Optimizing Bonding of Resins in Primary Teeth
Dr. Jen MacLellan
Dr. Raymond Lee
In this episode of CDA Oasis Live, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites leading practitioners from the Canadian Academy of Pediatric Dentistry, Dr. Jennifer MacLellan and Dr. Raymond Lee, to discuss the bonding of resins in primary teeth.
Responding to a recent systematic review in the International Journal of Pediatric Dentistry entitled Review of Etching Time and Bonding of Adhesive Systems to Dentin of Primary Teeth, Dr. MacLellan and Dr. Lee offer their informed insight and give valuable tips based on their own practice.
Here are the key takeaways from the conversation:
- There is limited literature on the bonding of resins in primary teeth, as compared to what is available for permanent teeth.
- The conclusion of this systematic review article states that reducing the acid-etching time for primary dentin improves the long term bond strength of a resin restoration in a primary tooth.
- Both Dr. Lee and Dr. MacLellan believe in using a range of restorative materials for primary teeth. They emphasize that material selection depends on several factors including: caries risk assessment, age of child, and the nature and depth of the lesion.
- Composite resin is not a default material of choice in primary teeth for Dr. Lee and Dr. MacLellan. For Class 3 and Class 5 restorations, both favour resin-modified glass ionomers.
- MacLellan tends to use resin for Class 1 restorations, etching the enamel and dentin for a shorter time that normal (~10 seconds). She will often place an RMGIC liner. Finally, she will seal over a resin and all other susceptible pits and fissures.
- When using resins, Dr. Lee prefers to use a glass ionomer lining to cover dentin and then etches enamel, over the GI, and any exposed dentin. He seals over restorations at the margins.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team