The active use of adhesion allows you to restore the dentition with various defects. All damage and destruction can be easily repaired and the smile will again become aesthetically pleasing. Adhesion in Latin means "sticking" of various kinds of hard surfaces to each other. Adhesive systems in dentistry have been actively used for more than a dozen years, but their composition has been somewhat improved in recent years. Thanks to this decision, it was possible to identify the latest methods of adhesion of the substance to the tooth tissue, due to which it became possible to use adhesives for many indications.
The term "adhesive"
Adhesive is a complex chemical. It helps to ensure a tight bond between the material used for filling and the etched enamel. Before installing a seal, the substance is applied to enamel and dentin, because without it, the materials used in dentistry will not be able to bond properly. Dentin tissue and adhesive systems used in dentistry are joined together, resisting separation, transferring the load through the bonding surfaces. To carry out high-quality filling, adhesion is indispensable. Filling materials will not be able to independently bond with the dentinal tissue and there are several reasons for this:
- high viscosity of materials;
- lack of chemical similarity with dentinal tissue, gasket and enamel.
It is impossible to use only mechanical fixation of the seal, because its service life in this case will be significantly reduced.
Principles of adhesive systems
Composite materials require additional substances in order to fix more securely on the dental tissue. It is these materials that are considered modern adhesive systems, which are also called bonds in a different way. In their chemical composition, they are similar to dentinal tissue and have a micromechanical ability to bond with it.
If adhesives are not used during tooth filling, then the connection between dentin and the composite will be disrupted. Such treatment during the polymerization of the composite material will shrink and an edge gap will appear.
Such consequences lead to the fact that the patient develops secondary caries or worse - the pulp is damaged. Many types of composite materials have good adhesion to the enamel surface. But the dentinal tissue is wet and does not allow the seal to firmly bond to the surface.
Adhesive bond can be divided into three stages:
- substrate preparation;
- adhesive application and its thorough processing;
- overlay filling and its processing.
To carry out the restoration of teeth in a quality manner is possible only when using modern adhesive systems in dentistry. To reliably glue materials, many different techniques and tools have been created. The adhesive quality requirements can be compared with industrial ones.
Basic requirements for adhesive systems
Adhesive systems are a complex of complex fluids that help attach composite and other types of materials to the hard surface of a tooth. That is why a lot of serious requirements are imposed on them. Among them:
- providing resistant to chewing function and long-lasting effect of tooth tissue binding;
- compensation for the voltage that occurs during shrinkage of the composite;
- adhesion to dentin should be equal to adhesion to enamel;
- biocompatibility with tooth tissues and insolubility in the oral cavity;
- providing good marginal adaptation of the restoration to prevent leakage and the development of secondary caries;
- providing ease of use;
- long shelf life;
- versatility and compatibility with various materials;
- complete absence of sensitizing effect.
Today, a large number of adhesive systems have been developed, the problems of which are minimized. Most of the new generation helps to ensure the strongest attachment of the composite to tooth tissues and other materials used in dentistry: metal, plastic, porcelain and others.
Classification of adhesive systems in dentistry
Today, experts highlight two types of adhesive systems:
- For enamel. They contain hydrophobic monomers of the composite in liquid form. Due to the fact that they are fastened by the micromechanical method, they are firmly attached to the enamel surface. They do not provide adhesion with dentin; therefore, an insulating layer cannot be dispensed with, since it is precisely it that can protect against toxic effects on dentin. The kit contains adhesives with chemical polymerization.
- For dentin. A similar system developed throughout its entire existence. During this period, the procedure for its use and composition changed. In the pharmaceutical market today there are 7 generations of adhesive systems. In dentistry, they are all actively used.
With the development of modern technologies, the adhesive materials used for dentinal tissue have also improved. Today, scientists offer several of their types, which are considered to be generations in dentistry. Each of them differs from the others in dentin adhesion and ligament strength.
Generations of adhesive systems
All seven generations have their own characteristics and properties:
- The first one. It appeared back in the distant 70s. Its distinguishing features are the use of ionic and chelating bonds with components representing dentin, most often with calcium. It features excellent adhesion to enamel. It does not form a reliable bond with dentin, because the tissues contain a large amount of moisture, which ultimately reduces adhesion. After treatment, the sensitivity of enamel increases.
- The second one. It appeared in the 80s. The creators improved the smeared layer from 2 to 8 MPa. Traction with dentin increased several times. But this system is not entirely perfect, since leakage was noticed, and after treatment, many patients complain of special tooth sensitivity. The properties of the system after a year decreased by almost 30%. Often, dentists used dentin etching in addition to therapy, followed by the introduction of iron ions. This principle has helped to ensure reliable adhesion to dentin calcium.
- The third. It appeared in the same 80s, but a little later than the second. The adhesion was increased to 15 MPa. Scientists worked hard on her and were able to reduce sensitivity after treatment. This generation has become a new step in dentistry. The characteristic qualities of the binding system lost their power several years later. The main components of this generation are aluminitrates and aluminosilicates.
- 4-generation adhesive systems in dentistry were born in the 90s of the last century. Binding force has grown to 25 MPa. The sensitivity level decreased several times more. This generation is characterized by the bonding of the composite and the hybrid dentin layer. In this case, it is possible to create an intermediate layer. The substance was mixed in equal proportions. But it turned out that it was easy to do this in laboratories, but in practice there were difficulties. Its main components are: primer, air conditioning and a special system.
