total etch self-etch - REALITY Publishing Company

Transcription

DENTAL ADHESIVES
TOTAL ETCH
1. OptiBond/OptiBond FL 4.6
Kerr
2a. OptiBond Solo plus 4.2
Kerr
2b. Prime & Bond NT/Prime & Bond NT Dual Cure 4.2
Dentsply/Caulk
3a. One-Step Plus 4.1
Bisco
3b. PQ1 4.1
Ultradent
4a. Adper Scotchbond Multi-Purpose Plus 4.0
3M ESPE
4b. All-Bond 2 4.0
Bisco
4c. Gluma Comfort Bond + Desensitizer 4.0
Heraeus Kulzer
5a. Cabrio CQ 3.9
Discus
5b. DenTASTIC UNO•DUO 3.9
Pulpdent
6. Adper Single Bond Plus 3.8
3M ESPE
7a. One-Step 3.7
Bisco
7b. PermaQuick 3.7
Ultradent
SELF-ETCH
1. Clearfil SE Bond 4.3
Kuraray
2. Clearfil Protect Bond
Kuraray
4.2
3a. Clearfil S3 Bond 4.0
Kuraray
3b. Prelude 4.0
Danville Materials
4a. Clearfil Liner Bond 2V
Kuraray
3.7
4b. G-Bond 3.7
GC
4c. OptiBond Solo plus Self-Etch 3.7
Kerr
4d. Xeno IV 3.7
Dentsply/Caulk
5a. Contax 3.6
DMG/Zenith
5b. Tyrian SPE/One-Step Plus 3.6
Bisco
© 2006 REALITY Publishing Co. Vol. 20
The Ratings
197
DENTAL ADHESIVES
Total Etch
OptiBond/OptiBond FL
Kerr
Prime & Bond NT/
Prime & Bond NT
Dual Cure
Dentsply/Caulk
One-Step Plus
Bisco
$16.50
Bottle
$12.29
$24.17
Introductory Bottle:
$25.72
Dual Cure Introductory:
$25.32
Amalgam Bonding
Accessory: $19.18
Unit Dose
Kit
N/A
$24.17
$19.24
$16.88
Primer or OneComponent
Adhesive
$9.43
$22.17
N/A
$14.83
Bond Resin
$9.43
N/A
N/A
N/A
Catalyst
$22.08
N/A
$25.58
N/A
N/A
$20.25
N/A
$15.83
N/A
$2.42
$2.40
$1.69
N/A
$2.03
N/A
$1.58
Uses
Direct restorations (all
types) and indirect,
metal-free restorations
using light-cured and
dual-cure cement.
Light-cured and dualcure direct and indirect,
metal-free restorations.
All types of restorations.
pH
FL Prime: 1.9
FL Adhesive: 6.9
Dual Cure Activator/
Paste: 6.3
2.2
NT Adhesive: 1.9
NT Adhesive/Self-Cure
Activator: 4.8
Amalgam Bonding Base/
Catalyst: 6.1
4.4
Enamel
23.0
20.4
28.2
23.4
Dentin
32.4
26.1
21.7
22.7
Can it Be Cured with LED?
Probably
Probably
Probably
Probably
Optimal Moisture Level After Etching
Moist
Moist
Wet
Wet
Time (seconds)
15
15
20
15
Method
Gentle Agitation
Gentle Agitation
Gentle Agitation
Gentle Agitation
Gentle Air
Gentle Air
Gentle Air
Gentle Air
Time (seconds)
No Specific Time
Required
N/A
N/A
N/A
Method
Brush-on/Brush-off
N/A
N/A
N/A
20
10
10
10
Price/ml
Bottle
Refills
Unit Dose
Kit
Price/Unit
Dose
Bond Strength
(MPa)
Adhesive
Application
Refills
Air Pressure for Primer or One-Component Adhesive
Solvent Evaporation
Bond Resin
Application
Light-Cure Time for Bond Resin or One-Component
Adhesive (seconds)
198
OptiBond Solo plus
Kerr
The Ratings
DENTAL ADHESIVES
PQ1
Ultradent
Adper Scotchbond
Multi-Purpose Plus
3M ESPE
All-Bond 2
Bisco
Gluma Comfort Bond
+ Desensitizer
Heraeus Kulzer
Bottle
$29.16
$17.74
$7.48
N/A
Unit Dose
Total Etch
Kit
Price/ml
Bottle
Refills
N/A
N/A
N/A
N/A
Adhesive
$13.12
$19.08
$9.33
$23.49
Bond Resin
N/A
$19.08
$4.33
N/A
Catalyst
N/A
$25.85
$4.67
N/A
Unit Dose
Price/Unit
Dose
$10.00
N/A
N/A
$20.09
Kit
N/A
N/A
N/A
N/A
Refills
$2.00
N/A
N/A
$2.01
Light-cured and dualcure direct and indirect
restorations.
Light-cured and dualcure direct and indirect
restorations plus selfcure direct restorations.
1.7
Activator : 8.1
Primer: 4.0
Activator/Primer: 4.7
Adhesive: 8.2
Catalyst: 5.7
Adhesive/Catalyst: 6.9
Primers A/B: 5.7
Dentin/Enamel
Bonding Resin: 7.5
Pre-Bond: 4.4
Pre-Bond/Dentin/Enamel
Bonding Resin: 4.6
2.4
Enamel
24.5
17.7
21.3
22.3
Dentin
20.1
28.2
25.3
22.0
Probably
Probably
Probably
Probably
Moist
Moist
Wet
Wet
Time (seconds)
15
10
20
20
Method
Rubbing Motion
Gentle Agitation
Gentle Agitation
Scrubbing Motion
Gentle Air
Gentle Air
Gentle Air
Gentle Air
Time (seconds)
N/A
No Specific Time
Required
No Specific Time
Required
N/A
Method
N/A
Brush-on/Brush-off
Brush-on/Brush-off
N/A
20
10
20
20
Uses
pH
Bond Strength
(MPa)
Adhesive
Application
Solvent Evaporation
Bond Resin
Application
Adhesive (seconds)
The Ratings
199
DENTAL ADHESIVES
Cabrio CQ
Discus
DenTASTIC
UNO•DUO
Pulpdent
Adper Single
Bond Plus
3M ESPE
One-Step
Bisco
PermaQuick
Ultradent
Bottle
$10.56
$13.22
$28.52
$16.50
$15.55
Unit Dose
Total Etch
Kit
Price/ml
Bottle
Refills
$15.60
N/A
$17.98
N/A
N/A
Adhesive
$10.42
$10.00
$26.80
$14.50
$7.91
Bond Resin
N/A
N/A
N/A
N/A
$7.91
Catalyst
$10.00
$18.33
N/A
N/A
N/A
Unit Dose
Price/Unit
Dose
Bond Strength
(MPa)
N/A
N/A
N/A
N/A
N/A
Kit
$1.95
N/A
$1.98
N/A
N/A
Refills
N/A
N/A
N/A
N/A
N/A
All types of
restorations.
Light-cured and
dual-cure direct
and indirect
restorations.
Uses
All types of
restorations.
All types of
restorations.
Light-cured and
dual-cure direct
and indirect
restorations plus
self-cure direct
restorations.
pH
Adhesive: 1.3
Adhesive/
Catalyst: 2.1
UNO: 2.8
UNO•DUO: 3.5
4.6
5.0
Primer: 1.8
Bonding Resin: 2.6
25.4
25.2
25.4
22.7
26.4
Enamel
Dentin
22.4
29.4
30.3
21.0
23.9
Probably
Probably
Probably
Probably
Probably
Primer or Onecomponent
adhesive
Application
Moist
Moist
Moist
Wet
Moist
Time (seconds)
20
15
15
15
15
Method
Gentle Agitation
Gentle Agitation
Gentle Agitation
Gentle Agitation
Rubbing Motion
Gentle Air
Gentle Air
Gentle Air
Gentle Air
Gentle Air
Time (seconds)
N/A
N/A
N/A
N/A
15
Method
N/A
N/A
N/A
N/A
Rubbing Motion
10
10
10
10
20
Solvent Evaporation
Bond Resin
Application
Adhesive (seconds)
200
The Ratings
DENTAL ADHESIVES
Clearfil SE Bond
Kuraray
Clearfil Protect
Bond
Kuraray
Clearfil S3 Bond
Kuraray
Prelude
Danville Materials
Clearfil Liner Bond
2V
Kuraray
Bottle
$12.00
$16.82
$24.50
$8.66
$8.80
Unit Dose
Self-Etch
Kit
Price/ml
Bottle
Refills
N/A
N/A
$27.00
N/A
N/A
Adhesive
$6.50
$15.83
N/A
$9.99
$6.50
Bond Resin
$17.80
$18.00
N/A
$9.99
$19.80
Catalyst
N/A
N/A
N/A
$9.99
$18.00
Unit dose
Price/Unit
Dose
N/A
N/A
N/A
N/A
N/A
Kit
N/A
N/A
$2.70
N/A
N/A
Refills
N/A
N/A
N/A
N/A
N/A
Primers + Bond A:
Light-cured and
dual-cure direct
restorations.
Primers + Bond A/B:
Self-cure direct and
indirect restorations.
Uses
Light-cured and
dual-cure direct
restorations.
Light-cured and
dual-cure direct
restorations.
Light-cured and
dual-cure direct
restorations.
Primer + Adhesive:
Light-cured and dual-cure
restorations.
Primer + Adhesive + Link:
Self-cure direct restorations.
pH
Primer: 2.0
Bond: 1.8
Primer: 1.9
Bond: 3.6
3.1
Primer: 2.1
Adhesive: 2.8
Link: 9.3
Primers A/B: 2.8
Bond A: 1.7
Bond A/B: 1.8
Self-Etch
24.9
29.8
25.3
19.2
32.8
Etch w/PA
32.3
27.3
26.7
21.2
28.6
Self-Etch
29.3
24.7
23.3
29.3
38.8
Etch w/PA
30.8
19.5
26.1
23.7
33.2
Probably
Probably
Probably
Probably, but dentin bond
strengths were low
Probably
Optimal Moisture Level Before Applying
Self-Etch Primer or One-Component Adhesive
Dry
Dry
Dry
Moist
Dry
Time (seconds)
20
20
20
10–15
30
Method
Gentle Agitation
Gentle Agitation
Gentle Agitation/
Let Sit
Scrubbing
Gentle Agitation
Gentle Air
Gentle Air
Medium Air
Gentle Air
Gentle Air
Time (seconds)
No Specific Time
Required
No Specific Time
Required
N/A
10–15
No Specific Time
Required
Method
Brush-on/Brush-off
followed by
gentle air
Brush-on/Brushoff followed by
gentle air
N/A
Scrubbing followed by
gentle-medium air
Brush-on/Brush-off
followed by gentle air
10
10
10
10
10
Bond Strength
(MPa)
Adhesive
Application
Enamel
Dentin
Solvent Evaporation
Bond Resin
Application
Adhesive (seconds)
The Ratings
201
DENTAL ADHESIVES
Self-Etch
G-Bond
GC
Kit
Price/ml
Contax
DMG/Zenith
Tyrian SPE/
One-Step Plus
Bisco
Bottle
$22.50
N/A
$26.67
$11.70
$5.50
$32.00
$16.23
$17.60
N/A
$14.67
Adhesive
N/A
$9.10
N/A
$14.19
N/A
Bond Resin
N/A
$22.17
N/A
$14.19
$14.83
Catalyst
N/A
N/A
N/A
$14.19
N/A
Bottle
N/A
$20.25
N/A
N/A
One-Step Plus: $15.83
Tyrian SPE: $16.62
Kit
$3.20
$3.25
$2.20
N/A
$1.69
Refills
N/A
$2.03
N/A
N/A
One-Step Plus: $1.58
Tyrian SPE: $2.16
Light-cured and
dual-cure direct
restorations.
Light-cured and
dual-cure direct and
indirect, metal-free
restorations.
Light-cured
direct
restorations.
Primer + Bond:
Light-cured and dualcure direct restorations.
Primer + Bond/Activator:
Self-cure direct
restorations.
