I saw 100 videos from other drs just to understand and I couldn’t , I was so happy to find this video because you cleared all my doubts , now I understand it thank you
Hi Jason, One of the reasons you can't cure the Optibond FL before cementing is the film of the resin component is way too tick and your restoration might not seat completely. For CADCAM you might have to twitch some parameters if you want to cure the Optibond FL. Thanks for the video. Best regards
Very informative ..thank u for taking time and effort to share valuable info. But i got a little confused..ans kindly correct me if im wrong.. rely x ultimate is an adhesive resin cement...not self adhesive ..so it requires use of scotch bond for bonding. and immediate dentin sealing would increase the bond strength...but SELF adhesive cements like rely x u200 do not require the use of bonding agent..as they are self adhesive... Do u still recommend Ids pre treatment of tooth..as i have read that it can lower the bond strength if use it with self adhesive cements... I would be ever grateful if anyone can explain if we should do ids with both adhesive and SELF adhesive cements too?
Very good explanation doc 🙏, i have a question, does the protocol of IDS works the same way if we want to do direct composite restoration? (not indirect restoration) do we need to do IDS when we are doing direct restoration (composite) ? Thank You
Nicolas Brian You are essentially doing IDS when doing a composite anyway! The only difference is the maturing of the bond. To do this with a composite, you would have to wait 4-5 mins after applying your bonding agent. That would require some good isolation and patience!
@@TheComprehensiveDentist If I understood correctly: first you do IDS, apply the bonding agent to enamel and dentine, wait 4-5 min and than apply the direct composite layers?
Thank you very much for your efforts In cementation visit after we applying itching to tooth, it will not effect or remove old bond of IDS ? and if we put another layer of bond in 2nd visit as you mentioned, this will not make the dentin bond too thick as we put old and new bond layer? the new adhesive will bond to old adhesive after provisionals phase ?
mohammed almousawy The old bond will not be removed. The last layer is bonding to the enamel at the periphery of the prep and some will bond to the layer from IDS. The cement layer of the restoration is the space for your new bond and resin cement. I find it best to use a bonding agent that offers a dual cure capability Bc I do not want to light cure my bond prior to placing the restoration. Cured bonding agent could prevent proper seating of the restoration. I am currently using e.max and multilink automix. The last bond layer in my protocol is the A and B bond that comes with Multilink Automix.
Hi, Do you ever run into a situation where the Scanner is not able to pick up the thickness of the clear primer/bonding agent applied (no composite added), and the restoration after milling doesn't seat ?
Hey nice video!! I have a question about temporizing..u said to make a provisional its useful to use glycerine gel or Alkohol after IDS to be able to remove it...that’s logic for me.. but how are u cementing the provisional afterwards with normal prov cement? Or spot bonding? Greetings
It should be emphasized that in vitro studies showed much better results with 2step selfetch adhesive systems. Single step ones are unfortunately more permeable with their monomethacrylates content and not as stable as dimethacrylate containing twostep selfetch adhesives. Regarding 3m sbmp might work better.
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15 sec orthophosphoric acid etching on dentin is required for 4th and 5th gen adhesive systems but why for single bottle universal adhesive? Even the comonomer in sbu works in exposed collagen mesh but can not stop matrix metalloproteninase activity afterwards. Mild selfetch capability of sbu is quite well and adequate, as i know. Also why to etch enamel then grind and reetch prior to adhesive cementation? Does not too much etch on enamel dijish surface roughness by destroying highly mineralised prism walls? Also on vital tooth alcohol may cuase permenant damage after vaporisaion cooling.
Thank you but If the thickness of the restoration is big like more than 3 mm in endo crowns or large onlays I think we should cure the bonding agent just before seating the restoration to be sure that my bond is polymerized
ali jawad well that really depends on the bonding agent that you use. Scotchbond universal with a dual cure activator or mixed with rely-x unicem will self cure. The same is true for clearfil SE when used with a dual cure activator. For light cure only options, you are absolutely correct!
Thank you so much for this video! I am a 4th year student and this is very helpful. Are you doing this routinely in your practice now? Also, would the protocol be similar for 5th gen bonding agent like Optibond solo?
