CONTINUING EDUCATION 2
INDIRECT COMPOSITE RESIN RESTORATIONS
Adhesive Cementation of Indirect Composite Inlays and Onlays: A Literature Review Camillo D’Arcangelo, DDS; Lorenzo Vanini, MD, DDS; Matteo Casinelli, DDS; Massimo Frascaria, DDS, PhD; Francesco De Angelis, DDS, PhD; Mirco Vadini, DDS, PhD; and Maurizio D’Amario, DDS, PhD
LEARNING OBJECTIVES
đƫ %/ 1//ƫ !*0 (ƫ $!/%2!ƫ Abstract: The authors conducted a literature review focused on materials and /5/0!)/ƫ".+)ƫ +0$ƫ ƫ techniques used in adhesive cementation for indirect composite resin restora- $%/0+.% (ƫ * ƫ 1..!*0ġ 5ƫ ,!./,! 0%2! tions. It was based on English language sources and involved a search of online đƫ!4,( %*ƫ'!5ƫ %û!.!* !/ƫ databases in Medline, EMBASE, Cochrane Library, Web of Science, Google !03!!*ƫ2 .%+1/ƫ $!/%2!ƫ Scholar, and Scopus using related topic keywords in di"erent combinations; it /5/0!)/Čƫ%* (1 %*#ƫ!0 $ġ * ġ.%*/!Čƫ/!("ġ!0 $Čƫ * ƫ was supplemented by a traditional search of peer-reviewed journals and cross- /!("ġ $!/%2!
referenced with the articles accessed. The purpose of most research on adhe- đƫ !/ .% !ƫ0$!ƫ2 .%+1/ƫ sive systems has been to learn more about increased bond strength and simpli- .!/%*ƫ !)!*0ƫ#.+1,/ƫ +. %*#ƫ0+ƫ fied application methods. Adherent surface treatments before cementation are ,+(5)!.%6 0%+*ƫ,.+ !// necessary to obtain high survival and success rates of indirect composite resin. Each step of the clinical and laboratory procedures can have an impact on longevity and the esthetic results of indirect restorations. Cementation seems to be the most critical step, and its long-term success relies on ad- herence to the clinical protocols. The authors concluded that in terms of survival rate and esthetic long-term outcomes, indirect composite resin techniques have proven to be clinically acceptable. However, the correct management of adhesive cementation protocols requires knowledge of adhesive principles and adherence to the clinical protocol in order to obtain durable bonding between tooth structure and restorative materials.
he proliferation of resin composites and adhesive sys- issue of marginal infiltration associated with direct techniques, to tems has met the increasing demand for esthetic resto- date, no method has produced acceptable results.8,9 rations in both anterior and posterior teeth.1 Depending Posterior indirect restorations are widely used in modern re- on the respective clinical indication, resin composite storative dentistry to overcome the problems resulting from direct materials are suitable for both direct and indirect res- techniques.2 The adhesive concepts that have been used for direct Ttorations.2 Although direct resin composites have replaced other restorative procedures are now being applied to indirect restora- restorative options, there are a number of issues associated with tions and have been incorporated into daily practice.10 Indirect their use in the posterior region. These include: high polymeriza- composites o"er an esthetic alternative to ceramics for posterior tion shrinkage; gap formation; poor resistance to wear and tear; teeth.10,11 The clinical performance of composite resin restora- color instability; and insu!cient mechanical properties.3 Direct tions is comparable to ceramic restorations, but the relatively low restorations can result in contact area instability, di!culty in gener- cost associated with composites has resulted in increased use of ating proximal contour and contact, lack of marginal integrity, and composite resin-based indirect restorations in the posterior re- postoperative sensitivity.4 All of these factors impact the longevity gion.12-14 Ceramic materials exhibit a very high elastic modulus, thus and clinical success of restorations.5-7 Despite e"orts to reduce the they cannot absorb most of the occlusal forces. Since polymeric
566 COMPENDIUM September 2015 Volume 36, Number 8 materials absorb a significant amount of occlusal stress, they should further classified into three-step and two-step systems. Three-step be considered the material of choice.10,15 systems require separate etching, priming, and bonding. Two-step The success of adhesive restorations depends primarily upon the adhesives are instead characterized by an application of an etching luting agent and adhesive system.16 Several authors investigated the compound and then an agent that combines a primer and a bonding. properties of resin luting materials such as bond strength, degree of The etching application removes the smear plugs, demineralizes the conversion, and wear, in order to predict their clinical behavior.17-22 dentin, and exposes the intertubular dentin collagen fibers, obtaining Among the parameters that may influence the clinical success of an ideal micromechanical anchor for the adhesive.32,33 indirect restorations is a proper degree of polymerization of the Self-Etch Systems—Self-etch refers to an adhesive system that resin luting agent, which should be taken into account.23 Moreover, dissolves the smear layer and infiltrates it at the same time, without successful adhesion depends on proper treatment of the internal a separate etching step.31 The self-etch adhesives have been further surfaces of the restoration as well as the dentinal surface.2,16 classified into two-step systems and one-step systems, which simul- This article discusses materials and techniques used in adhesive taneously provide etching, priming, and bonding.34 cementation for indirect composite resin restorations. Self-Adhesive Systems—In the past few years, new resin cements, so-called “self adhesives,” have been introduced. This particular The Adhesive Systems resin cement needs only to be applied on tooth substrate, without A Historical Overview any etching, priming, or bonding phases.35 Because the microscopic structure of two di"erent contact surfaces presents irregularities, an adherent is necessary. The introduction Tooth Preparation of adhesive materials as alternatives to traditional retentive tech- After caries and/or failed restoration removal, a cavity with slightly niques has greatly revolutionized restorative dentistry.24 In the occlusal divergent walls (5° to 15°) and round internal angles is development of dental adhesives, the ultimate goal is to achieve prepared by using decreasing grit (from 60–70 µm to 15–20 µm grit) strong, durable adhesion to dental hard tissues.25 In 1955, Buono- cylindrical round-ended diamond burs. Preparation margins are not core showed how the treatment of enamel with phosphoric acid bevelled but prepared via butt joint.2 After cavity preparation and increases the exposed enamel surface by producing micro-irregu- before cavity finishing, adhesive procedures are performed36 using larities on it, resulting in improved adhesion potential. The modern a rubber dam in order to achieve an immediate dentin sealing.37,38 concept of enamel bonding can be traced to his published findings.26 In keeping with rubber dam placement for subsequent restoration In 1965, Bowen formulated the first generation of dentinal ad- placement, the interproximal margin must be supragingival. To hesive.27 The increasing interest in adhesion in dentistry led to the avoid a dual marginal leakage, no direct composite is used for gingi- development of four generations of adhesive systems, with the 