The document discusses the role and importance of adhesive dentistry. It describes the different generations of dentine bonding agents from the early phosphoric acid-based systems to newer self-etch adhesives. Key challenges in dentine adhesion are the structural differences between enamel and dentine such as dentine's high water content and presence of a smear layer. Conditioning with acid or chelators is needed to remove the smear layer and expose collagen fibers for bonding to occur. Current adhesive systems are classified as etch-and-rinse or self-etch and involve either two or three step application processes.
polymerization shrinkage in composite restoration.pptxsikandaronline66
Assalam o Alaikum . Welcome to our SlideShare Educational Account, where the world of dental education unfolds, and knowledge becomes the key to unlocking your professional and academic potential. Join us on a transformative journey where we delve into the complexities of dentistry, share evidence-based practices, and explore the latest advancements shaping the future of oral healthcare.
Who We Are
At our educational hub, we are more than just a repository of slides. We are a community of passionate dental professionals, educators, and students committed to advancing dental knowledge and fostering a culture of continuous learning. Our goal is to provide a dynamic platform where industry experts share insights, students find valuable resources, and professionals stay abreast of the latest trends.
What Sets Us Apart
1. Expert-Led Content
Our slides are curated by industry experts, bringing you credible, up-to-date information. Whether you are a seasoned practitioner or a dental student, our content is designed to cater to diverse learning needs, ensuring a comprehensive and engaging educational experience.
2. Diverse Topics and Specializations
From the intricacies of restorative dentistry to the latest breakthroughs in dental technology, our SlideShare covers a wide array of topics and specializations. Explore presentations on cosmetic dentistry, oral surgery, orthodontics, and more, tailored to meet the varied interests and expertise levels within the dental community.
3. Cutting-Edge Research and Innovations
Stay at the forefront of dental science with our presentations on cutting-edge research and innovations. We regularly feature content that delves into the latest advancements, materials, and techniques shaping the future of dental practice.
4. Interactive Learning
Our educational platform goes beyond static slides. We incorporate interactive elements, quizzes, and discussions to enhance your learning experience. Engage with the material, test your knowledge, and connect with fellow learners through our interactive features.
5. Continuous Updates and Fresh Content
Dentistry is a dynamic field, and so is our content. Expect regular updates with fresh presentations, ensuring that you have access to the most current and relevant information in the ever-evolving landscape of oral healthcare.
The document discusses odontogenic tumors, which are lesions derived from epithelial, ectomesenchymal, or mesenchymal elements of the tooth forming apparatus. These tumors are found exclusively in the maxillofacial skeleton, soft tissues overlying tooth areas, or alveolar mucosa. The document categorizes odontogenic tumors as malignant tumors (odontogenic carcinomas and sarcomas), benign tumors (those involving epithelial and ectomesenchymal elements with or without hard tissue formation), bone-related lesions, and other tumors. It provides examples and descriptions of specific tumor types within each category.
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 various periodontal instruments, their classifications, parts, and uses. It discusses different types of instruments including mouth mirrors, probes, explorers, scalers, curettes, sonic and ultrasonic instruments, and surgical instruments. For each type of instrument, the document describes their design features and how they are used to examine or treat patients during nonsurgical and surgical periodontal procedures.
This document discusses elements of dental esthetics. It defines esthetic dentistry as enhancing an individual's beauty within functional limits. Cosmetic dentistry aims to improve tooth, gum, and bite appearance. Key elements of dental esthetics discussed include tooth size, shape, width, symmetry, alignment, contacts, color, translucency, surface texture, and gingival aesthetics. Treatment options to achieve esthetics include ameloplasty, bleaching, composite resins, porcelain veneers, and full crowns. Veneers are thin layers applied to teeth that can be made of composite resin or porcelain.
Universal adhesives were introduced as the seventh generation of dental adhesives. They can be used with self-etch, selective-etch, and total-etch techniques without needing separate activators. They contain MDP monomers that enable effective bonding to calcium, dentin, enamel, zirconia and metal alloys. Universal adhesives simplify the application process and are more resistant to contamination compared to previous adhesive generations. They form both a hybrid layer and chemical bonds through MDP monomers, making the bond more durable over time.
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.
This document provides information on the ART (Atraumatic Restorative Treatment) procedure. It begins with an introduction stating that ART is a minimally invasive cavity preparation and restoration technique. The principles of ART are removing caries using only hand instruments and restoring the cavity with an adhesive material. Indications for ART include small, accessible cavities, while contraindications include exposed or inflamed pulps. Advantages include conserving tooth structure, reducing pain and trauma, and enabling the technique to be used in remote areas. The document describes the instruments, materials, procedures and concludes that ART focuses on providing dental care in developing countries.
polymerization shrinkage in composite restoration.pptxsikandaronline66
Assalam o Alaikum . Welcome to our SlideShare Educational Account, where the world of dental education unfolds, and knowledge becomes the key to unlocking your professional and academic potential. Join us on a transformative journey where we delve into the complexities of dentistry, share evidence-based practices, and explore the latest advancements shaping the future of oral healthcare.
Who We Are
At our educational hub, we are more than just a repository of slides. We are a community of passionate dental professionals, educators, and students committed to advancing dental knowledge and fostering a culture of continuous learning. Our goal is to provide a dynamic platform where industry experts share insights, students find valuable resources, and professionals stay abreast of the latest trends.
What Sets Us Apart
1. Expert-Led Content
Our slides are curated by industry experts, bringing you credible, up-to-date information. Whether you are a seasoned practitioner or a dental student, our content is designed to cater to diverse learning needs, ensuring a comprehensive and engaging educational experience.
2. Diverse Topics and Specializations
From the intricacies of restorative dentistry to the latest breakthroughs in dental technology, our SlideShare covers a wide array of topics and specializations. Explore presentations on cosmetic dentistry, oral surgery, orthodontics, and more, tailored to meet the varied interests and expertise levels within the dental community.
3. Cutting-Edge Research and Innovations
Stay at the forefront of dental science with our presentations on cutting-edge research and innovations. We regularly feature content that delves into the latest advancements, materials, and techniques shaping the future of dental practice.
4. Interactive Learning
Our educational platform goes beyond static slides. We incorporate interactive elements, quizzes, and discussions to enhance your learning experience. Engage with the material, test your knowledge, and connect with fellow learners through our interactive features.
5. Continuous Updates and Fresh Content
Dentistry is a dynamic field, and so is our content. Expect regular updates with fresh presentations, ensuring that you have access to the most current and relevant information in the ever-evolving landscape of oral healthcare.
The document discusses odontogenic tumors, which are lesions derived from epithelial, ectomesenchymal, or mesenchymal elements of the tooth forming apparatus. These tumors are found exclusively in the maxillofacial skeleton, soft tissues overlying tooth areas, or alveolar mucosa. The document categorizes odontogenic tumors as malignant tumors (odontogenic carcinomas and sarcomas), benign tumors (those involving epithelial and ectomesenchymal elements with or without hard tissue formation), bone-related lesions, and other tumors. It provides examples and descriptions of specific tumor types within each category.
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 various periodontal instruments, their classifications, parts, and uses. It discusses different types of instruments including mouth mirrors, probes, explorers, scalers, curettes, sonic and ultrasonic instruments, and surgical instruments. For each type of instrument, the document describes their design features and how they are used to examine or treat patients during nonsurgical and surgical periodontal procedures.
This document discusses elements of dental esthetics. It defines esthetic dentistry as enhancing an individual's beauty within functional limits. Cosmetic dentistry aims to improve tooth, gum, and bite appearance. Key elements of dental esthetics discussed include tooth size, shape, width, symmetry, alignment, contacts, color, translucency, surface texture, and gingival aesthetics. Treatment options to achieve esthetics include ameloplasty, bleaching, composite resins, porcelain veneers, and full crowns. Veneers are thin layers applied to teeth that can be made of composite resin or porcelain.
Universal adhesives were introduced as the seventh generation of dental adhesives. They can be used with self-etch, selective-etch, and total-etch techniques without needing separate activators. They contain MDP monomers that enable effective bonding to calcium, dentin, enamel, zirconia and metal alloys. Universal adhesives simplify the application process and are more resistant to contamination compared to previous adhesive generations. They form both a hybrid layer and chemical bonds through MDP monomers, making the bond more durable over time.
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.
This document provides information on the ART (Atraumatic Restorative Treatment) procedure. It begins with an introduction stating that ART is a minimally invasive cavity preparation and restoration technique. The principles of ART are removing caries using only hand instruments and restoring the cavity with an adhesive material. Indications for ART include small, accessible cavities, while contraindications include exposed or inflamed pulps. Advantages include conserving tooth structure, reducing pain and trauma, and enabling the technique to be used in remote areas. The document describes the instruments, materials, procedures and concludes that ART focuses on providing dental care in developing countries.
The document discusses Keyes triad of dental caries, which describes the three factors necessary for dental caries (tooth decay) to occur: susceptible host (teeth), cariogenic bacteria (bacteria that cause decay), and fermentable carbohydrates (sugars). The triad explains that for caries to develop, all three factors must be present and interacting over a period of time. Understanding the triad is important for dental professionals to help prevent and manage tooth decay in patients.
This document provides information on the classification and treatment of tooth discoloration. It begins with an introduction on the importance of properly diagnosing the cause of discoloration in order to determine the appropriate treatment. Tooth discoloration is then classified in various ways, including by location (intrinsic, extrinsic, internalized), etiology (pre-eruptive, post-eruptive causes), and chemistry of the staining agent. Diagnosis involves taking a medical history and pretreatment photos in order to analyze the cause. Potential treatments discussed include prevention methods, scaling, microabrasion, macroabrasion, veneers, bleaching of vital and non-vital teeth, and the use of various agents
The periodontal ligament contains different types of collagen fibers that are organized into groups based on their orientation. The principal groups are the gingival fibers that run from cementum to gingiva and the dento-alveolar fibers that run from cementum to the alveolar bone. These fiber groups include dento-gingival fibers, alveo-gingival fibers, circumferential fibers, dento-periosteal fibers, and trans-septal fibers. The periodontal ligament also contains elastic fibers, ground substance, and may contain cementicles.
Esthetics in complete dentures dentogenic conceptAnusha Gattu
This document discusses dentogenic concepts in prosthodontic treatment and esthetics. It begins with defining dentogenics as the art and techniques used to achieve esthetic goals in dentistry. It then covers the history of dentogenics and influences like sex, personality, age on esthetics. Key esthetic principles like composition, balance, symmetry and dominance are explained. Structural components of esthetics like facial features, smile components and dental components are outlined. Techniques for achieving natural look in complete dentures include following principles of depth grinding, abrasion and SPA factors. Errors in esthetics are also mentioned.