Tyrian SPE Primer A/B
(bottles): 0.5
Tyrian SPE Primer A/B
(unidose): 0.6
One-Step Plus: 4.4
Unit dose
Uses
pH
2.8
Self-Etch Primer: 1.9
Adhesive: 2.2
2.7
Primer: 2.4
Bond: 3.9
Activator: 3.0
Bond/Activator: 3.4
Self-Etch
20.3
24.6
31.9
22.5
24.2
Etch w/PA
30.9
20.4
28.2
21.4
23.4
Self-Etch
21.4
26.1
34.9
26.0
23.2
Etch w/PA
24.5
26.1
26.2
23.4
22.7
Probably
Probably
Maybe not due
to low dentin
bond strengths
Probably
Probably
Optimal Moisture Level Before Applying
Self-Etch Primer or One-Component Adhesive
Dry
Moist
Dry
Dry
Moist
Time (seconds)
20
15
15 x 2
20
10
(20 on uncut enamel)
Method
Gentle Agitation/
Let Sit
Gentle Agitation
Scrubbing
Rubbing
Gentle Agitation
Medium Air
Gentle Air
Gentle Air
Do not apply air—leave
surface with a thin,
shiny layer of primer
Blot—
do not apply air
Time (seconds)
N/A
15
N/A
20
15
Method
N/A
Gentle Agitation
followed by gentle air
N/A
Rubbing followed by
gentle air
Gentle Agitation
followed by
gentle air
10
10
10
20
10
Bond Strength
(MPa)
Adhesive
Application
Enamel
Dentin
Solvent Evaporation
Bond Resin
Application
Adhesive (seconds)
202
Xeno IV
Dentsply/Caulk
Unit Dose
Refills
Price/Unit
Dose
OptiBond Solo plus
Self-Etch
Kerr
The Ratings
DENTAL ADHESIVES
Dental adhesives, as the name implies, are products that allow us to
adhere various types of dental materials to enamel, dentin, and other
dental materials. Conventional adhesives utilize etching with phosphoric
acid as the first step. However, virtually all adhesives recently introduced
are considered “self-etching”, where a low pH solution that etches and
primes at the same time replaces phosphoric acid. Regardless of whether
the product is self-etching or not, these adhesives are typically hydrophilic
to some extent to be compatible with dentin. This hydrophilic property
distinguishes them from the old hydrophobic enamel bonding agents.
reported marginal staining as early as the 6-month recall, significantly
worse than reported for total etchers.
Types of Adhesives
does not have any light-curing capabilities. This component is typically
premixed and packaged in one bottle or syringe, but some primers may
be two components that require mixing. In self-etching systems, it is
typically this component that etches and primes at the same time. Indeed,
one product terms this component a “self-priming etchant”!
There are many ways to categorize adhesives. One popular method uses
the “generations” nomenclature. But, unless you are a dental historian,
there is really no value in using the “generations” system. Who really
cares if an adhesive is a “fifth generation” or “sixth generation” or even the
newly created “seventh generation”? Who is counting anyway?
Another way to separate these products is by the number of
components. This system became popular (and was used by us in the
past) during the years that the single-component products were being
introduced. We still use this nomenclature to describe the products, but
not for categorization.
We used to categorize these products as to whether they could
be used for all procedures or just those for light-cured procedures.
These latter products were not effective when self-cure composites
and/or indirect restorative procedures were used. However, even these
products can usually be transformed into all-purpose by using various
bond enhancers. Therefore, we have dropped this separation.
More recently, the type of adhesive could be separated into the
aforementioned self-etching versions compared to those still relying
on phosphoric acid as a separate etch prior to their application. While
these products have now been assimilated into mainstream bonding, we
believe that there is a basis for knowing whether a product is self-etching
or not. Therefore, we continue to use this property for categorization
purposes.
Total Etch Still the most versatile and reliable, these adhesives can be
used for virtually any type of restoration and have the track record to
prove it. The major reason many dentists stop using total etch adhesives
is due to their patients suffering from postoperative sensitivity. However,
if you apply the adhesives carefully following our simplified instructions,
we are confident that you can greatly minimize or eliminate the sensitivity
problem in the vast majority of patients.
Self-Etch Postoperative sensitivity is the primary reason for most
clinicians who have made the switch. One of the reasons that self-etchers
seem to cause less sensitivity is due to the fact that since etching and
priming are being done concurrently, it is not possible to etch deeper
than the primer can penetrate. However, it doesn’t mean a restoration was
done properly just because a patient does not have any sensitivity. Selfetchers can work well in Class I, II, and V situations, but the application
procedures of these materials can greatly influence their performance
maybe even more so compared to total etch. And their abilities to bond
to self-cure composites and unprepared enamel is typically below that
of the total etchers. Indeed, some self-etchers recommend etching the
enamel with phosphoric acid, especially if it’s unprepared. One evaluator
Components and Composition
Most adhesives still have multiple components, while a few have just one
(other than the etchant) and the newest self-etchers incorporate everything into one bottle or unidose. Those with more than one component
typically have the following:
Primer Applied first, contains a solvent, and usually (but not always)
Bonding Resin Applied after the primer. Can enhance adhesion by
its wetting agent function or it can also have hydrophilic qualities and
thus can actually contribute to enhancing the hybrid layer. (Most current
thought is that the bonding resin should be hydrophobic to prevent
formation of water trees—see below.) If its companion primer is one
component, the bonding resin may have two components that need to
be mixed when it needs self-cure capability. Conversely, if the primer is
in two components and needs to be mixed, the bonding resin may only
need to be one component. And, in the products that were introduced
as single-component adhesives, the primer and bonding resin are mixed
together in one bottle.
Filled Adhesives
Some adhesives add different types of fillers to the normally unfilled
product for the following reasons:
1. Fluoride release if the filler glass has this capacity. While this is a
noble goal, it is highly unlikely that there will be enough fluoride
released by the adhesive to be of clinical value.
2. Lower modulus of elasticity to impart added flexibility to a
restoration done with a stiff material such as a hybrid composite.
Materials with more elasticity, such as microfills, may be better
retained in Class V lesions due to their higher flexibility, compared
to hybrids. The flexibility could also help to reduce the stress
at the interface between the restoration and tooth caused by
polymerization shrinkage. In other words, the elasticity of the
adhesive could absorb within itself some of the curing stresses.
By reducing this stress at the tooth-restoration interface, the
restoration could be expected to have better retention. While this
theory sounds feasible, it has yet to be proven.
3. Filler could actually reinforce and strengthen the hybrid layer.
4. Filler could help the adhesive cover the dentin surface in one
application rather than multiple ones.
The Ratings
T
203
DENTAL ADHESIVES
Enamel vs. Dentin
Enamel
While dentin is the substrate that has garnered most of the interest,
enamel is still the most reliable tooth tissue for adhesion. Although some
initial dentin bond strengths may even exceed those of enamel, the longterm stability of this adhesion favors enamel. In addition, microleakage
testing usually shows significantly lower scores on enamel compared to
those on dentin/cementum.
The main reason bonding to enamel is more reliable is that it is
primarily inorganic.You etch it, you dry it, you bond to it. There is nothing
complicated or very technique-sensitive about this procedure. Etching
creates micromechanical retention by selectively demineralizing the
surface. Once dried, low viscosity resin penetrates into the microscopic
spaces in its surface that were created by the etching process. After
curing the resin, it tenaciously adheres to the enamel.
However, when a hydrophilic adhesive is used, drying the enamel
is not necessary and may not even be beneficial. Our tests have shown
moist or wet protocols, developed for dentin, are usually also effective
on enamel. Nevertheless, if no dentin is exposed, a hydrophilic adhesive
probably offers no benefits over a simple, unfilled resin applied to dry,
etched enamel.
Dentin
Unlike enamel, dentin is primarily organic, mainly collagen and water,
making it a much different substrate for bonding. It is also directly above
the pulp, which tells us that whatever we do to dentin must be done in a
way that it doesn’t injure the pulp.
Most efforts to bond to dentin have focused on both mechanical
and theoretical chemical adhesion. The early adhesives tried to bond
to the smear layer, which is basically the layer of preparation debris
that is difficult to remove with conventional cleaning procedures, but,
paradoxically, is not firmly attached to the dentin for bonding purposes.
This means that trying to bond to the smear layer has been unreliable
and not very successful.
As mentioned previously, conventional adhesives use an etchant
to remove the smear layer and to demineralize the dentin surface. This
leaves a lattice of unsupported collagen. The adhesive then infuses the
collagen with resin, locking into it to form a micromechanical bond,
similar to that of enamel. This complex of resin-reinforced dentin has
been termed the hybrid layer.
The self-etching products, however, presumably dissolve and
penetrate through the smear layer but do not remove it. With selfetching products, the smear layer becomes part of the hybrid layer.
Another issue of dentin bonding is the stability of the bond. This
topic rarely arises with enamel, but the question is: Do dentin bonds
get weaker or start to hydrolyze over time? To test this issue, we tested
several adhesives after five months storage in the temperature/humidity
Heliobond
(control)
Clearfil
Protect
Bond
Enamel
25.2
29.8
24.9
25.3
20.3
Dentin
N/A
24.7
29.3
23.3
21.4
Enamel
45.7
31.7
34.5
28.4
32.4
Dentin
N/A
39.3
33.6
42.4
47.4
Bond Strengths
(MPa)
Immediate
5 months
204
The Ratings
Clearfil Clearfil S3
G-Bond
SE Bond
Bond
chamber. The results clearly show bond strengths became higher,
especially on dentin for the two 1-component products. However, these
specimens did not obviously have pulpal fluid with which to combat.
There is also preliminary evidence from Editorial Team Member
Dr. Franklin Tay that enzymes called matrix metalloproteinases
(MMPs), which can break down the collagen scaffolding that is essential
for stable bonds, can be inactivated by pretreatment of dentin with
chlorhexidine that is not rinsed off. To inhibit MMP activity, the evidence
suggests chlorhexidine in concentrations as low as 0.01% or even less
are effective. Therefore, it seems applying aqueous chlorhexidine after
etching but before the primer/adhesive is a prudent procedure.
Tests
Bond Strength
These are the most common tests done on adhesives. They can be done
relatively quickly and are especially valuable when trying to distinguish
between technique variations. Many manufacturers tout the superiority
of their adhesives based on these scores. Indeed, there have even been
conferences devoted to “battle of the bonds”, which are sort of like bond
strength Olympiads!
The most common yardstick to judge whether a specific adhesive
has an adequate bond strength is to compare it to an enamel control.
Since bonding to frosty, dry, etched enamel using a conventional unfilled
resin has been validated with over 30 years of clinical use, equivalent
dentin values should be an indication that the product will perform
satisfactorily.
In the RRL, we periodically test bond strength to dry, frosty enamel
using an unfilled, hydrophobic resin (Heliobond). While consistency
is our goal, there have been variations in this bond strength test over
the years based on the temperature and humidity in the lab, as well as
differences in human extracted teeth. The range of these bond strengths
have been from 20MPa to 27MPa. Therefore, bond strengths for
adhesives that produce similar values should be clinically acceptable.
However, the clinical significance of bond strength tests (and just
about all in vitro tests) continues to be debated. No one really knows how
much bond strength is enough. It is also unknown whether adhesives
with bond strengths, which exceed that of the enamel control, have any
clinical advantages over those with equivalent values.
Therefore, we continue to use bond strength tests as screening
devices. For example, when we first discovered clinically that self-cure
core materials were debonding when a single-component adhesive was
used, we tested this combination in the lab and confirmed that fact that
there is a basic incompatibility between most one-component adhesives
and self-cure composites.
Spotting trends and discovering uses of these materials that just
don’t work are really the main purposes of these tests. Consequently,
while bond strengths falling below that of the enamel control may
cause some justifiable concern, we do not use these values as the sole
determinant in ranking the products, unless the scores are significantly
lower than the average in the group.
DENTAL ADHESIVES
Equipment
Specific Tests
Our usual testing apparatus (developed by Ultradent) employs a mold
that produces a small cylinder of composite about 2.2mm in diameter
and 2.0mm in height. While this is adequate for testing adhesives in
the light-cured mode using typical 2.0mm increments of composite, it
does not permit adhesive performance testing when bulk filling a deep
preparation for a core build-up. To solve this problem, we developed
molds that are wider (3.8mm in diameter) to allow easier insertion of the
restorative material and in various depths (2mm, 3mm, 4mm, and 5mm).
These deeper and wider molds are manufactured by 3M ESPE.
For example, using the 5mm deep molds, we can now test the
bond strength of light-cured and dual-cure core materials, which would
typically only be used in deep cavities. The other molds (2mm, 3mm,
4mm) are used to test the depth of cure of a product, in conjunction
with hardness (see Hybrids and Packable Composites). And, using
precured composite cylinders fabricated in the 5mm molds, we can test
the best way to bond thick indirect restorations such as onlays.
Moisture Status of Preparation After rinsing the phosphoric acid
Tooth Specimens
All bond strength testing is done on extracted teeth that have been
embedded in acrylic and then flattened. While flattened teeth really do
not simulate cavity preparations, this protocol is essential to conduct
these tests. The only exception to this “flat tooth” rule is when unprepared
enamel is tested. In this case, we select the extracted teeth that are as flat
as nature would allow, but this variable is unavoidable. Consequently,
we do not perform bond strength tests on unprepared enamel as a
rule. Although dentin is the substrate that we are most often testing, all
adhesives are also tested on enamel.
