John Burgess 205-996-5795 JBurgess@uab€¦ · • Permaquick 96% @ 5 yr. DeMunck JDR 82:Abs 907,...

•  John Burgess •  205-996-5795 •  [email protected]

Adhesives- What makes them work

Generation Components Examples Solvents

4th, TE 2 bottle, 3 step SBMP, Optibond FL

Acetone, water, ethanol

5th, TE 1 bottle, 2 step P& B NT, Single Bond

Acetone or ethanol

6th, SE 2 bottle, 2 step Kuraray SE Bond

Acetone or ethanol

7th- Universal TE, SE, Sel E

1 bottle, SE, Varies

I Bond, All Bond Universal, SBU

Mainly ethanol

Clinical Success class 5 restorations- 3 yrs- 2 bottle total etch 4th generation

Scotchbond MP 96% Van Meerbeek JDR 73:1690, 1996.

• Scotchbond MP 97.8% Trevino et al JDR 75:397, 1996.

• Scotchbond MP 95% Silux Mathis JADA, 135:451-7, 2004

• All Bond 2 + Z 100 – 83.4% McCoy et al JDR 75:23, 1996.

• Optibond FL 100%@ 5 yr. • Permaquick 96% @ 5 yr. DeMunck JDR 82:Abs 907, 2003.

• Optibond FL–100% • PMQ – 98% Van Meerbeek Oper Dent 2004, 29:376

• Roughened NCCL-diamond • 100 NCCL Optibond DC • 50% etched E and D • 95% etched enamel only • 84% etched both • 89% retention overall Wilder et al JADA 140:526-35,

12 yr retention of Optibond DC

13 year retention of 7 adhesives -4th generation

• 270 Class NCCL restorations -4 etch-and-rinse, 1 self-etch adhesive, RMGI.

• 13 years, 215 evaluated. • Annual retention: Optibond 3.1%, Permagen

13.0%, Scotchbond MP 4.8%, Syntac classic 2.8%; self-etch P&S 4.4%; RMGI-Vitremer 2.7%.

• Best retention RMGI and 4-step etch-and-rinse system- Optibond.

• van Dijken JW, Pallesen U. Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions. Dent Mater. 2008 Jul;24(7):915-22.

Fifth Generation DBA• Total etch • One bottle • Combined adhesive

and primer • Etch – 15 sec • Rinse, 1 Bottle Primer/

Bond • VLC

Clinical success- total etch 1 bottle- 5th generation • One Step - 45% @ 5 yr. • Gluma 2000 - 52% @ 5 yr Van Dijken IADR Abst 42, 2000 • One Step 50% @ 18 mos Bracket et al Oper Dent

30:424-29, 2005 • Single Bond - 75% @ 3 yr . Van Dijken Dent Mater

16:285-91, 2000 • Single Bond – 90% @ 3 yr. Burgess et al Operative

Dentistry, 2005, 30-3,290-296. • Single Bond - 77% @ 3 yr . Burrow & Tyas Oper Dent

32:11-15, 2007 • One Step Plus- 100% @ 1 yr. Perdigão J, restorations. Am

J Dent. 20:125-33, 2007

• Optibond Solo - 93% @ 3 yr. Swift JADA 132:1117, 2001.

• One Coat Bond- 86% @ 3 yr. Gallo, Burgess Am J Dent. 2004 Jun;17(3):147-50

• Prime & Bond - 91% @ 2 year recall Turkin J Dent 31:527-34, 2003.

• Excite – 79% @ 2 yr, 52%@ 5yr. Franco et al Oper Dent 31:403-8, 2006.

• SE Bond 90% 3 yr. Burrow and Tyas-Oper Dent 2007; 32:11-15. • SE Bond 92%, Protect Bond 94% 18 mos. Burgess et al (Abst #1781) JDR 2006. • SE Bond 96% 13 yr. M. Peumans et al. Dent Mat 31,:3, 2015, 308-314 • Bond 99%- 5 years. Peumans et al. J Adhes Dent 2007;9:7-10 • One Up Bond 92% 5 years. Burrow & M. Tyas. JDR 1153:2006. • SB - 92%, Scotchbond SE- 91%, SBMP- 91%,-18 mos. Perdigao et al Oper Dent 37:3-11, 2012. • SB-94%, SE 97%, Easy Bond 90% 3 yrs. Burgess et al Oper Dent

