When it comes to restorative dentistry, a versatile, strong, and durable dental adhesive that bonds effectively to enamel and dentin and seals the margins is all a critically important factor for long-term restoration success.
In my practice, we perform many different types of dental restorations, so access to a universal adhesive that delivers superior results and is easy to work with is a key consideration.
In a recent case, a patient scheduled a visit to evaluate 6 older porcelain-fused-to-metal (PFM) crowns on teeth Nos. 6 to 11 in the upper anterior region. The patient’s chief concern was that the metal was becoming visible at the margins, and she was ready for a new aesthetic look.
The preparation for this procedure included sectioning and removing the old PFM crowns from teeth Nos. 6 to 11. The preps were then modified to allow for the new wax-up designs. Once this step was complete, we performed an intraoral scan using iTero (Align Technology) and placed the provisional crowns. We chose Ivoclar Vivadent’s IPS e.max for the new crowns, a monolithic lithium disilicate that demonstrates high mechanical strength and remains an affordable alternative to PFMs and zirconia-based restorations.
Once the patient’s new IPS e.max porcelain crowns were manufactured and ready for placement, I sectioned and removed the provisional crowns. I then micro-etched the preps and fully rinsed them with air/water before beginning a total etch with Kerr’s OptiBond Gel Etchant (Figure 1). I also placed MicroPrime G (Zest Dental Solutions), an antimicrobial and universal desensitizing agent, to help further reduce the risk of postoperative sensitivity (Figure 2).
Figure 1. Teeth Nos. 6 to 11 in the upper anterior were prepped for placement of IPS e.max porcelain crowns (Ivoclar Vivadent). Micro-etching and total-etching techniques were used prior.
Figure 2. Prepping the restora- tion with MicroPrime G (Zest Dental Solutions), an antimicrobial and desensitizing agent, helped to reduce the risk of postoperative sensitivity.
Figure 3. Using Kerr’s new OptiBond Universal 360 adhesive, 2 coats were liberally applied to the teeth undergoing crown restoration. This single- component universal adhesive was chosen specifically for its versatility, durability, strength, and protection against microleakage and post-op sensitivity.
Once I air-thinned the area, I began applying 2 coats of Kerr’s new OptiBond Universal 360 to affix the first 6 replacement crowns (Figure 3).
The choice to use this new single-component universal adhesive was quite easy. Data demonstrate that this new adhesive is now one of the strongest available. It delivers exceptional bond strength to direct and indirect substrates, including dentin, enamel, zirconia, metal, ceramic, and composite. One bottle can be used for etching, priming, and bonding, and it’s compatible with self-etch, selective-etch, and total-etch techniques. The improved bottle design also made this adhesive simple to apply with one hand. Kerr has developed a Ternary Solvent System technology that provides excellent penetration into dentinal tubules, achieving superior bond strength and protection against microleakage and post-op sensitivity. The major advantages of this adhesive include its versatility of use with virtually any restorative materials or techniques, as well as its strength and durability.
Figure 4. IPS e.max porcelain crowns, a monolithic lithium disilicate that demonstrates high mechanical strength, were chosen for this restoration.
Figure 5. This photo illustrates the progress of the restoration. Four of the 6 porcelain crowns were seated and affixed.
Once the patient’s crowns were seated and affixed (Figures 4 and 5), I light cured the restoration.
Follow-up x-rays showed a perfect seat with closed margins, achieving excellent functional and aesthetic results (Figure 6).
Figure 6. Once the restoration was complete, follow-up radiographs confirmed exceptional seating and margins for this patient.
CONCLUSION
Selecting the right tools for any dental restoration will improve the outcome. While we have so many choices of technology and materials to improve oral health and advance restorative dentistry for our patients, the universal adhesive remains one of the most important tools for clinicians. Its selection in my armamentarium is based on its versatility, durability, strength, performance, and ease of use. Plus, the results keep our patients smiling.
For more information, call Kerr at (800) KERR-123 (537-7123) or visit the website go.kerrdental.com/optibond360.
ABOUT THE AUTHOR
Dr. Savage is the owner of a multidisciplinary group practice in Orange, Calif. A Yorba Linda, Calif, native and a University of the Pacific Dugoni School of Dentistry graduate, he specializes in smile makeovers using veneers, whitening, clear aligners, and full-mouth ceramic crown restorations.
