Nakamura et al.

Asian Pac J Dent 2011; 11: 61-65.

Clinical application of a tri-n-butylborane initiated adhesive resin
filled with pre-polymerized composite particles
Mitsuo Nakamura, DDS, PhD,a,b Hiroyasu Koizumi, DDS, PhD,b,c Mariko Nishimaki,DDS,b and Hideo Matsumura, DDS, PhDb,cabc

Private Practice, Ichikawa, Department of Fixed Prosthodontics, and Division of Advanced Dental
Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, JapanA tri-n-butylborane (TBB) initiated adhesive resin with pre-polymerized filler particles (Bondfill SB) has beenreleased. This article describes bonding technique and short-time clinical performance of the adhesive. The
materials and procedure reported here are applicable as an option of the restorative treatments for the patients
incompatible to currently available materials. (Asian Pac J Dent 2011; 11: 61-65.)
Key Words: adhesive, attrition, tri-n-butylborane, wear, wedge-shaped defectIntroduction
Attrition, gingival recession, wear, and wedge-shaped defect progress, especially for aged patients, due toclenching, grinding, mastication, tapping, tooth brushing, and other factors. It is beneficial for both toothstructure and dental material if their wear resistance were equivalent, in particular at the occlusal contact areas.
An adhesive resin initiated with tri-n-butylborane (TBB) derivative, in combination with varying primers, isbeing used for bonding between tooth structure and restorative materials. One of the problems associated with
the TBB-initiated adhesive resin has been insufficient wear resistance.1,2
A modified TBB resin that contains pre-polymerized filler particles (Bondfill SB, Sun Medical Co, Ltd,Moriyama, Japan) was released. The manufacturer claims that the material is applicable as a filling, luting, orsealing agent. Property test demonstrated that the Bondfill SB material showed different wear characteristics ascompared with the conventional acrylic resins.3 This article presents adhesive techniques of the Bondfill SB
resin applied mainly for bonding dentin.

Clinical Report
Table 1 summarizes the difference between the Super-Bond C&B and Bondfill SB resins.
Table 1.

Tri-n-butylborane (TBB) initiated adhesive resins

Material / Trade nameManufacturer

Super-Bond C&BSun Medical Co., Ltd.

Composition

Monomer

MMA, 4-META

Polymer

PolyMMA, Pigment

Catalyst

TBB, TBB-O

Bondfill SB

Sun Medical Co., Ltd.

Teeth Primer

4-META, Acetone, Water, Reducing agent

Monomer

MMA, 4-META, Polyfunctional methacrylate

PowderPolyMMA, TMPT pre-polymerized filler, Pigment

Catalyst V

TBB, TBB-O, Hydrocarbon

MMA, methyl methacrylate; 4-META, 4-methacryloyloxyethyl trimellitate anhydride; TBB, tri-n-butylborane; TBB-O, partially
oxidized tri-n-butylborane; TMPT, trimethylolpropane trimethacrylate

Cervical dental caries
The patient felt cold-water pain after detachment of composite restoration of the maxillary premolar (Fig. 1).

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Asian Pac J Dent 2011; 11: 61-65.

The tooth surface was minimally reduced with a diamond rotary cutting instrument. The Teeth Primer wasapplied to the non-retentive reduced surface and air-dried. The Bondfill SB resin (Medium Powder) was filled
into the cavity with a brush-dip technique (Fig. 2). The excess material was removed and the surface waspolished with silicone rotary instruments (Fig. 3). After the restoration, the cold-water pain was disappeared
immediately.

Fig. 1. Premolar dental caries

Fig. 2. Filling the Bondfill SB

Fig. 3. Post-operative view

Incisal attrition
An aged patient was seen with a chief complaint of uncomfortableness of anterior dentition derived from toothwear. Examination revealed severe attrition of mandibular incisors with steps along the dentino-enamel junction(Fig. 4). The tooth surface was slightly reduced with a diamond rotary instrument. The Teeth Primer wasapplied to the incisal areas and air-dried (Fig. 5). The Bondfill SB resin (Light Powder) was filled into the cavity
with a brush (Fig. 6). The surface was polished with silicone rotary instruments (Fig. 7). Smoothness of theincisal area was recovered after the restoration.

Fig. 4. Worn incisors

Fig. 6. Filling the Bondfill SB resin

Fig. 5. Application of the Teeth Primer

Fig. 7. Restored surfaces

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Asian Pac J Dent 2011; 11: 61-65.

Occlusal attrition
The patient preferred carbonated beverages, and occlusal planes of mandibular molars were attritedconsiderably (Fig. 8). The tooth surface was reduced and the Teeth Primer was applied. The Bondfill SB resin(Light Powder) was then filled into the defects with a brush (Fig. 9).

