• What are the clinical procedures of

restoration of composite resin ?

- Acid etching of the tooth
- Primer application
- Application of adhesive/ dentine
bonding agent
- Application of Composite resins on
prepared cavity
• Contents:
• Introduction & history
• What is the mechanism of acid etching
• Effect of acid etching on enamel
• Factors which affect acid etching
• Different types of acid etching
ACID ETCHING OF TOOTH FOR
COMPOSITE RESIN
 INTENDED LEARNING OUT COMES:
• At the end of the lecture the student should be able to:-
• 1. Understand the principle behind acid-etching
• 2. Analyze different types of acid etching
• 3. Differentiate the types of acid etching
• 4. Recall the factors which affect the acid etching
• 5.Inculcate the clinical skills to perform acid etch techniques
The retention of composite resins on the
tooth structure is very essential for the
success of restoration.
Despite of advancements in material if the
procedure does not help in retention of the
restoration will be a failure
• History:
• Buonocore in 1955 introduced the acid-
etch technique for the adhesion of resin to
the tooth
• What is Acid etching?
Is a procedure by which the
tooth surface is made porous
by selective dissolution of
inorganic constituents which
helps in creation of resin tags
of 20-30 microns in length for
the micro-mechanical
retention of the resin
composites
• Mechanism Of Adhesion:
Micro-Mechanical: Irregular
enamel surface created due to
dissolution of Hydroxyapatite
crystals
Which permits penetration of fluid
adhesive by capillary action which
creates resin tags , and these tags
after setting forms
micromechanical retention.
• What are different Types/ patterns of
acid etching:
According to Silverstone There are 5
types of acid etching patters:
1. Type-I: Where there will be
preferential dissolution of prism Core
, resulting in Honey Comb
appearance.
2. Type-II : Where there is preferential
dissolution of prism peripheries ,
giving COBBLE STONE
appearance.
• Type-III : A mixture of Type-I &
II pattern

• Type-IV: Pitted of enamel surface

which looks unfinished puzzle.

• Type-V: Flat and smooth surface

• What is the effect of acid etching on
enamel?
1. It removes the Smear layer/ cleans the
surface
2. It increases the surface energy of
enamel
3. It increases the surface area of enamel
4. It helps in preferential dissolution of
hydroxyl apatite crystals
5. It creates micro porosities on enamel
6. It helps in micro-mechanical retention
• Factors which influence the enamel etching:
1. Type of acid: Maleic acid, acrylic acid, citric acid, phosphoric
acid.
2. Concentration of acid
Optimum Concentration is 37% of aqueous solution of Ortho-
phosphoric acid which produces the highest bond strength to the
enamel
3.Time of etching: Optimum time for etching is 15-30 secs
4. Form of etchant: liquid or gel form.
• Acid etchant may be available
in liquid form or gel form
• Gel is preferred due to better
control of placement on enamel
• Acid may be applied by means
of syringe or micro brush ,
syringe placement is easy and
precise.
• After acid etching , the enamel
surface should be thoroughly
rinsed with a continuous stream
of water spray for 5-10 seconds
so that the acid is completely
washed off.
• This should be followed by
proper drying which will
produce a frosty white
appearance
• Type of tooth:
Teeth with FLUOROSIS are
more resistant to acid etching
and requires more time for
etching
Hence the use of Non-
fluoridated pumice paste is
recommended before composite
restorations.
• Are there any other methods to produce
rough surface on tooth structure?
Yes there are different methods:
1. Crystal growth theory: acids having
sulfate ions like seen in poly acrylic
acid is placed on to the tooth, which
helps in growth of Calcium sulfate di-
hydrate crystals, which helps in
adhesion of composite resin on to
tooth surface
2. Air-Abrasion: Aluminum oxide
with particle size like 5 microns is
sprayed on to the tooth structure
with high pressure to create rough
surface
3. LASER etching:
Nd-YAG Neodymium, Yettrium,
Aluminum Garnet
But bond strength is very less
II. APPLICATION OF DENTIN BONDING AGENTS
• Intended Learning Objects:
• At the end of the lecture the student should
be able to :
1. Have knowledge about concept of
adhesion
2. Able to recall the composition of dentin
bonding agents
3. Analyze different types of DBA
4. Perform clinical steps diligently
• Contents of The lecture:
- Introduction and principles of adhesion
- History
- Composition
- Classification
• Basic Concepts of adhesion:
ADHESION: Is a process where two
surfaces are held together by an
interfacial force by interlocking.
An adhesive material is usually a
liquid or viscous fluid which joins
two substrates together and is able to
transfer load from one surface to an
other
• Requirements for good adhesion:
- Surface of the substrate should be clean
- The adhesive should wet thoroughly on
the substrate
- The adhesive should have low contact
angle.
- The bond strength between adhesive
and adherent should be strong
• What are these Bonding Agents?
These are materials of low
viscosity when applied on acid
etched tooth structure helps in
adhesion of composites on to
tooth structure by forming micro-
mechanical bond.
• What are the ideal requirements of
Dentin bonding Agents:
1. Biocompatible and non toxic
2. Low film thickness and low
viscosity
3. Form strong bond
4. Coefficient of thermal expansion
should be similar to tooth structure
5. Lower thermal conductivity
6. Prevent micro-leakage
• Is bonding to enamel and dentin are
same?

