Lee Ann Brady DMD
Adhesive dentistry is the mainstay of what we do, and two of the most common questions I get are about how to improve the predictability and durability of bonded procedures. The first thing I think about when asked this question is going back to the basics to see where we can maximize bond strengths and success.
1) Are you properly storing your dentin adhesive materials? Take a look at the manufacturers recommendations for your dentin adhesive. Does it say “refrigeration required”? Most offices store their dentin adhesives in procedure tubs in order to make room set-up efficient, but many of these products are temperature sensitive.
2) Keep a close eye on expiration dates. We always check expiration dates when we receive product, and then make sure we use it in the order of the expiration. I have been in office where the new product is put away in front of the old, and then when they need that older stock, it turns out it is well beyond the expiration.
3) When are you dispensing the dentin adhesive? All adhesive products contain a solvent. These solvents evaporate in the presence of air, altering the viscosity of the material. Most dental assistants I watch in the name of efficiency set out all of the materials in advance, including the dentin adhesive. Dentin adhesives should only be dispensed as they are about to be used, and discarded once they have been out in the air. The single use systems are fabulous for this, just twist it open when you are ready to apply to the tooth. For bottles, I have my assistant take the lid off and dispense a drop directly onto the micro brush as she hands it to me.
4) Do you know the manufacturer directions? Each dentin adhesive system is unique and has different instructions. Things to know about the product you use include, whether it should be shaken prior to dispensing, the amount recommended time the material should be applied to the tooth and the number of coats recommended.
5) What are the procedure and compatibility recommendations of the manufacturer? Not all dentin adhesives are compatible with all types of resin cements so confirm compatibility when you combine materials. The manufacturer has looked at the efficacy of the material in different clinical situations; know the procedures they recommend their product for.