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Title Carbides Chosen Over Diamonds When Using Self-Etch Bonding Agents
Clinical Question For an adult patient needing a posterior composite restoration bonded with a (self-etch 6th or 7th generation) dentin bonding agent, would using a tungsten carbide bur offer a better dentinal surface for adhesive bonding than using a diamond bur?
Clinical Bottom Line Carbide burs offer a better dentinal surface for adhesive bonding compared to diamond burs. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18652265Yiu/200850 extracted human 3rd molarsin vitro Comparative study
Key resultsAccording to the study’s results section, the p-value is less than 0.001. In other words, the probability of getting a false positive is less than 0.001 and therefore, “the effects of dentin surface preparations, adhesive systems, and their interaction were statistically significant.” The study also showed that “the micro tensile bond strength was the highest when bonding Self Etchant to dentin surface prepared with 600-grit SiC abrasive paper (47.3 +/- 7.4 MPa), followed by high-speed tungsten carbide burs (40.8 +/- 6.1 MPa), and the lowest when bonding S3 to dentin surfaces prepared with a high-speed diamond bur (15.2 +/- 6.2 MPa).”
Evidence Search Search "Dentin-Bonding Agents"[Mesh] Search "Composite Resins"[Mesh]Search "tungsten carbide" [Supplementary Concept]"Diamond"[Mesh]
Comments on
The Evidence
This article is a comparative study done in the laboratory on extracted 3rd molars.
Applicability This article is applicable to dentists choosing between using a diamond or carbide bur when working with patients needing a restoration preparation for use with a dentin bonding agent.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Adhesives, Composite Resins, Dental Bonding, Dentin-Bonding Agents
ID# 787
Date of submission: 04/04/2011spacer
E-mail buimt@livemail.uthscsa.edu
Author My Hanh Bui
Co-author(s) e-mail
Faculty mentor/Co-author Rita Renee Parma, DDS
Faculty mentor/Co-author e-mail PARMA@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Rebeka Andrade and Petrina Gerogianni (San Antonio, TX) on 10/08/2014
A PubMed and TRIP database search conducted on September 2014, confirmed the aforementioned statement. However, two more recent publications were found to support the current statement: Marques MS, 2009, PMID: 19678451 and Ayad MF, 2011, PMID: 21874939, both in vitro comparative studies. The first study showed that a fine cut carbide bur provided the best combination of increased bond strength and decreased variability, indicative of more reliable bond strength performance. The second study confirmed that the micro-tensile bond strength values when using self-etch bonding agents, were significantly higher with tungsten carbide finishing burs and smooth dentin surfaces.

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