Immediate vs. Delayed Testing
Immediate Since we usually begin to stress a restoration with finishing
procedures as soon as it is light cured, it is important to know this early
bond strength. We literally test each adhesive as soon as light curing is
completed. This is our most common test.
5 Minutes Typically used for all self-cure core materials and self-
cure cements to simulate the usual waiting time for these materials to
chemically polymerize in the mouth. Some testing of dual-cure materials
is also done at this time, but not routinely since we have found only
small differences in bond strength between immediate and five minutes.
The time starts after the mold is filled and the specimen is placed in an
incubator set at 37°C/95% humidity in an effort to simulate the oral
environment if a patient is allowed to close during the polymerization
period. (While the intraoral temperature and humidity may not perfectly
match these parameters in all cases, it should be reasonably close.) Teeth
used for these tests are typically warmed to body temperature prior to
testing.
24 Hours Most common test reported by manufacturers. It may produce
higher values compared to those recorded immediately. In addition,
many research facilities do not have their equipment conveniently arranged for immediate testing, so the 24 hour test is done due to logistical
considerations. We use this time delay typically only for dual-cure and
self-cure core materials and cements, the latter of which is consistent
with the usual advice given to patients to be careful with what they eat
for the first 24 hours after luting a restoration.
etchant when using a total etch adhesive or prior to applying a self-etch
primer, you need to know the optimal moisture status of the preparation.
Our tests show that this can be one of the most critical steps during the
adhesive process. However, the directions from many manufacturers
either omit this description entirely or it is covered inadequately.
Therefore, we test all adhesives using three protocols:
• Dry Dry with forceful air for 2-3 seconds for a small preparation
or longer until the cavity is completely void of visible moisture,
but not totally desiccated.
• Moist Blot with a lint-free, dry 2x2 gauze, mini-sponge, or virtually any absorbent product that will not leave a residue on the
tooth surface. The result should be a tooth surface with no visible
moisture, which appears to have either a matte or slightly shiny
appearance (depending on the character of the dentin and type
of instrument used to prepare it). This protocol will leave necessary moisture in the demineralized dentin (created by the etching
process). Clinically, you would have to cut the 2x2 gauze (if used)
into small sections or use other products such as an applicator tip
or mini-sponge to siphon off the excess moisture in small areas.
For large areas, such as a complete crown preparation, draping an
intact 2x2 over the preparation may be more effective and expeditious.
• Wet Use the same type of blotting material described under
Moist and dip it into distilled water. Then blot this wet material
with a dry 2x2 to create a “damp” blotting material. Use this “damp”
material to blot the cavity preparation, leaving tooth surface with
a definite sheen of water on it, but be sure all puddles of water are
removed.
NOTE
To create the moist or wet status, many manufacturers will tell you to use your
air syringe. Typical instructions will tell you to “dry lightly for 2-3 seconds” or
some variation thereof. Our tests show that using air to create moist or wet
options is not effective. From a clinical perspective, it is even more difficult. For
example, if you are trying to “dry lightly” an MOD preparation, you may merely
be blowing the excess water from one proximal box to another. Therefore, the
blotting techniques we have developed have proven to be much more effective
and easier to calibrate.
In addition, when using the moist or wet option, you should apply the
adhesive or primer immediately after blotting the tooth. If you wait even 15
seconds (especially if you are using the rubber dam), some of the moisture could
evaporate, which could affect the performance of the adhesive.
Method and Time for Applying the Primer/Adhesive The manner
by which you apply a primer or adhesive can vary from the simple “let
sit” of some manufacturers to literally scrubbing it into the surface of
the preparation. “Let sit” may be effective in the laboratory on flat test
teeth, but it rarely works with the complex surfaces found in many
preparations, especially vertical ones. Scrubbing is a relative term and the
force by which it is accomplished is limited by the application instrument.
“Gentle agitation”, which refers to applying the primer/adhesive and then
basically moving it around on the preparation surface to be sure that
there is even contact in all areas, is in-between scrubbing and let sit.
The Ratings
T
205
DENTAL ADHESIVES
Application time can also vary the effectiveness. Our tests found the best
method and optimal time to apply the adhesive. Be aware that the size of
the preparation will determine the length of time you apply the adhesive.
While the stated times are application for small Class V preparations, you
should extend the times for large Class IIs. In addition, don’t start the
timer until the preparation is thoroughly wet with primer or adhesive.
Method of Evaporating the Solvent The monomers in the primers or
in adhesives themselves may be dissolved in solvents, which carry these
monomers into the demineralized surface of the preparation. Etching
with phosphoric acid or through the action of self-etching primers creates
this demineralized surface. These solvents, besides being the vehicle in
which the monomers are dissolved, need to be hydrophilic since the
demineralized dentin surface contains moisture to prevent the collagen
network from collapsing. The solvents also tend to be “water-chasing.”
This property refers to the solvent being attracted to the moisture content
of the dentin. As the solvent “chases the water”, it literally brings the
active monomers with it. Once this job is done, however, the solvent
needs to be evaporated, since it can actually interfere with adhesion if it
remains in the adhesive due to the dilution factor and the hydrophobic
materials subsequently being placed. The solvents most commonly used
in primers and single-component adhesives are ethanol and acetone,
although several also contain water.
After application of an adhesive or primer, the excess is usually first
removed by suctioning, being careful to allow a continuous coating to
remain on the tooth. If you don’t suction the excess, there is a tendency
to just blow the primer or adhesive from one part of the cavity to another
section or onto the soft tissue, which can cause untoward reactions
that are typically self-limiting but may provoke undesirable questions
from the patient. After suctioning the excess, the solvent needs to be
evaporated using air.
The typical method is to place the tip of the air syringe about 1.0cm
from the tooth and direct a gentle stream of air (like a breeze) at the
preparation surface. Some adhesives, however, require a more forceful air
flow, not only to evaporate the solvent, but also to keep the film thickness
as minimal as possible so the layer of adhesive does not interfere with
the complete seating of an indirect restoration. When using forceful air,
be careful not to blow the primer or adhesive completely off the tooth.
This can usually be done by starting the evaporation procedure with
gentle air and proceed to forceful. We have determined the optimal
technique for each adhesive.
The result of this evaporation effort should be a layer of primer
that appears dry (you can’t move it around with the air syringe) and the
preparation surface appears shiny. This air-evaporation effort may take
five or more seconds, depending on the size of the cavity.
If the dentin surface is not shiny, it may not be sealed. Therefore, it
seems prudent to apply additional adhesive and repeat the evaporation
process. Typically, the reapplication is merely applying the material and
immediately beginning the evaporation process—you don’t need to
wait as you may have when you applied it initially. If, after the second
application, the dentin surface is still not shiny, we recommend applying
the adhesive one final time.
Light Curing the Primer/Adhesive If this is the final component in the
adhesive system, you would typically cure it at this time. The conventional
206
The Ratings
curing time has always been 20 seconds, using a halogen light. However,
this may be overkill for some adhesives. We tested the optimal curing
time for each adhesive. But be aware that even these times may need
to be altered based on the distance from the tip of the light to the tooth
surface. For some adhesives used in the dual-cure or self-cure mode, in
which an activator is mixed with the main component of the kit, you
may need to wait until the restorative material or indirect restoration is
placed to cure the adhesive or allow it to cure concurrently along with
the dual-cure or self-cure composite or cement.
Method of Applying the Bonding Resin As this component does
not typically contain any solvents and, indeed, is usually primarily
hydrophobic, you do not have to apply air other than to thin out the
layer. While this will work, overaggressive use of the air can lead to
overthinning, which, in turn, can affect the performance of the adhesive.
You can alternately remove the excess by using the same applicator, but
blotting it with a 2x2 each time you remove more excess. This is known
as the brush on, brush off technique and works well.
Component(s) to use when bonding a dual-cure core or an indirect
restoration such as an onlay It has been thought that, if you are using
a dual-cure core material to build up a tooth or dual-cure cement to lute a
thick, indirect restoration, you also need to use a dual-cure adhesive (two
components) for compatibility and just in case the light doesn’t penetrate
to the tooth surface. However, if you can light cure all the way through the
core or to the bottom of the indirect restoration (especially if you position
the tip of the curing light on the facial, lingual, and occlusal surfaces and
use a high-powered light), then a single-component, light-cured adhesive
or the light-cured version of a multi-component product may be quite
satisfactory. In addition, a light-cured cement may also work instead of
a dual-cure version for the indirect restoration.
The first test simulates a direct, dual-cure core build-up (5mm deep)
immediately after light curing. If bond strengths are not substantial at
this stage, you may be able to dislodge the core when you remove the
core form or matrix band. The second test simulates bonding a 5mm
thick onlay with both light-cured and dual-cure adhesives and/or
cement.
Component(s) to use when bonding a self-cure core or an indirect, metal-based restoration such as a ceramometal crown
Similar to the dual-cure core test, this test is done by using the self-cure
version of the adhesive (if it has one). The test simulates a direct, self-cure
core build-up or indirect restoration cemented with a self-cure resin
cement if you waited five minutes after placement to allow the material
to chemically-cure.
Microleakage
While bond strength tests are done on flat tooth specimens, which really
do not simulate a clinical procedure, microleakage is performed by
restoring cavity preparations. In this respect, it has more clinical relevance
than bond strength. However, it should still just be considered another
screening tool, since the teeth are obviously pulpless and we do not subject
them to occlusal forces.
Standardized Class V preparations with margins coronal and apical
to the CEJ are restored using a standard composite (TPH Spectrum
DENTAL ADHESIVES
or TPH ) in combination with all the adhesives. After finishing and
polishing, the teeth are stored at least 24 hours in the temperature/
humidity chamber and then thermocycled 500 times between 5˚C and
55˚C. The teeth are then stained, sectioned, and scored for microleakage
using digital imaging software, which measures the % penetration of
the dye to the midway point of preparation from both the coronal
(enamel) and cervical (dentin) margins. The lower the percentage, the
less leakage is being allowed.
3
pH
A low pH is presumably one of the main reasons single-component
adhesives do not bond well to self-cure materials. We measured the pH
of all these products using a special probe and digital pH meter.
Miscellaneous Adhesive Issues
Effect of Moisture on Restorative Materials
If a restoration fractures, not only do we have to bond to the remaining
section of the restoration, but also to any exposed tooth surface. If dentin
is exposed, you would typically want to use an adhesive that will bond
securely to it to ensure optimal adhesion and so the tooth will not be
sensitive. If your typical adhesive requires you to leave the tooth moist
for optimal bond strength, then it may be difficult to leave the tooth moist
but dry the fractured area of the restoration.
We tested the effect of moisture on bond strength to several
restorative materials. Using Prime & Bond NT
NT, the level of moisture on
the restorative materials was the same as if we were bonding to a tooth.
This bond strength was then compared to the more typical dry bonding
you would do when luting an indirect restoration.
Our test results confirm that most indirect resins and ceramic
materials should be repaired dry. Therefore, the use of an adhesive that
bonds to dry enamel and dentin reasonably well would be the product
of choice. The products that can be used in this manner are OptiBond
FL, Gluma Comfort Bond + Desensitizer, and Adper Scotchbond MultiPurpose Plus. Even though all three products have their performances
maximized by the moist protocol, they can also be used dry without
suffering a major decline in efficacy.
Effect of Silane on Tooth Structure
When a repair is done, silane is typically applied to the restorative material
prior to applying the adhesive to the tooth and restorative material.
We wanted to know what effect silane could have on the bond of the
repair material to dentin. Our test results show that silane can interfere
with the bond of the composite to dentin. When doing a repair, make
every attempt to confine the application of silane just to the fractured
restorative material. Since silane is a liquid, this confinement will not be
possible if you merely douse the tooth with it. But if you apply the silane
with a fine brush, keeping it off the tooth is certainly a possibility.
Water Additives
With the increased concern about contaminated water lines, some
dentists are adding chemicals to their dedicated water supplies. However,
most of these products have not been tested properly as to their effects
on adhesion. Our own testing of one product showed bond strengths
decreased 22% compared to the untreated control. Therefore, we strongly
suggest not adding a disinfectant to your water supply without having
data on its effect on issues such as adhesion.
Water Trees
Even when the dentin is shiny and appears to be totally sealed, the
adhesives that do not employ a final layer of a hydrophobic bonding
resin may be subjected to a phenomenon called the semi-permeable
membrane effect. Discovered by Editorial Team Member Dr. Franklin
Tay, this effect is characterized by a porous hybrid layer, which allows
pulpal fluid to diffuse onto the dentin surface and potentially interfere
with the bond between the restorative material and adhesive. This
diffusion effect simulates branches on a tree, thus the term “water trees”
was created to describe it. However, while this effect has been shown to
exist clinically, it remains to be seen what its long-term sequelae may
be. Nevertheless, using a multi-component adhesive that includes a
final layer of a hydrophobic bonding resin will presumably prevent this
problem from occurring and is one reason that the multi-component
adhesives are making somewhat of a comeback.