Kate Moon Hello Kate! I personally use Clearfil SE or Optibond FL for immediate Denton sealing. Scotchbond would be a third option for me. Honestly, Optibond Solo is one of the worst bonding agents on the market. I would not recommend it for this procedure.
1) can we straight away apply glycerin on the uncured adhesive(scthbond universal adhesive) and light cure through it ? or we need to light cure them seperately for 10secs 2) if we need to apply flowable in a deep dentine area, do you light cure it seperately before apply glycerin? Thank You Dr :)
anis zulkarnain Hello! What ever the last layer of material you use (bonding agent or flowable composite), cure, then apply glycerin and re-cure. Don’t apply glycerin for the bond if you plan to use flowable composite over it. Don’t apply glycerin without curing bonding agent first so you do not contaminate unset bond. Remember, the glycerin is only to help you cure that last few microns of uncured resin on the oxygen exposed areas of IDS.
syafiq ramli Anything is possible. Most universal bonding agents are not recommended in the immediate dentin sealing protocols. I was at a clinic once that only had scotchbond universal. I did immediate dentin sealing with that but there are better options. Definitely use a layer of flowable over top!
If that is the only bonding agent you have, place scotchbond universal after you prep. Thin layer of flowable next. When it is time to cement, do your normal cementation protocol with multilink using the A&B from multilink.
@@TheComprehensiveDentist . Amazing.. Thanks, appreciate it I also read that IDS is also advisable for direct restorations. How should we go about it. For example, IDS+Resin Coat ... Should we reapply bond on top of the Resin Coat and cure before composite restorations. Or Is it possible to composite restoration straight away on top of the resin coat. Which one would maximise the IDS strength and having higher survivability of restorations?
@@TheComprehensiveDentist that's great. We here in balkans do though. Most of us at least. Maybe that has to do with crowns being quite cheap, so the price of the crown doesn't cover all expenses.
Rigon Hasani so do you prep the tooth and just not temporize until the crown is ready? IDS could still work but I would recommend placing a small amount of flowable on top of Dentin after IDS
Hi doc Can we do IDS with scotchbond and cementation by using the multilink automix adhesive and cement or the IDS should be done with multilink automix adhesives??? Thanks
Manpreet Kaur if you are using multilink, the IDS is separate from the cementation. Here is an example, I recently did IDS with Optibond fl, a three step etch and rinse adhesive. At cementation, I used the multilink a and b on the tooth just before cementing. You can do ids with scotchbond in theory but it is best done with optibond fl or Clearfil se.
How to do IDS with Scotchbond: Don't 😂 Just don't use it. According to move than a few studies, it is down right inferior, especially when compared to systems like Optibond FL or Clearfil SE Protect. It already costs too much for what you get, so why not put your money towards a gold-standard dentin bonding agent?
cosmogang I couldn’t agree more! I personally do not use it. The hard reality is, people do use it and although it is clearly inferior to optibond fl or Clearfil SE based on retention studies, there are people who still think it is clinically acceptable and won’t switch away from it. We have not clearly defined what clinically acceptable really is in dentistry. And scotchbond is still a better choice than 70% of the other bonding agents on the market. I teach my preferences but I also believe a restorative dentist should be able to make the most of any situation by applying their knowledge and what they have available. Some providers don’t have a choice to just up and switch because they are merely employees and must submit to the office they work for. In those situations they should at least use best evidence to get the most out of their materials even if it is not the gold standard. Understanding of foundational principles is bedrock to being a good restorative dentist. We learn foundational principles and develop preferences.
Adhese Universal is suitable for sealing cavity surfaces before impression taking and the application of temporary restorations. All of the bond strength values were over 30 MPa. No significant difference was observed between the reference teeth (no IDS or temporary cementation) and the teeth undergoing immediate dentin sealing and temporary cementation.--R&D Ivoclar Vivadent, FL, August 2013
Hey Doc. I have a question: when it comes to bonding strength, do we lose some by bonding the ceramic piece to the enamel and flowable composite vs if we don´t do IDS and bond the ceramic piece to enamel and non sealed dentin? Thank you
88PianoKeys Well look at it this way, you will bond to the tooth when doing a ceramic crown at some point. Whether this is IDS or immediately before you cement. One of the perks of IDS...it allows the bond to the tooth to mature. When bonding agent cures or when composite cures, the material shrinks some and puts stress on the dentin-bond interface. Over time, minutes even, that stress will decrease and relax. When you bond to tooth and immediately cement, you stress that bond further. If anything, experts would suggest IDS improves bond strengths.