- The fifth generation of adhesive systems in dentistry has led to the development of single-component substances. This substance did not require any mixing of the individual components and quickly hardened. The main features of the primer and adhesive were able to be combined in one substance. It was planned to use the system in the same cases as the 4th generation, only application was carried out in two stages. The first half is a primer, and the second played the role of an adhesive. This system simplified the work of specialists and eliminated all the problems with the frequent confusion of bottles with substances.
- The sixth generation is one-step. They do not require separate etching of the dentin surface. The main distinguishing features are self-etching and self-conditioning. Unwetted dentin does not cause dentists connection problems. In parallel, two processes pass - demineralization and priming. Using this system, a specialist can restore teeth with any of the existing materials, while reliable adhesion is guaranteed.
- The evolution of adhesive systems in dentistry has helped create the seventh generation, which is currently in high demand. They are one-component and light curing. In the composition of these substances there is a desensitizer. Everything is included in one bottle, and this is very convenient and significantly reduces the time of the dentist. But this system has a characteristic feature - partial tearing of the dentinal tubules with the formation of a structural connection. If you use this generation on the surface of enamel, then this can significantly strengthen it. In addition, this system has the ability to penetrate deeply into the dentin, which creates reliable sealing of all channels.
Today, thanks to modern technologies, the development of new generations is constantly ongoing and in the near future it is planned to release the 8th generation, which will be even more reliable and practical.
What are the advantages of these systems?
Modern adhesive systems in dentistry help to recreate the integrity of the dentition and have a host of other advantages that make them so popular:
- The negative impact on dental units is minimized, which serves as a reliable support for the structure. There is no need for depulping, and surface treatment is orthopedic reversible. Due to this, it is possible to maintain the sensitivity of healthy teeth.
- The procedure is completely painless and does not require the use of painkillers.
- Significantly reduced prosthetics time.
The main advantages of adhesive systems include low cost. The use of these systems helps restore damaged teeth for a minimal amount, which is why this type of prosthetics is chosen by many patients with defects in the dentition.
Top adhesives
About 50 years have passed since the first developments began and the first adhesives appeared. During this period, many unique systems have appeared that make it possible to solve even the most complex problem. Among this huge variety, dentists distinguish several adhesive systems, the characteristics of which differ slightly:
- Prime Bond NT is a one-component filler material that significantly improves adhesion strength.
- Optibond Solo is also a one-component filler material - barium glass.
- DMG is a water-based material without any solvents, odorless.
- OptiBond is a universal adhesive that helps to reliably bond composite materials.
- Syntac is a reliable substance that guarantees a strong bond with dental tissue.
- Peak Universal Bond is an ideal substance for direct and indirect adhesion.
This is a small list of adhesive materials and systems in dentistry that are actively used to help patients eliminate all defects in the dentition. They are widely used in dental practice in recent years and have proved that they do not cause any unwanted manifestations and discomfort.
How to choose adhesive systems?
It is better to give preference to materials that are able to provide a strong bond of composite substances and tooth tissues. It is very important that adhesion occurs within seconds after application. The primer should easily spread and penetrate the structure of collagen fibers.
A system that can be used in various clinical situations is considered useful. It is possible to achieve time and material savings only if innovative composites are used, which, when exposed to an air stream, immediately dry out and do not form bumps.
In their daily work, many specialists prefer the 4th generation of adhesion in dentistry, its interaction with the hard tissues of the tooth is simply perfect.
As for the adhesion of the 7th generation, which appeared relatively recently, it can be used for indirect and direct restorations. Whichever of the systems the patient chooses, it is important not to deviate from the manual for the use of adhesive, because the manufacturer precisely prescribes the limitations and principles of interaction with other materials.
Reviews
- "Single Bond" is a high-quality product that is used if it is necessary to conduct total etching, as well as in various operations related to porcelain and ceramic veneers. The main feature of this system is full transparency and the absence of sediment formation when conditions change.
- "G Bond" is another self-etching adhesive system, which has one important plus - the complete lack of secondary tooth sensitivity to this substance. In addition, its use excludes the additional use of etching gel.
About other materials there are also many good reviews of specialists who work easily with them. Patients speak well of the systems of the latest generations, because they do not feel them at all. But after interviewing the majority who restored the dentition of one of the adhesive systems, it became clear that most of the materials provide reliable adhesion to enamel. Systems do not cause side effects; they retain their original appearance for a long time. Therefore, patients who have already tried adhesive systems recommend them to all those who have problems with their teeth. Of course, there are those who were dissatisfied with these systems for various reasons, but their percentage is negligible compared to the number of positive reviews about adhesive systems.
Conclusion
Dental adhesive systems have been widely used in practice recently. Today in the market you can find for total etching and self-etching systems. All of them perfectly etch the surface of the tooth and provide excellent retention of materials for restoration or construction after the adhesive has hardened. Any of the systems has its own characteristics, which relate to the application technique and indicators of the strength of the connection.
All systems have their pros and cons, but it is impossible to say exactly which one is suitable in a particular case. The fourth generation system is suitable for one patient, and only the seventh is suitable for another. The main thing is that both of them can easily solve problems with defects in the dentition. Which one to use, the doctor will decide during the work with the patient, and as the characteristics of his dental system and body are clarified.