This document discusses pulp calcification and pulp stones. It notes that pulp stones are a physiological manifestation that may increase in number or size due to local or systemic pathology. The etiological factors involved in their formation are not fully understood. As people age, the pulp space decreases in size and the blood vessels, nerves, and cells in the pulp also decrease. Pulp stones can form due to factors like age, circulatory disturbances, orthodontic tooth movement, and genetic predisposition. They are typically composed of calcium and phosphorus. Pulp stones may block access to canal orifices or engage instruments, but can usually be removed during root canal treatment with magnification, access, and proper instruments.
"PERIODONTAL- INSTRUMENTS AND INSTRUMENTATION"Dr.Pradnya Wagh
The document provides an overview of periodontal instruments and their classification and uses. It discusses the different types of instruments used for assessment and therapeutic purposes, including probes, explorers, scalers, curettes, files and surgical instruments. Curettes are described in more detail, including universal curettes and area-specific Gracey curettes. The key parts and materials of instruments are also outlined.
Ellis and Davey developed a classification system for tooth fractures in the late 1980s. Their system categorizes fractures into 4 classes based on the location and extent of the fracture. Class 1 fractures involve enamel only, Class 2 fractures extend into dentin but not the pulp, Class 3 fractures expose the pulp, and Class 4 fractures involve complicated crown fractures.
This document provides an overview of pit and fissure sealants. It discusses the history, definition, morphology, materials used, application process, advantages, and recent advances. Key points include:
- Pit and fissure sealants were developed in the 1950s to isolate deep pits and fissures from the oral cavity and prevent dental caries.
- The application process involves cleaning, isolating, and etching the tooth surface, followed by placement of the sealant material into the pits and fissures.
- Common materials used are resin-based sealants and glass ionomer cement. Recent advances include self-etching and fluoride-releasing sealants.
- Proper application
This document provides an overview of oral pigmentation and pigmented lesions. It begins by defining pigment and describing normal oral mucosal color. Melanin is identified as the primary pigment producing brown coloration in the body. Factors that can affect melanogenesis are discussed such as sun exposure, drugs, hormones and genetic constitution. The document then classifies pigmentation into endogenous (originating from within the body such as melanin pigmentation) and exogenous (from external sources). Specific endogenous and exogenous pigmented lesions are described. The document concludes by discussing malignant melanoma, describing its clinical presentation and treatment which primarily involves wide local excision surgery.
This document describes the anatomy of the deciduous maxillary and mandibular second molars. It details their features compared to the permanent first molars, including having smaller crowns but longer, more slender roots. The maxillary second molar has two prominent buccal cusps and three lingual cusps, while the mandibular second molar has two equal lingual cusps and three similar buccal cusps. Both teeth have pulp cavities with horns corresponding to the cusps and three root canals.
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.
The document discusses bleaching, including its classification of stains, etiology of discoloration, chemistry and mechanisms of bleaching. It describes factors affecting bleaching and various bleaching materials and techniques. Vital bleaching techniques include at-home bleaching with trays, in-office bleaching using heat or light activation, and walking bleach. Non-vital bleaching involves accessing the pulp chamber. Proper temporary and permanent restorations after bleaching are also discussed.
Class III, IV, V Cavity preparations for Composites- SELVIPalaniselvi Kamaraj
This document discusses cavity preparations for class III, IV, and V composite restorations. It begins by outlining the general considerations and indications/contraindications for these restorations. It then describes the clinical techniques for preparing class III, IV, and V cavities, including obtaining access, removing defective structures, creating convenience form, and obtaining retention features. Specific preparation designs like beveled, conventional, and modified are discussed for each class. Lingual approaches and indications for facial approaches in class III preparations are also covered. The document concludes by listing references.
This document discusses dental veneers. It defines veneers as thin layers of tooth-colored material applied to teeth to restore defects or discoloration. It describes the different types of veneers including direct composite, porcelain, and ceramic veneers. It outlines the indications and contraindications for veneers and discusses techniques for both direct and indirect veneer placement and repair.
Restorative and esthetic dental materialsSaeed Bajafar
The document summarizes key information about restorative and esthetic dental materials. It discusses the American Dental Association standards for new materials, properties materials must have like mechanical strength and how they respond to stress, temperature changes, electricity, corrosion, and their application characteristics. It provides details on direct restorative materials like amalgam, composites, glass ionomers and their uses, composition, placement techniques, and issues.
CEMENTATION OF INLAY AND VARIOUS TECHNIQUE FOR TEMPORIZATIONms khatib
A provisional or temporary restoration is necessary when using indirect systems that require two appointments. it is important that the patient be comfortable and the tooth be protected and stabilized with an adequate temporary restoration. The temporary restoration should satisfy the following requirements: it should -
When properly made, the custom temporary restoration can satisfy these requirements and is the preferred temporary restoration.
Temporaries can be fabricated intraorally directly on the prepared teeth (direct technique) or outside of the mouth using a post-operative cast of the prepared teeth (indirect technique).
The indirect technique is not as popular as the direct technique because of the increased number of steps and complexity ; however, it is useful when making temporaries that might become “locked on” (e.g., intracoronal inlays) when using the direct technique
Atraumatic restorative treatment (art) for tooth
Atraumatic Restorative Treatment (ART), is based on removing decalcified tooth tissue using only hand instruments and restoring the cavity with an adhesive filling material.
A minimally invasive approach to both prevent dental carious lesions and stop its further progression
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
new dba-1(1).pptx DENTIN BONDING AGENTS GENERATIONS, ADVANTAGES N DISADVANTAGESaishwaryakhare5
Dentin bonding agents are used to bond resin composites to tooth structure. They were introduced to reduce microleakage and the need for extensive tooth preparation. There are several mechanisms of adhesion, including mechanical interlocking, adsorption, and diffusion. Conditioning of the tooth with acid creates an irregular surface that allows resin tags to form. For dentin bonding, acid etching is followed by rinsing, drying, and application of a primer and adhesive. The primer infiltrates demineralized dentin to form a "hybrid layer". This bonding technique reduces leakage and the need for removal of tooth structure.
The document discusses the history and generations of dentin bonding agents. It describes the challenges of bonding to dentin due to its composition and structure. Early bonding agents bonded weakly to the smear layer rather than dentin. Current bonding agents condition and prime the dentin surface to allow resin infiltration and strong bonding. They are classified based on their treatment of the smear layer and number of clinical steps.
The document discusses Keyes triad of dental caries, which describes the three factors necessary for dental caries (tooth decay) to occur: susceptible host (teeth), cariogenic bacteria (bacteria that cause decay), and fermentable carbohydrates (sugars). The triad explains that for caries to develop, all three factors must be present and interacting over a period of time. Understanding the triad is important for dental professionals to help prevent and manage tooth decay in patients.
This document provides information on the classification and treatment of tooth discoloration. It begins with an introduction on the importance of properly diagnosing the cause of discoloration in order to determine the appropriate treatment. Tooth discoloration is then classified in various ways, including by location (intrinsic, extrinsic, internalized), etiology (pre-eruptive, post-eruptive causes), and chemistry of the staining agent. Diagnosis involves taking a medical history and pretreatment photos in order to analyze the cause. Potential treatments discussed include prevention methods, scaling, microabrasion, macroabrasion, veneers, bleaching of vital and non-vital teeth, and the use of various agents
The periodontal ligament contains different types of collagen fibers that are organized into groups based on their orientation. The principal groups are the gingival fibers that run from cementum to gingiva and the dento-alveolar fibers that run from cementum to the alveolar bone. These fiber groups include dento-gingival fibers, alveo-gingival fibers, circumferential fibers, dento-periosteal fibers, and trans-septal fibers. The periodontal ligament also contains elastic fibers, ground substance, and may contain cementicles.
Esthetics in complete dentures dentogenic conceptAnusha Gattu
This document discusses dentogenic concepts in prosthodontic treatment and esthetics. It begins with defining dentogenics as the art and techniques used to achieve esthetic goals in dentistry. It then covers the history of dentogenics and influences like sex, personality, age on esthetics. Key esthetic principles like composition, balance, symmetry and dominance are explained. Structural components of esthetics like facial features, smile components and dental components are outlined. Techniques for achieving natural look in complete dentures include following principles of depth grinding, abrasion and SPA factors. Errors in esthetics are also mentioned.
This document discusses pulp calcification and pulp stones. It notes that pulp stones are a physiological manifestation that may increase in number or size due to local or systemic pathology. The etiological factors involved in their formation are not fully understood. As people age, the pulp space decreases in size and the blood vessels, nerves, and cells in the pulp also decrease. Pulp stones can form due to factors like age, circulatory disturbances, orthodontic tooth movement, and genetic predisposition. They are typically composed of calcium and phosphorus. Pulp stones may block access to canal orifices or engage instruments, but can usually be removed during root canal treatment with magnification, access, and proper instruments.
"PERIODONTAL- INSTRUMENTS AND INSTRUMENTATION"Dr.Pradnya Wagh
The document provides an overview of periodontal instruments and their classification and uses. It discusses the different types of instruments used for assessment and therapeutic purposes, including probes, explorers, scalers, curettes, files and surgical instruments. Curettes are described in more detail, including universal curettes and area-specific Gracey curettes. The key parts and materials of instruments are also outlined.
Ellis and Davey developed a classification system for tooth fractures in the late 1980s. Their system categorizes fractures into 4 classes based on the location and extent of the fracture. Class 1 fractures involve enamel only, Class 2 fractures extend into dentin but not the pulp, Class 3 fractures expose the pulp, and Class 4 fractures involve complicated crown fractures.
This document provides an overview of pit and fissure sealants. It discusses the history, definition, morphology, materials used, application process, advantages, and recent advances. Key points include:
- Pit and fissure sealants were developed in the 1950s to isolate deep pits and fissures from the oral cavity and prevent dental caries.
- The application process involves cleaning, isolating, and etching the tooth surface, followed by placement of the sealant material into the pits and fissures.
- Common materials used are resin-based sealants and glass ionomer cement. Recent advances include self-etching and fluoride-releasing sealants.
- Proper application
This document provides an overview of oral pigmentation and pigmented lesions. It begins by defining pigment and describing normal oral mucosal color. Melanin is identified as the primary pigment producing brown coloration in the body. Factors that can affect melanogenesis are discussed such as sun exposure, drugs, hormones and genetic constitution. The document then classifies pigmentation into endogenous (originating from within the body such as melanin pigmentation) and exogenous (from external sources). Specific endogenous and exogenous pigmented lesions are described. The document concludes by discussing malignant melanoma, describing its clinical presentation and treatment which primarily involves wide local excision surgery.
This document describes the anatomy of the deciduous maxillary and mandibular second molars. It details their features compared to the permanent first molars, including having smaller crowns but longer, more slender roots. The maxillary second molar has two prominent buccal cusps and three lingual cusps, while the mandibular second molar has two equal lingual cusps and three similar buccal cusps. Both teeth have pulp cavities with horns corresponding to the cusps and three root canals.
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.
