Indications for Adhesive Dentistry
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Questions and Answers

What is the concentration of phosphoric acid commonly used in etching enamel?

  • 37%
  • 85%
  • 30-40% (correct)
  • 25%

What is the recommended etching time for phosphoric acid on permanent enamel?

  • 30 seconds
  • 90 seconds
  • 15 seconds (correct)
  • 60 seconds

What is the primary mechanism of dentin adhesion?

  • Micromechanical bonding
  • Chemical bonding
  • Penetration of adhesive monomers into collagen fibers (correct)
  • All of the above

What is a major difference between enamel and dentin bonding?

<p>Dentin contains more water and organic material (A)</p> Signup and view all the answers

Why is bonding to dentin more challenging than bonding to enamel?

<p>All of the above (D)</p> Signup and view all the answers

What percentage of phosphoric acid was originally used by Buonocore?

<p>85% (C)</p> Signup and view all the answers

What is the primary component of enamel?

<p>Hydroxyapatite (A)</p> Signup and view all the answers

What is the main reason for the difference in bonding between enamel and dentin?

<p>Enamel is more mineralized (A)</p> Signup and view all the answers

What is the purpose of step I in the clinical application of etchant gel?

<p>To apply etchant gel for 15 seconds on the tooth surface (B)</p> Signup and view all the answers

What type of monomers are typically found in the adhesive in a two-step etch-and-rinse adhesive system?

<p>Hydrophobic monomers (B)</p> Signup and view all the answers

What is the advantage of self-etch adhesives?

<p>They reduce the number of steps during bonding (D)</p> Signup and view all the answers

What is the concentration of phosphoric acid in the etchant gel?

<p>37% (B)</p> Signup and view all the answers

What is the purpose of step IV in the clinical application of a two-step etch-and-rinse adhesive system?

<p>To light cure for the recommended manufacturer time (C)</p> Signup and view all the answers

What is the difference between a two-step etch-and-rinse adhesive system and a multi-step etch-and-rinse adhesive system?

<p>The number of bottles used (D)</p> Signup and view all the answers

What is the advantage of using a self-etch approach?

<p>It reduces the number of steps during bonding (D)</p> Signup and view all the answers

What is the purpose of step III in the clinical application of a multi-step etch-and-rinse adhesive system?

<p>To apply primer on the substrate (A)</p> Signup and view all the answers

What is the primary mechanism of resin-enamel adhesion?

<p>Resin microtag formation within the enamel surface (D)</p> Signup and view all the answers

What inspired Buonocore to develop the acid-etch technique for enamel adhesion?

<p>Industrial use of 85% phosphoric acid for adhesion (C)</p> Signup and view all the answers

What is the concentration of phosphoric acid used in industrial applications, as mentioned in the text?

<p>85% phosphoric acid (C)</p> Signup and view all the answers

What is the characteristic of Type I etch pattern?

<p>Dissolution of prism cores without dissolution of prism peripheries (B)</p> Signup and view all the answers

Which of the following is NOT a type of etch pattern?

<p>Type IV etch pattern (B)</p> Signup and view all the answers

What is the characteristic of Type III etch pattern?

<p>Less distinct pattern that includes areas resembling other patterns (A)</p> Signup and view all the answers

What is the purpose of acid etching in enamel adhesion?

<p>To facilitate adhesion of resins to enamel (D)</p> Signup and view all the answers

What is the year Buonocore introduced the acid-etch technique?

<p>1955 (B)</p> Signup and view all the answers

Flashcards

Class I Restoration

Restoring cavities where tooth decay has affected the chewing surfaces.

Class II Restoration

Restoring cavities on the chewing surfaces of premolars or molars, involving the cusps.

Class III Restoration

Restoring cavities on the biting surfaces of front teeth, affecting the tooth's edge.

Class IV Restoration

Restoring cavities on the biting surfaces of front teeth, involving the corner of the tooth.

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Class V Restoration

Restoring cavities on the smooth surfaces of the teeth, near the gum line.

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Class VI Restoration

Restoring cavities on the biting surfaces of teeth, affecting the root.

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Resin Veneers

Thin, custom-made shells of tooth-colored composite resin, applied to the front surfaces of teeth to improve appearance.

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Acid Etching

A technique using acid to create microscopic holes in tooth enamel, allowing for stronger bonding of restorative materials.

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Dental Adhesion

A process that aims to achieve strong and long-lasting bonds between dental materials and tooth structure.