Hybridizing the Dentin at the Preparation
Appointment
There is a trend to create a hybrid layer at the preparation appointment for
an indirect restoration. The purposes of the hybrid layer in this instance
are to protect the pulp by sealing the dentin surface, minimize or eliminate
sensitivity between the preparation and seating appointments, and allow
seating of the definitive restoration without having to anesthetize the
tooth. While these are noble goals, there are also some downsides to
this procedure. In the first place, the hybridizing procedure is done
before taking the impression. Depending on the type of adhesive used
to create the hybrid layer, the sharp margins of the preparation could
be less distinct and more difficult for the lab to see. Second, applying
an adhesive after preparing a tooth especially for full coverage may be
difficult due to the challenges of adequately isolating the preparation.
Third, the adhesive could bond with the provisional cement if a resin
version is used. Fourth, bonding to this precured adhesive layer may not
be as adhesive as starting with fresh tooth structure. And, finally, unless
you are using a hydrophobic layer over your hydrophilic adhesive, this
presumably sealed dentin surface may be susceptible to the formation of
water trees. Therefore, this procedure may not produce all of its presumed
benefits and may not be worth the effort it takes.
Shaking the bottle/Stirring the Unidose
Many adhesives suffer from phase separations of their components in
bottles and unidose vessels. This means that most bottles should be
shaken before dispensing and the contents of unidose vessels should
be stirred before applying to the preparation. Some bottles even have a
small ball inside to act as a shaker to help mix the components. When
in doubt, shake or stir.
Simplified Application Techniques
In each product commentary, we have listed the application techniques
that we have found to be most effective and practical for clinical use.
In some instances, these procedures may vary from the manufacturer’s
directions. However, we feel strongly that our techniques will give you
the best chance for success and will minimize failures.
The Ratings
T
207
TOTAL ETCH
DENTAL ADHESIVES
DENTAL ADHESIVES
Kerr
(4.6)
1
Bond Strength (MPa)
Enamel
23.0
Dentin
32.4
Can You Cure It With an LED?
Probably, since dentin bond strengths using an LED were close to that of the halogen
control.
PRICES
KIT
REFILLS
OptiBond FL Bottle Kit
$196.65 ($12.29/ml)
1 btl (8ml) of FL Prime or
FL Adhesive
$75.40 ($9.43/ml)
OptiBond Dual Cure
Activator
1 btl (3ml)
$66.25 ($22.08/ml)
OptiBond Dual Cure Paste
3 syringes (1.25g ea)
$66.25 ($17.67/g)
SHELF LIFE
1 year for light-cured components
2 years for dual-cure components
USES
Direct restorations (all types) and indirect, metal-free
restorations using light-cured and dual-cure cement. Do
not use with metal-based, indirect restorations.
COMPOSITION
FL Prime (1) HEMA, GPDM, mono (2-methacryloxy ethyl)
phthalate (PAMM), ethyl alcohol, camphorquinone, and
water.
Direct restorations (all types)
1. Etch for 15s.
2. Rinse and leave preparation MOIST.
3. Apply FL Prime (1) for 15s with GENTLE AGITATION.
4. Apply GENTLE AIR to evaporate the solvent.
5. Apply FL Adhesive (2) using brush-on/brush/off.
6. Light-cure FL Adhesive (2) for 20s.
Indirect, metal-free restorations
1. Etch for 15s.
3. Apply FL Prime (1) for 15s with GENTLE AGITATION.
5. Apply FL Adhesive (2) using brush-on/brush/off.
6. Seat restoration with light-cured or dual-cure cement and light-cure adhesive
simultaneously with cement.
Component Applied to Inside Surface of Indirect Restoration
FL Adhesive or unfilled resin (apply and gently air-thin, do not cure).
FL Adhesive (2) BIS-GMA, HEMA, barium aluminum
borosilicate glass (0.6µ particle size), fumed silica,
disodium hexafluorosilicate, glycerol dimethacrylate,
and camphorquinone.
OptiBond
Dual Cure Activator (3A) BIS-GMA, HEMA, glycerol
dimethacrylate, and catalysts (benzoyl peroxide and
camphorquinone).
Dual Cure Paste (3B) Barium aluminum borosilicate
glass, fumed silica, disodium hexafluorosilicate, HEMA,
glycerol dimethacrylate, and tertiary amine. When
mixed, this component is 48% filled by weight.
pH
FL Prime
1.9
FL Adhesive
6.9
Dual Cure Activator/Paste
6.3
RAVES & RANTS
+ Dry, moist, wet — all will work
+ Longest track record next to All-Bond 2
– 3A/3B probably not necessary after all
– Cannot use with metal-based indirects
208
The Ratings
DENTAL ADHESIVES
´´´´
(4.2)
2a
OptiBond Solo plus
Kerr
Bond Strength (MPa)
Enamel
20.4
Dentin
26.1
Probably, since dentin bond strengths using an LED exceeded those using a halogen light.
PRICES
KITS
REFILLS
Bottle or Unidose
$241.65/10ml
($24.17/ml)
Bottle
$115.25/5ml ($22.17/ml)
Unidose
$202.50 ($20.25/ml or
$2.03/unidose)
SHELF LIFE
2 years
USES
Light-cured and dual-cure direct and indirect, metalfree restorations.
Simplified Application Technique
1. Etch for 15s.
3. Apply Adhesive for 15s with GENTLE AGITATION adding more adhesive about
every five seconds or so.
5. Light-cure Adhesive for 10s.
Unfilled resin or OptiBond Solo plus (apply and gently air-thin, do not cure).
COMPOSITION
BIS-GMA, HEMA, GDM, GPDM (glycero-phosphate
dimethacrylate), ethanol, fumed silica, barium glass,
sodium hexafluorosilicate, CQ (camphorquinone).
Approximately 15% filled by weight with 0.4µ glass.
pH
2.2
RAVES & RANTS
+ Good bond strengths with indirects
+ Consistent, reliable performance
– Dual-cure version a flop
– Need to thin out very carefully with indirects
The Ratings
T
209
DENTAL ADHESIVES
´´´´
(4.2)
2b
Prime & Bond NT/
Prime & Bond NT
Dual Cure
Dentsply/Caulk
www.caulk.com
PRICES
KITS
REFILLS
Introductory Bottle
$115.75/4.5ml ($25.72/ml)
Self Cure Activator
$115.10/4.5ml
($25.58/ml)
Unit Dose Package
$192.35/10ml ($19.24/ml or
$2.40/dose)
Dual Cure Introductory
$227.85/9ml ($25.32/ml)
Bond Strength (MPa)
Enamel
28.2
Dentin
21.7
Amalgam Bonding
Accessory
$115.10/6ml ($19.18/ml)
SHELF LIFE
2 years
Probably, since dentin bond strengths using an LED were only slightly lower than those using
a halogen light.
USES
COMPOSITION
NT Adhesive PENTA (dipentaerythritol penta acrylate
monophosphate), UDMA, R5-62-1, camphorquinone,
cetylamine hydrofluoride, nanofillers (amorphous silicon
dioxide) and two proprietary elastomeric resins (T-resin
and D-Resin) in acetone.
Self-Cure Activator Aromatic sodium sulfinate in
acetone and ethanol.
Amalgam Bonding Base BIS-GMA, TEGDMA.
Amalgam Bonding Catalyst Benzoyl peroxide,
dimethacrylate resins.
pH
NTT Adhesive
1.9
NTT Adhesive/Self-Cure Activator
4.8
Amalgam Bonding Base/Catalyst
6.1
RAVES & RANTS
+ Long track record
+ Unit dose or bottle
– Activator is probably not necessary with dual-cure
– Failed semi-permeable membrane test
Direct restorations (using light-cured or dual-cure materials)
Metal-free indirect restorations (using light-cured or dual-cure cement)
1. Etch for 15s.
2. Rinse and leave preparation WET.
3. Apply NT Adhesive for 20s with GENTLE AGITATION adding more adhesive about
5. Light-cure NT Adhesive for 10s.
Direct restorations (using self-cure materials)
1. Etch for 15s.
3. Mix NT Adhesive and Self-Cure Activator in 1:1 ratio and apply for 20s with GENTLE
AGITATION adding more of the adhesive mix about every five seconds or so.
5. Light-cure NT Adhesive/Self-Cure Activator for 10s.
Metal-based indirect restorations (using self-cure cement)
1. Etch for 15s.
3. Mix NT Adhesive and Self-Cure Activator in 1:1 ratio and apply for 20s with GENTLE
5. Light-cure NT Adhesive/Self-Cure Activator for 10s.
5. Mix Amalgam Bonding base and catalyst in 1:1 ratio and apply using brush-on/brush/off.
6. Quickly seat restoration with self-cure cement. Amalgam Bonding base and catalyst
will self-cure along with cement.
Components Applied to Inside Surface of Indirect Restoration
Light-cured/dual-cure
Unfilled resin (apply and gently air-thin, do not cure).
Self-cure
Amalgam Bonding base and catalyst (mix) (apply and gently air-thin, do not cure).
210
The Ratings
DENTAL ADHESIVES
´´´´
(4.1)
3a
One-Step Plus
Bisco
www.bisco.com
PRICES
KITS
REFILLS
Bottle w/ Syringe
Etchant
$99.00/6ml ($16.50/ml)
Bottle
$89.00 ($14.83/ml)
Unit-Dose
$135.00/8ml ($16.88/ml or
$1.69/unidose)
Unidose
$95.00 ($15.83/ml or
$1.58/unidose)
SHELF LIFE
2 years
USES
COMPOSITION
BPDM (biphenyl dimethacrylate), BIS-GMA, HEMA,
acetone, 8.5% fluoroaluminosilicate glass fillers.
pH
4.4
RAVES & RANTS
+ Best bond to self-cure materials for single components
+ Filler makes it less technique-sensitive
– Dry prep causes much lower bond strength
– Must be shaken before using—don’t forget!
Bond Strength (MPa)
Enamel
23.4
Dentin
22.7
Probably, since dentin bond strengths using an LED were equal to those using a
halogen light.
1. Etch for 15s.
One-Step Plus (apply and gently air-dry for five seconds to evaporate the acetone, do not
cure). For self-cure indirects, use Primer B from the All-Bond 2 kit.
The Ratings
T
211
DENTAL ADHESIVES
´´´´
(4.1)
3b
Bond Strength (MPa)
Enamel
24.5
Dentin
20.1
PQ1
Ultradent
Probably, since dentin bond strengths using an LED were only slightly less than those using
a halogen light.
PRICES
KIT
REFILLS
Introductory
$69.99/2.4ml ($29.16/ml)
4 pack
$62.99 ($13.12/ml)
Unit Dose
50 pack
$99.99/10ml ($10.00/ml or
$2.00/unit dose)
five seconds or so.
4. Apply GENTLE AIR to evaporate the solvent and to eliminate the milky appearance.
SHELF LIFE
1.5 years refrigerated
You are finished when the coat of PQ1 is translucent.
USES
Light-cured and
restorations.
dual-cure
direct
and
indirect
COMPOSITION
HEMA, proprietary monomers, camphorquinone, 40%
filled with barium borosilicates (0.7µ), proprietary natural
resins, and fluoride in 8% ethanol.
1. Etch for 15s.
3. Apply Adhesive for 15s with RUBBING MOTION adding more primer about every
4. Apply GENTLE AIR to evaporate the solvent and to eliminate the milky appearance.
pH
1.7
You are finished when the coat of PQ1 is translucent.
RAVES & RANTS
+ Convenient syringe delivery
+ High filler leads to consistent bonding
– Milky look only for mustaches
– Mediocre results with indirects
212
1. Etch for 15s.
3. Apply Adhesive for 15s with RUBBING MOTION adding more primer about every
The Ratings
5. Seat restoration with light-cured or dual-cure cement and light-cure PQ1
PQ1 (apply and gently air-thin and evaporate the ethanol, do not cure).
DENTAL ADHESIVES
´´´´
(4.0)
4a
Adper Scotchbond
Multi-Purpose Plus
3M ESPE
Probably, although dentin bond strengths using an LED were somewhat lower than those
using a halogen light.
PRICES
KIT
Bond Strength (MPa)
Enamel
17.7
Dentin
28.2
REFILLS
$425.80/24ml ($17.74/ml) 1 btl (8ml) of primer or
adhesive
$152.60 ($19.08/ml)
1 btl (4ml) of activator or
catalyst
$103.40 ($25.85/ml)
SHELF LIFE
3 years refrigerated
USES
COMPOSITION
Activator, component 1.5 Ethanol-based solution of
benzenesulfinic acid salt plus photoinitiator.
Primer, component 2 Water, HEMA, and polycarboxylic
acid copolymer.
Adhesive, component 3 BIS-GMA and HEMA plus
photoinitiator.
