yet effective appliances. In other words, complicated mechanics with abundant use of coil springs and multilooped arches lends itself less well to bonding and easily can compromise the integrity of tooth enamel and gingival tissues around brackets on small bonding bases.
Dentin bonding agents /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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.
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
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.
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
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
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
the slide show was made for new dental graduates. Presented in BSMMU auditorium in Dental career festival arranged by Dental Times. the aim was to guide them for being a good dental clinician.
This document has been created to run the MBBS students through the basics of dental health, diseases, dental treatments and Oral Manifestations of Systemic Diseases.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Bonding and bonding agents
1. Direct Restorative Materials
Dr. Md. Arifur Rahman
BDS (DU), MPH
Assistant Professor & Head
Northeast Medical College Dental Unit
drarifur_rahman@neub.edu.bd
3. Bonding
Bonding and adhesion comprise a
complex set of physical, chemical and
mechanical mechanisms that allow
the attachment and binding of one
substance to another.
3
drarifur_rahman@yahoo.com
4. Function of Banding agent
A dental bonding system performs three essential
functions:
(1) Provides resistance to separation of an adherend
substrate (i.e. enamel, dentin, metal, composite,
ceramic) from a restorative or cementing material;
(2) distributes stress along bonded interfaces; and
(3) seals the interface via adhesive bonding between
dentin and/or enamel and the bonded material, thus
increasing resistance to microleakage and
decreasing the risk for postoperative sensitivity,
marginal staining, and secondary caries.
4
drarifur_rahman@yahoo.com
5. Mechanism of adhesion
the fundamental mechanism of adhesion to
tooth structure can be regarded simply as
an exchange by which inorganic tooth
material (hydroxyapatite) is replaced by
synthetic resins.
This process involves two parts:
(1) removing hydroxapatite to create
micropores.
(2) infiltration of resin monomers into the
micropores and subsequent
polymerization. As a result, resin tags
are formed that micromechanically
interlock or interpenetrate with the hard
tissue.
FIGURE :
Scanning electron
microscopy image
of tags formed by
the penetration of
resin into etched
areas of enamel.
5
drarifur_rahman@yahoo.com
6. Mechanism of adhesion (cont.)
In general, the following factors can play major or
minor roles in achieving adhesive bonds:
1. Surface energy and wetting
2. Interpenetration (formation of a hybrid zone)
3. Micromechanical interlocking
4. Chemical bonding
6
drarifur_rahman@yahoo.com
7. ACID-ETCH TECHNIQUE
• ENAMEL ETCHING
• DENTIN ETCHING
Both dentin and enamel are etched typically using
37% phosphoric acid. Dentin etching is more
technique sensitive than enamel etching because of
the complexity of the dentin structure. Unlike
enamel, dentin is a living tissue, consisting of 50
vol% of calcium phosphate mineral
(hydroxyapatite), 30 vol% of organic material
(mainly type I collagen), and 20 vol% fluid.
7
drarifur_rahman@yahoo.com
8. ACID-ETCH TECHNIQUE (cont.)
Acid etching removes hydroxyapatite almost completely
from several microns of sound dentin, exposing a
microporous network of collagen suspended in water.
Whereas etched enamel must be completely dry to form a
strong bond with hydrophobic adhesive resins, etched
dentin must be moist to form a hybrid layer.
Acid etching is a very effective way to improve bonding and
durability as well as to ensure a sealed interface. It has
markedly expanded the use of resin-based restorative
materials because it provides a strong bond between resin
and teeth, forming the basis for many innovative dental
procedures.
8
drarifur_rahman@yahoo.com
9. PROCESS AND PROCEDURAL FACTORS
Several aspects of the total-etch, etch-and-rinse, and
related techniques are critical to the success or
failure of bonding Systems
• Etching time
• Rinsing and Drying stage
• Cleanness of the Bonding Surfaces
9
drarifur_rahman@yahoo.com
10. Etching time
Currently, the etching time for most etching gels is
approximately 15 seconds. The advantage of
such short etching times is that they yield
acceptable bond strength in most instances,
while conserving enamel and reducing treatment
time.
10
drarifur_rahman@yahoo.com
11. Rinsing and Drying stage
Once the tooth is etched, the acid should be rinsed away
thoroughly with a stream of water for about 20 seconds, and
the rinsed water must be removed.
When enamel alone is etched and is to be bonded with a
hydrophobic resin (e.g., bisphenol A glycidyl methacrylate
[bis-GMA]–based resin), it must be dried completely with
warm air until it takes on a white, frosted appearance.