4th val margin rebuilding.39 If any deep subgingival margin persists after generation achieving good results for dentin bonding in the 1990s.28 cavity preparation—thus precluding proper rubber dam placement— the feasibility of a surgical crown-lengthening procedure and/or an Modern Adhesive Systems orthodontic extrusion must be considered.40 A light-curing compos- The modern formulation of an enamel-dentin adhesive system ite filling material is used to block out defect-related undercuts.2,41 includes the following three components29: The finishing phases are performed with diamond burs with a slight taper and with silicone points (Table 1). The teeth are protected with Ċŋ Etchant—an organic acid with the function of demineralizing the temporary eugenol-free restorations after impression making.42 surface, dissolving hydroxyapatite crystals, and increasing free surface energy. Ċŋ Primer—an amphiphilic compound that increases the wettabil- TABLE 1 ity of the hydrophilic substrate (dentin) to a hydrophobic agent (bonding or resin). Tooth Preparation Phases for Ċŋ Bonding agent—a fluid resin used to penetrate the etched and primed Indirect Composite Resin substrate and, after curing, to create a real and stable adhesive bond. TOOTH PREPARATION
In order to obtain an optimal infiltration of enamel and den- đƫ ! .! /%*#ƫ#.%0ƫĨ".+)ƫćĀĢĈĀƫµ)ƫ0+ƫāĆĢĂĀƫµ)ƫ#.%0ĩƫ tin substrates, the ideal features of an adhesive material are: low 5(%* .% (ƫ.+1* ġ!* ! ƫ % )+* ƫ 1./ viscosity; high superficial tension; and e"ective wettability. The đƫ (%#$0(5ƫ+ (1/ (ƫ %2!.#!*0ƫ3 ((/ƫĨĆŋƫ0+ƫāĆŋĩ fundamental requisite is wettability, which depends on the intrinsic đƫ +1* ƫ%*0!.* (ƫ *#(!/ properties of fluid and dental substrate.30 đƫ 100ƫ&+%*0ƫ,.!, . 0%+*ƫ) .#%*/ The classification of the respective adhesive systems is based on their etching characteristics and the number of steps they require.31 đƫ ))! % 0!ƫ !*0%*ƫ/! (%*#ƫ1/%*#ƫ $!/%2!ƫ,.+ ! 1.!ƫ * ƫ.1 !.ƫ ) Etch-and-Rinse Systems—The etch-and-rinse technique is char- acterized by the etching of the enamel and/or dentin with an acid đƫ (+ '%*#ƫ+10ƫ !"! 0ġ.!( 0! ƫ1* !. 10/ agent (orthophosphoric acid at 35% to 37%), which needs to be sub- đƫ %*%/$%*#ƫ3%0$ƫ % )+* ƫ 1./ƫ * ƫ/%(% +*!ƫ,+%*0/ sequently washed away. The etch-and-rinse adhesive systems can be
www.compendiumlive.com September 2015 COMPENDIUM 567 CONTINUING EDUCATION 2 | ƫ ƫ ƫ
Dentin Treatments veneered indirect restorations—neither immediate dentin seal- Research on adhesive systems is focused mainly on increasing bond ing nor primer agent applications are necessary, since the etching strength and simplifying application. The application of phosphoric and bonding phases ensure an optimal bond for enamel adhesion.46 acid increases the surface energy of the dentin by removing the Immediate dentin sealing should be followed by air blocking and smear layer and promoting demineralization of surface hydroxy- pumicing to generate ideal impressions.47 In-vitro studies have apatite crystals. The resin monomers, by means of the primer shown increased bond strength for IDS versus delayed dentin agent’s amphiphilic properties, infiltrate the water-filled spaces sealing (DDS) techniques.48-52 The IDS technique also eliminates between collagen fibers, which results in a “hybrid layer” composed any concerns regarding the film thickness of the dentin sealant and of collagen, resin, residual hydroxyapatite, and traces of water. It protects dentin against bacterial leakage and sensitivity during results in an ideal micromechanical anchor substrate for adhesive the provisional phase of treatment.45 Moreover, it was suggested systems on dentin.16,43,44 that multiple adhesive coatings can improve the quality of resin- Immediate dentin sealing (IDS) is a strategy in which a dentin dentin bonds.53 bonding agent is applied to freshly cut dentin and polymerized before making an impression.45 The recommended technique fo- Surface Treatments for Composite Restorations cuses on the use of the “etch-and-rinse” systems. Etching should Several techniques have been suggested for increasing bond extend slightly over enamel to ensure the conditioning of the entire strength, involving treating the internal surfaces of indirect res- dentin surface. The use of either two-step or three-step dentin torations (Table 2).54,55 The surface treatments aim not only to bonding agents is equally e"ective. Self-priming resins, however, achieve a high retentive bond strength of the restoration, but also generate a more excess resin layer, which may extend over the to avoid any microbiological leakage.56 Composite surface treat- margin and require additional bur corrections. IDS can be imme- ments are necessary for adhesion of indirect composite restora- diately followed by the placement of composite in order to block tions.57 Acid-etching with phosphoric acid, acidulated phosphate out eventual undercuts and/or build up deep cavities, reducing fluoride, or hydrofluoric (HF) acid is one of the treatments reported restoration thickness and ensuring the light-cured polymerization in literature.58-60 of the luting agent. Finally, enamel margins are usually reprepared The internal surfaces of indirect restorations can be abrad- before final impression to remove excess adhesive resin and pro- ed with aluminium oxide, using an intraoral sandblasting de- vide ideal taper.45 vice.58,59,61-63 Also, silane coupling agents are used as adhesion pro- When the preparation exposes no dentinal areas—eg, in moters.64,65 Another method, the tribochemical coating, forms a silica-modified surface as a result of airborne-particle abrasion
with silicon dioxide (SiO2)-coated aluminium particles. The sur- TABLE 2 face becomes chemically reactive to the resin by means of silane coupling agents.63,66,67 Suggested Treatment for the Internal Many studies show that Er:YAG laser treatment enhances bond Surfaces of Indirect Restorations strength between composite and resin cement.68,69 Other studies 67,70 COMPOSITE RESTORATION SURFACE TREATMENTS demonstrate no influence of laser treatment on bond strength. Roughening the composite area of adhesion, sandblasting, or đƫ % ƫ!0 $%*# both sandblasting and silanizing can provide statistically significant đƫ * ( /0%*#ƫ3%0$ƫ (1)%*1)ƫ+4% ! additional resistance to tensile load. Acid-etching with silane treat- ment does not reveal significant changes in tensile bond strength. đƫ %( *!ƫ +1,(%*# Sandblasting treatment is the main factor responsible in improv- đƫ .% + $!)% (ƫ + 0%*# ing the retentive properties of indirect composite restorations.57 đƫ /!.ƫ0.! 0)!*0
wTABLE 3
Recommended Clinical Protocol, According to Review Outcomes
DENTIN SURFACE COMPOSITE SURFACE CEMENTATION TREATMENT TREATMENT ))! % 0!ƫ !*0%*ƫ/! (%*#ƫ +"0ġ/ * ( /0%*#ƫ đƫ +*/0 *0(5ƫ1/%*#ƫ.1 !.ƫ )ƫ%/+( 0%+*ƫ3%0$ƫ0$.!!ġ/0!,Čƫ 1/%*#ƫ ƫ0$.!!ġ/0!,Čƫ0+0 (ġƫ ĨĆĀµ)ƫ(Ăăƫ1/%*#ƫ 0+0 (ġ!0 $Čƫ(%#$0ġ 1.! ƫ !)!*0ƫ/5/0!) !0 $ƫ !*0%*ġ +* %*#ƫ #!*0ƫ *ƫ%*0. +. (ƫ/ * ( /0ġ đƫ .!$! 0%*#ƫ0$!ƫ(%#$0ġ 1.! ƫ +),+/%0!ƫ.!/%*ƫ !)!*0 3%0$ƫ ƫü((! ƫ $!/%2!ƫ.!/%*ƫ %*#ƫ !2% !ƫ 0ƫĂƫ .ƫ * ƫ.1 !.ƫ )ƫ%/+( 0%+* ,.!//1.!ĩƫ . /%+*ƫ+"ƫ đƫ !)+2%*#ƫ.!/% 1 (ƫ !)!*0ƫ1/%*#ƫ!4,(+.!.Čƫ/ (,!(/Čƫ 0$!ƫ +),+/%0!ƫ%*0!.* (ƫ * ƫý+//ƫ !"+.!ƫ +),(!0!ƫ,+(5)!.%6 0%+*ƫ * ƫāĆ ƫ /1." !/ƫ / (,!(ƫ "0!.ƫ,+(5)!.%6 0%+*
