1. Chapter 4 Adhesive Materials

2. Introduction
Adhesive—a material that can stick to a flat surface or bond two flat surfaces together
Micromechanical bonding—bonding using surface irregularities smaller than can be seen with the naked eye or felt with a dental explorer
Macromechanical bonding—bonding that can be seen or felt

3. Introduction (cont.) Adhesive Materials in Dentistry Acid Etching
Dentinal Bonding
Glass Ionomers
Uses of Bonding in Dentistry

4. I. Adhesive Materials in Dentistry
Use of adhesion/bonding in dentistry
Development of dental adhesives
Surface factors

5. A. Use of Adhesion/Bonding in Dentistry
Retention of restorations
Reduction of microleakage
Reduction of recurrent caries

6. Microleakage and Percolation

7. B. Development of Dental Adhesives
Historical perspective
Acid etching
Chemical adhesion in dentistry
Polycarboxylate cements
Glass ionomer cements
Dentinal bonding agents

8. C. Surface Factors
Cleanliness
Biofilms

9. D. Testing Adhesion
Adhesive failure
Cohesive failure

10. II. Acid Etching Acid-etching process Enamel Acids Time Surface
Resin systems

11. A. Acid-Etching Process

12. B. Etched Enamel

13. C. Acids
Orthophosphoric acid at 37%

14. D. Time
15 to 30 seconds
Longer for deciduous than permanent teeth

15. E. The Surface
Clean and dry
Sensitive to contamination after etching

16. F. Resin Systems Low-viscosity resin
Polymethyl methacrylate–like polymer
Set via addition polymerization
Composite material
Placed after bonding resin
Chemically bonds to resin

17. Enamel Bonding System and Composite Material

18. III. Dentinal Bonding Dentinal bonding systems
Three-step dentinal bonding systems
Two-step dentinal bonding systems
Two-step systems with self-etching primers
One-step self-etching adhesives
Courtesy of BISCO, Inc.

19. Dentinal Bonding Systems

20. A. Dentinal Bonding Systems
Tooth tissues
Structure of dentin
Smear layer
Historical fallacies and dentinal bonding
History of dentinal bonding systems

21. B. Three-Step Dentinal Bonding Systems
Etch dentin and enamel
Apply primer
Apply adhesive
Composite placement
Dentinal bonding adhesive mechanisms
Clinical research

22. B. Three-Step Dentinal Bonding Systems (cont.)

23. B. Three-Step Dentinal Bonding Systems (cont.)

24. 5. Dentinal Bonding Adhesive Mechanisms
Micromechanical bonding
Resin tags
Formation of hybrid layer composed of:
Resin
Decalcified dentin

25. C. Two-Step Dentinal Bonding Systems
Etch
Apply adhesive

26. C. Two-Step Dentinal Bonding Systems— Etchant not Shown (cont.)

27. E. One-Step Systems with Self-Etching Primers

28. IV. Glass Ionomers Materials based on polyacrylic acid
Polycarboxylate and glass ionomer cements
Bonding mechanisms of glass ionomers

29. C. Bonding Mechanisms of Glass Ionomers

30. V. Uses of Bonding in Dentistry
Adhesion
Sealants
Dentinal
Composite restorations
Glass ionomer
Cervical lesions in both dentin and enamel
Patient with high caries risk
Courtesy of Dr. Birgitta Brown, Morgantown, WV.
Courtesy of GC America, Inc.