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Bonding in dentistry

 In dentistry, bonding of resin-based materials


to tooth structure is a result of four possible
mechanisms
 1. Mechanical—penetration of resin and
formation of resin tags within the tooth surface
 2. Adsorption—chemical bonding to the
inorganic component (hydroxyapatite) or
organic components (mainly type I collagen) of
tooth structure
Sturdevant’s Art and Science
of Operative Dentistry 2018
 3. Diffusion—precipitation of substances on
the tooth surfaces to
 which resin monomers can bond
mechanically or chemically
 4. combination of the previous three
mechanisms
 For good adhesion, close contact must exist
between the adhesive and the substrate
(enamel or dentin). he surface tension of the
adhesive must be lower than the surface
energy of the substrate.
 Failures of adhesive joints occur in three
locations, which are generally combined when
an actual failure occurs:
 (1) cohesive failure in the substrate
 (2) cohesive failure within the adhesive;
 (3) adhesive failure, or failure at the interface
of substrate and adhesive.
Indication of Adhesive restorative techniques

 Restore Class I, II, III, IV, V, and VI carious


lesions or traumatic defects.
 Change the shape and the color of anterior
teeth (e.g., with
 full or partial resin veneers).
 Improve retention for porcelain-fused-to-metal
(ceramometal) or metallic crowns.
 Bond all-ceramic restorations
 Seal pits and fissures.
 Bond orthodontic brackets.
Enamel Adheion

 Inspired by the industrial use of 85%


phosphoric acid to facilitate adhesion of paints
and resins to metallic surfaces, Buonocore
envisioned the use of acids to etch enamel for
sealing pits and fissures.
 Various concentrations of phosphoric acid have
been used to etch enamel. Most current
phosphoric acid gels have concentrations of
30% to 40%, with 37% being the most common
 shear bond strengths of composite to
phosphoric acid-etched enamel usually
exceed 20 megapascals(MPa) - 53 Mpa.
 Acid etching transforms the smooth enamel
into an irregular surface and increases its
surface-free energy.
 The formation of resin microtags within the
enamel surface is the fundamental
mechanism of resin-enamel adhesion.
Scanning electron micrograph of enamel etched with 35%
phosphoric acid (3M Oral Care) for 15 seconds.
Challenge in Dentin Bonding

 Bonding to enamel is a relatively simple process,


without major technical requirements or diiculties.
 Bonding to dentin presents a much greater
challenge.
 Several factors account for this diference between
enamel and dentin bonding.
 Enamel is a highly mineralized tissue composed of
more than 90% (by volume) hydroxyapatite, whereas
dentin contains a substantial proportion of water
and organic material, primarily type I collagen
 Dentin also contains a dense network of
tubules that connect the pulp with the
dentinoenamel junction.
 A cuf of hypermineralized dentin called
peritubular dentin lines the tubules.
 The less mineralized intertubular dentin
contains collagen fibrils with the
characteristic collagen banding .
 Intertubular dentin is penetrated by submicron
channels, which allow the passage of tubular
liquid and fibrils between neighboring tubules,
forming intertubular anastomoses.
 Dentin is an intrinsically hydrated tissue,
penetrated by a maze of fluid-filled tubules.
Movement of fluid from the pulp to the DEJ is a
result of a slight but constant pulpal pressure.
 Whenever tooth structure is prepared with a
bur or other instrument, residual organic and
inorganic components form a “smear layer” of
debris on the surface.
 The smear layer fills the oriices of dentin
tubules, forming “smear plugs”and decreases
dentin permeability by nearly 90% in vitro.
 The composition of the smear layer is basically
hydroxyapatite and altered denatured collagen.
WHAT IS DENTIN BONDING ??

 In dentin bonding ,formation of the


hybrid layer, a biocomposite containing
dentin collagen and polymerized resin
adhesive.

Oper Dent.2015 Jan-Feb;40(1):4-18.


Dentin bonding: can we make it
last?
Tjäderhane L
Dentine structure

 50% Minerals
 30% Type I Collagen & Non collagenous
proteins
 20% Water
Dentinal tubule
Peritubular dentin
(Highly mineralized)

Intertubular dentin
(Mineralized
collagenous
organic matter)
HISTORY

 The total-etching technique, in which


enamel and dentin are etched
simultaneously, was introduced by
Fusayama . In this technique, the smear
layer created on the surface by cutting
with the bur is removed, and 3 to 5 μm of
superficial dentin is demineralized to
expose the collagen network and produce
funnel-shaped dentinal tubules
Dentin cross section showing Etched dentin : Dentin tubule
the smear layer on top of the orifices appear funneled due to
mineralized dentin and smear the demineralization of the
plugs obliterating the tubules peritubular dentin mineral .
Intertubular dentin :
Demineralized up to 4 to 5 μm
The image shows the deep
penetration of resin tags into the
dentinal tubules exposed by the
acid-etching process
GENERATIONS OF DENTIN BONDING
AGENTS

