When it comes to restorative dentistry, a versatile, strong, and durable dental adhesive that bonds effectively to enamel and dentin and seals the margins is all a critically important factor for long-term res­toration success. 

In my practice, we perform many differ­ent types of dental restorations, so access to a universal adhesive that delivers supe­rior results and is easy to work with is a key consideration. 

In a recent case, a patient scheduled a visit to evaluate 6 older porcelain-fused-to-metal (PFM) crowns on teeth Nos. 6 to 11 in the upper anterior region. The patient’s chief concern was that the metal was becoming visible at the margins, and she was ready for a new aesthetic look. 

The preparation for this procedure included sectioning and removing the old PFM crowns from teeth Nos. 6 to 11. The preps were then modified to allow for the new wax-up designs. Once this step was complete, we performed an intraoral scan using iTero (Align Technology) and placed the provisional crowns. We chose Ivoclar Vivadent’s IPS e.max for the new crowns, a monolithic lithium disilicate that dem­onstrates high mechanical strength and remains an affordable alternative to PFMs and zirconia-based restorations. 

Once the patient’s new IPS e.max porce­lain crowns were manufactured and ready for placement, I sectioned and removed the provisional crowns. I then micro-etched the preps and fully rinsed them with air/ water before beginning a total etch with Kerr’s OptiBond Gel Etchant (Figure 1). I also placed MicroPrime G (Zest Dental Solu­tions), an antimicrobial and universal desen­sitizing agent, to help further reduce the risk of postoperative sensitivity (Figure 2). 

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Once I air-thinned the area, I began applying 2 coats of Kerr’s new OptiBond Uni­versal 360 to affix the first 6 replacement crowns (Figure 3). 

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The choice to use this new single-com-ponent universal adhesive was quite easy. Data demonstrate that this new adhesive is now one of the strongest available. It delivers exceptional bond strength to direct and indirect substrates, including dentin, enamel, zirconia, metal, ceramic, and com-posite. One bottle can be used for etching, priming, and bonding, and it’s compatible with self-etch, selective-etch, and total-etch techniques. The improved bottle design also made this adhesive simple to apply with one hand. Kerr has developed a Ternary Solvent System technology that provides excellent penetration into dentinal tubules, achiev-ing superior bond strength and protection against microleakage and post-op sensitiv-ity. The major advantages of this adhesive include its versatility of use with virtually any restorative materials or techniques, as well as its strength and durability. 

Once the patient’s crowns were seated and affixed (Figures 4 and 5), I light cured the restoration. 

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Follow-up x-rays showed a perfect seat with closed margins, achieving excellent functional and aesthetic results (Figure 6). 

Conclusion 

Selecting the right tools for any dental restoration will improve the outcome. While we have so many choices of technol­ogy and materials to improve oral health and advance restorative dentistry for our patients, the universal adhesive remains one of the most important tools for clini­cians. Its selection in my armamentarium is based on its versatility, durability, strength, performance, and ease of use. Plus, the results keep our patients smiling. 

The opinions expressed in this article are those of Dr. Savage, who is a paid consultant of Kerr. Clinicians should use their own professional judgment in treating their patients. Kerr is a medical device manufacturer and does not dispense medical advice. The article was originally published by Dentistry Today .

For more information, call (800) KERR- 123 (537-7123) or visit go.kerrdental.com.