Dentaltown August 2013 - (Page 24)

second opinion column » Finally, One Adhesive that Can Do It All by Jeffrey B. Dalin, DDS, FACD, FAGD, FICD, FADI Second opinions are common in health care, whether a doctor is sorting out a difficult case or a patient is not sure what to do next. In the context of our magazine, the first opinion will always belong to the reader. This feature will allow fellow dental professionals to share their opinions on various topics, providing you with a “second opinion.” Perhaps some of these observations will change your mind, while others will solidify your position. In the end, our goal is to create discussion and debate to enrich our profession. – Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine Many dentists today are confused about adhesives, and rightly so. First, second, third, fourth generations, self-etch, total-etch… a lot of us have reached a point where we’re saying, “enough!” Over the years, I personally have used them all – bonding agents with resin kits, light-cured total-etch, self-etch – you name it. For some time I stuck with the fourth generation, as the consensus seemed to be that fifth-, sixth- and seventh-generation adhesives came with drawbacks in strength and longevity. Of course, these later generations were developed to help address problems with post-operative sensitivity, which they did, but as we learned, they too required sacrifices. “It almost seems too good to be true, but the fact is that now we finally have an adhesive system that is truly universal and delivers strength with no sensitivity – regardless of the surface it is used on and the etching mode utilized.” After a time, I decided to stick with the fourth generation due to the fact that it offered good strength and longevity, and was well supported by research. I used a careful technique to avoid sensitivity, and by following all the rules and adhering to the multiple steps required for this generation, used it successfully. As stated, however, this required stringent adherence to technique and allowed little room for errors. Many other clinicians have adapted to the adhesive overload situation by keeping multiple adhesive systems stocked in the practice. By doing this, the dentist can have an adhesive on hand for each of the various clinical situations they might encounter. Perhaps a fourth generation would be used for certain types of cases, but a self-etch system is also stocked for cases where it is easier to apply. While this at least gives dentists some flexibility in their materials, it can also be a hassle to stock the multiple materials in multiple operatories, not to mention keeping each of the various techniques straight for each product. A New Alternative It almost seems too good to be true, but the fact is that now we finally have an adhesive system that is truly universal and delivers strength with no sensitivity – regardless of the surface it is used on and the etching mode utilized. This new adhesive is 3M ESPE Scotchbond Universal Adhesive, and for dentists who give it a chance, it is going to do away with the eenymeeny-miny-moe of adhesive selection. Scotchbond Universal adhesive eradicates the generation confusion by providing a truly universal solution. It’s a single-bottle system that can be used for direct and indirect restorations. It can be used on both dentin and enamel, in total-etch, self-etch or selectiveetch modes. It also has a combined primer/adhesive capability that allows it to bond to indirect substrates, including metals, zirconia, alumina and glass ceramics without a separate primer. To use, the adhesive is applied to the tooth surface and scrubbed for 20 seconds. The tooth should then be air dried for five seconds, followed by a 10 second light cure. For the total-etch or selective-etch technique, dentists can simply etch the proper areas with phosphoric acid for 15 seconds before placing the adhesive. That’s it. There are no complicated instructions or techniques to master. continued on page 26 24 AUGUST 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown August 2013

Dentaltown.com Highlights
Howard Speaks: Dentists Are Still Doing Way Too Many Three-Unit Bridges
Professional Courtesy: Hire Slow, Fire Fast
Continuing Education Update
Second Opinion: Finally, One Adhesive that Can Do It All
All-on-4?
Intracornal Bleaching of Endodontically Treated Teeth
Product Profile: CAESY
Product Profile: ClearCorrect
Product Profile: DENTIS USA
Product Profile: Imaging Sciences
Corporate Profile: 123 Postcards
New Products
The Silent Killer of Dentistry
Industry News
Smile Design
Endo Versus Implants: Does Your Treatment Plan Pass the “Mama Test”?
Improving the Future of Overdentures with Small Diameter Implants and Locator Attachments
The Democratization of Dental Implants for General Dentistry
Single Tooth Implant Case
Continuing Education: The Dental CAD/CAM Evolution of 2013
Beatlemania Has Deep Roots
In This Issue: The Value of Saliva Testing
Perio Reports
Ad Index
Profile in Oral Health: Salivary Testing in the Office
Dentally Incorrect

Dentaltown August 2013