Operative Dentistry Chapter 4: Adhesion Concepts
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Questions and Answers

What characteristic do semi-permeable membranes exhibit regarding dentinal fluid?

  • They only allow air to pass through.
  • They prevent dentinal fluid from passing through.
  • They completely seal off the dentin surface.
  • They allow dentinal fluid to transudate across them. (correct)
  • Which category of self-etching adhesives generally provides excellent dentin bond strengths?

  • Moderate self-etch adhesives.
  • Selective etching adhesives.
  • Ultramild self-etching primers. (correct)
  • Aggressive self-etch systems.
  • What is a key requirement for using universal adhesives in dental restorations?

  • They can only bond to dentin.
  • Selective enamel etching is optional.
  • They must only be applied in a two-step process.
  • They bond to multiple substrates, requiring specific preparation. (correct)
  • Why is an extra coat of a hydrophobic bonding layer applied in some cases?

    <p>To increase the bond strength by compensating for transudation.</p> Signup and view all the answers

    What is the restoration of choice for a large occlusal caries in tooth # 47?

    <p>Composite restoration.</p> Signup and view all the answers

    What is the main purpose of the etchant in a three-step etch-and-rinse adhesive system?

    <p>To remove the smear layer</p> Signup and view all the answers

    Which component of the three-step etch-and-rinse system is responsible for creating a hybrid layer?

    <p>Bonding agent</p> Signup and view all the answers

    What is a characteristic of the primer in the three-step etch-and-rinse system?

    <p>It includes hydrophilic and hydrophobic monomers</p> Signup and view all the answers

    What effect does the etching process have on dentin structure?

    <p>It opens the tubules in a funnel configuration</p> Signup and view all the answers

    What is the primary function of the bonding agent in the adhesive system?

    <p>To promote compatibility with restorative materials</p> Signup and view all the answers

    What is the significance of decreasing the surface free energy of dentin during the adhesion process?

    <p>It enhances the bonding capability to resin materials</p> Signup and view all the answers

    Which of the following adhesive systems does NOT belong to the three-step etch-and-rinse category?

    <p>Self-etch adhesive systems</p> Signup and view all the answers

    What is a potential outcome of improper adhesion to dentin?

    <p>Increased likelihood of restoration failure</p> Signup and view all the answers

    What is a major drawback of the total etch system?

    <p>Immediate collapse of the collagen fiber network due to excessive dryness</p> Signup and view all the answers

    Which of the following methods can effectively remove excess water after rinsing the etching gel?

    <p>High-volume suction</p> Signup and view all the answers

    What technique is eliminated in self-etching adhesives compared to total etch systems?

    <p>Drying the dentin surface before application</p> Signup and view all the answers

    What is the benefit of a two-step self-etching adhesive over total etch systems?

    <p>Reduces technique sensitivity and simplifies application</p> Signup and view all the answers

    How do self-etching adhesives contribute to reduced postoperative sensitivity?

    <p>By retaining some of the smear layer</p> Signup and view all the answers

    Which of the following represents a type of self-etching adhesive?

    <p>One-step self-etch adhesive</p> Signup and view all the answers

    What happens to resin monomers on excessively dry dentin?

    <p>They fail to penetrate effectively</p> Signup and view all the answers

    What is a key advantage of one-step self-etch systems?

    <p>They incorporate all components in a single bottle</p> Signup and view all the answers

    Study Notes

    Adhesion of Resins to Dentin

    • Classification of contemporary adhesive systems includes three-step total etch (etch and rinse).
    • The three components: Etchant (E), Primer (P), and Bonding agent (B).
    • Three-step system removes the smear layer, exposing intertubular and peritubular collagen.
    • Opening dentinal tubules enhances bonding by decreasing surface free energy up to 7.5 µm.
    • Examples of three-step systems include Scotch Bond MultiPurpose, All Bond 2, and Panavia 21.

    Two-Step Etch-and-Rinse System

    • Simplifies bonding procedures compared to total etch systems.
    • Examples include One-Step Plus, Prime & Bond NT, Adper Single Bond Plus, and OptiBond SOLO Plus.

    Drawbacks of Total Etch System

    • Excessive dryness can occur if dentin is air-dried, leading to collagen fiber collapse.
    • Excessive wetness dilutes the primer, reducing its effectiveness.

    Moist Bonding

    • Removing excess water post-etching can be performed with damp cotton, high-volume suction, disposable brushes, or tissue without affecting bond strengths.

    Self-Etching Adhesives

    • Classified as non-rinsing conditioners or self-priming etchants.
    • Types include two-step and one-step self-etching adhesives.

    Advantages of Self-Etching Adhesives

    • Simplified techniques reduce technique sensitivity.
    • Elimination of rinsing prevents over-wetting or drying issues.
    • Less postoperative sensitivity compared to etch-and-rinse adhesives due to partial smear layer removal.

    One-Step Self-Etch Systems

    • Incorporate all necessary components in a single bottle.
    • May allow transudation of dentinal fluid; solutions include adding a hydrophobic bonding layer or applying a flowable composite liner.

    Categories of Self-Etching Primers (SEPs)

    • Classified by pH into mild, moderate, and aggressive:
      • Mild and ultramild SEPs offer better dentin adhesion but weaker enamel bonds.
      • Aggressive SEPs excel in bonding to enamel without selective etching.

    Universal Adhesives

    • Bond to multiple substrates, including indirect ceramics and resin restorations.
    • Typically mild or ultra-mild one-step self-etching adhesives, requiring selective enamel etching.

    Case-Based Discussion

    • Example of a 40-year-old woman with Class I tooth preparation for composite restoration in tooth #47.
    • Considerations for adhesive system selection for Class II preparation in tooth #16.
    • Factors influencing adhesive choices for restoring tooth #11, with justifications required.

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    Description

    This quiz explores fundamental concepts of enamel and dentin adhesion as outlined in Chapter 4 of the 6th edition of 'Art and Science of Operative Dentistry'. It involves differentiating between current strategies for resin adhesion to dentin and includes a case discussion for selecting adhesive systems based on cavity preparation. Test your understanding of operative dentistry principles and applications.

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