The document discusses bleaching, including its classification of stains, etiology of discoloration, chemistry and mechanisms of bleaching. It describes factors affecting bleaching and various bleaching materials and techniques. Vital bleaching techniques include at-home bleaching with trays, in-office bleaching using heat or light activation, and walking bleach. Non-vital bleaching involves accessing the pulp chamber. Proper temporary and permanent restorations after bleaching are also discussed.
Class III, IV, V Cavity preparations for Composites- SELVIPalaniselvi Kamaraj
This document discusses cavity preparations for class III, IV, and V composite restorations. It begins by outlining the general considerations and indications/contraindications for these restorations. It then describes the clinical techniques for preparing class III, IV, and V cavities, including obtaining access, removing defective structures, creating convenience form, and obtaining retention features. Specific preparation designs like beveled, conventional, and modified are discussed for each class. Lingual approaches and indications for facial approaches in class III preparations are also covered. The document concludes by listing references.
This document discusses dental veneers. It defines veneers as thin layers of tooth-colored material applied to teeth to restore defects or discoloration. It describes the different types of veneers including direct composite, porcelain, and ceramic veneers. It outlines the indications and contraindications for veneers and discusses techniques for both direct and indirect veneer placement and repair.
Restorative and esthetic dental materialsSaeed Bajafar
The document summarizes key information about restorative and esthetic dental materials. It discusses the American Dental Association standards for new materials, properties materials must have like mechanical strength and how they respond to stress, temperature changes, electricity, corrosion, and their application characteristics. It provides details on direct restorative materials like amalgam, composites, glass ionomers and their uses, composition, placement techniques, and issues.
CEMENTATION OF INLAY AND VARIOUS TECHNIQUE FOR TEMPORIZATIONms khatib
A provisional or temporary restoration is necessary when using indirect systems that require two appointments. it is important that the patient be comfortable and the tooth be protected and stabilized with an adequate temporary restoration. The temporary restoration should satisfy the following requirements: it should -
When properly made, the custom temporary restoration can satisfy these requirements and is the preferred temporary restoration.
Temporaries can be fabricated intraorally directly on the prepared teeth (direct technique) or outside of the mouth using a post-operative cast of the prepared teeth (indirect technique).
The indirect technique is not as popular as the direct technique because of the increased number of steps and complexity ; however, it is useful when making temporaries that might become “locked on” (e.g., intracoronal inlays) when using the direct technique
Atraumatic restorative treatment (art) for tooth
Atraumatic Restorative Treatment (ART), is based on removing decalcified tooth tissue using only hand instruments and restoring the cavity with an adhesive filling material.
A minimally invasive approach to both prevent dental carious lesions and stop its further progression
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
new dba-1(1).pptx DENTIN BONDING AGENTS GENERATIONS, ADVANTAGES N DISADVANTAGESaishwaryakhare5
Dentin bonding agents are used to bond resin composites to tooth structure. They were introduced to reduce microleakage and the need for extensive tooth preparation. There are several mechanisms of adhesion, including mechanical interlocking, adsorption, and diffusion. Conditioning of the tooth with acid creates an irregular surface that allows resin tags to form. For dentin bonding, acid etching is followed by rinsing, drying, and application of a primer and adhesive. The primer infiltrates demineralized dentin to form a "hybrid layer". This bonding technique reduces leakage and the need for removal of tooth structure.
The document discusses the history and generations of dentin bonding agents. It describes the challenges of bonding to dentin due to its composition and structure. Early bonding agents bonded weakly to the smear layer rather than dentin. Current bonding agents condition and prime the dentin surface to allow resin infiltration and strong bonding. They are classified based on their treatment of the smear layer and number of clinical steps.
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.
Dentin bonding agents are resinous materials used to bond dental composites to dentin by forming a hybrid layer. They were introduced to reduce the need for extensive tooth preparation. A dentin bonding agent consists of a conditioner/etchant, primer, and adhesive. It bonds to dentin by partially demineralizing it with acid and forming resin microtags within the dentin. Dentin bonding agents have various clinical applications including bonding composites, veneers, and orthodontic appliances to teeth.
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.
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
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.
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 summarizes a study that compares the bond strength of orthodontic brackets bonded to enamel surfaces prepared by different methods: phosphoric acid etching, Er:YAG laser etching, a combination of acid etching and laser etching, and laser etching followed by acid etching. Sixty human premolars were divided into four groups based on the enamel preparation method used. Brackets were bonded to the prepared enamel surfaces using a standard protocol. The bond strength of each sample was then tested using a universal testing machine. The study aims to investigate methods that provide maximum bond strength and analyze the fracture mode for each preparation method.
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.
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.
The document discusses various principles of adhesion in dentistry. It describes the different mechanisms of adhesion including mechanical adhesion, adsorption adhesion, diffusion adhesion, and electrostatic adhesion. It also outlines the requirements for good adhesion such as sufficient wetting of the adhesive, low viscosity, rough surface texture of the adherend, and high surface energy of the adherend. Additionally, it explains factors that affect adhesion to tooth structures like the smear layer and differences between adhesion to enamel versus dentin.
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.
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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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
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This document discusses acid etching of dental surfaces. It describes how acid etching was first proposed in 1955 to increase bond strength between composite resin and enamel. Acid etching removes enamel and creates an irregular porous surface that allows resin to penetrate through micromechanical interlocking, improving bond strength. Factors like acid type/concentration, etching duration, and fluoride levels can affect bonding. While acid etching is effective, some alternatives under investigation include crystal growth solutions, air abrasion, and lasers, but they have not achieved bond strengths as high as acid etching.
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The document discusses the history and development of dentin bonding agents over several generations from the 1970s to 2000s. It covers key topics such as the role of the smear layer, conditioning of dentin, components of bonding agents, and critical steps for clinical use. Dentin bonding agents have evolved from early attempts at chemical bonding to current multi-step and self-etching adhesives that provide both mechanical and chemical bonding via a hybrid layer between resin and dentin. Proper isolation, acid-etching, moisture control, and curing technique are important for achieving optimal bond strength.
This document discusses different methods for delivering fluorides, including topical and systemic methods. It focuses on topical fluoride delivery methods which are applied directly to teeth. Topical fluorides can be divided into professionally applied and self-applied products. Professionally applied products contain higher fluoride concentrations and include neutral sodium fluoride, acidulated phosphate fluoride, and stannous fluoride solutions, gels, pastes, and varnishes. Application techniques for professionals include the paint on and tray methods. Stannous fluoride and sodium fluoride are discussed in more detail regarding their preparation, mechanisms of action, advantages, and application procedures. Repeated topical fluoride treatments over time help strengthen tooth enamel and reduce the risk of dental caries.
Megaloblastic anaemia . And all anout anaemia, pernicious anaemia,GaurishChandraRathau
Megaloblastic anemia is a type of deficiency anemia characterized by abnormally large nucleated red blood cell precursors called megaloblasts in the bone marrow. It is most commonly caused by vitamin B12 or folic acid deficiencies, which lead to defective DNA synthesis. The pathophysiology involves an imbalance between the cytoplasm and nucleus in red blood cells due to improper nucleoprotein synthesis. Laboratory diagnosis shows macrocytic anemia with large red blood cells, hypersegmented neutrophils, and giant platelets in peripheral blood smears.
This document discusses insulin and antidiabetic drugs. It begins by describing the pancreatic axis and role of insulin and glucagon in maintaining glucose homeostasis. It then defines diabetes mellitus and describes the main types, Type 1 and Type 2 diabetes. It discusses treatment approaches for both types, including lifestyle changes and various drug classes. The mechanisms and preparations of insulin are outlined in detail. Finally, it reviews common oral antidiabetic drug classes like sulfonylureas, meglitinides, biguanides, thiazolidinediones and alpha-glucosidase inhibitors.
Leukemia is a cancer that affects the blood and bone marrow. It causes the body to overproduce immature white blood cells that do not function properly. There are four main types of leukemia - acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML). The document discusses the definition, causes, signs and symptoms, diagnosis, treatment approaches which may include chemotherapy, targeted therapy and stem cell transplant, and management of the different types of leukemia.
Removable partial dentures (RPDs) replace missing teeth and are part of prosthodontic treatment. RPDs are designed to provide support from teeth and tissues, retention to prevent displacement, and stability to resist lateral forces. They are made of biocompatible materials and connected by major connectors like lingual bars that provide cross-arch support and stability. RPDs are classified based on location of missing teeth to aid in proper design of retainers, rests, and other components.
The document discusses the anatomy and histology of the gingiva. It defines gingiva as the part of oral mucosa that surrounds the teeth. Macroscopically, it describes the three types of gingiva: marginal, interdental, and attached gingiva. Microscopically, it explains that gingiva contains stratified squamous epithelium, the epithelium-connective tissue interface, and connective tissue. It details the layers of the epithelium, the cells present, and their roles in keratinization and immune response.
This document discusses megaloblastic anemia, which is caused by deficiencies in vitamin B12 or folic acid. It describes the history and discoveries regarding B12 and folic acid, including their roles in DNA synthesis and hematopoiesis. The document covers absorption, transport, functions and deficiencies of B12 and folic acid, as well as their treatment and uses. It also briefly discusses erythropoietin and drugs used to treat neutropenia.
This document provides an overview of the Russel's Periodontal Index and the CPITN (Community Periodontal Index of Treatment Needs). It discusses the scope, procedure, scoring criteria, and calculation methods for both indices. The Russel's Periodontal Index was developed in 1956 to estimate the prevalence and severity of periodontal disease on a scale of 0-8. The CPITN was developed in 1982 by the WHO and FDI to survey and evaluate periodontal treatment needs, examining six index teeth in each sextant and assigning codes from 0-4 based on probing depth and other factors. The document reviews the advantages, limitations, and modifications of these two common indices used in epidemiological studies of periodontal health.
This document discusses the history and development of dentin bonding agents across 7 generations from the 1950s to 2000s. It describes the ideal requirements for bonding agents and challenges bonding to dentin like the smear layer. The roles of conditioners, primers, and adhesives are explained. Critical factors for bonding like moisture control and the hybrid layer formation are also summarized.
This document provides an overview of dental casting procedures and defects. It discusses the history of casting, the lost wax technique, and steps in the casting process including investing, wax burnout, alloy casting, and cleaning. Key aspects covered are sprue formation, crucible and ring usage, investing materials, and factors that influence dimensional changes like wax and alloy shrinkage. Causes of common casting defects are also mentioned but not described in detail.
The document discusses various types of drugs used to treat angina pectoris. It describes nitrates, calcium channel blockers, and beta blockers. Nitrates are vasodilators that work by converting to nitric oxide and relaxing smooth muscles. Common nitrates include nitroglycerin. Calcium channel blockers block calcium channels, reducing calcium entry into cardiac and smooth muscle cells. Examples given are verapamil, diltiazem, and nifedipine. Beta blockers inhibit sympathetic stimulation by blocking beta receptors. They decrease heart rate and contractility. Propranolol, atenolol and metoprolol are beta blockers mentioned.