Sixth generation - 2 bottle self-etch

NCCL- SE Bond enamel margins etched vs not etched • Clearfil SE Bond NCCL- 1 restoration of non etched

group lost - 5 yrs, 1 etched lost- 8 yrs. • 13-year overall retention rate 96%. • Selective enamel acid-etching of cavity margins

prior to SE Bond (2-step self-etch) adhesive minor positive effect on marginal integrity and absence of marginal discoloration.M. Peumans, M. J. De Munck K. Van Landuyt B. Van Meerbeek Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Dent Mat 31,:3, 2015, 308-314

• 100 Clearfil SE Bond etched with 40% or not 29 patients restored with Clearfil AP-X

• At 5 yr recall 1 restoration lost – non etch gp. Overall 99% retention

• Non etch gp more enamel defects, & poorer marginal adaptation

• Marginal integrity decreased both gps. • Peumans et al J Adhes Dent 2007;9, 7-10.

Selective vs self etching NCCL• No significant difference for any clinical outcome was observed between the groups at 1-

year recall. At 18 months to 2 years and on longer-term follow-ups, less marginal discoloration and better marginal adaptation was observed with selective enamel etching.

• In the 3-year meta-analysis of the present study the retention rates of restorations were improved by selective enamel etching

• J.W.V. Van Dijken. Clinical evaluation of three adhesive systems in class V non-carious lesions. Dent. Mater., 16 (2000), pp. 285-291

• L.S. Türkün The clinical performance of one- and two-step self-etching adhesive systems at one year. J. Am. Dent. Assoc., 136 (2005), pp. 656-664.

•Sibelli Parreiras, Alessandra Reis, Alessandro Loguercio.. Selective enamel etching in cervical lesions for self-etch adhesives: A systematic review and meta-analysis. Journal of Dentistry. 53, 2016, 1-11

Universal Adhesives• •

Total etch Self etch Selective etch

• Futrabond U- VOCO • All-Bond Universal (Bisco) • Adhese Universal (Ivoclar) • Scotchbond Universal (3M ESPE) • Prime & Bond Elect Universal Adhesive (Dentsply) • Optibond Universal (Kerr)

Scotchbond Universal: Composition

• MDP Phosphate Monomer • Dimethacrylate resins • HEMA • Vitrebond Copolymer • Silane • Ethanol • Water • Filler • Initiators

Bond of 4 adhesives to tooth thermocycled 10,000

25

36.6

29.7 28.7

9.1 7.89.6

2.7

23.5

33.4

21.4

12

SBU P & B Elect All Bond U Peak0

10

20

30

40

50

60

MPa

Etched enamel Unetched Enamel Etched dentin

S. Kwon et al JDR Abstr 2014.

Universal Adhesives- bond to tooth, metal, and ceramic. Bond of 4 adhesives to metal

thermocycled 10,000

27

9.9

38.2

16.9

26.9

7.4

3127.1

10.47.4

25.2

18.4

9.97.9

10.4

16.9

CrCo Gold Zirconia e.max 0

10

20

30

40

50

60

MPa

SBU All Bond U Peak P & B Elect

B. Chang et al JDR Abstr 2014.

37 Silane

2.5 2.73.22.32.3 2.5

10-MDP Phosphate ester PENTA P

pHFiller 0% 8% 0%4%8%

Adhesive Monomer

Universal Adhesives

Acetone

Ethanol

20%

Ethanol Ethanol Ethanol Ethanol Ethanol

GPDM

Acetone + Ethanol

7%2.5

Universal Adhesives- bond to etched and unetched enamelEtch enamel - improves enamel bond!

•Burgess, unpublished data •Burgess, unpublished data

3 yr clinical AdheSE- 2 bottle used as SE vs. selective etch • NCCL- AdheSE adhesive in self-etch or selective enamel etch.

Composite Point 4 • Self-etch retention- 1 yr=100%, 2 yrs=98% and 3 yrs= 91.5%;

Selective etch retention 1 yr=100%, 2yrs=100 % and 3yrs= 97.9% • Significantly higher marginal discoloration and enamel marginal

defects in self-etch vs. selective etch (p = 0.0001).

Can Say E, Özel E, Yurdagüven H, Soyman M. Three-year clinical evaluation of a two-step self-etch adhesive with or without selective enamel etching in non-carious cervical sclerotic lesions. Clin Oral Investig. 2014.

How about sensitivity Total vs self-etch?

