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Practitioner variability effects on dentin bonding with an acetone-based one-bottle adhesive

Department of Preclinical Dentistry, Dental School, University of Cologne, Cologne, Germany.
The journal of adhesive dentistry (Impact Factor: 1.44). 02/1999; 1(4):311-4.
Source: PubMed

ABSTRACT The objective of this study was to investigate the effect of operator variability on the marginal performance of resin composite restorations bonded with an acetone-base one-bottle adhesive in standardized dentin preparations.
Five general practitioners were recruited for this trial. In the first group, each dentist received six extracted human teeth with dentin preparations (Ø 3.5 mm, 1.5 mm deep), cut in flatground proximal dentin, and original packages of Gluma One Bond adhesive and Charisma resin composite (Heraeus-Kulzer, Werheim, Germany) including instructions for use. For the second group, the operators were orally instructed, emphasizing the importance of the moist technique, before they received another six teeth for restoration with the same materials. Finally, a third group of six preparations was restored in order to evaluate a possible training effect. The restored teeth were stored in a hygrophor prior to removal of excess material and microscopic determination of the maximum marginal gap width (MGW). Statistical analyses were performed with the Kruskal-Wallis and Wilcoxon tests at p < 0.05.
Apart from two samples, preparation margins in the first test group showed gaps between 1 and 12 microns. In the second and third groups, 15 and 16 restorations were gap free, respectively. Significant interoperator variation was found in the first group only. Marginal performance of group 1 restorations was significantly inferior to groups 2 and 3, which were not different (p = 0.79).
Application of the one-bottle adhesive is technique-sensitive and requires meticulous attention to the instructions.

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    • "(Koliniotou-Koubia et al. 14 , 2001). In spite of its inherent toxicity, the aggressive potential of acetone is controversial due to its high and fast volatilization (Finger, Balkenhol 8 , 1999). The results of the study by Ivanyi et al. 12 (2002) suggest that dental bond materials applied on a very thin layer of dentin may affect the blood supply to the dental pulp. "
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    • "Recognition over the last few years that the largest proportion of restoration failures arises from secondary (recurrent ) caries or complications (Deligeorgi et al., 2000, 2001) has led to technological advancements in dental materials, in an attempt to reduce their leakage characteristics and improve their longevity (Kugel and Ferrari, 2000). Operator handling (Ciucchi et al., 1997; Finger and Balkenhol, 1999) and surgical skill remain important for influencing treatment success, most likely due to the need for restorations to be finished with a very high technical quality (Murray et al., 2001). It is a pity that many student dentists do not have laboratory exercises where they can perfect their bonding technique by measuring bond strengths to teeth bonded in vitro, before they begin using them clinically (D.H. Pashley, personal communication). "
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    • "The moisture dependence of dentin is related to the type of solvent in the adhesives chemical formulations. Ethanol-based adhesive systems seem less sensitive to the amount of moisture in dentin (Jacobsen & Söderholm, 1998; Finger & Balkenhol, 1999; Reis & others, 2003). "
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