Adhesion to Dentin: Contemporary Systems
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Questions and Answers

What is the primary characteristic of aggressive self-etch systems?

  • They require selective etching of enamel.
  • They provide excellent bond strengths to dentin.
  • They are only suitable for use on direct composites.
  • They do not require selective etching of enamel. (correct)
  • What is one method to address the issue of dentin permeability in adhesive systems?

  • Applying a layer of traditional varnish.
  • Using a thicker layer of the same adhesive.
  • Selecting a more aggressive adhesive system.
  • Adding an extra coat of a hydrophobic bonding layer. (correct)
  • Why are universal adhesives termed as such?

  • They are applicable only for direct restorations.
  • They can only bond dentin.
  • They bond only with enamel.
  • They can bond to various substrates besides dentin. (correct)
  • Which category of self-etching primers tends to provide poorer enamel bonds?

    <p>Mild SEPs.</p> Signup and view all the answers

    What is the recommended adhesive system for restoring tooth # 11?

    <p>A mild or ultra-mild self-etching adhesive.</p> Signup and view all the answers

    What is the primary function of the etchant in a three-step total etch adhesive system?

    <p>To remove the smear layer</p> Signup and view all the answers

    Which statement best describes the composition of the bonding agent in the three-step total etch system?

    <p>It contains both hydrophilic and hydrophobic monomers.</p> Signup and view all the answers

    What is the result of opening the tubules in dentin during the etching process?

    <p>Increases surface free energy of dentin</p> Signup and view all the answers

    Which of the following is an example of a bonding agent used in the current strategies for adhesion?

    <p>Scotch Bond MultiPurpose</p> Signup and view all the answers

    During the bonding process, what does the primer do in the three-step total etch system?

    <p>Co-polymerizes with bonding agents</p> Signup and view all the answers

    What is primarily exposed by the etching step in the three-step total etch adhesive system?

    <p>Intertubular collagen</p> Signup and view all the answers

    What is the main purpose of the hybrid layer formed during the adhesion process?

    <p>To help bond the resin to dentin</p> Signup and view all the answers

    Which property of dentin is improved by the bonding process involving primer and bonding agents?

    <p>Surface energy</p> Signup and view all the answers

    What is a primary drawback of the total etch system?

    <p>Immediate collapse of the collagen fiber network with excessive drying</p> Signup and view all the answers

    How can excess water from rinsing the etching gel be effectively removed?

    <p>With a damp cotton pellet</p> Signup and view all the answers

    Which of the following is NOT an advantage of two-step self etching adhesives over total etch systems?

    <p>Increased technique sensitivity</p> Signup and view all the answers

    What is the primary function of resin tags formed in dentinal tubules?

    <p>Providing a stronger bond</p> Signup and view all the answers

    Which method is included in the self etching adhesive types?

    <p>Two-step self etching adhesives</p> Signup and view all the answers

    In self etching systems, what is a critical aspect that is retained?

    <p>Partial retention of the smear layer</p> Signup and view all the answers

    Which adhesive product is an example of a two-step etch-and-rinse system?

    <p>Adper Single Bond Plus</p> Signup and view all the answers

    What effect does excessively wet dentin have on the bonding process?

    <p>Dilution of the primer, making it less effective</p> Signup and view all the answers

    Study Notes

    Adhesion to Dentin

    • Contemporary Adhesive Systems are categorized into three main types
      • Three-Step Total Etch System (Etch and Rinse) involves etching, priming, and bonding
      • Two-Step Etch and Rinse System (E + [PB]) simplifies the process by combining primer and bonding agents
      • Self Etching Adhesives include two-step and one-step (or all-in-one) systems

    Three-Step Etch and Rinse (E + P + B)

    • Etchant (E):
      • Removes the smear layer from dentin
      • Exposes intertubular and peritubular collagen
      • Opens dentinal tubules in a funnel configuration (up to 7.5 μm)
      • Decreases surface free energy of dentin
    • Primer (P):
      • Contains bifunctional molecules (hydrophilic and hydrophobic)
      • Envelops the external surface of collagen fibrils
      • Re-establishes surface free energy compatible with hydrophobic restorative materials
    • Bonding Agent (B):
      • Consists of hydrophobic monomers like Bis-GMA and a small percentage of hydrophilic monomers like HEMA
      • Co-polymerizes with primer molecules
      • Penetrates and polymerizes into inter-fibrillar spaces, forming the hybrid layer (resin-dentin interdiffusion zone)
      • Penetrates and polymerizes in open dentinal tubules, forming resin tags

    Two-Step Etch and Rinse (E + [PB])

    • Rationale: Simplifies the bonding procedure
    • Examples: One-Step Plus, Prime & Bond NT, Adper Single Bond Plus, OptiBond SOLO Plus

    Drawbacks of Total Etch Systems

    • Moisture Sensitivity:
      • Excessive Dryness: Collagen fiber network collapses, hindering resin monomer penetration
      • Excessive Wetness: Pooled moisture dilutes the primer, reducing its effectiveness

    Moist Bonding

    • Excess water after rinsing etching gel can be removed using:
      • Damp cotton pellet
      • High-volume suction
      • Disposable brush
      • Laboratory tissue paper

    Self Etching Adhesives

    • Non-rinsing conditioners/self-priming etchants
    • Types:
      • Two-step self etching adhesive (2 bottle):
      • One-step self etching adhesive (1 bottle or all in one):

    Two-Step Self Etching Adhesives

    • Main advantages compared to total-etch systems:
      • Simplified technique (less technique-sensitive)
      • Elimination of rinsing and drying steps: Reduces the risk of over-wetting or over-drying
      • Do not remove the smear layer completely: Results in less post-operative sensitivity

    One-Step Self-Etch Systems (All-in-One or Single Bottle)

    • All components in one bottle
    • Semi-permeable membranes: Do not form a hermetic seal for vital deep dentin due to transudation of dentinal fluid
    • Solutions:
      • Extra coat of hydrophobic bonding layer
      • Thin layer of flowable composite liner

    Self Etching Adhesive (SEPs) Classification by pH

    • Mild and Ultramild SEPs: Excellent dentin bond strengths but poorer enamel bonds
    • Aggressive self-etch systems: Excellent enamel bonds and no need for selective enamel etching

    Universal Adhesives

    • Bond to various substrates; dentin, indirect ceramic, resin-based restorations (crowns, inlays, onlays, veneers)
    • Mild or ultra-mild one-step self-etching adhesive
    • Selective enamel etching is mandatory

    Case Discussion

    • Class II Preparation in Tooth #16:
      • The specific bonding system choice is not provided in the text. It is crucial to consider the specific characteristics of the preparation, the available bonding systems, and the manufacturer's recommendations for making an informed decision.
    • Restoring Tooth #11:
      • The specific bonding system choice is not provided in the text. It is crucial to consider the specific characteristics of the preparation, the available bonding systems, and the manufacturer's recommendations for making an informed decision.

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    Description

    Explore the principles and types of contemporary adhesive systems used in dentistry. This quiz covers the three main systems: Three-Step Total Etch, Two-Step Etch and Rinse, and Self Etching Adhesives, providing essential details on their processes and components.

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