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Special Issues
July/August 2015
Volume 36, Issue 2

Indirect Bonding with Ease and Peace of Mind

Family of products enables simplified process, long-lasting bond

Sam Simos, DDS

Founder, President, and Instructor, Allstar Smiles and the Allstar Smiles Learning Center, Bolingbrook, Illinois

Key Takeaway Points

Silane coupling agents can be used to improve bonding between porcelain restorations and resin cements.

Use of All-Bond Universal offers the convenience of a single-bottle adhesive with no activator required.

The product combination used in this case enabled ease of use and a durable result.

 

A 72-year-old man presented with an unsalvageable, fractured lateral incisor that required removal. After reviewing options for replacement, including immediate implant placement and restoration, the patient chose to move forward with a conservative winged lithium-disilicate bridge to replace tooth No. 10. The clinician used an assortment of products from Bisco, Inc. (www.bisco.com), including Porcelain Primer containing silane to prime the restoration, Uni-Etch® w/BAC 32% etchant, All-Bond Universal® adhesive, and Duo-Link Universal™ luting cement. This ensured compatibility between adhesive and luting cement while simplifying the restoration process. In addition to peace of mind for both clinician and patient, the result was a strong, long-lasting bond that the patient can depend on for years to come.

1. After root removal of tooth No. 10, non-retentive lingual preparation of teeth Nos. 9 and 11 was completed.

2. A temporary was fabricated and bonded into place.

3. After sufficient healing of the extraction site, a final impression was taken and a lithium-disilicate lingual-retained winged restoration was fabricated (as shown). When the restoration was received in the office it was primed with Bisco Porcelain Primer/Silane Primer.

4. After successful try-in and confirmation of marginal integrity, bonding was completed and (as shown) the restoration was cleaned with 32% phosphoric acid-etch with benzalkonium chloride (BAC) (Bisco Uni-Etch w/BAC).

5. Uni-Etch w/BAC was rinsed off the restoration and dried.

6. The restoration was then coated with Bisco All-Bond Universal adhesive, which was blown thin and light-cured for 20 seconds. The restoration was then set aside.

7. Teeth Nos. 9 and 11 were isolated and prepared, and then etched with 32% phosphoric acid-etch with BAC (Uni-Etch w/BAC) for 10 seconds and rinsed.

8. The clean, dried prepared teeth Nos. 9 and 11 were then coated with All-Bond Universal. Two coats of the adhesive were applied, blown thin, and light-cured for 20 seconds.

9. Duo-Link Universal dual-cure luting cement was then placed on prepared surface of the teeth.

10. The winged, lithium-disilicate restoration was then set in place.

11. After the restoration was tack-cured for 3 to 5 seconds and cleaned, it was light-cured for 20 seconds on each tooth, both buccal and lingual surfaces.

12. Final restoration in place immediately after bonding.

(lab work provided by Mac Dental Laboratory & Milling Center, macdentallab.com)

Figure 1 After root removal of tooth No. 10, non-retentive lingual preparation of teeth Nos. 9 and 11 was completed.

Figure 1

Figure 2 A temporary was fabricated and bonded into place.

Figure 2

Figure 3 After sufficient healing of the extraction site, a final impression was taken and a lithium-disilicate lingual-retained winged restoration was fabricated (as shown). When the restoration was received in the office it was primed with Bisco Porcelain Primer/Silane Primer.

Figure 3

Figure 4 After successful try-in and confirmation of marginal integrity, bonding was completed and (as shown) the restoration was cleaned with 32% phosphoric acid-etch with benzalkonium chloride (BAC) (Bisco Uni-Etch w/BAC).

Figure 4

Figure 5 Uni-Etch w/BAC was rinsed off the restoration and dried.

Figure 5

Figure 6 The restoration was then coated with Bisco All-Bond Universal adhesive, which was blown thin and light-cured for 20 seconds. The restoration was then set aside.

Figure 6

Figure 7 Teeth Nos. 9 and 11 were isolated and prepared, and then etched with 32% phosphoric acid-etch with BAC (Uni-Etch w/BAC) for 10 seconds and rinsed.

Figure 7

Figure 8 The clean, dried prepared teeth Nos. 9 and 11 were then coated with All-Bond Universal. Two coats of the adhesive were applied, blown thin, and light-cured for 20 seconds.

Figure 8

Figure 9 Duo-Link Universal dual-cure luting cement was then placed on prepared surface of the teeth.

Figure 9

Figure 10 The winged, lithium-disilicate restoration was then set in place.

Figure 10

Figure 11 After the restoration was tack-cured for 3 to 5 seconds and cleaned, it was light-cured for 20 seconds on each tooth, both buccal and lingual surfaces.

Figure 11

Figure 12 Final restoration in place immediately after bonding. (lab work provided by Mac Dental Laboratory & Milling Center, macdentallab.com)

Figure 12

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