Fig. 8. Attrited mandibular molar

Fig. 9. Bondfill SB restoration

Secondary dental caries
Secondary dental caries was detected along the interface between the centric holding cusp and theresin-bonded retainer (Fig. 10). The recurrently decayed tooth structure was removed, the Teeth Primer wasapplied, and the Bondfill SB resin (Light Powder) was filled into the cavity (Fig. 11).

Fig. 10. Secondary dental caries under the retainer

Fig. 11. Restoration with the Bondfill SB

Repair of fractured composite veneer
A patient with fractured composite resin veneered restoration was seen (Fig. 12). The patient requested
one-visit repair. The fractured area was reduced with a diamond rotary cutting instrument, and the V-Primer(Sun Medical Co., Ltd.) was applied to the metal surface to be repaired.

The V-Primer contains 6-(4-vinylbenzyl-n-propyl) amino-1,3,5-triazine-2,4-dithione (VTD) and effective only for noble metal alloys.4 The
Bondfill SB resin with Medium Powder was applied to the incisal coping surface and the metallic color wasmasked (Fig. 13). The Bondfill SB resin with Light Powder was layered on the primarily placed material (Fig.
14). The repair was completed within a short period.

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Fig. 12. Fractured veneer

Asian Pac J Dent 2011; 11: 61-65.

Fig. 13. Repairing with the Bondfill

Fig. 14. Completed repair

Pit and fissure sealants
The TBB resins were developed originally as an adhesive for orthodontic brackets as well as a pit and fissuresealant (Fig. 15). A phosphoric acid etchant (High-viscosity, Red) was applied (Fig. 16), rinsed with water, andair-dried. The Bondfill SB resin was filled into the pits and fissures (Figs. 17 and 18).

Fig. 15. Pre-operative viewFig. 16. Etching with phosphoric acid (Red)

Fig. 17. Application of the Bondfill SB

Fig. 18. Sealed pits and fissures

Fig. 19. Inlay cavity

Figs. 20, 21. Application of adhesive after priming

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Fig. 22. Seated restoration

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Asian Pac J Dent 2011; 11: 61-65.

Seating detached restorations with insufficient retentive structure
Detachment of inlay restoration is sometimes experienced in relation with shallow cavities (Fig. 19). Prior tore-seating the restoration, the metal surface was air-abraded with alumina, followed by priming with theV-Primer, when the material was a noble metal alloy (Fig. 20). The restoration was seated with the Bondfill SB
resin (Figs. 21 and 22). Probability of detachment will be reduced by application of the bonding system shownin this case.

Discussion
This article presented application of the Bondfill SB resin to occlusal contact areas. Clinical experiences haveshown that cusps and incisal edges tend to suffer from fracture when these areas consist of rigid substances
including hydroxyapatite. The Bondfill SB material is not so much rigid as conventional composite resin andadhesive to dentin. Such material shows characteristics of gradual wear and continuous surface smoothness
rather than sudden fracture in an oral environment.

In addition, inorganic component of the TMPT

pre-polymerized filler is one of the submicron fillers. Application of the TMPT filler therefore contributes tosurface smoothness of the polymerized material. Clinicians, however, should aware that the Bondfill SB resin
must cautiously be applied to patients as a successional material of the Super-Bond C&B resin, because
long-term clinical results have not been reported in literature. The clinical cases presented in this article willappear secondarily in another publication with Japanese language.5
Acknowledgments
This work is supported in part by Grant-in-Aid for Scientific Research (C23592871, 2011) from the Japan Society for the Promotion ofScience (JSPS) and Grant from Dental Research Center (2010), Nihon University School of Dentistry.

References
1. Rou WJ, Chang PI, Imai Y. A new method for the evaluation of the wear of restorative materials on class V cavity. Dent Mater
J 1988; 7: 206-16.
2. Shinkai K, Suzuki S, Leinfelder KF, Katoh Y. Effect of surface-penetrating sealant on wear resistance of luting agents.
Quintessence Int 1994; 25: 767-71.
3. Naito K. Bonding and wear characteristics of a tri-n-butylborane initiated adhesive resin filled with pre-polymerized composite
particles. J Oral Sci 2011; 53: 109-16.
4. Koishi Y, Tanoue N, Yanagida H, Atsuta M, Nakamura M, Matsumura H. Evaluation of 2 thione primers and 3 resin adhesives
for silver-palladium-copper-gold alloy bonding. Quintessence Int 2006; 37: 395-9.
5. Nakamura M, Yamamoto N, Matsumura H. Clinical application of the Bondfill SB TBB -initiated adhesive restorative material.
Nippon Dent Rev 2011; 71(3): 85-90.

Correspondence to:Dr. Hiroyasu Koizumi
Department of Fixed Prosthodontics, Nihon University School of Dentistry
1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
Fax: +81-3-3219-8351 E-mail: koizumi@dent.nihon-u.ac.jp
Copyright ©2011 by the Asian Pacific Journal of Dentistry.

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Accepted February 28, 2011.
Online ISSN 2185-3487, Print ISSN 2185-3479