Challenges in Dentin Bonding

CHALLENGES IN
DENTIN BONDING
Made By :-
Danish Bin Sattar
Muhammad Hashim Kiani

Hammad Ali
Momin Khan
Fahim Sarwar
Hasan Ahmed
INTRODUCTION
 This topic is part of Adhesive Dentistry , which is a branch of dentistry
that deals with adhesion or bonding to the natural substance of the teeth
, enamel and dentin.
 In order to understand this topic , we must first know that there are in
fact two types of bonding. Namely , Dentin and Enamel. (As stated in the
previous point.)
 In this presentation , we will discuss the challenges or complications

faced in dentin bonding.
CONCERNS OVER THE
POTENTIALLY DAMAGING EFFECTS
OF ACIDS ON VITAL DENTINE
 These concerns were related to what was considered a well-established fact that acid-
containing restoratives placed in contact with vital dentine cause irritation and/or
irreversible pathological change to the pulp.
 Current philosophy on this important point is that most cases of pulpal irritation were not
related to direct chemical traumatization with phosphoric acid but were as a result of
ineffective sealing of cavity margins due to lack of adhesion.
 Hence, most authorities now accept that the dentine and pulp are able to withstand a
greater chemical insult with acids than was once thought to be acceptable.
OPENING OF DENTAL TUBULES BY
ETCHING
 In view of the fact that most restorative resins are relatively hydrophobic,
any increase in the moisture content of the surface of dentine is likely to
make bonding more difficult to achieve.
 Current thinking appreciates the damage which can be caused by

desiccation (state of extreme dryness) of dentine and tries to overcome
the moisture problem by the use of primers and solvents.
 Furthermore, it is now recognized that dentinal tubular fluid flow is

negligible in anaesthetized teeth due to the reduction in pulpal blood flow
as a consequence of the effect of the vasoconstrictor (usually
epinephrine) in the local anaesthetic solution.
 Dentinal tubular fluid is a transudate from the blood vessels of the pulp,
when pulpal perfusion pressure falls, the rate of transduction also falls.
DENTINAL TUBULE OPENINGS OCCUPY ONLY A SMALL
SPACE
o The dentinal tubule openings occupy only about 5% of the cut dentine surface in
superficial dentine (near the amelodentinal junction).
o This rises to near 20% in deep dentine.
o Hence, it was suggested that in inserting resin tags into dentinal tubules the
effectiveness of the bond to dentine would be limited by the relatively small
proportion of the area being utilized.
o It is currently being accepted that whereas tags in dentinal tubules can

