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23 Operative > 16 - Enamel and Dentin Adhesion (Bonding Part 1) INCOMPLETE > Flashcards

16 - Enamel and Dentin Adhesion (Bonding Part 1) INCOMPLETE Flashcards

1
Q

___: Etching both the enamel and dentin for increased adhesion

A

Total Etch

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2
Q

___: Etching only the enamel (avoiding the etching of the dentin-usually
done in order to maintain the smear layer)

A

Selective Etch

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3
Q

___: No etchant is used. The bonding agent has primers that etch the
enamel or dentin or both.

A

Self Etch

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4
Q

___: Bipolar monomers that have a hydrophyllic molecule on one end of the chain,
and a hydrophobic acrylic group on the other end (hence bipolar)

A

Primer

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5
Q

___: Usually either ethanol or acetone which serve to carry the suspended primers
deep into the wet dentin substrate and tubules

A

Solvent

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6
Q

___: The bis-GMA or other resin based agents that bond to the
substrate

A

Bonding Agent (adhesive)

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7
Q

: Layer of freshly cut dentin/debris lining the floor and walls of a
prep

A

Smear Layer

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8
Q

___: The zone in which resin of the adhesive system micromechanically
interlocks with enamel and or dentinal collagen

A

Hybrid Layer

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9
Q

___: This is pure bis-GMA resin that has been prevented from
polymerizing by the oxygen in the ambient air, and it will combine with the
unpolymerized bis-GMA resin of the subsequent resin addition, thereby serving to
unite the two increments.

A

Air Inhibited Layer

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10
Q

what is adhesion

A

Adhesion is defined as the force that binds two
dissimilar materials together when in intimate
contact.

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11
Q

what is adhesion in dentistry

A

In dentistry, it refers to the process of
attaching/bonding a restorative material to tooth
structure

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12
Q

successful adhesion depends on what

A
  1. Preparing the surface by removing
    plaque and debris
  2. Acid etching with phosphoric acid to
    increase porosity and wettability
  3. Applied bonding agents flowing into the
    porosities and creating resin tags( macro
    and micro tags) for micromechanical
    retention
  4. Applied resin bonding chemically to
    underlying bonding agents (primary
    bond)
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13
Q

intimate contact between ___ and ____ is crucial

A

adhesive and substrate

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14
Q

what does the intimate contact between adhesive and substrate dependon

A
  1. wettability of substrate surface
  2. viscosity of adhesive
  3. surface orughness
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15
Q

Sufficient wetting of the
adhesive will occur only if
its surface tension is ___the surface free
energy of the adherend
(substrate).

A

LESS
THAN

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16
Q

what has high surface energy: enamel or dentin

A

enamel

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17
Q

what has low surface energyy: enamel or dentin

A

dentin

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18
Q

what depicts how well the adhesive wets the surface

A

The contact angle, the angle between
the surface and a tangent line drawn to
the edge of the adhesive droplet
through the droplet itself, depicts how
well the adhesive wets the surface. The
lower the contact angle, the better an
adhesive will wet the surface and
enhance adhesion.

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19
Q
A
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20
Q

___ increases ability to be wet by a resin bonding agent, resulting in stronger bond

A

acid etching of enamel

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21
Q

a ___ contact angle indicates good wetting as liquid spreads over surface

A

LOW

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22
Q

a ___ contact angle indicates poor wetting as liquid beads on the surface like water on waxed car

A

HIGH

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23
Q

what are mechanisms of bonding of resin-based materials to tooth structures

A
  1. mechanical
  2. absorpotion
  3. diffusion
  4. combination of previous three mechh
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24
Q

what is the penetration of resin and formation of resin tags within tooth surface

A

mechanical

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25
Q

what is a chemical bonding to inorganic component (HAP) or organic components (mainly type I collagen) of tooth structure

A

adsorption

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26
Q

what is the precipitation of substances on tooth surfaces to which resin monomers can bond mechanicallly or chemically

A

diffusion

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27
Q

how do the failures of adhesive joints occu

A

I. Cohesive failure in the substrate
II. Cohesive failure within the adhesive
III. Adhesive failure, or failure at the interface of substrate and adhesive.