@@TheComprehensiveDentist thank you for your answer! But does ceramic bond to dentin the same way it bonds to the flowable composite in IDS? Thats my main question
The bond to flowable is very similar. With IDS you still have a well established, matured hybrid layer. I have seen studies where if these bonded crowns fail, they Debond at the composite-cement interface, which is a favorable failure bc you cannot get Caries on composite or cement from leakage but you can get Caries in Dentin. Remember, even when bonding ceramic to dentin, you still have to create a hybrid layer with bond.
Awsome video!! I have one concept, that I'm finding difficult to undesrtand-and forgive me if this is too basic, but I'm still in 3rd year. So if I essentially sealed my dentinal tubules with IDS, what purpose does it serve me to then etch that same dentin later on? Is it just to roughen the surface? Thank u so much in advance!
Khalil Ghufran Hello. Later on you are etching the enamel as well, which is the most important part of the “later” etch. However, by re-etching the bonded dentin, you are in essence cleaning it, removing particulate, and increasing surface energy for better bonding and cementation. Hope that helps.
hoda saleh scotchbond universal is a universal material and does contain a silane. Technically, you would have to do this step but it has been shown in the literature that using a separate silane with universal adhesive is better. Vasconcelos AF (2017). Effect of prior silane application on the bond strength of a universal adhesive to a lithium disilicate ceramic. The Journal of Prosthetic Dentistry 118(5).
@@TheComprehensiveDentist you mean that the silane of the universal adhesive differ than the normal silane ? and if this was true why we dont apply universal adhesive only after the HF without normal silane ? I mean why the 2 layers ?
You can only apply the adhesive after HF acid etch!! That was what I said earlier when I referenced the article. You can only apply adhesive but the literature shows that universal adhesive only leads to weaker bond strengths than universal adhesive plus a separate silane. Keep in mind that in dentistry, there are many combinations or ways you can do the same procedure. Some combinations or protocols will be better than others and result in better results. My clinic has been using rely-x ultimate cement and the manufacturer instructions recommends only using the adhesive as the silane after HF acid. However, we have been using Monobond etch and prime as our porcelain etch and silane. Then we add the scotchbond universal. But that is only one way to do it!! If you have not already, go join our website at www.comprehensivedentist.com to find more information on this topic!
I saw 100 videos from other drs just to understand and I couldn’t , I was so happy to find this video because you cleared all my doubts , now I understand it thank you
Great job. We should collaborate sometime on a few videos. Rich Stevenson
Stevenson Dental Solutions That would be awesome!
@@TheComprehensiveDentist That's really great to see you both! Can't wait for the video
Hi Jason,
One of the reasons you can't cure the Optibond FL before cementing is the film of the resin component is way too tick and your restoration might not seat completely. For CADCAM you might have to twitch some parameters if you want to cure the Optibond FL.
Thanks for the video.
Best regards
Microdontology good point! This is true, for cad/cam that is a creative and valid solution!
Very informative ..thank u for taking time and effort to share valuable info. But i got a little confused..ans kindly correct me if im wrong.. rely x ultimate is an adhesive resin cement...not self adhesive ..so it requires use of scotch bond for bonding. and immediate dentin sealing would increase the bond strength...but SELF adhesive cements like rely x u200 do not require the use of bonding agent..as they are self adhesive...
Do u still recommend Ids pre treatment of tooth..as i have read that it can lower the bond strength if use it with self adhesive cements...
I would be ever grateful if anyone can explain if we should do ids with both adhesive and SELF adhesive cements too?
