Adhesive protocols for indirect aesthetic restorations – durability and longevity

Introduction. Indirect aesthetic restorations are part of the daily work in a dental practice. The choice of method for functionalization of the surface of indirect restorations in the aim of long-lasting seal of the cemente to the cavite walls is a complex and challenging clinical decision associated with various factors: type of material for indirect obturation, type of adhesive cement, specific location of the cavity margins, etc. The technique of application of all components in the cementing protocol is a key factor in achieving long-lasting, well-adapted and functional indirect obturation.

1. Theoretical part: Within 2 academic hours, basic theoretical and practical questions are discussed including:

• History and present of the adhesive strategy;
• Great innovations in adhesion that guarantee the durability and longevity of the adhesive bond in functional environment: masticatory forces, temperature stress and acid attacks;
• Golden standards in adhesion to enamel, dentin and the surface of biomaterials. Critical analysis;
• Rules and working technique in different clinical situations in the posterior area and the smile.
• Selection of adhesive system and composite cement, as well as a method for functionalization of the indirect restoration in different clinical cases.

2. Demonstration part: Within 2 academic hours the course presenter introduces to the participants the golden standards adhesive systems, composite cements, pramers for functionalization available on the Bulgarian market, as well as the tools supporting good restoration technique. Next up is a demonstration of extensive complex cusp-capping cavity preparation and indirect composite obturation manufacturing. Various methods of functionalization are presented and the cementing protocol is applied. The demonstrations are on phantom models and/or extracted teeth, including the application of golden standards adhesive systems, primers and composite cements to achieve aesthetic and long-term sustainable restorations.

3. Practical part: Under supervision and assistance by the course presenter within 4 academic hours, the participants perform the following procedures – extensive complex cusp-capping cavity preparation and indirect composite obturation manufacturing and cementation by applying the indicated method of functionalization, and resin-composite cement. The course ends with an individual completion of a final assessment test and a satisfaction survey.