POOJA B K

CONTENTS

• INTRODUCTION

• PRINCIPLES OF ADHESION

• BONDING IN COMPLETE DENTURES

• BONDING TO DENTAL SUBSTRATES

– Tooth interface

– Adhesive interface

– Restorative interface
 INTRODUCTION

To replace a missing part of a tooth structure, a tooth, teeth or the

entire set of teeth and to restore its functions, the prosthetic

restorations for these rehabilitations are bonded to the the hard

tissue and soft tissue. Hence it is necessary to understand the

fundamental principles that are associated with bonding.

 Two solids can adhere to each other with or without the help of a
third substance or device.

When molecules of one substrate adhere or are attracted towards

molecules of other substrate;

ADHESION : unlike molecules COHESIVE : like molecules

 PRINCIPLES OF ADHESION

All materials are built up from atoms and molecules that are held together by atomic
interactions. The nature of the atoms and their arrangements determine the
composition and microstructure of the material and consequently its properties

INTERATOMIC BOND

PRIMARY BONDS SECONDARY BONDS

Ionic bond Metallic bond Hydrogen bond Van der waals forces
Covalent bond
 Ionic
bonding
PRIMARY BOND

Transfer of electron to attain

stable configuration
 Covalent
bonding
PRIMARY BOND

Sharing of electrons to be sufficiently

stable and electrically neutral
 Metallic
bonding
PRIMARY BOND

 Electron cloud or gas

 Electrostatic attraction between

electron cloud and positive ions
 Hydrogen
bonding
SECONDARY BONDS

The positive hydrogen gets attracted

to the negative oxygen forming
hydrogen bridge.
 Van der
Waals forces
SECONDARY BONDS

Random movement of
electrons within the molecules
creates fluctuating dipoles.
Surface energy
Surface tension

A property of liquids in which the exposed surface tends to contract to the

smallest possible area, as in the spherical formation of drops; a phenomenon
attributed to the attractive forces, or cohesion, between the molecules of the
liquid
Ability to wet the surface is a dominating
contributor to the adhesive bond when Wetting
adhesive sets from solid to liquid

Angle of wetting
LOW SURFACE ENERGY HIGH SURFACE ENERGY
HIGH CONTACT ANGLE LOW CONTACT ANGLE
 Capillary rise

PENETRATION OF LIQUIDS INTO NARROW CREVICES IS KNOWN AS CAPILLARY

ACTION

Contact angle

 Microleakage

 Denture base retention

 Mechanical bonds
Mechanical bonding can result in a strong attachment of one substance to another
 Complete denture bonding

Bonding of acrylic teeth to denture base

Denture base retention

 Bonding of acrylic teeth to denture base

• The polymerisable monomer plasticizes the surfaces of denture teeth and

diffuses into the denture tooth acrylic resin.. Upon polymerization an interwoven
network of polymer chains that unites denture base to resin tooth is formed.

• Bond strength depends upon degree of penetration of monomer and strength of

interwoven polymer network.
 Complete denture retention

ADHESION INTERFACIAL SURFACE COHESION

TENSION

ATMOSPHERIC PRESSURE AND PERIPHERAL SEAL

ORAL AND FACIAL MECHANICAL LOCKING

MUSCULATURE INTO UNDERCUTS
Bonding of restorations to tooth surface involves the following interfaces :

Tooth structure Adhesive interface Restorative interface

Structure and morphology of enamel

Inorganic : Hydroxyapatite 89%

Organic : Protein and water
Structure and morphology of dentin
• 50% dentin interspersed with
hydroxyapatite crystals between
collagen fibers.
• Dentinal tubules are 0.5-1.5 µm in
diameter
Smear layer When both enamel and dentin tissues are
mechanically cut, a layer of adherent
0.05 to 15µm thick grinding debris and organic film known ad
smear layer is left on their surfaces.

µ
Smear layer
Weakly cohesive to dentin :
bond strength 5-10 MPa

REMOVE

ENHANCE ITS PROPERTIES

Adhesive interface
 If true adhesion of restorative materials to tooth structure is to be achieved,

 Sound tooth structure must be conserved

 Optimal retention achieved

 Microleakage prevented

Fundamental mechanism of adhesion to tooth structure can be

regarded simply as an exchange in which hydroxyapatite is replaced
with synthetic resins
 Factors to achieve adhesive bond
 Surface energy and wetting

 Interpenetration

 Micromechanical interlocking

 Chemical bonding
 Dentin bonding agents
Dentin bonding agents are designed to provide a sufficiently strong interface
between restorative composites and tooth structure to withstand mechanical forces
and shrinkage stress.

 Initially hydrophobic enamel bonding agents were used only to enhance wetting
and adaptation of resin to conditioned enamel surfaces. These have no potential
for adhesion but improve micromechanical bonding by optimum formation of resin
tags within enamel. They work well because enamel can be kept fairly dry.

