Bonding Agents

Applications-composites, resin-modified gIass ionomers, ceramic bonded to enamel restorations, veneers, orthodontic brackets, and desensitizing dentin by covering exposed tubules (Maryland bridges, composite and ceramic repair systems, amalgams and amalgam repair, and pinned amalgams)

Definitions;-

Smear layer - Layer of compacted debris on enamel and/or dentin from the cavity preparation process  that is weakly held to the surface (6 to 7 MPa) , and that limits bonding agent strength if not removed

Etching (or, conditioning)- smear layer removal and production of microspaces for micromechanical bonding by dissolving –minor amounts of surface hydroxyapatite crystals

Priming..- micromechanical (and chemical) bonding to the microspaces created by conditioning step.

Conditioning/priming agent-agent that accomplishes both actions

Bonding- formation of resin layer that connect  the primed surface to the overlying restoration (e.g., composite) .. –

Enamel bonding System-for bonding to enamel (although dentin bonding may be a Second step)

Dentin bonding system  for bonding  to dentin (although  enamel bonding  may have been a first step)

•        First-generation dentin bonding system for bonding to smear layer

•        New-generation dentin bonding system- for removing smear layer and etching intertubular dentin to allow  primer and/or bonding agent to diffuse into spaces between collagen and form hybrid zone

Enamel and dentin bonding system-for bonding to enamel and dentin surfaces with the same procedures

Amalgam bonding  system for bonding to enamel, dentin, and amalgam, dentin and amalgam during an amalgam placement procedure or for amalgam repair

Universal bonding system-for bonding to enamel, dentin, amalgam, porcelain , or any other substrate intraorally that may be necessary for a restorative procedure  using the  same set of procedures and materials

Types

Enamel bonding systems

Dentin bonding systems

Amalgam bonding systems

Universal bonding systems

Structure

o        Components of bonding systems

o        Conditioning agent-mineral or organic acid

Enamel only   37% phosphoric acid

Dentin only or enamel and .dentin---37% phosphoric acid, citric acid, maleic acid, or nitric acid

o        Priming agent

Hydrophobic-solvent-soluble, light cured monomer system

Hydrophilic-water-soluble, light-cured monomer system

Bonding agent

BIS-GMA-type monomer system

UDMA-type monomer system

Reaction

Bonding occurs primarily by intimate micromechanical retention with the relief created by the conditioning step

Chemical bonding is possible but is not recognized as contributing significantly to the overall bond strength

Manipulation-follow manufacturer's directions

Properties

Physical-thermal expansion and contraction may create fatigue stresses that debond the interface and permit micro leakage

Chemical-water absorption into the bonding agent may chemically alter the bonding

Mechanical-mechanical stresses may produce fatigue that debonds the interface and permits microleakage

Enamel bonding-adhesion occurs by macrotags (between enamel prisms) and microtags (into enamel prisms) to produce micromechanical retention

Dentin bonding-adhesion occurs by penetration of smear layer and formation of microtags into intertubular dentin to produce a hybrid zone (interpenetration zone or diffusion zone) that microscopically intertwines collagen bundles and bonding agent polymer

Biologic

Conditioning agents may be locally irritating if they come into contact with soft tissue

Priming agents (uncured), particularly those based on HEMA, may be skin sensitizers after several contacts with dental personnel

Protect skin on hands and face from inadvertent contact with unset materials and/ or their vapors

HEMA and other priming monomers may penetrate through rubber gloves in relatively short times (60 to 90 seconds)

Principles of cutting, polishing, and surface cleaning

• Surface mechanics for materials

Cutting-requires highest possible hardness materials to produce cutting

Finishing-requires highest possible hardness materials to produce finishing, except at margins of restorations where tooth structure may be inadvertently affected

Polishing- requires materials with Mohs ./ hardness that is 1 to 2 units above that of substrate

 Debriding-requires materials with Mohs hardness that is less than or equal to that of substrate to prevent scratching

•    Factors affecting cutting, polishing. and surface cleaning
  • Applied pressure
  • Particle size of abrasive
  •  Hardness of abrasive
  •  Hardness of substrate
•      Precautions
  • During cutting heat will build up and change the mechanical behavior of the substrate from brittle to ductile and encourage smearing
  • Instruments may transfer debris onto the cut surface from their own surfaces during cutting, polishing, or cleaning operations (this is important for cleaning implant surfaces)

CLEANING AND PICKLING ALLOYS

The surface oxidation or other contamination of dental alloys is a troublesome occurrence. The oxidation of base metals in most alloys can be kept to a minimum or avoided by using a properly adjusted method of heating the alloy and a suitable amount of flux when melting the alloy . Despite these precautions, as the hot metal enters the mold, certain alloys tend to become contaminated on the surface by combining with the hot mold gases, reacting with investment ingredients, or physically including mold particles in the metal surface. The surface of most cast, soldered, or otherwise heated metal dental appliances is cleaned by warming the structure in suitable solutions, mechanical polishing, or other treatment of the alloy to restore the normal surface condition.

