Bonding Agents

dental composite or white filling

 Dental Bonding Agents

Dental bonding agents vary significantly from generation to generation and even from company to company. However, basically all have an acidic conditioner, dentin primer, and bonding resin.

Cost of dental bonding agents

The cost of bonding agents is extremely high and you should ensure staff is not wasting the material.

As a reference for something that your staff can understand you can compare to the cost of gas or milk.

Milk                                               $4.34

Gas                                                 $3.18

Bisco All Bond Universal           $100,313.00

Gluma                                            $44,721.00

PMMA and composite primer  $74,572.00

Acrylic resin                                 $697.00

4th Generation dental bonding agent

Gold standard. 1 etch 2 rinse 3 prime 4 bond more technique sensitive Top 3

  • 3M Adper Scotchbond Multi-purpose plus
  • Optibond FL
  • All-Bond 2

5th Generation dental bonding agent

1 etch 2 rinse 3 prime and bond. not all adhesives in this category are compatible with DC and SC composites because the lower pH of the oxygen inhibited layer de-activate the tertiary amine in chemical cured composites.

  • Optibond Solo Plus adds a dual cure activator, benzene sulphinic-acid/sodium salt solution, to raise pH.  With that it can bond to DC and SC but the extra chemical lowers bond strength.
  • 3M Adper Single bond plus, Excite, Prime&Bond NT

6th Generation dental bonding agent

Selective etch products
Type 1 – 1 etch and prime 2 bond.

  • Clearfil SE Bond, AdheSE

Type 2

  • All-Bond SE, Adper Prompt L-Pop, Xeno III

7th Generation dental bonding agent

Selective etch with a all-in-one consistency

  • Clearfil S3 Bond
  • G-Bond, Futurabond DC, Bond Force, Xeno IV

Universal dental Bonding agents

(2011) Compatible with both total and self etch systems, some work with both dual and self cure products, primer for silica and zirconia.  Recommend to use selective etch technique or TE.  Great article from Gary Alex Jan 2015 Compendium.  From his article it appears he uses Bisco All Bond Universal and I have seen him lecture at Bisco and I also use All Bond for reasons found in article.

  1. Differs from 7th in that can bond dentin after phosphoric etch due to higher pH
  2. Contains Silane (ceramic)=useless Chen 2013 and/or acidic monomer like MDP (zirconia). Tests show a coat of silane still improves and HF is mostly responsible anyway so not sure much advantage. Burgess 2013 Even if silane in bottle doesn’t bond to silica containing ceramic Suh 2014
  • Scotchbond Universal 3M has silane and phosphate monomer.  Not DC/SC
  • All-Bond Universal Bisco said has phosphate monomer BUT said needs Z-Prime still? Burgess 2013 True only if don’t want to light cure bond on restoration Suh 2014 DC universal
  • Voco Futrabond U  is DC universal
  • Clearfil Universal Kuraray Not DC/SC
  • Prime and Bone Elect Dentsply Not DC/SC
Source
Generation Dates Dentin Bond
Strength (MPa)		 Smear Layer Products
4th Late 1980’s 20-35 Removed ALL-BOND 2, OptiBond FL., Adper Scotchbond Multipurpose
5th Early 1990s 20-30 Removed Optibond SOLO Plus, Prime & Bond NT,
Adper Single Bond Plus, Excite
6th Type I Mid-late 1990’s 15-35 Modified AdheSE,CLEARFIL SE Bond
6th Type II Mid-late 1990’s 10-30 Modified ALL-BOND SE, Adper Prompt L-Pop, Xeno III
7th Early 2000’s 20-30 Modified CLEARFIL S3 BOND, G-BOND,Futurabond DC, BOND FORCE, Xeno IV
Universal Late 2011 30-50 Modified Scotchbond Universal, Peak Universal,
ALL-BOND Universal, Optibond XTR,
Prime & Bond Elect
Universal Bonding Agent Shear Bond Strength –
Enamel (MPa)		 Shear Bond Strength –
Dentin (MPa)
Optibond XTR 39 47
Scotchbond Universal 26 (SE) / 30 (TE) 41 (SE) / 43 (TE)
ALL-BOND Universal nt 29 (SE) / 39 (TE)
Total Etch and Self Etch
Bonding Agents		 Shear Bond Strength –
Enamel (MPa)		 Superficial Dentin-(MPa)
Kerr Optibond All In One 26.3 40.4
3M ESPE Adper Scotchbond SE 34 33
All Bond TE 22 34

