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This is a review of the literature of the last 21 years about cementing or luting indirect restorations to tooth structure. Recommendations are made as to the surface preparation of precious metals, non-precious metals, indirect composite materials, and all available porcelain materials including feldspathic, luecite reinforced, lithium di-silicate, slip cast aluminum oxide, densely sintered aluminum oxide, and zirconia prior to luting. Using data from a variety of sources, product categories of materials and various bonding materials and procedures are ranked according to their bond strength and durability.

Objectives: The use of all-ceramic restorations has been steadily increasing in the decades since the introduction of high-strength core ceramics as an alternative to metal cores. Even with high-strength ceramic cores, the crowns are susceptible to fractures during clinical function, probably the major concern associated with all-ceramic restorations. The aim of this study was to analyze fracture features of clinically fractured crowns in order to determine crack initiation sites and crack propagation paths., Methods: Fractographic methods were used to analyze 27 all-ceramic full coverage crowns with alumina cores and feldspatic veneering ceramic. The fractured crowns were supplied by dentists in private and public practices with information of type of cement and time in function if available., Results: The fractured crowns comprised 13 incisors, 3 premolars and 11 molars. The results revealed that all fractures initiated in the cervical margin of the crowns and usually from the approximal area close to the most coronally placed curvature of the margin. There was no statistically significant association between the cement used and time in function., Significance: Fractography of clinically failed all-ceramic crowns can provide information on the fracture modes and design considerations. The findings are in contrast to fracture modes from in vitro tests. The results suggest that more clinically relevant in vitro test methods to study the durability of ceramic crowns should be developed., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Peri-implant disease can be the result of residual excess cement. While there is no ideal implant restorative cement, the clinician must be aware that the material selection for implant restorations should not be based on properties which are more suited to restoration of the natural dentition. More appropriate criteria would be those unique to implants and the specific challenges these medical devices bring to the restorative dentist.

To evaluate the influence of cementation on fracture load of anterior crowns made of CAD/CAM-resin-blocks (ART), leucite-reinforced glass-ceramics (LRG), lithium disilicate ceramics (LIT), veneered zirconia (ZRO) and veneered alloy (DEG). Each crown group (n=15/subgroup) was cemented on the metal abutment as follows: i. using glass ionomer, ii. using self-adhesive resin cement, and iii. not cemented. Crowns were tested and analyzed with 2-way and 1-way ANOVA (Scheffé test), and Weibull statistics (p<0.05). Within LRG, self-adhesive cemented subgroup showed higher fracture load compared to other groups (p<0.001). Among DEG, lower results were measured for non-cemented crowns than for cemented (p<0.001). For ART, LIT and ZRO no influence of cementation was observed. For fracture load test methodology, metal ceramic crowns should be generally cemented. Glass-ceramic crowns should be cemented using adhesive cement. Cementation and cement type did not have an influence on the fracture load results for resin, zirconia or lithium disilicate crowns.

Cement selection can be confusing because factors such as substrate, the type of restoration, and patient needs must be considered. Some substrates require additional treatment before cementation. This article describes the most commonly used traditional crown and bridge cements (GI and RMGI) used for metal and metal-ceramic restorations, and resin cements used for all-ceramic restorations. Advantages, disadvantages, indications, and contraindications of cements have been reviewed. Recommended uses of cements for metal, ceramic, and laboratory composite restorations have been presented. General guidelines for surface treatment ot silica- and zirconia-based restorations when using resin cements have been discussed.

Objective: To investigate the use of bonded molar tubes (BMTs) by specialist orthodontists., Design: Prospective postal questionnaire., Setting: Ireland., Participants: Registered members of the Orthodontic Society of Ireland., Methods: A questionnaire was posted to registered members of the Orthodontic Society of Ireland. It investigated demographics, pattern of use, reasons for use and techniques for placement of BMTs., Results: A 74% response rate was obtained. In more than 80% of cases, BMTs were used on first and second permanent molars by 52% and 33% of orthodontists respectively. BMT usage was adopted by 97% of respondents in the previous decade. Direct bonding was used by all for BMT placement. Etch times for molars, compared to other teeth, increased from 15 to 30 seconds by 51% of orthodontists. Of the respondents, 97% used light-cured adhesives and 17% used self-etching primers. Molar tube holders were preferred by 54% for placement. Only with a history of epilepsy, were bands preferred to BMTs. BMTs were regarded as more cost-effective than molar bands by 66% of responding clinicians., Conclusions: Specialist orthodontists preferred BMTs to bands on first permenent molars. Direct bonding was favoured using a 30-second etch, a light-cured primer and adhesive with specialized molar tube holders. BMTs were perceived to be more cost-effective than molar bands.

Purpose: To retrospectively compare the fixation modalities semipermanent and permanent for all cemented single crowns and Fixed Dental Prostheses (FDPs) placed at the Department of Prosthodontics in the years 2002 to 2010 with regard to the incidence of survival and complications., Materials and Methods: Two hundred forty-one patients (48.5% male, mean age 57.3 years) received 166 FDPs and 232 single crowns. A total of 50.6% of the FDPs and 54.7% of the single crowns were fixed using semipermanent cements. Aside from fixation, age, gender, type, location, and material of the suprastructures were assessed as possible factors affecting complications, namely de-cementation, chipping, framework, or abutment fracture., Results: During an observation period of up to 6.6 years (mean 2.24 years; standard deviation 1.38), the survival rates were 96.4% and 100% for FDPs (semipermanent/permanent cementation), and 98.4% and 92.4% for single crowns (semipermanent/permanent). The success rates achieved, counting every complication, for the FDPs were 61.9% and 70.7% (semipermanent/permanent) and for single crowns were 75.6% and 77.1% (semipermanent/permanent). The cement used had a significant effect on loss of retention of the FDPs (p = .006), but no significant effect on the retention of the single crowns. Cementation procedure exhibited no significant impact on chipping for both FDPs and single crowns. The frequency of framework or abutment fractures was too low for further statistical analyses., Conclusion: Both semipermanent and permanent cementation of FDPs and single crowns resulted in high survival rates. Within the limitations of the study design, because of the amount of chairside aftercare required, implant-borne FDPs could be recommended for permanent cementation., (© 2011 Wiley Periodicals, Inc.)

