Adper Scotchbond SE Self-Etch Adhesive. technical product profile. Adper

Similar documents
Adper Easy Bond. Self-Etch Adhesive. Technical Product Profile

Adper Scotchbond SE. Self-Etch Adhesive. Self-etch technology that s visibly better

Bisco UNIVERSAL PRIMER

Adhesive Solutions. Scotchbond Universal Adhesive. SEM pictures of Scotchbond Universal Adhesive. One bottle for all cases! Total-Etch and Self-Etch

DUO-LINK UNIVERSAL KIT

Scotchbond Universal Adhesive. Technical Product Profi le

Breakthrough Performance

ALL-BOND 2. Bisco. Instructions for Use. Universal Dental Adhesive

Adper Single Bond Plus Adhesive. technical product profile. Adper

3M Scotchbond Universal Adhesive. Technical Product Profile

Technical Product Profile

BIS-SILANE. Bisco Instructions for Use. 2-Part Porcelain Primer

ACE ALL-BOND TE. Bisco CE Universal Dental Adhesive System. Dual- Cured

RESINOMER Dual- Bisco. Instructions for Use. Cured Amalgam Bonding/Luting System

Pulpal Protection: bases, liners, sealers, caries control Module C: Clinical applications

G-Premio BOND. Introducing a premium bonding experience

ÆLITE Composites. Bisco. Instructions for Use. Light- Cured. U.S. Patent: 6,709,271

Bonding to dentine: How it works. The future of restorative dentistry

PRO-V IDS Kit. Bisco. Instructions for Use. Provisional Restorative System

G-Premio BOND. One component light cured universal adhesive. BOND with the BEST

GLUMA Comfort + Desensitizer

UNIVERSAL ADHESIVE SYSTEM. PEAK UNIVERSAL BOND Light-Cured Adhesive with Chlorhexidine

RelyX Unicem Self-Adhesive Universal Resin Cement Frequently Asked Questions

Adhese Universal. The universal adhesive. Direct Indirect Total-Etch Selective-Etch Self-Etch Wet & Dry. All in. one click

Luting Cement. in the Clicker Dispenser. Technical Product Profile Ketac Cem Plus

illustrated technique guide

Forgives Nothing. Forgives Almost Anything. Science Update

Change the Way You Think About Bulk Fill Composites

Calibra. Cements. The Simple Choice for Easy Cleanup

Restorative Resin Cement for Bonding and Masking Tetracycline and Dark Stained Teeth for All Veneers

ExciTE F L I G H T - C U R I N G T O T A L - E T C H A D H E S I V E. ExciTE F DSC D U A L - C U R I N G T O T A L - E T C H A D H E S I V E

***Handout*** Adhesive Dentistry Harald O. Heymann, DDS MEd Dentin Bonding Rewetting/Desensitization

Pulpal Protection: bases, liners, sealers, caries control Module A: Basic Concepts

XP BOND. Universal Total-Etch Adhesive. Directions for Use

THE ONE AND ONLY. CLEARFIL Universal Bond

values is of great interest.

Used Products. Variolink N LC. Proxyt fluoride-free. OptraStick. Ivoclean. Monobond N. OptraDam. N-Etch. Tetric N-Bond.

Adhesive Solutions. Adper Easy One Self-Etch Adhesive. One for all.

Adhese Universal The universal adhesive

A Collection of Scientific Results. Adper. Scotchbond 1 XT. Total-Etch-Adhesive

TOOTH - Crown - Lithium disilicate - Non-retentive preparation - Variolink Esthetic - Adhese Universal

Product Information. ibond Universal All-purpose convenience. Giving a hand to oral health.

Metal-Free Restorations PROCEDURES FOR POSTERIOR DIRECT & SEMI-DIRECT COMPOSITE RESTORATIONS D I D I E R D I E T S C H I. For.

Spectrum TPH. Syringe Starter Pack Resin-based dental restorative system. Directions for Use

Prime&Bond elect Universal Dental Adhesive. The universal adhesive that s more than strong. NEW! FLIP TOP BOTTLE

CLINICAL TECHNIQUES. CORE BUILDUP TECHNIQUE (VITAL TEETH) 1. Isolate, Control Hemorrhage, Clean the Substrate and Kill microbes (holy triad)

stabilisation and surface protection

TOOTH - Crown - Lithium disilicate - Retentive preparation - Super- and equigingival - Visible margin - Variolink Esthetic - ExciTE F DSC

D.T. LIGHT-POST. Instructions for Use. Bisco 0459 D.T. LIGHT-POST X-RO. Radiopaque Translucent Fiber Post System ILLUSION

DiaDent Group International DIA.DENT DiaRoot BioAggregate. Root Canal Repair Material

