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Questions and Answers
What is the concentration of phosphoric acid commonly used in etching enamel?
What is the recommended etching time for phosphoric acid on permanent enamel?
What is the primary mechanism of dentin adhesion?
What is a major difference between enamel and dentin bonding?
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Why is bonding to dentin more challenging than bonding to enamel?
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What percentage of phosphoric acid was originally used by Buonocore?
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What is the primary component of enamel?
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What is the main reason for the difference in bonding between enamel and dentin?
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What is the purpose of step I in the clinical application of etchant gel?
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What type of monomers are typically found in the adhesive in a two-step etch-and-rinse adhesive system?
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What is the advantage of self-etch adhesives?
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What is the concentration of phosphoric acid in the etchant gel?
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What is the purpose of step IV in the clinical application of a two-step etch-and-rinse adhesive system?
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What is the difference between a two-step etch-and-rinse adhesive system and a multi-step etch-and-rinse adhesive system?
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What is the advantage of using a self-etch approach?
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What is the purpose of step III in the clinical application of a multi-step etch-and-rinse adhesive system?
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What is the primary mechanism of resin-enamel adhesion?
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What inspired Buonocore to develop the acid-etch technique for enamel adhesion?
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What is the concentration of phosphoric acid used in industrial applications, as mentioned in the text?
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What is the characteristic of Type I etch pattern?
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Which of the following is NOT a type of etch pattern?
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What is the characteristic of Type III etch pattern?
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What is the purpose of acid etching in enamel adhesion?
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What is the year Buonocore introduced the acid-etch technique?
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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!
