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Abstract:
The process of ensuring proper retention, marginal seal, and durability of indirect
restorations depends heavily on effective cementation. Careful consideration must be made
when selecting an adhesive cement for a given application. This article provides
information on resin cements that can guide clinicians in determining which type of cement
is best suited to their clinical needs regarding cementation of indirect restorations.
Emphasis is placed on successful cementation of all-ceramic restorations.
Cementation is a crucial step in the process of ensuring the retention, marginal seal, and
durability of indirect restorations.1 Since the introduction of the first all-porcelain crown in
the early 1900s, various cements have been used to adhere porcelain crowns to tooth
structure. Initially, only luting cements were available for use, which led to many failures.
Presently, another category has been added—the adhesive cements. Resin cements fall
into this category of adhesive cements. Adhesive cements must bond to a variety of
different substrates, including dentin and enamel, porcelain and other ceramics, gold and
other metal alloys, and indirect resin composites.2
There are several characteristics of resin cements that make them clinically superior luting
agents. Resin cements may have high bond strengths both to tooth structure and porcelain,
high tensile and compressive strengths, and the lowest solubility of the available
cements.3 Flexural properties—including modulus and strength—are important to prevent
de-bonding during function, and resin cements have both a high modulus and strength. In
fact, they have the highest strength of the cements currently in use.4,5
The disadvantages of resin cements are associated with their technique sensitivity and
difficulty with clean-up. Resin cements may change shade during curing and can darken
during their lifetime. This can be a crucial factor, especially since esthetics is a particularly
important characteristic for all-ceramic restorations.6 Because these materials depend upon
bonding, the operator must be careful to follow all steps in proper order and with the
recommended time for each step.6
Conclusions
The key points for clinicians to bear in mind regarding resin-based cements are:
• Bond strengths vary among specific cements, but total-etch cements generally provide the
greatest retention; self-etching systems are intermediate; and self-adhesive cements can
provide bond strength nearly equal to self-etching systems.7
• Self-adhesive resin cements can create bond strengths to dentin that exceed the strength
of the ceramic material.27
• High bond strengths can be achieved with self-adhesive resin cements on non-retentive
teeth.27
• Large coefficients of variation indicate that the bond strength cannot consistently be
achieved.27
While in vitro data may show some cement bond differences among investigators, self-
adhesive cements perform well clinically.32 Although clinical evaluations are few and short-
term, the result of this review of self-adhesive resin cements would suggest that these
materials may be expected to show clinical performance similar to that of other resin-based
and nonresin-based dental cements.2 The handling properties of these materials appear to
be excellent, and their acceptance by the profession is increasing.2
References
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Poster, CEREC 20-year celebration in Vegas. Las Vegas, NV, October 14, 2006.
22. Hollis W, Pecora NF, de Rijk WG. An Evaluation of the Shear Bond Strength of Four
Universal Cements to Five Prosthodontics Substrates. Kerr
University. http://www.kerrdental.com/index/kerrdental-cements-maxcemelite-3rdparty-2.
Accessed September 27, 2012.
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material to enamel and dentin. Dent Mater. 2004;20(10):963-971.
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sensitivity for new self-adhesive resin cement [abstract]. J Dent Res. 2008;87(spec iss B).
Abstract 3142.
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[abstract]. J Dent Res. 2003;82(spec iss B). Abstract 1616.
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