Research: etching enamel margins before use of self-etching primers is an acceptable procedure

By Gordon J. Christensen, DDS, MSD, PhD

Etching enamel margins before use of self-etching primers has received criticism from some researchers. This was a clinical study in a patient population that compared the use of Clearfil SE alone or with an enamel margin etch prior to using Clearfil self-etch primer and bond. Resin-based composite was used as the restorative material (Clearfil AP-X).

Both techniques showed acceptable clinical performance in Class III restorations at three years. Additional etching of the enamel margins improved the marginal quality of restorations bonded with this adhesive system.

Ermis RB, et al. Clinical performance of a two-step self-etch adhesive with additional enamel etching in Class III cavities. Op Dent 2010; 35(2):147-155.

Dr. Gordon Christensen comments:I recommend using viscous acid gel when etching enamel margins. A good example is Ultradent’s Ultraetch. When washing the gel acid off the enamel margins, use a rapid, copious blast of air/water to remove the acid quickly, thus avoiding getting it on the dentin surfaces.

Click here to read more clinical tips and current research from Dr. Gordon ChristensenAuthor bioDr. Christensen is a practicing prosthodontist in Provo, Utah, and a Diplomate for the American Board of Prosthodontics. He is the founder and director of Practical Clinical Courses, an international continuing education organization initiated in 1981 for dental professionals. Dr. Christensen is a cofounder (with his wife, Rella) and senior consultant of CLINICIANS REPORT (formerly Clinical Research Associates), which has conducted research in all areas of dentistry since 1976. Dr. Christensen is an adjunct professor for Brigham Young University and the University of Utah.