Indirect and Direct Restorative Protocols - Caulk

“I use Xeno IV for my patients
because of its simplicity and its
ability to eliminate postoperative
sensitivity in my patients.”
Ronald A. Feinman, DDS
Private practice, Atlanta, GA
Figure 3. After conditioning of the enamel and dentin, an adhesive agent
is applied with a fl ocked applicator to moisten the tooth surfaces.
Figure 4. Finishing of the direct resin restoration is conducted using
Enhance ® Finishers, followed by PoGo ® One-Step Diamond MicroPolishers
for the fi nal polish.
Table. Recommended Adhesive According to Clinician Profile
User Consideration
Prime &
Bond ® NT XP Bond Xeno ® IV
My preparation is confined to enamel ■ ■
My preparation extends into the dentin layer
■
I occasionally have difficulty judging moisture levels on my conditioned cavity ■ ■
Long-term clinical performance is more important to me than ease-of-use
■
Reducing my patients’ postoperative sensitivity is paramount
■
Marginal fit is imperative ■ ■ ■
I generally prefer the total-etch technique ■ ■
I usually employ the self-etch technique
■
I prefer the ease of application and simplified handling of a one-bottle solution ■ ■ ■
When used as an adhesive agent for an indirect restoration, XP
BOND does not need additional curing. The material will
completely “dark cure” on its own even if parts of the bonding
interface are not light cured.
Self-etch, non-rinsing adhesives are also available to condition
and prime enamel and dentin simultaneously without separate
acid etching. Self-etching adhesives penetrate the smear layer
and partially dissolve hydroxyapatite to generate the hybrid layer.
One-bottle, self-etch adhesives such as Xeno® IV (DENTSPLY
Caulk, Milford, DE) are often regarded as more convenient and
less technique sensitive (Figures 1 through 4), as their application
time is reduced compared to etch-and-rinse adhesives or
two-bottle, self-etching systems. These adhesives do not require
a moist dentin substrate because of the water inherent in their
composition, and no etching is involved.
The availability of adhesive systems that coincide with
a clinician’s preferred bonding technique (Table) has thus
simplified the delivery of direct resin restorations. Once the
tooth surfaces are properly conditioned and the adhesive
agent has been applied and cured, incremental layers of a
universal composite such as Esthet•X® or TPH®3 (DENTSPLY
Caulk, Milford, DE) can be placed to achieve an aesthetic
restoration with excellent physical properties and longevity.
Consequently, concepts such as adhesive dentistry, aesthetics,
and simplicity—once distant goals—can now be conducted
in daily practice. ■
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