Catalyst, component 3.5 BIS-GMA, HEMA, and benzoyl
peroxide.
pH
Activator, component 1.5
8.1
Primer, component 2
4.0
Activator/Primer (mixed)
4.7
Adhesive, component 3
8.2
Catalyst, component 3.5
5.7
Adhesive/Catalyst (mixed)
6.9
RAVES & RANTS
+ Will bond to good old dry tooth structure
+ Light-cured, dual-cure, self-cure
– Keeping track of which components to use is confusing
– Low enamel bond strength
1. Etch for 15s.
3. Apply Primer (2) for 10s with GENTLE AGITATION.
5. Apply Adhesive (3) using brush-on/brush/off.
6. Light-cure Adhesive (3) for 10s.
1. Etch for 15s.
3. Apply Activator (1.5) and merely air-dry gently for five seconds.
7. Light-cure Adhesive (3) for 10s.
Metal-free indirect restorations (using light-cured cement)
1. Etch for 15s.
6. Seat restoration with light-cured cement and light-cure adhesive simultaneously
with cement.
Metal-free indirect restorations (using dual-cure cement)
1. Etch for 15s.
6. Mix Adhesive (3) and Catalyst (3.5) in 1:1 ratio using brush-on/brush/off.
7. Seat restoration with dual-cure cement and light-cure adhesive simultaneously
with cement.
1. Etch for 15s.
6. Apply Catalyst (3.5) using brush-on/brush/off.
7. Seat restoration with self-cure cement. Adhesive will self-cure along with cement.
Light-cured
Adhesive or unfilled resin (apply and gently air-thin, do not cure).
Dual-cure
Catalyst (apply and gently air-thin, do not cure).
Self-cure
Catalyst/Adhesive (apply and gently air-thin, do not cure).
The Ratings
T
213
DENTAL ADHESIVES
´´´´
(4.0)
4b
All-Bond 2
Bisco
www.bisco.com
PRICES
COMPLETE KIT
REFILLS
$157.00/21ml
($7.48/ml)
1 btl (6ml) of Primer A or B
$56.00 ($9.33/ml)
1 btl of Dentin/Enamel Bonding
Resin (6ml)
$26.00 ($4.33/ml)
1 btl of Pre-Bond (3ml)
$14.00 ($4.67/ml)
Bond Strength (MPa)
Enamel
21.3
Dentin
25.3
SHELF LIFE
2 years
USES
COMPOSITION
Primer A NTG-GMA, acetone, and ethanol.
Primer B BPDM (biphenyl dimethacrylate), acetone,
and ethanol.
Dentin/Enamel Bonding Resin BIS-GMA, UDMA, and
HEMA.
Pre-Bond BIS-GMA, triethyleneglycol dimethacrylate,
HEMA, and benzoyl peroxide. This acts as a wetting
agent and slows down the reaction between Primers
A & B and a dual-cure or self-cure resin cement used
for indirect restorations. Slowing down the setting
time between the adhesive and resin cement helps
tremendously when cleaning the excess cement off
the restoration. The benzoyl peroxide will chemically
polymerize when it is “sandwiched” between the tertiary
amine in Primer A and the dual-cure or self-cure resin
cement. For a true dual-cure/self-cure bonding resin,
mix Pre-Bond with the Dentin/Enamel Bonding Resin.
pH
Primers A/B
5.7
Dentin/Enamel Bonding Resin
7.5
Pre-Bond
4.4
Pre-Bond/Dentin/Enamel Bonding Resin
4.6
RAVES & RANTS
+ Has longest track record
+ Can do everything with it
– Too many bottles
– Very susceptible to overdrying
Probably, since dentin bond strengths using an LED were roughly equal to those using a
halogen light.
Direct restorations
1. Etch for 15s.
3. Mix Primers A & B and apply for 20s with GENTLE AGITATION adding more of
the primer mix about every five seconds or so.
5. Apply D/E Resin using brush-on/brush/off.
6. Light-cure D/E Resin for 20s.
1. Etch for 15s.
5. Apply D/E Resin using brush-on/brush/off.
6. Seat restoration with light-cured or dual-cure cement and light-cure D/E Resin
1. Etch for 15s.
5. Mix D/E Resin and Pre-Bond in 1:1 ratio using brush-on/brush/off.
6. Quickly seat restoration with self-cure cement. Adhesive will self-cure along with
cement.
D/E Resin (apply and gently air-thin, do not cure)
Self-cure
Primer B (apply and gently air-thin and evaporate the acetone, do not cure).
214
The Ratings
DENTAL ADHESIVES
´´´´
(4.0)
4c
Gluma Comfort Bond +
Desensitizer
Heraeus Kulzer
PRICES
KITS
REFILLS
None
Bottle
$93.94/4ml ($23.49/ml)
Single Dose
$80.34/4ml ($20.09/ml or
$2.01/single dose)
Bond Strength (MPa)
Enamel
22.3
Dentin
22.0
Probably, since dentin bond strengths using an LED were only slightly lower than those
using a halogen light. However, the bond strengths with the LED were not as consistent as
they were with the halogen.
1. Etch for 15s.
3. Apply Adhesive for 20s with SCRUBBING MOTION adding more adhesive about
SHELF LIFE
3 years
USES
Light-cured and dual-cure direct and indirect
restorations plus self-cure direct restorations.
COMPOSITION
GCB+D (apply and gently air-dry for five seconds to evaporate the ethanol and water, do
not cure).
4-META, UNMA, HEMA, glutaraldehyde, maleic acid,
methacrylic polycarboxylic acid, and photoinitiator in
ethanol and water.
pH
2.4
RAVES & RANTS
+ Tooth wetness status not critical
+ Bond and desensitize in one step
– Inconsistent bond strengths with LED
– Unidose applicator too large for small preps
The Ratings
T
215
DENTAL ADHESIVES
Bond Strength (MPa)
Enamel
25.4
Dentin
22.4
Cabrio CQ
´´´´
(3.9)
5a
Discus
Probably, since dentin bond strengths using an LED are roughly equal to those using a
halogen light.
PRICES
KITS
REFILLS
Bottle
$95.00/9ml ($10.56/ml)
1 btl of adhesive (6ml)
$62.50 ($10.42/ml)
Unidose
$39.00/2.5ml ($15.60/ml or
$1.95/dose)
1 btl of catalyst (3ml)
$30.00 ($10.00/ml)
SHELF LIFE
Adhesive 1.5 years
Catalyst 1.5 years refrigerated
USES
COMPOSITION
Adhesive PMGDM, monomer resin and activators in
acetone.
Catalyst NTG-GMA and acetone.
pH
Adhesive
1.3
Adhesive/Catalyst (mixed)
2.1
RAVES & RANTS
+ Top bond strength in self-cure cement mode
+ 1:1 ratio makes more sense
– Expiration date on adhesive bottle is erased instantly
during disinfection
– No instructions for using with self-cure cores
WHAT’S NEW?
Unidose
New packaging
216
The Ratings
1. Etch for 15s.
1. Etch for 15s.
3. Mix Adhesive and CQ Catalyst in 1:1 ratio and apply for 20s with GENTLE
4. Apply GENTLE AIR to evaporate the solvent. DO NOT LIGHT-CURE.
5. Place self-cure restorative material or seat restoration with self-cure cement. Adhesive
will self-cure along with restorative material or cement.
Light-cured/dual-cure (metal-free)
Unfilled resin (apply and gently air-thin, do not cure).
Self-cure (metal-based)
Adhesive and Catalyst (mix) (apply and gently air dry for five seconds to evaporate the
acetone, do not cure).
DENTAL ADHESIVES
´´´´
(3.8)
5b
DenTASTIC UNO•DUO
Pulpdent
www.pulpdent.com
PRICES
KIT
REFILLS
$119.00/9ml ($13.22/
ml)
1 btl of UNO adhesive (6ml)
$60.00 ($10.00/ml)
1 btl of DUO catalyst (3ml)
$55.00 ($18.33/ml)
SHELF LIFE
1.5 years
COMPOSITION
Bond Strength (MPa)
Enamel
25.2
Dentin
29.4
UNO PMGDM, HEMA, water, photoinitiator, and acetone.
DUO MgNTG-GMA, ethanol, and acetone.
USES
pH
UNO
2.8
UNO•DUO (mixed)
3.5
RAVES & RANTS
+ Not necessary to light cure with UNO•DUO
+ Moist and wet will both work
– 2:1 ratio with UNO•DUO not intuitive
– No unidose
Direct restorations (using light-cured materials)
1. Etch for 15s.
3. Apply UNO for 15s with GENTLE AGITATION adding more UNO about every five
seconds or so.
5. Light-cure UNO for 10s.
Direct restorations (using dual-cure or self-cure materials)
1. Etch for 15s.
3. Mix UNO and DUO in 2:1 ratio and apply for 15s with GENTLE AGITATION adding
more UNO/DUO about every five seconds or so.
4. Apply GENTLE AIR to evaporate the solvent. DO NOT LIGHT-CURE.
5. Place dual-cure or self-cure restorative material or seat restoration with self-cure
cement. Adhesive will self-cure along with restorative material or cement.
Light-cured
UNO (apply and gently air dry for five seconds to evaporate the acetone, do not cure).
Dual-cure/Self-cure
UNO•DUO mixture (apply and gently air dry for five seconds to evaporate the acetone and
ethanol, do not cure).
The Ratings
T
217
DENTAL ADHESIVES
´´´´
(3.8)
6
Adper Single Bond Plus
3M ESPE
www.3mespe.com
PRICES
KITS
REFILLS
Intro (Bottle)
$159.70/5.6ml ($28.52/ml)
1 btl
$150.10/5.6ml ($26.80/ml)
Unit Dose
$79.10/4.4ml ($17.98/ml or
$1.98/unit dose)
SHELF LIFE
3 years
USES
Light-cured and dual-cure direct and indirect
restorations plus self-cure direct restorations.
COMPOSITION
BIS-GMA, HEMA, ethanol, water, dimethacrylates,
photoinitiator, and methacrylate functional copolymer of
polyacrylic and polyitaconic acids (polyalkenoic acid).
Filled 10% by weight with 5.0nm (0.005µ) silica.
pH
4.6
RAVES & RANTS
+ Very easy to achieve shiny dentin surface
+ Can be used in virtually all applications
– Filler doesn’t prevent semi-permeable membrane
effect
– Bursting the bubble not as easy as anticipated
Bond Strength (MPa)
Enamel
25.4
Dentin
30.3
1. Etch for 15s.
every five seconds or so..
ASB Plus (apply and gently air-dry for five seconds to evaporate the ethanol and water, do
not cure).
218
The Ratings
DENTAL ADHESIVES
´´´´
(3.7)
7a
Bond Strength (MPa)
Enamel
22.7
Dentin
21.0
One-Step
Bisco
Probably, since dentin bond strengths using an LED were equal to those using a halogen
light.
PRICES
KIT
REFILL
Standard Package
$99.00/6ml ($16.50/ml)
Bottle
$87.00/6ml ($14.50/ml)
SHELF LIFE
2 years
USES
COMPOSITION
BPDM (biphenyl dimethacrylate), BIS-GMA, and HEMA
in acetone.
pH
1. Etch for 15s.
One-Step (apply and gently air-dry for five seconds to evaporate the acetone, do not cure).
For self-cure, use Primer B from the All-Bond 2 kit.
5.0
RAVES & RANTS
+ The original single-component that bonds to self-cure
materials
+ Highest pH of single-components
– Be sure it’s wet
– Has to play second fiddle to Plus
The Ratings
T
219
DENTAL ADHESIVES
Bond Strength (MPa)
Enamel
26.4
Dentin
23.9
PermaQuick
´´´´
(3.7)
7b
Ultradent
Probably, since dentin bond strengths using an LED equaled those using a halogen light.
PRICES
KIT
REFILLS
$55.99/3.6ml ($15.55/ml) 4 pack Primer or Bonding
Resin
$37.99 ($7.91/ml)
SHELF LIFE
40 months refrigerated
USES
Light-cured and
restorations.
dual-cure
direct
and
indirect
1. Etch for 15s.
3. Apply Primer for 15s with RUBBING MOTION adding more primer about every
4.
5.
6.
7.
COMPOSITION
Primer Canadian balsam, HEMA, methacrylic acid,
camphorquinone, and a phosphate monomer in ethanol.
The key ingredient is the Canadian Balsam (better
known as tree sap).
Bonding Resin BIS-GMA, TEGDMA, HEMA, diluent
monomer, tertiary amine, camphorquinone, and
proprietary glass silicate fillers which release fluoride.
Filled 45% by weight. Filler particle size <0.7µ.
pH
Primer
1.8
Bonding Resin
2.6
RAVES & RANTS
+ Syringe packaging very convenient
+ Incredible shelf life
– Isn’t balsam a hair conditioner?
– We miss the white knuckles
220
The Ratings
Apply GENTLE AIR to evaporate the solvent.
