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FACTORS TO CONSIDER
FACTORS TO CONSIDER
RESTORATION MATERIAL
TOOTH PREPARATION
CEMENT
Cementation with Zirconium Dioxide (Zirconia)
Cementation with Zirconium Dioxide (Zirconia)
Zirconia is most often luted to the tooth structure using glass-ionomer or other type of cement. However, several primers and cements containing the chemical 10 methacryloyloxydecyl dihydrogen phosphate (10-MDP) may aid in creating a chemical bond with zirconia and the corresponding resin cement. Glass-ionomers bond weakly or not at all. Zirconia bonding might improve retention to the tooth structure that is particularly helpful with minimum reduction and short crown preparations. When zirconia restorations are non-adhesively cemented, a low-pressure sandblasting of the internal surface is recommended using about 25-50 psi (2 bar) with 25-50 μm alumina. This provides for some mechanical retention of the cement.
Clearfil Ceramic Primer (Kuraray Noritake) and Monobond Plus (Ivoclar Vivadent) are the best zirconia primers
Clearfil Ceramic Primer Plus
Clearfil Ceramic Primer Plus
Clearfil Ceramic Primer Plus contains 10 MDP monomer and silane monomer
CEMENTATION with GLASS IONOMER
CEMENTATION with GLASS IONOMER
Either material can be cemented with RMGIC
Mechanical (not chemical) bond
BONDING with ADHESIVE RESIN
BONDING with ADHESIVE RESIN
Glass in Lithium Disilicate can be etched and bonded
Bonding to Zirconia is more complicated
IVOCLEAN
IVOCLEAN
https://www.ivoclar.com/en_gb/products/cementation/ivoclean
Proper cleaning after try-in
The universal cleaning paste Ivoclean effectively cleans the bonding surfaces of prosthetic restorations after intraoral try-in and thus creates optimum pre-requisites for the adhesive luting procedure.
LITHIUM DISILICATE
LITHIUM DISILICATE
Immediate Dentin Sealing of the prepared tooth
LAB PRESCRIPTION: Do you ask lab to etch fitting surface of the tooth with Hydrofluoric Acid (HF)?
After try in, etch intaglio surface of the restoration with HF, or if already etched then etch with phosphoric acid.
Apply silane coupling agent to the intaglio surface of the restoration
Apply bond to the tooth (light cure?)
Apply resin inside the restoration
Fit restoration and remove excess
Light cure
*Follow bonding protocol of the resin as per manufacturers instructions
ZIRCONIA
ZIRCONIA
Immediate Dentin Sealing of the prepared tooth
LAB PRESCRIPTION: Do you ask lab to etch fitting surface of the tooth with Hydrofluoric Acid (HF)?
After try in, clean restoration un ultrasonic bath in alcohol for 5 minutes
Air particle abrasion (30-60 microns alumina) of intaglio surface for 5 seconds
Apply zirconia primer to the intaglio surface of the restoration
Apply bond to the tooth (light cure?)
Apply resin inside the restoration
Fit restoration and remove excess
Light cure
*Follow bonding protocol of the resin as per manufacturers instructions
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