Universal, Total Etch and Self Etch bonding agents tested using the Shear Test. (“nt” = not tested, “SE” = self-etch, “TE” = total-etch)

Chemical impact on dental bonding

Hemostatic agents impact on dental bonding

There is a negative impact of bonding to dentin when using hemostatic agents for self-etching bonding agents.

15 seconds of etch or 60 seconds of EDTA is effective at regaining the bond strength. Etch is usually around so just do that. If using a universal bond this is great because can just switch to total etch from self-etch by simply etching the dentin.

Bernades JADA 2014

Silane contamination effect dental bonding

When repairing a porcelain fracture with exposed dentin, any silane hitting the dentin will not impact bond strength.  The silane is done before the bond step and that is how the reserach was conducted.  Chen JPD 2017

Composite Bonding Protocol

Anterior filling Total etch technique

  1. Place mylar strip and wave wedge
  2. Etch enamel 15 seconds and dentin 10 seconds then wash and dry (with bac etch)
  3. 2% CHX unknown duration 30-60 sec suggested (only beneficial on areas etched) air dry
  4. Gluma 10-20 seconds with scrubbing in dentin and air dry
  5. If deep, line dentin with RMGI (but etch and CHX steps get moved to right after this step)
  6. Step 1 Optibond Fl Prime 15 seconds scrubbing then air dry 5 sec
  7. Step 2 1 tooth?=same brush Optibond Fl Adhesive 15 seconds scrubbing then air thin 3 sec
  8. Cure
  9. Layer composite curing as needed
  10. Peel mylar strip back place flowable comp IP and pull mylar through and cure

Buccal filling Total etch technique

  1. Place #0 cord soaked in hemodent
  2. Etch enamel 15 seconds and dentin 10 seconds then wash and dry (with bac etch)
  3. 2% CHX unknown duration 30-60 sec suggested (only beneficial on areas etched) air dry
  4. Gluma 10-20 seconds with scrubbing in dentin and air dry
  5. If deep, line dentin with RMGI (but etch and CHX steps get moved to right after this step)
  6. Step 1 Optibond Fl Prime 15 seconds scrubbing then air dry 5 sec
  7. Step 2 1 tooth?=same brush Optibond Fl Adhesive 15 seconds scrubbing then air thin 3 sec
  8. Cure
  9. Layer composite curing as needed
  10. Remove cord

Posterior filling Selective etch technique

  1. Place V-ring if IP
  2. Etch enamel 15 seconds then wash and dry (with bac etch)
  3. 2% CHX unknown duration 30-60 sec suggested (only beneficial on areas etched) air dry
  4. Gluma 10-20 seconds with scrubbing in dentin and air dry
  5. If deep, line dentin with RMGI (but etch and CHX steps get moved to right after this step)
  6. Step 1 Clearfil SE Protect prime and etch 20 seconds with scrubbing then air dry
  7. Step 2 Clearfil SE Protect bond, air thin then cure 5-10 seconds
  8. Burnish metal matrix if needed
  9. Layer composite curing as needed
  10. Removal V-ring, wedge, and peel back matrx to cure IP

Finish and polish

  1. Bulk reduction excess composite
  2. Check occlusion and excursion with Troll foil
  3. Check contacts with floss
  4. Fine tune with finishing burs
  5. Polish

Total etch article is good

Kanca article on HEMA.
6 month test showing total etch maintains bond strength best
Kanca article JADA 92 on moist bonding with total etch technique
Kanca says HEMA is acting as the wetting agent, most glutaraldehyde products also contain that.

Bryan Bauer, DDS, FAGD
630-665-5550