Dr. Paul Kelley has a long history with Apex Dental Materials products. He started using the company’s first bonding system, Simplicity, in 2005 and was thrilled with the results-especially compared to other systems he’s used throughout his more than 30-year career. So when Apex introduced the Surpass self-etch bonding system , he just had to give it a try.
He still uses both systems, but said the biggest difference is the stronger bond strengths Surpass offers. It also comes as a three-part system (conditioner, primer and resin) instead of Simplicity’s two. The conditioner etches both the enamel and dentin in a unique way that prevents post-operative sensitivity. The primer then penetrates the dentinal tubules, while the bonding resin links the primed surface to all self-cure, dual-cure and light-cure restorative materials.
“With Surpass, if you follow the instructions you’re going to get a good bond,” he says. “You can’t screw it up. Other products I’ve used are much more technique sensitive, and if you don’t use them exactly right, it’s not going to work. That’s what drew me to Simplicity and then to Surpass.”
Most bonding agents require you to first etch the entire tooth, dry it and then re-wet it, Dr. Kelley says. If you don’t complete this step just right, the bond won’t last. The bond might work while patients are still in the chair, but it won’t give them the long-term results they’re after. That isn’t a worry with Surpass or Simplicity, as neither require re-wetting.
“This is critical to bond strength to the dentin and critical to the next step, which is when you put the bonding agent on so it actually adheres to the tooth structure,” Dr. Kelley says. “Surpass is a fail-safe system where you can’t dry it too much or wet it too much. With other products if you don’t do this exactly right the bond is going to fail.”
Because Surpass eliminates the re-wetting of the tooth preparation, Dr. Kelley is able to give patients more predictable outcomes. He knows the bond will not only work that day, it won’t fall apart three or four years later. It also provides no post-operative sensitivity for patients like other adhesive systems do. Because Surpass is a no-rinse system there is no need to dry between the etch and prime stage which can lead to sensitivity.
“Patients get a restoration that is bonded to the tooth,” he says. “They get a better bonded filling that adheres to the tooth structure, which is what every dentist and every patient wants.”
A one-bottle adhesive may be attractive to some dentists, Dr. Kelley says. He finds these solutions just don’t work as well, and while Surpass may require more brushes and perhaps more material, the results are worth it.
“It doesn’t cost more and it might take 35 seconds to apply the bonding material,” Dr. Kelley says. “But you know you’re getting a good bond and the patient is getting a better restoration.”
Surpass actually takes less time than most single bottle protocols, according to Apex. So not only does it save you time not having to redo the restoration, the initial protocol is only 35 seconds and can be less time than the initial protocol with some leading one-bottle systems.
Dr. Kelley often hears about young dentists having trouble with one-bottle bonding agents. Patients will call the day after the procedure because they’re in pain. The reason? The bond wasn’t completed correctly, which means the restoration must be re-done, costing more time and more money.
“I haven’t had to re-do any composite restorations because of bond failure since 2005. It just doesn’t happen,” he says. “Dentists get in a hurry and want to complete bonding in five seconds and then move on. If you do that it will come back to haunt you later.”
Dr. Kelley likes the fact that the company behind Surpass is owned by a dentist who’s involved in product development. It’s a small business so he can talk to the chemist who developed the product or the dentist who started the company.
“I can call in and say I have this clinical situation and they can tell me exactly what to do,” he says. “You can’t get that from any other company. It’s just not possible. That’s another reason I like using this product. I really think it’s the best bonding system out there.”