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</p> Signup and view all the answers

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

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

    What percentage of phosphoric acid was originally used by Buonocore?

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

    What is the primary component of enamel?

    <p>Hydroxyapatite</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</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</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</p> Signup and view all the answers

    What is the advantage of self-etch adhesives?

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

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

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

    What is the primary mechanism of resin-enamel adhesion?

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

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

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

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

    <p>1955</p> Signup and view all the answers

    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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