Bisco D.T. LIGHT-POST X-RO ILLUSION

HIGH DEMANDS AND POWER PANAVIA TM F 2.0

One cement that can take you just about anywhere! RelyX. Unicem. Self-Adhesive Universal Resin Cement

Press Release. Press Contact. The concept for Class II restoration Delicate preparation, rapid procedure and reliable results

Incognito Appliance System Bonding Protocols Step-by-Step Procedures

MDJ Evaluation the effect of eugenol containing temporary Vol.:9 No.:2 2012

Introduction to Layering with Filtek Supreme Plus Universal Restorative. Filtek. Supreme Plus Universal Restorative

Continually Fluoride Releasing Aesthetic Dental Restorative Material

Used Products. Multilink Automix. Proxyt fluoride-free. OptraStick. Monobond Etch&Prime. OptraDam. Liquid Strip. OptraPol.

Posterior Adhesive Dentistry

G-COAT PLUS G-COAT PLUS GET THE BEST OF BOTH WORLDS WITH THE STROKE OF A BRUSH

D.T. LIGHT-POST. Bisco. Instructions for Use. Radiopaque Translucent Fiber Post System. Double Taper

Ketac Universal Aplicap

< 1% shrinkage! * new record: Low Shrink Posterior Restorative. volumetric. The fi rst direct posterior composite to achieve less than 1 % shrinkage.

Ultra-Bond Plus. Dual-Cure Restorative Resin Cement Kit. Store Under Refrigeration

6/1/15. Bonding Ceramic Veneers in What we did? What we do? Using Evidence-Based Dentistry XXXX ?????

EQUIA. Self-Adhesive, Bulk Fill, Rapid Restorative System

THE FUTURE DEMANDS THE RIGHT EQUIPMENT CLEARFIL SE BOND 2

Developed to make a difference... every step of the way. CEREC CAD/CAM solutions

G-CEM LinkForce. Made to fit. Designed to last. from GC. all your adhesive challenges. Dual-cure adhesive luting cement

DH220 Dental Materials

Monobond Plus is the universal primer for the conditioning of all types of restoration surfaces

Clinical report. Drs Paul and Alexandre MIARA and F. CONNOLLY COMPOSITE POSTERIOR FILLINGS. How to control. layering? 8 - Dentoscope n 124

G-CEM LinkForce. Strong. Dependable. Universal.

Peak. Universal Bond Light Cure Adhesive with Chlorhexidine. With its versatile formulation, Peak Universal Bond is the only adhesive you need.

G-CEM LinkAce. The new strength in self-adhesive cement

lec: Dental material dr. Aseel Mohammed Filling material

RelyX Ultimate. Adhesive Resin Cement. Technical Data Sheet

QuickPro. Instructions for use

3 Tips for Selecting the Right Dental Cement. Plus, a Bonus Checklist for Bonding Zirconia

Fuji II LC. A Perfect Choice

XBW BW A1 A2 A3 A3.5 A4 B1 B2 B3 C3 CV CVD. Outside Translucent Shades DT CT GT NT WT CVT. GRADIA DIRECT Flo & LoFlo - 7 Shades (radiopaque) Standard

CERASMART. The new leader in hybrid ceramic blocks

TOOTH - Crown - Lithium disilicate - Retentive preparation - Super- and equigingival - Visible margin - SpeedCEM Plus

Anterior Esthetic Techniques & Materials

Cementation Solutions. RelyX Ultimate Adhesive Resin Cement. Glass ceramic

riva helping you help your patients

Universal light-curing dental adhesive. All the power you need in one drop.

Product Information. GLUMA Desensitizer & GLUMA Desensitizer PowerGel More gain, less pain. Giving a hand to oral health.

shrink less than 1 %

Shadeguides Ceramic Veneers: Tooth Preparation for Enamel Preservation

Ketac Nano Light-Curing Glass Ionomer Restorative. An esthetic glass ionomer. Fewer steps. Faster treatment.

Self-Adhesive (SA) Cement VS Dual-Cured (DC) Resin Cement

Filtek. Any place. Any class. Supreme XTE. It s the one that can do it all. Universal Restorative. Class III. Class IV. Class II. Class I.

