........just another Self-etching Adhesive?
Advantages
fast, easy and safe handling
no mixing, no inadvertent change of bottles,
no wrong dosage
no technique sensitivity: critical steps of the
total-etch-technique - etching, rinsing and
“correct“ degree of moisture in dentin - are
eliminated
The “All inclusive“ Bond
with a special feature......
Components and Functions Base
 4-META:
 MMA:
 THIT
 HEMA:
 Aceton:
 Water:
Conditioning of enamel and dentin
Infiltration promotor
Diffusion promotor
Trifunctional cross linking agent
Amphiphilic monomer,
Hydrophobation of collagen
solvent for monomers
Hydrolysis of 4-META (dissociation = acid)
......the application tips contain a
polymerization initiator
the special
Hybrid Bond
Brush
4-META
4-methacryloxyethyl trimellitate anhydride
clinically proven monomer for years
(Super Bond C&B, AQ Bond, Chemiace)
excellent etching of enamel
good affinity to dental hard tissue
good penetration of exposed collagen
scaffold
bonding to Ca++
enhanced bond strength to enamel and
dentin
Indications
 direct restorations with composite resins
(incl. compomers, ormocers)
 indirect restorations in combination with self-, light- or
dual-curing composites (inlays, onlays, veneers,
crowns, bridges, build-ups)
Application
Cervical lesion after
minimally invasive
preparation
Application with
HB brush, one
coat only (20 sec)
Air-dry gently
(5-10 sec)
Light activation
depending on curing
light 3 to 10 sec.
Metafil Flo
restoration,
finished and
polished
Easy Procedure - Strong Effect (1)
Solubilization of
Smear Layer
Smear Layer
Dentin
Bur-cut surface
covered with
smear Layer
Hybrid Bond
application
Apply one coat of
Hybrid Bond with
HB brush and
leave for 20 sec
Demineralization
of dentin
The surface is
conditioned
Easy Procedure - Strong Effect (2)
volatilization
of acetone
separation ofmonomer and
water
remaining liquid
separates into
monomer and
water
air
monomercoating
penetrated
monomer
adhesive layer
hybridlayer
Elimination of
water film (5-10
sec) including
dissolved
smear layer
Light ativation for 310 sec depending on
curing unit used
Hybrid Layer
Hybridlayer
HL
≈ 500 nm
10 K
Finger, WJ
University of Cologne
2004
To be noticed
dispensed Hybrid Bond should be
used within 2 minutes
 close bottle immediately after
dispensing (volatilization of aceton)
 up to 2 drops of Hybrid Bond can be
activated with one Hybrid Bond Brush
Shear Bond Strength (SBS): Hybrid Bond
with light- or self-curing resin composite
MPa
35
30
Dentin
Enamel
30
25
20
25
22
22
15
10
5
0
light-curing composite
24 h storage in 37° C water
self-curing composite
Finger WJ, University of Cologne, 2004
Self-polymerization of Hybrid Bond
Exotherms of Hybrid Bond (air-dried) in Differential Scanning Calorimeter (DSC) at 37℃.
Hybrid Bond covered with Metafil Flo
to avoid air inhibition
Exothermic intensity
8 min
21 min
10
Data by Sun Medical
20
Hybrid Bond exposed in air
30
40
Time/min
SBS of Hybrid Bond/Twinlook on Dentin
MPa
30
25
20
15
10
a
ab
b
5
0
ANOVA: p = 0.026
Data by W. J. Finger, University of
Cologne, Germany
HYB no l.a. HYB l.a.
TWL redox TWL redox
HYB l.a.
TWL l.a.
Marginal Gap Width (MGW) in
Cylindrical Dentin Cavities
10
µm
b
a
a
c
I Bond
One Up
Bond F
Mean Cavity Diameter: 4.1 mm
8
Venus Resin Composite
6
4
2
0
n=8
Clearfil
Protect
Bond
Hybrid
Bond
Kruskal-Wallis ANOVA: p<0,001; Mann-Whitney U Test: sig. difference < 0,05.
Data by W. J. Finger, University of Cologne, Germany
SBS on Enamel (MPa)
30
10 min
24 hours
25
22,3
20
15
10
13,9
18,8
15,5
9,6
9,1
18,5
17,3
17,0
11,3
5
0
ABS
GBO
HYB
IBO
PLP
Absolute
G-Bond
Hybrid Bond
I-Bond
Prompt-L-Pop
Composite: Venus
Endo W & Finger WJ: 2005
n=8
SBS on Dentin (MPa)
30
25
26,7
24 hours
22,5
20
15
25,6
10 min
14,3
19,6
16,6
20,1
16,1
13,1
10
11,7
5
0
ABS
GBO
HYB
IBO
PLP
Composite: Venus
Endo W & Finger WJ: 2005
n=8
MGW of Self-etching Adhesives (µm)
# gapfree
10
0
6
4
4
7
0
a
b
b
b
b
a
8
6
29
µm
4
2
9
40
0
ABS
Endo W & Finger WJ: 2005
GBO
HYB
10 min
IBO
EXP
Experimental
product
PLP
n=8
Micro Tensile Bond Strength (MTBS)
Composite resin
Enamel
Caries-infected dentin
Grinded dentin
Caries-affected dentin
Bonding agent
Composite resin
Dentin
Test pieces of
Test pieces of
caries-infected dentin sound dentin
Quintessence Vol.23, No.11, 2004
Micro Tensile Bond Strength (MTBS)
Test results
Unit：MPa
HYB GB ABS APL PB
Sound Dentin
44
40
25*
17* 49
Caries affected
dentin
43
10
－
－
16
MTBS of G-Bond and Protect Bond to the carious affected
dentin were remarkably low, while MTBS of these to sound
dentin were sufficiently high.
