DentaltownUK April 2017 - 45

there's a gap at the pulpal floor. (The ethanol is attracted to the water in the tubules and moves
toward it, dragging the resin with it. Then when you cure it those fingers of resin form, sealing
off the tubules and blocking the sensitivity.)
If the layer's too dry, the ethanol can't penetrate to get to the tubules. If it's too wet, the ethanol gets stuck in that water. Either way, you get a gap between the pulpal floor and the composite,
and the composite flexes during force, stimulating the open tubules. That's one cause. Another
is curing the composite too fast with both buccal and lingual cusps connected, so the shrinking
composite pulls on them. Proper layering where you don't connect buccal-lingual cusps together
solves that. Pulse curing is vital with most composites to reduce the rate of shrinkage. The bulk
cures work because the molecules bond together differently, not creating that force.
For what it's worth, I've never used Gluma-I only use Vitrebond as a quick temporary. I
rarely have sensitivity with composites, never with bulk-fills, and replacing the composite has
always solved the sensitivity. I believe that last week I read that uncured resins do not cause sensitivity. Could be wrong about that, but someone we all know wrote something to that effect. ■

8/6/2016

I use a selective enamel etch with phosphoric acid gel, then use a self-etching primer on
enamel and dentin (Clearfil SE) for my bonding protocol. Rarely ever get postop sensitivity.
Problem with using etch-and-rinse systems is that not all the demineralized dentin gets penetrated by the primer, causing water movement and resultant pain. Self-etching primers don't
have this problem, because etching and priming are done simultaneously. However, the acid is
weak for uncut enamel; hence, the selective enamel etch with phosphoric acid. ■

adventure
Member Since: 09/04/16
Post: 38 of 62

9/11/2016

Apex makes Surpass and Simplicity and both work wonderfully but Simplicity is even easier
to use. The key is the etch bottle #1 leaves the dentin wet, and not desiccated, when you apply
the bond. Then lightly blow-dry (not desiccated) and reapply bond (bottle #2) to cure it. I then
use Voco Ionoseal as a thin (1mm) liner, which also assures that the bond is fully polymerized.
Try it, I believe you will love it. It was Dentaltown that turned me on to it. ■

upcountrydentist
Member Since: 05/09/12
Post: 40 of 62

11/5/2016

I have been a fourth-generation system user since AllBond 2 hit the marketplace in 1991.
Was lucky to have heard John K. several times from 1990 to 1994. I started using composite
exclusively in 1985 after a year or two of going back to amalgam after going to another course
and hearing some speaker predict doom and gloom for posterior composite.
Used Heliomolar from 1985-1987 and then switched to Herculite on Dr. Ron Jordan's
recommendation. Lots of sensitivity early on in 1985, so we used Ketacem as a base/liner and
that helped but did not solve the problem completely. After hearing John K. in Moncton, N.B.
in 1991 at an AGD course I became an AllBond 2 user. The sensitivity is caused by movement
of fluid in the dentinal tubules when the tooth is under pressure. A good hybrid layer (sealed
dentin) is the solution to eliminating sensitivity. Many different bonding systems will do this.
I don't use any liners/bases no matter how close to the pulp since it is a total waste of
time-no research to support using liners/bases one way or the other. My comment is dentists
use liners/bases for the dentist's benefit! Tried Gluma years ago as well as Consepsis and other
desensitizers but they are just extra unnecessary steps. Definitely follow the instructions. I apply
my etch first to the enamel and then cover the dentin. Ideal time for enamel etching is about 30
seconds and dentin is 15 seconds.
I used pulse curing years ago but got away from it and I don't think it matters as sensitivity

