Clearfil SE Bond: Zero Post Operative Pain?

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Dr. L. asks:
I love Clearfil SE Bond [Kuraray]. Gordon Christensen recommended this and told the audience that it would result in zero post-operative pain. And he was absolutely right. I have been just delighted with this bonding system. The only problem that I have is that on anterior restorations, I sometimes get a darkening of the cavosurface. May even turn brownish. I have had to do a number of these over. What am I doing wrong? How can I eliminate these dark lines along the cavosurface?

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8 Responses to “ Clearfil SE Bond: Zero Post Operative Pain? ”

  • Randall G. Cohen, DDS February 10th, 2009

    Dr. L. Try etching the tooth with 40 % phosphoric acid BEFORE you prepare anything. Then do your prep into dentin, and use the self-etching adhesive. I also suggest switching to Clearfil Protect Bond because it contains a fluoride component that resists breakdown by salivary esterases. Lastly, I would apply Clearfil Surface Coat to all anterior restorations after you have done the rough finishing and have adjusted occlusion.

    Randall

  • Mike Razzano February 10th, 2009

    Dr L,

    We have been using SE Bond for greater than 10 years with excellent results. Our technique is very simliar to Dr Cohens- we etch the tooth prior to prepping. With ethcing the enamel, beveling the margins, and good isolation (we use Isolite)you should not have any problem with the margins staining/discoloring. Hope this helps.

  • Mike February 10th, 2009

    Dr. L. The previous comment recommended etching with 40% phosphoric acid on the tooth before applying your self-etch. You never, never want to do that. Many manufacturers of self-etch bonding agents strongly advise not doing this. Reason being the self-etch already contains phosphoric acid in them and if you mix this acid with a seperate etching gel you are causing a problem with the chemistry of the bonding agent. This will lead to a decrease in bond strength. Etching with a self-etch completely defeats the purpose of using a self-etch your basically doing the Total Etch technique. Most of the time the dark color you are seeing has to do with microleakage. You might want to switch to another self-etch bonding agent like Xeno IV from Dentsply or Brush n Bond from Parkell, I have had great success with those and they are used by a lot of other dentist I know. Hope this helps.

  • Jeffrey Hoos DMD February 10th, 2009

    The literature shows…..do not etch the tooth after prep or before when using se bond.
    It decreases the bond strength.
    Discoloration…
    If the surface has been touched by a burr, then se is perfect.
    You much rub the surface with the primer. Air dry with no contamination…..bonding liquid and wick it away not blow off…….
    this should help
    Best

  • Dan C February 11th, 2009

    Dr. L:
    With SE Bond and other self-etching products, the self-etch time (20 seconds wtih SE Bond) is critical if the composite is finished on the uncut enamel (past the Kavo surface). Our data shows, after a full 20 seconds, SE Bond will have a good bond to uncut enamel, however, a 10 second etch of the uncut enamel will provide a much more forgiving bond technique and provide better marginal integrity. Also make sure to not use anything on the tooth before applying the SE Pimer, this may impair adhesion.

    Dan C.
    (Kuraray Dental Mfg)

  • Thomas P Keogh, MD, DDS February 12th, 2009

    It isn’t infrequent to find marginal stainning while using SE Bond. Particularly when enamel is involved and on the anterior dentition. The reasoning is out there in medline: self etchants in general but specially one step systems do not provide quality bonding compared to Total etch. Staining of the air-inhibited layer not polished off has been suggested.
    In any kind of anterior restorations total etch techniques are superior. I have been using and studying SE etchants since 1990 with my mentor the Prof Takao Fusayama (rip).

  • Dr.SanH Bo February 13th, 2009

    Dr.L,
    Zero Post Operative Pain can be achieved with any brand of bonding system.How?Immediate anti-inflammatory therapy follow every composite or G.I filling,etch or non etch method.This way, I have not seen single patient with post filling pain and pulp necrosis.We should keep in mind that teeth are hard tissues.Also as bone and joint inflammation,our teeth have self destruction action due to inflammatory process.As soon as the pulp was stimulated,the inflammatory reactions start,increasing pressure in the pulp chamber and nowhere to relieve it as in soft tissue,it press the pulpal tissue and damage follow leading to pain and pulp necrosis.As little as 50mg of Diclofenac orally immediate after tooth fillings will prevent it well.So,you don’t have to wander around so special brands of bonding systems and filling materials to avoid P.O Pain.Try this.

  • Dr. Calderwood March 11th, 2010

    I’ve been using Lpop for 6 years and had 1 case of post op sensitivity. FWIW.

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