568 COMPENDIUM September 2015 Volume 36, Number 8 Cementation fluidity.76-78 The suggested temperature for composite preheating Resin cements are divided into three groups according to polym- is 39°C.79 The necessary working time for positioning the indirect erization process: chemically activated cements, light-cured ce- restorations and removing the excess cement can be extended at ments, and dual-cured cements.16,71 Of the three, light-cured resin the discretion of the clinician, using a light-curing composite as cements have the clinical advantages of longer working time and luting agent, thus overcoming the relatively restricted working better color stability, but curing time, restoration thickness, and time allowed by dual-cure cements.2 overlay material significantly influence the microhardness of the Total-etching of dentin substrate is recommended as the first resin composites employed as luting agents.46,72 step for the two- and three-step adhesive systems.80 To reduce the Dual-cured resin cements have the advantages of controlled number of operative steps and to simplify the clinical procedures, working time and adequate polymerization in areas that are inac- self-etching adhesive systems, which do not require a separate cessible to light. Conversely, they are relatively di!cult to han- acid-etching step, have been introduced.81 Literature reports dem- dle.23,73,74 Photoactivation increases the degree of conversion and onstrate that multi-bottle systems with simultaneous etching and surface hardness of dual-cured cements.75 rinsing show superior in-vitro and in-vivo activities compared to Optimal luting of indirect restorations is dependent on the light the new all-in-one systems.44,82 source power, irradiation time, and dual-cure luting cement or The self-adhesive resins may be considered an alternative for light-curing composite chosen. Curing should be calibrated for luting indirect composite restorations onto non-pretreated dentin each material to address high degrees of conversion. Preheating surfaces,83 even if bond strengths are lower than etch-and-rinse light-cured filled composites allows the materials to reach optimal systems.84,85 The etch-and-rinse technique provides more reliable
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bonding compared to self-etch luting agents and self-adhesive An appropriate treatment of the fitting surface of the resin com- luting agents when used to bond indirect composite restorations posite restoration and dentin substrate is necessary to establish to dentin.22,86-88 a strong and durable bond.57 The constant use of rubber dam isolation is necessary for the It is recommended that the freshly cut dentin surfaces be sealed cementation protocol with adhesive systems. Removing residual with a dentin bonding agent immediately following tooth prepa- cement using explorers, scalpels, and floss before complete polym- ration, before taking impression.45 Immediate dentin sealing re- erization, and a 15c scalpel after polymerization, is recommended sults in a high bond strength for total-etch and self-etch adhesives; in order to avoid compromising restoration marginal accuracy, however, the microleakage is similar to that with conventional compared to the use of burs, discs, or strips (Table 3).2 cementation techniques.49 When following a protocol of cementation using an adhesive Discussion and Conclusions system, constant rubber dam isolation and careful hand finish- Resin-based composites give predictable results in teeth res- ing are necessary to provide predictable clinical results (Figure toration with respect to both mechanical and 1 through Figure 4).2 esthetic properties when they are used as indi- Supragingival margins facilitate impression rect restoration materials.2 Indirect composites Resin cements are making, definitive restoration placement, and make it possible to overcome some shortcom- divided into three detection of secondary caries.94 In addition, ings of direct techniques. Indirect restorations— some studies have demonstrated that subgin- ie, those created outside of the mouth—result groups according to gival restorations are associated with higher in better proximal and occlusal contacts, better polymerization levels of gingival bleeding, attachment loss, and wear and marginal leakage resistance, and en- gingival recession than supragingival restora- hancement of mechanical properties compared process: chemically tions.95,96 Therefore, in all cases where rubber to direct techniques.6,85 activated cements, dam cannot be adequately placed, surgical Since the dentin substrate has a high organic crown lengthening or orthodontic extrusion content, tubular structure variations, and the light-cured cements, should be taken into account. Otherwise, tra- presence of outward fluid movement, bonding and dual-cured ditionally cemented restorations are preferable to dentin is a less reliable technique when com- to the use of adhesive procedures. pared to enamel bonding.89,90 Bonding composite cements. Sandblasting of the composite surfaces has restorations to tooth structure involves the den- been recommended as a predictable means for tin/adhesive-cement interface and composite enhancing the retention between resin cements restorations/cement interface.22 and indirect composite restorations.57,97 The ap- Each step of the clinical and laboratory procedures can have plication of an appropriately selected adhesive material with proper an impact on the esthetic results and longevity of indirect resto- technique will ensure predictable results and successful long-term rations.91 Cementation is the most critical step and involves the clinical outcomes. application of both the adhesive system and resin luting agent.92,93 Modified United States Public Health Service criteria are the most complete and commonly used assessment techniques in clini- Fig 5. cal trials on indirect composite restorations.37,98 XƫD’Arcangelo, et al, 2014 Ă QƫManhart, et al, 2001 āĀĀ ƫBarone, et al, 2008 ć Oƫ eirskar, et al, 1999 āĀā As shown in Figure 5, restorations were evaluated at baseline and ĊĊ 102 VƫHuth, et al, 2011 ƫScheibenbogen-Fuchsbrunner, et al, 1999 after a follow-up period for secondary caries, marginal adaptation, marginal discoloration, color match, anatomic form, surface rough- 100 O ness, endodontic complications, fracture of the restoration, fracture 90 X V of the tooth, and retention of the restoration.2,6,99-102 In many of the 80 reported follow-up studies, indirect restorative procedures were 70 carried out by dental students,99-102 and the main reasons for fail- 60 ures during the observation period seemed to be secondary caries, 1,2 50 endodontic complications, and fractures. The literature sources support the clinical acceptability of 40 indirect composite resin techniques regarding survival rate and 30 esthetic outcomes at up to 10 years’ follow-up.1,103 Adhesive cemen- 20 tation is a complex procedure that requires knowledge of adhesive 10 principles and adherence to the clinical protocol in order to obtain 0% durable bonding between tooth structure and restorative material. 24 months 36 months 48 months 60 months DISCLOSURE Fig 5. 1.2%2 (ƫ. 0!ƫ+"ƫ%* %.! 0ƫ +),+/%0!ƫ.!/0+. 0%+*/ƫ.!,+.0! ƫ%*ƫ .!"!.!* !/ƫĂČƫćČƫĊĊġāĀĂċƫ$!ƫ/1.2%2 (ƫ. 0!ƫĨŌĩƫ%/ƫ ( 1( 0! ƫ +*/% !.%*#ƫ 0$!ƫƫ .%0!.% ċƫ The authors had no disclosures to report.