Dentin, in contrast, cannot withstand such aggressive drying,
which would cause bond failure because of the formation of
impermeable, collapsed collagen fibers.
In the total-etch technique, a dentin bonding agent and
primer must be used that are compatible with both
moist dentin and moist enamel
11
drarifur_rahman@yahoo.com
12. Cleanness of the Bonding Surfaces
The etched surfaces must be kept clean (free of contaminants) and
sufficiently dry until the resin is placed to form a sound
mechanical bond. Although etching raises the surface energy,
contamination can readily reduce the energy level of the etched
surface. Reducing the surface energy, in turn, makes it more
difficult to wet the surface with a bonding resin that may have
too high a surface tension to wet the contaminated surface. Thus,
even momentary contact with saliva or blood can prevent
effective resin tag formation and severely reduce the bond
strength. Another potential contaminant is oil that is released
from the air compressor and transported along the air lines to
the air–water syringe.
If contamination occurs, the contaminant should be removed, and
the surface should be etched again for 10 seconds.
12
drarifur_rahman@yahoo.com
14. Dental Bonding
Dental bonding agents are designed to provide a
sufficiently
strong interface between restorative composites and tooth
structure to withstand mechanical forces and shrinkage
stress.
The success of adhesives is dependent on two types of
bonding:
1. Micromechanical interlocking, chemical bonding with
enamel and dentin, or both.
2. Copolymerization with the resin matrix of composite
materials
14
drarifur_rahman@yahoo.com
15. Requirement for successful bonding
As discussed in the earlier section on adhesion
mechanisms, a successful dentin bonding system must
meet several requirements:
1. Adequate removal or dissolution of the smear layer from
enamel and dentin
2. Maintenance or reconstitution of the dentin collagen
matrix
3. Good wetting
4. Efficient monomer diffusion and penetration
5. Polymerization within tooth structure
6. Copolymerization with the resin composite matrix
15
drarifur_rahman@yahoo.com
16. Composition of Bonding
Irrespective of the number of bottles or components, a
typical dentin bonding system includes :
1. etchants,
2. Primers / resin monomers,
3. solvents,
4. Adhesives ,
5. initiators and inhibitors,
6. fillers, and
7. sometimes other functional ingredients such as
antimicrobial agents.
16
drarifur_rahman@yahoo.com
17. Etchants
Etchants are relatively strong acids (pH = 1–2) used to
remove smear layers and to dissolve the mineral phase to
allow formation of micromechanical interlocking in
enamel and in dentin. A number of acidic agents have
been used to produce the required microporosity.
However, phosphoric acid at a concentration between
30% and 50%, typically 37%, is the preferred etching
agent to produce consistent etching patterns while not
damaging the pulp.
17
drarifur_rahman@yahoo.com
18. Primers
Dentin etching is highly technique sensitive because the
demineralized collagen network readily collapses when dried.
Therefore, priming is necessary to maintain an expanded
collagen network while removing residual water to allow for the
infiltration of the hydrophobic adhesive monomer. Primers are
solutions containing hydrophilic monomers dissolved in a
solvent such as acetone, ethanol, or water. Such monomers
exhibit hydrophilic properties through phosphate, carboxylic
acid, alcohol, or ester functional groups. HEMA (2-hydroxyl
ethyl meth acrylate) is a widely used primer monomer because of
its high hydrophilicity and solvent-like nature.
If a primer has the ability to both etch and prime, it is
categorized as a self-etching primer. For this purpose, acidic
monomers are frequently used to formulate self-etching primers.
18
drarifur_rahman@yahoo.com
19. Solvents
Solvents also play important roles in priming systems. The
most commonly used solvents are water, ethanol, and
acetone.
In addition to the enhancement of wetting of hydrophilic
dentin, each solvent has a specific contribution to
improve bond adhesion.
-Water can ionize acidic monomers as well as re-expand
the collapsed collagen network.
-Ethanol and acetone have better miscibility with relatively
hydrophobic monomers, and their “water chasing”
ability facilitates water removal.
19
drarifur_rahman@yahoo
.com
20. Adhesives
For dentin bonding, the primary purpose of adhesives is to
fill the interfibrillar space of the collagen network,
creating a hybrid layer and resin tags to provide
micromechanical retention upon polymerization.
In addition, adhesive layers also should prevent fluid
leakage along the restorative material’s margin, since
they make up the major part of the intermediate layer
between dentin and/or enamel and restorative
composites.