Post-op sensitivity

Author (YR) Eval time Material Winner # Blanchard 2013 (PEARL)

485 1,4,13wks Various Some difference

Ghavamnasiri 2012 76 1yr P&B NT and Clearfil SE No difference

Perdigao 2012 125 18mo Scotchbond MP, Single Bond +, Scotchbond SE, Easy Bond

No difference

Ermis 2009 87 2yr SingleBond and Clearfil SE No difference

Aykor 2009 300 1,2,5yrs Scothbond MP and AdheSE No difference

Casselli 2006 104 0,1wks, 6mo Single Bond and Clearfil SE No difference

Peumans 2005 100 3yr Clearfil SE (w/ and w/o etch) No difference

Perdigao 2004 98 2wk P&B NT and Clearfil SE

No difference

Perdigao 2003 66 2,8wks, 6mo P&B NT and Clearfil SE

No difference

Total vs self-etch - cold response

No difference!!!!

Universal Adhesives- bond to etched and unetched dentin

Etching does not lower dentin bond.

•Burgess, unpublished data •Burgess, unpublished data

Halvorson JDR 75: 1997.

Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.Drying Dentin - Bond Strengths.

2623 24

16

2421

18

13

23

16

9 10

SBMP Single Bond One Step Prime and Bond 2.10

5

10

15

20

25

30

MPa

Dentin Surface DrynessBlotted Dry 3 sec. dry5 Sec Dry

Moist Wet OverwetSingle Bond 19.2 21.2 20.3One-Step 20.5 13.7 13.3Prime and Bond NT 20.3 20.5 22.4Scotchbond MP 23.1 25.3 23.3

Bonding dry vs wet - but how wet ???

Swift E et al 1997.

Does dentin wetness affect Adhesives?

• Single Bond to dry dentin- 89%, wet dentin 100% retention. Prime & Bond NT 94% retention to dry dentin and 92% retention moist dentin.

• Moist dentin less sensitive restored teeth with both adhesives.

Perdigao J, Carmo AR, Geraldeli S. J Adhes Dent 2005;7(3):253-8.

Clinical bond to wet and dry dentin- 5th Generation- 18 Mos

Perdigao et al Oper Dent 2014;39(2)113-27.

• 200 restorations-4 groups

• SBU - etch and rinse, etch-rinse-dry, selective etch, self-etch

Scotchbond Universal Clinical- 18 mos

Scotchbond Universal 4 Application modes - 18 mos

94 98 96 9494100

90 9496 98 100 9694 94 93100

Margin discolor Retention Marginal adap Sensitivity0

20

40

60

80

100

% Alpha SBU- E & R SBU- E & Rinse & Dry SBU Sel Etch SBU- SE

Perdigao et al NCCL study, 18 mos, 200 restorations, 39 patients, Oper Dent 2013; 38:36

Dentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air dryingDentin Bond after air drying

2325

1821

27

2023

29

2323 2325

Easy Bond Xeno IV Clearfil S30

5

10

15

20

25

30

MPa

Air Drying Time1 sec 3 sec 8 sec 15 sec

Primer or adhesive drying time

Ethanol Acetone Ethanol + water

Chlorhexidine improves bond with total etch• Third molars sectioned bonded phosphoric acid

etched, 2% 60 secs, blotted dry. Single Bond and Z 250.

• 2 teeth extracted immediately and 14 months later.

• Chlorhexidine did not reduce immediate microtensile bond.

• Extracted chlorhexidine treated teeth at 14 mos no bond degradation untreated significantly lower.

Carrilho, MRO, et al In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res 86:529-33, 2007.

• Chaussin et al role of metalloproteinases in human caries. JDR 2006, 85, 22-32.

• Breschi et al Chlorhexine stabilizes the adhesive interface: a 2 yr in vitro study. Dent Mater 2010:26:320-5.

• Brackett et al in vivo stabilization of hybrid layers of an acetone-based dentin- 30 sec application stabilized hybrid layer in vivo.

• DeMunk et al Inhibition of enzymatic degradation of adhesive dentin interfaces. JDR 2009:88:1101-6. Optibond FL and Clearfil SE Bond- decline of MTBS in both with time, less with SE Bond, Optibond released MMP due to demin of dentin SE Bond did not.

Loguercio AD et al. 24-month clinical evaluation in non-carious cervical lesions of a two-step etch-and-rinse adhesive applied using a rubbing motion. Clin Oral Investig. 2011 Aug;15(4):589-96

Adhesive Agitation- Clinical trial

Alcohol Acetone Alcohol

• 40 patients -120 restorations- Prime & Bond NT and EsthetX.