This document discusses denture base materials, specifically acrylic resins. It begins by defining denture base and classifying denture base resins into categories such as metallic vs. non-metallic, temporary vs. permanent, and ANSI/ADA classifications. It then discusses the ideal requirements for dental resins and their various uses. The document goes on to explain key terms like polymer, monomer, copolymer, polymerization, and cross-linking as they relate to denture base materials. It also discusses composition, curing techniques, and important considerations for both heat cure and self-cure acrylic resins.
Cellular adaptations occur through atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia in response to environmental stresses. Atrophy is a decrease in cell size or number, hypertrophy is an increase in cell size, and hyperplasia is an increase in cell number. Metaplasia is the reversible change of one adult cell type into another. Dysplasia involves disordered cellular development accompanied by metaplasia and hyperplasia.
This document summarizes the key properties and characteristics of different elastomeric impression materials, including polysulfide, condensation silicone, addition silicone, and polyether elastomers. It describes the composition, setting reactions, available consistencies, and mechanical properties of each material. Properties like viscosity, working and setting times, dimensional stability, hardness, tear strength, and detail reproduction are compared between the different elastomers. The document also discusses techniques for mixing and using impression materials, as well as their wettability and hydrophilicity.
The document discusses cell injury and its causes, pathogenesis, and morphology. It defines cell injury as stress encountered by cells due to changes in their internal or external environment. Cell injury can be caused genetically or acquired through various external factors like hypoxia, physical or chemical agents, microbes, immunological reactions, nutritional imbalances, aging, and psychological stress. The pathogenesis of cell injury depends on the type of cell, extent of injury, and underlying biochemical processes. Reversible cell injury causes changes like hydropic swelling, fatty changes, and hyaline changes. Irreversible injury leads to autolysis, necrosis, apoptosis, or gangrene.
Neoplasia refers to abnormal tumor growth. Benign tumors are non-invasive and localized, while malignant tumors are invasive and spreading. Tumors are named based on the tissue of origin, such as carcinomas arising from epithelial tissue and sarcomas from connective tissue. Well-differentiated tumors resemble normal cells, while poorly-differentiated tumors have primitive, undifferentiated cells. Malignant tumors exhibit features like irregular growth, invasion, increased size and mitosis, and lack of differentiation. Dysplasia refers to disordered cell growth showing abnormalities but remaining in situ.
Pathological calcification involves the abnormal deposition of calcium salts in tissues other than bone. There are two main types: dystrophic calcification occurs in dead or damaged tissue with normal calcium levels, while metastatic calcification affects normal tissues and is caused by high calcium levels in the blood (hypercalcemia). Dystrophic calcification is seen in areas of necrosis, atherosclerosis, and infarcts. Metastatic calcification is associated with disorders that cause hypercalcemia like hyperparathyroidism and bone destruction. The deposits appear histologically as basophilic intracellular and extracellular calcium salt accumulations.
Amyloidosis is a condition characterized by the abnormal deposition of amyloid protein fibrils in tissues and organs. The fibrils form when normally soluble proteins misfold and aggregate extracellularly. Amyloidosis has many subtypes classified by the precursor protein involved, pattern of organ involvement, and hereditary versus inflammatory causes. Diagnosis involves tissue biopsy with Congo red staining to identify the apple-green birefringence of amyloid under polarized light, as well as immunohistochemistry to determine the subtype. Advanced imaging and molecular PET can also detect amyloid plaques in neurodegenerative diseases like Alzheimer's.
This document discusses various types of cellular adaptations, including atrophy, hypertrophy, hyperplasia, and metaplasia. It also discusses pathologic calcification. The main types of cellular adaptation are a decrease in cell size and number through atrophy, an increase in individual cell size through hypertrophy, an increase in cell number through hyperplasia, and the replacement of one cell type with another through metaplasia. Pathologic calcification can occur through either dystrophic or metastatic calcification and results in the abnormal deposition of calcium salts in tissues.
The document discusses various methods of sterilization including physical agents like heat, radiation and filtration, as well as chemical agents. It defines sterilization as a process that eliminates all microorganisms, while disinfection only destroys pathogenic organisms. Several sterilization techniques are described in detail, such as moist heat methods using steam under pressure in an autoclave, dry heat methods using hot air ovens, and chemical agents like alcohols, aldehydes, and dyes. The ideal properties of chemical disinfectants are also outlined.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
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at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
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Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
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How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
2. CONTENTS
INTRODUCTION
ROLE OF ADHESIVE DENTISTRY
CONCEPT OF ADHESION
ENAMEL ADHESION
DENTINE ADHESION
CHALLENGES IN DENTINE ADHESION
ENAMEL BONDING
STEPS FOR ENAMEL BONDING
MECHANISM INVOLVED
3. DENTINE BONDING
CONDITIONING OF DENTINE
PRIMING OF DENTINE
DENTINE BONDING AGENTS
CLASSIFICATION
GENERATIONS OF BONDING AGENTS
FIRST GENERATION
SECOND GENERATION
THIRD GENERATIONS
FOURTH GENERATION
FIFTH GENERATION
SIXTH GENERATION
SEVENTH GENERATION
4. ROLE OF MICROLEAKAGE
BIOCOMPATIBILITY
ANTIBACTERIAL PROPERTY
CLINICAL FACTORS IN DENTINE ADHESION
NEWER CLINICAL INDICATIONS OF DENTINE
ADHESIVES
DESENSITISATION
ADHESIVE AMALGAM RESTORATIONS
INDIRECT ADHESIVE RESTORATIONS
FAILURES IN DENTINE BONDING
SUMMARY
BIBLIOGRAPHY
5. INTRODUCTION
There is much interest and activity in dentistry today with dentin bonding
agents.
In the modern society, aesthetics has become a major concern for every
individual .Thus most of us desire for a perfect set of teeth.
Therefore, teeth that have been deformed or ravaged by dental diseases
need to be restored to their natural form and colour.
Moreover, the classic concepts of tooth preparation advocated in the early
1900s have changed dramatically.
6. Now more focus is laid upon conservative approach to the tooth
preparation.
Therefore the introduction of adhesive restorative materials has reduced
the need for an extensive tooth preparation.
In order to successfully accomplish this, dentin bonding systems have
been introduced which bond the composite resin to the tooth structure.
7. DEFINITION
Adhesion is derived from Latin meaning "a state in which two surfaces are
held together by interfacial forces like valence forces or interlocking forces
or both".
(The American Society for Testing and Materials)
8. Thus for the process of adhesion to occur , we need to understand the role
of following components:
ADHESIVE
ADHEREND
ADHESIVE STRENGTH
9. ADHESIVE is defined as a material , frequently a viscous fluid that
joins two substrates together by solidifying , resisting separation &
transferring a load from one surface to the other.
ADHEREND is defined the surface to which an adhesive adheres.
10. ADHESIVE STRENGTH is the measure of the load-bearing capacity of an
adhesive joint.
Therefore the development of resin based restorative material has opened
new vistas to a more conservative approach to caries management.
12. INDICATIONS FOR ADHESIVE DENTISTRY
Restoration of class 1,2,3,4,5,6 carious lesions
Change the shape & colour of anterior teeth(using full or partial veneer )
Seal pits and fissures
Bond orthodontic brackets
Desensitize exposed root surfaces
Bond amalgam restorations to tooth
Bond fractured segments of anterior teeth.
Bond pre-fabricated fibre or metal posts and cast posts.
Seal root canals during endodontic therapy.
13. ENAMEL ADHESION
In 1955,Michael Buonocore described a clinical technique that used a diluted phosphoric acid to
etch the enamel surface to provide retention of unfilled, self-cured acrylic resins.
The resin would mechanically lock to the microscopically roughened enamel surface, forming
small "tags" as it flowed into the 10-µm to 40-µm deep enamel microporosities and then
polymerized.
The first clinical use of this technique was the placement of pit and fissure sealants.
The formation of resin micro tags within the enamel surface is the basis of RESIN-ENAMEL
ADHESION.
The steps involved are:
14. Acid etching transforms smooth enamel into an irregular surface & increases its free surface
energy
Application of a fluid resin based material to the irregular etched surface , facilitates
penetration of the resin into the surface aided by capillary action
Monomers in the material are polymerised and the material becomes interlocked with the
enamel surface.
15. ETCH PATTERN
Enamel etching leads to the following types of micro morphological
patterns:
TYPE 1 ETCH PATTERN-dissolution of prism cores without involvement of
prism peripheries.
TYPE 2 ETCH PATTERN-PERIPHERAL ENAMEL IS DISSOLVED , but
the cores are left intact.
TYPE 3 ETCH PATTERN-it is less distinct than the other two patterns.
16. ETCHANT CONCENTRATION
Buonocore used 30-40% phosphoric acid.
Currently,37% phosphoric acid in gel form is used.
Silverstone found that the application of 30-40% phosphoric acid resulted
in a very retentive enamel surface.
>40% - Calcium salts are less dissolved - ETCH patterns with
poorer definition.
<27% - Formation of dicalcium phosphate dihydrate -
cannot be easily removed by rinsing.
17. ETCH TIME
Currently, an etching time of 15 seconds is used.
An etching time of 60 seconds originally was recommended for
permanent enamel using 30-40% phosphoric acid.
However , studies show that a 15 second etch resulted in a similar
surface roughness as that provided by a 60 second etch.
18.
19. Phosphoric acid is said to be a more aggressive acid,so alternative etchants have
been suggested:
EDTA (24%; ph=7)
Citric acid
Tannic acid
Maleic acid
Polyacrylic acid
ALTERNATE ETCHANT SYSTEMS:
Lasers
Air abrasion-Al2O3 particles
20. LASERS
Adhesion to dental hard tissues after Er:YAG laser etching is inferior to that
obtained after conventional acid etching.
Enamel and dentin surfaces prepared by Er:YAG laser etching show
extensive subsurface fissuring that is unfavorable to adhesion.
(J Prosthet Dent 2000;84:280-8.)
Adhesion to laser-ablated or laser-etched dentin and enamel was inferior
to that of conventional rotary preparation and acid etching.
( Dental Materials (2005) 21, 616–624)
21. Figure 1 Scanning electron microscopic images of dentin: (A)
rotary-prepared and acid-etched (3500!),
(B) laser-prepared (9000!), and (C) laser-prepared and then acid-
etched (3500!).
(Fig. 1A) revealed a smoothsurface with tubule orifices
devoid of smear plugs.
The intertubular dentin is undisturbed.
In contrast, SEM of a cross-section of
laser-ablated, laser-etched dentin showed a highly
irregular surface and fissuring. Areas of poor hybridization
between composite and dentin suggest poor hybridization,
or no hybridization.
Laser-prepared dentin revealed surface scaling and
flaking, along with peritubular cuffing (Fig. 1B). Acid-
etching after
laser ablation appeared to decrease some of the surface
scaling and flaking (Fig. 1C).
22. Figure 3 Separation of resin adhesive and
unaffected subsurface dentin from laser-
ablated, then acid-etched dentin.