3M Fast Release Varnish

BioCoat Featuring SmartCap Technology

Shades: A1, A2, A3, A3.5, A4, B1, B2, B3, C2, C3, C4, D3, DB, OA2, OA3, OA3.5, OB2, Incisal, SL,SLO, SLT, YB

Microleakage around zirconia crowns after ultrasonic scaling around their margin

Transcription:

Adper Scotchbond SE Self-Etch Adhesive technical product profile Adper

2

Table of Contents Introduction................................................................5 Product Description.......................................................5 Composition................................................................5 Application Technique.......................................................6 Background................................................................6 Mechanism of Adhesion to Enamel for Total-Etch Adhesives....................6 Mechanism for Adhesion to Dentin for Total-Etch Adhesives....................7 Bonding Mechanism for Adper Scotchbond SE Self-Etch Adhesive................8 Role of Inorganic Filler in Bonding.............................................9 Test Results................................................................11 Laboratory Evaluation....................................................11 Bond Strengths to Dentin and Cut Enamel...................................11 Thermal Cycling Data....................................................13 Moisture Tolerance.......................................................14 Marginal Integrity........................................................15 Microleakage............................................................16 Nanoleakage............................................................17 Low Post-Operative Sensitivity.............................................17 Step-by-Step Technique Guides...............................................19 Direct Light Cure Restoration..............................................19 Porcelain Repair.........................................................20 Porcelain Repair, Continued...............................................21 Root Surface Desensitization...............................................22 Root Surface Desensitization, Continued....................................23 Instructions for Use.........................................................24 3

4

Introduction Product Description Adper Scotchbond SE Self-Etch Adhesive is a simple to use, two-bottle, self-etch bonding agent from 3M ESPE. This brand-new self-etch adhesive provides excellent bonding performance equivalent to total-etch systems on prepared enamel and dentin. The system consists of an aqueous primer (Liquid A) and an acidic adhesive (Liquid B). The primer contains a pink color indicator that ensures complete coverage of the preparation. The pink color disappears upon application of the adhesive, indicating activation of the acid and assuring that a proper etch is taking place. The technique provides for a solvent-free, hydrophobic overcoat similar to the bonding philosophy of Adper Scotchbond Multipurpose adhesive. This novel bonding approach, combining the unique color change technology and hydrophobic overcoat, results in low technique sensitivity and more consistent performance. The adhesive contains a bonded zirconia nanofiller that provides radiopacity to reduce the chance of misdiagnosis of secondary caries in the case of adhesive pooling. In addition, the bonded nanofiller enhances bond strength. Adper Scotchbond SE Self-Etch adhesive can be used for the following indications. Bonding between dentin/enamel and composite filling materials Bonding between dentin/enamel and compomer filling materials Intraoral repair of porcelain, composite and metal using light-cure composite resin Desensitization of hypersensitive teeth/root surface desensitization Contraindications: Use with dual-curing or self-curing materials Indirect applications including use in veneer placement Composition Adper Scotchbond SE Self-Etch Adhesive consists of an aqueous primer (Liquid A) and an acidic adhesive (Liquid B). Separation of the aqueous and acidic components minimizes hydrolysis of the acidic phosphates for improved shelf stability. The two-bottle composition consists of the following. Liquid A Water HEMA Surfactant Pink colorant Liquid B UDMA TEGDMA TMPTMA (hydrophobic trimethacrylate) HEMA phosphates MHP (methacrylated phosphates) Bonded zirconia nanofiller Initiator system based on camphorquinone 5

Application Technique The application technique is depicted in Figure 1. The initial color of Liquid A gives a good indication that full coverage of the adhesive on the prepared surface is achieved (Figure 1-1). When Liquid B is applied to the tooth surface, the color disappears (Figure 1-2). This color change indicates the activation of the acidic monomers in Liquid B and the commencement of the etching process. Although the color change is instantaneous, it is important to maintain agitation on the surface for 20 seconds to ensure a proper etch. After 20 seconds of agitation, the adhesive is air-dried to remove water (Figure 1-3). Liquid B (adhesive) is reapplied and can be air thinned before it is light cured (Figure 1-4). This solvent-free second coat of adhesive provides a hydrophobic overcoat. Figure 1: Adper Scotchbond SE Self-Etch Adhesive application technique (Images courtesy of Dr. Jorge Perdigao, University of Minnesota). Figure 1-1: Liquid A (primer) applied Figure 1-2: Liquid B (adhesive) applied Figure 1-3: Mixed solution dried Background Figure 1-4: Liquid B (adhesive) reapplied and light-cured The majority of dental adhesives fall into two categories, total-etch and self-etch. In totaletch adhesives, a phosphoric acid etchant is typically used to etch the surfaces of dentin and enamel. The adhesive subsequently forms a micromechanical bond with these etched surfaces, which provides a substrate upon which a composite material can be chemically bonded. Mechanism of Adhesion to Enamel for Total-Etch Adhesives Untreated enamel does not provide a suitable surface for dental adhesive bonding due to minimal porosities and a surface energy poorly suited for wetting with monomers. For total etch adhesives, a phosphoric acid etchant is used to superficially demineralize the hydroxyapatite of enamel. The demineralization greatly increases the surface area available for bonding, as shown in Figure 2. 6

