Wednesday, February 26, 2020

Why Does Bonding Fail in both Operative and Fixed Restorative Procedures?


One of the most frustrating problems in clinical dentistry is failures in bonded restorations.  Whether it’s a newly placed crown that simply doesn’t seem to want to stay in place or a simple 2 surface composite restoration with chronic sensitivity, bonding can be both highly predictable as well as the source of unending frustrations for the clinician.

There are several points in bonded system where failure can occur.  Things such as compatible chemistries, bonding agents, the choice of total etch vs. self etch, and curing lights can all have a dramatic impact on the outcome of procedures.

Over the years, despite the development of newer bonding systems, I’ve stayed with the 5th Generation technique.  This is the technique where a total etch of both enamel and dentin is done, followed by a dentin primer and bonding agent in a single step, followed by placement of the composite.  This technique has loads of research and has also proven to provide very good bond strengths.  This technique can be used in both operative and when bonding fixed prosthetics with pretty predictable results.

In the latest issue of Dental Products Report my good buddy Laura Dorr had done a terrific article detailing the fine art of "Picking up the pieces when a dental restoration fails”.

She interviewed myself and other doctors on how we troubleshoot problems that *every* dentist has at one point or another.  Laura is very talented writer and I feel that anyone who practices dentistry should give this article a look.  You can find it on the DPR website.  

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