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........just another Self-etching Adhesive?

........just another Self-etching Adhesive?. Advantages. fast, easy and safe handling no mixing, no inadvertent change of bottles, no wrong dosage

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........just another Self-etching Adhesive?

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  1. ........just another Self-etching Adhesive?

  2. Advantages • fast, easy and safe handling • no mixing, no inadvertent change of bottles, no wrong dosage • no technique sensitivity: critical steps of the total-etch-technique - etching, rinsing and “correct“ degree of moisture in dentin - are eliminated

  3. The “All inclusive“ Bond with a special feature......

  4. Components and Functions Base • 4-META: Conditioning of enamel and dentin Infiltration promotor • MMA: Diffusion promotor • THIT Trifunctional cross linking agent • HEMA: Amphiphilic monomer, Hydrophobation of collagen • Aceton: solvent for monomers • Water: Hydrolysis of 4-META (dissociation = acid)

  5. ......the application tips contain a polymerization initiator the special Hybrid Bond Brush

  6. 4-META 4-methacryloxyethyltrimellitateanhydride • clinically proven monomer for years (Super Bond C&B, AQ Bond, Chemiace) • excellent etching of enamel • good affinity to dental hard tissue • good penetration of exposed collagen scaffold • bonding to Ca++ • enhanced bond strength to enamel and dentin

  7. Indications • direct restorations with composite resins (incl. compomers, ormocers) • indirect restorations in combination with self-, light- or dual-curing composites (inlays, onlays, veneers, crowns, bridges, build-ups)

  8. Application Light activation depending on curing light 3 to 10 sec. Cervical lesion after minimally invasive preparation Application with HB brush, one coat only (20 sec) Metafil Flo restoration, finished and polished Air-dry gently (5-10 sec)

  9. Solubilization of Smear Layer Smear Layer Hybrid Bond application Demineralization of dentin Dentin Easy Procedure - Strong Effect (1) Bur-cut surface covered with smear Layer Apply one coat of Hybrid Bond with HB brush and leave for 20 sec The surface is conditioned

  10. volatilization of acetone air adhesive layer hybridlayer monomercoating penetrated monomer separation of- monomer and water Easy Procedure - Strong Effect (2) remaining liquid separates into monomer and water Elimination of water film (5-10 sec) including dissolved smear layer Light ativation for 3-10 sec depending on curing unit used

  11. Hybrid Layer Hybridlayer HL ≈ 500 nm 10 K Finger, WJ University of Cologne 2004

  12. To be noticed • dispensed Hybrid Bond should be used within 2 minutes • close bottle immediately after dispensing (volatilization of aceton) • up to 2 drops of Hybrid Bond can be activated with one Hybrid Bond Brush

  13. Shear Bond Strength (SBS): Hybrid Bond with light- or self-curing resin composite MPa 24 h storage in 37° C water Finger WJ, University of Cologne, 2004

  14. Self-polymerization of Hybrid Bond Exotherms of Hybrid Bond (air-dried) in Differential Scanning Calorimeter (DSC) at 37℃. 8 min Hybrid Bond covered with Metafil Flo to avoid air inhibition Exothermic intensity 21 min Hybrid Bond exposed in air 10 20 30 40 Time/min Data by Sun Medical

  15. SBS of Hybrid Bond/Twinlook on Dentin MPa a ab b ANOVA: p = 0.026 HYB no l.a. TWL redox HYB l.a. TWL redox HYB l.a. TWL l.a. Data by W. J. Finger, University of Cologne, Germany

  16. Marginal Gap Width (MGW) in Cylindrical Dentin Cavities b a a c µm Mean Cavity Diameter: 4.1 mm Venus Resin Composite Clearfil Protect Bond One Up Bond F Hybrid Bond I Bond Kruskal-Wallis ANOVA: p<0,001; Mann-Whitney U Test: sig. difference < 0,05. Data by W. J. Finger, University of Cologne, Germany n = 8

  17. SBS on Enamel (MPa) Absolute G-Bond Hybrid Bond I-Bond Prompt-L-Pop Composite: Venus n = 8 Endo W & Finger WJ: 2005

  18. SBS on Dentin (MPa) Composite: Venus n = 8 Endo W & Finger WJ: 2005

  19. MGW of Self-etching Adhesives (µm) # gapfree 0 6 4 4 7 0 a b b b b a µm ABS GBO HYB IBO EXP PLP Experimental product 10 min n = 8 Endo W & Finger WJ: 2005

  20. Micro Tensile Bond Strength (MTBS) Composite resin Enamel Caries-infected dentin Grinded dentin Bonding agent Caries-affected dentin Composite resin Dentin Test pieces of caries-infected dentin Test pieces of sound dentin Quintessence Vol.23, No.11, 2004

  21. HYB GB ABS APL PB Sound Dentin 44 40 25* 17* 49 Caries affected dentin 43 10 － － 16 Micro Tensile Bond Strength (MTBS) Test results Unit：MPa MTBS of G-Bond and Protect Bond to the carious affected dentin were remarkably low, while MTBS of these to sound dentin were sufficiently high. In actual clinical cases, sometimes it is difficult to take off all caries-affected dentin after preparation of carious cavity.

