Dentin bonding agent /certified fixed orthodontic courses by Indian dental academy

Definition of Dentin BondingDefinition of Dentin Bonding
AgentsAgents
The dentin bonding agents are di or multiThe dentin bonding agents are di or multi
functional organic molecules that containfunctional organic molecules that contain
reactive groups which interact with dentinreactive groups which interact with dentin
and the monomer of the restorative resinand the monomer of the restorative resin
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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REQUIREMENTS DENTINREQUIREMENTS DENTIN
BONDING AGENTSBONDING AGENTS
When developing a clinically acceptable dentin bonding agentWhen developing a clinically acceptable dentin bonding agent
following goals must be met.following goals must be met.
Bond strength – The adhesive should be capable of achieving anBond strength – The adhesive should be capable of achieving an
acceptable bond strength to withstand the stresses caused byacceptable bond strength to withstand the stresses caused by
polymerization contraction of compostes. Optimum bond strengthpolymerization contraction of compostes. Optimum bond strength →→
17 Mpa – 20 Mpa.17 Mpa – 20 Mpa.
Biocompatibility of the material. The adhesion used should beBiocompatibility of the material. The adhesion used should be
biocompatible with structures in contact with it.biocompatible with structures in contact with it.
Long-term durability of the bond it is a highly desired factor.Long-term durability of the bond it is a highly desired factor.
Prevents microleakage by reduced gap formation between toothPrevents microleakage by reduced gap formation between tooth
structure and restorative material.structure and restorative material.
Have to potential for sensitization of patients or operators.Have to potential for sensitization of patients or operators.
Be compatible with a wide range of resins.Be compatible with a wide range of resins.
Show no reduction in bond strength when applied to moist surface.Show no reduction in bond strength when applied to moist surface.

ADHESIONADHESION
DefinitionDefinition ::
is a process of solid and / or liquid of oneis a process of solid and / or liquid of one
material (adhesive/adherent) with anothermaterial (adhesive/adherent) with another
(adhered) at a single interface. Most instance of(adhered) at a single interface. Most instance of
dental adhesion are also called “Dentaldental adhesion are also called “Dental
Bonding”.Bonding”.
Adhesive is defined by the “American society forAdhesive is defined by the “American society for
testing and materials” as a substance capable oftesting and materials” as a substance capable of
holding materials together by surfaceholding materials together by surface
attachment.attachment. www.indiandentalacademy.comwww.indiandentalacademy.com

Adhesion (according to DCNA 1993)Adhesion (according to DCNA 1993)
can be classified as:can be classified as:
Chemical.Chemical.
Mechanical.Mechanical.
Physical.Physical.
Physical adhesion is by Vander Waals or otherPhysical adhesion is by Vander Waals or other
electrostatic interactions is relatively weak.electrostatic interactions is relatively weak.
Chemical adhesion involves bonding at the atomic orChemical adhesion involves bonding at the atomic or
molecular level.molecular level.
Mechanical adhesion is based on retention by theMechanical adhesion is based on retention by the
interlocking of one phase into the surface of the other.interlocking of one phase into the surface of the other.

Mechanical is can be due to:Mechanical is can be due to:
Geomechanical effectsGeomechanical effects – These are– These are
caused by mircosopie porosity orcaused by mircosopie porosity or
roughness of the surface i.e.roughness of the surface i.e.
mechanical locking provided due tomechanical locking provided due to
undercuts, grooves.undercuts, grooves.
Rheological effectsRheological effects – This is caused– This is caused
by the flow of the materials in bothby the flow of the materials in both
liquid or semi solid phase e.g. use ofliquid or semi solid phase e.g. use of
adhesives or cements to hold twoadhesives or cements to hold twowww.indiandentalacademy.comwww.indiandentalacademy.com

Requirements for adhesion:Requirements for adhesion:
These must beThese must be good wettinggood wetting inin
order to produce good bonding.order to produce good bonding.
Surface to be joined must beSurface to be joined must be
cleaned.cleaned.