• No rubbing, slight rubbing, or vigorous rubbing. 24-month retention 82.5% no rubbing, 82.5% slight rubbing, and 92.5% vigorous rubbing.

• Retention (24-months) statistically lower with no or slight rubbing.

•Scrub the adhesive during application.

Bond strength after bottle opening




























































Full bottle opened and bonded.4 drops removed daily open 5min/day until1/2 bottle remained......until 1/3 bottle remained.Refrigated full bottle.

))

))

• Full bottle opened and bonded • 4 drops removed daily open 5

min. • 1/2 bottle remained • 1/3 bottle remained • Almost empty • Refrigerated full bottle





























































Full bottle opened and bonded.4 drops removed daily open 5min/day until1/2 bottle remained......until 1/3 bottle remained.Refrigated full bottle.

))

))

Curing Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedCuring Lights ComparedLight Mode Output

Ivoclar Bluephase High 1211

Turbo 1970

Ultradent Valo Standard 1002

High Mode 1539

Plasma Mode 2571

• Jan W.V. van Dijken Ulla Pallesen. A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material. Journal of Dentistry 40, Issue 12,2012,1060-1067

• D.C.N. Chan, W.D. Browning, K.B. Frazier, M.G. Brackett. Clinical evaluation of the soft-start (pulse-delay) polymerization technique in Class I and II composite restorations Operative Dentistry, 33 (2008), pp. 265-271. 1 year recall- PAC light vs pulse delay.

• Brackett, D.A. Covey, H.A. St Germain Jr. One year clinical performance of a self-etching adhesive in Class V resin composites cured by two methods. Operative Dentistry, 28 (2002), pp. 200-206.

• H. Oberländer, K.-H. Friedl, G. Schmalz, K.-A. Hiller, A. Kopp. Clinical performance of polyacid-modified resin restorations using “softstart-polymerization”Clinical Oral Investigations, 3 (1999), pp. 55-61

No difference in clinical durability of composite restorations reported with different light curing

techniques: conventional continuous light, a soft-start or a pulse-delay curing mode.

Bond strength & curing light distance










Dent & Burgesss JDR 2000

Floor of gingiva box is 2-7mm from curing light. Measured SBS at 0, 2.3, 4.6, 6.9 mm.Bond strenght decreased with distance.

)

))

•Gingival box is 2-7mm from marginal ridge

•Measured bond strength at 0,2.3, 4.5, 6mm

•Bond strength deceased with distanceXu, Sandras and Burgess. Shear bond strength with increasing light guide distance from dentin.

J Esth and Rest Dent 2006:18:10-28.

21.4

7.9

18.2

21.4

0 mm- 20 sec. 4.5 mm- 20 sec. 4.5 mm- 20 sec 4.5 mm- 60 sec0

5

10

15

20

25

MPa Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem Correcting the distance problem

Dent, Burgess et al Oper Dent 2001

Reznik, Kulkarni, Shah, Chang, Burgess, Robles, Lawson

Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength Curing distance and bond strength

21.4

12.2

7.34.5

0 mm 2.3 mm 4.5 mm 6 mm0

5

10

15

20

25

MPa

Xu, Sandras and Burgess. Shear bond strength with increasing light guide distance from dentin. J Esth and Rest Dent 2006:18:10-28.

Scotchbond Universal-3 year recall

• Split mouth design, 5 general dentists. UK-PBRN setting

• Baseline 64 placed, at 3 yrs 45 Supreme Ultra restorations- 22 in each mode

• No difference self-etch or total etch modes- variety of cavity types dominantly load bearing.

• 53% with rubber dam. 20% (9) single cusp replacement.

Burke et al. A randomized controlled trial of a Universal Bonding agent at three years: Self etch vs Total etch. Unpublished data. Thanks to F.J. Burke

Clinical studies with Universal Adhesives

• 200 restorations- 4 groups: ERm: etch-and-rinse+moist dentin; ERd: etch-and-rinse+dry dentin; Set-Selective enamel etching; and SE: self-etch. 8 restorations (ERm: 1; ERd: 1; Selective Etch 1, SE: 5 lost after 36 mos, significant for SE compared with baseline.

• Marginal staining ERm, ERd, and Set 6.8% and 17.5% of the SE restorations.

