Glutaraldehyde is more than a desensitizer: Lesser-known uses for total-etch adhesive techniques

Courtney Lavigne, DMD

While adhesive dentistry has added a whole new world of benefits to the field, it’s not without its frustrations and shortcomings. One of the most common complaints is postoperative sensitivity. It’s frustrating for the patient, and it’s frustrating for the practitioner. It’s an extra appointment with a disgruntled or uncomfortable patient that doesn’t have to happen.

Glutaraldehyde is commonly used to decrease sensitivity. Many practitioners use it for deep fillings, but I’ve found through conversations I’ve had that very few are using it as part of their protocol for all bonded direct and indirect restorations.

I want to elucidate some of the lesser-known benefits of glutaraldehyde, and in doing so, I hope that you’ll come away with a greater understanding of how this little liquid can decrease those unnecessary second visits. I’m going to make a case for using glutaraldehyde as the second step in all of your total-etch adhesive techniques—that is, any time you use a fourth- or fifth-generation bonding system.

Desensitizes, disinfects, and strengthens

Glutaraldehyde, popularized by the name brand Gluma Desensitizer by Kulzer (figure 1), has become well-known as an additive to desensitize. But glutaraldehyde’s benefits extend far beyond desensitization. It not only desensitizes, but it also disinfects and strengthens the bonding agent’s ability to penetrate, therefore making your bond last longer.

Figure 1:  Gluma Desensitizer (Kulzer)