The cost of one bond failure?

Resin-based bonding to dentine has improved substantially in the past two decades, and the new group of Universal (multi-mode) bonding agents, with Scotchbond Universal (3M ESPE, Seefeld, Germany) and Clearfil Universal (Kuraray) appearing to hold promise although, as with any new material, we all await the results of clinical trials. A common factor in this new group of materials is 10-MDP monomer, originally introduced to dentistry by Kuraray in 1981, which appears effective for bonding to enamel, dentine and metal alloys. Readers will remember this resin as a component of Panavia (Kuraray) luting materials. The 10-MDP resin appears to be important for the status of the bond interaction with hydroxyapatite.

Dentists use adhesion for non-retentive restorations such as Class V, resin-retained bridges, etc. So what is the cost of one adhesive restoration failure, for example, of the restoration shown in Figures 1 and 2? First, there is an emergency attendance (10 minutes, perhaps?), possibly with a disgruntled patient for whom you need to embark on a charm offensive, and then a further appointment (30 minutes perhaps – depending on the size and complexity of the restoration) to replace the lost restoration. Readers can work out the cost according to their hourly rate, but I would suggest that the minimum is £75–£150!