Podcast
Questions and Answers
What is the primary function of the etchant in the three-step total etch system?
What is the primary function of the etchant in the three-step total etch system?
Which of the following components is crucial for establishing hydrophilicity in the three-step etch-and-rinse system?
Which of the following components is crucial for establishing hydrophilicity in the three-step etch-and-rinse system?
When utilizing a three-step total etch system, which element aids in opening the dentinal tubules?
When utilizing a three-step total etch system, which element aids in opening the dentinal tubules?
Which adhesive system mentioned has hydrophobic monomers such as Bis-GMA?
Which adhesive system mentioned has hydrophobic monomers such as Bis-GMA?
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What is the result of the three-step etch-and-rinse process on dentin?
What is the result of the three-step etch-and-rinse process on dentin?
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How deep can demineralization occur during the etching process in dentin?
How deep can demineralization occur during the etching process in dentin?
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In the bonding agent of a total etch system, which type of molecules are integrated with the primer molecules?
In the bonding agent of a total etch system, which type of molecules are integrated with the primer molecules?
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What is the purpose of reducing the surface free energy of dentin during the bonding process?
What is the purpose of reducing the surface free energy of dentin during the bonding process?
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Which of the following systems is an example of a three-step total etch system?
Which of the following systems is an example of a three-step total etch system?
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What aspect of the dentin surface is enhanced through the use of a primer in the three-step system?
What aspect of the dentin surface is enhanced through the use of a primer in the three-step system?
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What characteristic do self-etching primers (SEPs) exhibit?
What characteristic do self-etching primers (SEPs) exhibit?
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Which type of self-etching system is likely to provide better dentin bond strengths?
Which type of self-etching system is likely to provide better dentin bond strengths?
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What problem may arise from the use of polymerized adhesives?
What problem may arise from the use of polymerized adhesives?
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What is a requirement for universal adhesives?
What is a requirement for universal adhesives?
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Which bonding system is most suitable for restoring tooth # 11?
Which bonding system is most suitable for restoring tooth # 11?
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Which category of self-etching primers does not require selective etching of enamel?
Which category of self-etching primers does not require selective etching of enamel?
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What is a potential consequence of leaving hard discolored dentin on the pulpal floor during preparation?
What is a potential consequence of leaving hard discolored dentin on the pulpal floor during preparation?
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In the context of adhesive systems, what type of adhesive provides the best bond to indirect ceramic restorations?
In the context of adhesive systems, what type of adhesive provides the best bond to indirect ceramic restorations?
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What should clinicians consider when selecting an adhesive for Class II preparations?
What should clinicians consider when selecting an adhesive for Class II preparations?
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What is the main function of applying an extra coat of a hydrophobic bonding layer?
What is the main function of applying an extra coat of a hydrophobic bonding layer?
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What is a primary benefit of using self-etching adhesives over total etch systems?
What is a primary benefit of using self-etching adhesives over total etch systems?
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Which of the following is NOT a drawback of total etch systems?
Which of the following is NOT a drawback of total etch systems?
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What is the main function of resin tags formed during the bonding process?
What is the main function of resin tags formed during the bonding process?
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Which method can effectively remove excess water after rinsing the etching gel without impacting bond strengths?
Which method can effectively remove excess water after rinsing the etching gel without impacting bond strengths?
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What characteristic does a one-step self-etching adhesive system have?
What characteristic does a one-step self-etching adhesive system have?
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What could happen if the dentin surface is dried excessively with air?
What could happen if the dentin surface is dried excessively with air?
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What type of self-etching adhesive is described as having no rinsing conditioners?
What type of self-etching adhesive is described as having no rinsing conditioners?
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What is one of the main advantages of a two-step self-etching adhesive?
What is one of the main advantages of a two-step self-etching adhesive?
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In which scenario would the bonding effectiveness be negatively impacted?
In which scenario would the bonding effectiveness be negatively impacted?
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Why is moisture control critical when using dentin bonding systems?