CHEMISTRY OF ADHESIVECHEMISTRY OF ADHESIVE
AGENTS (Op Dent Supp/1992; 5)AGENTS (Op Dent Supp/1992; 5)
The dentin adhesives are characterizedThe dentin adhesives are characterized
by containing monomers that haveby containing monomers that have
hydrophilic or hydrophobic groups.hydrophilic or hydrophobic groups.
The polymerized adhesive system shouldThe polymerized adhesive system should
provide aprovide a stable linkstable link with structurewith structure
and bulk of the restoration.and bulk of the restoration.

HYDROPHOBIC –AWAY FROMHYDROPHOBIC –AWAY FROM
WATERWATER
HYDROPHILLIC-WATREHYDROPHILLIC-WATRE
FRIENDLYFRIENDLY

Chemistry of adhesiveChemistry of adhesive
agents can be explained asagents can be explained as
follows:follows:
ChemicalChemical adhesion.adhesion.
Adhesion byAdhesion by coupling agentcoupling agent..
Adhesion byAdhesion by Grafting reactionGrafting reaction..

Chemical adhesionChemical adhesion
These are of two types:These are of two types:
ByBy primary valence forcesprimary valence forces →→ which can be by:which can be by:
Covalent bonds – strongestCovalent bonds – strongest
Co-ordinative bondsCo-ordinative bonds
Ionic bondsIonic bonds
ByBy secondary valence forcessecondary valence forces →→ which can be:which can be:
Intermolecular attraction (Vander Waals forces).Intermolecular attraction (Vander Waals forces).
Hydrogen bonds.Hydrogen bonds.

Adhesion by coupling agentsAdhesion by coupling agents
Coupling agents utilizing the conceptCoupling agents utilizing the concept
ofof hydrophobic and hydrophilichydrophobic and hydrophilic groupsgroups
are the monomers based on phosphateare the monomers based on phosphate
or phosphonates.or phosphonates.
Phosphate groupPhosphate group (hydrophilic)(hydrophilic) reactsreacts
with calcium ions of dentin.with calcium ions of dentin.

DENTIN BONDING AGENTSDENTIN BONDING AGENTS
MAY ACTMAY ACT
By way ofBy way of chemical reaction.chemical reaction.
By their ability to penetrate not only theBy their ability to penetrate not only the
dentinal tubules but also thedentinal tubules but also the intertubularintertubular
substancesubstance of the surface layer of dentinof the surface layer of dentin
known as “intertubular bonding”.known as “intertubular bonding”.

PHYSICOCHEMICAL ASPECTSPHYSICOCHEMICAL ASPECTS
It involves theIt involves the interfacial attractioninterfacial attraction betweenbetween
the tooth surface and the adhesive.the tooth surface and the adhesive.
Each treatment of the dentin leaves it to aEach treatment of the dentin leaves it to a
specific conditionspecific condition that requires specificthat requires specific
polarity and solubility parameters of thepolarity and solubility parameters of the
ensuing treatment in the bonding procedure.ensuing treatment in the bonding procedure.
If this requirement is met, the bonding systemIf this requirement is met, the bonding system
will possesswill possess maximum efficacymaximum efficacy (Amussen and(Amussen and
Uno, 1992).Uno, 1992). www.indiandentalacademy.comwww.indiandentalacademy.com

Factors affecting adhesionFactors affecting adhesion
There must be anThere must be an intimate contactintimate contact between toothbetween tooth
structure and restorative materials.structure and restorative materials.
Salivary and / orSalivary and / or blood contamination.blood contamination.
MoistureMoisture contamination from handpiece or air-watercontamination from handpiece or air-water
syringes.syringes.
OilOil contamination of handpieces or air-water syringes.contamination of handpieces or air-water syringes.
Surface roughnessSurface roughness of tooth surface.of tooth surface.
Mechanical undercutsMechanical undercuts in tooth preparation.in tooth preparation.
Presence ofPresence of plaque, calculus, intrinsic stains orplaque, calculus, intrinsic stains or
debris.debris.

