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Questions and Answers
What is the main result of resin infiltration of acid-etched dentin?
What is the main result of resin infiltration of acid-etched dentin?
What happens to the volume of etched dentin when it is dried?
What happens to the volume of etched dentin when it is dried?
What is a characteristic of the hybrid layer formed in dentin adhesive procedures?
What is a characteristic of the hybrid layer formed in dentin adhesive procedures?
Which statement is true regarding the composition of aged dentin?
Which statement is true regarding the composition of aged dentin?
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What is the purpose of using phosphoric acid in dentin adhesion?
What is the purpose of using phosphoric acid in dentin adhesion?
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What is the primary benefit of adhesion in Operative Dentistry?
What is the primary benefit of adhesion in Operative Dentistry?
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Which mechanism of adhesion involves the chemical bonding to hydroxyapatite or collagen?
Which mechanism of adhesion involves the chemical bonding to hydroxyapatite or collagen?
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What is a key characteristic of acid etching in dentistry?
What is a key characteristic of acid etching in dentistry?
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What type of failure occurs at the interface of the substrate and adhesive?
What type of failure occurs at the interface of the substrate and adhesive?
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What did Michael Buonocore contribute to the field of Adhesive Dentistry?
What did Michael Buonocore contribute to the field of Adhesive Dentistry?
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What is the main feature of resin tag formation in adhesion?
What is the main feature of resin tag formation in adhesion?
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Which bonding strategy can be used in adhesion techniques?
Which bonding strategy can be used in adhesion techniques?
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Which of the following materials would benefit from the use of adhesion in dentistry?
Which of the following materials would benefit from the use of adhesion in dentistry?
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What is the primary mechanism of adhesion to dentin?
What is the primary mechanism of adhesion to dentin?
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Which component primarily makes up enamel?
Which component primarily makes up enamel?
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What effect does the smear layer have on dentin permeability?
What effect does the smear layer have on dentin permeability?
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What happens to collagen in dentin over time after etching and adhesive application?
What happens to collagen in dentin over time after etching and adhesive application?
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Why is dentin adhesion considered to be difficult and unpredictable?
Why is dentin adhesion considered to be difficult and unpredictable?
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What is the recommended etching time for effective dentin preparation?
What is the recommended etching time for effective dentin preparation?
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How does the number of dentin tubules change as one approaches the pulp?
How does the number of dentin tubules change as one approaches the pulp?
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What is one of the challenges associated with dentin adhesion?
What is one of the challenges associated with dentin adhesion?
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Study Notes
Operative Dentistry - Adhesive Dentistry I
- The introduction of enamel and dentin adhesion marked a new era in Operative Dentistry.
- Adhesive techniques allow for more conservative tooth preparation.
- Less enamel removal is possible during procedures.
- Restorations can be repaired more effectively.
- Conservative aesthetic procedures are also facilitated.
- Resin-based dentistry relies on dental adhesives.
Adhesion
- Adhesion is the state where two surfaces are held together by interfacial forces, potentially including valence forces and interlocking forces.
Mechanisms of Adhesion in Dentistry
- Mechanical penetration: Resin penetrates the tooth surface forming resin tags.
- Adsorption: Chemical bonding to inorganic components (hydroxyapatite) or organic (type I collagen).
- Diffusion: Precipitation of substances on tooth surfaces for mechanical or chemical bonding with resin monomers.
- A combination of the above three mechanisms is often observed.
Failure of Adhesion
- Cohesive failure can occur in the substrate, adhesive, or restorative material.
- Adhesive failure occurs at the interface between the substrate, restorative material, and adhesive.
Bonding System Considerations
- Adhesive strategies (e.g., dry vs. wet bonding, direct vs. indirect).
- Materials compatibility (e.g., silica-based porcelain, zirconia).
- Factors like solvent use, dual curing, and sensitivity.
Enamel Adhesion
- Acid etching (using phosphoric acid, 35% for at least 30 seconds) prepares the enamel surface.
- The etched surface creates resin tags in the enamel.
- This process leads to high bond strength and a reliable bond.
Dentin Adhesion
- Materials can bond with dentin either mechanically or chemically, or both.
- Micromechanical interlocking of resin into the collagen fibrils, left exposed by acid etching, is a primary mechanism.
- Glass ionomer cements and some phosphate-based self-etch adhesives facilitate chemical bonding.
Dentin as a Dynamic Substrate
- Dentin is a dynamic tissue, making adhesion difficult and unpredictable.
- Dentin contains water and organic substances (mainly type I collagen).
Challenges in Dentin Adhesion
- Dentin's dense network of tubules connecting the pulp with the DEJ.
- Increasing number and size of tubules closer to the pulp.
- Lower adhesion quality closer to the pulp (tubules occupy only 1% of the surface near the DEJ vs 22% near the pulp).
- Dentin is an intrinsically hydrated tissue with collagen-lined intertubular dentin.
- Resins are hydrophobic.
- Collagen degradation by dentin proteinases can negatively affect the bonded interface.
- Smear layer: formation of organic/inorganic debris on the tooth surface after preparation with a bur or instrument.
- Smear layer fills dentin tubules forming "smear plugs", decreasing dentin permeability by nearly 90%.
Dentin Adhesion - Steps
- Step 1: Acid etching (remove smear layer, demineralize inter-tubular and peri-tubular dentin, expose collagen fibrils).
- Step 3: Application of liquid acrylic monomers (hydrophobic) as a final layer.
Hybrid Layer Formation
- Resin infiltration of acid-etched dentin transforms the surface from crystalline to an organic, acid-resistant, and hydrophobic structure.
Wet Dentin Adhesion
- A method of bonding tooth structure using phosphoric acid as a conditioner. Improves bond strength through acid-etching of dentin and bonding to wet dentin surfaces.
- Drying etched dentin greatly reduces its volume and leads to a poor hybrid layer.
- The collagen fiber network of etched dentin literally floats in water.
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Description
Explore the essential principles of adhesive dentistry, focusing on the mechanisms of adhesion in operative procedures. This quiz examines how enamel and dentin adhesion have revolutionized tooth preparation while promoting conservative techniques and effective restorations. Test your knowledge on the various adhesion mechanisms including mechanical penetration, adsorption, and diffusion.