Summitt's Fundamentals of
Operative Dentistry
Three-step etch-and-rinse adhesives

Etching
1. Apply 35% to 37% phosphoric acid to enamel
for 15 to 30 s and to dentin for 15 s.
2. Rinse the etched surface for 15 s with an
air-water spray.
3. Gently air dry to remove excess moisture.
Priming
1.Perform active application of primer for at
least 30s (gently agitated or rubbed onto the
dentin surface)
Bonding
1. Generously apply the adhesive resin with
a microbrush.
2. Use a bristle brush to thin and create a
homogenous layer.
3. Cure for manufacturer recommended
time, which is typically about 10 to 20 s.
Two-step etch-and-rinse adhesives

Etching
1. Apply 35% to 37% phosphoric acid to
enamel for 15 to 30 s and to dentin for 15
s.
2. Rinse the etched surface for 15 s with an
air-water spray.
3. Gently air dry to remove excess moisture.
Priming and bonding
1. Apply primer/bonding solution generously,
producing a shiny appearance, then
vigorously rub at least 30 s.
2. Air dry to evaporate solvent for 30 to 40 s.
3. Actively reapply the primer/bonding solution
and air dry.
4. Cure for manufacturer recommended time,
which is typically about 10 to 20 s.
Two-step self-etching adhesives

Etching and priming


1. Selectively etch enamel with 35% to 37%
phosphoric acid for 15 s.
2. Air-water rinse for 15 s, trying to minimize
rinsing over the dentin. Dry gently.
3. Actively apply the selfetching primer agent
on etched enamel and unetched smear layer–
covered dentin for the time recommended by the
manufacturer(typically 20s).
4. Air dry to remove any excess solution and solvent
and terminate the etching
Bonding
1. Generously apply the adhesive resin with
a microbrush.
2. Use a bristle brush to thin and create a
homogenous layer.
3. Cure for manufacturer recommended
time, which is typically about 10 to 20 s.
One-step self-etching adhesives

Etching, priming, and bonding


1. Selectively etch enamel with 35% to 37%
phosphoric acid for 15 s.
2. Air-water rinse for 15 s, trying to minimize
rinsing over the dentin . Dry gently.
3. Actively apply the one-step adhesive on
etched
enamel and unetched smear layer covered
dentin
4. Air dry to remove any excess solution
and solvent and terminate the etching
reaction.
5. Reapply the adhesive in multiple layers
using an active rubbing motion.
6. Air dry to remove any excess solution
and solvent and terminate the etching
reaction.
7. Cure for manufacturer recommended
time,
which is typically about 10 to 20s
Wet vs dry bonding

 Surface moisture is an important factor in


optimal bonding.
 On enamel, a dry condition is theoretically
preferred.
 On dentin, certain amount of moisture is
needed to avoid collapse of the exposed
collagen fibers.
Collapse of etched dentin by air drying
SEM images of moist
& dry dentin

Moist dentin

Dry dentin
Wet bonding has following advantages over dry
bonding:

1. It prevents collapse of exposed collagen


2. It improves the infiltration of bonding
agents
3. It increases the thickness of hybrid layer
4. It increases bond strength
Materials

Dental adhesives consist of three main components:


(1) Etchant
(2) Primer
(3) Bonding Resin Or Adhesive Resin
 The etchant
Is composed of acidic molecules that alter or remove
the smear layer.
PRIMING

 Second step of dentin bonding procedure


 Adhesion promoting agents
 Hydrophilic monomer dissolved in a solvent
 Eg HEMA and 4-META
The acetone or ethanol on volatilization
displaces water from dentin as well as
collagen fibrils.

Resin can penetrate easily.


