BONDING AGENTS

1. Adhesion- state of holding two surfaces together by interfacial forces which may
be valence forces or interlocking forces or both.
2. Adhesive- a material, frequently a viscous liquid which is used to adhere two
surfaces together and which is able to transfer forces from one surface to
another.
3. Adherend- the surface which is being adhered to another surface by means of an
adhesive.
4. NEED FOR ADHESION
a. Reduces marginal gap between tooth and restoration
b. Prevents microleakage and secondary caries.
5. MECHANISMS OF ADHESION-
a. Mechanical- Adhesive interlocks micromechanically in the surface
roughness and irregularities of adherend surface by forming tags.
b. Adsorption- Adhesive forms chemical bonds (H bonds, van der walls
forces) with adherend surface.
c. Diffusion- Mobile molecules of both surfaces will diffuse together to form
a single surface.
d. Electrostatic- Surfaces having different polarity joined by electrostatic
forces. Ex- resin and metal.
6. Requirements of good adhesion
a. Materials to be joined should be in close proximity
b. Clean and rough adherend surface
c. Good wetting properties of adhesive- low contact angle (~15 degrees)
d. Low surface tension of adhesive, but high for adherend.
e. Intimate adaptation b/w adhesive and adherend.
f. Enough bond strength to resist debonding
g. Adhesive should be well-cured.
h. Adhesive should be neither too viscous nor too fluid.
7. Methods to increase surface tension
a. Cleaning with pumice or prophylactic pastes
b. Acid etching
8. ACID ETCHING
a. PRINCIPLE
i. Introduced by Buenocore
ii. Acid is used to etch enamel and create surface irregularities
iii. This increases the free surface energy.
iv. Resin penetrates the microporosities and irregularities by capillary
action.
v. Monomers are converted into polymers and the fluid adhesive
bonds to enamel by mechanical interlocking.
vi. Resin tags created in the enamel help in adhesion.
 b. PROCEDURE
i. Currently, 37 % phosphoric acid is used for 15 second.
ii. Acid- liquid or gel. Gel- better control
iii. Syringe or brush- syringe better.
iv. After etching
1. Wash with water for 5-10 sec
2. Thorough drying
3. Frosty white surface
c. TYPES OF ETCH PATTERNS
i. Type 1
1. Prism cores dissolved leaving peripheries intact
2. Honeycomb appearance
ii. Type 2
1. Prism peripheries dissolved
2. Cobblestone appearance
iii. Type 3
1. No prism structures.
 

 
9. ENAMEL BONDING AGENTS
a. Buenocore- first to discover adhesion of acrylic resin to acid etched
enamel. Used 85% phosphoric acid.
b. Silverstone recommended 30-50% to get adequate adhesion.
c. Percentage of etchants used- 37%
d. If conc. >50, monocalcium phosphate monohydrate ppt --> can be rinsed
off . It prevents further dissolution.
e. If conc. <27%, dicalcium phosphate monohydrate ppt- cannot be rinsed
off and interferes with adhesion.
f. Etching time
i. 15 seconds- produces same roughness as a 60 sec etch time.
g. Teeth needing longer application
i. Acid resistant teeth- with high F content/ fluorosis
ii. Primary teeth -more aprismatic.
 
 
ADVANTAGES OF ENAMEL ADHESION
10. Bond strengths of composite to phosphoric acid —etched enamel usually exceed
20 Mpa (range-145MPa)
11. Such bond strengths provide adequate retention for a broad variety of
procedures and prevent micro leakage around enamel margins of restorations
12. Provide other benefits such as cusp reinforcement after tooth preparation. -
Adhesive restorations substantially reinforce remaining enamel and dentin,
making them less susceptible to fracture.
 a. Currently Bis-GMA and UDMA
b. Diluents like TEGDMA to lower their viscosity.
c. Explain principle again.
 

 
 
 
DENTIN ADHESION
 
13. PRINCIPLE
a. Adhesive monomers penetrate the filigree of collagen fibers left behind
by acid etching.
14. CHALLENGES
a. Much more organic and fluid content (30% organic, 20% fluid) than
enamel
b. Random arrangement of HA crystals.
c. Dentinal fluid which flows outward
d. Tubules contain vital processes of odontoblasts, which makes dentin
sensitive.
e. Dynamic tissue
f. Sclerosed dentin- difficult to penetrate as peritubular dentin becomes
wider.
g. Cut surface of dentin- smear layer- HA crystals and degraded collagen.
h. SMEAR LAYER
i. Blocks tubules by forming smear plugs
ii. Decreases permeability by 85%
iii. Removal of plugs- more fluid release
iv. Fluid- interfere with adhesion since resins are hydrophobic.
15. DENTIN BONDING AGENTS
HISTORICAL STRATEGIES
16. FIRST GENERATION
a. NPG-DMA- surface acting comonomer.
b. Theory- comonomer + Ca in HA - water resistant chelate
c. Chemical bonds b/w resin and dentin
d. Practice- no bonds b/w Co. and HA. Poor bond strength= 2-3 MPa
e. Eg.- Cervident
17. SECOND GENERATION
a. Phosphate esters ( Phenyl-P and hydroxyethyl methacrylate in ethanol)
b. MOA- Polar interactions between phosphate group (-ve) and Ca (+ve) in
smear layer.
c. DRAWBACKS
i. Smear layer loosely attached to dentin
ii. Poor bond strength ( <1-5 Mpa)
 iii. No hydrophilic groups in resins so less wettability
iv. Less penetration into dentin across smear layer.
d. Eg.- Clearfil bond, Scotchbond, Bondlite
18. THIRD GENERATION
a. Phosphate based materials containing HEMA and a 10-C molecule called
10-MDP
b. Usually modifies smear layer and allows penetration of acidic monomers
like phenyl-p or penta.
c. Mixed clinical results.
d. Ex- clearfil new bond
 