Figure 2: Enamel etch pattern 35% phosphoric acid. This allows the low viscosity, polymerizable resins of the adhesive to penetrate the porosities revealed by the etching procedure to form an interlocking mechanical bond after curing. These interlocking resin tags are shown in Figure 3. Figure 3: Image courtesy of Dr. Patricia Pereira, University of North Carolina Mechanism for Adhesion to Dentin for Total-Etch Adhesives For dentin bonding with total-etch adhesives, a similar process is involved to form the micromechanical bonding. A typically prepared dentin surface will contain a smear layer as shown in Figure 4. Figure 4: Smear layer seen through a scanning electron microscope 7

Upon acid etching the dentin surface, the smear layer is removed, opening the dentin tubules. In addition, the intertubular dentin is demineralized, leaving a layer of collagen fibers as shown in Figure 5. Figure 5: Dentin tubule with surrounding collagen fibers. Image courtesy of Dr. J. Perdigao, University of Minnesota The open dentin tubules create a surface where adhesive can penetrate and form resin tags. In addition, the expanded collagen fiber network creates an additional bonding surface for the intertubular dentin, known as the hybrid layer. Figure 6 is a scanning electron micrograph (SEM) showing the formation of the hybrid layer and resin tags by the application of adhesive onto etched dentin. Figure 6: Scanning electron micrograph showing hybrid layer and resin tags. Provided the collagen layer remains hydrated, these fibers will remain expanded and the infiltration of adhesive resin monomers is maximized. Upon desiccation, however, the collagen layer collapses limiting the infiltration of resin monomers and impairing the formation of a hybrid layer. In this situation, localized adhesion may be compromised during polymerization contraction of the composite restorative material, contributing to gaps between the adhesive and dentin substrate. A possible outcome of this is post-operative sensitivity. Bonding Mechanism for Adper Scotchbond SE Self-Etch Adhesive Adper Scotchbond SE Self-Etch Adhesive differs from the total-etch adhesives discussed in the previous section. As a self-etch adhesive, the etching and subsequent penetration of resin monomers into the demineralized dentin and enamel is carried out without a separate etch 8

and rinse step. In the case of Adper Scotchbond SE Self-Etch Adhesive, the aqueous primer is initially applied to the prepared tooth surface. When the adhesive is subsequently applied to the prepared surface, the acidic monomers are activated, initiating simultaneous etching and adhesive penetration. A major benefit of this procedure for dentin bonding is that the etching depth and the depth of penetration of the adhesive are identical. In addition, this keeps the collagen fibers from collapsing and eliminates dependence on moist bonding characteristic of the 5th generation systems. This is important because technique sensitivity associated with bonding systems requiring a "moist bonding" technique may be associated with post-operative sensitivity. A possible adhesion mechanism for the original Prompt L-Pop adhesive was described by Professor Reinhardt (University of Münster) and can also be used to describe the mechanism of Adper Scotchbond SE Self-Etch Adhesive. The adhesive part of Adper Scotchbond SE Self-Etch Adhesive contains phosphoric acid esters, which under aqueous conditions will etch the surfaces of dentin and enamel to allow for the micromechanical bonding of the adhesive to the tooth. After the aqueous primer is applied to the prepared surface, the adhesive is added which starts the acid activation and etching process. Once the acid is activated, bonding to dentin with Adper Scotchbond SE Self-Etch Adhesive involves dissolving the inorganic smear layer and demineralizing the intertubular dentin. The adhesive simultaneously penetrates the demineralized dentin to form the hybrid layer and flows into the dentin tubules to create resin tags. The depth of the demineralized zone corresponds to the depth of penetration of the monomers to be polymerized. Nanoleakage resulting from an insufficient penetration depth of the adhesive can be minimized by this mechanism. Figure 7 shows a transmission electron micrograph (TEM) of the hybrid layer formed with Adper Scotchbond SE Self-Etch Adhesive. The micrograph shows that Adper Scotchbond SE Self-Etch Adhesive displays a hybrid layer of approximately 1 micron in thickness. Figure 7: Transmission electron micrograph showing hybrid layer formed with Adper Scotchbond SE Self-Etch Adhesive (image from Dr. Patricia Pereira). Role of Inorganic Filler in Bonding Adper Scotchbond SE Self-Etch adhesive contains a bonded zirconia nanofiller. It has been theorized that the presence of filler in adhesives helps to develop a uniform film, which in turn can lead to higher bond strengths. Figure 8 shows shear bond strength with and without the presence of filler on a prepared enamel substrate. This data shows that the nanofiller improves the bond strength to prepared enamel. A two sample t-test on the data gives a p-value of 0.019, which indicates a statistically significant difference in the two sets of data. 9