No It is not the same, bond strength to

enamel is more than that of dentin bond
strength.
- Bond strength mainly depends on the
inorganic component of the tooth
structure, which is more in enamel than
dentin.
- That is the reason even unsupported
enamel is preserved.
• What is the problem in Dentin:
Dentin is a dynamic tissue unlike enamel
What does it mean?
Enamel cells- ameloblasts die after the formation of enamel
where as it is different in case of Dentin
1.There is continuous formation of dentin by odontoblasts,
during aging, caries, restorative procedure
2. Dentin is full of Dentinal tubules , where the diameter of the
tubule is larger at the pulpal end
3. Dentinal tubules are filled with
fluid called dentinal fluid or dental
lymph, which constantly flows out
ward from the pulp
4. The composition of dentin is
different having 50% of in-organic
, 25% water and 25% organic
5. Presence of Smear layer on
dentinal surface
• SMEAR LAYER
What is smear layer?
Is a layer of debris deposited on the cut
tooth structure, comprised of hydroxyl
apatite, denatured collagen ,saliva and
micro organisms
How is it formed?
Smear layer is formed during tooth
preparation, when done with the help of
rotary or hand instruments on the
surface of the tooth
• What are the parts of Smear
layer?

It has two parts

1. Superficial layer
2. Smear-plug
• What is the function of Smear layer?
There are two schools of thoughts
One school says to RETAIN the smear layer:
1. It blocks the orifice of the dentinal tubules so
- It lowers the dentin permeability
- It reduces the sensitivity
Second school of thought says
REMOVE the smear layer
- Smear layer is full of debris and
bacteria so it acts as source of
bacteria
- Smear layer will block the proper
adhesion of the composite resin to
the tooth structure
Hence they decided to MODIFY the
smear layer, How to modify By
removing the superficial layer and
retaining only the smear plug
• What is Hybrid Layer?
• Is Resin-Dentin inter diffusion zone in
which dentin bonding agent enters in
between the collagen fibers of the inter
tubular dentin
How Hybrid Layer is formed?
Hybrid layer is formed as follows
Acid etching of tooth structure removes
the smear layer and exposes collagen
fibers
Then apply DBA which diffuses in to these
spaces between the collagen and sets to
form Hybrid Layer
• Composition Of Dentin Bonding Agents:
The design of DBA can be represented as follows
M-R-X molecule
M- methacrylate group for bonding to resin matrix of
composites

R- Spacer such as hydrocarbon chain

X- Functional group for bonding to organic and inorganic

component of dentin
• Classification of Dentin bonding Agents:
Depending on the chemical composition , number of clinical
steps and on the smear layer treatment the DBA are classified as
follows:
Ist Generation of DBA:
Introduced in 1960
It contains NPG-GMA( N-phenyl Glycol Glycedyl
methacrylate)
This chelates with the Calcium of the tooth structure by
chemical bond with bond strength of 2-3 Mpa
• 2nd Generation of dentin bonding agents:
Composition : Phosphate ester material with
HEMA (Hydroxyethyl methacrylate)
Mechanism of Adhesion: chemical interaction
between phosphate group and calcium in the tooth
structure
Smear layer: Is retained , since it is attached
loosely to the dentin , the bond strength is very
weak
Clinical steps: two
• Third Generation of DBA:
- Fusayama -1979 said that dentin can be etched
as well, with the same phosphoric acid

Composition : Phosphate –ester type

Phenyl-P or PENTA
Smear layer: It is been modified , by retaining the
Smear plug
No.Clinical steps: 3
Bond strength : is less 3-5Mpa
• Fourth Generation:
Composition
Smear layer: Removal,
they thought that smear layer is a barrier for the diffusion of the resin
material ,
It believes with acid etching of dentin
The method is called Total – etch or etch and rinse technique
Smear layer : Remove
No. of clinical steps: 3 steps
- Acid etching
- Primer application : Primer
contains reactive hydrophilic
monomers in ethanol, acetone
or water
- Adhesive application
- Bond strength is 13-30 MPa
• Fifth Generation:
These adhesives are the simplified version of
fourth generation also called single step but its
not so, they still require two steps
- Acid etchant is present as separate bottle
- Primer and adhesive combined in one bottle
- Advantage is fewer steps
- Disadvantage is : bond strength is 2-25MPa
less than the fourth generation DBA
• Sixth generation DBA: in 1990
- They dissolve the smear layer and does not require
rinsing with water.
- Advantage: It reduces the sensitivity as tubules are not
exposed.
- There are two types :
1. SEP & Adhesive: Etchant and primer in one bottle , but
adhesive will be in an other bottle
- 2. Self Etching Adhesive: Where etchant, primer and
Adhesive are all in one packet, but needs to be mixed
before using , usually not compatible with self curing
composites
• Seventh Generation :
• Developed in 2002
Also called All-In-One
- Etchant , primer and adhesive are in
one bottle, and it does not require
any mixing
- Not compatible with self curing
composites
- No.of steps: one
- Bond strength is less than the fourth
and fifth generation DBA
• Composite curing ( polymerization)
1. Chemical cure
2. Light cure:
- Uv-Light
- Visible light cure
• Light curing units:
• Quartz- Tungsten Halogen(QTH)
• Light-Emitting Diode(LED)
• Plasma Arc
• LASER
THANK YOU ALL