Dr. Gordon Christensen’s favorite selective-etch steps
There are numerous techniques and a wide array of bonding agents available to today’s clinicians. Any of the techniques will work when performed correctly, and if you are currently pleased with your own bonding technique, don’t change.
After combining his research with formal and informal surveys of practitioners, Dr. Christensen prefers this technique for busy practices with the known challenge of predictably treating multiple patients.
There are numerous techniques and a wide array of bonding agents available to today’s clinicians. Any of the techniques will work when performed correctly, and if you are currently pleased with your own bonding technique, don’t change.
Here, Dr. Gordon Christensen explains what he likes about his favorite selective-etch technique, which is, in summary: tooth preparation, etch external enamel margins with gel resin and rinse rapidly, glutaraldehyde, bioactive material on deepest dentin surfaces (3M ESPE VitreBond or GC Fuji LINING LC or BISCO Theracal), second application of glutaraldehyde, self-etch primer, bond and composite restorative.
After combining this research with formal and informal surveys of practitioners, Dr. Christensen prefers this technique for busy practices with the known challenge of predictably treating multiple patients. This technique offers high quality restorations in minimal time. An in-depth explanation of this technique follows:
Bonding 101: Everything you need to know to have satisfied patients
• Gel-etch the enamel margins after the cavity preparation is complete. Evacuate the acid wash with a rapid, high volume air-water spray to ensure etch of the enamel. (Reports on some of the self-etch primers show adequate bond to enamel without this step.)
• Apply two one-minute glutaraldehyde/HEMA applications for desensitization and disinfection of the tooth preparation.
• Apply a bioactive liner to cover the deep dentin areas, desensitize and release fluoride.
• Apply a second minor application of glutaraldehyde to replace the glutaraldehyde that was washed off by the previous wash.
• Apply self-etch primer and bond to reduce or eliminate post-operative sensitivity.
• Use adequately powerful curing lights and thin layers of restorative resin (up to 2 mm) to help reduce post-operative tooth sensitivity.
More on bonding: Bonding resin to tooth structure is still confusing
Watch a video of the above technique:
