DentaltownUK August 2017 - 28
Fig. 1
Fig. 2
self-etch adhesive over the entire surface of the
tooth to be bonded.
Newer, simplified self-etch materials have
milder acids incorporated into the system and
do not require phosphoric acid etching. Self-etch
adhesives that eliminate the 'etch, wash and
dry' step streamline the adhesive portion of the
restorative process.
Efficacy of total-etch versus self-etch adhesives
has been the subject of much debate. According
to one study on primary enamel that compared
total-etch versus self-etch systems in vitro, no
statistically significant difference was found in efficacy.7,8 A study comparing
microleakage and beveling versus nonbeveling of cavo-surface margins, as well
as total-etch and self-etch systems to primary and permanent teeth, found
less microleakage with total-etch systems. However, the effect of the beveled
or nonbeveled cavo-surface margin was of greater significance in reducing
microleakage than the type of adhesive system used.9
Given the simplicity of use of self-etch universal systems and similar efficacy,
for paediatric patients, a simpler choice of a self-etch adhesive is the better choice.
Use of adhesives in primary enamel in paediatric dentistry
Fig. 3
Can it be assumed that primary and permanent tooth structure behave
similarly?
Manufacturer directions for use of adhesives don't differentiate between
primary and permanent tooth structures. There are no products in existence for
use solely on primary teeth. We must ask if the morphology of primary versus
permanent teeth warrants a difference in technique for adhesion, but clinical
studies of primary dentition adhesion are scarce.10,11
In the available literature, an aprismatic zone is reported in primary enamel.
An aprismatic zone is more highly mineralised because of the perpendicular
alignment of the crystals, and a longer etching time has been suggested as
being required.12 That zone has been reported as inconsistent, however, and
reported frequency and distribution ranges from less than 20 percent to as
much as 100 percent.13-15 Several studies do show that bond strength, in general,
interfacial micromorphology and adaptation to primary and permanent enamel
and dentin are similar in primary and permanent teeth.16-26
Techniques using universal self-etch adhesives
Use of universal self-etch adhesives in paediatric dentistry offer many
advantages to dentists and patients. Universal self-etch adhesives offer flexibility
of technique. Universal self-etch adhesives work well with multiple clinical
procedures: self-etch technique (otherwise called nonetch technique), total-etch
technique and selective-etch techniques.
The self-etch technique is particularly useful for noncompliant patients,
when a phosphoric acid etch and a thorough wash-and-dry simply can't be
28
AUGUST 2017 // dentaltownuk.com
http://www.dentaltownuk.com
Table of Contents for the Digital Edition of DentaltownUK August 2017
Cover
On Dentaltown.com
Editorial with Mike Gow
Meet the Team
Howard Speaks: Drive-Thrus and Dentistry
Endodontic Reboot: Part One
Classified Listings
Brand Advertising
A United Voice
Adhesion in Primary Dentition Restorative Dentistry
Additive Dentistry
Zero Moment of Truth
Through the Keyhole
Message Boards: Re-treats question
Due Diligence—A Vendor's Perspective
Message Boards: Antibiotics after Surgical Extraction
Adding Value to the Patient Experience
Lifestyle
Poll: General Dentistry
CE Update
Students Section
Wishlist
DentaltownUK August 2017 - Cover
DentaltownUK August 2017 - Cover2
DentaltownUK August 2017 - 3
DentaltownUK August 2017 - 4
DentaltownUK August 2017 - On Dentaltown.com
DentaltownUK August 2017 - Editorial with Mike Gow
DentaltownUK August 2017 - 7
DentaltownUK August 2017 - Meet the Team
DentaltownUK August 2017 - 9
DentaltownUK August 2017 - Howard Speaks: Drive-Thrus and Dentistry
DentaltownUK August 2017 - 11
DentaltownUK August 2017 - Endodontic Reboot: Part One
DentaltownUK August 2017 - 13
DentaltownUK August 2017 - 14
DentaltownUK August 2017 - Classified Listings
DentaltownUK August 2017 - 16
DentaltownUK August 2017 - 17
DentaltownUK August 2017 - 18
DentaltownUK August 2017 - 19
DentaltownUK August 2017 - 20
DentaltownUK August 2017 - 21
DentaltownUK August 2017 - 22
DentaltownUK August 2017 - Brand Advertising
DentaltownUK August 2017 - 24
DentaltownUK August 2017 - A United Voice
DentaltownUK August 2017 - Adhesion in Primary Dentition Restorative Dentistry
DentaltownUK August 2017 - 27
DentaltownUK August 2017 - 28
DentaltownUK August 2017 - 29
DentaltownUK August 2017 - 30
DentaltownUK August 2017 - 31
DentaltownUK August 2017 - Additive Dentistry
DentaltownUK August 2017 - 33
DentaltownUK August 2017 - Zero Moment of Truth
DentaltownUK August 2017 - 35
DentaltownUK August 2017 - 36
DentaltownUK August 2017 - Through the Keyhole
DentaltownUK August 2017 - 38
DentaltownUK August 2017 - 39
DentaltownUK August 2017 - 40
DentaltownUK August 2017 - 41
DentaltownUK August 2017 - Message Boards: Re-treats question
DentaltownUK August 2017 - 43
DentaltownUK August 2017 - 44
DentaltownUK August 2017 - 45
DentaltownUK August 2017 - 46
DentaltownUK August 2017 - 47
DentaltownUK August 2017 - 48
DentaltownUK August 2017 - 49
DentaltownUK August 2017 - 50
DentaltownUK August 2017 - 51
DentaltownUK August 2017 - Due Diligence—A Vendor's Perspective
DentaltownUK August 2017 - 53
DentaltownUK August 2017 - 54
DentaltownUK August 2017 - 55
DentaltownUK August 2017 - Message Boards: Antibiotics after Surgical Extraction
DentaltownUK August 2017 - 57
DentaltownUK August 2017 - 58
DentaltownUK August 2017 - 59
DentaltownUK August 2017 - Adding Value to the Patient Experience
DentaltownUK August 2017 - 61
DentaltownUK August 2017 - Lifestyle
DentaltownUK August 2017 - 63
DentaltownUK August 2017 - 64
DentaltownUK August 2017 - 65
DentaltownUK August 2017 - 66
DentaltownUK August 2017 - 67
DentaltownUK August 2017 - 68
DentaltownUK August 2017 - 69
DentaltownUK August 2017 - 70
DentaltownUK August 2017 - 71
DentaltownUK August 2017 - 72
DentaltownUK August 2017 - 73
DentaltownUK August 2017 - Poll: General Dentistry
DentaltownUK August 2017 - 75
DentaltownUK August 2017 - CE Update
DentaltownUK August 2017 - 77
DentaltownUK August 2017 - Students Section
DentaltownUK August 2017 - 79
DentaltownUK August 2017 - 80
DentaltownUK August 2017 - 81
DentaltownUK August 2017 - 82
DentaltownUK August 2017 - 83
DentaltownUK August 2017 - 84
DentaltownUK August 2017 - 85
DentaltownUK August 2017 - 86
DentaltownUK August 2017 - 87
DentaltownUK August 2017 - Cover4
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