570 COMPENDIUM September 2015 Volume 36, Number 8 ABOUT THE AUTHORS .+3*/Čƫ * ƫ .% #!/ċƫGen DentċƫĂĀĀćĎĆąĨĆĩčăāĀġăāĂċ 14.ƫ5'!*0ƫČƫ+* !)ƫ Čƫ65!/%(ƫČƫ!0ƫ (ċƫû! 0ƫ+"ƫ %û!.!*0ƫü*%/$%*#ƫ Camillo D’Arcangelo, DDS 0! $*%-1!/ƫ"+.ƫ.!/0+. 0%2!ƫ) 0!.% (/ƫ+*ƫ/1." !ƫ.+1#$*!//ƫ * ƫ 0!ġ Department of Restorative Dentistry, School of Dentistry, University G. D’Annunzio - .% (ƫ $!/%+*ċƫJ Prosthet DentċƫĂĀāĀĎāĀăĨąĩčĂĂāġĂĂĈċ Chieti, Italy 15.ƫ !%*"!( !.ƫ ċƫ * %.! 0ƫ,+/0!.%+.ƫ +),+/%0!ƫ.!/%*/ċƫCompend Contin Educ DentċƫĂĀĀĆĎĂćĨĈĩčąĊĆġĆĀăċ Lorenzo Vanini, MD, DDS 16.ƫ *0+/ƫƫ .Čƫ *0+/ƫ Čƫ%6' (( ƫċƫ $!/%2!ƫ !)!*0 0%+*ƫ+"ƫ!0 $ġ Private Practice, Chiasso, Switzerland (!ƫ !. )% ƫ!/0$!0% ƫ.!/0+. 0%+*/ċƫJ Can Dent AssocċƫĂĀĀĊĎĈĆĨĆĩčăĈĊġăĉąċ Matteo Casinelli, DDS 17.ƫ /$(!5ƫČƫ%1 $%ƫČƫ *+ƫČƫ!0ƫ (ċƫ+* ƫ/0.!*#0$ƫ2!./1/ƫ !*0%*!ƫ Unit of Restorative Dentistry, Department of Life, Health and Environmental /0.1 01.!čƫ ƫ)+ !((%*#ƫ ,,.+ $ċƫArch Oral BiolċƫāĊĊĆĎąĀĨāĂĩčāāĀĊġāāāĉċ Sciences, School of Dentistry, University of L’Aquila, L’Aquila, Italy 18.ƫ *ƫ !!. !!'ƫČƫ!. %#Y+ƫ Čƫ ) .! $0/ƫČƫ *$!.(!ƫċƫ$!ƫ (%*% (ƫ ,!."+.) * !ƫ+"ƫ $!/%2!/ċƫJ DentċƫāĊĊĉĎĂćĨāĩčāġĂĀċ Massimo Frascaria, DDS, PhD 19.ƫ( 00ƫ ċƫ!/%*ƫ !)!*0/čƫ%*0+ƫ0$!ƫĂā/0ƫ !*01.5ċƫCompend Contin Unit of Restorative Dentistry, Department of Life, Health and Environmental Educ DentċƫāĊĊĊĎĂĀĨāĂĩčāāĈăġāāĉĂċ Sciences, School of Dentistry, University of L’Aquila, L’Aquila, Italy 20.ƫ. # ƫČƫ!/ .ƫČƫ+*6 # ƫċƫ ! $ *% (ƫ,.+,!.0%!/ƫ+"ƫ Francesco De Angelis, DDS, PhD .!/%*ƫ !)!*0/ƫ3%0$ƫ %û!.!*0ƫ 0%2 0%+*ƫ)+ !/ċƫJ Oral Rehabilċƫ Department of Restorative Dentistry, School of Dentistry, University G. D’Annunzio - ĂĀĀĂĎĂĊĨăĩčĂĆĈġĂćĂċ Chieti, Italy 21.ƫ.!/ $%ƫ Čƫ 66+*%ƫČƫ1##!.%ƫČƫ!0ƫ (ċƫ!*0 (ƫ $!/%+*ƫ.!2%!3čƫ #ġ %*#ƫ * ƫ/0 %(%05ƫ+"ƫ0$!ƫ +* ! ƫ%*0!." !ċƫDent MaterċƫĂĀĀĉĎĂąĨāĩčĊĀġāĀāċ Mirco Vadini, DDS, PhD 22.ƫĚ. *#!(+ƫČƫ!ƫ*#!(%/ƫČƫĚ) .%+ƫ Čƫ!0ƫ (ċƫ$!ƫ%*ý1!* !ƫ Department of Restorative Dentistry, School of Dentistry, University G. D’Annunzio - +"ƫ(10%*#ƫ/5/0!)/ƫ+*ƫ0$!ƫ)% .+0!*/%(!ƫ +* ƫ/0.!*#0$ƫ+"ƫ !*0%*ƫ0+ƫ Chieti, Italy %* %.! 0ƫ.!/%*ġ /! ƫ +),+/%0!ƫ * ƫ !. )% ƫ.!/0+. 0%+*/ċƫOper Dentċƫ ĂĀĀĊĎăąĨăĩčăĂĉġăăćċ Maurizio D’Amario, DDS, PhD 23.ƫĚ. *#!(+ƫČƫ!ƫ*#!(%/ƫČƫ %*%ƫ Čƫ!0ƫ (ċƫ *ý1!* !ƫ+"ƫ 1.%*#ƫ Unit of Restorative Dentistry, Department of Life, Health and Environmental 0%)!Čƫ+2!.( 5ƫ) 0!.% (ƫ * ƫ0$% '*!//ƫ+*ƫ0$.!!ƫ(%#$0ġ 1.%*#ƫ +),+/ġ Sciences, School of Dentistry, University of L’Aquila, L’Aquila, Italy %0!/ƫ1/! ƫ"+.ƫ(10%*#ƫ%* %.! 0ƫ +),+/%0!ƫ.!/0+. 0%+*/ċƫJ Adhes Dentċƫ Queries to the author regarding this course may be submitted to ĂĀāĂĎāąĨąĩčăĈĈġăĉąċ 24.ƫ+1(!0ƫ ċƫƫ3+.( ƫ3%0$+10ƫ $!/%+*ĕƫJ Adhes DentċƫĂĀĀāĎăĨĂĩčāāĊċ [email protected]. 25.ƫ '!)1. ƫ Čƫ* +ƫċƫƫ.!2%!3ƫ+"ƫ+1.