Figure 8: Shear bond strength of filled vs. unfilled Adper Scotchbond SE Self-Etch Adhesive on prepared bovine enamel (3M ESPE internal data, notchededge shear test). Another benefit of the bonded zirconia nanofiller is the inherent radiopacity of this material. In the case of adhesive pooling, it can be difficult to distinguish the adhesive from tooth decay on a radiograph. Figure 9 shows an X-ray taken where adhesive pooling was simulated with Adper Scotchbond SE Self-Etch Adhesive and a non-radiopaque self-etch adhesive. 3M ESPE Filtek Z250 restorative was used as the filling material in this study. The cross-sectional view in Figure 9 shows two Class II restorations after application of Filtek Z250 restorative. The left side (distal-occlusal) was bonded with a non-radiopaque selfetch adhesive. Note the appearance of dark lines in multiple locations along the compositeadhesive-tooth interfaces caused by pooled radiolucent adhesive. The right side (mesialocclusal) was bonded with Adper Scotchbond SE Self-Etch Adhesive. Due to Adper Scotchbond SE Self-Etch Adhesive s radiopacity, there are no dark areas present at any point along the composite-adhesive-tooth interfaces. The dark areas could potentially be confused with tooth decay, so having a radiopaque adhesive is advantageous in the situation of inadvertent pooling of adhesive. Figure 9: Radiographic crosssection showing benefit of radiopaque adhesive The radiopacity is reported as the ratio of the optical density of the test sample to that of an aluminum block of the same thickness according to ISO 4049. Adper Scotchbond SE Self- Etch Adhesive has been measured to have a radiopacity value of 1.0-1.1 mm, where a value of 1 or greater is considered to be radiopaque by the ISO standard. 10

Test Results Laboratory Evaluation Test Centers: University of Alabama-Birmingham (Dr. Burgess), University of Minnesota (Dr. Perdigao), University of Ulm (Professor Dr. B. Haller) Bond Strengths to Dentin and Cut Enamel Adper Scotchbond SE Self-Etch Adhesive demonstrates bond strengths on dentin and prepared enamel comparable to leading total-etch and self-etch adhesives. Dr. John Burgess, University of Alabama-Birmingham, used a shear test method to measure the bond strength of Adper Scotchbond SE Self-Etch Adhesive and other bonding agents (Figures 10-1 and 10-2). Figure 10-1: Shear bond strengths to cut enamel Figure 10-2: Shear bond strength to dentin 11

An internal study was conducted comparing Adper Scotchbond SE Self-Etch Adhesive to leading self-etch (blue bars) and total-etch (green bars) adhesives on bovine cut enamel and dentin (Figures 11-1 and 11-2). A notched-edge shear test method was used with Filtek Z250 restorative. Figure 11-1: Shear bond strength to cut enamel Figure 11-2: Shear bond strength to dentin 12

Thermal Cycling Data An adhesive thermal stability study was conducted on bovine cut enamel and dentin. 3M ESPE Filtek Z250 restorative was used as the composite in this study. The samples were thermally cycled, where one cycle consisted of 30 seconds at 5 C and 30 seconds at 55 C, and bond strength testing was conducted every 10,000 cycles. The results show very good thermal stability for Adper Scotchbond SE Self-Etch Adhesive, and the results are statistically equivalent to the total-etch control of Adper Single Bond Plus adhesive (Figures 12-1 and 12-2). Figure 12-1: Thermal cycling results, cut enamel (3M ESPE internal data, notched-edge shear test) Figure 12-2: Thermal cycling results, dentin (3M ESPE internal data, notched-edge shear test) 13

Moisture Tolerance A study was conducted to determine the effect of surface moisture on bond strength for Adper Scotchbond SE Self-Etch Adhesive. The following graph shows shear bond strength data on bovine dentin and cut enamel with either a moist or dry surface (Figures 13-1 and 13-2). Two-sample t-tests conducted on both sets of data show that the bond strength of Adper Scotchbond SE is statistically equivalent regardless of surface moisture for both dentin and enamel substrates. Figure 13-1: Bond strengths to dry versus moist cut enamel (3M ESPE internal data, notched-edge shear test) Figure 13-2: Bond strengths to dry versus moist dentin (3M ESPE internal data, notched-edge shear test) 14

Marginal Integrity Professor Dr. B. Haller of the University of Ulm measured several parameters pertaining to Class V restorations before and after thermal cycling to determine marginal integrity. Adper Scotchbond SE Self-Etch Adhesive displayed very good marginal adaptation. The following graphs show the % continuous margins with dentin and cut enamel before and after thermal cycling for Adper Scotchbond SE Self-Etch Adhesive and other adhesives (Figures 14-1 and 14-2). The percent continuous margin after thermal cycling is very high for Adper Scotchbond SE Self-Etch Adhesive (99.9% for enamel, 98.4% for dentin). Figure 14-1: Continuous margin, cut enamel Figure 14-2: Continuous margin, dentin 15