Primer

Primer helps make the dentin surface(hydrophilic),


become more hydrophobic in order to accept the
very hydrophobic bonding resin.
 Thus, the primer typically contains a molecule or
molecules with both hydrophilic and hydrophobic
characteristics, ie, amphiphilic.
 It functions by penetrating the demineralized dentin
and preparing it for the bonding resin.
BONDING RESIN

 All dental adhesive systems are based on polymeric


materials. These materials have a variety of chemical
characteristics, ranging from very hydrophilic (glass
ionomer) to very hydrophobic (the adhesive resin
component of many adhesive systems).
 Considering the hydrophilic nature of the tooth,
especially dentin, it is logical that an adhesive also
should have a hydrophilic nature when placed in
order to wet the surface and penetrate the available
microstructure.
 hydrophobic nature is considered to be beneficial
once the material has established a bond with the
tooth substrate.
 A hydrophobic polymeric layer is more insoluble
and resistant to erosion and degradation by acids.
 Thus, the ideal adhesive would have a hydrophilic
nature during placement and would become much
more hydrophobic after curing.
 The major difference between hydrophilic and
hydrophobic adhesives is the chemistry of their
monomers and solvents. Monomers with alcohol, acid,
hydroxyl, and amino groups are more capable of
enhancing chemical interactions with the collagen and
hydroxyapatite of tooth structure than are molecules
consisting predominantly of hydrocarbons.
 As hydroxyl, carboxylic, phosphate, and amide functional
groups are substituted for groups containing hydrogen,
methyl, ethyl, and so forth, on the polymer chain, and as
ether and ester linkages are incorporated, the polymer
becomes slightly more hydrophilic.
 A monomer like hydroxylethyl methacrylate (HEMA)
is totally miscible in water and serves as an excellent
polymerizable wetting agent for dental adhesives .
 Bisphenol glycidyl methacrylate (bis-GMA), the main
monomer used in most dental composites and many
adhesives (the final component of the bonding
system application process), is much more
hydrophobic and will only absorb about 3% water by
weight into its structure when polymerized.
 These solvents are typically water, ethyl alcohol,
butyl alcohol, or acetone. The first three are very
hydrophilic and thus enhance the interaction of the
monomers with surface water, while acetone is good
at displacing(“drying”) water from within the dentin.
However, any solvent not displaced during the
placement procedure, such as by drying
appropriately, will be incorporated into the bonding
layer and may serve as a weakening contaminant.
 Because it is not a polymerizable molecule and
cannot bond with the newly formed polymer, such an
agent is called a plasticizer, so named because it
softens the polymer structure in the bonding layer
by expanding the polymer network and reducing the
beneficial physical entanglements of individual
polymer chains that contribute to its strength.
BONDING

 To achieving bonding to the tooth is the conversion


of the monomers that penetrated the tooth structure
into a rigid, strong polymer. This process, called
polymerization
 Involves the chemical splitting of carbon-carbon
double bonds of the monomers, followed by the
formation of carbon-carbon single bonds linking one
monomer to another, thus building a long chain of
molecules much like adding links to a chain .
 Bonding to organic part of dentin involves
interacting with
Amino(-NH), Hydroxyl(-OH), Carboxylate(-
COOH), Amide(-CONH) groups present in
dentinal collagen.

 Dentin bonding agents have isocyanates,


aldehydes, carboxylic acid anhydrides and
carboxylic acid chlorides which remove
hydrogen from the above groups and combine
chemically.
LIGHT CURING

 The polymerization process typically is begun by


exposing the adhesive to radiation from a high-intensity
light source tuned to the same wavelength range (400 to
500 nm, blue light) that is absorbed by the purposely
added photoinitiator.
 Thus, photons of blue light are directed into the uncured
adhesive, and the photoinitiator molecule within
(typically camphorquinone) absorbs these photons,
raising these molecules to an excited state from which
they are capable of interacting chemically with the
monomer molecules to split carbon-carbon double bonds
and initiate the polymerization reaction.
CHEMICAL CURING

 It is also possible to use chemicals in the absence of


light
 energy to produce the reaction in what are called
self-curing materials, as opposed
 to the light-curing materials just described.
DUAL CURE
VOLUMETRIC SHRINKAGE

 Accompanying the polymerization reaction is a


volumetric change of the adhesive material.
 The overall volume contraction depends on the size
of the molecules reacting and the extent to which
they reacted (polymerized) and can be as high as
10% for an unfilled resin.
 The shrinkage of the material during curing
produces a dimensional change that causes stresses
to build up between the tooth surface and the
adhesive and ultimately between the tooth and the
composite restorative through the adhesive.
 These stresses can be very detrimental in that they
may lead to the composite and adhesive being pulled
away from the tooth surface to which it is trying to
establish a bond.
Curing of the dental composite causes it to shrink, pulling
the material away from the cavity walls of the tooth and
toward its center.
CONCLUSION

 The classic concepts of tooth preparation


advocated in the early ‘90s have changed
drastically over the last 20 years due to
introduction of adhesive dentistry.
 This has resulted in a more conservative
approach to tooth preparation, less reliance on
macromechanical retention, and less removal of
unsupported enamel.
 For successful bonding a thorough knowledge of
the mechanism and the chemistry of the
materials should be known.
 THANK YOU