Light-cure Primer for 20s.
Apply Bonding Resin for 15s with RUBBING MOTION.
Light-cure Bonding Resin for 20s.
Indirect restorations (using light-cured or dual-cure cement)
1. Etch for 15s.
3. Apply Primer for 15s with RUBBING MOTION adding more primer about every
4.
5.
6.
7.
Light-cure Primer for 20s.
Apply Bonding Resin for 15s with RUBBING MOTION.
Seat restoration with light-cured or dual-cure cement and light-cure Bonding Resin
Bonding Resin (apply and gently air-thin, do not cure).
SELF-ETCH
DENTAL ADHESIVES
DENTAL ADHESIVES
Clearfil SE Bond
´´´´
(4.3)
1
Kuraray
www.kuraraydental.com
PRICES
KIT
REFILLS
$132.00/11ml
($12.00/ml)
1 btl of self-etching Primer
(6ml)
$39.00 ($6.50/ml)
1 btl of Bond liquid (5ml)
$89.00 ($17.80/ml)
SHELF LIFE
USES
Light-cured and dual-cure direct restorations.
COMPOSITION
Primer 10-Methacryloyloxydecyl dihydrogen phosphate
(MDP), HEMA, hydrophilic dimethacrylate, dlCamphorquinone, N,N-diethanol p-toluidine, water.
Bond 10-Methacryloyloxydecyl dihydrogen phosphate
(MDP), BIS-GMA, HEMA, hydrophobic aliphatic
dimethacrylate, dl-Camphorquinone, N,N-diethanol ptoluidine, silanated colloidal silica. Filled 10% by weight.
pH
Primer
2.0
Bond
1.8
RAVES & RANTS
+ Gold standard for self-etchers
+ Clinical performance exemplary
– Two bottles are very nearly the same color
– Weak effectiveness with indirects
Bond Strength (MPa)
Enamel
Self-etch
24.9
Etch w/PA
32.3
Dentin
Self-etch
Etch w/PA
29.3
30.8
Probably, although dentin bond strengths using an LED were lower than those using a
halogen light.
1. Leave preparation DRY, but don’t desiccate the tooth.
2. Apply Primer for 20s with GENTLE AGITATION adding additional Primer during
the 20-second application period.
5. Apply Bond resin using brush on/brush off method, then use GENTLE AIR to thin
this layer to create an even, medium-thin, shiny coating.
6. Light-cure Bond resin for 10s.
The Ratings
T
221
DENTAL ADHESIVES
Clearfil Protect Bond
´´´´
(4.2)
2
Kuraray
PRICES
KIT
REFILLS
$185.00/11ml
($16.82/ml)
1 btl of self-etching Primer
(6ml)
$95.00 ($15.83/ml)
1 btl of Bond liquid (5ml)
$90.00 ($18.00/ml)
SHELF LIFE
USES
COMPOSITION
Primer 10-Methacryloyloxydecyl dihydrogen phosphate
(MDP), HEMA, hydrophilic dimethacrylate,
12-methacryloyloxydodecylpyridinium, water.
Bond 10-Methacryloyloxydecyl dihydrogen phosphate
(MDP), BIS-GMA, HEMA, hydrophobic aliphatic
dimethacrylate, dl-Camphorquinone, N,N-diethanol
p-toluidine, silanated colloidal silica, sodium fluoride.
Filled 10% by weight.
pH
Primer
1.9
Bond
3.6
RAVES & RANTS
+ Great bonding and kill bugs at the same time
+ Follows success of SE Bond
– More expensive than stablemate
– Difficult to disinfect dispenser
222
The Ratings
Bond Strength (MPa)
Enamel
Self-etch
29.8
Etch w/PA
27.3
Dentin
Self-etch
Etch w/PA
24.7
19.5
light.
2. Apply Primer for 20s with GENTLE AGITATION adding additional Primer during
the 20-second application period.
4. Apply Bond resin using brush on/brush off method, then use GENTLE AIR to thin
this layer to create an even, medium-thin, shiny coating.
5. Light-cure Bond resin for 10s.
DENTAL ADHESIVES
´´´´
(4.0)
3a
Clearfil S3 Bond
Kuraray
NEW
PRICES
KIT
Bottle
$98.00/4ml ($24.50/ml)
Unidose
$135.00/5ml ($27.00/ml or $2.70/dose)
SHELF LIFE
USES
COMPOSITION
HEMA, bisphenol A diglycidylmethacrylate,
10-methacryloyloxydecyl, dihydrogen phosphate, silica
and CQ in ethanol and water. Filled 10% by weight.
pH
3.1
Bond Strength (MPa)
Enamel
Self-etch
25.3
Etch w/PA
26.7
Dentin
Self-etch
Etch w/PA
23.3
26.1
RAVES & RANTS
+ Homogeneous—doesn’t need to be shaken or stirred
+ Has Clearfil self-etch legacy behind it
Probably, since dentin bond strengths using an LED were similar to those using a halogen
light.
– Direction of forceful air caused lower enamel bond
strength
– Direction of let sit was not effective on enamel
1. Leave preparation DRY, but don’t desiccate the tooth. Moist worked just as well for
dentin, but dry was more consistent on enamel.
2. Apply Adhesive initially with GENTLE AGITATION followed by allowing it to
sit for 20s. The manufacturer’s direction of letting it sit for 20s was just as effective
on dentin, but not on enamel.
3. Apply MEDIUM AIR to evaporate the solvent. The manufacturer’s direction of
forceful air was also effective on dentin, but not on enamel.
The Ratings
T
223
DENTAL ADHESIVES
Prelude
´´´´
(4.0)
3b
Danville Materials
www.daneng.com
NEW
PRICES
KIT
REFILLS
Self-Etch
$129.95/15ml
($8.66/ml)
1 btl (5ml) of Primer, Adhesive,
or Link
$49.95 ($9.99/ml)
SHELF LIFE
2 years
USES
Primer + Adhesive Light-cured and dual-cure direct
restorations.
Primer + Adhesive + Link Self-cure direct restorations.
COMPOSITION
Primer HEMA and GPDM in ethanol and water.
Adhesive BIS-GMA, HEMA, GPDM, barium
aluminoborosilicate glass, fumed silica, and sodium
hexaflorosilicate in ethanol. Filled 25% by weight;
average particle size is 0.4µ.
Link BIS-GMA, TEGDMA, and accelerators in ethanol.
pH
Primer
2.1
Adhesive
2.8
Link
9.3
RAVES & RANTS
+ No mixing for self-cure mode
+ Highest bond strength of self-etchers to self-cure cores
– 2-compartment well is not consistent with 3
components
– Enamel bond strength was on the low end
Bond Strength (MPa)
Enamel
Self-etch
19.2
Etch w/PA
21.2
Dentin
Self-etch
Etch w/PA
29.3
23.7
Probably, since enamel bond strengths using an LED were equal to those using a halogen
light. However, dentin bond strengths were much lower using the LED.
Direct restorations (using light-cured and dual-cure materials)
1. Leave preparation MOIST. Dry was slightly less effective on dentin and slightly more
2.
3.
4.
5.
effective on enamel.
Apply Primer for 10–15s with SCRUBBING.
Apply Adhesive IMMEDIATELY using SCRUBBING for 10–15s, then use GENTLE
TO MEDIUM AIR to evaporate the solvent and thin this layer.
Light-cure Adhesive for 10s.
1. Leave preparation MOIST. Dry was slightly less effective on dentin and slightly more
effective on enamel.
2. Apply Primer for 10–15s with SCRUBBING.
4. Apply Adhesive IMMEDIATELY using SCRUBBING for 10–15s, then use GENTLE
TO MEDIUM AIR to evaporate the solvent and thin this layer.
6. Apply Link using brush on/brush off method, then use GENTLE AIR to evaporate
solvent, which produces a dull surface. Allow to cure with self-cure composite.
224
The Ratings
DENTAL ADHESIVES
´´´´
(3.7)
4a
Bond Strength
(MPa)
Enamel
Self-etch
32.8
Etch w/PA 28.6
Clearfil Liner Bond 2V
Kuraray
Dentin
Self-etch
Etch w/PA
PRICES
KIT
REFILLS
$176.00/20ml
($8.80/ml)
1 btl (6ml) of Primer A or B (6ml)
$39.00 ($6.50/ml)
38.8
33.2
Can You Cure It
With an LED?
1 btl of Bond A (5ml)
$99.00 ($19.80/ml)
Probably, since dentin
bond strengths using an
LED were equal to those
1 btl of Bond B (3ml)
$54.00 ($18.00/ml)
SHELF LIFE
USES
Primers + Bond A Light-cured direct restorations.
Primers + Bond A/Bond B Self-cure direct and indirect
restorations.
Direct restorations
2. Mix Primers A & B and apply for 30s with GENTLE AGITATION adding additional
Primer during the 30-second application period.
3. Apply GENTLE AIR to evaporate the solvent. Surface of preparation will look non-
COMPOSITION
Primer A 2-hydroxyethyl methacrylate, hydrophilic
dimethacrylate, 10-methacryloyloxydecyl, dihydrogen
phosphate, N, N-diethanol-p-toluidine, d,
1-camphorquinone, water.
Primer B 2-hydroxyethyl methacrylate, hydrophilic
dimethacrylate, water.
Bond A Silanated colloidal silica, bisphenol A
diglycidylmethacrylate, 2-hydroxyethyl methacrylate,
hydrophobic dimethacrylate, 10-methacryloyloxydecyl,
dihydrogen phosphate, N, N-diethanol-p-toluidine,d,
l-camphorquinone.
Bond B Silanated colloidal silica, bisphenol A
diglycidylmethacrylate, 2-hydroxyethyl methacrylate,
hydrophobic dimethacrylate, benzoyl peroxide.
shiny.
4. For light-cured and dual-cure materials, apply Bond resin A using brush on/brush
off method, then use GENTLE AIR to thin this layer to create an even, medium-thin,
shiny coating. For self-cure materials, mix and apply Bond resins A & B instead of
just using Bond resin A by itself.
5. Light-cure Bond resin A or the mixture of Bond resin A & B for 10s.
Metal-free indirect restorations
shiny.
pH
Primers A/B (mixed)
2.8
Bond A
1.7
Bond A/B (mixed)
1.8
RAVES & RANTS
+ Surprisingly good bond to prepared enamel
+ Highest bond strength to dentin
– Not very effective with indirects
– Tepid results with self-cure materials
4. When using light-cured cement, apply Bond resin A using brush on/brush off
method, then use GENTLE AIR to thin this layer to create an even, medium-thin,
shiny coating. When using dual-cure cement, mix Bond resins A & B and apply
instead of just Bond resin A.
5. Seat restoration with light-cured or dual-cure cement and light-cure Bond resin A or
the mixture of Bond resins A & B simultaneously with cement.
shiny.
4. Mix Bond resins A & B and apply using brush on/brush off method, then use GENTLE
AIR to thin this layer to create an even, medium-thin, shiny coating.
5. Seat restoration with self-cure cement and allow Bond resin mix to polymerize si-
multaneously with cement.
Light-cured indirect restorations
Bond Liquid A, but do not cure.
Dual-cure/self-cure indirect restorations
Bond Liquid A/B (mix), but do not cure.
The Ratings
T
225
DENTAL ADHESIVES
´´´´
(3.7)
4b
G-Bond
GC
www.gcamerica.com
NEW
PRICES
KIT
Bottle
$112.50/5ml ($22.50/ml)
Unidose
$160.00/5ml ($32.00/ml or $3.20/dose)
SHELF LIFE
2 years
USE
COMPOSITION
4-META, phosphoric ester monomer. UDMA, silica, and
CQ in acetone and water. Filled 5% by weight.
pH
2.8
Bond Strength (MPa)
Enamel
Self-etch
20.3
Etch w/PA
30.9
Dentin
Self-etch
Etch w/PA
21.4
24.5
RAVES & RANTS
+ Unidose can be recapped
+ Can be used moist or dry
– Let sit directions not as effective
– Bond strengths w/o PA on the low end
1. Leave preparation DRY, but don’t desiccate the tooth. Moist was also effective, but
results were not as consistent as when dry was used.
2. Apply Adhesive initially with GENTLE AGITATION followed by allowing it to
sit for 20s. The manufacturer’s direction of letting it sit for 10s was not as effective
except when phosphoric acid was used to pre-etch tooth.
3. Apply MEDIUM AIR to evaporate the solvent. The manufacturer’s direction of
forceful air was also effective, but the results were not as consistent. However, when
phosphoric acid was used to pre-etch tooth, forceful air was very effective.
226
The Ratings
DENTAL ADHESIVES
´´´´
(3.7)
4c
OptiBond Solo plus
Self-Etch
Kerr
Bond Strength (MPa)
Enamel
24.6
Dentin
26.1
Probably, since dentin bond strengths using an LED exceeded those using a halogen light.