Microleakage Dr. Perdigao at the University of Minnesota conducted a microleakage study with Adper Scotchbond SE Self-Etch Adhesive and selected other adhesives. Restorations were placed in extracted human teeth with margins in enamel and dentin using the manufacturer s instructions for use. Samples were thermally cycled from 5 C to 55 C for approximately 24 hours and then immersed in a dye solution for 24 hours. Teeth were removed, sectioned, and measured using the following scale: 0 = no leakage 1 = less than one-third 2 = one-third to two-thirds 3 = greater than two-thirds but within surrounding wall 4 = involve axial wall Figure 15 shows the results of Dr. Perdigao s microleakage study. Figure 15: Human teeth microleakage 16

Nanoleakage Dr. Perdigao conducted a nanoleakage study on human teeth with Adper Scotchbond SE Self-Etch Adhesive and selected other adhesives. Class V cavities were prepared, and the adhesive was applied per manufacturer s instructions, followed by Filtek Z250 composite. The prepared specimens were immersed in an ammoniacal silver nitrate solution for 24 hours, followed by eight hours in a photo-developing solution. After further specimen processing, the specimens were cross-sectioned through the center of the restoration. The cross-sections were viewed using field-emission scanning electron microscopy (FE-SEM). Nanoleakage was calculated as a percentage of the dye penetration into total preparation wall length. Adper Scotchbond SE Self-Etch Adhesive was the only bonding agent to show no signs of nanoleakage in any of the specimens. Figure 16 shows the nanoleakage results. Figure 16: Human teeth nanoleakage Low Post-Operative Sensitivity An in vivo field evaluation was conducted in Germany and Italy involving 100 dentists. Over 4,700 restorations were placed using Adper Scotchbond SE Self-Etch Adhesive. Dentists were asked to record instances of post-operative sensitivity. Table 1 shows the results, in which a very low rate of post-operative sensitivity was observed. Total number of dentists 100 Table 1: Post-operative sensitivity results Number of dentists encountering post-operative sensitivity Total number of cases of post-operative sensitivity 10 24 Total number of restorations placed 4714 Percentage of restorations having post-operative sensitivity 0.51% 17

18

Step-by-Step Technique Guides Direct Light Cure Restoration Adper Scotchbond SE Self-Etch Adhesive Direct Light Cure Restoration! 1 2 3 4 5 6 19

Porcelain Repair Adper Scotchbond SE Self-Etch Adhesive Porcelain Repair! 1 2 3 4 5 6 20

Porcelain Repair, Continued 7 8 9 10 11 3M ESPE Dental Products St. Paul, MN 55144-1000 3M ESPE AG Dental Products 82229 Seefeld Germany 3M, ESPE, Adper, and Scotchbond are trademarks of 3M or 3M ESPE AG. 3M 2007. All rights reserved. 44-0007-4519-8/01 (April 2007) 21

Root Surface Desensitization Adper Scotchbond SE Self-Etch Adhesive Root Surface Desensitization! 1 2 3 4 5 6 22

Root Surface Desensitization, Continued 7 8 9 10 11 3M ESPE Dental Products St. Paul, MN 55144-1000 3M ESPE AG Dental Products 82229 Seefeld Germany 3M, ESPE, Adper, and Scotchbond are trademarks of 3M or 3M ESPE AG. 3M 2007. All rights reserved. 44-0007-4521-4/01 (April 2007) 23