Laser ablated,acid-etched dentin
demonstrated areas of detachment
From both the resin adhesive and the
unaffected subsurface dentin (Fig. 3).
23. SEM photographs of 37% orthophosphoric acid, 10% maleic
acid, and Er,Cr:YSGG hydrokinetic laser-treated enamel are
shown in Figure 4.
The enamel surface etched with 2 acid solutions and a laser
system showed different results according to Silverstone’s10
etching patterns.
• The 37% orthophosphoric acid removed the periphery core
material but left the prism core relatively unaffected (type II),
producing a very rough enamel surface.
• The 10% maleic acid treatment resulted in preferential
removal of prism core material and left the periphery intact
(type I).
• Er,Cr:YSGG hydrokinetic laser treated enamel showed a
more random etching pattern in which adjacent areas of tooth
surface correspond to types I and II, mixed with regions where
the pattern could not be related to prism structure. There was
no recrystallization or melting observed
24. BOND STRENGTH
Shear bond strength of composite to phosphoric acid etched enamel
exceeded 20 Mpa.
According to studies,a minimum of 17-21MPa of bond strength is needed
to prevent the disruption of the bond between the tooth and composite.
25. DENTIN ADHESION
Bonding to dentin is challenging & difficult.
Adhesion to dentin occurs by mechanical method,chemical or both.
But the main method is by penetration of adhesive monomers into collagen
fibrils which are exposed post acid etching.
Structural differences exist between enamel & dentin.
Therefore the following reasons account for challenges faced in dentin
adhesion:
STRUCTURE OF DENTIN
SMEAR LAYER
STRESSES AT RESIN-DENTIN INTERFACE
26. STRUCTURE OF DENTIN
Enamel contains 90% of hydroxyapatite crystals whereas dentin has only
50% and the rest is constituted by water(25%) and type I collagen(25% by
volume).
Dentinal tubules exert pressure of 25-30mmHg, thus creating decreased
stability of bond between composite resin and dentin.
The number of dentinal tubules decreases from about 45000 near the pulp
to 20000 near DEJ
27. Also the tubule diameter decreases from 2.37µm to 0.63µm near DEJ.
Adhesion can also be affected by remaining dentin thickness(RDT) as
bond strength is greater for superficial dentin and its lesser for deeper
dentin
28. WHAT IS SMEAR LAYER?
It is the residual organic or inorganic components formed when a tooth is
prepared using a bur or other instrument.
(Sturdevant’s Art & Science of operative dentistry,4th edition)
It is 1-10 µm thick .
29. COMPOSITION OF SMEAR LAYER:
According to SEM studies done by Shulien TM(1988),it consists of:
Small particles of mineralized collagen matrix
Inorganic tooth preparation
Saliva
Blood
Bacteria
According to branstroem,the organic component consisted of coagulated
proteins from collagen denatured by frictional heat of cutting.
30. Therefore optimal bonding can occur by:
A. Removal of smear layer by using etch and rinse adhesives.
B. Incorporation of smear layer into bonding layer by self-etch adhesives
Complete removal of smear layer increases the dentin permeability by 90%.
31. STRESSES AT THE RESIN-DENTIN INTERFACE:
As composites polymerize,shrinkage occurs leading to stresses upto
7MPa.
When the composite is bonded only to one surface,stresses are relieved
by flow from the unbended surface.
Davidson et al. postulated that minimum bond strength of 17-20 MPa to
enamel and dentin is needed to resist contraction forces of resin composite
materials.
In the present study, both the self-etching adhesives showed optimal bond
strength values greater than 20 MPa for both uncontaminated and
contaminated dentin.
32. DENTINE BONDING AGENTS
It is defined as ”a thin layer of resin applied between conditioned dentin and resin
matrix of a composite.”
The term dentine bonding agents is no longer relevant as current bond agents bond to
enamel and dentine.
Due to acid –etching ,micro leakage or loss of retention is not a hazard at the resin-
enamel interface but its encountered at the resin-dentine interface.
Due to the differences in the composition of enamel and dentine,developing agents
that will adhere to dentine was challenging due to the following reasons:
The high water content interferes with bonding.
Presence of a smear layer on the dentine surface.
33. Therefore the bonding agent should be hydrophilic to displace the water
,permitting it to penetrate the porosities in dentine and react with the
inorganic/organic components.
But, restorative resins are hydrophobic, therefore the bonding agent should
contain both hydrophilic and hydrophobic components.
The hydrophilic part bonds with either calcium or collagen whereas the
hydrophobic part bonds with the restorative resin.
34. CONDITIONING OF DENTIN
It is the etching of dentin surface with acids or calcium chelators.
So, when acid is applied to it, dissolution of hydroxyapatite crystals in
intertubular dentin and outer surface of peritubular dentin occurs
Ultimately, the smear layer gets removed and collagen fibrils are exposed.
Materials used are: 37% phosphoric acid
nitric acid
citric acid
EDTA(ethylene diamine tetra-acetic acid)
35. DURATION OF ETCHING ON DENTIN
Ideal duration is 15-20 seconds.
Increased duration: greater collapse
of collagen due to denaturation.
Decreased monomer infiltration.
Decreased duration: insufficient
depth of etching.
36. PRIMING OF DENTIN
It is the process of applying primers to the etched/conditioned dentin
surface to improve the diffusion of the adhesive resin into moist and
demineralized dentin
Primer solution is a mixture of monomers with hydrophilic and hydrophobic
components dissolved in organic solvent
Priming agents are HEMA(hydroxyethyl methacrylate) and 4-META(4-
methacryloxyethyl trimellitae anhydride)
39. CLASSIFICATION
1. HISTORICAL STRATEGIES
FIRST GENERATION(1965)
SECOND GENERATION(1978)
THIRD GENERATION(1984)
2. CURRENT STRATEGIES
ETCH & RINSE ADESIVES
i. THREE STEP-ETCH &RINSE ADHESIVE(FOURTH GENERATION)
ii. TWO STEP –ETCH & RINSE ADHESIVE(FIFTH GENERATION)
SELF ETCH ADHESIVES
TWO COMPONENT –SELF ETCH ADHESIVE(SIXTH GENERATION)
o TWO STEP-TWO COMPONENT –SELF ETCH ADHESIVE
o ONE STEP –TWO COMPONENT - SELF ETCH ADHESIVE
SINGLE COMPONENT-ONE STEP-SELF ETCH ADHESIVE(SEVENTH
GENERATION)
40. Current strategies
ETCH & RINSE ADESIVES SELF ETCH ADHESIVES
THREE STEP-ETCH &RINSE ADHESIVE TWO STEP –ETCH & RINSE ADHESIVE
(FOURTH GENERATION) (FIFTH GENERATION)
TWO COMPONENT –SELF ETCH ADHESIVE SINGLE COMPONENT-
ADHESIVE(SEVENTH
( SIXTH GENERATION ) ( SEVENTH GENERATION)
TWO STEP-TWO COMPONENT –SELF ETCH ADHESIVE
ONE STEP –TWO COMPONENT - SELF ETCH ADHESIVE
41. BASED ON MODERN ADHESION STRATEGY:
Van Meerbek et al(2001) suggested a classification based on adhesion strategy.
TOTAL ETCH SELF ETCH
TWO STEP MILD
THREE STEP ADHESIVES MODERATE
INTERMEDIARY STRONG
TYPE OF ADHESIVE STEPS INVOLVED
ETCH AND RINSE
ADHESIVES
THREE STEP ADHESIVE:FOURTH GENERATION
TWO STEP ADHESIVE:FIFTH GENERATION
SELF ETCH ADHESIVES
TWO STEP ADHESIVE:SIXTH GENERATION
ONE STEP ADHESIVE:SEVENTH GENERATION
42. BASED ON THE TREATMENT OF SMEAR LAYER:
Smear layer modifying
Smear layer removal
Smear layer dissolving
43. DECADE BONDING AGENT FEATURES
1960s
1970s
FIRST GENERATION
SECOND GENERATION
• DENTIN ETCHING WAS CONTRAINDICATED
• ADHESION WAS TO SMEAR LAYER
• WEAK BOND STRENGTH
1980s THIRD GENERATION • ETCHING ENAMEL & DENTIN
• PRIMING-A SECOND STEP WAS DONE
• BETTER BOND STRENGTH
EARLY 1990s FOURTH GENERATION • TOTAL ETCH CONCEPT WAS INTRODUCED
• WET BONDING & HYBRID LAYER CONCEPTS
INTRODUCED
• MULTIPLE TECHNIQUE SENSITIVE CLINICAL STEPS
MID 1990s FIFTH GENERATION • PRIMER & ADHESIVE COMBINED IN ONE BOTTLE
• HIGHER BOND STRENGTHS
LATE 1990s SIXTH GENERATION • INTRODUCTION OF SELF-ETCHING PRIMERS
• POST OPERATIVE SENSITIVITY WAS REDUCED
• LOWER BOND STRENGTHS
EARLY 2000s SEVENTH GENERATION • ALL IN ONE/ONE STEP BOND CONCEPT
INTRODUCED
• BOND STRENGTH LOWER THAN 4TH & 5TH
GENERATIONS
45. Most products use a three-component system consisting of a conditioner, primer, and
adhesive.
1. CONDITIONER (CLEANSER, ETCHANT) –
weak organic acid (e.g., maleic acid),
a low concentration of a stronger inorganic acid (e.g., phosphoric or nitric acid)
a chelating agent (e.g., EDTA).
46. MAIN ACTIONS:
Alters or removes the smear layer.
demineralizes peritubular and intertubular dentin
exposes collagen fibrils --demineralizes up to a depth of 7.5 microns.
peritubular dentin is etched more deeply than the intertubular dentin
increases dentin permeability.
47. PRIMER
bifunctional monomer in a volatile solvent such as acetone or alcohol
examples of HEMA (hydroxyethyl methacrylate),
NMSA (N-methacryloyl-5- aminosalicylic acid),
NPG (N-phenylglycine),
PMDM (pyromellitic diethylmethacrylate), and
4-META (4- methacryloxyethyl trimellitate anhydride).
48. MAIN ACTIONS:
Links the hydrophilic dentin to the hydrophobic adhesive resin
Promotes infiltration of demineralized peritubular and intertubular dentin
increases wettability of the conditioned dentin surface
49. ADHESIVE (BONDING RESIN):
It is an unfilled or partially-filled resin; may contain some component of the primer (e.g.,
HEMA) in an attempt to promote increased bond strength.
MAIN ACTIONS:
Combines with the primer s monomers to form a resin-reinforced hybrid layer ( resin-dentin
interdiffusion zone ) 1 to 5 microns thick.
Forms resin tags to seal the dentin tubules
50. FIRST GENERATION DENTIN BONDING AGENT
It consisted of surface active co-monomer NPG-GMA(N-phenylglycine
glycidyl methacrylate)
MECHANISM OF ACTION:
This co-monomer could chelate with calcium on the tooth surface to
generate chemical bonds of resin to calcium.
