Since 1955, Buonocore’s acid-etching technique has made it possible to bond successfully to enamel.1 However, achieving consistent dentin bonding has been more challenging based on factors such as microleakage, resin infiltration and penetration, hydration versus desiccation, and postoperative sensitivity.2 To mitigate these factors, the evolution of dentin bonding has included a shift from total-etch techniques involving placement of 30% to 40% phosphoric acid on both enamel and dentin surfaces (ie, etch-and-rinse), to self-etch techniques, where phosphoric acid esters are contained within the bonding agent and no etchant gel is placed on the preparation.3
Recently, a third bonding technique has emerged—one that allows for hybridization of the remaining dentin smear layer and includes phosphoric etching of exposed enamel to maximize bond strength and prevent marginal discoloration. The selective-etch technique is designed to harness the positive attributes of both techniques for improved clinical outcomes. Several recent studies found that selective-etch adhesives have increased enamel bonding without postoperative sensitivity.4,5 A meta-analysis reported by Heintze and Rousson concluded that restorations placed with rubber-dam isolation and enamel-etching technique showed the best overall performance.6
Prime and Bond Elect™ from DENTSPLY Caulk is designed as a one-bottle dental adhesive suitable for all three adhesive modes: total-etch, self-etch, and selective-etch. Based on 13 years of proven PENTA (ie, the adhesive resin dipentaerythritol pentaacrylate monophosphate) technology from Prime and Bond® NT™, this new bonding agent provides a unique micromechanical and chemical bond for long-term success.7 It is ideal in cases where the preparation is primarily in enamel and total-etch technique is indicated; in mostly dentin preparations where a self-etch technique can be used; and for preparations containing a significant amount of enamel and dentin where a selective-etch technique is advised. Practitioners using Prime and Bond Elect according to the directions need not fear negative sequelae experienced with other products, such as decreased dentin bond strengths, if phosphoric etchant gel unintentionally contacts exposed dentin.
Jason H. Goodchild, DMD, holds a position in clinical research and education with DENTSPLY Caulk, and is a Clinical Associate Professor, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania.
More Information
DENTSPLY Caulk
P 1-800-LD-CAULK
W PrimeandBondElect.com
References
1. Buonocore MG. A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces. J Dent Res. 1955;34(6):849-853.
2. Alex G. Is total-etch dead? Evidence suggests otherwise. Compend Contin Educ Dent. 2012;33(1):12-14, 16-22, 24-25.
3. Perdigão J, Geraldeli S, Hodges JS. Total-etch versus self-etch adhesive: effect on postoperative sensitivity. J Am Dent Assoc. 2003;134(12):1621-1629.
4. Frankenberger R, Lohbauer U, Roggendorf MJ, et al. Selective enamel etching reconsidered: better than etch-and-rinse and self-etch? J Adhes Dent. 2008;10(5):339-344.
5. Perdigão J. New developments in dental adhesion. Dent Clin North Am. 2007;51(2):333-357.
6. Heintze SD, Rousson V. Clinical effectiveness of direct class II restorations - a meta-analysis. J Adhes Dent. 2012;14(5):407-431.
7. Van Landuyt KL, Snauwaert J, De Munck J, et al. Systematic review of the chemical composition of contemporary dental adhesives. Biomaterials. 2007;28(26):3757-3785.
8. Yazici AR, Akca T, Ozgünaltay G, Dayangaç B. Bond strength of a self-etching adhesive system to caries-affected dentin. Oper Dent. 2004;29(2):176-181.
Figures and Images
Figure 1
