Dentsply Sirona’s universal adhesive offers reliable bond strength in diverse conditions, making it the only adhesive many dentists will ever need.
Dentsply Sirona spoke with Dr. Jason Goodchild, Associate Professor and Chairman of the Department of Diagnostic Sciences at Creighton University School of Dentistry, about universal adhesives and the benefits Prime&Bond elect® adhesive offers to clinicians.
Dentsply Sirona (DS): What are some of the challenges associated with achieving a reliable bond in direct and indirect restorations?
Dr. Jason Goodchild (JG): Achieving a reliable bond presents several challenges. Treatment planning and material choices have to be considered. Once the procedure begins, the environment can be unpredictable: is it too wet, too dry? Can it be isolated? Is there blood present? The condition of the substrate is important too; working with dentin, enamel, or the root surface can all create different challenges, including how cements react with the surfaces. There’s also a question of whether to light cure or not. In general, if it’s impossible to achieve a controlled environment, our work becomes very difficult.
DS: How important is an adhesive’s ability to work in a moist environment?
JG: In both direct and indirect adhesive dentistry, some areas will be a little too dry, and others will be a little too wet. It’s very difficult to achieve a consistent level of moisture, so it’s certainly important that an adhesive be able to work effectively in these unpredictable environments. The best adhesives are robust enough to work consistently in almost any environment.
DS: What makes for good handling in an adhesive?
JG: Some people feel that a more viscous bonding agent makes it easier to know when you’ve completely covered the preparation. But thicker bonding agents can have a negative effect on fit, and can lead to more pooling in the corners and other problems. So ideally, a thinner adhesive layer is preferable.
DS: Do you usually know before beginning a procedure which etching technique you’ll use?
JG: I make my decision once I have the tooth prepared, since the amount of remaining substrate, dentin or enamel, will determine the mode I want to use. But I think most dentists generally use whichever bonding system they happen to have in their office, no matter what the prep looks like. If a clinician has married himself to a certain bonding system and that system isn’t universal, they’ll use whichever system they carry in their office.
The beauty of a universal adhesive is that you don’t have to commit to one technique. You can choose once you’ve prepared the tooth based on remaining substrate. A universal system lets you choose on the fly based on what’s left after the preparation has occurred.
DS: What are the other benefits of using a universal adhesive?
JG: The ability to select your etching mode on the fly is beneficial. It’s also more streamlined, so it’s easier to educate dentists to use a single system, which leads to more consistent results. Having just one adhesive that you can really understand, and that gives you flexibility for etching modes, direct, and indirect, can be a huge benefit for a practice.
DS: How has your experience been with Prime&Bond elect?
JG: It allowed me to get rid of all my other bonding agents for a more streamlined procedure. My dental assistant knows exactly what to do, and it’s made my ordering and inventory that much simpler. I know that because it has low film thickness, I won’t have any problem seating crowns. I can use it under crowns and inlays and have no worries about my ability to get that margin completely closed. It’s compatible with my cements and build up materials, so it can be used for all indications. And I can say that post-operative sensitivity is virtually non-existent in my office.
DS: Can you talk about the viscosity? Why is that important?
JG: It’s important because you want to create a smooth surface that isn’t pooled in any one area. It’s easy to cover the tooth, and it creates a nice glistening surface, and because of the acetone the solvent blows off easily, leaving a thin layer. It would actually be difficult to get Prime&Bond elect to pool!
DS: Prime&Bond elect cures clear. Is that beneficial?
JG: Yes, especially for anterior restorations. As we move toward thinner and thinner restorations, more light transmissible restorations, and really thin veneers, color becomes very important. Anything that changes your stump shade—which becomes your adhesive tooth—can change the final color outcome. If you’re only going to carry one product, you’d want it to cure clear.
DS: What are your thoughts on Prime&Bond elect’s unique PENTA chemistry? Does its established clinical history make a difference to you?
JG: PENTA is essentially the same monomer as MDP, but with five bonding sites instead of one to prevent breakdown over time.
It’s not just about how many bonds you have, it’s how many you can keep. PENTA helps keep the bonds, delaying breakdown. It’s been in the market a long time and has good outcome data to support it. To dentists, years of data, outcomes, and success are a big deal.
DS: Final question: if you had to choose one word to describe Prime&Bond elect, what would it be?
JG: “Versatility.” You can throw everything else out and make this your one bonding system.