20
drarifur_rahman@yahoo.com
21. Initiators
Similar initiator systems are used in both adhesives and
restorative composites.
Polymerization can be initiated either through a photo
initiator system consisting of a photosensitizer (e.g.,
camphorquinone) and an initiator (e.g., tertiary
amine), through a self-cure system that includes a
chemical initiator (e.g., benzoyl peroxide), or through
a dual cure initiator system.
21
drarifur_rahman@yahoo.com
22. Filler Particles
Nanometer-sized silica particles have been added to some
adhesives to reinforce the adhesive and thereby
produce higher bond strengths. However, the
strengthening effect of the fillers in adhesives is uncertain
because it is not clear whether these fillers can actually
penetrate into the demineralized collagen networks, since the
interfibrillar space of the collagen networks is within the
range of 20 nanometers (nm) while the filler particles have a
size of approximately 40 nm.
The other reason for the addition of fillers is to effectively
modify adhesive viscosity to a thicker, pastier consistency.
When such an adhesive is applied to an etched dental surface,
it yields a thicker bonding layer that can promote increased
bond strength by preventing oxygen inhibition. Moreover, a
thick adhesive layer can reduce shrinkage stress because it is
more compliant compared with restorative composites.
22
drarifur_rahman@yahoo
.com
23. Other Ingredients
A number of additional ingredients are used with dentin
bonding agents for a variety of specific purposes. A few
examples include the following:
1. glutar aldehyde (Probond, Dentsply, York, PA) is added as
a desensitizer.
2. The monomer MDPB [12-meth acryloyl oxydo
decylpyridinium bromide] (Clearfil Protect Bond, Kuraray
America, New York, NY) and parabene (Adper Prompt-L-
Pop, 3M ESPE, St. Paul, MN) are used as antimicrobials.
3. Fluoride (Prime & Bond NT, Dentsply, York, PA) is added
to prevent secondary caries.
4. Benzal konium chloride (e.g., Etch 37, Bisco,
Schamburg, IL) and chlorhexidine (e.g., Peak LC Bond
Resin, Ultradent Products, South Jordon, UT) are used to
prevent collagen degradation.
23
drarifur_rahman@yahoo.com
24. Classification of Bonding agent
This classification was developed by Van Meerbeek et al. (2003). As shown in
Figure, it is based on two general approaches to etching, priming, and applying
the bonding resin to dentin and enamel surfaces, and further subdivided into
the number of steps in the process. Thus, the major categories of bonding
systems are known as “etch-and-rinse” and “self-etch” systems, with two
subcategories, each according to the number of clinical steps involved.
24
drarifur_rahman@yahoo
.com
25. Etch-and-Rinse Adhesives
Three-step (fourth generation): At this time, the most
established, most reliable adhesion method in this category
consists of three steps: (1) an acid etchant application, (2)
application of the primer, and (3) application of the actual
bonding agent or bonding resin. The primer contains
hydrophilic functional monomers dissolved in an
organic solvent such as acetone, ethanol, or water.
Two-step (fifth generation): A simplified method in this
category combines the primer and adhesive resin into one
application. This etch-and-rinse strategy is the most effective
to achieve efficient and stable bonding to enamel. Etching,
usually with a 30% to 40% phosphoric gel that is rinsed away,
promotes the dissolution of enamel rods, creating porosities
that are filled by bonding agents through capillary action and
then followed by polymerization of resin.
25
drarifur_rahman@yahoo
.com
26. Self-Etch Adhesives
Two-step (sixth generation): This approach does not
involve a separate etching step. In this case an acidic
monomer which is not rinsed, is used to condition and
prime the tooth at the same time.
One-step (seventh generation): The simplified
method in this category combines conditioner, primer,
and bonding resin into a single step. Most one-step or
“all-in-one” systems are delivered by a bottle, vial, or
single-unit dose applicator, which are formulated as a
single component. However, Adper Promp L-Pop (3M
ESPE, St. Paul, MN) is a variation on this theme, in
which two liquid components are packaged in separate
“blister” compartments in a single dispenser.
26
drarifur_rahman@yahoo.com
27. Aging Effects and
Degradation of the Hybrid
Layer
Several investigations have found that the
bond strength of three-step adhesive
systems show little or no decrease
in contrast to two-step adhesive
systems that decrease significantly
during a 4- to 5-year span.
Research has also shown that peripheral
bonding to etched enamel, which seals
the resin bond from exposure to water,
can significantly increase bond
durability.