Surface tarnish or oxidation can be removed by the process of pickling. Castings of noble or high-noble metal may be cleaned in this manner by warming them in a 50% sulfuric acid and water solution . . After casting, the alloy (with sprue attached) is placed into the warmed pickling solution for a few seconds. The pickling solution will reduce oxides that have formed during casting. However, pickling will not eliminate a dark color caused by carbon deposition 

The effect of the solution can be seen by comparing the submerged surfaces to those that have still not contacted the solution. the ordinary inorganic acid solutions and do not release poisonous gases on boiling (as sulfuric acid does). In either case, the casting to be cleaned is placed in a suitable porcelain beaker with the pickling solution and warmed gently, but short of the boiling point. After a few moments of heating, the alloy surface normally becomes bright as the oxides are reduced. When the heating is completed, the acid may be poured from the beaker into the original storage container and the casting is thoroughly rinsed with water. Periodically, the pickling solution should be replaced with fresh solution to avoid excessive contamination.

Precautions to be taken while pickling

With the diversity of compositions of casting alloys available today, it is prudent to follow the manufacturer's instructions for pickling precisely, as all pickling solutions may not be compatible with all alloys. Furthermore, the practice of dropping a red-hot casting into the pickling solution should beavoided. This practice may alter the phase structure of the alloy or warp thin castings, and splashing acid may be dangerous to the operator. Finally, steel or stainless steel tweezers should not be used to remove castings from the pickling solutions. The pickling solution may dissolve the tweezers and plate the component metals onto the casting. Rubber-coated or Teflon tweezers are recommended for this purpose.

ACID ETCH TECHNIQUE

Cavities requiring added retention (to hold firmly) are treated with an acid etching technique. This technique improves the seal of the composite resin to the cavity wall. The enamel adjacent to the margins of the preparation is slightly decalcified with a 40 to 50 percent phosphoric acid solution. This etched enamel enhances the mechanical retention of the composite resin. In addition, the acid etch technique is used to splint unstable teeth to adjacent teeth. The acid is left on the cut tooth structure only 15 seconds, in accordance with the directions for one common commercial brand. The area is then flushed with water for a minimum of 30 seconds to remove the decalcified material. Etched tooth structure will have a chalky appearance.

WETTABILITY
To minimise the irregularities on the investment & the casting a wetting agent can be used .

FUNCTIONS OF A WETTING AGENT

1 . Reduce contact angle between liquid & wax surface .
2 .Remove any oily film left on wax pattern .

Cement liners

Applications (if remaining dentin thickness is <0.5 mm)

o    Used for thermal insulation where cavity preparation is close to the pulp
o    Used for delivering medicaments to the pulp

•    Calcium hydroxide stimulates reparative dentin or
•    Eugenol relieves pain by desensitizing nerves
•    Used to deliver F ion to enamel and dentin

Components

o    Paste of calcium hydroxide reactant powder, ethyl toluene sulfonamide dispersant, zinc oxide filler, and zinc stearate radiopacifier
o    Paste of glycol salicylate reactant liquid, titanium dioxide filler powder, and calcium tungstenate radiopacifier

Reaction

Chemical reaction of calcium ions with salicylate to form methylsalicylate salts Moisture absorbed to allow calcium hydroxide to dissociate into ions to react with salicylate Mixture sets from outside surface to inside as water diffuses

Manipulation

Dentin should not be dehydrated or material will not setMix drop of each paste together for 5 secondsApply material to dentin and allow I to 2 minutes to set

Properties

o    Physical-good thermal and electrical insulator
o    Chemical-poor resistance to water solubility and may dissolve
o    Mechanical-low compressive strength (100 to 500 psi)
o    Biologic-releases calcium hydroxide constituents, which diffuse toward the pulp and stimulate
o    reparative dentin formation