 These have now been replaced with systems that are used on dentin.
 Design of dentin bonding agent
Conditioning(cleaning) Bonding(mechanical adhesion, curing)

Priming(wettng, adapting)

composition

etchant primer Solvent Adhesives Filler Initiator others

 Enamel etching

Depending on the concentration of the acid, it removes about 10µm of enamel

to expose prisms of enamel rods to create honeycomb like high energy retentive
surface.

Resin tags : 6µm in diameter and 10-20µm in length

Type I Type II

Rubbing etching agent with fine brush

Decalcification of enamel

Debris free interface

Etching of dentin

25% polyacrylic acid 10% phosphoric acid

20% lactic acid

32% phosphoric acid

 Etching of dentin

Hybrid zone

A study by nakabayashi et al revealed that

hydrophilic resins can infiltrate into the
acid demineralized collagen fibers that is
produced in etched dentin and form a
layer of resin infiltrated dentin with high
cohesive strength
 Etchant
pH 1-2

Phosphoric acid (30-50%) preferably 37%

Supplied as gel : Colloidal silica or polymer beads

Concentration greater than 50% results in deposition of adherent layer

of monocalcium phosphate monohydrate on etched surface which
inhibits further dissolution
 Primer
• Dentin etching is highly technique sensitive because demineralized dentin
readily collapses when dried

• Therefore priming is necessary to maintain an expanded collagen network

while removing residual water to allow for infiltration of hydrophobic resin
monomer.

• Primers are solution containing hydrophilic monomers dissolved in solvent

such as acetone, ethanol or water.

• HEMA is used widely

 Primer
• Primer mixtures have a wide range of pH because of variations in the
functional groups of corresponding monomers.

• If concentration of acidic monomers is increased in a HEMA base, primer may

have a low enough pH to remove the smear layer : Self etching Primers.

• HEMA phosphate, 10 MDP

 Solvents
• Primer and adhesives tend to have low viscosity due to the prescence of solvents
thus improving diffusion ability through the micro-retentive tooth surface.

Water Acetone
Ethanol
 Adhesives
Primary purpose of adhesive is to fill the
interfibrillar space of the collagen
HYDROPHILICITY HEMA
network creating a hybrid layer and resin
tags to provide micromechanical
retention upon polymerisation

It must also prevent fluid leakage along

HYDROPHOBICITY Bis-GMA and
restorative material’s margin. TEGDMA
Although dimethacrylate adhesives yield strong bond strength the
polar ester bond inevitably absorbs water and gradually hydrolyses.
Since carbamides are more hydrolytically stable than ester ,
methacrylamides have recently been adopted to replace
methacrylates.groups
 Initiators
Photoinitiator system : photo sensitizer : Camphoroquinone
Initiator : Tertiary Amine

Self cure : Chemical Initiator : Benzoyl Peroxide.

Filler
 Higher bond strength
Nanometer size
 Reduce shrinkage stress
silica particles
 Etchant
37% phosphoric acid

(HEMA)
Hydrophilic

Primer

Hydrophobic
(BisGMA)

Adhesive
Classification of dentin bonding agents

• CLASSIFICATION BY GENERATIONS

• CLASSIFICATION BY MECHANISM OF ADHESION/CLINICAL STEP

FIRST GENERATION ADHESIVES SECOND GENERATION ADHESIVES

(1960) (Late 1970s)

• Development of surface active • Phosphate ester dentin bonding

co-monomer NPG GMA agents were introduced containing

• chelates with the calcium on phenyl P and Hema in ethanol.

the tooth surface to generate • polar interaction between negatively

chemical bonds of resins to charged phosphate groups in resins

dentinal calcium and positively charged calcium ions in

• Bond strength : 2-3Mpa smear layer.

• Poor clinical results • Bond strength : 5-6Mpa

• Drawback : hydrophobic in nature and
loosely attatched to smear layer.
 Third generation adhesives(1980s)
• The third generation was designed not to remove the entire smear layer but
modify it and allow penetration of acidic monomers.
• Here acid etching got introduced to heavily alter or remove the smear layer or
demineralizing dentin and a separate primer designed to penetrate dentin by its
own monomer and those of adhesive monomers.
• Bond strength : 3-8MPa
 Fourth Generation (Early 1990s)
• When primer and bonding resin are applied to etched dentin they penetrate the
intertubular dentin forming a resin dentin interdiffusion zone or hybrid layer.
• Ability to bond as strongly to dentin as to enamel
• Reduction in micro-leakage
• Bond strength : 13-30MPa