Example:
Cervident(S S White burs,Lakewood)
51. Clinical result:
It had poor bond strength of 2-3MPa.
Therefore when used to restore noncarious cervical lesions without
mechanical retention.
52. SECOND GENERATION DENTIN BONDING
AGENT:
Introduced in 1978.
They were based on phosphorous esters of methacrylate derivatives.
MECHANISM OF ACTION:
Adhesion was by means of ionic interaction between the negatively charged
phosphate groups & positively charged calcium in the smear layer.
Advantage:
Bond strength was 3 times higher than the earlier ones.
Disadvantage:
Bond strength was still lower around 5-6 Mpa.
Clinical failure due to the bonding instability in the wet oral environment & their
primary bonding to the smear layer and not the dentin.
53. ADVANTAGE:
Bond strength was 3 times higher than the earlier ones.
DISADVANTAGE:
Bond strength was still lower around 5-6 Mpa.
Clinical failure due to the bonding instability in the wet oral environment &
their primary bonding to the smear layer and not the dentin.
55. THIRD GENERATION BONDING AGENT:
It was a phosphate based material containing HEMA and a 10-carbon
molecule 10-MDP(10-methacryloyloxy decyl dihydrogen phosphate)
These were introduced with Clearfil New Bond in 1984.
MECHANISM OF ACTION:
The concept of phosphoric acid etching of dentin before the application of
a phosphate ester type of bonding agent was put forward by FUSAYAMA
et al in 1979
56. Most of the other III generation bonding agents were designed not to
remove the smear layer but only to modify it and therefore allow the
penetration of acidic monomers like pheny-P or PENTA(dipentaerythritol
penta-acrylate monophosphate)
EXAMPLES:
Clearfil New Bond(Kuraray)
Scotchbond 2(3M ESPE)
57. COMPOSITION OF SOME III
GENERATION
DENTIN BONDING AGENTS
Adhesive
system
Etchant Primer Adhesive Bond
strength
Scotch Bond
2
2.5% maleic
acid + 55%
HEMA
HEMA Bis GMA 8.8 Mpa
Tenure
Oxalate bonding
system
aluminium
oxalate in
2.5% nitric
acid
NPG-GMA. BisGMA,
TEGDMA
15 Mpa
This generation attempted to deal with both the smear layer and dentinal fluid,
with following 2 approaches:
i. Smear layer modification to improve its properties.
ii. Remove s.layer without disturbing the smear plugs that occlude dentinal tubules.
58. CLASSIFICATION
1. HISTORICAL STRATEGIES
FIRST GENERATION(1965)
SECOND GENERATION(1978)
THIRD GENERATION(1984)
2. CURRENT STRATEGIES
ETCH & RINSE ADESIVES
i. THREE STEP-ETCH &RINSE ADHESIVE(FOURTH GENERATION)
ii. TWO STEP –ETCH & RINSE ADHESIVE(FIFTH GENERATION)
SELF ETCH ADHESIVES
TWO COMPONENT –SELF ETCH ADHESIVE(SIXTH GENERATION)
o TWO STEP-TWO COMPONENT –SELF ETCH ADHESIVE
o ONE STEP –TWO COMPONENT - SELF ETCH ADHESIVE
SINGLE COMPONENT-ONE STEP-SELF ETCH ADHESIVE(SEVENTH GENERATION)
59. CURRENT STRATEGIES FOR RESIN-DENTIN
BONDING
1. ETCH AND RINSE ADHESIVE:
The smear layer is considered to be an obstacle that must be removed to
permit resin bonding to dentin.
The next generation of dentin adhesives was introduced for use on acid –
etched dentin.
The clinical technique involves simultaneous application of an acid to enamel
& dentin.This was called as total-etch technique.
60. MECHANISM OF ACTION:
application of acid to dentin results in complete or partial removal of smear layer and
demineralization of dentin
Intertubular & peritubular dentin are demineralised,thus exposing collagen fibres & increasing
microporosity of intertubular dentin
7.5µm of dentin is demineralised
Primer increases the free surface energy of dentin
Formation of resin tags and hybrid layer.
61. MOIST BONDING TECHNIQUE WITH ETCH AND RINSE ADHESIVE
• This was given by Kanca & Gwinett in 1990.
• Excess water on the substrate that is the tooth surface is not indicated due to the
following reasons:
• Swelling of collagen occurs leading to the decrease in the space available for resin
penetration
• Secondly, it dilutes the primer.
• Thirdly, when priming is done in such conditions, phase separation of hydrophobic and
hydrophilic components occur leading to blister & globule formation at the resin-dentin
interface.
• Thus these water blisters may compress when the restoration is under,forcing dentinal
fluid towards pulp and causing post-operative sensitivity.
62. How wet or dry should the dentin be?
It should be hydrated that is clinically glistening and moist.
How to achieve it?
After etching and rinsingblot the excess water dry with a sponge & which
shoulbe touched to the surface of water and not pressed against dentin.
63. Why is complete drying of dentinal surface contraindicated?
Vital dentin is moist.Therefore drying the dentin with air would cause
collapse of dentinal collagen fibrils and thus leading to its shrinkage.
The interfibrillar space should be left open and hydrated for effective resin
infiltration.
64. SEM of dentin that was acid etched with 37% phosphoric acid for 15s & rinsed
with water and then briefly air dried.there is disappearance of spaces between
collagen fibrils in top 1µm of demineralized zone that extends 5µm.although liquid
monomers can permeate the tubules,it cannot pass through the spaces between
collagen fibrils in intertubular dentin. TL-dentinal tubule.
65. SEM of dentin that was kept
moist after rinsing off etchant.
The abundant intertubular
porosity serves as a pathway for
the penetration of the dentin
adhesive . T, dentinal tubule.
66. Scanning electron micrograph of
dentin collagen after acid etching
with 35% phosphoric acid.Dentin
was air dried.
The intertubular porosity
disappeared due to collapse of
collagen secondary to the
evaporation of water.
68. Here three components came into being:
Phosphoric acid etchant(in gel form)
Primer –it consisted of hydrophilic monomers in ethanol , acetone or water.
Primer is a bifunctional molecule having a hydrophilic and a hydrophobic
part.the former attaches to tooth whereas the latter attaches to composite
resin.
Examples:HEMA
NTG-GMA
PENTA
69. Bonding agent:
It consists of unfilled or filled resin which may be BisGMA(Bisphenol
glycidyl methacrylate),UDMA(urethane dimethacrylate) with TEGDMA &
HEMA(2-hydroxyethyl methacrylate).
Thus after the application of primer and bonding agent to etched surface
aids in their penetration into intertubular dentin to form a resin-dentin inter
diffusion zone called HYBRID LAYER which was introduced by
Nakabayashi in 1982.
70. ADVANTAGES:
Higher bond strength of 17-24MPa.
They show reliable and consistent results.
DISADVANTAGES:
Technique sensitive
Time consuming procedure
Over wetting or over drying of dentin may occur
71. • BRAND NAMES-
• All Bond 2 & All Bond 3
• Optibond FL(Kerr Corporation)
• Adper Scotchbond Multi-purpose(3M ESPE)
• BOND STRENGTH-
• 17-30 Mpa.
72. CLINICAL STEPS INVOLVED:
STEP1:application of etchant gel(37% phosphoric acid) for 15 seconds .
STEP2:rinse the etchant thoroughly and blot dry the substrate
(moist bonding technique)
STEP3:application of primer (bottle 1) on the substrate.
STEP4:application of adhesive(bottle 2)on the tooth substrate.
STEP5: light cure .
73. 1st step:
-Total etching(removal of
smear layer)
Leaving free minerals on
surface
-Rinse surface
-Without drying of surface
(residual water left)
2nd step :
adding primer
3rd step:
Adding adhesive resin &
then composite
Composite
Smear layer
Residual
water
Primer
Adhesive resin
74. WHAT IS HYBRID LAYER?
DEFINITION
“The structure formed in the dental hard tissue by demineralization of the
surface and the sub-surface followed by infiltration of monomers &
subsequent polymerization.”
( Nakabayashi,1982)
It is a hybrid combination of the above two. It is a process which creates a
molecular level interfacebetween dentin and composite resin.
75. ZONES
TOP LAYER MIDDLE LAYER BASE
TOP LAYER :loosely arranged collagen fibrils directed towards adhesive resin.
MIDDLE LAYER: collagen fibrils separated by electron lucent spaces(10-20nm)
represent areas in which HA crystals have been replaced by resin due to
hybridization.
BASE : partially demineralized dentin.
76. TWO STEP :ETCH & RINSE ADHESIVES (FIFTH
GENERATION)
This was developed to simplify the procedures involved in bonding.
Therefore , the primer and the bonding agent is present in a single bottle.
COMPONENTS:
ETCHANT GEL + PRIMER & ADHESIVE
79. STEPS INVOLED ARE:
STEP1:application of etchant gel.
STEP2:rinse the etchant thoroughly and blot dry the substrate
(moist bonding technique)
STEP3:application of primer and adhesive (single bottle)
STEP4:light cure .
BRAND NAMES:
Prime & Bond NT(Dentsply)
Adper single bond2
ExciTE(Ivoclar,Vivadent)
One coat Bond
XP Bond
80. CLASSIFICATION
1. HISTORICAL STRATEGIES
FIRST GENERATION(1965)
SECOND GENERATION(1978)
THIRD GENERATION(1984)
2. CURRENT STRATEGIES
ETCH & RINSE ADESIVES
i. THREE STEP-ETCH &RINSE ADHESIVE(FOURTH GENERATION)
ii. TWO STEP –ETCH & RINSE ADHESIVE(FIFTH GENERATION)
TWO COMPONENT –SELF ETCH ADHESIVE(SIXTH GENERATION)
o TWO STEP-TWO COMPONENT –SELF ETCH ADHESIVE
o ONE STEP –TWO COMPONENT - SELF ETCH ADHESIVE
SINGLE COMPONENT-ONE STEP-SELF ETCH ADHESIVE(SEVENTH
GENERATION)
81. SELF-ETCH ADHESIVES
They are defined as “bonding systems which dissolve the smear layer and
create porosities in the underlying dental substrates without needing an
extra conditioning agent(eg:phosphoric acid) to be applied in a single step.
(Quintessence International,vol(8), nov-dec2013)
No separate etching step is needed.
ADVANTAGES:
Decrease in the number of steps
Less technique sensitive.
82. The self-etching approach has been proposed in an effort to simplify the
dentin/enamel bonding systems.
These materials combine tooth surface etching and priming steps into one
single procedure.
