Page 68 - CEREC Q2 | 2014

66 | CERECDOCTORS.COM | QUARTER 2 | 2014
in this recurring section of cerecdoctors.commagazine, we share a sample of conversations
occurring online:
cerecdoctors.com members from all over the world pool their collective experience and knowledge
to support a fellow CAD/CAM dentist with her debonding issue. Is it a moisture problem? Could it be
powder residue? A materials issue? Read on to get to the bottom of this dentist’s frustrating and recurring debonds.
Debonding
A Frustrated Clinician Finds Answers to a Recurring Challenge
D I S C U S S I O N F O R U M | | |
Compiled from www.cerecdoctors.com/discussion-boards/view/id/26732
Sandra Cove | Ashland, Mass.
I have an extreme amount of debondings. I would
say two aweek. I first usedUnicemandMultilink.
I do not know what I am doing wrong. I etch the enamel,
do the A and B on the tooth, and then theMultilink. The bond
is always broken from the tooth. I am feeling I need to get the
intraoral sandblaster to stop this. It is becoming too real and I
amunsurewhy.Most of these caseswereprobably temporized
and thendelivered, therefore creatingmore of a dentin issue.
Love any input.
Peter Gardell (Faculty) | Stamford, Conn.
Multilink is a rock-solid product. Breakdown of
dentin bond is frustrating; is it happening with
one type of material only? What temp cement?
David Edelson | Plainville, Conn.
These cases were temporized? Eugenol-based
temporary cement? With Multilink, there’s no
need to etch enamel either. I don’t, and debond has not
been an issue withmy use of Multilink or Unicem. I’ve had
them, don’t get me wrong, but not to the extent you appear
to be having. Pumice prep maybe or I use telio or gluma
prior to A and B primer. Moisture control okay?
Rich Rosenblatt (Faculty) | Highland Park, Ill.
What are you using for isolation?
David Honey | Lincolnshire, Ill.
HF acid etch 20 seconds? Are you silinating the
crown with monobond? How old is the mono-
bond plus?
Marc Thomas | Sparks, Nev.
Bluecamor Omni?My question relates to powder
residue.
Gregor Sonin | Potsdam, Germany
According to studies, powder residue does not
affect bonding. What could be an issue is the
roughness of the prep: the produced smear layer on dentin
becomes thicker and less easy for the chemicals to penetrate
if you prep with toomuch pressure and too coarse burs. Try
to use a red-coded bur for finishing up. The sandblaster is
a good tool, too (you can also use an air flow device with
aluminiumtrihydroxide, not the sodium stuff ).
Sandra Cove
The debonding is happening with all products,
Multiblocks and e.max, premolar and molar.
I sandblast the crown, was porcelain etching for 20
seconds. Temp cement is zone, non-eugenol. I have just
started making sure my preps are super smooth. I thought
about the powder and have used peroxide first, then
etched the enamel, really rubbed in the A and B. Mono-
bond the crown for 30 seconds. I isolate with dry angles
and cotton rolls. It’s dry in there when I seat it. Maybe I
should use the Isolite.
My products are newusually as I go through thempretty
quickly. I keep them in the fridge.
Using a Bluecam.
I though it was a bite issue but it is so frequent that I am
considering getting the sandblaster for intraoral. There is
something not right, and I am getting terribly frustrated.