In actual clinical cases, sometimes it is difficult to take off
all caries-affected dentin after preparation of carious cavity.
MTBS of self-etching adhesives
to various caries dentin
Product Name
Micro-tensile Bond Strength (MPa)
Caries-affected
Caries-infected
Sound dentin
dentin
dentin
Protect Bond
44.8+6.7
23.6+4.9
14.1+4.7
G-Bond
One-up Bond F
Absolute
Touch&Bond
=AQ Bond
AQ Bond Plus
33.6+8.3
20.1+5.7
24.9+4.1
24.6+6.7
16.7+3.4
24.2+7.9
14.1+4.7
14.6+4.6
12.5+2.8
24.9+8.1
27.3+4.4
26.6+7.0
33.6+7.3
29.4+4.1
28.9+6.7
30.7+7.7
32.8+4.4
28.4+7.9
Brush&Bond
=Hybrid Bond
Abstract of IADR 2005 at Baltimore
Quintessence Vol.23, No.11, 2004
Efficiency of Hybrid Bond/Metafil CX
in Class V cavities
U. Blunck, Berlin 2004
•
•
•
•
•
Eight human incisors in each of three groups
Oval shaped cavities (4 mm in incisal-apical, and 3 mm in mesiodistal directions)
Half of cavity margin located underneath cemento-enamel junction
– Group 1, 20 s undisturbed dwell time
– Group 2, 20 s brush agitation
– Group 3, 30 s brush agitation
21 days water storage
– replica
– 2000 thermocycles (TC) between 5 and 55° C, replica
Qualitative and quantitative analysis of cavity margin at 200-fold
magnification (SEM)
Perfect Margin in % of Total Margin Length
Hybrid Bond/Metafil CX
before TC
%
100
after TC
90
80
70
60
50
E 20s -A E 20s +A E 30s +A D 20s -A D 20s +A D 30s +A
Application time (s) on Enamel or Dentin with (+A) or without (-A) brush agitation
Data by U. Blunck, University of Berlin, 2004
Microtensile strength of adhesives utilizing
indirect and direct composites
Brown, P.L. et al., IADR Honolulu 2004
Adhesive
Indirect resin
Indirect resin
Direct resin Direct resin
24hrs
12weeks
24hrs
12weeks
AllBond2
45.9
43.5
44.8
60.4
Prime&Bond
NT DC
46.6
34.5
44.5
57.4
Optibond
Solo+DC
49.3
31.7
61.8
70.9
Brush&Bond
=HybridBond
45.4
54.8
50.4
61.2
iBond
45.4
47.2
44.7
35.6
Clinical Study: Hybrid Bond and Xeno III
in cervival lesions: one year results
Ernst et.al., AADR Orlando 2006
• 50 patients with two cervical lesions each
• Hybrid Bond or Xeno III combined with Filtek
Supreme
• After six months all restorations in place and
acceptable according to USPHS criteria (apart from
one Xeno III)
• ► After one year all Hybrid Bond restorations
retained and showed clinically excellent results, while
5 Xeno III restorations were lost in part or in toto
Hybrid Bond and Xeno III in cervical
lesions: one year results (% alpha ratings)
Ernst et.al. 2006
Margins
Marg.
Discol.
Sec.
Caries
Retention
Sensitivity
HYB
94
94
100
100
100
XEN
78
88
100
90
98
Comparison of the mechanical properties
of resin-based adhesives and fissure
sealants
Kunzelmann et.al., ConsEuro Rome 2006
• Comparison of surface micro hardness, elastic
modulus, wear strength
• Hybrid Bond exhibited highest modulus of elasticity.
HB and Clearfil SE achieve comparable hardness
values as fissure sealant Delton FS
• ► Dentin Bonding agents can be an alternative for
conventional fissure sealants
In-vitro evaluation of self-etching adhesive
with build-up composite resin
Nakano et.al., AARD Orlando 2006
• Comparison of in vitro bond strength of Brush&Bond
(= Hybrid Bond) and build-up resin Absolute Dentin
(Parkell) with or without various dentin surface
treatments
• ► Hybrid Bond in combination with Absolute Dentin
can be used to bond to root dentin whether the dentin
is untreated, prepped with phosphoric acid, or with
phosphoric acid followed by NaOCl (10%). There was
no substantial difference of MTBS whether the core
material was light cured or allowed to self-cure
Hybrid Bond = Brush & Bond*
* Parkell, USA
CRA Newsletter
Nov/Dec 2003
Which SEP Adhesives have most of
the clinically desirable characteristics
(number of steps, time, safety)?
Brush&Bond = Hybrid Bond
AdheSe
Clearfil SE Bond
(totally 21 Products!)
Application Steps and Time
Product
Step1
Step 2
Step 3
Step 4
Step 5
Total
Time
3
26 - 35 s
Hybrid
Bond
1 Layer
Bond 20 s
Air-drying
3-5 s
Light-curing
3-10 s
Xeno III
Mixing
Liquid A+B
Application
20 s
Air-dispers.
3s
Light-curing
10 s
4
38 s
Adper
PLP
Squeezing,
Folding 10 s
Application
15 s
Air-dispers.
3s
Light-curing
10 s
4
38 s
iBond
1. Layer
2. Layer
3. Layer
30 s
Air-drying
Light-curing
20 s
5
< 50 s
AdheSE
Primer
3 + 15 s
Air-dispers.
15 s
Bond 5 s
Air-drying
3s
Light-curing
10 s
5
51 s
Clearfil
SE
Primer 20 s
Air-drying
3s
Bond 10 s
Air-dispers.
3s
Light-curing
10 s
5
46 s