Loguercio AD, de Paula EA, Hass V, Luque-Martinez I, Reis A, Perdigão J new universal simplified adhesive: 36-Month randomized double-blind clinical trial. J Dent 2015 Sep;43(9):1083-1092.

36-mos clinical Scotchbond Universal in NCCLs• 4 restorations/patient, TE (wet or dry) or

self-etch (with or without selective enamel etching).

• SE greater number of restorations with marginal discrepancy (28%) in comparison with the other groups (8%, 6%, and 8% respectively for the ERM, End, Set)

• 18 mos retention rate. 98% Erm, 100% TE & Dry,

Clinical studies- SBU- 18 mos.

Perdigao et al Oper Dent 2014;39(2)113-27.

Bond to sclerotic dentin

• Etch time 15 to 30 sec.

0

12.5

25

37.5

50

Normal dentin Sclerotic 15 Sclerotic 30 Sclerotic SE

18.7

42.245.9

28.6

A AB

uTB of Scotchbond Universal dentin

MPa

B

•Burgess, unpublished data

3327

2114

23

Control No dry No agitation FeS04 Na hypochlorite0

10

20

30

40

MPa

Burgess and Faimeena

SBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrsSBU Enamel shear bond strength- 24 hrs

Burgess and Faimeena

SBU enamel bond- Na Hypochlorite 24 hrs

33

2318 16

Control Rinsed off Air dried 10 min, rinse bond 0

10

20

30

40

MPa

Bonding to enamel and contaminants

Shear bond Katana translucent zirconia

Anvita, McLaren E. Lawson N. JDR Abst , 2018

Scotchbond Universal- Dentin application errors








































2831

2320 18

15 16

Etch No etch Dry D Wet D No dry No VLC No agitate05

101520253035

MPa

Shear bond


Anvita, McLaren E. Lawson N. JDR Abst , 2018

Scotchbond Universal- Dentin contamination








































28

21

27 27

14

Etch Saliva Al Chloride Epi pellet Fe Sulfate05

1015202530

MPa

Shear bond


Faimeena, F. Burgess, JO. JDR Abst , 2019









































28

14 14

6

Etch E, FeSO4, SBU FeSO4, E, SBU E, SBU, FeSO405

1015202530

MPa

Shear bond

Faimeena, F. And Burgess, JO. JDR Abstract 2019


Faimeena, F. Burgess, JO. JDR Abst , 2019- Zirconia buttons- Na Hypochlorate on dentin









































2831

12 10

SE Etch SE, Bleach, R SE, Bleach, No R05

101520253035

MPa

Shear bond

Scotchbond Universal vs Scotchbond MP - 1 year

100 100 100

80

9197100 98 100

8795

100100 100 100

8997 97

Anatomic form

Color Match

Recurrent Caries

Marginal integrity

M. Discoloration

Retention

0

20

40

60

80

100

% Alpha SBU- Self Etch SBU- Total Etch SBMP

Scotchbond Universal vs Scotchbond MP - 5 year

90 90100

5060

8795

82

100

7782

969488

100

65 65

88

Anatomic form

Color Match

Recurrent Caries

Marginal integrity

M. Discoloration

Retention

020406080

100

% Alpha SBU- Self Etch SBU- Total Etch SBMP

•Robles A, Lawson NC, Fu CC, Givan DA, Burgess JO. Clinical Evaluation of Universal and Two Bottle Total Etch Adhesives at 5 Years. J Dent Res 97 (Spec Iss A); 2018:1491.

• TE, SE and SE • All contain water- longer drying time • Higher pH (range-2.3 to 3.2) • Selective or total etch technique is

recommended for MDP containing adhesives • Silane containing Universal adhesives (SBU)

are not as effective as a separate application of silane

Universal Adhesives

•  Agitate etchant and bonding agents •  Apply chlorhexidine after etch •  To moist dentin apply sufficient

primer (shiny) and dry •  Avoid contamination •  Adequate light curing

• Agitate etchant and bonding agents • One coat or shiny surface • Dry throughly - adequate light cure • Universal adhesives tolerate drier

tooth surfaces • Avoid contamination, rinse and re

apply

John Burgess 205-996-5795 JBurgess@uab€¦ · • Permaquick 96% @ 5 yr. DeMunck JDR 82:Abs 907,...

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Transcript of John Burgess 205-996-5795 JBurgess@uab€¦ · • Permaquick 96% @ 5 yr. DeMunck JDR 82:Abs 907,...