Best video, best content regarding ids. Great job bro
Very good explanation doc 🙏, i have a question, does the protocol of IDS works the same way if we want to do direct composite restoration? (not indirect restoration) do we need to do IDS when we are doing direct restoration (composite) ? Thank You
Nicolas Brian You are essentially doing IDS when doing a composite anyway! The only difference is the maturing of the bond. To do this with a composite, you would have to wait 4-5 mins after applying your bonding agent. That would require some good isolation and patience!
@@TheComprehensiveDentist thank you doc for your response , it means a lot 🙏 God Bless
@@TheComprehensiveDentist If I understood correctly: first you do IDS, apply the bonding agent to enamel and dentine, wait 4-5 min and than apply the direct composite layers?
@@giggina18 Yes, after polymerization wait for it, then apply composite incrementally 👍
Great video. What's the reason behind re-etch, bond after air abrasion of the tooth prior to cementation?
Thank you
Many resin cements require bonding protocols. Depending on the cement, this will be necessary.
Thank you very much for your efforts
In cementation visit after we applying itching to tooth, it will not effect or remove old bond of IDS ? and if we put another layer of bond in 2nd visit as you mentioned, this will not make the dentin bond too thick as we put old and new bond layer? the new adhesive will bond to old adhesive after provisionals phase ?
mohammed almousawy The old bond will not be removed. The last layer is bonding to the enamel at the periphery of the prep and some will bond to the layer from IDS. The cement layer of the restoration is the space for your new bond and resin cement. I find it best to use a bonding agent that offers a dual cure capability Bc I do not want to light cure my bond prior to placing the restoration. Cured bonding agent could prevent proper seating of the restoration. I am currently using e.max and multilink automix. The last bond layer in my protocol is the A and B bond that comes with Multilink Automix.
Hi, Do you ever run into a situation where the Scanner is not able to pick up the thickness of the clear primer/bonding agent applied (no composite added), and the restoration after milling doesn't seat ?
Hey nice video!! I have a question about temporizing..u said to make a provisional its useful to use glycerine gel or Alkohol after IDS to be able to remove it...that’s logic for me.. but how are u cementing the provisional afterwards with normal prov cement? Or spot bonding? Greetings
Same question.
Same here
?
It should be emphasized that in vitro studies showed much better results with 2step selfetch adhesive systems. Single step ones are unfortunately more permeable with their monomethacrylates content and not as stable as dimethacrylate containing twostep selfetch adhesives. Regarding 3m sbmp might work better.
15 sec orthophosphoric acid etching on dentin is required for 4th and 5th gen adhesive systems but why for single bottle universal adhesive? Even the comonomer in sbu works in exposed collagen mesh but can not stop matrix metalloproteninase activity afterwards. Mild selfetch capability of sbu is quite well and adequate, as i know. Also why to etch enamel then grind and reetch prior to adhesive cementation? Does not too much etch on enamel dijish surface roughness by destroying highly mineralised prism walls? Also on vital tooth alcohol may cuase permenant damage after vaporisaion cooling.
Thank you but If the thickness of the restoration is big like more than 3 mm in endo crowns or large onlays I think we should cure the bonding agent just before seating the restoration to be sure that my bond is polymerized
ali jawad well that really depends on the bonding agent that you use. Scotchbond universal with a dual cure activator or mixed with rely-x unicem will self cure. The same is true for clearfil SE when used with a dual cure activator. For light cure only options, you are absolutely correct!
A good idea. However filter effect of the thick ceramic or polymer restoratin can be overwhelmed by prolonged curing as well
Thank you so much for this video! I am a 4th year student and this is very helpful. Are you doing this routinely in your practice now? Also, would the protocol be similar for 5th gen bonding agent like Optibond solo?
Kate Moon Hello Kate! I personally use Clearfil SE or Optibond FL for immediate Denton sealing. Scotchbond would be a third option for me. Honestly, Optibond Solo is one of the worst bonding agents on the market. I would not recommend it for this procedure.
@@TheComprehensiveDentist thanks for that. I will have to try this with Scotchbond once clinic resumes !
Kate Moon Good luck! I know we are all aching to get back to normal!!