Instructions for Use General Information Adper Scotchbond SE Self-etch adhesive, manufactured by 3M ESPE, is a simple to use, two-bottle, self-etch bonding adhesive with bottle A containing the aqueous primer and bottle B containing the acidic adhesive. The primer contains a color indicator which indicates complete coverage of the preparation. The color disappears upon addition of the adhesive, indicating activation of the acid and insuring that a proper etch is taking place. Adper Scotchbond SE Self-etch adhesive offers the dental practitioner a wide range of applications. These include bonding to all classes of light curing direct restorations as well as procedures involving porcelain, composite, and metal repair and root surface desensitization. Recommendations Adper Scotchbond SE Self-etch adhesive is cured by exposure to visible light. The light curing times instructed with this product assume the use of a 3M ESPE light curing unit, manufactured by 3M ESPE, or other dental visible curing light of comparable intensity. Curing lights should be checked often for proper output using a reliable metering system. Air used for drying should be free of oil and water contaminants. Indications Bonding between dentin/enamel and composite filling materials Bonding between dentin/enamel and compomer filling materials Intraoral repair of porcelain, composite and metal using light-cure composite resin Desensitization of hypersensitive teeth/root surface desensitization Contraindications Adper Scotchbond SE Self-etch adhesive is suited for purely light-curing materials, but not for dual-curing or self-curing materials, and is not indicated for indirect applications including use in veneer placement. Precautions Precautionary Information for Patients This product contains substances that may cause an allergic reaction by skin contact in certain individuals. Avoid use of this product in patients with known acrylate allergies. If prolonged contact with oral soft tissue occurs, flush with large amounts of water. If allergic reaction occurs, seek medical attention as needed, remove the product if necessary and discontinue future use of the product. Precautionary Information for Dental Personnel This product contains substances that may cause an allergic reaction by skin contact in certain individuals. To reduce the risk of allergic response, minimize exposure to these materials. In particular, avoid exposure to uncured product. If skin contact occurs, wash skin with soap and water. Use of protective gloves and a no-touch technique is recommended. Acrylates may penetrate commonly used gloves. If product contacts glove, remove and discard glove, wash hands immediately with soap and water and then re-glove. If allergic reaction occurs, seek medical attention as needed. 3M ESPE MSDSs can be obtained from www.mmm.com/msds or contact your local subsidiary. 24

Preparation Remove loose preparation debris by spraying with water. Use 2-3 brief blows of air to dry the cavity. The cavity should only be dried to the extent that there is no water visible on the surface. Over-drying may result in post operative sensitivity. Clean untreated tooth structure with a rubber cup and an oil and fluoride-free cleaning paste (e.g. pumice paste); rinse thoroughly with water spray and dry. Pulp Exposure Use Vitrebond Plus Light Cure Glass Ionomer Liner/base, manufactured by 3M ESPE, in areas of deep cavity excavation such as Class I and II restorations. If pulp exposure has occurred, use a minimum amount of calcium hydroxide (e.g. Alkaliner, manufactured by 3M ESPE) followed by an application of Vitrebond Plus liner/base. Adper Scotchbond SE Self-etch adhesive will bond to Vitrebond Plus liner/base. Instructions for bonding to dentin and cut enamel with a light cured composite 1. Isolation: a rubber dam is the preferred method of isolation 2. Lightly dry tooth 3. Dispense 1 drop of Liquid A into one of the dispensing wells, and 1 drop of Liquid B into the second dispensing well. 4. Wet brush tip with Liquid A. Apply to the entire bonding area so that a continuous red-colored layer is obtained on the surface. Discard this brush. 5. Wet second brush tip with Liquid B, and scrub into the entire wetted surface of the bonding area. The red color will disappear quickly, indicating that the etching components have been activated. Continue scrubbing with moderate finger pressure for 20 seconds to ensure a proper etch. 6. Air dry thoroughly for 10 seconds to evaporate water. Adhesive should remain in place and be shiny in appearance upon completion of this step. 7. Re-coat brush with Liquid B, and apply second coat to the entire bonding surface. Lightly air thin adhesive layer to adjust film thickness/consistency. 8. Light cure for 10 seconds. 9. Restorative placement: Refer to manufacturer s instructions for placement, cure and finishing of restorative material. Note: for bonding to uncut enamel a separate etch using 3M ESPE Scotchbond etchant is recommended before application of Adper Scotchbond SE Self-etch adhesive. Instructions for bonding to composite 1. Isolation: Rubber dam is the preferred method of isolation. 2. Roughen the existing material: Roughen the surface of existing composite using either a bur, diamond or a sandblast technique. 3. Dispense 1 drop of Liquid A into one of the dispensing wells, and 1 drop of Liquid B into the second dispensing well. 4. Wet brush tip with Liquid A. Apply to the entire bonding area so that a continuous redcolored layer is obtained on the surface. Discard this brush. 5. Wet second brush tip with Liquid B, and scrub into the entire wetted surface of the bonding area. The red color will disappear quickly, indicating that the etching 25

