GC presents a masterclass in step-by-step protocols for bonding direct and indirect restorations, available on demand as a webinar.
Nik Sethi is the president elect for the British Academy of Aesthetic Dentistry, and director of Elevate Dentistry, Square Mile Dental Centre and Dental Beauty Basildon.
In a recently released Dentistry Webinar, Nik talked in depth about his step-by-step, evidence-based protocols to achieve successful bonding in both direct and indirect restorations, using only proven techniques and materials.
As an expert in restorative dentistry, Nik believes there is a lot of confusion amongst dentists when it comes to bonding and the choice of bonding agents. His webinar aims to provide a clear workflow for all restorations bonded adhesively to overcome daily problems such as marginal staining, post-op sensitivity, premature bond failures, fractures, cracks and secondary caries.
Read on for a preview of this insightful webinar.
The process
Firstly, adhesive success starts in the planning stage. Nik talks through a detailed assessment of a case to determine whether a direct or indirect restorative approach is appropriate, taking both local and general factors into consideration.
When teeth will be placed back into a compressive state, Nik considers cavity margin design, shrinkage stress, the importance of biofilm removal and why the border between tooth and restoration is always problematic.
Bonding agents
The right choice of bonding agent is key to restorative success. Nik illustrates the current systems available for indirect adhesive luting, providing tips on choosing the correct material for long-term success.
A discussion of different universal and self-etch bonding systems follows, and he sets out a self-etch bonding protocol using a one-bottle system such as G-Premio BOND, or a two-bottle system such as G-2 BOND Universal.
‘These are two incredible bonding agents that do the work for you. They are able to condition and form a bond to the dentine without the need to etch it first,’ he says.
Nik completes the long-term hybrid layer over the dentine with the application of a flowable composite. His choice is to use G-ænial Universal Injectable (GUi) as ‘it’s incredibly highly filled and incredibly strong’. In his opinion, it’s a restorative material in its own right!
Base build-up
With the bonding protocol completed, Nik moves on to the base build-up to shape molars with a predictable build-up protocol, using GUi followed by heated G-ænial A’CHORD universal composite and G-ænial light-cured radiopaque composite restorative.
This is followed by finishing and polishing, with a reminder that polishing must be done quickly before the composite fully matures.
As part of the base build-up Nik demonstrates a mini core build up using GUi and explains how to deal with undercuts. He gives some useful advice about which light curing unit to use and a short summary of polishing protocols.
There is also a constant reminder from Nik, throughout his presentation, of the importance of having a great relationship with your lab technician, to ensure the restoration is a success every time.
Cementation
The conclusion is the cementation stage, where Nik explains protocols for the try-in, preparing the adhesion fit surface for placing the onlay after removing the provisional, and luting protocols.
To close the webinar, Nik presents a thought-provoking final case study to illustrate that clinicians sometimes have to think ‘outside the box’. A patient presented with three large failing restorations and, because of time restraints, Nik used a direct approach for selective cusp reduction to predictably restore the dentine and cusp.
Watch on demand
For a limited time only, Nik’s full webinar on step-by-step protocols for success with bonding for direct and indirect restorations is available on demand. Catch up now.
For further information on GC’s full range of restorative products contact GC UK on 01908 218999, email [email protected] or visit gc.dental/europe/en-GB.
