Surpass: A Universal Eighth Generation Bonding System
New system offers more advantages than previous generations.
Several generations of bonding systems have been formulated during the last several decades. The first three generations ranged from barely successful to modestly successful. The fourth generation of bonding systems included a phosphoric-acid rinse etchant, primer(s), and a separate bonding resin. The materials within this group performed well, and have come to be known as the “gold standard.” Over the last decade and a half, there has been an effort to simplify bonding systems. Bonding systems became somewhat simpler with the advent of the fifth-generation of bonding systems, which were compromised of a phosphoric-acid rinse etchant and a one-bottle resin adhesive Although these systems reduced the components by one bottle, ostensibly making them simpler, reports suggest that they are not as effective as fourth-generation materials. The sixth-generation bonding materials also are comprised of two bottles but there is no rinsing. With some of the systems, the two bottles are mixed and applied together and in some the two parts are applied sequentially. Reports suggest that the sixth-generation materials are not as effective as the fourth-generation systems. More recently, manufacturers have attempted to incorporate all bonding ingredients into a single bottle. While this does seem to simplify bonding procedures, it may come at the cost of performance. The literature suggests that these materials may not perform as well as desired. The literature also notes that fifth-, sixth- and seventh-generation systems are incompatible with self-cure materials and dual-cure materials that cannot be effectively light-cured.
The number of parts in adhesive systems has been reduced over the years but performance has suffered as well. It was decided that a new system would be developed that had the best attributes of the fourth generation and the ease of the sixth-generation bonding systems, and that system is Surpass® from Apex Dental Materials (Figure 1). It is suggested that Surpass is an eighth-generation material because it is very different from other generations. It consists of three bottles: an etchant/conditioner, a primer, and a separate hydrophobic bonding resin. In that regard, it resembles fourth-generation materials but the etchant/conditioner is not rinsed from the tooth. Thus, Surpass also has characteristics of the sixth generation—the ease of a no-rinse system but the performance of a fourth-generation system. With rinse/etch systems there is a need to make a decision as to the right amount of moisture on the dentin once the etchant is rinsed away. Clinicians often find it difficult to determine what it is too wet or too dry. With Surpass there is no interpretation ever needed. Either the surface is left wet or it is dried thoroughly, making the application process very simple.
Surpass 1 is applied to the dentin and enamel for about 10 seconds, agitating gently. Three brushfuls of Surpass 2 are then applied right onto the wet preparation. Once the three brushfuls have been applied, the preparation is dried thoroughly for 10 seconds. It cannot be overdried and the drier the tooth is following application of Surpass 2, the better the result. Then a layer of Surpass 3 is applied to the preparation and light-cured for 10 seconds. This is the only technique for Surpass no matter what kind of procedure is being performed. Most fourth-generation bonding systems are compatible with self-cure and dual-cure resin materials but, when self-cure and dual-cure materials are used, separate catalysts must be employed and that means an alteration in technique. Surpass may be used with any resin materials—dual-cure, self-cure, and light-cure—and no catalysts are required. The Surpass procedure for use with self-, dual-, and light-cure materials is the same. There is only one technique for all materials. For use with indirect restorations, Surpass is simply made very thin prior to light-curing. For direct restorations, the bonding resin can be made to the desired thickness, although a thin uniform layer is recommended.
As Surpass may be used for all adhesive needs, it is the only bonding system that needs to be kept in the office, which simplifies inventory and simplifies staff training.
Surpass 1 has been shown to etch both cut and uncut enamel as well as phosphoric acid.1 Most self-etch bonding systems do not adequately etch enamel, which can lead to marginal staining over time. Surpass 1 has a pH of 0.6, which allows it to adequately prepare enamel for bonding procedures and generate excellent and durable enamel bond strengths (Figure 2, Figure 3, Figure 4, Figure 5). Surpass can be used for the placement of all classes of direct resin restorations, veneers, core build-ups, post cementation, sealing crown preparations, bonding all-ceramic crowns —for anything that requires an adhesive bonding system.
Surpass dentin bond strengths have been demonstrated to be in the mid-50 MPa range at the University of North Carolina, Tufts University, and at other testing institutions. Surpass produces bond strengths to enamel equal to or higher than phosphoric acid-etch bonding systems (Figure 6). Dentin bond strengths with Surpass have been reported to be unchanging over 3 years.2 Surpass is a bonding system which is truly universal, generates high bond strengths to dentin and enamel, eliminates postoperative sensitivity, and fulfills all the needs of restorative adhesive dentistry.
1. Tay FR, Pashley DH, King NM, et al. of self-etch adhesives on unground enamel. Oper Dent. 2004;29(3):309-316.
2. Kanca J, Greitzer G. Long term bond strength evaluation of an adhesive system. J Dent Res. 2010;89(Spec Iss): Abstract 442.
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Apex Dental Materials
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