Problems in bondingProblems in bonding
EnamelEnamel is 92% inorganic (hydroxyapatite) by volumeis 92% inorganic (hydroxyapatite) by volume
dentin has about 65% inorganic component and rest beingdentin has about 65% inorganic component and rest being
collagen and water.collagen and water.
DentinDentin is more hetrogenous in nature.is more hetrogenous in nature.
HydroxyapatiteHydroxyapatite crystals incrystals in enamelenamel are regularly arranged,are regularly arranged,
where as inwhere as in dentindentin are randomly arranged in an organicare randomly arranged in an organic
matrix.matrix.
Within theWithin the dentindentin there are many variations in thethere are many variations in the
substrate –substrate –
Change in volume of dentimal tubules (1%) near surfaceChange in volume of dentimal tubules (1%) near surface
towards the pulp (22%) of surface.towards the pulp (22%) of surface.www.indiandentalacademy.comwww.indiandentalacademy.com

Sclerosed dentinSclerosed dentin, if present is difficult to, if present is difficult to
penetrate.penetrate.
Presence ofPresence of smear layersmear layer reduces the bond strength.reduces the bond strength.
Presence of surface deposits such asPresence of surface deposits such as plaque,plaque,
calculus, pellicle etc.calculus, pellicle etc.
Dentin isDentin is hydrophilichydrophilic while most adhesives arewhile most adhesives are
hydrophobichydrophobic

MECHANISM OF BONDINGMECHANISM OF BONDING
(LATEST DISCOVERIES)(LATEST DISCOVERIES)
The adhesion agents bonds toThe adhesion agents bonds to
dentin via thedentin via the chemical or micromechanicalchemical or micromechanical
bond.bond.
TheThe chemical bondchemical bond is generated between theis generated between the
intertubular dentin and the primer throughintertubular dentin and the primer through
the primer’s bifunctional molecules –the primer’s bifunctional molecules –
“intertubular bonding”.“intertubular bonding”.
TheThe micromechanical bondmicromechanical bond is obtainedis obtained
through a double mechanism:through a double mechanism:
The bonding agent penetration inside theThe bonding agent penetration inside thewww.indiandentalacademy.comwww.indiandentalacademy.com

Creation of resin –Creation of resin – Dentine into diffusingDentine into diffusing
area.area. Called hybrid layer – This area isCalled hybrid layer – This area is
created by the penetration of liquid resincreated by the penetration of liquid resin
into the etched dentin, and its thicknessinto the etched dentin, and its thickness
will be determined by the relation betweenwill be determined by the relation between
the depth of action of the etching acid andthe depth of action of the etching acid and
the penetration capacity of the resin itself.the penetration capacity of the resin itself.

Dentin Adhesive SystemDentin Adhesive System
Components of dentin adhesive systems:Components of dentin adhesive systems:
The three main components are:The three main components are:
A)A) Conditioner.Conditioner.
B)B) Primer.Primer.
C)C) Bonding agents / adhesives.Bonding agents / adhesives.

Conditioner:Conditioner:
Conditioning of dentin is defined as anyConditioning of dentin is defined as any
alteration of the dentin done after the creation ofalteration of the dentin done after the creation of
dentin cutting debris usually termed the smeardentin cutting debris usually termed the smear
layer.layer.
Objective:Objective:
To create a surface capable of micromechanicalTo create a surface capable of micromechanical
and possibly. Chemical bonding to a dentinand possibly. Chemical bonding to a dentin
bonding agent.bonding agent.
Principal effects of conditioner on the dentin are:Principal effects of conditioner on the dentin are:
Physical changes.Physical changes.www.indiandentalacademy.comwww.indiandentalacademy.com

Physical changes:
Increase or decrease in morphology of smearIncrease or decrease in morphology of smear
layer.layer.
Changes in the shape of dentinal tubulesChanges in the shape of dentinal tubules

.Chemical Changes:.Chemical Changes:
- Modification of the function of organic
matter (usually about 20% by
volume).
- Decalcification of the inorganic
portion.