dkdocterry
Member Since: 09/17/07
Post: 43 of 62

dentaltownuk.com \\ APRIL 2017

45


http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK April 2017

Cover
Meet the Team
Mike Gow
Industry News
Howard Speaks
International Dental Show
Through the Keyhole: Surgery—Home and Away
What's on Dentaltown
Golden Nuggets
Continuing Education
BACD: Rise of Cosmetic Dentistry
3-D Printing
Google: Leading Cause of Truth Decay
General Practice: Message Board
Time Out
Probing Report
Eating Disorders
Physiotherapy in the Treatment of Craniomandibular, Craniofacial and Craniocervical Disorders
Prosthodontics: Message Board
Plan Z
Online Marketing
Product Profile
Finance: Message Board
Lifestyle Section
Student Section
Poll
The European Society of Hypnosis
Wish List
DentaltownUK April 2017 - Cover
DentaltownUK April 2017 - Cover2
DentaltownUK April 2017 - 3
DentaltownUK April 2017 - 4
DentaltownUK April 2017 - Meet the Team
DentaltownUK April 2017 - 6
DentaltownUK April 2017 - 7
DentaltownUK April 2017 - 8
DentaltownUK April 2017 - 9
DentaltownUK April 2017 - Mike Gow
DentaltownUK April 2017 - 11
DentaltownUK April 2017 - Industry News
DentaltownUK April 2017 - 13
DentaltownUK April 2017 - 14
DentaltownUK April 2017 - 15
DentaltownUK April 2017 - Howard Speaks
DentaltownUK April 2017 - 17
DentaltownUK April 2017 - International Dental Show
DentaltownUK April 2017 - 19
DentaltownUK April 2017 - 20
DentaltownUK April 2017 - 21
DentaltownUK April 2017 - 22
DentaltownUK April 2017 - 23
DentaltownUK April 2017 - Through the Keyhole: Surgery—Home and Away
DentaltownUK April 2017 - 25
DentaltownUK April 2017 - 26
DentaltownUK April 2017 - 27
DentaltownUK April 2017 - What's on Dentaltown
DentaltownUK April 2017 - Golden Nuggets
DentaltownUK April 2017 - 30
DentaltownUK April 2017 - 31
DentaltownUK April 2017 - Continuing Education
DentaltownUK April 2017 - 33
DentaltownUK April 2017 - BACD: Rise of Cosmetic Dentistry
DentaltownUK April 2017 - 35
DentaltownUK April 2017 - 3-D Printing
DentaltownUK April 2017 - 37
DentaltownUK April 2017 - 38
DentaltownUK April 2017 - Google: Leading Cause of Truth Decay
DentaltownUK April 2017 - 40
DentaltownUK April 2017 - 41
DentaltownUK April 2017 - General Practice: Message Board
DentaltownUK April 2017 - 43
DentaltownUK April 2017 - 44
DentaltownUK April 2017 - 45
DentaltownUK April 2017 - 46
DentaltownUK April 2017 - 47
DentaltownUK April 2017 - Time Out
DentaltownUK April 2017 - 49
DentaltownUK April 2017 - Probing Report
DentaltownUK April 2017 - 51
DentaltownUK April 2017 - Eating Disorders
DentaltownUK April 2017 - 53
DentaltownUK April 2017 - 54
DentaltownUK April 2017 - 55
DentaltownUK April 2017 - Physiotherapy in the Treatment of Craniomandibular, Craniofacial and Craniocervical Disorders
DentaltownUK April 2017 - 57
DentaltownUK April 2017 - 58
DentaltownUK April 2017 - 59
DentaltownUK April 2017 - 60
DentaltownUK April 2017 - 61
DentaltownUK April 2017 - Prosthodontics: Message Board
DentaltownUK April 2017 - 63
DentaltownUK April 2017 - 64
DentaltownUK April 2017 - 65
DentaltownUK April 2017 - 66
DentaltownUK April 2017 - 67
DentaltownUK April 2017 - 68
DentaltownUK April 2017 - Plan Z
DentaltownUK April 2017 - 70
DentaltownUK April 2017 - 71
DentaltownUK April 2017 - Online Marketing
DentaltownUK April 2017 - 73
DentaltownUK April 2017 - 74
DentaltownUK April 2017 - 75
DentaltownUK April 2017 - Product Profile
DentaltownUK April 2017 - 77
DentaltownUK April 2017 - Finance: Message Board
DentaltownUK April 2017 - 79
DentaltownUK April 2017 - 80
DentaltownUK April 2017 - 81
DentaltownUK April 2017 - 82
DentaltownUK April 2017 - 83
DentaltownUK April 2017 - 84
DentaltownUK April 2017 - 85
DentaltownUK April 2017 - Lifestyle Section
DentaltownUK April 2017 - 87
DentaltownUK April 2017 - 88
DentaltownUK April 2017 - 89
DentaltownUK April 2017 - 90
DentaltownUK April 2017 - 91
DentaltownUK April 2017 - 92
DentaltownUK April 2017 - 93
DentaltownUK April 2017 - 94
DentaltownUK April 2017 - 95
DentaltownUK April 2017 - Student Section
DentaltownUK April 2017 - 97
DentaltownUK April 2017 - 98
DentaltownUK April 2017 - 99
DentaltownUK April 2017 - 100
DentaltownUK April 2017 - 101
DentaltownUK April 2017 - 102
DentaltownUK April 2017 - 103
DentaltownUK April 2017 - Poll
DentaltownUK April 2017 - The European Society of Hypnosis
DentaltownUK April 2017 - Wish List
DentaltownUK April 2017 - Cover3
DentaltownUK April 2017 - Cover4
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