ƫ !2!(+,)!*0ƫ+"ƫ !*0 (ƫ $!ġ /%2!/Ģ!û! 0/ƫ+"ƫ. % (ƫ,+(5)!.%6 0%+*ƫ%*%0% 0+./ƫ * ƫ $!/%2!ƫ)+*+ġ REFERENCES )!./ƫ+*ƫ $!/%+*ċƫDent Mater JċƫĂĀāĀĎĂĊĨĂĩčāĀĊġāĂāċ 26.ƫ1+*+ +.!ƫ ċƫƫ/%),(!ƫ)!0$+ ƫ+"ƫ%* .! /%*#ƫ0$!ƫ $!/%+*ƫ+"ƫ .5(ġ 1. $+. .1,ƫ Čƫ /% +.ƫČƫ®./0! ġ%* /(!2ƫċƫƫ,.+/,! 0%2!ƫ (%*% (ƫ/01 5ƫ % ƫü((%*#ƫ) 0!.% (/ƫ0+ƫ!* )!(ƫ/1." !/ċƫJ Dent ResċƫāĊĆĆĎăąĨćĩčĉąĊġĉĆăċ +"ƫ%* %.! 0ƫ * ƫ %.! 0ƫ +),+/%0!ƫ * ƫ !. )% ƫ%*( 5/čƫ0!*ġ5! .ƫ.!/1(0/ċƫ 27.ƫ+3!*ƫ ċƫ $!/%2!ƫ +* %*#ƫ+"ƫ2 .%+1/ƫ) 0!.% (/ƫ0+ƫ$ . ƫ0++0$ƫ0%/ġ Quintessence IntċƫĂĀĀćĎăĈĨĂĩčāăĊġāąąċ /1!/ċƫăċƫ+* %*#ƫ0+ƫ !*0%*ƫ%),.+2! ƫ 5ƫ,.!ġ0.! 0)!*0ƫ * ƫ0$!ƫ1/!ƫ+"ƫ 2. Ě. *#!(+ƫČƫ .+3ƫ Čƫ!ƫ*#!(%/ƫČƫ!0ƫ (ċƫ%2!ġ5! .ƫ.!0.+/,! 0%2!ƫ /1." !ġ 0%2!ƫ +)+*+)!.ċƫJ Dent ResċƫāĊćĆĎąąĨĆĩčĊĀăġĊĀĆċ (%*% (ƫ/01 5ƫ+"ƫ%* %.! 0ƫ +),+/%0!ƫ.!/0+. 0%+*/ƫ(10! ƫ3%0$ƫ ƫ(%#$0ġ 1.! ƫ 28.ƫ+1(!0ƫ ċƫ++(ġ,.++"ƫ $!/%2!/ĕƫJ Adhes DentċƫĂĀĀĂĎąĨāĩčăċ +),+/%0!ƫ%*ƫ,+/0!.%+.ƫ0!!0$ċƫClin Oral InvestigċƫĂĀāąĎāĉĨĂĩčćāĆġćĂąċ 29.ƫ *ƫ !!. !!'ƫČƫ!ƫ 1* 'ƫ Čƫ 00 .ƫČƫ!0ƫ (ċƫ % .+0!*/%(!ƫ +* ƫ 3. *$ .0ƫ Čƫ 1*6!() **ƫ Čƫ$!*ƫČƫ% '!(ƫċƫ ! $ *% (ƫ,.+,!.ġ /0.!*#0$/ƫ+"ƫ *ƫ!0 $ƫĒƫ.%*/!ƫ * ƫ/!("ġ!0 $ƫ $!/%2!ƫ0+ƫ!* )!(ƫ * ƫ !*ġ 0%!/ƫ * ƫ3! .ƫ !$ 2%+.ƫ+"ƫ(%#$0ġ 1.! ƫ, ' (!ƫ +),+/%0!ƫ.!/%*/ċƫDent 0%*ƫ /ƫ ƫ"1* 0%+*ƫ+"ƫ/1." !ƫ0.! 0)!*0ċƫOper DentċƫĂĀĀăĎĂĉĨĆĩčćąĈġććĀċ MaterċƫĂĀĀĀĎāćĨāĩčăăġąĀċ 30.ƫ1// $!.ƫ Čƫ !ƫ +*#ƫČƫ2 *ƫ!(0ƫČƫ.!* /ƫ ċƫ$!ƫ/1." !ƫ".!!ƫ 4. !* +*` ƫ Čƫ!0+ƫČƫ *0% #+ƫ Čƫ!0ƫ (ċƫ%.! 0ƫ.!/%*ƫ +),+/%0!ƫ !*!.#5ƫ+"ƫ$1) *ƫ !*0 (ƫ!* )!(ċƫBiomater Med Devices Artif Organsċƫ .!/0+. 0%+*/ƫ2!./1/ƫ%* %.! 0ƫ +),+/%0!ƫ%*( 5/čƫ+*!ġ5! .ƫ.!/1(0/ċƫJ Con- āĊĉąĎāĂĨāġĂĩčăĈġąĊċ temp Dent PractċƫĂĀāĀĎāāĨăĩčĂĆġăĂċ 31.ƫ *ƫ !!. !!'ƫČƫ!ƫ 1* 'ƫ Čƫ+/$% ƫČƫ!0ƫ (ċƫ1+*+ +.!ƫ)!)+.% (ƫ 5. !1.0/!*ƫċƫ%+ +), 0% %(%05ƫ+"ƫ.!/%*ġ)+ %ü! ƫü((%*#ƫ) 0!.% (/ċƫCrit (! 01.!ċƫ $!/%+*ƫ0+ƫ!* )!(ƫ * ƫ !*0%*čƫ 1..!*0ƫ/0 01/ƫ * ƫ"101.!ƫ $ (ġ Rev Oral Biol MedċƫĂĀĀĀĎāāĨăĩčăăăġăĆĆċ (!*#!/ċƫOper DentċƫĂĀĀăĎĂĉĨăĩčĂāĆġĂăĆċ 6. .+*!ƫČƫ!. $%ƫČƫ+//%ƫČƫ!0ƫ (ċƫ +*#%01 %* (ƫ (%*% (ƫ!2 (1 ġ 32.ƫ /$(!5ƫČƫ .2 ($+ƫ ċƫ!*0%*!ƫ,!.)! %(%05ƫ * ƫ !*0%*!ƫ $!ġ 0%+*ƫ+"ƫ +* ! ƫ +),+/%0!ƫ%*( 5/čƫ ƫăġ5! .ƫ/01 5ċƫQuintessence Intċƫ /%+*ċƫJ DentċƫāĊĊĈĎĂĆĨĆĩčăĆĆġăĈĂċ ĂĀĀĉĎăĊĨāĩčćĆġĈāċ 33.ƫ!.. .%ƫ Čƫ #% % +ƫ Čƫ /+*ƫċƫ % .+)+.,$+(+#% ƫ.!( 0%+*ġ 7. %/ƫ Čƫ !,.%* !ƫ Čƫ$+.0 ((ƫČƫ!0ƫ (ċƫ%#$ƫ%.. % * !ƫ 1.%*#ƫ * ƫ /$%,ƫ !03!!*ƫ.!/%*ƫ * ƫ !*0%*ƫ%*ƫ( //ƫ ƫ.!/0+. 0%+*/čƫ *ƫ%*ƫ2%2+ƫ * ƫ%*ƫ *+) (%!/ƫ+"ƫ!4,+/1.!ƫ.! %,.+ %05ƫ( 3ƫ%*ƫ.!/%*ġ /! ƫ) 0!.% (/ċƫJ Dentċƫ 2%0.+ƫ%*2!/0%# 0%+*ƫ 5ƫ/ **%*#ƫ!(! 0.+*ƫ)% .+/ +,5ċƫQuintessence Intċƫ ĂĀāāĎăĊĨĉĩčĆąĊġĆĆĈċ āĊĊąĎĂĆĨāĂĩčĉćāġĉććċ 8. $+*!) **ƫČƫ! !.(%*ƫ Čƫ $) (6ƫČƫ.1* (!.ƫċƫ+0 (ƫ +* %*#ƫ2/ƫ 34.ƫ.!/ $%ƫ Čƫ!. %#Y+ƫ Čƫ +,!/ƫ Čƫ!0ƫ (ċƫ +.,$+(+#% (ƫ/01 5ƫ /!(! 0%2!ƫ +* %*#čƫ) .#%* (ƫ ,0 0%+*ƫ+"ƫ( //ƫĂƫ +),+/%0!ƫ.!/0+. ġ +"ƫ.!/%*ġ !*0%*ƫ +* %*#ƫ3%0$ƫ ƫ * ƫ%*ġ(!