April 2014, Volume 35, Issue 4
Published by AEGIS Communications
DENTSPLY Caulk’s Prime&Bond Elect®: Predictable Bond Strengths, Without Sensitivity
Newer is not always better, according to Jason H. Goodchild, DMD, who still believes that the 4th generation bonding systems—that is, those composed of an etch-and-rinse step, followed by separate applications of primer and adhesive—are still the top-performing adhesive products.
Goodchild, who is Research Dentist in the Department of Clinical Research & Education at DENTSPLY Caulk, says it is for this reason that his company has continued to produce an earlier 4th generation product called ProBond®. But standard of care does not always represent state-of-the-art, and significant research and advancements are being made to dental bonding systems, he maintains.
As described by Goodchild, the bonding market has evolved to include newer products such as etch-and-rinse one-bottle systems, followed by one-bottle self-etch products that offer benefits such as fewer procedural steps and avoidance of phosphoric acid, which was incorrectly thought to cause postoperative sensitivity.
“Self-etch bonding agents work by hybridizing the dentin smear layer, and these products may contain phosphoric acid esters. The pH of self-etch adhesives and the presence of the smear layer ensure that exposed dentin is not over-etched; but there is a tradeoff,” says Goodchild. The tradeoff, he explains, is the potential for decreased enamel bond strength. “While dentin bond strengths are acceptable for these products, enamel bonding may be less effective. Bond failure to uncut enamel can lead to marginal breakdown, staining, and recurrent decay,” he notes.
“The state-of-the-art for our company is Prime&Bond Elect® Universal Dental Adhesive,” Goodchild states, adding that the product is based on more than 13 years of clinically proven PENTA (dipentaerythritol penta acrylate monophosphate) resin technology. “Prime&Bond Elect is unique because it allows the clinician the opportunity to select when and how to use phosphoric acid, in either a total-, self-, or selective-etch technique.”
“We know through clinical research that the most durable bond to enamel is achieved after acid-etching, and Prime&Bond Elect can be used in those cases where remaining enamel margins can be etched to maximize bond performance,” Goodchild explains. “Dentists can now depend on predictable bond strengths to enamel and dentin, choose when and how to use phosphoric acid, and feel comfortable that the outcome will be an outstanding restoration with virtually no postoperative sensitivity.”
Goodchild describes the resources DENTSPLY Caulk provides to its customers to support best usage for all its products. “We offer numerous scientifically supported continuing education courses and are active in publishing research and technique articles. We have a dedicated customer service department, as well as approximately 120 field service representatives who call on doctors using our products and continuously check in to see if they’re having any issues, making sure they are realizing good product performance.”
Goodchild says he expects to see continued improvement within the universal adhesive category, including the creation of products that can be used with any substrate for either direct or indirect procedures. “For the most part, adhesive products thus far have been robust and user-friendly; however, now with the universal category, we can harness the best parts of earlier systems to realize significant clinical advantages. We want to help dentists by simplifying techniques and reducing inventory while also maximizing clinical outcomes,” he maintains.
As for innovations in the universal adhesive category in the coming years, Goodchild expects research to continue to focus on methods of matrix metalloproteinase (MMP) inhibition as means to prevent bond degradation, as well as exploration of the potential of creating resin monomers with bioactive potential at the dentin interface.
“The goal is always to develop products that offer clinical benefits to both patient and dentist, Goodchild concludes. “By doing so we can help create exceptional restorations that function successfully for many years.”
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