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28
Q

what is the dental adhesive system components

A
  1. etchant
  2. primer
  3. bonding/adhseive resin
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29
Q

what are the diferent classifications of adhesive systems

A
  1. etch-and-rinse/total etch (3 and 2 step)
  2. self etching (2 and 1 step)
  3. universal (2/1 step) (also called multimode)
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30
Q

enamel % minerals, organic content, and water

A

96% minerals
4% organic content and water

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31
Q

what is a homogenous structures, predictable bonding, and excellent long term bonding durability

A

enamel

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32
Q

Treatment of enamel with an ___ before
placement of a restorative material.

A

acid

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33
Q

who introduced enamel etching

A

Buonocore in 1950s

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34
Q

what does etched enamel appear

A

frosty white when dried

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35
Q

etching produces a rough surface into pits causing what

A

resin flows and forms rresin tags for micromechanical retention

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36
Q

T/F: Etching follows completion of cavity prep
and will follow base/liner placement, if indicated

A

TRUE

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37
Q

what is first: enamel etching or primer/adhesive placement

A

enamel etching

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38
Q

functions of acid etching

A
  1. Leaves clean enamel surface which permits
    better wetting of surface, facilitates better
    adaptation of restorative material
  2. Contact angle between adhesive and enamel
    is reduced=better wetting
  3. Etch increases enamel surface energy
  4. When a low viscosity adhesive is applied, it is
    drawn into the surface irregularities
  5. acid attacks/decalcifies enamel leaving numerous microscopic irregularities (peaks and valey)
  6. improve marginal seal of restoration
  7. decreate effect of polymerizatino shrinkage of resin material by holding resin close to cavosurface and minimizing pull away effect as resin polymerizes and shrinks
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39
Q

what chemical is etching material

A

35-37% phosphoric acid

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40
Q

etching enamel/dentin contact time

A

10-15 seconds

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41
Q

how is etching material supplied

A

supplied as gel by adding colloidal silica to acid

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42
Q

acid etch applied for how long

A

15-30 seconds. rinse for about 20 seconds then dry

43
Q

how should enamel appear after acid etching

A

frosty white

44
Q

what should you do if contamination occurs (e.g., saliva blood etc)

A

re-etch

45
Q

what part of rod etches the best

A

rod ends etch better than sides

46
Q

what are rod core and interprismatic substance have been etched or preferentially decalcified over the rod sheath

A

because the rod sheath is more organic in
composition

47
Q

acid attacks inorganic structures in enamel creating what

A

“peaks and valleys”

48
Q

is more or less organic material left behind in enamel etchign

A

more oreganic material left behind

49
Q

how do enamel rods eenhance retention

A

mechanical locks and greater surface content area (2000x)

50
Q

what enamel does not etch as readily as other

A

Enamel of primary teeth
Teeth with high fluoride levels
Enamel of older patients
People who use whitening agents
Uncut enamel
Enamel adjacent to glass ionomer
restorations

51
Q

why do enamel adjacent to glass ionomer restorations not etch readily

A

because they release fluoride

52
Q

what etching location is not as retentive and not as many peaks and valleys

A

sides of rods

53
Q

where do you sometimes place a bevel on preps to prevent this type of etching pattern form class 3, 4, 5

A

sides of rods

54
Q

ends of rods have surface irregularities of ___ microns deeps

sides of rods have surface irregularitites of ___ microns dep

A

10-30; 5 so ends give better retention

55
Q

what type of etching pattern results when prism core and interprismatic substance are dissolved and prism sheath is left standing

A

TYPE I

56
Q

what is the best etch pattern

A

TypeI

57
Q

what results when the prism sheath is preferentially decalcified and rod core and interprismatic substance are left standing

A

type II

58
Q

what results when aprismatic enamel is etched, often a combo

A

type III

59
Q

what type of teeth are type III Etch done

A

primary teeth or gingival 1/3 of permanent teeth

60
Q

does type III produce as good retention as type I or II?

A

NO!

61
Q

can you have type I, II, or III all on the same tooth next to each other?

A

YES!