Chemical Changes:Chemical Changes:
Modification of the function of organicModification of the function of organic
matter (usually 20% by volume)matter (usually 20% by volume)
Decacification of inorganic portion.Decacification of inorganic portion.

Conditioning of dentin
i) Chemical modification
a. Acidic conditioner.
b. Calcium chelators.
ii) Thermal modifications
a. Lasers.
iii) Mechanical modifications
Microabrasionwww.indiandentalacademy.comwww.indiandentalacademy.com

Conditioners employed
i) 17% EDTA (Gluma).
ii) 1% Nitric acid.
iii) Tenure (Ferric oxalate).
iv) Aluminium oxalates.
v) 37% phosphoric acid (All bond-10%).
vi) 2.5% maleic acid
vii) 10% citric acid.
Hard tissue lasers viz. Pulsed Nd: YAG lasers

Smear layerSmear layer
Subsequent to instrumentation of theSubsequent to instrumentation of the
tooth,the natural deposits composed oftooth,the natural deposits composed of
microcrystalline cutting debrismicrocrystalline cutting debris
embeded with in the denaturedembeded with in the denatured
collagen is formed on the cut surfacecollagen is formed on the cut surface
known as smear layer.known as smear layer.

The smear layer and smear plugs thus actsThe smear layer and smear plugs thus acts
as barrier to the fluid movement to theas barrier to the fluid movement to the
surface via the tubules and may also limitsurface via the tubules and may also limit
the access of microorganisms and toxins tothe access of microorganisms and toxins to
the pulp.the pulp.
Removal of the smear plugs increase theRemoval of the smear plugs increase the
permeability of dentin 5-20 times (Pashleypermeability of dentin 5-20 times (Pashley
1989) and the following fluid movement1989) and the following fluid movement
would then be detrimental for adhesion .would then be detrimental for adhesion .www.indiandentalacademy.comwww.indiandentalacademy.com

PrimersPrimers
Primer is defined as a chemical capable ofPrimer is defined as a chemical capable of
improving the wettability of adherents orimproving the wettability of adherents or
capable of being corporated into the surfacecapable of being corporated into the surface
of the substrate to form chemical bondof the substrate to form chemical bond
across the interfaceacross the interface

Role of primer:Role of primer:
- Increase the surface wettability and
spreadability of the monomer.
- Stabilize the collagen fibers.
- Restores the surface energy.
- Enhances the monomer penetration.

Bonding AgentsBonding Agents
1) Bonding via the dentinal tubules to etched
dentine.
2) Formation of precipitates on pretreated
dentinal tubules with the adhesive resin
bonding either chemically or mechanically.
3) Chemical union to the inorganic, organic or
both the components.

Dentin bonding agents
can be classified as-

Polyurathanes
Polyacrylic acids
Organic phosphonatesOrganic phosphonates
Mellitic anhydride plus methyl methacryate
Hydroxyethyl methacrylate and glutaraldehyde
Ferricoxalate www.indiandentalacademy.comwww.indiandentalacademy.com

On the basis of chronology,On the basis of chronology,
chemistry and shear bondchemistry and shear bond
strength:strength:

Category ICategory I
Include dentinal adhesives which produces shear bond
strength values of 5-6 MPa.
Examples:
- Scotchbond dual cure.
- Dentin adhesit.
- Gluma.
The failures occurred at the interface or in the resin

Category IICategory II
Included the experimental and commercial products
derived from Bowen’s work with ferric and aluminum
oxalates and have produced shear bond strength values
between 8-14 MPa.
Examples:
- Tenure.
- Mirage bond.
As the strength increased, wettability also
increased.

