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Clinical Benefits of Single-Bottle Universal Adhesive
Strength and efficiency are not compromised by convenience
For years, clinicians have been inundated with new adhesive products. Although incremental advances have been made in the past, an improvement in one area of performance often came at the expense of properties such as bond strength or operator convenience.
The current generation of dental adhesives represents a significant technological achievement. By pairing state-of-the-art etching, priming, and bonding chemistries, manufacturers have managed to produce single-bottle solutions for almost every dental adhesive need.
One such product is ALL-BOND UNIVERSAL™ (BISCO, Inc., www.bisco.com), which combines effective self-etching and total-etching technologies with proven bond strengths in a single bottle.
ALL-BOND UNIVERSAL is unique because it can be used for both direct restorations and indirect restorations in either the self-etch or total-etch mode. In addition, because ALL-BOND UNIVERSAL bonds to all surfaces, it is indicated as a primer and bond enhancer for metal, zirconia, alumina, silica-based porcelain, lithium disilicate, and composite.1 Finally, ALL-BOND UNIVERSAL lives up to its name, as it is compatible with light-cured, self-cured, and dual-cured composite materials without requiring a separate activator.2
Restorative dentists are frequently faced with the challenge of restoring a tooth with multiple defects. In this case, the patient exhibited a facial Class V lesion on the facial and distal surfaces of tooth No. 20, necessitating mesio-facial and disto-occlusal composites (Figure 1). After caries removal, a bevel was added to the cavosurface margins (Figure 2). To allow for a more esthetic blending effect, a more aggressive bevel was placed along the facial margins (Figure 3).
A size 1 retraction cord (UniBRAID+: Aluminum Potassium Sulfate, Dux Dental, www.duxdental.com) was placed along the preparation margin to prevent crevicular fluid contamination. The preparations were rinsed and dried without desiccation, and then the site was isolated with gauze. Because of the patient’s history of bruxism, the facial margins were etched, rinsed, and dried according to manufacturer’s recommendations to enhance bond strengths in that area. A drop of ALL-BOND UNIVERSAL was scrubbed into the prepared areas for 15 seconds (Figure 4). After a second coat, the site was gently dried for 15 seconds and light cured for 10 seconds per surface.
Shades OA2 and OA1 of ESTELITE® SIGMA QUICK (Tokuyama Dental Cor-poration, www.tokuyama-dental.com) were placed and cured in layers according to the manufacturer’s instructions. The anatomy was refined and the composite flash was removed using 12-fluted carbide finishing burs. Finally, the restoration was polished using silicone polishing points. Figure 5 and Figure 6 demonstrate the natural gradation that was ultimately achieved.
From a clinician’s point of view, using a one-bottle dental adhesive without an activator in this and other cases has some noticeable benefits, including not having to store and keep track of activating brushes and multiple bottles. There is also the measurable time savings of not having to etch the preparation or mix multiple chemicals.
Other benefits of a single-bottle universal adhesive include the ability to rely upon a single bonding agent to fulfill all restorative needs and the option to use the same material to prime zirconia and lithium disilicate restorations, which results in lower material usage and inventory. The use of ALL-BOND UNIVERSAL resulted in a predictable and esthetic result for this patient, as well as a time- and cost-effective appointment for the restorative team.
1. Chen L, Ahn Y, Child PL, et al. Bond strengths of new “universal” dental adhesives. Presented at: International Association for Dental Research General Session; June 23, 2012; Iguaçu Falls, Brazil.
2. Chen L, Suh B. New one-bottle self-etch adhesive is compatible with self-cure materials. Presented at: American Association for Dental Research Annual Meeting; March 24, 2012; Tampa, Florida.
Joseph Kim, DDS
Sugar Grove, Illinois