Bonding to enamel using alternative Enamel Conditioner/etchants.

OBJECTIVE: Enamel bond durability of three new alternative etchants combined with three representative adhesives was determined. METHODS: The 'immediate' and 'aged' micro-tensile bond strength (µTBS) of the 3-step etch&rinse adhesive OptiBond FL ('O-FL', Kerr), 2-step self-etch (SE) adhesive Clearfil SE Bond 2 ('C-SE2', Kuraray Noritake) and universal adhesive Adhese Universal ('ADU', Ivoclar Vivadent) were measured when bonded to enamel following either a proprietary organic acid-containing Enamel Conditioner ('EC', Shofu), a phosphoric-acid monomer-containing Multi Etchant ('ME', Yamakin: 10-methacryloyloxy tetraethylene glycol dihydrogenphosphate or MTEGP), or a metal salt-based ZON etchant ('ZON', Ivoclar Vivadent: ZrO(NO3)2). All alternative etchants were used in replacement of phosphoric acid, the latter (K-Etchant, Kuraray Noritake) also used with O-FL and ADU, in addition to C-SE2 that was solely used in SE mode (controls). The enamel-etching patterns and de-bonded fracture surfaces were examined by SEM, while the interfaces with enamel were ultra-morphologically characterized by TEM. RESULTS: No statistically significant difference in immediate and aged µTBS, obtained by combining the three alternative etchants with the three adhesives, was recorded as compared with the respective controls, except for ME combined with O-FL. Upon aging, significant reduction in µTBS was recorded for the ME/C-SE2 and ME/ADU combinations. The percentage of adhesive failures increased with aging. SEM revealed similar etching patterns produced by EC and ZON as by classic phosphoric-acid etching, for which also numerous micro-resin tags at the adhesive-enamel interface were disclosed. SIGNIFICANCE: Durable bonding to enamel was generally obtained for all etchant/adhesive combinations with the exception of the ME/O-FL combination.

Esthetic Rehabilitation of Retained Primary Teeth-A Conservative Approach.

With the advancement in ceramic restorations bonded to tooth structure, the treatment has become a feasible and conservative option to restore teeth with alteration in shape when owing to high demand in esthetics, with or without minimum tooth preparation. This article describes a report of a 32-year-old woman who was dissatisfied with her smile. The patient reported that she still had deciduous teeth, and that the maxillary lateral incisors had been restored with direct resin composite to correct the teeth shape. After discussing the restorative possibilities, a decision was made to place all-ceramic crowns (lithium disilicate glass-ceramic) with minimal tooth preparation, which figures as a conservative full-coverage approach. An esthetic outcome resembling a natural-looking smile resulted in the patient's satisfaction. Bonding of all-ceramic crowns onto minimally prepared deciduous teeth figures as a conservative treatment in case of partial anodontia, which decreases the chance of root resorption induced by trauma and benefits from good adhesion to enamel.