  22. MTBS of self-etching adhesives to various caries dentin Micro-tensile Bond Strength (MPa) Product Name Caries-affected dentin Caries-infected dentin Sound dentin 23.6+4.9 14.1+4.7 Protect Bond 44.8+6.7 G-Bond 14.1+4.7 33.6+8.3 24.6+6.7 20.1+5.7 One-up Bond F 16.7+3.4 14.6+4.6 Absolute 24.2+7.9 12.5+2.8 24.9+4.1 Touch&Bond 26.6+7.0 24.9+8.1 27.3+4.4 =AQ Bond AQ Bond Plus 29.4+4.1 33.6+7.3 28.9+6.7 Brush&Bond =Hybrid Bond 32.8+4.4 30.7+7.7 28.4+7.9 Abstract of IADR 2005 at Baltimore Quintessence Vol.23, No.11, 2004

  23. Efficiency of Hybrid Bond/Metafil CX in Class V cavitiesU. Blunck, Berlin 2004 • Eight human incisors in each of three groups • Oval shaped cavities (4 mm in incisal-apical, and 3 mm in mesio-distal directions) • Half of cavity margin located underneath cemento-enamel junction • Group 1, 20 s undisturbed dwell time • Group 2, 20 s brush agitation • Group 3, 30 s brush agitation • 21 days water storage • replica • 2000 thermocycles (TC) between 5 and 55° C, replica • Qualitative and quantitative analysis of cavity margin at 200-fold magnification (SEM)

  24. Perfect Margin in % of Total Margin Length Hybrid Bond/Metafil CX % Application time (s) on Enamel or Dentin with (+A) or without (-A) brush agitation Data by U. Blunck, University of Berlin, 2004

  25. Microtensile strength of adhesives utilizing indirect and direct compositesBrown, P.L. et al., IADR Honolulu 2004

  26. Clinical Study: Hybrid Bond and Xeno III in cervival lesions: one year resultsErnst et.al., AADR Orlando 2006 • 50 patients with two cervical lesions each • Hybrid Bond or Xeno III combined with Filtek Supreme • After six months all restorations in place and acceptable according to USPHS criteria (apart from one Xeno III) • ► After one year all Hybrid Bond restorations retained and showed clinically excellent results, while 5 Xeno III restorations were lost in part or in toto

  27. Margins Marg. Discol. Sec. Caries Retention Sensitivity HYB 94 94 100 100 100 XEN 78 88 100 90 98 Hybrid Bond and Xeno III in cervical lesions: one year results (% alpha ratings)Ernst et.al. 2006

  28. Comparison of the mechanical properties of resin-based adhesives and fissure sealantsKunzelmannet.al., ConsEuro Rome 2006 • Comparison of surface micro hardness, elastic modulus, wear strength • Hybrid Bond exhibited highest modulus of elasticity. HB and Clearfil SE achieve comparable hardness values as fissure sealant Delton FS • ► Dentin Bonding agents can be an alternative for conventional fissure sealants

  29. In-vitro evaluation of self-etching adhesive with build-up composite resinNakanoet.al., AARD Orlando 2006 • Comparison of in vitro bond strength of Brush&Bond (= Hybrid Bond) and build-up resin Absolute Dentin (Parkell) with or without various dentin surface treatments • ► Hybrid Bond in combination with Absolute Dentin can be used to bond to root dentin whether the dentin is untreated, prepped with phosphoric acid, or with phosphoric acid followed by NaOCl (10%). There was no substantial difference of MTBS whether the core material was light cured or allowed to self-cure

  30. Hybrid Bond = Brush & Bond* * Parkell, USA

  31. CRA Newsletter Nov/Dec 2003 Which SEP Adhesives have most of the clinically desirable characteristics (number of steps, time, safety)? Brush&Bond = Hybrid Bond AdheSe Clearfil SE Bond(totally 21 Products!)

  32. Product Step1 Step 2 Step 3 Step 4 Step 5 Total Time Hybrid Bond 1 Layer Bond 20 s Air-drying 3-5 s Light-curing 3-10 s 3 26 - 35 s Xeno III Mixing Liquid A+B Application 20 s Air-dispers. 3 s Light-curing 10 s 4 38 s Adper PLP Squeezing, Folding 10 s Application 15 s Air-dispers. 3 s Light-curing 10 s 4 38 s iBond 1. Layer 2. Layer 3. Layer 30 s Air-drying Light-curing 20 s 5 < 50 s AdheSE Primer 3 + 15 s Air-dispers. 15 s Bond 5 s Air-drying 3 s Light-curing 10 s 5 51 s Clearfil SE Primer 20 s Air-drying 3 s Bond 10 s Air-dispers. 3 s Light-curing 10 s 5 46 s Application Steps and Time

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