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Document Text Contents
Page 2

Sturdevant ’ s
Art and Science of

OPERATIVE DENTISTRY
A South Asian Edition

US Editors

Harald O Heymann, DDS, MEd
Professor , Department of Operative Dentistry

The University of North Carolina , School of Dentistry
Chapel Hill, NC

Edward J Swift, Jr, DMD, MS
Professor and Chair , Department of Operative Dentistry
The University of North Carolina , School of Dentistry

Chapel Hill, NC

Andr é V Ritter, DDS, MS
Professor and Graduate Program Director , Department of Operative Dentistry

The University of North Carolina , School of Dentistry
Chapel Hill, NC

Adaptation Editor

V Gopikrishna, MDS, FISDR
Professor

Department of Conservative Dentistry and Endodontics
Thai Moogambigai Dental College

Dr MGR Educational and Research Institute University
Chennai, INDIA



ELSEVIER
A division of

Reed Elsevier India Private Limited

Prelims.indd iiiPrelims.indd iii 24/06/13 4:40 PM24/06/13 4:40 PM

Page 22

187CHAPTER 10 Fundamental Concepts of Enamel and Dentin Adhesion

iii. Third Generation (1984)

Chemical
It was a phosphate-based material containing HEMA
and a 10-carbon molecule known as 10-MDP, which
included long hydrophobic and short hydrophilic
components.57

Mechanism of action

1. The concept of phosphoric acid-etching of den-
tin before application of a phosphate ester-type
bonding agent was introduced by Fusayama
et  al in 1979.65 Clearfi l New Bond (Kuraray,
Japan) was the only third generation bonding
agent to follow the etched dentin philosophy.

2. Most of the other third-generation materials were
designed not to remove the entire smear layer but,
rather, to modify it and allow the penetration of
acidic monomers, such as phenyl-P or PENTA.

Brand names

1. Clearfi l New Bond (Kuraray Co, Ltd, Osaka,
Japan)

2. Scotchbond 2 (3M ESPE Dental Products)

Clinical result
Clinical results were mixed, with some reports of good
performance and some reports of poor performance.63,64

II. Current Strategies for Resin–Dentin
Bonding

i. Etch and Rinse Adhesives

Concept
The smear layer is considered to be an obstacle that
must be removed to permit resin bonding to the
underlying dentin substrate.42 The next generation
of dentin adhesives was introduced for use on acid-
etched dentin.66 The clinical technique involves
simultaneous application of an acid to enamel and
dentin, this method was originally known as the
total-etch technique. Now more commonly called
etch-and-rinse technique, it was the most popular
strategy for dentin bonding during the 1990s and
remains somewhat popular today (Fig. 10.11).

Mechanism of action
Box 10.2 explains the mechanism of action of etch-
and-rinse adhesives.

Primer/Adhesive + CompositeAcid-Etching + Rinsing

Composite

Dentin Adhesive

Hybrid Layer

T
U

B

U
L
E

Etched Dentin with

Exposed Collagen Fibers

Dentin Smear Layer

Prepared with Bur

Fig. 10.11 Bonding of resin to dentin using an etch-and-rinse technique.

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Page 23

Fig13.1.eps


C H A P T E R

13

241

Class III and IV
Direct Composite Restorations

“A thing of beauty is a joy forever.”
—JOHN KEATS

Class III and IV Direct Composite
Restorations

This chapter presents information about class III and
IV direct composite restorations (Fig. 13.1).

Indications

Class III and IV direct composite restorations are
mainly indicated in the:

1. Restoration of caries lesions (class III and IV)
2. Anterior enamel and/or dentin crown fractures

(class IV)

A B

C D

Fig. 13.1 Direct composite restorations before and after. A and B, Class III. C and D, Class IV.

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Page 43

f017-034AD-9780323083331.eps


453CHAPTER 24 Class II Cast Metal Restorations

Disadvantages

1. There is a chance of locking hardened tempo-
rary materials into small undercuts on the pre-
pared tooth and the adjacent teeth.

2. The marginal fi t may be slightly inferior to the
indirect technique.

3. It is more diffi cult to contour the temporary res-
toration without the guidelines offered by the
postoperative cast.7

Technique
1. Step 1: Forming the temporary restoration di-

rectly on the prepared tooth requires the preop-
erative impression.

2. Step 2: Trial-fi tting seats the preoperative im-
pression onto teeth to verify that it seats com-
pletely.

3. Step 3: The temporary material is mixed, fol-
lowing the manufacturer’s instructions.
Temporary materials that use automixing
tips are especially convenient (Fig. 24.19C).
The dentist places the material into the pr-
eoperative impression in the area of the pre-
pared tooth, taking care not to entrap any air
(Fig. 24.19D).

4. Step 4: The impression is placed on teeth, and
the dentist ensures that it seats completely (Fig.
24.19E). Most temporary systems recommend

A B

C D

Fig. 24.18 Maximum intercuspation interocclusal record made with polyvinyl siloxane bite registration paste. A, One
of many commercially available bite registration materials used in this technique. B, Using a cartridge dispenser and a
disposable automixing tip, the base and accelerator pastes are automatically mixed and applied to the prepared teeth,
their neighbors, and the opposing teeth. C, Have the patient close into maximum intercuspation position. Be sure that the
adjacent unprepared teeth are touching in their normal relationships. D, Remove the maximum intercuspation interocclusal
record carefully after it has set, and inspect it for completeness. Areas where the adjacent, unprepared teeth have penetrated
through paste should be seen.

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