Why is moisture control critical when using dentin bonding systems?
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Study Notes
Adhesion to Dentin
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Current Strategies for Adhesion of Resins to Dentin
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Three-step total etch system (etch and rinse): Removes the smear layer, exposes collagen, and opens tubules in a funnel configuration.
- Etchant (E): Demineralizes dentin with an acid, creating a roughened surface.
- Primer (P): Bifunctional molecules with hydrophilic and hydrophobic properties. Envelops collagen fibrils, creating a compatible surface for a hydrophobic restorative material.
- Bonding Agent (B): Hydrophobic monomers penetrate and polymerize into the inter-fibrillar spaces to form a hybrid layer, which is a resin-dentin interdiffusion zone. The bonding agent also penetrates and polymerizes within the open dentin tubules, forming resin tags.
- Examples: Scotch Bond MultiPurpose (3M), All Bond2 (bisco), Panavia 21
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Two-step etch-and-rinse (E + [PB]): Simplified bonding procedure with primer and bonding agent combined.
- Examples: One-Step Plus (Bisco), Prime & Bond NT (DENTSPLY Caulk), Adper Single Bond Plus (3M ESPE), OptiBond SOLO Plus
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Main drawbacks of total etch system:
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Moisture content after rinsing:
- Excessive dryness: Collagen fiber network collapses, preventing resin monomer penetration.
- Excessive wetness: Dilutes primer and renders it less effective.
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Moisture content after rinsing:
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Self-etching adhesives: Non-rinsing conditioners or self-priming etchants.
- 2-step self-etching adhesive: Two separate bottles, one for etching and one for bonding.
- 1-step self-etching adhesive: All-in-one bottle.
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Advantages of self-etching adhesives over total etch systems:
- Simplified technique, less technique sensitive.
- Eliminates rinsing and drying, reducing risk of over-wetting or over-drying.
- Does not completely remove the smear layer, which may lead to less post-operative sensitivity.
- One-Step Self-Etch Systems (all in one systems or single bottle systems): All components in one bottle, behaving as a semi-permeable membrane which may allow fluid droplets to form on the adhesive surface.
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Problems with one-step self-etch systems:
- Do not create a hermetic seal for vital deep dentin due to fluid transudation.
- Can be overcome by adding an extra coat of hydrophobic bonding layer or applying a thin layer of flowable composite liner.
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Self-etching adhesives are categorized by pH:
- Mild and ultramild: Excellent dentin bond strengths, poorer enamel bonds.
- Aggressive: Poorer dentin bond strengths, excellent enamel bonds, no need for selective enamel etching.
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Universal adhesives: Bond to various substrates besides dentin, including indirect ceramic and resin-based restorations.
- Considered mild or ultramild one-step self-etching adhesive.
- Selective enamel etching is mandatory.
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Three-step total etch system (etch and rinse): Removes the smear layer, exposes collagen, and opens tubules in a funnel configuration.
Case Based Discussion
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Case 1: A 40-year-old woman with occlusal caries in tooth # 47, compound class I tooth preparation. Hard discolored dentin left on the pulpal floor.
- Best adhesive system: A self-etching system is recommended due to the presence of exposed dentin. A one-step self-etch system is preferable to a two-step system for ease of application.
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Case 2: Class II preparation in tooth # 16
- Best adhesive system: One-step self-etching adhesive is a good option for Class II restorations due to its simplicity and potential for less post-operative sensitivity.
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Case 3: Restoration of tooth # 11
- Best adhesive system: Universal adhesive is an appropriate choice for tooth # 11, which has a high potential for wear and tear. Universal adhesives are more durable and can handle higher stress.
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Description
This quiz explores current strategies for adhesion of resins to dentin, focusing on the three-step total etch system and its components including etchant, primer, and bonding agents. Gain insight into how these materials interact with collagen and the importance of resin tags for effective bonding. Ideal for dental students and professionals looking to deepen their understanding of adhesive dentistry.