 
CURRENT STRATEGIES
 
ETCH AND RINSE/ TOTAL ETCH TECHNIQUE
19. FOURTH GENERATION
a. 3-step total etch adhesive system
b. PROCEDURE
i. Acid causes
1. Complete or partial removal of smear layer
2. Demineralization of dentin with collagen exposure
3. Altered free surface energy
ii. Primer and bonding resin on dentin-- inside intratubular dentin
iii. Resin- dentin interdiffusion zone- HYBRID ZONE.
c. COMPONENTS
i. Etchants- Phosphoric acid gel --> rinsed off
ii. Primer --> hydrophilic monomers in ethanol, acetone or H2O
(solvent)
iii. Unfilled or filled resin bonding agent
d. Ex- Scotchbond (multipurpose 3M)

 
20. FIFTH GENERATION
a. Simplified
b. One bottle system
c. Components -
i. Separate etching
ii. Primer and adhesive in 1 bottle
d. ADV- Fewer steps
e. DISADV- inferior bond strength (3-75 Mpa)
f. MOA, diagram- 4th gen.
g. Ex. - Single bond (3M), one-step
 
SELF-ETCH ADHESIVES
 21. SIXTH GENERATION/ NON-RINSING CONDITIONER (NRC)
a. Further tries to minimize steps by reducing rinsing step. Prevents
overwetting and over drying.
b. SEP- SELF ETCHING PRIMERS
i. Acids- lower conc- 2.5 nitric acid, 10% phosphoric, 10 % maleic
ii. COMMERCIALLY, 2 FORMS
1. Self-etching primers
i. Etchant +primer
ii. Adhesive
iii. Clearfil SE bond, Xeno
2. Self etching adhesives
i. All 3 in one
ii. Mixing
iii. Prompt-l-pop (3M)

 
22. SEVENTH GENERATION
a. All in one
b. Most recent
c. Only 1 bottle
d. No premixing
e. Hydrophilic +hydrophobic components
f. Bond strength less
g. Advantages over 6th generation
i. Disinfection
ii. Desensitizing
iii. F- release
iv. Color change
v. Low or no post-operative sensitivity.
h. Clearfil S3 Bond, Xeno IV.
 
8th generation
23. Bonding agent within composite resin restorative matrix.
24. Self-etching self-adhering composite technology
25. No separate bonding step
26. Stable nanofillers.
27. Ex- single bond, vertise flow(kerr)
 
The Smear Layer
28. It is iatrogenically produced layer of debris calcific in nature, produced by
reduction or instrumentation of dentine, enamel or cementum that prevents
interaction with underlying pure tooth tissue.
29. CHARACTERISTICS
 a. Produced by rotary or hand instruments in cavity or root canal prep etc.
to obtain good bonding with tooth surface.
b. Burnishing action of instruments--> frictional heat + shear forces -->
smear layer attached, does not wash off.
c. Conditioners-
i. EDTA -best
ii. Acids- citric, polyacrylic, lactic, phosphoric
iii. Cavity cleaners (slight effect)- H202
d. Thickness- 0.5-2 um>> inc with inc bur size and roughness.
e. Granular, irregular
f. Extends upto 1-10 um in dentinal tubules and blocks them.
g. CONTENTS
i. Crushed HA
ii. Denatured collagen
iii. Bacteria
iv. Saliva
h. Reduces dentinal permeability by 86%
i. Removed / reduced by etch and rinse or self-etch procedures. >> inc
dentinal permeability by 90%
30. INTERNAL DENTINAL WETNESS-Wetness of dentine or cavity surface from fluid
of tubules
31. EXTERNAL DENTINAL WETNESS- due to environmental humidity.
32. WHY DENTIN-BONDING AGENTS SHOULD BE HYDROPHILIC-
a. Removal of smear layer >> bonding surface wet >> fluid competes at all
hard tissue sites by hydrolysis and interferes with polymerization of
adhesives or bonding agents.
33. DENTIN PERMEABILITY AND WETNESS DEPENDS ON-
a. Diameter and length of tubules
i. Wet x depth bcz in deep cavity dia inc and length dec.
ii. Occlusal dentin more permeable over pulp horns than at center.
b. Viscosity and molecular size of dentinal fluid
i. Inv prop to int den wetness
c. Pressure gradient - dp.
d. Surface are avsilable for diffusion
i. Wider cavity x wetness
ii. Proximal dentine more permeable than occlusal
iii. Cornoal > root dentin
e. Patency of tubules
i. Sclerotic dentine less permeable.
ii. Rate of removal of substance by pulpal circulation.