Category III:Category III:
Included dentinal adhesives which produced shear
bond strength values of about 1720 MPa
Examples:
- Superbond
- Scothchbond-2
Scotchbond multipurpose

On the basis ofOn the basis of
Generation:Generation:
Seven generations are available.Seven generations are available.

First generation dentin
bonding agents
i) Glycophosphoric acid dimethacrylate.
ii) Cyanoacrylates.
iii) N-phenyl glycine and glycidyl methacrylate
(NPG-GMA).
iv) Polyurethane.


This mainly consisted of a surface activeThis mainly consisted of a surface active
compomer viz. NPG-GMA, added to BIS-compomer viz. NPG-GMA, added to BIS-
GMA resin to facilitate adhesion.GMA resin to facilitate adhesion.

The NPG-GMA acted as an adhesionThe NPG-GMA acted as an adhesion
promoter between the tooth structure andpromoter between the tooth structure and
resin material by chelating with surfaceresin material by chelating with surface
calcium.calcium.

Disadvantages of 1Disadvantages of 1stst
generationgeneration
bonding agents:bonding agents:
1. Hydrolysis of glyco-phosporic acid dimethacrylate in
the oral environment.
2. Difficulty in bulk polymerization of the cyanoacrylates.
3. Instability of NPG-GMA in solution.

Second Generation
Dentin Bonding System:
The agents used were:
i) Halophosphorous esters of Bisphenyl A glycidal
methacrylation (BIS-GMA).
ii) Polyurethans: It requires the presence of a
smear layer.

Bonding mechanisms involves improvedBonding mechanisms involves improved
wetting of the surface and ionic interactionwetting of the surface and ionic interaction
between the phosphate group and calciumbetween the phosphate group and calcium
of the tooth.of the tooth.
eg.Clearifileg.Clearifil

Disadvantage:Disadvantage:
It was not possible to achieve a long-lasting bond
possibly due to:
a) Low bond strength.
b) Hydrolysis of the phosphate calcium bond.

Third Generation
Bonding Systems:
- This generation DBA requires either removal,
modification or dissolution of the smear layer.
These agents used a conditioning step on the
dentin in conjunction with a bonding agent.
- The chemistry of these agents is more diverse than
2nd
generation systems and includes various agents
for conditioning the dentin.

example of third generation is Oxalate .
Scotch Bond
XR PRIMERXR PRIMER

Disadvantages of 3Disadvantages of 3
generation system:generation system:
1) increased chair side complexity.
2) More time consuming.
3) Technique sensitive.

Fourth Generation Bonding
System
The fourth generation bonding systems are based on the
complete removal of smear layer.
- It allows the use of both conservative and alt etch
technique.
- Also know as universal bonding systems as these bond
to dentin, enamel, amalgam, porcelain, composite.

Mechanism of bonding
- Diffusion and impregnation of resin into the
substrate of partially decalcified dentin followed by
polymerization creating a hybrid resin reinforced
layer.
- The hybrid layer formed is an acid resistance
mixture of polymerize and tooth structure
components creating a resin / dentin composite.

Probond:Probond:
a) Primer : Acetone / ethanol
PENTA
b) Resin: UDMA
PENTA
Glutaraldehyde

Liner bond 2 (Kurary,
Japan)
This system introduced the concept of no rinse self-
etching primer.
a) Primer: Pheny P
HEMA
5-NMSA
b) Bonding resin BIS-GMA
Colloidal silica
MDP

Amalgam bond:Amalgam bond:
) Conditioner: 10% citric acid
3% ferric chloride
b) Primer: HEMA with water
c) Resin: 4 META
- MMATBB (Methyl methacrylate tri-N-butylchlorine)