1) can we straight away apply glycerin on the uncured adhesive(scthbond universal adhesive) and light cure through it ? or we need to light cure them seperately for 10secs
2) if we need to apply flowable in a deep dentine area, do you light cure it seperately before apply glycerin?
Thank You Dr :)
anis zulkarnain Hello! What ever the last layer of material you use (bonding agent or flowable composite), cure, then apply glycerin and re-cure. Don’t apply glycerin for the bond if you plan to use flowable composite over it. Don’t apply glycerin without curing bonding agent first so you do not contaminate unset bond. Remember, the glycerin is only to help you cure that last few microns of uncured resin on the oxygen exposed areas of IDS.
What is your opinion on brush and bond and how does it differ from 3m ? Thankx
Can you over cure preparation?
Great content.
A quick question, is it possible to you Prime & Bond Universal by Dentsply for IDS techniques?
syafiq ramli Anything is possible. Most universal bonding agents are not recommended in the immediate dentin sealing protocols. I was at a clinic once that only had scotchbond universal. I did immediate dentin sealing with that but there are better options. Definitely use a layer of flowable over top!
If that is the only bonding agent you have, place scotchbond universal after you prep. Thin layer of flowable next. When it is time to cement, do your normal cementation protocol with multilink using the A&B from multilink.
I’ll try to post a document on this video for you to download soon.
I put a link in the description to the handout. It should help you out!
@@TheComprehensiveDentist . Amazing.. Thanks, appreciate it
I also read that IDS is also advisable for direct restorations. How should we go about it.
For example,
IDS+Resin Coat ...
Should we reapply bond on top of the Resin Coat and cure before composite restorations.
Or
Is it possible to composite restoration straight away on top of the resin coat.
Which one would maximise the IDS strength and having higher survivability of restorations?
Hello Doc. Let's say a patient can't afford temporary crowns, can you sti do IDS as effectively? Thanks!
Rigon Hasani Can’t Afford temporary crowns? I am sorry, I don’t understand the question.
We don’t typically charge for temporary crowns.
@@TheComprehensiveDentist that's great. We here in balkans do though. Most of us at least. Maybe that has to do with crowns being quite cheap, so the price of the crown doesn't cover all expenses.
Rigon Hasani so do you prep the tooth and just not temporize until the crown is ready? IDS could still work but I would recommend placing a small amount of flowable on top of Dentin after IDS
@@TheComprehensiveDentist thanks a lot Doc.
What is the very best bonding agent and filling for long-term retention while sealing and desensitizing dentin?
Use All-bond universal!
Fourth generation.
Hi doc
Can we do IDS with scotchbond and cementation by using the multilink automix adhesive and cement or the IDS should be done with multilink automix adhesives??? Thanks
Manpreet Kaur if you are using multilink, the IDS is separate from the cementation. Here is an example, I recently did IDS with Optibond fl, a three step etch and rinse adhesive. At cementation, I used the multilink a and b on the tooth just before cementing. You can do ids with scotchbond in theory but it is best done with optibond fl or Clearfil se.
If I am going to apply a desensitizing agent should it be before etching or after etching and does it affect the bond strength?
Sherif Elkishky That question depends on your bonding agent. If you are using scotchbond universal then use it after etching before you apply bond.
Desentising agent..then calcium hydroxide..then glass inomermer....then etch..then the boding agent
How to do IDS with Scotchbond: Don't 😂
Just don't use it. According to move than a few studies, it is down right inferior, especially when compared to systems like Optibond FL or Clearfil SE Protect. It already costs too much for what you get, so why not put your money towards a gold-standard dentin bonding agent?
cosmogang I couldn’t agree more! I personally do not use it. The hard reality is, people do use it and although it is clearly inferior to optibond fl or Clearfil SE based on retention studies, there are people who still think it is clinically acceptable and won’t switch away from it. We have not clearly defined what clinically acceptable really is in dentistry. And scotchbond is still a better choice than 70% of the other bonding agents on the market. I teach my preferences but I also believe a restorative dentist should be able to make the most of any situation by applying their knowledge and what they have available. Some providers don’t have a choice to just up and switch because they are merely employees and must submit to the office they work for. In those situations they should at least use best evidence to get the most out of their materials even if it is not the gold standard. Understanding of foundational principles is bedrock to being a good restorative dentist. We learn foundational principles and develop preferences.