The elimination of separate etching and rinsing steps simplified the
bonding technique and has been responsible for the increased popularity
of these systems in daily practice33
83. Based on the acidity of self-etch primers & adhesives, they are classified
as:
Weak- pH-2
Medium pH-1.5
Strong pH≤1
Most commonly pH ranges from1.3-2.7
85. VI GENERATION BONDING AGENT
1. 2 STEP : 2 COMPONENT SELF-ETCHING ADHESIVES:
(NONRINSING CONDITIONERS OR SELF PRIMING ETCHANTS)
MECHANISM OF ACTION:
These acidic primers contain phosphonated resin molecule that performs
two function:
Etching and priming of enamel
Incorporating smear plugs into resin tags.
86. Steps involved are:
Application of bottle I(etchant +primer)
After 10 s, application of bottle2 on tooth surface
Light cure
BRAND NAMES:
Clearfil SE Bond(Kuraray,Japan)
AdheSE(Ivoclar-Vivadent)
Optibond Solo Plus Self-etch(Kerr Corp)
87. 2. ONE STEP:TWO COMPONENT-SELF-ETCH ADHESIVE:
consists of- BottleI +Bottle II
Bottle I:conditioner +primer
Bottle II: adhesive resin
Both have to be mixed prior to application on tooth surface.
BRAND NAMES:
Xeno III(Dentsply)
One up bond(Tokuyama)
Prompt L bond(3M ESPE)
88. Self etching primers are acidic in nature, leading to its penetration along
the aqueous channels found in the smear layer and widening them.
These offer a simpler clinical step when compared to the tota;l etch
adhesive systems.
self etching primers contain acidic esters like HEMA,TEGDMA,MDP.
These primers are similar to those found in third generation dentin bonding
systems, the only difference being that in the latter ones only milder acids
were used leading to inability to etch beyond the smear layer.
89. In the sixth generation dentin bonding systems, acidic monomers like 4-
MET and 10-MDP are used ,thus dissolving the smear layer.
When the concentration of acidic monomers increasd from 5-10% wt %(III
generation dentin bonding agent) to 30-40% (VI generation dentin bonding
agent) and dissolved in 30-40% HEMA, pH-1-2 was developed which
aided in etching through smear layer.
90. ADVANTAGES
No etching needed, therefore possibility of over-etching or over-drying is removed
Less technique sensitive.
Self-etch adhesives are less likely to result in discrepancy between depth of demineralization
and depth of resin infiltration as both the processes are done simultaneously.
Less time consuming
DISADVANTAGES
Decreased shelf life
Incompatible with chemical cure composites.
Self-etch adhesives that are currently available do not etch as efficiently as phosphoric acid,
especially if the enamel has not been instrumented.
91. TYPE 2 ( TWO BOTTLE 1 STEP SYSTEM):
Liquid A contains primer.
Liquid b contains a phosphoric acid modified resin.
Both are mixed before application.
Eg:Xeno 3(Dentsply),Adper-prompt L-pop(3M).
92. SEVENTH GENERATION(early 2000s):
(SELF-ETCHING ADHESIVES)
Here the etchant, primer and the adhesive resin are combined into one
bottle .
In vitro studies have shown that tooth-restoration interface created when
using self etching adhesives do not eliminate the micro leakage and
bacterial penetration, which can lead to secondary caries.
(Kakar S,Goswami M,nagar R.Dentin bonding agents-2 Recent trials.
World J Dent2012;3(1);115-118.
93. ADVANTAGES OF VII GENERATION DENTIN BONDING AGENTS:
Lesser application time
Decrease in errors with each step.
95. iBond
COMPONENT FUNCTION
UDMA
(urethane dimethacrylate)
MATRIX COMPONENT
ETCHING & CONDITIONING OF ENAMEL & DENTIN
BONDING TO COLLAGEN VIA HYDROGEN
BONDING
BONDING TO CALCIUM IONS VIA CHELATION
COMPLEXES
4-META
(4-methyloxyethyl trimellitic acid)
MATRIX COMPONENT
CROSS-LINKING
WATER SOLVENT FOR MONOMERS
PROVIDES WATER FOR ETCHING
CAMPHORQUINONE PHOTOINITIATORS
GLUTARALDEHYDE DISINFECTANT/DESENSITIZER
STABILIZERS
96. How is iBond applied?
1. Isolate tooth from saliva contamination during adhesive procedure
2. Clean the tooth prepation,removing all debris with water.
3. Saturate the microbrush with iBond liquidfrom the bottle or single dose
vial.
4. Apply 3 consecutive coats of iBond to enamel & dentin
5. Use gentle air pressure to remove excess solvent
6. Cure for 20s with curing light
7. Place the composite resin.
97. Both the hydrophilic and the hydrophobic components are mixed in this system.
Though this simplifies the clinical steps,it has following shortcomings:
Due to the complex nature of this solution,they are more prone to phase separation.
It forms droplets within the adhesive layer.
This adhesive layer acts as a semi-permeable membrane permitting bi-directional water
currents.
Thus these bonding agents show much reduced bond strength when compared to the
fourth,fifth,and sixth generation of bonding agents.
98. Advantages:
Most time efficient application procedure.
Unidose application,which prevents cross-contamination.
Simultaneous demineralisation & resin penetration.
Less sensitivity to dentin wetness conditions.
Disadvantages:
Reduced shelf life.
Less sealing capacity.
Least bond strength.
Incompatibility with auto/chemical curing composites.
99. ONE COAT 7 BOND.
7TH generation ,one component.
Light cured self etching resin.
High performance on any surface.
Has a fast application in 35 seconds.
On wet surfaces maintains uniform composition, producing an
effective bond.
100.
101.
102. DECADE BONDING AGENT FEATURES
1960s
1970s
FIRST GENERATION
SECOND GENERATION
• DENTIN ETCHING WAS CONTRAINDICATED
• ADHESION WAS TO SMEAR LAYER
• WEAK BOND STRENGTH
1980s THIRD GENERATION • ETCHING ENAMEL & DENTIN
• PRIMING-A SECOND STEP WAS DONE
• BETTER BOND STRENGTH
EARLY 1990s FOURTH GENERATION • TOTAL ETCH CONCEPT WAS INTRODUCED
• WET BONDING & HYBRID LAYER CONCEPTS
INTRODUCED
• MULTIPLE TECHNIQUE SENSITIVE CLINICAL STEPS
MID 1990s FIFTH GENERATION • PRIMER & ADHESIVE COMBINED IN ONE BOTTLE
• HIGHER BOND STRENGTHS
LATE 1990s SIXTH GENERATION • INTRODUCTION OF SELF-ETCHING PRIMERS
• POST OPERATIVE SENSITIVITY WAS REDUCED
• LOWER BOND STRENGTHS
EARLY 2000s SEVENTH GENERATION • ALL IN ONE/ONE STEP BOND CONCEPT
INTRODUCED
• BOND STRENGTH LOWER THAN 4TH & 5TH
GENERATIONS
103. RECENT ADVANCES :
UNIVERSAL ADHESIVE
In 2012, the term “universal adhesive” has been given several definitions
which are:
a)Can be used in total-etch, self-etch, and selective etch techniques;
b)Can be used with light-cure, self-cure, and dual-cure materials (without the
separate activators);
c)Can be used for both direct and indirect substrates;
d)Can bond to all dental substrates, such as dentin, enamel, metal, ceramic,
porcelain, and zirconia.
104. In November 2011, a new “ScotchBond Universal” was discovered.
Which needs a separate self-cure activator or a special amine-free dual-
cure cement when in use with dual-cure or self-cure materials, hence not
a truly “universal” adhesive.
105. In March 2012, a “All-Bond Universal” was discovered, which can be
used in:
i.total-etch, self-etch and selective etch techniques,
ii.can be used with any dual-cure, self-cure and light-cure
materials without the need of a separate activator,
iii.can also be used for both direct and indirect substrates, and
can bond with any dental substrates.
All-Bond Universal is the first truly “universal adhesive”.
107. BASED ON THE TREATMENT OF SMEAR LAYER
SMEAR LAYER SMEAR LAYER SMEAR LAYER
MODIFYING REMOVAL DISSOLVING
108. SMEAR LAYER
It was first suggested by Skinner in 1961.
Coined by Boyde in 1963.
0.5-2µm thick, granular
Smear plugs…1-10µm
109. WHY IS THE PRESENCE OF SMEAR LAYER
DETRIMENTAL TO BONDING?
It is a weak attachment to dentin and is brittle
so it can be easily dislodged & prone to cohesive failure.
Therefore to overcome this, etch & rinse adhesive was developed.
110. SMEAR LAYER REMOVAL
DRAWBACK OF COMPLETE REMOVAL OF SMEAR LAYER:
Increases dentin permeability and flow of the dentinal fluid
Thus diluting the bonding agent
Examples:
IV & V generation dentin bonding agents.
111. SMEAR LAYER MODIFYING
Examples:
II & III generation dentin bonding agents.
Incorporation of smear layer inhibited proper bonding and resulted in loss
of bond strength.
112. SMEAR LAYER DISSOLVING
Self-etching adhesives dissolve and include the smear layer in the
hybridization process.
BASED ON Ph
STRONG INTERMEDIARY MILD
(<1) (1-2) (≅ 2)
113. Suresh Chandra et al.Comparative evaluation of self-etching
primers sixth, fourth& fifth generation dentin bonding systems
on carious and normal dentin.J Conser Dent2008;11(4):154-158
Study comparing bond strengths of total etch and self etch primer to
carious affected and normal dentin.
Result- higher bond strength with normal dentin than caries affected dentin
Discussion: self etching primers needed highest mean shear load to
fracture followed by V, IV generation bonding agents
Self etching primers superficially demineralize normal dentin by dissolving
fibrils
114. Thus aiding in monomer infiltration.
Later the dentin is not washed therefore shrinkage of collagen is avoided.
According to the study the bond strength of self etching primers > fourth &
fifth .
115. BONDING EFFICACY OF VI AND VII
GENERATION BONDING AGENTS
Manjula Nair, Joseph Paul et al. comparative evaluation of bonding
efficacy of VI and VII generation dentin bonding agents: an invitro study. J
Conserv Dent 2014; 17(1):27-30.
Aim: to compare shear bond strength of VIth and VII dentin bonding
agents.
Materials
used
VI DBA
ADPER
SEPLUS
PH<1
XENO III PH-1.4
VII DBA
ADPER
EASY ONE
PH-2.3
XENO V
116. Result:
VII>VI DBA
Discussion:
VI generation bonding agents have less bond strength to dentin due to high
acidity resulting in higher amount of demineralization.
But the VII generation dentin bonding agents (mild self etch adhesives)
demineralise upto one µm only keeping residual hydroxyapatite still attached
to collagen.
This 1µm is enough for micromechanical retention .
117. The retention of hydroxyapatite within the hybrid layer acts as receptor for
chemical bonding.
Therefore this leads to higher bond strength with mild self etch adhesives.
So this is the cause for low bond strength with Adper SE Plus and Xeno III.
Though according to this study VII generation has higher adhesive
property than VI, some studies contradict this.
