Using Gluma as a Rewetting Agent Under a Posterior Composite: Etch 15s à Rinse à Lightly dry (do not Desicate) à Re-wet dentin with Gluma (DO not dry!)
Gluma Desensitizer – How Does it Work?
Optibomd FL.
Response: Overall, SE adhesives do not bond well to uncut enamel (pH for most is >2.0), while Phosphoric acid (pH < 0.5) is very effective in etching enamel. Many Self-Etch DBAs (Dental Bonding Agents) are too hydrophilic (water trees = water channels). Water trees are observed in ”all-in-one” adhesives which contain water(ethanol or from incomplete water removal. How do dentin bonds fail? Failure of the adhesive along the bonding interface (hydrolysis, etc.) Deterioration of the dentin along the bonding interface from MMP activity; (matrixmetalloproteinases) What are MMPs? MMPs are matrix metalloproteinases, which are collagen associated enzymes that can degrade the collagen matrix through proteolysis, thereby deteriorating the dentin-resin bond over time. Short-term clinical research has demonstrated that chlorhexidine may inhibit MMP activity when placed under composite restorations. Why are Self-Etching Adhesives so popular? Very simple procedure (”idiot proof!) Low sensitivity is very easy to achieve Self-Etching Primers do not open the tubules à LOW SENSITIVITY!
● Kills bacteria ● Seals tubules ● Fosters Collagen bonding ● Inhibits MMPs (Recent research indicates that glutaraldehyde in Gluma has the potential to inhibit the destructive effects of MMPs when placed under composite restorations). «The use of Gluma may contribute to the preservation of adhesive interface by inhibition of endogenous dentin MMPs» Sabatini et.al ● Other Glutaraldehyde Containing Desensitizers (inneholder glutaraldehyde (vanligvis 5%), HEMA og vann) - GluSense (Centrix) - Calmit (Caulk) - Microprime G (Danville) - G5 (Clinician’s Choice) - Desenstizing Crown Preps (Gluma Desensitizer PowerGel) - Caution! Not for use as a rewetting agent when placing posterior composites.
Bond strenghts to sclerotic dentin are much lower – Do NOT use self-etch adhesives! Hypermineralized layer 15-18 microns thick. How do you best treat sclerotic lesions? ● Roughen internal walls with diamond or particle abrasion. ● Bevel enamel margins
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