Bonding Protocol

1. Anesthetize!
Use no epinephrine, no preservative anesthetic (etching, washing and drying required by the dual cure resin technique can cause considerable discomfort without anesthetic).
We use polocaine by Astra.

2. Remove the temporary (your choice of instruments).
If durelon cement is used to cement the temporary or is used as a temporary , a thin layer under temporary may remain on walls of preparation. This is quickly removed with a Cavitron. Drilling through the center of the durelon temporary helps to weaken for removal. Very sensitive patients may not be able to handle quick cure temporaries and durelon cement is another option to cover preparations.

3. If you have to leave preparations open, clean the preparation with flour of pumice (no fluoride) use cotton pellet and cotton forceps (be gentle to the gingival tissue).
If bleeding should begin stop it with ferric sulfate solution by Utradent Co. or apply aloe vera gel on cotton over area.

4. Try placing the porcelain or Premise Indirect (neutral) restoration, adjusting contacts with micro thin carbon paper (place small piece between contacts allow carbon to mark without pulling on the paper or ribbon) adjust to desired feel with dental floss.

5.  Remove the restoration and polish adjusted areas.

6. Have assistant prepare restoration with Dry bond, apply three coats of Tenure (A&B) dry between coats, Place restoration on carding wax applicator to aid handling, then add a light coat of Tenure S.

7. Before prepping the crown prep, see the picture below, then prep the tooth. Etch the entire preparation, wash, place moisture barrier (rubber dam or 5″ by 5″ plastic extra thin .001 sheet) and dry.

Apply Dry bond and dry, three coats of Tenure dry between coats, apply Tenure S one light coat, REMOVE excess with microbrush. Tooth is ready for bonding.

8. Mix Holistore (use only plastic mixing stick) and load into Centrix syringe tip of your choice, apply to inlay preparations. Filling crowns as well as inlays with mixing stick is a faster method.

9. Seat restoration. The amount of base and catalyst determines working time. Assistant holds restoration in place while you remove excess with brush. Floss contacts before using UV light for three seconds on all sides. Remove excess with scaler and finish 30 seconds UV set on all sides.

10. Check occlusion sitting and standing position, polish.

11. Recheck occlusion in four of five days when possible. Occlusion must be perfect.

Before bonding with Holistore use #2 Round Bur to place retentive spots in two or more places to aid bonding the crown. The shaft of the bar will limit the depth to one half of the #2 bur.

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