Chairside - Glidewell Dental Labs

worrying that self-etchers don’t have the same bond strength
to enamel. So you are getting the best of both worlds. It’s
a technique I’ve been using now for almost a year, and it’s
working really, really well. The other thing I like about it is
I can do it for both direct and indirect. I can use the same
technique, and that makes it easy as well. I’m fond of my
new technique.
MD: So tell me what you’re going to do on a deep, Class I
posterior composite, something simple like that.
LB: How deep? Am I worried about the pulp? Am I thinking
pulp cap?
MD: No. You’ve got 1.5 millimeters of remaining dentin. I just
mean something that’s primarily bonding to dentin with an
enamel rim around it. Are you doing your selective etching on
those direct composites as well?
Whether it’s a Class I, Class II or
Class III composite, even a metal
Class V composite, I do selective
etching. I put phosphoric acid just on
the enamel. One of the things about
that is you have to play with your
etchings because you want one that
is very viscous. It can’t be runny, or it
runs everywhere.
LB: I am. I’m doing my selective etching on those. I have
been doing adhesive dentistry for a lot of years, and I really
don’t have a lot of reason in my practice to not trust dentin
bonding. Even with that, I like preparations that have enamel
margins, and I want to make sure I have a great bond to
that enamel. So even with something like that, whether it’s a
Class I, Class II or Class III composite, even a metal Class V
composite, I do selective etching. I put phosphoric acid just
on the enamel. One of the things about that is you have
to play with your etchings because you want one that is
very viscous. It can’t be runny, or it runs everywhere. I’m
actually using the new Select HV Etch from Bisco, and I
use it for that reason, because it’s very thick. But the other
reason I love it is the tip on there is teeny-tiny, so you can
get literally a band of phosphoric acid that’s no more than
a millimeter wide.
MD: Are you placing any kind of flowable in there as the base
of that restoration?
LB: You know, I’m not. The only place I use flowable in my
direct composites is on Class II and Class III, and I just run
a little bead of it at the marginal interface on the box. I only
do that because we still know that there are issues with
adequate condensation right down into the corners of those
proximal boxes. I’m not using it as a liner.
MD: Are you finding much use for self-etching resin cements?
Walk me through what you might use for a PFM bridge; for an
IPS e.max crown; and for a bonded, single-tooth restoration,
an all-ceramic in the anterior. I’m curious to see if you’re
finding much use for the self-etching resin cements.
LB: I do use the self-etching, self-priming resin cement
family. I use them when I want to cement; when I have a
prep that has retention form and resistance form, so I’m
not worried about the bonding being my retention, and I
want something translucent. If I’m doing a PFM and I’ve got
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