Is It Possible to Have Bonding on Front Tooth Without Roughening It with Drilling Machine?

In order for the bonding technique to be successful, the tooth surface has to be clean and free of any potential contaminants.  Once the tooth is clean, a mild acid is applied to the surface that will have bonding apllied so that the material will adhere.

Dentists will often use a drill to be certain that the surface is clean, but there is no need to drill away any tooth structure.  The goal of bonding is to be as conservative as possible, and to leave as much of the existing tooth structure in tact as possible.

Hope this was helpful

Dr Champagne

Generally speaking, bonding is very conservative.  Without seeing the tooth, it is hard to speculate.  However, placing a small bevel on the enamel is usually all that is needed as far as tooth preparation.  Sometimes there is already enough of a break that air abrasion can be used.  If possible, I prefer not to bond the entire tooth but to skillfully blend the shades and color of the bonding to match the remaining tooth.  Also, if the bevel is minimal usually no anesthesia is necessary.

Bonding can look beautiful when skillfully done.

 

Sometimes patients ask dentists to do things or not do things which have a negative impact on the outcome of the procedure. There are a couple of good reasons for roughening or beveling the tooth. One reason is there is a stronger bond when you spread the bonded surface over more area and the area has been lightly prepped. Another good reason is the dentist can make interface between the tooth and the bonding material disappear so it looks like a natural tooth....... not a filling on a tooth. In the end it depends on how the patient wants the final restoration to look and if the dentist is willing to compromise his or her artistic results.

The research has shown that the best bonds to enamel are when the enamel is slightly roughened (prepped) versus enamel that is not roughened (unprepped).  Your dentist suggested that technique so that the situation for the best enamel bond can be created.  Also, this will help to blend the material so that there is no visible distinction between the tooth and the bonded composite material.  The minimal amount of roughened enamel will help in the long term.  Also, roughening the enamel should not be painful, but you will sense some vibration.  

Bonding can be done without roughening the tooth surface but it will likely reduce the bonding strength of the filling to the tooth.  There are times when a handpiece (drill) , a laser or air abrasion are required to alter the shape of the tooth in order to increase the strength of the bonded filling.  The success of such fillings increases when there are no sharp edges or the bonding is done to freshly cut dentin.

It's certainly possible to bond teeth without mechanically roughening them, but the results may not be as strong, look as good or be as long lasting. The amount of reduction needed for bonding is probably less than for a crown, maybe a lot less. Keep in mind that bonding isn't as long lasting as a crown, and if the bonding breaks it could take more tooth with it, so a crown could be the best value for your money long term.

Actually, there is recent data to support bonding with no preparation.  Corky Wilhite, one of the premier dental educators on this particular area of study shared with me that 60 second etch of UNPREPPED enamel provides equivalent bond strength to prepped enamel.  Now, technically, the etch is removing some microscopic tooth structure, but we're talking very microscopic, that is you'd have to use a microscope to see what it had taken away.  So it's a good bit less reduction than prepping the tooth.  

That said, sometimes we will prep the tooth to allow for an interface between tooth and resin that is more natural looking.  If there is a hard line between the two materials, it will be visible and will never look like a real tooth.  We would create a bevel so that there is a gradual transition from resin to natural tooth structure.  This is purely for esthetics, not for strength.  

Personally, I like to use a sandblaster to clean the tooth and then etch it.  Again, this removes a microscopic amount of tooth structure, but I think it's well worth it to ensure that the surface I'm bonding to is free of contamination so it will last.  Hope this helps - best of luck!

JW

Its always possible that a patient can attain a given time frame of usefulness with "No Prep" Dental Bonding.The long term gains though are much better when the Dentist is able to minimally 'roughen up" the tooth surface. This roughening always micropores to form and enhance the available surface area for chemical and mechanical adhesion or Dental Bonding. The amount of tooth preparation can be quite minimal and in many cases can be done without Dental Anesthesia. All of these questions and concerns should always be addressed before treatment and your Dentist will be happy to discuss your options. Good Luck!

The rough surface creates more surface area for bonding.  This gives a stronger bond of the filling material to the tooth.  By roughening in a specific way it is possible to create a restoration that blends esthetically into the tooth.  We can design restorations are so life-like that it is difficult to distinguish them from the tooth itself.  So, for esthetics it is much better.

If the tooth is already broken, a small amount of roughening won't change what is left of the tooth.  You might think that the roughening process will create a small stump of a tooth, but in reality it is such a small amount of tooth structure that is removed, it is just microns from the surface and not even the whole surface of the tooth.

There are several steps taken to ensure the success of bonding to tooth structure.  For better bonding, roughening of the surface is necessary.  However, this roughening is minimal and the benefit to risk ratio is high.  Then that roughened surface is etched with an acid to create micropores that will serve for mechanical retention of the bonding.  Following that, an adhesive is applied and then the composite itself.  Best, Dr. Elizabeth Jahanian