Chapter 44

Dental Liners, Bases and Bonding Systems

Copyright 2003, Elsevier Science (USA).
All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher. PowerPoint presentation slides may be displayed and may be reproduced in print form for instructional purposes only, provided a proper copyright notice appears on the last page of each print-out. Produced in the United States of America ISBN 0-7216-9770-4

Copyright 2003, Elsevier Science (USA). All rights reserved.

Introduction
Dental liner, bases, and bonding systems are in a classification of dental materials that provide additional protection for the health and well-being of a tooth being restored.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Prepared Tooth Structures

The design of the cavity preparation gives
strength within the tooth and helps determine how the tooth will hold the restoration in place.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Pulpal Responses
Types of stimulus Physical Mechanical Chemical Examples of stimulus Thermal, electrical Handpiece, traumatic occlusion Acid from dental materials

Biologic

Bacteria from saliva

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dental Liners
Dental liners provide a thin barrier that protects
the pulpal tissue from irritation caused by physical, mechanical, chemical and biologic element.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Calcium Hydroxide
Indications for use
Protects the pulp from chemical irritation by its sealing ability. Stimulates the production of reparative or secondary dentin. Compatible with all types of restorative materials.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Calcium Hydroxide-contd
Application process
Placed only on dentin. Placed directly over the deepest portion of the preparation.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Fig. 44-1 Location for placement of calcium hydroxide.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Varnishes
Indications for use*
Seal the dentinal tubules. Reduce leakage around a restoration. Act as a barrier to protect the tooth from highly acidic cements such as zinc phosphate. * This material is contraindicated in its use under composite resins and glass ionomer restorations.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Varnishes-contd
Application process
Applied with either a small disposable applicator or a cotton pellet. Thin coating of the varnish on the walls, floor, and margin of the cavity preparation. Apply a second coat.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Fig. 44-5 Location for placement of cavity varnish.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dentin Sealer
Indications for use
Treat or prevent hypersensitivity. Used instead of a varnish. Seal the dentinal tubules. Ideal for use under all indirect restorations.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dentin Sealer-contd
Application Process
Material used sparingly. Do not allow to contact soft tissues (HEMA and glutaraldehyde). Apply the dentin sealer with the cottontipped applicator. Apply over all areas of the exposed dentin.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dental Bases
Dental bases provide pulpal protection.
Protective base: Protect the pulp before the restoration is placed. Insulating base: Protect the tooth from thermal shock. Sedative base: Soothe a pulp that has been damaged by decay or irritated by mechanical means.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Types of Base Materials

Zinc oxide eugenol Zinc phosphate Polycarboxylate Glass ionomer

Copyright 2003, Elsevier Science (USA). All rights reserved.

Fig. 44-8 Location for placement of a base.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dental Bonding
Dental bonding improves retention by creating
a micromechanical retention between the tooth structure and the restoration.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Enamel Bonding
Enamel bonding is placed directly onto the

intact enamel surface. Examples of Enamel Bonding Sealants Bonded orthodontic brackets Resin-bonded bridges Bonded veneers

Copyright 2003, Elsevier Science (USA). All rights reserved.

Dentin Bonding
Dentin bonding is placed on prepared dentin in
order to bond. Smear layer Thin layer of debris Nature's bandage

Copyright 2003, Elsevier Science (USA). All rights reserved.

Etching Systems
Etching Systems remove the smear layer in

preparation for bonding. Supplied as: Liquid/Gel Maleic acid Phosphoric acid

Copyright 2003, Elsevier Science (USA). All rights reserved.

Clinical Application of the Etchant and Bonding Systems

Etchant is applied to remove the smear layer. Plaque or debris is removed before the bonding
process. Avoid overdrying etched teeth. Too much primer is better than too little. Bonding solution covers all surfaces. Contamination with saliva requires the entire procedure to be redone. Allow time for bonding material to mature before completing the restoration.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Table 44-2: Supplementary Dental Materials and their Application in Order of Use

Copyright 2003, Elsevier Science (USA). All rights reserved.