Dentin-adhesive cementation

A dentin adhesive bonding is a method of treatment in dentistry for attaching filling material or dental prosthesis to the tooth. The dentin surface of a cavity is chemically pretreated in that thin- bodied dentin bonding agents can penetrate the surface structures and, after chemical hardening, form a micromechanical bond between dentin and the composite filling (plastic filling). This means that macromechanical retentions, which result in a greater loss of tooth substance, can be dispensed with.

execution

The adhesive cementation of a restoration to the dentine is carried out in four steps:

Conditioning

The dentin surface is etched with 35% phosphoric acid for 15 seconds. The etching time is halved for milk teeth. Thereafter, the acid is rinsed for about 30 seconds with the air-water spray, whereby the dissolved hard substance, and the so-called smear layer ( English lubricating layer ) is removed. What remains is the dentin freed from the minerals . The remaining structures made of collagen fibers and the pores of the dentinal tubules that have been cleaned from the smear layer form the prerequisite for the micromechanical bond.

Priming

By applying a primer ( English primer ) the dentine and collagen fiber network is to receive the hydrophilic monomers prepared. Sufficient surface moisture of the dentin is necessary so that the collagen fiber network does not collapse and the monomer can penetrate it.

Acid etching technique

In contrast to dentin, the etching process ( acid etching technique ) is sufficient for tooth enamel to create microretentions in the enamel structure. The application of a low- viscosity plastic ( bonding ) creates a good mechanical bond that guarantees the marginal density of a restoration.

Application of the adhesive

The monomer is applied and penetrates the collagen fiber network into the dentinal tubules. The resulting hybrid layer is cured by light-induced polymerisation . This polymer layer is now anchored micromechanically via tags ( English cones ) in the tubules and in the penetrated collagen fiber network.

Application of the composite

Subsequently, the chemical attachment to the actual plastic filling is performed by applying a maximum of 1 mm thin layer flow ( English low-viscosity composite ) that enhances the hybrid layer. This is also cured by light-induced polymerisation.

Applications

The dentin adhesive technique is also used in prosthetics for the attachment of crowns made of lava zirconium, Empress ceramic or other ceramics , e.g. B. Cerec used.

Individual evidence

↑ ^a ^b Peter Gängler, Thomas Hoffmann, Brita Willershausen: Conservative Dentistry and Periodontology . Georg Thieme Verlag, March 24, 2010, ISBN 978-3-13-154073-7 , pp. 188–.
↑ Klaus M. Lehmann, Elmar Hellwig, Hans-Jürgen Wenz: Dental Propaedeutics: Introduction to Dentistry; with 32 tables . Deutscher Ärzteverlag, 2012, ISBN 978-3-7691-3434-6 , p. 42–.
↑ Aesthetic Dentistry Josef Schmidseder Volume 15 of the Color Atlases of Dentistry 2009 (2nd, completely revised and expanded edition), published by Thieme Verlag Stuttgart - New York: pp. 103 ff. And p. 194. ISBN 3-13-100452- 5 .

[GänglerHoffmann2010-1] Peter Gängler, Thomas Hoffmann, Brita Willershausen: Conservative Dentistry and Periodontology . Georg Thieme Verlag, March 24, 2010, ISBN 978-3-13-154073-7 , pp. 188–.

[2] Klaus M. Lehmann, Elmar Hellwig, Hans-Jürgen Wenz: Dental Propaedeutics: Introduction to Dentistry; with 32 tables . Deutscher Ärzteverlag, 2012, ISBN 978-3-7691-3434-6 , p. 42–.

[3] Aesthetic Dentistry Josef Schmidseder Volume 15 of the Color Atlases of Dentistry 2009 (2nd, completely revised and expanded edition), published by Thieme Verlag Stuttgart - New York: pp. 103 ff. And p. 194. ISBN 3-13-100452- 5 .