Operative Dentistry

Adhesives, Cements and Intraoral Repair

ADHESIVE for direct bonding to enamel and dentin

Ultra-Etch 35% phosphoric acid (Ultradent)

Optibond FL (Kerr)

  1. adhesiveApply 35% phosphoric acid to enamel first, and then to dentin making sure that the etchant remains on dentin for LESS than 15 seconds. Rinse thoroughly for 15 seconds. Completely remove excess moisture from operating field, then from preparation with cotton pellet, sponget or microbrush. Dentin surface should appear slightly moist.
  2. Apply Primer (#1) with microbrush for 30 sec with continuous gentle agitation. Replenish primer as needed.
  3. Initially air dry primer gently, and then finish with moderate air pressure to evaporate all solvents. The dried surface should present a shiny, evenly primed appearance.
  4. Apply Adhesive (#2) with an applicator brush or microbrush to spread evenly, removing excess to avoiding pooling or marginal buildup. Do not use air syringe to disperse adhesive.
  5. Requires 18 J for light curing.
  6. Apply resin-based composite.

 

Indirect bonding of restorations

 

 

Luting and Resin Cements

All Bond 3 adhesives system

bisco all 3 bond bottles

Calibra (Dentsply/Caulk)  Use with All Bond 3

  • Base shades (3): translucent; opaque; light;
  • Catalyst (1): High viscosity
  • Description: light and dual-cured resin composite primarily used for cementation of resin composite or ceramic veneers, inlays/onlays
  • Follow adhesive resin system instructions for bonding to tooth and Calibra instructions for luting the indirect restoration.
  • If cementing veneer that is not excessively thick or opaque, use light cured base shade only. Simplifies luting procedure.

calibra

DUO-LINK (Bisco) Use with All Bond 3

  • Description: DUO-LINK is a dual-cured luting cement with ultrafine filler particles and is intended to be used with an adhesive system. Available in a universal TRANSLUCENT shade, the exceptionally high glass filler content increases strength making DUO-LINK resistant to wear and staining. It is ideal for cementing all-ceramic/porcelain, metal, and composite restorations (inlays, onlays, crowns, bridges), as well as fiber and metal posts.
  • Instructions for use: See manufacturer’s instructions.
    • Working time: ≥ 2 min
    • Setting time: ≤ 5 min 30 sec
    • Light cure each surface of the restoration for 40 sec (24 J)

luting agents

Panavia V5 (Kuraray) Includes adhesive system

  • Description: Dual-cure, fluoride-releasing, esthetic, universal cement for silica-based ceramics, zirconia, composites and metals (separate alloy primer needed - not shown below).
  • Indications: cementation of inlays, onlays, crowns, bridges, veneers, resin retained bridges, splints, implant restorations, post and cores and amalgam bonding.
  • Shades: Universal A2, Clear, Brown A4, White, Opaque (opaque is self cure only)
  • panavia v5

FujiCem 2 (GC America)

  • Description: Resin-modified glass ionomer primarily used for cementation of crowns and FPDs
  • Instructions for use: See manufacturer’s instructions

fujicem

 

 

Intraoral Repair Kit (Bisco)

intraoral repair kit

 

Chair side AIR ABRASION

  • chair side abrasionCoJet Silicate Ceramic Surface Treatment System (3M ESPE)
    • Description: High-purity aluminum oxide 30 μm, modified with silica (SiO2). Embeds a ceramic layer on the surface of metal, porcelain or previously cured composite, producing/enabling silane coupling with composite by a chemical bond.
    • chair side abrasionApplications: Intraoral repair of fractured composite or porcelain, even with exposed metal. Extra oral pre-treatment of inlays/onlays, veneers, crowns and bridges, and pins and posts for adhesive luting. Rocatec lab system is also marketed for extra oral surface preparation.
    • Effect of CoJet Silica on enamel and dentin bond is indeterminate

 

 

Chair side AIR ABRASION

Alumina 50 micron (Ivoclar Vivadent)chair side abrasion

  • Description: Alumina (Al2O3) air abrasive.

 

 

 

 

Porcelain etchant: Buffered hydrofluoric acid gel (Bisco)

  • Indications:acid gel
    • intraoral repair
    • preparing restorative material surface for luting
  • HF porcelain etchant improves the adhesive bond between porcelain and RBC/cement by increasing the surface area of the porcelain to be bonded.
  • HF porcelain etchant is available in 2 concentrations:
    9.5% - reduce etching time during intraoral repair
    4% - during preparing restorative porcelain for luting
  • BARRIER GEL is placed where etching is not desired

 

SILANATING AGENT

Bis SILANE (Bisco)silane (two-part silane preferred due to stability as compared to single bottle)

  • Description: BIS-SILANE is a two-part silane coupling agent that is used to enhance adhesion between porcelain and composite resins. Based on clinical experience, it has been noted that the silane, as packaged in the one-bottle systems, tends to polymerize as it approaches the end of its shelf life. The two-bottle silane system offers a more stable system to ensure effective bonding to porcelain. Silane is a dual function monomer consisting of a silanol group that reacts with the porcelain surface, and a methacrylate group that co-polymerizes with the resin matrix of the composite. Silane coupling agents are known to enhance the wettability of glass substrates by composite resins, increase physical, mechanical and chemical bonding of composite to porcelain, and yield a greater resistance to water attack at the bonding interface.
  • Prior to applying BIS-SILANE, the porcelain surface must be etched with buffered hydrofluoric acid. This process allows porcelain to become not only highly porous, but also highly receptive to the silane by creating reactive hydroxyl groups on the surface of the porcelain.
  • Directions for use:
    • Mix the BIS-SILANE by dispensing one drop from each of the two bottles (Parts A & B) into a mixing well and stir. Brush on 1-2 coats (thin coats are sufficient) of BIS-SILANE to the internal surface of the etched porcelain restoration and wait for 30 seconds. Dry with (warm if available) air syringe. NOTE: Surface of the porcelain will look the same after BIS-SILANE application to the naked eye.
    • Continue with cementation procedures.