118. Comparative evaluation of bonding efficacy of sixth,seventh
and eighth generation bonding agents:an in vitro study. Paul
Joseph et al.Int .Res. J Pharm.2013,4(9)
The aim of the study was to compare In-vitro the micro tensile bond strength of sixth
generation (Clearfil SE Bond, Kuraray, Japan), seventh generation (Adper Easy One, 3 M
ESPE, Germany) and eighth generation ((Futurabond DC, Voco, Germany) dentin bonding
agents.
Results:
Futurabond DC, Voco, Germany>Clearfil SE Bond, Kuraray, Japan>Adper Easy One, 3 M
ESPE, Germany)
119. Figure 3: Specimens obtained after hard tis sue microtome sectioning Figure 4: Universal Testing Machine
120. CLINICAL APPLICATION OF SELF-ETCH
BONDING SYSTEMS
Class V composite resin restoration using a
self-etch two step system
a) Application of self-etch primer.
b) Application of adhesive.
c) Completed Class V composite resin
restoration.
122. POSTERIOR COMPOSITE RESIN RESTORATIONS
Core build up restoration with light cured composite resin using two-step self-etch
bonding system.
a) After removal of defective amalgam restoration
b) Application of self-etching primer
c) Application of adhesive
d) Completed composite restoration in molars and the premolar
123. RESTORATION OF PRIMARY TEETH
Self-etch adhesives are an alternative to total etch systems.
But ,the all in one adhesives should be used in combination with
compomers(polyalkenoic acid modified composite resins) & only in small
to medium sized cavities with adequate macroretention.
(Quintessence International, vol(8),nov-dec2013)
124. CORE BUILD-UP WITH LIGHT-CURED COMPOSITE RESIN:
CORE BUILD UP WITH FLOWABLE COMPOSITE….DEFECTIVE AMALGAM
RESTORATION…..TWO STEP SEA….FULL CERAMIC PARTIAL CROWN
125. EXAMPLE OF A SELF-ETCH TWO STEP BONDING SYSTEM
INCLUDING ACTIVATOR(ADHESE/ADHESE DC ACTIVATOR)
FOR COMBINATION WITH DUAL-CURED RESIN CEMENTS &
CORE BUILD-UP COMPOSITES
126. In the combined post & core technique,the same dual cured composite resin is used for adhesive
post cementation & as core material.
a. try in of FRC post.
b. application of self-etch primer-adhesive into root canal using endo-microbrush.
c.adhesively cemented FRC post with composite core build-up.
a
A.
127. TREATMENT OF CERVICAL DENTIN HYPERSENSITIVITY
PREVENTION OF ROOT SURFACE CARIES
ADHESIVE CEMENTATION OF INDIRECT RESTORATION
128. MICROLEAKAGE
DEFINITION
It is the passage of bacteria and their toxins between restoration
margins and tooth preparation walls
MECHANISM OF ACTION:
The presence of gaps at the resin-dentin interface leads to ingress of
bacteria.
129. Therefore bonding the resin to a preparation with cavosurface margins in
enamel is the best way to prevent microleakage.
Bacteria are able to survive & proliferate within the fluid filled marginal
gaps, thus leading to secondary caries.
130. NANOLEAKAGE
It is the small porosities in the hybrid layer or at the transition between the
hybrid layer and the dentin that allow the passage of particles of silver
nitrate dye.
Penetration of ammoniacal silver nitrate results in two patterns:
Spotted pattern-in the hybrid layer of self-etch adhesives due to incomplete
resin infiltration.
Reticular pattern-that occurs in the adhesive layer due to incomplete
removal of water from the bonding area.
131. NANOLEAKAGE UNDER ELECTRON MICROSCOPE.
Spotted pattern in the hybrid layer formed by one-step self-etch adhesive
Reticular pattern and water trees in adhesive layer formed by self etch adhesive
132. ANTIBACTERIAL PROPERTY OF DENTIN
BONDING
AGENTS
The development of adhesive systems have enabled variable cavity
designs to preserve tooth structure and treatment of dental caries has
shifted from the traditional method to that with downsized cavities.
Inspite of considerable improvement in the recent years , polymerization
shrinkage & the resultant contraction gaps in tooth restoration interface
continue to be a significant problem associated with composite resin
restorations.
133. Thus cariogenic bacteria like Streptococcus mutans,Lactobacillus
acidophilus,Lactobacillus casei and Streptococcus salivarius can invade
along the microgaps and lead to secondary caries.
Therefore it is imperial to provide resin based materials with antibacterial
activity.
Imazato et al have reported the antibacterial property of MDPB
((methacryloyldodecylpyridinium bromide) which is monomer present in
the bonding agent.
Also, acidic monomers like 10-MDP(10-methacryloyloxy decyl dihydrogen
phosphate) due to its inherent acidity has antibacterial property.
134. Amin S,Shetty HK,Varma RK,Amin V,Nair PM.Comparative
evaluation of antibacterial activity of total etch and self etch
adhesive systems:An ex vitro study.J Conser Dent 2014
;17:266-70
The purpose of the study was to compare the antibacterial activity of total-
etch and self-etch adhesive systems against Sreptococcus mutans ,
Lactobacillus acidophilus , and Actinomyces viscosus through disk
diffusion method .Of all the materials tested, the antibacterial effects may
be related to the acidic nature of the adhesive systems.
135. Sampath PB, Hegde MN, Hegde P.Assessment of the
antibacterial properties of newer dentin bonding agents. An in
vitro study.Contemp Clin Dent 2011;2:165-9.
The aim of this study was to evaluate and compare the antibacterial
activity on Streptococcus mutans using direct control test.The
incorporation of antibacterial agents into dentin bonding agents may
become an essential factor in inhibiting residual bacteria in the cavity.
136. Amin S,Shetty, HK,Varma et al. Comparative evaluation of antibacterial
activity of total etch and self etch adhesive systems:An ex vitro study.J
Conser Dent 2014 ;17:266-70
Aim: The aim of this ex vivo study was to compare the antibacterial activity of total-etch and self-
etch adhesive systems against Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces
viscosus through disk diffusion method.
Materials and Methods: The antibacterial effects of Single Bond (SB) and Adper Prompt (AP) and
aqueous solution of chlorhexidine 0.2% (positive control) were tested against standard strain of S.
mutans, L. acidophilus, and A. viscosus using the disk diffusion method. The diameters of inhibition
zones were measured in millimeters. Data was analyzed using Kruskal-Wallis test. Mann-Whitney U
test was used for pairwise comparison.
137. Result: Of all the materials tested, AP(Adper Prompt) showed the
maximum inhibitory action against S. mutans and L. acidophilus. Aqueous
solution of chlorhexidine 0.2% showed the maximum inhibitory action
against A. viscosus. Very minimal antibacterial effect was noted for
SB(Single Bond).
Conclusion: The antibacterial effects observed for the tested different
dentin bonding systems may be related to the acidic nature of the
materials.
138. BIOCOMPATIBILITY
Biological testing of DBA is a delicate and complex process.
Unlike most dental materials, many dentin bonding systems are made up
of more than one material e.g. cleanser , primer , bonding resin etc.
139. • A very limited number of reports have been published on the
biocompatibility of the first generation. Which may be due to their
inferior physical properties.
• Van Leeuwen et al showed no severe reactions even in extremely
deep caries in their study.
1st generation.
• Most studies are carried out using Scotch Bond.
• It might have a adverse effect on pulp tissue when placed
in contact with vital tooth and proper pulpal protection was
recommended.
2nd generation.
• Tests showed that the bonding material as well as the
individual components were toxic.
3rd generation.
141. *Aim *
To evaluate the genotoxicity of four different adhesives, Clearfil SE Bond,SL Bond, i
Bond and Clearfil Protect Bond and the primers of Clearfil SE Bond and Clearfil Protect
Bond.
*Results *
A significant increase (*P* < 0.001) compared to untreated controls in DNA damage was
observed with 'Clearfil Protect Bond' and 'Clearfil SE Bond' primer in human
lymphocytes at concentrations of 2.5 and 5.0 mg mL-1.
Clearfil Protect Bond and Clearfil SE Bond adhesives induced significant (*P* < 0.001)
DNA damage only at the higher concentration of 5.0 mg mL-1. No significant increase in
DNA damage was observed with SL Bond and i Bond.
Nosignificant DNA damage was observed with any dentine bonding agents at the lower
concentration of 1.25 mg mL-1.
*Conclusions *
'Clearfil Protect Bond' and 'Clearfil SE Bond' primers/adhesives increased DNA damage
in human peripheral lymphocytes in high doses.
142. CLINICAL FACTORS AFFECTING ADHESION
Flow of saliva and/or blood contamination
Moisture contamination from handpiece or air water syringe
Oil contamination of handpieces or air-water syringes
Fluoride content of teeth
Location and size of dentinal tubules
Presence of plaque,calculus,extrinsic stains or debris
Presence of bases or liners on prepared teeth
Tooth dehydration
Presence of residual intermediary cements
143. BONDING TO AMALGAM
Bonding of amalgam restoration to tooth is still a debatable topic.
The use of adhesive systems beneath amalgam restoration reduces or
prevents microleakage, makes cavosurface angle less susceptible to
demineralization when compared to varnish.
There is reduction in sensitivity and more conservative cavity preparation
can be achieved when amalgam is bonded to tooth.
144. Staninec M (1989) showed that retention with amalgam bonding is equal
to or superior to traditional means of mechanical retention.
Tig IA, Fodor O, Moldovan M et al (2005) noticed that at higher
magnification, teeth restored with unbonded amalgam had more spaces
and artifacts at the amalgam-tooth structure interface when compared with
those
145. Failures can occur at various levels:
between mineralised and demineralised dentin
between demineralised dentin and bonding agent
within layer of bonding agent
between bonding agent and composite resin.
Affected by –
dentin wetness
tooth flexure
arch
size of lesion
substrate
material factors
146. CONCLUSION
In today’s era, numerous improvements in materials and
procedures have been made to meet the growing aesthetic
demands of the patients.
In all the aesthetic restorations a bonding step is
involved to ensure durability and reliability.
147. Thus the ideal bonding system should be biocompatible,
bond perfectly to enamel and dentin, have sufficient
strength to resist to failure as a result of masticatory forces,
have mechanical properties close to those of tooth, and be
resistant to degradation in oral environment and easy to
use.
148. BIBLIOGRAPHY
STURDEVANT'S ART & SCIENCE OF DENTISTRY-4TH, 5TH & 6TH
EDITION
PHILLIPS-SCIENCE OF DENTAL MATERIALS...11TH EDITION
TOOTH COLORED RESTORATIVES-PRINCIPLES AND
TECHNIQUES..9TH EDITION
PICKARD'S MANUAL OF OPERATIVE DENTISTRY...8TH EDITION
TEXTBOOK OF OPERATIVE DENTISTRY-SUMEETHA
SANDHU..1ST EDITION
MATERIALS USED IN DENTISTRY….S.MAHALAXMI
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2.Taha MY, Al-Shakir NM, Al-Sabawi NA. Antibacterial effect of Dentin
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