contribute to bonding, other mechanisms involving all the exposed dentine
surface are at least equally as important.
COMPLICATIONS IN EVERYDAY
USE
o Durability :-
The material used in teeth bonding is made of a special type of plastic called
composite resin. It's a strong material, but the resin isn't as durable as your natural tooth
enamel, nor is it as hardy as the porcelain used in veneers or dental crowns. When you
receive a dental bond, you'll need to be particularly careful about eating and biting down
on hard foods to avoid chipping or breaking the bond. If the edge of the bonded teeth feels
rough or jagged, or if you notice any unevenness when you bite, it's a good idea to call
your dentist and have him or her take a look at the treated tooth. He or she may need to
file down the bond or replace it altogether.
CONTINUATION OF PREVIOUS SLIDE
• Not as Long-Lasting :-
Keep in mind because teeth bonding isn't as resilient as its alternatives, it usually has a
shorter shelf life as well. You can expect a bond to last anywhere from three to seven years,
according to Dr. Kimberly Harms cited in Everyday Health, compared to as long as 40 years
for a crown. How well you take care of your teeth and gums alongside your regular lifestyle
habits play a big part in determining the life of the bond.
• Not as Strain-Resistant :-
Another pitfall of dental bonding is that the material often used to create the bond isn't
particularly resistant to stains. Composite resin is more porous than tooth enamel or
porcelain, so it absorbs a deep-colored food more easily. If you're a regular coffee or red-wine
drinker, for example, you might notice the bonded tooth discolors more quickly and noticeably
than your natural teeth. Limiting coffee, wine and similar foods and drinks is therefore the
easiest way to avoid staining the bonding resin.
RISKS
Some of the risks of dental bonding, such as infection and allergic reaction, are rare. Other risks, such as
the bonding material becoming worn down, chipped, or stained, are more likely to occur; as such, patients
should expect to undergo dental bonding touch-up treatments every three to 10 years.
• Infection: Before the dental bonding material is placed, infection, tooth decay, and debris must be
cleaned away and the tooth sterilized. If an infection is still present after the composite resin material is
placed, it will continue to eat away at the natural tooth structure, and will eventually result in the need
for root canal therapy or tooth extraction.
• Allergic reaction: It is possible for patients to experience an allergic reaction to the conditioning
liquid, composite resin, or tools used during the dental bonding procedure.
• Wearing down of the bonding material: It is certain that composite resin used in the dental
bonding procedure will wear down over time, as is the case with a person's natural tooth enamel. In
more serious cases, the bonding material can even chip or crack.
• Discoloration of the bonding material: The composite resin material is not completely resistant to
staining; further, it will not respond to teeth whitening treatment.
Properly caring for your teeth, and avoiding certain foods, drinks, and habits can slow erosion, chipping,
and staining of the dental bonding material.
AFTERCARE INSTRUCTIONS AND ALTERNATIVES
Dental bonding patients should follow these aftercare instructions to ensure that the composite resin bonding material
lasts as long as possible.
• Brushing: Brush the teeth twice a day, ideally once in the morning and once at night, using toothpaste that
contains fluoride; Brush the outside, inside, and top of each tooth, and then brush the tongue. Replace your
toothbrush every three to four months to ensure that your teeth are properly cleaned.
• Flossing: Floss once a day; be sure to bring the floss all the way up to the gum line and thoroughly remove all
plaque before moving on to the next tooth.
• Drink water after meals: Drinking water after meals will help flush out food particles and reduce acidity levels in
the mouth.
• Foods and drinks that stain the teeth: Tea, dark colored sauces, red and white wine, berries, sports drinks,
sodas, juices, and candies with bright artificial coloring stain the teeth. Foods and drinks with dark or bright colors
are the most likely to stain the teeth because of their dark colors; the acidic qualities in many of these foods and
drinks can also accelerate tooth discoloration.
• Products that stain the teeth: Use of tobacco products, such as cigarettes or chewing tobacco, causes yellow and
brown stains to appear on the teeth and bonding material.
• Foods and drinks that wear down the bonding material: Acidic foods (such as citrus, soda, and wine) eat away
at tooth enamel and the composite resin; hard or crunchy foods such as candy, pretzels, and beef jerky can wear
down and even chip the bonding material due to the force that is exerted while chewing on these foods.
• Habits that wear down the bonding material: Certain habits, such as biting on fingernails, pen caps, pens,
pencils, and other hard objects, wears down the bonding material and tooth enamel over time.
AFTERCARE INSTRUCTIONS AND ALTERNATIVES
Any of these teeth bonding disadvantages can be a deal-breaker. If you find that the
drawbacks of dental bonding do outweigh the positives, you can always consider other
options.
A dental crown is a great choice in the event that a broken tooth needs to be fully restored, or
if a tooth has a cavity that is too large to correct with a filling. Your main concern may even
be correcting discolored teeth or changing the shape or alignment of slightly crooked teeth, in
which case veneers are also a good solution. Veneers are typically made of porcelain and are
attached to the front of your teeth.
Choosing between dental bonding and other restorative options is often a matter of cost and
convenience. Whereas bonding is more delicate than a crown or set of veneers, it's also a lot
of less expensive. You typically need just a single appointment for bonding, and the process
usually takes less than one hour per tooth. In contrast, veneers and crowns cost more upfront
and often require multiple trips to the dentist. The trade-off is that they will withstand stains
and hard objects much more easily, allowing them to last a lot longer than your typical
composite resin.
THANK YOU ~!!!!!!

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CHALLENGES IN

Muhammad Hashim Kiani

 In this presentation , we will discuss the challenges or complications

 Current thinking appreciates the damage which can be caused by

 Furthermore, it is now recognized that dentinal tubular fluid flow is

o This rises to near 20% in deep dentine.

o It is currently being accepted that whereas tags in dentinal tubules can

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