27
drarifur_rahman@yahoo.com
28. Which one is best?
General recommendations for specific situations are given below:
• For bonding composite cores, three-step, etch-and-rinse
(fourth-generation) systems are usually recommended.
• For bonding anterior and posterior composites and
cementation of veneers with resin cements, two-step etch-
and-rinse (fifth-generation) systems provide the best
performance.
• For bonding posterior composites, self etch, two-step (sixth-
generation) systems are the better choice.
• Dual-cure one-step, self-etch (seventh-generation) systems
are advised for esthetic posts and ceramic restorations
bonded with resin cement, while light-cured one-step, self-etch
(seventh-generation) systems are recommended for bonding
posterior composite restorations.
28
drarifur_rahman@yahoo.com
29. Which one is best? (Cont..)
Recently, however, van Landuyt et al. (2011)
showed in a randomized clinical trial that a
onestep, self-etch adhesive had similar clinical
performance after 3 years compared with that of
an etch-and-rinse adhesive in class V
restorations. However, the one-step group
exhibited more incisal marginal defects and
discoloration compared with the etch-and-rinse
group.
29
drarifur_rahman@yahoo.com
30. LUTING AGENTS AND RESIN CEMENTS
For many years, retention of indirect restorations could
only be attained by the use of favorable tooth
preparations and by micromechanical interlocking of the
luting agent into irregularities present on the
surface of the restoration and the tooth. Adhesive
bonding completely changed the use of direct and
indirect restorations.
A number of materials are available for cementation,
including zinc phosphate cements, polycarboxylate
cements, glass-ionomer cements (GIC), RMGI cements,
and resin cements.
30
drarifur_rahman@yahoo.com
31. ORTHODONTIC BRACKET BONDING
RESINS
Orthodontic treatment with fixed appliances involves
the use of attachments such as brackets and bands.
Bands are metal rings that go around teeth and are
usually used on molars. Brackets are bonded to
enamel. The development of bonding has
contributed to a decrease in banding even in
posterior teeth.
A variety of luting agents have been used in
orthodontics such as polycarboxylate cement, GIC,
and resin-modified glass ionomer (RMGI) cements.
31
drarifur_rahman@yahoo.com
33. Endodontic sealers are used in conjunction with a solid
or semisolid core material to fill voids and to seal root
canals during obturation. These sealers,
sometimes called cements, should fill and
promote a close seal between the core and the
dentinal walls of the canal, preventing or minimizing
leakage, entombing residual microorganisms, and
possibly filling inaccessible areas of the root canal
system. Sealer selection may influence the outcome of
endodontic treatment.
33
drarifur_rahman@yahoo.com
34. Traditionally, gutta-percha has been used as the solid
core material in combination with a zinc oxide and
eugenol (ZOE) or calcium hydroxide cement, or an epoxy-
based sealer. Clinical studies have shown predictable
results with these conventional root canal sealers. GICs
and resinmodified GICs are also used as root canal
sealers. These can chemically bond to root canal dentin,
but no bond is obtained to gutta-percha.
34
drarifur_rahman@yahoo.com
35. Recently, new materials have been introduced on the
market to improve the seal of the root canal system. These
include different types of core materials, the development
of low-viscosity methacrylate resin-based sealers, and the
incorporation of dentin bonding agents.
One system uses conventional cones that are coated with a
proprietary resin coating (EndoRez, Ultradent, South
Jordan, UT) in combination with a methacrylate-based,
dual-cured resin sealer and no dentin-bonding agent. In
this case, the endodontic seal is dependent on the
penetration of the hydrophilic sealer into the dentinal
tubules and lateral canals following removal of the smear
layer.
35
drarifur_rahman@yahoo.com
36. Another system, called Resilon (SybronEndo
Corporation, Orange, CA) is a thermoplastic composite
polycaprolactone-based core material that contains
dimethacrylate resin, radiopaque fillers, and glass-
ionomer particles. Resilon cones are applied in
combination with a methacrylatebased sealer to root
dentin treated with self-etching primers.
36
drarifur_rahman@yahoo.com
Wetting—Relative interfacial tension between a liquid and a solid substrate that results in a contact
angle of less than 90 degrees.
Wetting agent—A surface-active substance that reduces the surface tension of a liquid to promote
wetting or adhesion.
Recently, a new self-etch adhesive bonding agent has
been introduced that expands this category for use with
total-etch procedures (Scotchbond Universal Adhesive,
3M ESPE, St. Paul, MN). This system contains a specific phosphate monomer and silane and is claimed to offer
extended bond durability as well as versatility for use in
an array of clinical applications.