components have been activated. Continue scrubbing with moderate finger pressure for 20 seconds to ensure a proper etch. 6. Air dry thoroughly for 10 seconds to evaporate water. Adhesive should remain in place and be shiny in appearance upon completion of this step. 7. Re-coat brush with Liquid B, and apply second coat to the entire bonding surface. Lightly air thin adhesive layer to adjust film thickness/consistency. 8. Light cure for 10 seconds. 9. Restorative placement: Refer to manufacturer s instructions for placement, cure and finishing of restorative material. Instructions for metal or porcelain repair 1. Isolation: Rubber dam is the preferred method of isolation. 2. Preparation: Clean the surface to be repaired with a slurry of plain flour of pumice. Rinse and dry thoroughly. Roughen the surface of existing metal or porcelain using either a bur, diamond or a sandblast technique. Be careful to remove all loose porcelain and bevel the margin. Remove surface glaze 1mm beyond the margin. 3. Silane treatment for porcelain and metal: Apply RelyX Ceramic Primer to the etched surface and dry. 4. Dispense 1 drop of Liquid A into one of the dispensing wells, and 1 drop of Liquid B into the second dispensing well. 5. Wet brush tip with Liquid A. Apply to the entire bonding area so that a continuous redcolored layer is obtained on the surface. Discard this brush. 6. Wet second brush tip with Liquid B, and scrub into the entire wetted surface of the bonding area. The red color will disappear quickly, indicating that the etching components have been activated. Continue scrubbing with moderate finger pressure for 20 seconds to ensure a proper etch. 7. Air dry thoroughly for 10 seconds to evaporate water. Adhesive should remain in place and be shiny in appearance upon completion of this step. 8. Re-coat brush with Liquid B, and apply second coat to the entire bonding surface. Lightly air thin adhesive layer to adjust film thickness/consistency. 9. Light cure for 10 seconds. 10. Masking: To opacify the metal before the final composite placement, mask the metal surface with a thin layer (0.25-0.5mm) of the appropriate 3M ESPE Masking Agent shade using a brush. Light cure each layer for 20 seconds. 11. Restorative placement, cure and finishing: Refer to manufacturer s instructions for placement, cure and finishing of restorative material. Instructions for root surface desensitization 1. Lightly clean the root surface with flour of pumice. Rinse and blot dry. 2. Dispense 1 drop of Liquid A into one of the dispensing wells, and 1 drop of Liquid B into the second dispensing well. 3. Wet brush tip with Liquid A. Apply to the entire root surface so that a continuous redcolored layer is obtained on the surface. Discard this brush. 4. Wet second brush tip with Liquid B, and scrub into the entire wetted surface of the root 26

surface area. The red color will disappear quickly, indicating that the etching components have been activated. Continue scrubbing with moderate finger pressure for 20 seconds to ensure a proper etch. 5. Air dry thoroughly for 10 seconds to evaporate water. Adhesive should remain in place and be shiny in appearance upon completion of this step. 6. Re-coat brush with Liquid B, and apply second coat to the entire bonding surface. Lightly air thin adhesive layer to adjust film thickness/consistency. 7. Light cure for 10 seconds. 8. Remove the oxygen inhibited layer with a moistened gauze. Additional Notes It is extremely important that the adhesive Liquid B is scrubbed into the prepared surface for the entire 20 second period. Scrubbing the adhesive only partially or shortening the application time will compromise the etch pattern and have a negative effect on adhesion. Disinfect the dispensing vials using an intermediate level disinfection process (liquid contact) as recommended by the CDC and endorsed by the ADA. Guidelines for Infection Control in Dental Health-Care Settings - 2003 (Vol.52; No. RR-17), Centers for Disease Control and Prevention. Disposal See the Material Safety Data Sheet (available at www.mmm.com/msds or through your local subsidiary) for disposal information. Storage and Shelf Life Adper Scotchbond SE Self-etch adhesive should be protected from light. Product should be stored between 2 C/35 F and 27 C/80 F. Shelf life of Liquids A and B is 24 months at room temperature. Do not use after the expiration date. Caution: US Federal Law restricts this device to sale or use on the order of a dental professional. Customer Information No person is authorized to provide any information which deviates from the information provided in this instruction sheet. Warranty 3M ESPE warrants this product will be free from defects in material and manufacture. 3M ESPE MAKES NO OTHER WARRANTIES INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. User is responsible for determining the suitability of the product for user s application. If this product is defective within the warranty period, your exclusive remedy and 3M ESPE s sole obligation shall be repair or replacement of the 3M ESPE product. Limitation of Liability Except where prohibited by law, 3M ESPE will not be liable for any loss or damage arising from this product, whether direct, indirect, special, incidental or consequential, regardless of the theory asserted, including warranty, contract, negligence or strict liability. 27

3M ESPE, Adper, RelyX, Scotchbond, and Vitrebond are trademarks of 3M or 3M ESPE AG 3M 2007. AdheSE, All-Bond, Clearfil, G-Bond, L-Pop, OptiBond Solo, Prime & Bond NT, Prompt, Syntac, and Xeno are not trademarks of 3M or 3M ESPE AG. Dental Products 3M Center Building 275-2SE-03 St. Paul, MN 55144-1000 USA 3M Canada Post Office Box 5757 London, Ontario N6A 4T1 Canada 1-800-265-1840 ext. 6229 Please recycle. Printed in USA. 3M 2007. All rights reserved. 70-2009-3949-7