All bond:
All bond is a unique development in
the field of adhesive dentistry.
It is a universal bonding system that
will bond composite to all dental
related surface. Dentin, enamel, metal
alloy amalgam, porcelain and
composite.
It is also the only system that allows
the use of both the conservative and
all etch techniuqe.www.indiandentalacademy.comwww.indiandentalacademy.com

Mechanism of bonding:
- Bonding occur by hybridization.
- Research by Nakayabashi has shown that strong
bond is formed between dentin and resin when a
monomer such as 4-META, penetrates the tissue
and polymers.
The resin impregnation creates a transitional “Hybrid
layer that is neither resin not tooth, but a hybrid o the
two. This direct chemical interaction which the inter
tubular dentin is the key to bond strength

Advantages of All-Bond
- Bond strength – 18MPa.
- Leaves no residue on dentine surface (because of
semi-gel form).
- Wets better.
- Rinse easier.
- Bonds to wet surface.
All-bond provides a special resin called “Pre-bond” to be
used in place of light curing bonding resin when
cementing inlays, onlay or crown

Fifth Generation DentinFifth Generation Dentin
Bonding SystemsBonding Systems
The distinct characteristic of the so-called fifth generation
is the combination of the primer and bonding resin
application steps to achieve bonding with a one
component resin formula. (One bottle bonding system).
These systems rely on the hybridization of dentine
for achieving adhesion.

ADVANTAGESADVANTAGES
1) One step.
2) Single step system.
3) Bond strength – 27-29 MPa.
4) High resistance to microleakage.
5) It has low film thickness 10-20 µm and so it
is effective for indirect procedures as well.
6) Bonds to moist dentine.
7) Chemistry same as All bond.

Advantages of VAdvantages of Vthth
generation:generation:
- Increased bond strength.
- Less technique sensitive.
- Reduce treatment time.

Sixth Generation DentinSixth Generation Dentin
Bonding SystemBonding System
Example – Clearfil bond 2 system (Kurrary Co.).
- In this etchant and primer are combined. Also
known as self etching primer.
- It contains phosphate derivatives of hydrophilic
monomer such as phenyl-P (20-205%).

Biocompatibility of Dentin
Bonding Agents

First generation DentinFirst generation Dentin
bonding agentbonding agent
- A very limited number of reports have been
published on the biocompatibility of the first
generation DBA (which may be due to their
inferior physical properties).
- Van Leeuwen et al showed no severe reactions
even in extremely deep caries in their study
carried out on monkey teeth.

Second generation DBASecond generation DBA
- The most of the studies are carried out
using Scotch bond.
- Scotch bond might have an adverse effect
on the pulp tissue when placed in contact
with vital tooth and proper pulpal
protection was recommended.

Third generation:Third generation:
Test carried out showed that the bondingTest carried out showed that the bonding
material as well as the individual componentsmaterial as well as the individual components
were not toxic.were not toxic.

It involves a time consuming procedure.It involves a time consuming procedure.
Long term durability of bonding is yetLong term durability of bonding is yet
under speculationunder speculation
High cost factor involved limits its use inHigh cost factor involved limits its use in
every patient.every patient.
Shelf life is limited and storageShelf life is limited and storage
conditioners have to be critical.conditioners have to be critical.

Conclusion:Conclusion:
The reliability of dentine bonding has improved during
1990s and as a result the number of minimally invasive
techniques available to the restorative dentist have
increased. It may be anticipated that the effectiveness
of adhesive technique to be dentin will improve further
and that in due course all restorations including
crowns, will be placed using an adhesive procedure and
that reattachment technique will become the accepted
mode of treatment for fractured cusps and teeth.

ConclusionConclusion
The reliability of DB has improved duringThe reliability of DB has improved during
1990s and as a result minimally invasive1990s and as a result minimally invasive
technique available to restorative dentisttechnique available to restorative dentist
have increased.have increased.

Thank you
For more details please visit
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Dentin bonding agent /certified fixed orthodontic courses by Indian dental academy

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