ENCORE
PRICES
KITS
REFILLS
Unidose
$162.25/10ml ($16.23/ml
or $3.25/unidose)
Bottle (adhesive)
$115.25/5ml ($22.17/ml)
Unidose (adhesive)
$202.50/10ml ($20.25/ml
or $2.03/unidose)
Bottle (self-etch primer)
$45.50/5ml ($9.10/ml)
SHELF LIFE
2 years
USES
Light-cured and dual-cure direct and indirect, metalfree restorations.
COMPOSITION
Self-Etch Primer HFGA-GDM (hexafluoroglutaric
anhydride —glycerodimethacrylate adduct), GPDM,
MEHQ (4-methoxyphenol), ODMAB (2-[ethylhexyl]-4[dimethylamino] benzoate), CQ in ethanol.
Adhesive BIS-GMA, HEMA, GDM, GPDM (glycerophosphate dimethacrylate), ethanol, fumed silica, barium
glass, sodium hexafluorosilicate, CQ (camphorquinone).
Approximately 15% filled by weight with 0.4µ glass.
2. Apply self-etch primer for 15s with GENTLE AGITATION.
3. Create a non-shiny, matte surface by using GENTLE AIR FOR THREE SECONDS.
Blotting doesn’t work since you need to evaporate the ethanol solvent. With the
unidose version, this was not a problem. With the bottle version, the surface was
substantially shinier, even after as long as 50 seconds of drying, which, of course,
would never be done clinically. This shinier surface, unfortunately, resulted in lower
bond strengths.
every five seconds or so. Note: If you are using the self-etch unidose and the
applicator that comes with it, blot the applicator after applying the self-etch primer
before entering into the adhesive chamber. Blotting the applicator to remove the
excess self-etch primer significantly increased bond strengths in our tests. However,
once you have activated the adhesive, you can’t go back to the primer with the same
applicator.
Unfilled resin or OptiBond Solo plus (apply and gently air-dry for five seconds to evaporate
the ethanol in the OS+, do not cure).
pH
Self-Etch Primer
1.9
Adhesive
2.2
RAVES & RANTS
+ Good bond strengths with light-cured indirects
+ Borrows from a great heritage
– Dual-cure version doesn’t work
– Must blot primer applicator before adhesive
The Ratings
T
227
DENTAL ADHESIVES
´´´´
(3.7)
4d
Xeno IV
Dentsply/Caulk
www.caulk.com
NEW
PRICES
KITS
Introductory Bottle
$120.00/4.5ml ($26.67/ml)
Unidose (100)
$220.00/12.5ml ($17.60/ml or $2.20/dose)
SHELF LIFE
Unidose: 2 years refrigerated
Bottle: 3 years refrigerated
USE
Light-cured direct restorations.
COMPOSITION
PENTA (dipentaerythritol penta acrylate monophosphate),
UDMA, cetylamine hydrofluoride, camphorquinone, and
two proprietary elastomeric resins (T-resin and D-Resin)
in acetone and water.
pH
Dentin
Self-etch
Etch w/PA
34.9
26.2
2.7
RAVES & RANTS
+ Highest bond strengths among one-components
+ Unit dose has mini stand
– Requires double application for dentin
– Only one-component advising against PA on
unprepared enamel
228
Bond Strength (MPa)
Enamel
Self-etch
31.9
Etch w/PA
28.2
The Ratings
Maybe not, since dentin bond strengths using an LED were lower than those using a
halogen light.
2. Apply Adhesive for 15s with SCRUBBING, then APPLY AGAIN and SCRUB FOR
ANOTHER 15s. Applying once was adequate for enamel, but not for dentin.
DENTAL ADHESIVES
Bond Strength (MPa)
Enamel
Self-etch
22.5
Etch w/PA
21.4
Contax
´´´´
(3.6)
5a
DMG/Zenith
Dentin
Self-etch
Etch w/PA
NEW
PRICES
KIT
REFILLS
$175.45/15ml ($11.70/ml) 1 btl (5ml) of Primer, Bond,
or Activator
$70.95 ($14.19/ml)
SHELF LIFE
2 years
USES
Primer + Bond Light-cured and dual-cure direct
restorations.
Primer + Bond/Activator Self-cure direct restorations.
COMPOSITION
Primer Water, maleic acid, and sodium fluoride.
Bond Hydrophilic and Bis-GMA-based resin matrix and
catalyst.
Activator Aliphatic dimethacrylate, aromatic
dimethacrylate, carboxylic methacrylate and benzoyl
peroxide.
pH
Primer
2.4
Bond
3.9
Activator
3.0
Bond/Activator (mixed)
3.4
RAVES & RANTS
26.0
23.4
Probably, since dentin bond strengths using an LED were equal to those using a
halogen light.
Direct restorations (using light-cured and dual-cure materials)
1. Leave preparation DRY, but don’t desiccate the tooth. Moist is adequate on enamel,
2.
3.
4.
5.
but is less effective on dentin.
Apply Primer for 20s with RUBBING.
Do NOT air dry. Surface of preparation will look shiny.
Apply Bond for 20s with RUBBING, then suction excess and use GENTLE AIR to
thin this layer to create an even, medium-thin, shiny coating.
Light-cure Bond for 20s.
2. Apply Primer for 20s with RUBBING.
3. Do NOT air dry. Surface of preparation will look shiny.
4. Mix Bond and Activator and apply for 20s with RUBBING, then suction excess and
use GENTLE AIR to thin this layer to create an even, medium-thin, shiny coating.
5. Light-cure Bond/Activator mix for 20s.
+ More versatile than most self-etchers
+ Relatively inexpensive
– Just mediocre bond strength with self-cure cores
– Box difficult to store on shelf
The Ratings
T
229
DENTAL ADHESIVES
Bond Strength (MPa)
Enamel
24.2
Dentin
23.2
Tyrian SPE/
One-Step Plus
´´´´
(3.6)
5b
Bisco
light.
PRICES
KITS
REFILLS
Tyrian SPE/One-Step
Plus System (bottles)
$99.00/18ml ($5.50/ml)
One-Step Plus Bottle
$89.00/6ml ($14.83/ml)
One-Step Plus Unidose (60)
One-Step Plus/Tyrian
Plus
$95.00 ($15.83/ml or
SPE Unit-Dose (40)
$1.58/unidose)
$135.00/9.2ml ($14.67/ml
or $3.38/unidose)
Tyrian SPE Unidose (25)
$54.00 ($16.62/ml or
$2.16/unidose)
SHELF LIFE
2. Apply two coats of Tyrian SPE for 10s (20s on uncut enamel) with GENTLE
AGITATION using the supplied (in bottle kit) foam pellets. In unidose kit, you are
3.
4.
5.
6.
2 years
USES
supplied with a disposable brush.
Blot excess (with foam pellet) Tyrian SPE to eliminate the purple color, but leave
preparation surface WET.
Apply Adhesive for 15s with GENTLE AGITATION adding more adhesive about
Light-cure Adhesive for 10s.
COMPOSITION
One-Step Plus (apply and gently air-dry for five seconds to evaporate the acetone, do not
cure). For self-cure indirects, use Primer B from the All-Bond 2 kit.
Adhesive BPDM (biphenyl dimethacrylate), BIS-GMA,
HEMA, acetone, 8.5% fluoroaluminosilicate glass fillers.
Tyrian SPE
Primer A Thymol blue, ethanol, water.
Primer B AMPS (3-Acrylamido — 2-methyl
propanesulfonic acid), BisMEP (Bis[2{methacryloyloxy}ethyl] phosphate), TPO, ethanol.
pH
T
Tyrian
SPE Primer A/B (bottles)
0.5
T
Tyrian
SPE Primer A/B (unidose)
0.6
One-Step Plus
4.4
RAVES & RANTS
+ Purple color reduces the guesswork
+ Will bond to self-cure composite
– Don’t overdry Tyrian or else!
– Be sure to get rid of the purple
230
The Ratings
DENTAL ADHESIVES
REALITY
TOTAL ETCH
OptiBond/
OptiBond FL
STRENGTHS It continues to be, perhaps, the adhesive
with which you really have to try hard to get poor results.
Besides its lofty results in many independent studies and
anecdotal observations, our tests confirmed it is probably
the least technique-sensitive of any adhesive. Regardless
of whether your preparation is dry, moist, or wet, it will
still work. Even if you have a heavy hand on the air syringe
when you are evaporating the alcohol solvent, it will work.
If you want to use an adhesive that doesn’t force you to
think about things such as how wet the tooth needs to be
prior to its application, this is it.
WEAKNESSES The venerable original version with the
dual-cure components is probably not necessary — the FL
version seems to be able to do everything better than its
older sibling. We also confirmed that even the dual-cure
version is not effective when luting a metal-based indirect
restoration with self-cure cement. No unidose option.
BOTTOM LINE With a clinical heritage second to none, OptiBond FL is the safe choice for all but self-cure indirects.
OptiBond Solo
plus
STRENGTHS It has been a stellar performer (along with
the original version) for over eight years, being the gold
standard for most of our direct, light-cured bond strength
tests. It was also the first with unidose packaging.
From a clinical perspective, there has been very little
post-operative sensitivity reported by the evaluators. Its
increased viscosity makes applying it very easy, with only
two evaluators reporting any problems seating an indirect
restoration after light curing it.
WEAKNESSES Dual-cure/self-cure version is just not up
to the same high standards. Our tests showed adding
the activator to the adhesive decreased its performance
virtually across the board. We do not recommend its use.
This means that self-cure procedures cannot be done
without an adhesion promoter from another vendor.
BOTTOM LINE Light-cured version still performs with consistency and reliability.
Prime & Bond
NT Prime &
NT/
Bond NT
Dual Cure
STRENGTHS No surprises. It has proven chemistry and can
work across-the-board. Our tests suggest that the original
adhesive will perform better than the dual-cure version for
virtually anything that you can light cure, which means any
metal-free restoration less than 5mm in thickness. For selfcure purposes, however, the activator is still necessary.
Regardless of whether you are using the adhesive alone
or mixed with the self-cure activator, be sure to precure it
before placing the restoration. It also has the advantage of
having a unit dose version.
WEAKNESSES Sometimes requires additional coats
when mixed with the self-cure activator to achieve shiny
surface.
BOTTOM LINE Began the single-component adhesive trend and still continues to perform admirably in most clinical situations.
One-Step Plus
STRENGTHS Second generation, filled version of the
original single-component product in this category that
bonds to self-cure materials. This property is probably
due to the fact that its pH is relatively high compared to
most other single component adhesives. Least expensive
unidose.
WEAKNESSES Even though the addition of the filler makes
it easier to coat the dentin, you definitely need to use it on
a tooth that is wet, making its application protocol critical.
BOTTOM LINE Only having to deal with one bottle definitely simplifies all the uses.
PQ1
STRENGTHS Stable chemistry and application technique
that no longer requires white-knuckled scrubbing it into
the surface of the preparation.
WEAKNESSES No option for self-cure and syringe
application may limit access in some areas.
BOTTOM LINE Satisfactory performance with the convenience of syringe delivery and the totally unique single-dose syringes.
The Ratings
T
231
DENTAL ADHESIVES
REALITY
Adper
Scotchbond
Multi-Purpose
Plus
STRENGTHS Seems to work almost as well when the tooth
is dry, compared to moist. This is a great convenience
over having to worry whether you overdried or left it too
wet and makes it a good choice for repairs, when the
restorative material that is fractured needs to be dry. And,
you don’t even have to mix anything, even with self-cure
procedures, where its bond strength with directs was the
highest. Due to its hydrophobic bonding resin, it should
overcome any water tree issues.
WEAKNESSES Decimal point components can get
confusing and enamel bond strength results were
disappointing. No unidose option.
BOTTOM LINE Versatile adhesive with a proven track record.
All-Bond 2
STRENGTHS Proven two-primer system and hydrophobic
bonding resin that should overcome the water tree
problem. Our tests show that taking advantage of all the
components will give you results that exceeded or came
very close to all of our controls. This certainly provides
peace of mind that any procedure you need to accomplish
can be handled using it.
WEAKNESSES Definitely requires a moist or even wet
dentinal surface. Reports of postoperative sensitivity are
probably related to the application technique. One study
club had numerous failures when the directions were not
followed precisely. All the various components can also be
confusing and the instructions are not always as clear as
they could be. No unidose option.
BOTTOM LINE Still the most universal and complete system available today and has stood the test of time.
Gluma Comfort
Bond +
Desensitizer
STRENGTHS Adhesive and desensitizer in one simple
bottle. By using the proven chemistry of Gluma
Desensitizer (glutaraldehyde and HEMA) and 4-META in
an ethanol/water solvent, this is a product that not only
performs well, but is also less technique-sensitive than
some of its competitors due to its ability to bond under dry,
moist, or wet conditions. Even the application method and
curing time do not seem to affect its performance very
much. The single-dose packaging was also well-received
by our evaluators, with the only concerns being that
rather large head of the applicator, which may not fit into
a small preparation very well. In addition, it registered
a surprisingly high bond strength with the self-cure
composite.
