Bonding – Everything You Need to Know

Around a hundred bonding agents are on the market, and most of us left dental school trained on one. So a crown debonds after you followed the instructions to the letter, a composite comes back sensitive, and nothing on the bottle says why.

By the end of this course you should be able to place any bonding system in one of the four families, say what each of its three steps is doing to the tooth, and choose between total-etch, self-etch and selective etch for the tooth in front of you. Zirconia, glass ceramic and printed or milled resin each come with the protocol they need, and so do the isolation and curing that decide whether any of it holds.

Dr. Tony Mennito recorded it for iDD. A practicing dentist in Charleston, South Carolina, he also teaches in the dental school at the Medical University of South Carolina and holds a patent on an antimicrobial bonding agent, so the course is the mechanism behind each step rather than a product recipe.

He recorded this in early 2023. All the information and processes are still clinically relevant; just the products and prices are from then.

Two chapters, seven lessons and 84 minutes of lecture on slides, with a ten-question quiz after each chapter. Chapter 01 is the science, 30 minutes on the three steps, the four families, total-etch and self-etch. Then 53 minutes of clinic in chapter 02, on universal adhesives and selective etching, isolation and curing, and bonding to zirconia and glass ceramics.

What you will learn

• The three steps every bonding procedure takes, whatever the bottle count, and what each does to enamel and dentin
• The smear layer, and why a bond to it fails
• Total-etch against self-etch, the pH behind the difference, and the trade each makes on dentin
• Why dentin needs a primer, and why the field’s early one-bottle systems failed
• MMPs, over-etching and collagen collapse, the three ways a total-etch bond to dentin gives way over time
• Universal adhesives and the selective etch technique, with what the literature says about etching enamel first
• Two bottles or one, and hydrolytic degradation
• Rubber dam the way his team places it in about a minute, the clamps and dams he uses, and an etchant made for selective etching
• Curing as arithmetic, the energy a composite needs against what your light puts out, why he cures in ten-second bursts, and what an off-brand light does as its battery drains
• The conservative preparations adhesive dentistry makes possible
• The APC protocol for zirconia, decontamination after try-in, air abrasion pressure and dual-cure compatibility
• Hydrofluoric acid and silane for e.max and other glass ceramics, and why the zirconia protocol would crack them

2 CPD/CE hours, assessed by two ten-question quizzes with an 80 percent pass mark and unlimited attempts.

You get lifetime access, updates included.

Written for general dentists placing bonded restorations, from new graduates choosing a first system to owners who want to know why a protocol fails, and for anyone moving into CAD/CAM or printed restorations who now has to bond materials dental school never covered.

It does not cover tooth preparation or what happens to a ceramic before it reaches the chair. The preps are in Dr. Ahmad Al-Hassiny’s free Modern Prep Design and Margination, the finishing of the ceramics you will bond in his Perfect Ceramic Processing, and the anterior cases those bonds have to hold in Aesthetic Smile Design Excellence.

Sold on its own and as part of CEREC Same-Day Excellence, Planmeca Workflow Excellence and Digital Implantology.