Before I cement Zr Crowns with Fugi II, RMGI, I do a presrub with PA acid. And from my experience the few crowns I've removed after cementation had very nice bonds and I've had to cut them off, piece by piece, like a well cemented e.max. Anecdotal, I know
Ryan May That is very interesting. Never mentioned in the manufacturer’s instructions but makes sense. Would be interesting to see a study that looks at that clinically.
3 года назад+2
I cannot stress this enough on how good your content is, i always share it with my "dental friends" hahaha
Be Lo I really appreciate that. That is always my hope...that people find it helpful or useful. Most of it comes from questions and problems I have encountered!
Taylor Anderson Typically, class 5 non-carious lesions are going to be more calcified-sclerotic dentin. These can be a challenge to bond to. In theory, you are correct, you don’t necessarily have to do anything to the prep but it may not be a bad idea to toughen the prep first with a diamond bur prior to bonding.
@@TheComprehensiveDentist Figured I might as well try it so found a dentist that was willing. He used a GI (only had one color in stock so it's could be better), no prep just poly acid, seem pretty solid so far no sensitivity. I figure if I'm going to need these "filled" for the rest of my life I gotta find a way that either does no damage or stays on a very very long time. Will be interesting to see how long they last, the resins I've had seem to last about 3-4 years but are usually pretty crummy at the gumline, and if they'll fall off in one big chunk like the resins I've had or if they just wear away slowly. Thanks for the vids btw, helps me be an informed patient.
watersofthesouth the article references for the cavity conditioner is: Saad A (2017). Microtensile bond strength of RMGI cement to sound and artificial caries - Affected root dentin with different conditioning. Operative Dentistry 42(6).
@@TheComprehensiveDentist Thank you, but not what I asked. All studies agree they are inferior to resins as far as retention goes, but equal or better in terms of caries prevention (the ultimate goal). My work environment (schools) is trying to limit aerosol production, so we are switching to hydrophilic material(I don't have a choice) .My question was asked to find out if you have any input on whether the conditioner will be beneficial in my case or an unnecessary step.
Richard Vogel so if I understand correctly, you do use GI based sealant? If that is the case, I have seen studies that show a benefit using a conditioner in regards to retention. Granted those studies did not look at sealants specifically and bonding to enamel specifically. The conditioner contains polyacrylic acid. GI’s also have a component of polyacrylic acid so are in essence “self etching”. So is the conditioner beneficial? On one hand yes. How beneficial? I have no research to show a clinical significance in GI based sealants and for enamel. Certainly a desire to minimize aerosols would frown on conditioner due to the need to rinse.
I would also add that if you use a conditioner and then place a GI based sealant, you are looking at two steps. At that point, unless moisture control is an issue, I would just do a resin based sealant. This can also be two steps if you don’t use a bonding agent and will be a better choice. I would argue that retention is strongly related to caries prevention. Partially retained or lost sealants can easily lead to eventual caries in some patients. Sealants are only one small component of overall caries prevention.
What if I just use the blue etch (phosphoric acid)? Since it’s the same ingredient if the self conditioner, should be the same result right? Which means I only need to spend money in buying/using the blue etch instead of buying the cavity conditioner? 🤔
They are totally different chemicals. Phosphoric acid etch removes the smear layer and your ability to chemically bond to the tooth with it! Poly acrylic acid is what is found in GI/RMGI and should be your go to to maximize the benefit of the product. Remember, saving money and reducing steps does not typically equal “better dentistry.”
Abigail Fincel when you use 37% phosphoric acid, you are doing a total tech of the dentin. This means that you are removing hydroxyapatite from within the collagen. The cavity conditioner only does a partial etch and leaves some hydroxyapatite. Knowing this, glass ionomers and RMGIs bond via chemical bonding to hydroxyapatite. Which do you think would offer the best bond? Don’t use phosphoric acid unless you want inferior bonds.
@@TheComprehensiveDentist How about using a Universal Adhesive? Considering the fact that it contains an acidic monomer; it will modify the smear layer without sacrificing calcium. . In a study by Imbery et. al in 2013 (Evaluating Dentin Surface Treatments for Resin-Modified Glass Ionomer Restorative Materials), Total Etch technique yielded better results than a variety of Cavity Conditioners. The study didn't evaluate the bond's strength over a lengthy period of time like the study you mentioned by Saad et. al. So maybe that's a vulnerability of Imbery's Study?
Yes we need to use cavity conditioner, the restoration will last much longer. I use equia Forte all the time, great product.
Before I cement Zr Crowns with Fugi II, RMGI, I do a presrub with PA acid. And from my experience the few crowns I've removed after cementation had very nice bonds and I've had to cut them off, piece by piece, like a well cemented e.max. Anecdotal, I know
Ryan May That is very interesting. Never mentioned in the manufacturer’s instructions but makes sense. Would be interesting to see a study that looks at that clinically.
