Veterinary Quarterly

ISSN: 0165-2176 (Print) 1875-5941 (Online) Journal homepage: https://www.tandfonline.com/loi/tveq20

Adhesive Dentistry with Direct Restorative

Materials

A. W. van Foreest

To cite this article: A. W. van Foreest (1998) Adhesive Dentistry with Direct Restorative Materials,
Veterinary Quarterly, 20:sup1, S33-S34, DOI: 10.1080/01652176.1998.10807396

To link to this article: https://doi.org/10.1080/01652176.1998.10807396

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Published online: 18 Mar 2014.

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• ORTHOPEDIC SURGERY & DENTISTRY
ADHESIVE DENTISTRY WITH DIRECT RESTORATIVE MATERIALS
A. W van Foreest1
INTRODUCTION
There are many products available to restore the function
and the structure of a tooth. The modern restorative dental
materials should chemically bind to enamel and dentine, and
should possess ideal properties of strength, durability, and
compatibility. There are three basic restorative materials:
amalgam, glass ionomers, and composites. These products
are held in place by macromechanical retention, micro-
mechanical retention, or chemical crystal formations.
Macromechanical retention involves undercuts in the dentin
and is used with nonbonded amalgams and self- (or auto-)
curing composites. Amalgam is still one of the most easy to
use and durable restoratives. Amalgam does not bond to
tooth structure but is retained in the tooth mechanically. The
preparation must be undercut (loss of sound tooth struc-
ture!). Amalgam cements or bonding agents can improve re-
tention qualities. However, toxicity and esthetic image have
reduced its use. In this presentation amalgam will not be dis-
cussed further.
Micromechanical retention is obtained by the use of bonding
agents that microscopically interlock in enamel porosities.
dentinal tubules, or other structures. This method is used pri-
marily with light-cured composites and bonded amalgam
restorations.
Chemical crystal formations occur with glass ionomers as
they form crystals between the ionomer and the minerals
within the enamel and dentin.
ADHESIVE SYSTEMS
Direct adhesion between the tooth and restorative materials
is only possible with glass ionomers. Other restoration mate-
rials such as composite and compomer have to be combined
with an adhesive technique. These adhesive systems consist
of different components such as etching agents, primers and
bondings.
Glass ionomers
The basic composition of glass ionomers is an aluminosili-
cate glass powder mixed with a modified poly-acrylic acid.
Glass ionomers bind to clean enamel and dentin by ionic link
to forming salts that bond to the calcium in the tooth, even if
moisture is present. Glass ionomers slowly release fluoride
over time, which acts as an effective anticarigenic agent.
There are different types of glass ionomers: chemically-
cured and light-cured products.
Glass ionomers are strong in compression but weak in ten-
sion and therefore should not be used in stress-bearing areas.
Indications for their use include restoration of feline resorp-
tive lesions, sealing access sites of endodontically treated
teeth, intermediate layer of large restorations, and tooth
build-up under crowns.
Some glass ionomers make use of a dentine conditioner
(poly-acrylic acid or sodium hypochlorite) followed by rins-
ing off with water. This is used to remove the smear layer on
the dentine in an attempt to enhance the ionomer's bonding
I Veterinair Specialisten Centrum 'De Wagenrenk', Wageningen, the Netherlands.
S33 THE VETERINARY QUARTERLY, VOL.
to the dentin.
Glass ionomer can be coated with a layer of composite to im-
prove the wear resistance. After the glass ionomer is placed
against the dental walls the area is acid-etched, rinsed, and
dried. A composite resin is then bonded to the glass ionomer
and the enamel.
Plastic resins
Plastic materials consist of polymer/monomer combina-
tions. There are various adhesive systems to adhere resins to
the surface of the tooth.
Acrylics
The acrylic plastics, basically methylmethacrylate, mixed
from a powder (polymer) and liquid (monomer), are no
longer used as a restorative, due to high shrinkage during
polymerization and lack of resistance to wear.
Composite resins
This restorative material is composed of an organic polymer
matrix of high molecular weight, usually a bisphenol-A-gly-
cidyl-methacrylate (Bis-GMA) resin with or without fillers.
Unfilled resins are used to coat or line the area to be filled
and to help decrease microleakkage. Fillers are added to in-
crease hardness, strength, resistance to temperature, ability
to withstand wear, and control of shrinkage during polymeri-
zation. The initiation of the polymerization process is by ei-
ther chemical (self-cure) or light (photo-cure).
The light-cured form is the composite of choice because it
provides unlimited working time before curing light is used
to polymerize the composite.
Adhesive systems
Acid etchant
Acid-etchant or conditioners prepare the surface of the tooth.
The enamel layer of the tooth is lightly roughened by the
etchant and creates microporosities for the unfilled resin or
dentinal bonding agent to flow into. This will enhance the
bonding and increasing retention and the resistance to micro-
leakage at the margins. The filled resin will bind to this thin
film of unfilled resin. Acid etching materials (30%-40%
phosphoric acid) are available in gel, paste, or liquid form.
The etchant is brushed onto the defect and surrounding
sound enamel and allowed to remain in contact for 15-30 se-
conds. The etchant is rinsed off(l0-20 seconds) with lots of
water. The enamel is air-dried and will have a frosted ap-
pearance.
Primers
A primer is a solution of a resin with hydrophillic properties
which enables composite to adhere to dentin. After etching,
rinsing, and air-drying of the tooth, a primer is brushed onto
the tooth surface and is not rinsed off.
Enamel bonding agents
Enamel bonding agents are liquid unfilled or lightly filled
resins. These agents improve restoration retention and aid in
20, SUPPLEMENT l, APRIL 1998
• ORTHOPEDIC SURGERY & DENTISTRY
preventing marginal leakage. The area to be restored is first
thoroughly cleaned with a non-fluoride pumice paste, irriga-
ted with water, air-dried, acid-etched, rinsed and air-dried.
The bonding agent (light-cured or chemically-cured) is pain-
ted to the area with a small brush. Excess resin is removed by
gently blowing with oil- and water-free air. Composites are
bonded to the bonding agent.
Dentine bonding agents
During the preparation of the area of restoration a smear
layer is created on the exposed dentin surface by the instru-
mentation, blocking the entrance of the potential bonding
surfaces within the tubules. For all exposed dentine surfaces
the dentine bonding agents should be used as an adjunct to
the enamel bonding. The dentine-enamel bonding system
consists of an acid etchant for the enamel, a dentine primer
S34 THE VETERINARY QUARTERLY, VOL.
(resin monomer), and an adhesive bonding agent (unfilled
resin).
Adhesion to restoration materials
Adhesion of restorative materials to the surface of glass
ionomer, plastic resins, or metal can be created by macro-
mechanical retention, micromechanical retention, or chemi-
cal crystal formations. The surface (chips or fractures of
composite resins) of the restoration is prepared and!or rough-
ened with a burr. Acid etchant, primers and bonding agents
are used to prepare the surface for the new restoration with
plastic resins or glass ionomers.
Due to the variety of adhesive products, their differences in
technique of preparing and application, and their sensitivity
to variance in technique, the manufacturer's recommenda-
tion should be followed closely for each individual product.
20, SUPPLEMENT 1, APRIL 1998