*/ƫ ċƫAm J Dentċƫ 0%+*/ċƫOper DentċƫāĊĊĊĎĂąĨĆĩčĂćāġĂĈāċ ĂĀĀăĎāćĨąĩčĂćĈġĂĈąċ 9. +#1!. %+ƫČƫ(!// * . ƫČƫ 66+ +ƫ Čƫ!0ƫ (ċƫ % .+(! 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(ƫ/0.!*#0$Čƫ)+ 1(1/ƫ * ƫ/1." !ƫ$ . *!//ċƫJ /5/0!)/ċƫJ Adhes DentċƫĂĀĀĊĎāāĨĂĩčāĀĊġāāĆċ Oral RehabilċƫĂĀĀāĎĂĉĨāāĩčāĀĂĂġāĀĂĉċ 54.ƫ .A)!.ƫČƫ +$ 1!.ƫČƫ. *'!* !.#!.ƫċƫ $!/%2!ƫ(10%*#ƫ+"ƫ%* %ġ 75.ƫ *0+/ƫ Čƫ //+/ƫČƫ ƫ* .* `Y+ƫ Čƫ!0ƫ (ċƫ . !*%*#ƫ+"ƫ ƫ .! 0ƫ.!/0+. 0%+*/ċƫAm J DentċƫĂĀĀĀĎāăĨ/,! ƫ*+ĩčćĀġĈćċ 1 (ġ 1.!ƫ.!/%*ƫ !)!*0ƫ1/%*#ƫƫ * ƫ ƫ 1.%*#ƫ1*%0/ċƫJ Appl Oral 55.ƫ+ .!/ƫ Čƫ+ .!/ƫČƫ!.!%. ƫ Čƫ+*/! ƫċƫ1." !ƫ0.! 0)!*0ƫ SciċƫĂĀāĀĎāĉĨĂĩčāāĀġāāĆċ ,.+0+ +(/ƫ%*ƫ0$!ƫ !)!*0 0%+*ƫ,.+ !//ƫ+"ƫ !. )% ƫ * ƫ( +. 0+.5ġ 76.ƫ -1 2%2 ƫČƫ!.100%ƫČƫ )%ƫČƫ!0ƫ (ċƫ!#.!!ƫ+"ƫ +*2!./%+*ƫ+"ƫ ,.+ !//! ƫ +),+/%0!ƫ.!/0+. 0%+*/čƫ ƫ(%0!. 01.!ƫ.!2%!3ċƫJ Esthet Restor 0$.!!ƫ +),+/%0!ƫ) 0!.% (/ƫ!),(+5! ƫ%*ƫ0$!ƫ $!/%2!ƫ !)!*0 0%+*ƫ+"ƫ%*ġ DentċƫĂĀĀĆĎāĈĨąĩčĂĂąġĂăĆċ %.! 0ƫ.!/0+. 0%+*/čƫ ƫ)% .+ġ ) *ƫ * (5/%/ċƫJ DentċƫĂĀĀĊĎăĈĨĉĩčćāĀġćāĆċ 56.ƫ $) #!ƫČƫ '%.ƫČƫ!.#%6ƫ Čƫ"!%û!.ƫċƫû! 0ƫ+"ƫ/1." !ƫ +* %ġ 77.ƫ !ƫ !*!6!/ƫ Čƫ.. %/ƫČƫ% **%*%ƫ ċƫ *ý1!* !ƫ+"ƫ(%#$0ġ 0%2 0! ƫ 0%+*%*#ƫ+*ƫ0$!ƫ.!0!*0%2!ƫ +* ƫ/0.!*#0$/ƫ+"ƫü !..!%*"+. ! ƫ +),+/%0!ƫ * ƫ 10+ġƫ * ƫ 1 (ġ,+(5)!.%6%*#ƫ $!/%2!ƫ/5/0!)/ƫ+*ƫ +* ƫ/0.!*#0$ƫ ,+/0/ċƫJ Prosthet DentċƫĂĀĀĊĎāĀĂĨćĩčăćĉġăĈĈċ +"ƫ%* %.! 0ƫ +),+/%0!ƫ.!/%*ƫ0+ƫ !*0%*ċƫJ Prosthet DentċƫĂĀĀćĎĊćĨĂĩčāāĆġāĂāċ 57.ƫĚ. *#!(+ƫČƫ *%*%ƫ ċƫû! 0ƫ+"ƫ0$.!!ƫ/1." !ƫ0.! 0)!*0/ƫ+*ƫ0$!ƫ 78.ƫĚ) .%+ƫ Čƫ %+*%ƫČƫ ,+#.! +ƫ Čƫ!0ƫ (ċƫû! 0ƫ+"ƫ.!,! 0! ƫ $!/%2!ƫ,.+,!.0%!/ƫ+"ƫ%* %.! 0ƫ +),+/%0!ƫ.!/0+. 0%+*/ċƫJ Adhes Dentċƫ ,.!$! 0%*#ƫ 5 (!/ƫ+*ƫý!41. 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572 COMPENDIUM September 2015 Volume 36, Number 8 Dent MaterċƫĂĀĀĈĎĂćĨćĩčĊĀćġĊāąċ .!/%*ƫ !)!*0/ƫ0+ƫ !*0%*ƫ * ƫ *ƫ%* %.! 0ƫ.!/%*ƫ +),+/%0!ċƫDent Materċƫ 82.ƫ(1* 'ƫČƫ /( */'5ƫċƫû! 0%2!*!//ƫ+"ƫ ((ġ%*ġ+*!ƫ $!/%2!ƫ/5/0!)/ƫ ĂĀĀĂĎāĉĨĉĩčćĀĊġćĂāċ 0!/0! ƫ 5ƫ0$!.)+ 5 (%*#ƫ"+((+3%*#ƫ/$+.0ƫ * ƫ(+*#ġ0!.)ƫ3 0!.ƫ/0+. #!ċƫ 94.ƫ ƫ.16ƫ Čƫ .0+/ƫ Čƫ%(2!%. ƫ Čƫ!0ƫ (ċƫ +*0+,( /05ƫ //+ % 0! ƫ J Adhes DentċƫĂĀĀĈĎĊĨĂƫ/1,,(ĩčĂăāġĂąĀċ 3%0$ƫ (%*% (ƫ .+3*ƫ(!*#0$!*%*#ƫ%*ƫ) * #!)!*0ƫ+"ƫ!40!*/%2!ƫ .+3*ƫ 83.ƫ!ƫ 1* 'ƫ Čƫ .# /ƫ Čƫ *ƫ * 150ƫ Čƫ!0ƫ (ċƫ+* %*#ƫ+"ƫ *ƫ 10+ġ $!ġ !/0.1 0%+*ċƫJ Conserv DentċƫĂĀāĂĎāĆĨāĩčĆćġćĀċ /%2!ƫ(10%*#ƫ) 0!.% (ƫ0+ƫ!* )!(ƫ * ƫ !*0%*ċƫDent MaterċƫĂĀĀąĎĂĀĨāĀĩčĊćăġĊĈāċ 95.ƫ !.ƫ Čƫ+6%!.ƫČƫ ((ƫƫ .Čƫ )/!5ƫ ċƫû! 0ƫ+"ƫ .+3*ƫ 84.ƫ +2% ƫ Čƫ +*0% !((%ƫČƫ+. %ƫČƫ!0ƫ (ċƫ!("ġ $!/%2!ƫ.!/%*ƫ !ġ ) .#%*/ƫ+*ƫ,!.%+ +*0 (ƫ +* %0%+*/ƫ%*ƫ.!#1( .(5ƫ 00!* %*#ƫ, 0%!*0/ċƫJ )!*0/čƫ ƫ(%0!. 01.!ƫ.!2%!3ċƫJ Adhes DentċƫĂĀĀĉĎāĀĨąĩčĂĆāġĂĆĉċ Prosthet DentċƫāĊĊāĎćĆĨāĩčĈĆġĈĊċ 85.ƫØ.')!*ƫČƫ1.' *ƫ Čƫ%)%((%ƫČƫ'/Ø6ƫ ċƫ!*/%(!ƫ +* ƫ/0.!*#0$ƫ+"ƫ 96.ƫ $A06(!ƫ Čƫ * ƫČƫ*!.1 ƫČƫ!0ƫ (ċƫ$!ƫ%*ý1!* !ƫ+"ƫ) .#%*/ƫ+"ƫ %* %.! 0ƫ +),+/%0!