today GNYDM 25 Nov

By George Freedman, DDS, FAACD, FACD n When Michael Buonocore first described tooth surface adhesion in 1955, he could not have imagined the magnitude of the paradigm shift he was about to unleash on the den- tal profession during the next half- century. The road to predictable adhesion has not been easy or smooth, nor without controversy, but Buonocore’s discovery was the first of many steps along the long and complex path to the 21st-century adhesive dentistry that the dental profession enjoys (and too often takes for granted) today. Dental adhesives are the cor- nerstones of the popular treatment modalities in every branch of den- tistry: preventive to restorative, pedi- atric to geriatric and endodontic to orthodontic. The quantum leaps in adhesive technology have increased bondstrengthandlongevity,butmost importantly, they have decreased the need for invasive procedures. There have been four revolution- arytechno-chemicaladvancesinden- tal adhesion technology during two decades. • Fourth-generation adhesives (early 1990s) ushered in the era of rel- ativelypredictableestheticadhesion. Enamelanddentinwereetchedsimul- taneously, with good bond strength to both. Multiple technique-sensitive components and steps, over-etching and a rash of post-operative sensitiv- ity complaints were the downsides. Moist dentin, an undefined and elu- sive surface condition, was required to ensure successful adhesion to dentin. •Fifth-generationadhesives(1995) consolidated all the adhesive compo- nents (except for the etch). Both tech- nique and post-operative sensitivity weresignificantlyreduced. However, moist dentin, still undefined and elu- sive as ever, was still required. • Sixth-generation adhesives (2000) eliminated the separate etch- ing step. The multiple-bottle chem- istry provided excellent dentinal adhesion, but the enamel bonding wassomewhatlesspredictable.There were few reports of post-operative sensitivity. • Self-etching seventh-generation adhesives (2002) are the least tech- nique sensitive of all the bonding agents. Post-operative sensitivity is virtually non-existent. Most impor- tantly, they are equally effective on moist or dry tissues, eliminating the concern of moist dentin. All the necessary ingredients are contained in a single bottle, or compule, and delivered to both enamel and dentin in a single step. The highly popular seventh-gener- ation adhesives etch the enamel and dentin surfaces immediately upon application. The neutralized etch and itsdissolveddentinalcontentsarenot rinsed off the tooth surface; they are instead incorporated into the hybrid layer. Becausethesmearplugisnever removed to open dentinal tubules, there is little risk of post-operative sensitivity. Shofu’s seventh-generation Beauti- Bondhasuniquedual-adhesivemono- mers that provide equal (non-stress- ing) bond strength to both enamel and dentin with an ultrathin 5μ film thickness. A straightforward, single- step application makes it easier and totally predictable. BeautiBond and Beautifil Flow Plus,agiomercombiningthestrength and reliability of hybrid composites with the convenience of flowable delivery, are used together for the flow restoration, an innovative two- step posterior filling technique. speakers18 Greater New York Dental Meeting — Nov. 25, 2012 Seventh-generation self-etch adhesives: better, faster, easier and more predictable Attend today’s session TODAY from 4:30 to 5:30 p.m. in aisle 5000,room3,Dr.GeorgeFreedmanwill present “Beauty of Bonding” as part of the DTSC Symposia. In his session, he will discuss how simplified one-step seventh-generation adhesives make invisible bonding a snap, while mini- mal preparation and re-mineralizing giomer flowables, used together, have revolutionized the replacement of lost tooth structure. About the author GeorgeFreedman,DDS,FAACD,FACD, is a founder and past president of the American Academy of Cosmetic Den- tistry, a co-founder of the Canadian Academy for Esthetic Dentistry and a diplomate of the American Board of Aesthetic Dentistry. His most re- centtextbook,“ContemporaryEsthetic Dentistry,” is published by Elsevier. Freedman is the author or co-author of 12 textbooks, more than 700 dental articles and numerous webinars and CDsandisaTeamMemberofREALITY. He was recently awarded the Irwin Smigel Prize in Aesthetic Dentistry presented by NYU College of Den- tistry. He lectures internationally on dental esthetics, adhesion, desensitiza- tion, composites, impression materials and porcelain veneers. A graduate of McGill University in Montreal, he maintains a private practice limited to esthetic dentistry in Toronto. 5 Applying Beautifil Flow Plus 5 Applying BeautiBond (Photos/Provided by Dr. George Freedman) ▲ ▲ 5 Dr. George Freedman’s most recent textbook, ‘Contemporary Esthetic Dentistry’ and the Irwin Smigel Prize he was awarded from the NYU College of Dentistry.