Adhesives 4

Question 1

ideally, adhesives should mimic the DEJ

Answer 1

1) enamel
2) dentin
—
Bonds to the adherent

Question 2

why do we need adhesion

Answer 2

1) prevent leakage of bacteria and recurrent caries
2) provides seal over remaining decay
3) more conservative tooth prep
4) strengthen tooth tissue
5) bonding to enamel and dentin
6) reduce post op sensitivity

Question 3

sclerotic dentin

Answer 3

1) dentinal tubules completely filled with minerals
2) caused by aging or caries/attrition
3) less etchable
–
1) it is built in response to caries

Question 4

why worry about bond strength

Answer 4

1) required to overcome 17-18 mpa
2) if it shrinks and pulls away from walls, it will fail
3) needed for retention and peripheral seal
4) bonding failures are either adhesive or cohesive failure

Question 5

cohesion and adhesion

Answer 5

1) adhesion: between bonding agent, tooth, and restoration
2) cohesion: within the same material

Question 6

adhesive failure

Answer 6

1) interface of two surfaces

Question 7

cohesive failure

Answer 7

1) within one surface

Question 8

hybrid layer

Answer 8

1) a successful and long term stable bond depends on the hybrid layer with exposed collagen matrix infiltrated by resin adhesive
2) primer exposes them
- it has acid inside and the scrubbing helps
- also wets the dentin

Question 9

matrix metalloproteinases

Answer 9

1) collagen fibril degradation
2) normally released when dentin is severed
- hydrolyze dentin bond resulting in decreased dentin bonding strength
3) MMP inhibitors: chlorohexidine and benzalkonium chloride
- added to newest bonding agent

Question 10

review adhesive generations

Answer 10

4-7th

Question 11

total etch

Answer 11

1) removes smear layer
2) 4th and 5th

Question 12

self-etch

Answer 12

1) no rinse
2 incorporates smear layer
3) 6-7th

Question 13

universal

Answer 13

1) still self etch, new additives
2) 7th

Question 14

6th generation

Answer 14

1) acidic primer
- replaces phosphoric acid gel
- effective on dentin, not enamel
- no rinse
2) adhesive
- equivalent to adhesive in 4th gen
- hydrophobic

Question 15

7th generation

Answer 15

1) acidic primer and adhesive

Question 16

prelude

Answer 16

1) primer
2) adhesive
3) link
- allows for a light cured adhesive to be autocure *dualcure
- used when bonding to an opaque resin
- neutralize acidity of primer
- to cure oxygen inhibited layer of the adhesive
- not equivalent for scotchbond

Question 17

3M scotchbond

Answer 17

1) self etch
- good bond to dentine but mediocre bond to enamel
2) selective etch preferred
3) three additional ingredients
- MDP phosphate monomer
- vitrebond copolymer
-silane

Question 18

vitrebond copolymer

Answer 18

1) polyalkenoic acid copolymer
2) long chain organic acids from glass ionomer cements
3) provides ionic bonding to residual hydroxyapatite

Question 19

silane

Answer 19

1) bifunctional molecules
2) bonds resin to the silica quartz filler
- organic end to resin
- silicone end to glass

Question 20

10 MDP

Answer 20

1) 10 MDP monomer
2) bonds to many substrates
- dentin
- enamel
- metal
- ceramics
3) two functional groups that like…
- resin
- Ca2+ in tooth
- ceramic
4) long chain keeps the functional groups apart
5) phosphate group bonds to ceramic and calcium
6) methacrylate allows it to incorporate into adhesive (resin)

Question 21

scotchbond uses

Answer 21

1) direct restorations with light
2) cementation of veneers only to thin glass ceramic
3) repair composites, PFMs, all-ceramic restorations
4) poor performance with chemical or dual cure material

Question 22

tips

Answer 22

1) preserve enamel and dentin as much as possible
2) restore teeth using good principles of adhesive dentistry
3) understand the various generations and how their use is different
4) follow the exact correct process for each bonding system