Really? I have not seen any such studies; in fact the most recent iteration of SB, Universal, has some stellar studies behind it.
Adhese Universal is suitable for sealing cavity surfaces before impression taking and the application of temporary restorations. All of the bond strength values were over 30 MPa. No significant difference was observed between the reference teeth (no IDS or temporary cementation) and the teeth undergoing immediate dentin sealing and temporary cementation.--R&D Ivoclar Vivadent, FL, August 2013
Can you provide such studies?
Hey Doc. I have a question: when it comes to bonding strength, do we lose some by bonding the ceramic piece to the enamel and flowable composite vs if we don´t do IDS and bond the ceramic piece to enamel and non sealed dentin? Thank you
88PianoKeys Well look at it this way, you will bond to the tooth when doing a ceramic crown at some point. Whether this is IDS or immediately before you cement. One of the perks of IDS...it allows the bond to the tooth to mature. When bonding agent cures or when composite cures, the material shrinks some and puts stress on the dentin-bond interface. Over time, minutes even, that stress will decrease and relax. When you bond to tooth and immediately cement, you stress that bond further. If anything, experts would suggest IDS improves bond strengths.
@@TheComprehensiveDentist thank you for your answer! But does ceramic bond to dentin the same way it bonds to the flowable composite in IDS? Thats my main question
The bond to flowable is very similar. With IDS you still have a well established, matured hybrid layer. I have seen studies where if these bonded crowns fail, they Debond at the composite-cement interface, which is a favorable failure bc you cannot get Caries on composite or cement from leakage but you can get Caries in Dentin. Remember, even when bonding ceramic to dentin, you still have to create a hybrid layer with bond.
@@TheComprehensiveDentist Its amazing how clear you explain things, thank you once again :)
Awsome video!!
I have one concept, that I'm finding difficult to undesrtand-and forgive me if this is too basic, but I'm still in 3rd year. So if I essentially sealed my dentinal tubules with IDS, what purpose does it serve me to then etch that same dentin later on? Is it just to roughen the surface? Thank u so much in advance!
Khalil Ghufran Hello. Later on you are etching the enamel as well, which is the most important part of the “later” etch. However, by re-etching the bonded dentin, you are in essence cleaning it, removing particulate, and increasing surface energy for better bonding and cementation. Hope that helps.
@@TheComprehensiveDentist
Thank you, that makes complete sense!! :)
why you used bonding agent after the silane on the fitting surface of the restoration?
hoda saleh scotchbond universal is a universal material and does contain a silane. Technically, you would have to do this step but it has been shown in the literature that using a separate silane with universal adhesive is better. Vasconcelos AF (2017). Effect of prior silane application on the bond strength of a universal adhesive to a lithium disilicate ceramic. The Journal of Prosthetic Dentistry 118(5).
@@TheComprehensiveDentist you mean that the silane of the universal adhesive differ than the normal silane ? and if this was true why we dont apply universal adhesive only after the HF without normal silane ? I mean why the 2 layers ?
You can only apply the adhesive after HF acid etch!! That was what I said earlier when I referenced the article. You can only apply adhesive but the literature shows that universal adhesive only leads to weaker bond strengths than universal adhesive plus a separate silane. Keep in mind that in dentistry, there are many combinations or ways you can do the same procedure. Some combinations or protocols will be better than others and result in better results. My clinic has been using rely-x ultimate cement and the manufacturer instructions recommends only using the adhesive as the silane after HF acid. However, we have been using Monobond etch and prime as our porcelain etch and silane. Then we add the scotchbond universal. But that is only one way to do it!! If you have not already, go join our website at www.comprehensivedentist.com to find more information on this topic!
How I can glue stones
Thanks a lot !
🥰🥰🥰
😃
Where is your disclaimer ? Do you or do you not get paid by 3m ?
AlbanianDentist haha. We are currently non-profit and do not get paid by anyone.
Must get alot of toothaches