VIDEO: Optical Coherence Tomography (OCT) imagery
Ribbond made this video using Optical Coherence Tomography (OCT) imagery from a recent study by Alireza Sadr, DDS, PhD (University Of Washington) published in February 2020 in the journal of Dental Materials. This video shows how Ribbond prevents gap formation between the Ribbond and the tooth, which of course keeps the dentin sealed and prevents gap formation, leakage, reoccurring caries, and sensitivity. Also, because the bond at this critical interface remains intact the Ribbond bridges cracks in teeth.
In the video you will see that in the Ribbond sample there was no gap formation at the Ribbond/tooth interface. A small gap formed between the Ribbond and the restoration but any gap formation between the Ribbond and the restoration would have no negative clinical impact as the dentin remains sealed and there is no gap formation between the Ribbond and the tooth. You can clearly see in the composite restoration without Ribbond that a gap formed between the tooth and the restoration.The footage that we used to make the above video was given to us by Dr. Sadr. Attached is the study by Dr. Sadr that the video above was made from. This study compares the use of a common bulk-fill composite, placed with and without Ribbond at the cavity interface. It demonstrates that the polymerization of a bulk filled composite results in gaps at the cavity interface when used in two increments or in bulk. These interface gaps are not visible to the naked eye, but they can lead to post-operative sensitivity, leakage and recurrent decay. Other Optical Coherence Tomography (OCT) studies by the lead author have demonstrated this phenomenon with a variety of bonding agents and composites, so this is not unique to a single brand or type of composite.
All composites shrink and this shrinkage causes stress that can shorten the lifespan of the restoration and contribute to bond-interface gap formation, leakage and post-operative sensitivity. When Ribbond is well adapted into the cavity, interface gaps between the restoration and the tooth are nearly eliminated! The authors suggest that the Ribbond absorbs polymerization shrinkage stress, resulting in an intact bond interface. Other studies have confirmed increased fracture strength and a resistance to catastrophic fracturing of teeth restored with laminated Ribbond. With this study, we learn that by laminating Ribbond to the internal aspect of moderate to large composite restorations, we create the additional benefit of preventing bond interface gaps. Because the bond remains intact between the Ribbond and the tooth, possible cracks in the tooth remain bridged by the Ribbond. In addition to mitigating the harmful effects of C-factor Ribbond also strengthens structurally compromised teeth and allows dentists to save many teeth that using traditional methods would normally be considered hopeless.