62
Q

CONTINUE SLIDE 29-32

A
63
Q

what are the two types of enamel bonding afgent

A
  1. unfilled bisGMA resin
  2. dentinal bonding agents (prime and bond NT)
64
Q

what is:

Same chemically as filled resin, but no filler particles
Mechanical retention

A

unfilled bisGMA resin

65
Q

what is:

Developed for adhesion to dentin
Chemical and mechanical adhesion to enamel also
Attachment to enamel is stronger than unfilled bisGMA

A

dentinal bonding agents (prima nd bont NT)

66
Q

what is the current total etch technique

A

bonding agent appleid to both enamel and dentin

67
Q

bonding agents used for enamel bonding made from resins combined with what? why?

A

combined with dilutents to lower viscosity

68
Q

dentin % minerals, organic content, water

A

45% mineral
33% organic content
22% waterw

69
Q

what is a heterogenous structure with fair long term bonding durability

A

dentin

70
Q

what makes dentin a challenge when it comes to adhesive bonding

A
  1. Dentine is a living tissue (50% HA, 30% collagen, 20% fluid)
  2. Tubular nature of dentine (dentinal fluid)
  3. Branching patterns in tubules, may
    enhance retention
  4. Smear layer presence
  5. Possible side effects on the pulp
71
Q

The ___ is created whenever tooth surface is cut
with hand or rotary instruments

A

smear layer

72
Q

what is defined as any debris, usually calcific produced by
reduction or instrumentation of enamel, dentine or
cementum.

A

smear layer

73
Q

can bacteria trapper in smear layer can survive and multiply beneath restoration

A

YES

74
Q

if bacteria is retained in smear layer, what can happen?

A
  1. lowers dentin permeability
  2. decreases bond strength
  3. lowers the effect of pulpal pressure on bond strength.
75
Q

how does over etching affect dentin

A

leads to weaker bond and sensitivity

76
Q

over drying of dentin leads to what

A

collapse of collagen and occlusion of tubules

77
Q
A

wet/moist dentin

78
Q
A

dry dentin

79
Q
A

over wet -> wet -> overdry

80
Q

when acid conditioning dentin, what should you avoid

A

avoid excessive long time contact of etching

81
Q

long time contact of etchant on dentin does what

A

depletes calcium, adversely affect the ionic bond achievable

82
Q

if you deplete the calcium to the point where the collagen rich zone of dentin becomes too thick, what happens?

A

becomes difficult for adhesive to penetrate

83
Q

SLIDE 42

A
84
Q

dentin bonding agent solvenst

A

acetone or aclohol or water

85
Q

SLIDE 43

A
86
Q

SLIDE 44

A
87
Q

SLIDE 45

A
88
Q

SLIDE 46

A
89
Q

bond strength of enamel

A

25-40 MPa

90
Q

bond strength of dentin

A

20-25 MPa

91
Q

pulpal protection resins

A
  1. CaOH - stimulates (irritates) to enable pulpal repair (ultrablend here at school)
  2. glass Ionomer products (Fuji)
92
Q

always place a base/liner when dentin thickness is what

A

1 mm or less

93
Q

microleakage following etching an opening tubules is a problem. therefore what must you do

A

seal dentinal tubules

94
Q

do you need a THICK layer of liner for pulp

A

no! thin!

95
Q

do you need thermal protection of pulp for composites

A

no

96
Q

do you need a barrier for ehcmical irritation or stimulate a healthy pulpal response for the pulp

A

yes

97
Q

T/F: DO use a cavity varnish or eugenol containins compounds (interferes with bond)

A

DO NOT!!

98
Q

pulpal protection is placed on what part of dentin

A

deepest part of dentin

99
Q

where do you NEVER place a base?

A

on enamel or retention areas

100
Q

glass ionomer product advantages

A
  1. fluoride ion release into surrounding tooth structure
  2. Chemical bond to tooth structure
  3. Increased strength
  4. Radio-opaque
  5. Biocompatible (DO NOT place within 1mm of pulp)
  6. Can potentially improve marginal integrity and reduce microleakage
101
Q

do not acid condition the enamel before what

A

before the base has reached its initial set (2 min 20 seconds)

102
Q

should you avoid etchant contact with the glass ionomer base

A

yes

103
Q

what attaches to tooth structure for greater stability

A

glass ionomer bases

104
Q
A

23 Operative (15 decks)

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