Nakamura et al.

Asian Pac J Dent 2012; 12: 17-19.

Application to mandibular incisor fixation of an adhesive
4-META resin with sodium fluoride: a case report
Mitsuo Nakamura, DDS, PhD,a,b Hiroyasu Koizumi, DDS, PhD,b,c 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, JapanAn adhesive resin containing sodium fluoride (Super-Bond F3) has been released. This clinical report describes
bonding technique and clinical performance of the new adhesive. The material and procedure reported here areapplicable as a conservative treatments option for patients suffering from varying types of periodontal diseases.
(Asian Pac J Dent 2012; 12: 17-19.)
Key Words: adhesive, fixation, fluoride, splint, tri-n-butylborane

Introduction
A growing number of enamel bonding systems has been developed over the last decade. This is probably due
to progress in treatment of periodontal diseases. During or after the initial preparation of periodontal treatment,
the remaining teeth are frequently splinted for the stabilization of dentition. It is desirable for resin adhesivesthat the material is capable of releasing fluoride to prevent recurrence of dental caries after splinting. Kawabataet al.1 reported the influence of additives on bond strength to enamel of a 4-META/MMA-TBB resin. According
to their results, the influence of incorporation of calcium fluoride (CaF2) into the Super-Bond powder on thebond strength to enamel of the 4-META/MMA-TBB resin was not significant, when the added CaF2 ratio was 10wt% or less. However, none of the three additives improved the original or proper bond strength of the4-META/MMA-TBB resin. Su et al.2 evaluated properties of an acrylic resin containing 10% sodium fluoride(NaF) in the powder component. The results showed that fluoride release from the acrylic resin was comparable
to that from a conventional glass ionomer.
A modified 4-META/MMA-TBB resin that contains NaF (Super-Bond F3, Sun Medical Co., Ltd., Moriyama,Japan) has been released. The manufacturer claims that the material is applicable as a filling, luting, splinting orsealing agent. Laboratory evaluation demonstrated that the Super-Bond F3 resin released fluoride more than 100
ppm within 3 weeks, and inhibited activity of Streptococcus mutans.3,4 This article presents the adhesive
techniques of the Super-Bond F3 resin applied for splinting mandibular anterior dentition.

Clinical Report
Table 1 summarizes the difference between the Super-Bond C&B and Super-Bond F3 resins.

TheSuper-Bond F3 powder contains 70,000 ppm (7%) NaF. Unlike the Super-Bond C&B resin, the Super-Bond F3
resin employs butoxydibutylborane, which is a partially oxidized tri-n-butylborane (TBB), as a main componentof the initiator (Catalyst V). The catalyst V also contains hydrocarbon as a stabilizer.
A 57-year old female patient was seen for the treatment of chronic marginal periodontitis. Since the mobilityof mandibular incisal teeth was moderate, splinting with an adhesive resin was planned. Prior to the splinting,initial periodontal treatment was performed. Mobility of the teeth for the patient appeared to be derived frombone loss around the incisors.

17

Nakamura et al.
Table 1.

Asian Pac J Dent 2012; 12: 17-19.

Adhesive resins initiated with tri-n-butylborane (TBB) derivatives

Material / Trade name

Manufacturer

Super-Bond C&B

Sun Medical Co., Ltd.

Composition

Monomer

MMA, 4-META

Polymer

PolyMMA, Pigment

Catalyst
Super-Bond F3

TBB, TBB-O
Sun Medical Co., Ltd.

Monomer

MMA, 4-META

Powder F3

PolyMMA, NaF (70,000 ppm; 30,000 ppm as fluoride)

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

The tooth surface was cleaned with rotary brushing instrument with water coolant. The surface to be bonded
was etched with 20% phosphoric acid gel (Red Etchant) for 10 s, rinsed with water, and air-dried (Fig. 1). TheTeeth Primer agent was applied to the etched surface and air-dried (Fig. 2). The Super-Bond F3 resin was next
applied to the enamel surface with a brush-dip technique (Fig. 3). The excess material was removed and thesurface was polished with silicone rotary instruments. The mandibular incisors were stabilized with the adhesive(Fig. 4). After an observation period of 6 months, the splinted teeth are functioning satisfactorily.

Fig. 1. Etching enamel with phosphoric acid gel

Fig. 2. Application of the Teeth Primer

Fig. 3. Bonding enamel with Super-Bond F3Fig. 4. Post-operative view

Discussion
This report presented a case of splinting mandibular dentition with the Super-Bond F3 resin. Lingström et al.3
reported that the Super-Bond F3 resin resulted in a lower degree of demineralization compared to the18Nakamura et al.

Asian Pac J Dent 2012; 12: 17-19.

Super-Bond resin, and concluded that Super-Bond F3 is well suited for patients undergoing orthodontic
treatment with fixed appliances in order to reduce the risk of dental caries in enamel. Lingström et al.4 also
reported that the Super-Bond F3 seems to inhibit demineralization of dentin compared with the conventional
Super-Bond resin in their in situ model.
One of the advantages of the Super-Bond F3 resin is that the color of the polymerized material is translucent.
As shown in Fig. 4, the so-called black triangle between the exposed roots will be minimized by application of
the translucent Super-Bond F3 resin. Clinicians must keep it in mind that modified 4-META/MMA-TBB resinsshould be used when the merit of application of the modified resin exceeds the demerit of inapplication.

References
1. Kawabata R, Hayakawa T, Kasai K. Modification of 4-META/MMA-TBB resin for safe debonding of orthodontic brackets -influence of the addition of degradable additives or fluoride compound. Dent Mater J 2006; 25: 524-32.
2. Su L, Bai Y, Li S, Al-Naimi OT, McCabe JF. A new acrylic-based fluoride-releasing cement as a potential orthodontic bonding
agent. Acta Odontol Scand 2010; 68: 207-14.
3. Lingström P, Penny P, Tranaeus S, Kjellberg H, Birkhed D. A new fluoride-containing bonding material for orthodontic
brackets in vivo. ADEA/AADR/CADR, Abstract #0157, Orlando, FL, USA, March 2006.
4. Lingström P, Huysmans MC, Ruben J, Birkhed D. Effect of a fluoride-containing resin on dentine demineralization in situ.
IADR 86th General Session, Abstract #0107, Toronto, Canada, July, 2008.

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 ©2012 by the Asian Pacific Journal of Dentistry.

19

Accepted May 21, 2012.
Online ISSN 2185-3487, Print ISSN 2185-3479