Is L-Pop good enough?

[bioshawn]

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My office has L-Pop, one-step, unit-dose, self-etch adhesive, and wondering if it is good or better than a two step system, etch and prime & bond.

 

[The Musketeer]

I never like one-step adhesives as I believe they are not as effective than seperate etch, prime & bond (2-step) systems.

 

[HupHolland]

Why not look at the literature? I would upload a file presented to us during our EBD Operative Dentistry course, but the file is too large.

The conclusion states, "Long-term clinical trials with posterior composite resin restorations,
porcelain veneers, crowns, and resin and ceramic
inlays and onlays provide strong evidence of clinical success
and durability when using an etch-and-rinse adhesive technique.
While the multiple-bottle etch-and-rinse adhesives are
still the gold standard for all-purpose bonding, based upon
the current clinical evidence and the recommendations of
manufacturers, SE adhesive systems can be used successfully
for the restoration of Class I, II, III, and V preparations. Also
when the enamel interface is prepared to include non-carious
cervical lesions, SE adhesives provide adequate enamel etching
to resist microleakage and marginal staining, and adequate
retention of both prepared teeth and NCCL Class V restorations.
Whichever system the clinician selects to use, he or she
should follow the manufacturer's recommendations for clinical
applications to ensure clinical success."

This is taken from Contemporary Dental Adhesives
for Direct Placement
Composite Restorations, Strassler & Sensi

Hup

 

[bioshawn]

Hub, Are you talking about ONE-STEP SE system?

 

[jay47]

Why not look at the literature? I would upload a file presented to us during our EBD Operative Dentistry course, but the file is too large.

The conclusion states, "Long-term clinical trials with posterior composite resin restorations,
porcelain veneers, crowns, and resin and ceramic
inlays and onlays provide strong evidence of clinical success
and durability when using an etch-and-rinse adhesive technique.
While the multiple-bottle etch-and-rinse adhesives are
still the gold standard for all-purpose bonding, based upon
the current clinical evidence and the recommendations of
manufacturers, SE adhesive systems can be used successfully
for the restoration of Class I, II, III, and V preparations. Also
when the enamel interface is prepared to include non-carious
cervical lesions, SE adhesives provide adequate enamel etching
to resist microleakage and marginal staining, and adequate
retention of both prepared teeth and NCCL Class V restorations.
Whichever system the clinician selects to use, he or she
should follow the manufacturer’s recommendations for clinical
applications to ensure clinical success."

This is taken from Contemporary Dental Adhesives
for Direct Placement
Composite Restorations, Strassler & Sensi

Hup

Excellent place to start. That would have been my first instinct as well, look into the literature. However, it would be better if we could find a meta analysis of the literature (or literature review at least) to help eliminate potential biases and/or research inconsistencies. However, this is still better than "the sales rep said it was fine" type of conclusion.
I don't even know if they would have literature reviews of this type of topic though because it may be too new.

 

[Rajan247]

http://www.ncbi.nlm.nih.gov/pubmed/12927458

 

[bioshawn]

Thanks, Rajan

 

[DrJeff]

I never like one-step adhesives as I believe they are not as effective than seperate etch, prime & bond (2-step) systems.

Agree! I'm finding now that I've had my "self etching phase" cycle of restorations(lasted about a half dozen bottles of the type I was using {I-Bond}) in folks mouths and functioning for 5 or so years that the marginal breakdown in the form of leakage/discoloration is much higher than with my past, and once again current 5th generation bonding/adhesive agent of choice, Bond 1.

What some of the research is showing with the self etching systems, is that they do decent on dentin with MOST of the bond strength of "regular etch" systems, but where they don't have an equal performance is to enamel, since the self etching acids aren't as "potent" as the good old phosporic acid that is used by most in a "regular" etch situation. That decreased performance at the enamel/restoration junction can lead to an increase in leakage and ultimately failure. At least that was how Dr. John Kanca described it when I heard him speak on this topic 3 weeks ago.

 

[armorshell]

I've heard some real overachievers will apply the phospharic acid from their total etch kit solely on the enamel, then apply the SE bonding agent over the whole tooth. That way you get an "optimal" bond to each segment of tooth structure and reduce the potential for post-op dentinal sensitivity that can come from using TE bonding systems.

Obviously this runs counter to the "point" of the L-pop, but if you're wary about it's track record and have some phosphoric acid lying around...