WEAKNESSES Basic bond strengths were on the low end
of the continuum and its cost is on the high end. Name is
descriptive but cumbersome.
BOTTOM LINE If you are still plagued with patients complaining of sensitivity and still prefer to use a total etch adhesive,
this product could solve your problems.
Cabrio CQ
STRENGTHS Second version of this product that we
use for all of our dual-cure and self-cure testing due to
its consistent results and ease of use. It is particularly
effective with self-cure materials, registering the highest
bond strength in the self-cure cement test in this entire
group. And, when it is used with a self-cure product, its
performance is enhanced by allowing it to cure with the
cement, a characteristic that also simplifies its use. Now
has unidose option.
WEAKNESSES Directions could be improved.
BOTTOM LINE With very good performance in most of our other tests and a reasonable price, it could be considered one of
the best buys in this category.
232
The Ratings
DENTAL ADHESIVES
REALITY
DenTASTIC
UNO•DUO
STRENGTHS Applies evenly, creates a glossy dentin
surface without additional coats, seems to dry without
wrinkles, and has one of the highest bond strengths
to dentin. Our clinical experience with UNO has been
successful, with only a few reports of sensitivity. When
using it in the self-cure mode (UNO•DUO), you should not
light cure the mixture, but allow it to chemically set on the
tooth along with the self-cure material or cement. This is
a well-researched product from an established, reliable
manufacturer that is effective in all applications.
WEAKNESSES 2:1 ratio for mixing UNO and DUO is not
intuitive and could be confusing to staff members used to
the much more common 1:1 mixing of most products. No
unidose option.
BOTTOM LINE Unsung product that deserves more attention than it gets.
Adper Single
Bond Plus
STRENGTHS Nanofilled version of the original product.
High bond strengths on dentin and, with its relatively
high pH (for single-component adhesives), it is also
able to bond to self-cure materials. From a clinical
perspective, it applies easily and virtually always gives
you that sought-after shiny surface after evaporating
the solvent. In addition, we had only two reported cases
of sensitivity when it was applied to a moist tooth, while
another evaluator tried applying it to a dry tooth and had
sensitivity.
WEAKNESSES You must be certain to use a rolling motion
with the unit dose blisters or you’ll waste a lot of material
and/or not get enough of it on the applicator, the head of
which is quite large and will probably not fit into small
preparations. What’s more, the flip-back cap on the bottle
was not universally appreciated.
BOTTOM LINE Proven chemistry and solid performance make it a strong and versatile product.
One-Step
STRENGTHS Precursor to the filled version and its overall
clinical success has been good. Will bond to all types of
composite.
WEAKNESSES Definitely need to use it on a tooth that
is wet, making its application protocol critical. Its filled
sibling outshined it in our tests. No unidose option.
BOTTOM LINE Has a longer track record than all but the original Prime & Bond among the single-components, but its
application is technique-sensitive.
PermaQuick
STRENGTHS Syringe delivery system eliminates the need
for dispensing wells, separate brushes or applicator
tips, etc. Its unique chemistry also gives PermaQuick
remarkable stability.
WEAKNESSES Only phosphoric acid-based, multicomponent adhesive on our list that will not bond to
self-cure composite. No unidose option.
BOTTOM LINE Perhaps the easiest of the multi-components to use with its signature syringe system.
SELF-ETCH
Clearfil SE
Bond
STRENGTHS Most dependable self-etching product in this
category. While its older sibling, Liner Bond 2V, has more
impressive bond strength test results, SE Bond is simpler
and easier to use. Its excellent clinical performance to
date combined with its exceptional lab results makes it
the gold standard for self-etchers. The unique dispenser
allows you to handle both bottles with one hand.
WEAKNESSES Squeezing the dispenser requires more
pressure than is normally needed to express primers from
the bottles. It can also be somewhat messy and asepsis is
compromised. Its effectiveness with indirect restorations
is mediocre and it does not bond to self-cure materials
(without the help of an adhesion promoter). No unidose
option.
BOTTOM LINE For conventional light-cured restorations, it’s the one to choose if you want to use a self-etcher.
The Ratings
T
233
DENTAL ADHESIVES
REALITY
Clearfil Protect
Bond
STRENGTHS SE Bond with an antibacterial agent and
sodium fluoride. These additional ingredients presumably
add an extra level of protection against the inevitable
microbial invasion via microleakage and may eliminate
even trying to disinfect the preparation prior to placing
restorations. While this approach is sound and there is at
least one study giving credence to its efficacy, it would be
better if it performed up to the level of SE Bond AND had
the aforementioned benefits. Fortunately, our tests show
that its performance is quite good and even exceeds the
lofty status of its brethren on enamel.
WEAKNESSES Don’t follow the manufacturer’s advice
of just letting it sit undisturbed—you should agitate the
primer on the tooth surface. Same problems as SE Bond
when it comes to indirect and/or self-cure usage. And it is
much more expensive than its sibling. No unidose option.
BOTTOM LINE Almost as good as SE Bond, but with the added antimicrobial action.
Clearfil S3
Bond
STRENGTHS Unique characteristics include a new method
to prevent phase separation of the hydrophilic and
hydrophobic ingredients, which means you don’t need
to shake the bottle or stir the unidose. While this is not a
major issue if you are conscientious in always performing
this function (shaking or stirring), it’s just one less item
about which you need to be concerned. Its bond strengths
were adequate, no sensitivity was reported regardless
of the application method, and etching enamel with
phosphoric acid before applying it had virtually no effect
on bond strength.
WEAKNESSES Recommended application protocols
produced inconsistent results. Our clinical evaluation
found two lost restorations and staining at the margins
when the application technique that we suggest was not
followed.
BOTTOM LINE Latest in the line of self-etchers from the company that essentially initiated and continues to lead the
category.
Prelude
STRENGTHS Has both total etch and self-etch versions,
but the latter variant is the prime mover and shaker. It
utilizes a different approach than most multi-component
adhesives in that both its primer and adhesive contain
a solvent. Therefore, you must apply air to the adhesive
not just to thin it out, but to evaporate the solvent. In
addition, its self-cure mode is mediated by the application
of a third component (Link) that is placed sequentially
instead of mixed. While several total etch products use
this approach, this product is the only self-etcher with
this protocol. Self-cure bond strengths using the Link
component were adequate at 5 minutes and increased
substantially after 24 hours to offer the best retention for
self-etchers. Its dentin bond strength exceeded that of
the control. Etching enamel with phosphoric acid before
applying it had virtually no effect on bond strength. Our
clinical evaluation found no lost restorations and no
sensitivity. Least expensive of the self-etchers.
WEAKNESSES Enamel bond strength was lower than the
control. No unidose option.
BOTTOM LINE Versatile product that is challenging the Clearfil dominance in this subcategory.
Clearfil Liner
Bond 2V
STRENGTHS Highest dentin bond strength with light-cured
composite of any product in this category, conventional or
self-etch.
WEAKNESSES Only reasonably adequate with dual-cure
and self-cure directs and rather poor test results with
indirects. No unidose option.
BOTTOM LINE Longest track record and second generation of the original self-etch adhesive.
234
The Ratings
DENTAL ADHESIVES
REALITY
G-Bond
STRENGTHS Only product in this category that
incorporates the well-known adhesive properties of
4-META, which has been used successfully in numerous
products in the past. No sensitivity was reported
regardless of the application method. Its unidose is
also the only one that can be recapped, which could be
important if you wanted to use it for multiple restorations
done in a sequential rather than concurrent manner.
WEAKNESSES Bond strengths, while seemingly
adequate for clinical use, are lower than the control.
Our clinical evaluation found two lost restorations
when the application technique that we suggest was
not followed, suggesting technique sensitivity. We also
found its recommended application protocols produced
inconsistent results. Etching enamel with phosphoric
acid, however, before applying it boosted bond strength
substantially. Most expensive unidose of the self-etchers.
BOTTOM LINE Proven chemistry in one bottle, but technique appears to be critical to its success.
OptiBond Solo
plus Self-Etch
STRENGTHS More than satisfactory performance for lightcured and dual-cure direct restorations, plus light-cured
indirect restorations.
WEAKNESSES Falls short of the performance of its
total etch sibling with dual-cure indirect procedures.
Interestingly, the product in the unidose packaging
performed better than that in bottles.
BOTTOM LINE OptiBond Solo plus for those who don’t want to use phosphoric acid.
Xeno IV
STRENGTHS Adapts the one-component format pioneered
by its total etch brethren, Prime & Bond, and borrows
its main ingredient, PENTA. The result is the top bond
strengths for a one-component self-etcher. Curiously, this
is the only self-etcher that specifically advises against
etching unprepared enamel with phosphoric acid and our
tests confirm that bond strengths are actually lower when
pre-etching with phosphoric acid. Has unidose option.
WEAKNESSES To achieve high dentin bond strengths, you
have to apply the adhesive twice, which is somewhat
more labor-intensive than others. In addition, the
application requires scrubbing, which is a more difficult
protocol than gentle agitation. Our clinical evaluation
found at least five lost restorations when the application
technique that we suggest was not followed. There was
also several instances of sensitivity plus three cases
of relatively severe gingival “burns” due to overflow of
adhesive onto the soft tissue.
BOTTOM LINE One-component self-etcher with Prime & Bond’s legacy has great potential, but its application protocol is
not easily achieved clinically.
Contax
STRENGTHS More conventional (and less risky) approach
to being able to bond across-the-board when it comes to
direct restorations by having the sequential application
of a primer and bond for light-cured procedures, but
you merely mix the activator with the bond for self-cure
materials. In the light-cured mode, its dentin bond
strength is right on par with the control. Etching enamel
with phosphoric acid before applying it had virtually no
effect on bond strength. Our clinical evaluation found no
incidences of sensitivity and one evaluator reported no
lost restorations after two years of use. And, even though
there is no indication by the manufacturer that it can
be used for indirect restorations, one evaluator has had
success using it in this manner.
WEAKNESSES Enamel bond strengths are somewhat
lower. With self-cure composite, bond strength was weak
at 5 minutes and only mediocre at 24 hours. One evaluator
experienced three lost dual-cure core buildups, one at the
preparation appointment and two when the provisionals
were removed at the seating appointment. No unidose
option.
BOTTOM LINE Multi-components suggest less worry about water trees, but mediocre self-cure performance may limit its
versatility.
Tyrian SPE/
One-Step Plus
STRENGTHS Etching with Tyrian SPE produced bond
strengths on par with the phosphoric acid version in the
light-cured mode. Unique purple color.
WEAKNESSES Application protocol (leave it shiny wet) that
is mandatory for optimal performance. Cannot match its
conventional sibling in the dual-cure and self-cure modes.
BOTTOM LINE Only self-etcher in this group that can be used for all types of restorations, direct or indirect.
The Ratings
T
235
DENTAL ADHESIVES
REALITY
OTHER PRODUCTS IN THIS CATEGORY
236
AdHese
Ivoclar Vivadent
Excite DSC
Ivoclar Vivadent
Solid Bond
Heraeus Kulzer
Admira Bond
Voco
FL-Bond
Shofu
Solobond M
Voco
Adper Prompt L-Pop
3M ESPE
Futurabond NR
Voco
Solobond Plus
Voco
Amalgambond Plus
Parkell
iBond
Heraeus Kulzer
Stae
SDI
Bond-1
Pentron
IntegraBond
Premier
SternOmega Bonding Agent
Sterngold
Bond-1 C&B
Pentron
Lok
SDI
Syntac
Ivoclar Vivadent
Bond-It!
Pentron
Nano-Bond
Pentron
Tenure
Den-Mat
Bond Star S
Danville Materials
One-Up Bond F Plus
Tokuyama
Tenure Quik w/FL
Den-Mat
Brush&Bond
Parkell
One Coat Bond
Coltene/Whaledent
Tenure Uni-Bond
Den-Mat
Clearfil New Bond
Kuraray
One Coat SE Bond
Coltene/Whaledent
Touch and Bond
Parkell
Clearfil Photo Bond
Kuraray
OptiBond Solo plus Dual-Cure
Kerr
UniFil Bond
GC
Copalite SnapBond
Cooley & Cooley
PowerBond
Cosmedent
Versa Bond
Centrix
DiamondBond
DRM Research Laboratories
Prime One
Mirage
Wet Bond
Mirage
Encore Bond
Centrix
S Bond
Danville Materials
Xeno III
Dentsply/Caulk
Excite
Ivoclar Vivadent
Simplicity
Apex
The Ratings

total etch self-etch - REALITY Publishing Company

Transcription

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