3 different components

Complete removal of smear layer Total etch and moist dentin

TECHNIQUE SENSITIVE
 Fifth generation adhesives
• One step or One bottle system
• However they are applied in two steps(etchant+ primer and adhesive)
• Bond strength : 3-25MPa
• They lack many components necessary for multisubstrate bonding
• Multiple coats are required
 Sixth generation adhesive(late 1990s and early 2005)
• Dissolve smear layer when applied and do not require rinsing
• Minimise post operative sensitivity as they do not expose dentinal tubules. Bond
strength to enamel and dentin are typically greater than deeper dentin.
• Self etching primer and adhesive
• Bottle 1 : etchant and primer
• Bottle 2 : adhesive
 SEVENTH GENERATION (late 2002)
• Self etching adhesives, One step
• Requires no mixing
• Single bottle containing acidic adhesive

Significant amount of water in their formulations hence tendency for hydrolysis breakdown

Hydrophilic once polymerized hence more prone to water sorption creating voids
 • EIGHT GENERATION

• Voco Futurabond DC was introduced containing nano sized filler particles.

• Increases mechanical properties by increasing penetration of resin monomers and

hybrid layer thickness
CLASSIFICATION BY MECHANISM OF ADHESION/CLINICAL STEP

THREE-STEP :- ONE STEP

ETCH , PRIME AND BOND

TWO STEP

ETCH + PRIME AND BOND ETCH+PRIME AND BOND

ETCH AND RINSE SELF ETCH

Restorative interface
Surface treatment to restorative surface

• Adhesive bonding is dependant on the surface energy and wettability of the

adherent by the adhesive

• This bonding can be seen as more of a physico-chemical interaction involving

chemical bonding and micromechanical interlocking

MECHANICAL SURFACE TREATMENTS
Sandblasting
Tribochemical Silica coating

CHEMICAL SURFACE TREATMENTS

 Hydrofluoric acid etching

 Silane coupling agents
 Functional monomers.
 Sandblasting
• 50-110 µm Alumina

• Roughening the surface of a restorative material with the use of abrasive particle
brings about morphological changes and an increase in adhesive strength between
luting a restoration
 Tribochemical silica coating

• After abrading and coating the surfaces of dental resorations with silica
coated alumina particles, the use of silane coupling agent enhances the
bond strength by proving chemical bond between treated restorative
surface and resin luting material.
 Chemical surface treatments

HYDROFLUORIC ACID ETCHING

• Hydrofluoric acid removes the glassy matrix of glass ceramics created a high
surface energy substrate with microporosities for penetration and polymerization
of resin composite enabling micromechanical interlocking

• Etching of ceramic with 5% hydrofluoric acid for 2–3 min is enough to selectively
dissolve the glassy phase and make the surface porous for resin composite cement
penetration.

• This porous surface not only provides more surface area for resin bonding, but also
exposes and generates hydroxyl groups on the ceramic surface that are responsible
for chemical bonding via silane coupling agents
 M-R-X concept

Silane coupling agents

• Trialkoxysilanes are hybrid inorganic-organic bifunctional molecules that are able

to create a siloxane network with hydroxyl of Si in ceramic surface and

copolymerize with resin matrix of composites.

• In general, silanes have non-hydrolysable groups (such as methacrylate) and

hydrolysable groups (such as ethoxy), which is why they are chemically

bifunctional [8]. When reactive silanes are applied over the etched ceramic

surface, the hydrolysable alkoxy groups react with exposed hydroxyl groups, and

non-hydrolyzable organic groups polymerize with unset resin composite cement

 Functional monomers
• These materials present a chemical affinity to metallic oxides and can be
included both in resin cements, adhesives or applied over ceramic surface.

• Phosphate ester monomer such as 10-MDP are known to react with ZrO2
promoting a water resistant bond to densely sintered zirconia ceramics.

Vinyl Phosphate ester

Resin MDP MONOMER Zirconia
Luting agents
 Conclusion
Since the initial mid century discovery and introduction of biomodification of
dental tissues by Buonocore , restorative concepts have continued to evolve.
Transition from non adhesive mentality during the G.V. Black era to the
adhesive era resulted in a modification of the restorative mechanical paradigm
to a biologic, minimally invasive approach that preserves tooth structure. Last
half of the 20th century has evidenced two main bonding philosophies that
implement biomodification as greatly influenced by adhesive composition,
tooth surface mechanical treatment and micromorphology of dental tissues.
 References
• Phillips’ science of dental materials anusavice
• Craig’s restorative dental materials 13th ed
• Sturdevant’s art and science of operative dentistry 6th edition
• Impressions for complete denture Bernard levin
• Galip GurelThe Science and Art of Porcelain Laminate Veneers
• Aesthetifc and restorative dentistry: material selection and technique
Douglas terry
• Mizrahi B. The anterior all-ceramic crown: A rationale for the
choice of ceramic and cement. Br Dent J 2008;205:251-5.
• John O. Burgess, Taneet Ghuman A Practical Guide To The Use Of
Luting Cements. 2010
• Eshrak Sofan, Afrah Sofan classification review of dental adhesive
systems: from IV generation to universal type