restorative
feature
Posterior Composites and Universal
Bonding Agent Applications in the
Modern Dental Practice
by Gary M. Radz, DDS
Composite resins continue to increase in use and popularity
over the past 30 years1. Class II composites are one of the most
common restorations provided in today's general practice. Recent
studies suggest that newer generations of composites and bonding
agents provide the potential for composites to have a similar or
even better long-term success rate than amalgams2. Newer composites now have nano-hybrid particles that are highly filled and
have very low polymerization shrinkage. These improved physical
properties could allow for even better longevity. Since 1955-after
Dr. Michael Buonocore published his industry changing paper of
how it was possible to increase the adhesion of dental materials to the
enamel surface3 -the dental industry has been working to create the
perfect bonding system. For nearly 60 years we have certainly seen
dramatic improvements in bonding technology with systems that
provide better adhesion to enamel and dentin, that are also easier and
faster to use clinically.
The recent introduction of universal bonding systems has provided dentists with the opportunity to decide whether a total-etch,
a selective-etch, or a self-etch technique is best for any particular
restoration. These bonding systems now allow dentists to reduce
their bonding agent inventory to just one product that can be used
in all situations. Even though research has demonstrated that both
total-etch and self-etch bonding can have successful outcomes4,
many dentists want to choose which technique they'd prefer in
any given clinical situation based on his or her clinical experience.
The following case studies will demonstrate the use of the
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newest generation of composites in combination with a universal
bonding system in different combinations based on the given clinical situation and the clinician's preference based on his experience.
Case Study #1
A patient presented with failing posterior restorations. #3 has
a leaking Class I composite, two Class VI lesions, recurrent decay
present radiographically under a Class II amalgam and recurrent
decay noted radiographically under a Class II amalgam on #5
(Fig. 1). The patient is aesthetically aware and requests replacement with tooth-colored fillings.
Fig. 1
Figure 1. Preoperative view of teeth with failing restorations
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Table of Contents for the Digital Edition of Dentaltown February 2015