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Micromorphologic Patterns

A microscopic pattern created on the enamel surface after acid etching, crucial for strong bonding.

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Etchant Gel

A gel containing phosphoric acid, used to etch tooth enamel before bonding.

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Primer

A fluid containing monomers that penetrate etched enamel and dentin, enhancing the bond with resin.

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Adhesive

A resin-based material that bonds to the etched enamel and dentin, providing a strong foundation for restorations.

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Moist Bonding Technique

A technique that involves keeping the tooth surface slightly moist during the bonding process.

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Dry Bonding Technique

A technique that involves drying the tooth surface completely before applying the adhesive.

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Two-Step Etch-and-Rinse Adhesives

A bonding system that combines primer and bonding agent into one solution.

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Self-Etch Adhesives

A bonding system that eliminates the separate etching step, directly bonding to the tooth surface.

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Etchant Concentration

The percentage of acid in the etchant gel, affecting the etching depth and bonding strength.

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Etching Time

The amount of time the etchant gel is applied to the tooth surface, influencing the etching depth.

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Smear Layer

A layer of debris on the dentin surface that can hinder bonding.

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Resin-Dentin Interface

The area where the resin restoration meets the dentin, prone to stress and failure.

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Dentin Adhesion

The process by which adhesive monomers penetrate the exposed collagen network in dentin, creating a strong bond.

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Root Canal Sealing

The process of sealing the root canals during endodontic treatment.

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Internal Root Reinforcement

The process of reinforcing fragile teeth that have undergone root canal treatment.

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Study Notes

Indications for Adhesive Dentistry

  • Restore Class I, II, III, IV, V, and VI carious or traumatic defects
  • Change the shape and color of anterior teeth using resin veneers
  • Bond all-ceramic restorations
  • Seal pits and fissures
  • Bond orthodontic brackets
  • Bond periodontal splints
  • Repair existing restorations (composite, amalgam, and ceramic)
  • Provide foundations for crowns
  • Desensitize exposed root surfaces
  • Seal beneath or bond amalgam restorations
  • Bond fractured fragments of anterior teeth
  • Bond prefabricated fiber or metal posts and cast posts
  • Reinforce fragile endodontically treated roots internally
  • Seal root canals during endodontic therapy
  • Seal apical restorations placed during endodontic surgery

History of Enamel Adhesion

  • Buonocore introduced acid-etch technique in 1955, inspired by industrial use of 85% phosphoric acid
  • Many researchers have attempted to achieve methods for reliable and durable adhesion between resins and tooth structure

Mechanism of Resin-Enamel Adhesion

  • Formation of resin microtags within the enamel surface is the fundamental mechanism
  • Enamel etching results in three different micromorphologic patterns: Type I, Type II, and Type III

Components of Adhesives

  • Etchant gel
  • Primer (bottle I)
  • Adhesive (bottle II)

Clinical Steps for Application

  • Step I: Application of etchant gel on the tooth surface for 15 seconds
  • Step II: Rinse the etchant off thoroughly and blot dry the substrate (moist bonding technique) or air drying (dry bonding technique)
  • Step III: Application of primer on the substrate
  • Step IV: Application of adhesive on the substrate
  • Step V: Light cure for the recommended manufacturer time

Two-Step Etch-and-Rinse Adhesives

  • Combine primer and bonding agent into a single solution
  • Separate etching step still required
  • Clinical steps: application of etchant gel, rinse and blot dry, application of primer and adhesive, and light cure

Self-Etch Adhesives

  • Omit separate etching step
  • Elimination of etching procedure has advantages: clinician-friendly procedure, less technique sensitive, and overcome the problem of over dry or over wet dentinal substrate

Etchant Concentration and Time

  • Most current phosphoric acid gels have concentrations of 30-40%, with 37% phosphoric acid being the most common
  • Etching time of 15 seconds is recommended, similar to 60 seconds etch in terms of surface roughness and bond strength

Dentin Adhesion

  • Adhesion to dentin remains difficult due to structure of dentin, smear layer, and stresses at the resin-dentin interface
  • Mechanism: penetration of adhesive monomers into the network of collagen fibers left exposed by acid etching
  • Challenges: structure of dentin, smear layer, and stresses at the resin-dentin interface

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Description

This quiz covers the various indications for adhesive dentistry, including restoring carious defects, bonding orthodontic brackets, and desensitizing exposed root surfaces. It's a comprehensive guide for dental professionals. Test your knowledge and skills in this field!

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