/ƫ(10! ƫ3%0$ƫ0$.!!ƫ*!3ƫ/!("ġ $!/%2!ƫ.!/%*ƫ !)!*0/ƫ .!/0+. 0%+*/ƫ+"ƫ0$!ƫ,!.%+ +*0 (ƫ0%//1!/ƫ+2!.ƫĂćƫ5! ./ċƫJ Clin Periodon- 0+ƫ !*0%*ċƫJ Appl Oral SciċƫĂĀāāĎāĊĨąĩčăćăġăćĊċ tolċƫĂĀĀāĎĂĉĨāĩčĆĈġćąċ 86.ƫ1!*0!/ƫ Čƫ! ((+/ƫ Čƫ+*68(!6ġ ¨,!6ƫċƫ+* ƫ/0.!*#0$ƫ+"ƫ/!("ġ 97.ƫ%(//+*ƫČƫ( ! %*ƫČƫ .(//+*ƫČƫ!0ƫ (ċƫ 0+./ƫ û! 0%*#ƫ0$!ƫ $!/%2!ƫ.!/%*ƫ !)!*0/ƫ0+ƫ %û!.!*0ƫ0.! 0! ƫ%* %.! 0ƫ +),+/%0!/ċƫClin /$! .ƫ +* ƫ/0.!*#0$ƫ+"ƫ +* ! ƫ +),+/%0!ƫ%*( 5/ċƫInt J Prosthodontċƫ Oral InvestigċƫĂĀāăĎāĈĨăĩčĈāĈġĈĂąċ ĂĀĀĀĎāăĨāĩčĆĂġĆĉċ 87.ƫ%.8( !6ƫ Čƫ! ((+/ƫ Čƫ ..% +ƫ Čƫ+ .#1!6ƫ ċƫ .(5ƫ$ . *!//ƫ 98.ƫ 5*!ƫČƫ $) (6ƫċƫ!,.%*0%*#ƫ0$!ƫ ( //% ƫ .0% (!ƫ+*ƫƫ +"ƫ/!("ġ $!/%2!ƫ.!/%*ƫ !)!*0/ƫ 1.! ƫ1* !.ƫ%* %.! 0ƫ.!/%*ƫ +),+/%0!ƫ !2 (1 0%+*ƫ)!0$+ /ƫ"+.ƫ)! /1.%*#ƫ0$!ƫ (%*% (ƫ.!/! . $ƫ,!."+.) * !ƫ+"ƫ .!/0+. 0%+*/ċƫJ Esthet Restor DentċƫĂĀāāĎĂăĨĂĩčāāćġāĂąċ .!/0+. 0%2!ƫ) 0!.% (/ċƫClin Oral InvestigċƫĂĀĀĆĎĊĨąĩčĂĀĊġĂāąċ 88.ƫ%+00%ƫČƫ / 6ƫČƫ!* ƫČƫ!0ƫ (ċƫ % .+0!*/%(!ƫ +* ƫ/0.!*#0$ƫ+"ƫ 99.ƫ10$ƫ Čƫ$!*ƫČƫ !$(ƫČƫ!0ƫ (ċƫ(%*% (ƫ/01 5ƫ+"ƫ%* %.! 0ƫ +),+/ġ *!3ƫ/!("ġ $!/%2!ƫ(10%*#ƫ #!*0/ƫ * ƫ +*2!*0%+* (ƫ)1(0%/0!,ƫ/5/0!)/ċƫJ %0!ƫ.!/%*ƫ%*( 5/ƫ%*ƫ,+/0!.%+.ƫ/0.!//ġ ! .%*#ƫ 2%0%!/ƫ,( ! ƫ 5ƫ !*0 (ƫ Prosthet DentċƫĂĀĀĊĎāĀĂĨĆĩčăĀćġăāĂċ /01 !*0/čƫ.!/1(0/ƫ "0!.ƫąƫ5! ./ċƫJ DentċƫĂĀāāĎăĊĨĈĩčąĈĉġąĉĉċ 89.ƫ /$(!5ƫČƫ *+ƫČƫ%1 $%ƫČƫ!0ƫ (ċƫ $!/%+*ƫ0!/0%*#ƫ+"ƫ !*0%*ƫ 100ċƫ *$ .0ƫ Čƫ$!*ƫČƫ!1!.!.ƫČƫ!0ƫ (ċƫ$.!!ġ5! .ƫ (%*% (ƫ!2 (1 ġ +* %*#ƫ #!*0/čƫ ƫ.!2%!3ċƫDent MaterċƫāĊĊĆĎāāĨĂĩčāāĈġāĂĆċ 0%+*ƫ+"ƫ +),+/%0!ƫ * ƫ !. )% ƫ%*( 5/ċƫAm J DentċƫĂĀĀāĎāąĨĂĩčĊĆġĊĊċ 90.ƫ. *'!* !.#!.ƫČƫ .A)!.ƫČƫ!0/ $!(0ƫċƫ! $*%-1!ƫ/!*/%0%2%05ƫ+"ƫ 101ċƫ !%./' .ƫ Čƫ!* 1#ƫČƫ$+.!/!*ƫČƫ!0ƫ (ċƫ(%*% (ƫ,!."+.) * !ƫ+"ƫ !*0%*ƫ +* %*#čƫ!û! 0ƫ+"ƫ ,,(% 0%+*ƫ)%/0 '!/ƫ+*ƫ +* ƫ/0.!*#0$ƫ * ƫ %* %.! 0ƫ +),+/%0!ƫ.!/%*ƫ%*( 5/ĥ+*( 5/ƫ%*ƫ ƫ !*0 (ƫ/ $++(čƫ+ /!.2 0%+*/ƫ ) .#%* (ƫ ,0 0%+*ċƫOper DentċƫĂĀĀĀĎĂĆĨąĩčăĂąġăăĀċ 1,ƫ0+ƫăąƫ)+*0$/ċƫActa Odontol ScandċƫāĊĊĊĎĆĈĨąĩčĂāćġĂĂĀċ 91.ƫ0!3 .0ƫČƫ %*ƫČƫ+ #!/ƫ ċƫ$! .ƫ +* ƫ/0.!*#0$ƫ+"ƫ.!/%*ƫ !)!*0/ƫ 102ċƫ $!% !* +#!*ġ1 $/ .1**!.ƫČƫ *$ .0ƫ Čƫ .!)!./ƫ Čƫ!0ƫ (ċƫ3+ġ 0+ƫ +0$ƫ !. )% ƫ * ƫ !*0%*ċƫJ Prosthet DentċƫĂĀĀĂĎĉĉĨăĩčĂĈĈġĂĉąċ 5! .ƫ (%*% (ƫ!2 (1 0%+*ƫ+"ƫ %.! 0ƫ * ƫ%* %.! 0ƫ +),+/%0!ƫ.!/0+. 0%+*/ƫ%*ƫ 92.ƫ3%"0ƫ ƫ .Čƫ!. %#Y+ƫ Čƫ+) !ƫČƫ!0ƫ (ċƫû! 0/ƫ+"ƫ.!/0+. 0%2!ƫ ,+/0!.%+.ƫ0!!0$ċƫJ Prosthet DentċƫāĊĊĊĎĉĂĨąĩčăĊāġăĊĈċ * ƫ $!/%2!ƫ 1.%*#ƫ)!0$+ /ƫ+*ƫ !*0%*ƫ +* ƫ/0.!*#0$/ċƫAm J Dentċƫ 103ċƫ!0%*ƫČƫ*(1ƫČƫ+ *+#(1ƫċƫƫü2!ġ5! .ƫ (%*% (ƫ!2 (1 0%+*ƫ+"ƫ ĂĀĀāĎāąĨăĩčāăĈġāąĀċ %.! 0ƫ* *+ü((! ƫ * ƫ%* %.! 0ƫ +),+/%0!ƫ.!/%*ƫ.!/0+. 0%+*/ƫ%*ƫ,+/0!.%+.ƫ 93.ƫ 'ƫČƫ %ƫČƫ$!1*#ƫČƫ!0ƫ (ċƫ % .+ġ0!*/%(!ƫ +* ƫ0!/0%*#ƫ+"ƫ 0!!0$ċƫOper DentċƫĂĀāăĎăĉĨĂĩčāġāāċ