I cannot stress this enough on how good your content is, i always share it with my "dental friends" hahaha
Be Lo I really appreciate that. That is always my hope...that people find it helpful or useful. Most of it comes from questions and problems I have encountered!
Yes, you need to use a cavity conditioner.
It's only less important if the restoration is temporary.
You're welcome
Yes! That's your answer
Is it helpful to place Gluma after the Cavity Conditioner?? Thanks for the great video
Great vid! I've always wondered this myself.
Very good
This is really informational! If it bonds so well to dentin is there even a need for preparation for example on class V?
Taylor Anderson Typically, class 5 non-carious lesions are going to be more calcified-sclerotic dentin. These can be a challenge to bond to. In theory, you are correct, you don’t necessarily have to do anything to the prep but it may not be a bad idea to toughen the prep first with a diamond bur prior to bonding.
@@TheComprehensiveDentist Figured I might as well try it so found a dentist that was willing. He used a GI (only had one color in stock so it's could be better), no prep just poly acid, seem pretty solid so far no sensitivity. I figure if I'm going to need these "filled" for the rest of my life I gotta find a way that either does no damage or stays on a very very long time. Will be interesting to see how long they last, the resins I've had seem to last about 3-4 years but are usually pretty crummy at the gumline, and if they'll fall off in one big chunk like the resins I've had or if they just wear away slowly. Thanks for the vids btw, helps me be an informed patient.
Is it possible to have a link to the comparative research of bond strenghts?
Thank you very much for your time
watersofthesouth the article references for the cavity conditioner is: Saad A (2017). Microtensile bond strength of RMGI cement to sound and artificial caries - Affected root dentin with different conditioning. Operative Dentistry 42(6).
What about for off label use as a pit and fissure sealant? Any information on use of the conditioner when boding entirely to enamel?
GIs and RMGIs are the worst choice for sealants. They never last as long as resin and the bond to enamel without phosphoric acid is inferior.
@@TheComprehensiveDentist Thank you, but not what I asked. All studies agree they are inferior to resins as far as retention goes, but equal or better in terms of caries prevention (the ultimate goal). My work environment (schools) is trying to limit aerosol production, so we are switching to hydrophilic material(I don't have a choice) .My question was asked to find out if you have any input on whether the conditioner will be beneficial in my case or an unnecessary step.
Richard Vogel so if I understand correctly, you do use GI based sealant? If that is the case, I have seen studies that show a benefit using a conditioner in regards to retention. Granted those studies did not look at sealants specifically and bonding to enamel specifically. The conditioner contains polyacrylic acid. GI’s also have a component of polyacrylic acid so are in essence “self etching”. So is the conditioner beneficial? On one hand yes. How beneficial? I have no research to show a clinical significance in GI based sealants and for enamel. Certainly a desire to minimize aerosols would frown on conditioner due to the need to rinse.
I would also add that if you use a conditioner and then place a GI based sealant, you are looking at two steps. At that point, unless moisture control is an issue, I would just do a resin based sealant. This can also be two steps if you don’t use a bonding agent and will be a better choice. I would argue that retention is strongly related to caries prevention. Partially retained or lost sealants can easily lead to eventual caries in some patients. Sealants are only one small component of overall caries prevention.
They have a specific pit and fissure RMGI called Fuji Triage I believe. May be more purpose made for avoiding 2 steps
What if I just use the blue etch (phosphoric acid)? Since it’s the same ingredient if the self conditioner, should be the same result right? Which means I only need to spend money in buying/using the blue etch instead of buying the cavity conditioner? 🤔
They are totally different chemicals. Phosphoric acid etch removes the smear layer and your ability to chemically bond to the tooth with it! Poly acrylic acid is what is found in GI/RMGI and should be your go to to maximize the benefit of the product. Remember, saving money and reducing steps does not typically equal “better dentistry.”
Is there possible harm that can result from using 37% phosphoric acid? Or would it be better to do nothing?
Abigail Fincel when you use 37% phosphoric acid, you are doing a total tech of the dentin. This means that you are removing hydroxyapatite from within the collagen. The cavity conditioner only does a partial etch and leaves some hydroxyapatite. Knowing this, glass ionomers and RMGIs bond via chemical bonding to hydroxyapatite. Which do you think would offer the best bond? Don’t use phosphoric acid unless you want inferior bonds.
@@TheComprehensiveDentist How about using a Universal Adhesive? Considering the fact that it contains an acidic monomer; it will modify the smear layer without sacrificing calcium. . In a study by Imbery et. al in 2013 (Evaluating Dentin Surface
Treatments for Resin-Modified Glass Ionomer Restorative Materials), Total Etch technique yielded better results than a variety of Cavity Conditioners. The study didn't evaluate the bond's strength over a lengthy period of time like the study you mentioned by Saad et. al. So maybe that's a vulnerability of Imbery's Study?
Muhammad Bishr Interesting, I haven’t looked at that study myself. I’ll see if I can find it...
Radha Rai
Po
Can I just use GIC liquid as a conditoner since it is also made up of polyacrylic acid?