Ep. 636 - Bonding Breakthroughs: How Adhesive Innovations Are Transforming Dentistry

Are you relying too heavily on adhesive materials, or are they truly revolutionizing your restorative outcomes? As minimally invasive techniques become the standard of care, many clinicians are questioning where to draw the line between tooth preservation and predictable long-term success.

Dr. Troy Schmedding brings over three decades of clinical experience to this conversation. He earned his DDS from the University of the Pacific, Arthur A. Dugoni School of Dentistry, and has successfully maintained private practice for 17 years before transitioning to academia. Currently serving as Assistant Professor in the Department of Integrated Reconstructive Dental Sciences at University of the Pacific, Dr. Schmedding continues his private practice in Walnut Creek, California. He is one of only 450 dentists worldwide to achieve accredited membership with the American Academy of Cosmetic Dentistry and lectures nationally and internationally on advanced restorative materials and complex procedures.

This episode explores the clinical realities of modern adhesive dentistry, examining how contemporary bonding agents have shifted treatment paradigms from traditional crown-and-bridge approaches to minimally invasive restorative techniques. Dr. Schmedding shares his systematic approach to adhesive protocols, discussing why he has moved away from traditional retention-based preparations while maintaining excellent long-term outcomes. The conversation addresses the critical balance between preserving tooth structure and ensuring restoration longevity.

Episode Highlights:

• Universal bonding agents require precise technique despite simplified packaging, with application times as short as 3 seconds and film thicknesses reduced to 3-6 microns for improved marginal adaptation. The MDP monomer chemistry allows bonding to all dental substrates including enamel, dentin, ceramics, and non-glass-based materials in a single system.
• Core buildup procedures benefit from dual-cure compatibility between bonding agents and core materials, eliminating light-curing challenges in post spaces while creating a monoblock restoration. Self-cure activation occurs through chemical interaction between the bonding agent and dual-cure core material within 3-5 minutes.
• Indirect restoration cementation can rely entirely on self-cure mechanisms without light activation of the bonding agent, provided the cement system is chemically compatible. Surface preparation involves air abrasion or MDP-based cleaning agents to rejuvenate composite surfaces and remove debris.
• Zirconia bonding achieves predictable long-term success when proper cleaning, priming, and cement selection protocols are followed, with clinical evidence supporting non-retentive zirconia restorations lasting over seven years. Both zirconia and lithium disilicate materials offer appropriate applications depending on clinical requirements.
• Cross-compatibility issues between different manufacturers' adhesive systems can cause core buildup failures and restoration debonding, making it advantageous to use products within the same chemical family. Dual-cure activators may be required when mixing systems from different manufacturers to ensure proper polymerization.

Perfect for: General dentists seeking to optimize their adhesive protocols, restorative specialists evaluating minimally invasive techniques, and dental residents learning contemporary bonding systems and core buildup procedures.

Discover how systematic adhesive protocols can transform your approach to tooth preservation while maintaining predictable clinical outcomes.