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Adhesive Cementation of Indirect Composite Inlays and Onlays: A Literature Review Camillo D’Arcangelo, DDS; Lorenzo Vanini, MD, DDS; Matteo Casinelli, DDS; Massimo Frascaria, DDS, PhD; Francesco De Angelis, DDS, PhD; Mirco Vadini, DDS, PhD; and Maurizio D’Amario, DDS, PhD
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1. Issues associated with the use of direct resin composites in the 6. After cavity preparation and before cavity finishing, adhesive posterior region include: procedures are performed using a rubber dam in order to: ƫ ċƫ ƫ$%#$ƫ,+(5)!.%6 0%+*ƫ/$.%*' #!ċ ƫ ċƫ ƫ ! .! /!ƫ#.%0ċ ƫ ċƫ ƫ# ,ƫ"+.) 0%+*ċƫ ƫ ċƫ ƫ $%!2!ƫ *ƫ%))! % 0!ƫ !*0%*ƫ/! (%*#ċ ƫ ċƫ ƫ +(+.ƫ%*/0 %(%05ċ ƫ ċƫ ƫ!4,+/!ƫ%*0!.01 1( .ƫ !*0%*ƫ +(( #!*ƫü !./ċ ƫ ċƫ ƫ ((ƫ+"ƫ0$!ƫ +2! ƫ ċƫ ƫ %//+(2!ƫ0$!ƫ$5 .% ƫ( 5!.ċ
2. While the clinical performance of composite resin restorations is 7. The application of phosphoric acid increases the surface comparable to ceramic restorations, increased use of composite energy of dentin by removing the what and promoting resin-based indirect restorations in the posterior region is a demineralization of surface hydroxyapatite crystals? result of: ƫ ċƫ ƫ +(( #!*ƫü !./ ƫ ċƫ ƫ +),+/%0!/Ěƫ!4 !((!*0ƫ.!/%/0 * !ƫ0+ƫ3! .ƫ * ƫ0! .ċ ƫ ċƫ ƫ0.% + $!)% (ƫ + 0%*# ƫ ċƫ ƫ +),+/%0!/Ěƫ/1,!. ƫ) .#%* (ƫ%*0!#.%05ċ ƫ ċƫ ƫ$5 .% ƫ( 5!. ƫ ċƫ ƫ0$!ƫ.!( 0%2!(5ƫ(+3ƫ +/0ƫ //+ % 0! ƫ3%0$ƫ +),+/%0!/ċ ƫ ċƫ ƫ/)! .ƫ( 5!. ƫ ċƫ ƫ ƫ( 'ƫ+"ƫ,+/0+,!. 0%2!ƫ/!*/%0%2%05ƫ //+ % 0! ƫ3%0$ƫ +),+/%0!/ċ 8. Immediate dentin sealing (IDS) is a strategy in which a dentin 3. An adherent is necessary because the microscopic structure of bonding agent is applied to freshly cut dentin and two di!erent contact surfaces presents: polymerized before: ƫ ċƫ ƫ%..!#1( .%0%!/ċ ƫ ċƫ ƫ .%!/ƫ.!)+2 (ċ ƫ ċƫ ƫ.+1* ƫ%*0!.* (ƫ *#(!/ċ ƫ ċƫ ƫ) '%*#ƫ *ƫ%),.!//%+*ċ ƫ ċƫ ƫ ƫ (! *Čƫ/)++0$ƫ/1." !ċ ƫ ċƫ ƫ) .#%*ƫ,.!, . 0%+*ċ ƫ ċƫ ƫ ƫ 100ƫ&+%*0ċ ƫ ċƫ ƫ( /!.ƫ0.! 0)!*0ċ
4. What is an organic acid that demineralizes the surface, dissolves 9. What is the main factor responsible in improving the retentive hydroxyapatite crystals, and increases free surface energy? properties of indirect composite restorations? ƫ ċƫ ƫ,.%)!. ƫ ċƫ ƫ/ * ( /0%*#ƫ0.! 0)!*0 ƫ ċƫ ƫ +* %*#ƫ #!*0 ƫ ċƫ ƫ % ġ!0 $%*# ƫ ċƫ ƫ!0 $ *0 ƫ ċƫ ƫ/%( *%6 0%+* ƫ ċƫ ƫ(%#$0ġ 1.! ƫ +),+/%0!ƫü((%*#ƫ) 0!.% ( ƫ ċƫ ƫ,1)% %*#
5. What refers to an adhesive system that dissolves the smear layer and 10. Light-cured filled composites can reach optimal fluidity by infiltrates it at the same time, without a separate etching step? doing what to them? ƫ ċƫ ƫ/!("ġ!0 $ ƫ ċƫ ƫ!0 $%*#ƫ * ƫ.%*/%*#ƫ0$!) ƫ ċƫ ƫ/!("ġ $!/%2! ƫ ċƫ ƫ%/+( 0%*#ƫ0$!) ƫ ċƫ ƫ!0 $ġ * ġ.%*/! ƫ ċƫ ƫ,.!$! 0%*#ƫ0$!) ƫ ċƫ ƫ/!(! 0%2!ġ!0 $ ƫ ċƫ ƫ %.ƫ (+ '%*#ƫ0$!)
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574 COMPENDIUM September 2015 Volume 36, Number 8