Purpose: The objective of this retrospective study was to compare the incidence of chipping of implant-supported, all-ceramic, and metal-ceramic single crowns., Material and Methods: One hundred fifty-three patients (51.7% male, mean age 55.0 years) received 232 cemented implant-supported single crowns. One hundred and seventy-nine crowns had a metal framework (gold alloy) and 53 crowns were all-ceramic (zirconia framework and glass-ceramic veneer material). Age, gender, kind of cementation, and location of the restorations were assessed as possible factors affecting chipping., Results: During the observation period of up to 5.8 years (mean 2.1 years; standard deviation 1.4), a total of 13 (24.5%) all-ceramic and 17 (9.5%) metal-ceramic crowns suffered from chipping, a difference that was statistically significant. A total of ten single crowns had to be remade resulting in survival of 86.8% (all-ceramic) and 98.3% (metal-ceramic). The other possible factors did not have a significant effect on the chipping., Conclusion: Chipping was found to be more frequent for all-ceramic implant-supported single crowns. If the reasons for the vulnerability of all-ceramic crowns remain unknown, implants with all-ceramic single crowns should generally be recommended with care., (© 2011 Wiley Periodicals, Inc.)

This article will review the concept of extension for prevention popularized by G.V. Black around the early 1900s. Concepts of extension and prevention have changed over the years with a more informed knowledge of the caries process, improved materials, cutting instruments, and techniques. The reasons for placement of the outline form relative to the tooth morphology, gingival tissue, relationship to adjacent teeth, and the choice of material will be described for all of the materials used in restorative dentistry. Research will be cited to support the scientific basis for outline form placement.

Selecting the proper cement for sufficient bond strength has become progressively complicated as the number of different materials for indirect restorations has increased. The success of any restoration is highly dependent on the proper cement being chosen and used. The function of the cement is not only to seal the restoration on the tooth but also, in some cases, to support the retention of the restoration. This ability to strengthen retention varies by the cement chosen by the clinician; therefore, careful consideration must precede cement selection.

Soft tissue grafting is an integral part of treatment of cervical lesions due to the common lack of adequate attached gingiva and root exposure associated with these lesions. Complete root coverage is a predictable outcome for Miller Class I and II recession defects, and partial root coverage can be achieved in Miller Class III defects. In the esthetic zone, it is desirable to cover as much of the root as possible, and all sites require an adequate zone of attached gingiva, especially adjacent to a restoration. Restorations are required for cervical lesions with excessive depth and significant involvement of the enamel, but they should be avoided where the lesion is shallow and the enamel involvement is minimal. Of course, some sites will require both soft-tissue grafting and placement of a restoration. An interdisciplinary approach to treating cervical lesions will create the most biologically appropriate, stable, and esthetic outcome. Establishing the appropriate tooth form first in treatment planning and sequencing will determine the gingival level and extent of periodontal procedures necessary to achieve the desired outcome.

Background: Several all-ceramic restorative systems of various compositions, properties and indications are available to the dental practitioner. Because of the large number of systems, the dental team faces questions and decisions when choosing the appropriate system and the appropriate means of cementation., Overview: The authors present a brief overview of the cementation options for various types of all-ceramic restorations. In this article, they discuss the cementation of current all-ceramic restorations and make clinical recommendations tailored to each type of ceramic., Conclusion and Clinical Implications: The clinician must have a good understanding of the ceramic type to determine whether a restoration should be cemented adhesively or nonadhesively. Other variables, such as isolation and preparation design, also influence the cementation choice. Various ceramic types demand different surface treatments before cementation. Choosing and applying the appropriate surface treatment and cementation procedure will contribute to long-lasting restorations. The literature is lacking in clinical trial results that validate current in vitro data regarding cementation of all-ceramic restorations.

This study investigated the effects of the cement type and the water storage time on the push-out bond strength of a glass fiber post. Glass fiber posts (Fibrekor, Jeneric Pentron) were luted to post spaces using a self-cured resin cement (C&B Cement [CB]), a glass ionomer cement (Ketac Cem [KC]) or a resin-modified glass ionomer cement (GC FujiCEM [FC]) according to the manufacturers' instructions. For each luting agent, the specimens were exposed to one of the following water storage times (n=5): 1 day (T1), 7 days (T7), 90 days (T90) and 180 days (T180). Push-out tests were performed after the storage times. Control specimens were not exposed to water storage, but subjected to the push-out test 10 min after post cementation. Data (in MPa) were analyzed by Kruskal-Wallis and Dunn`s test (α=0.05). Cement type and water storage time had a significant effect (p<0.05) on the push-out bond strength. CB showed significantly higher values of retention (p<0.05) than KC and FC, irrespective of the water storage time. Water storage increased significantly the push-out bond strength in T7 and T90, regardless of the cement type (p<0.05). The results showed that fiber posts luted to post spaces with the self-cured resin cement exhibited the best bonding performance throughout the 180-day water storage period. All cements exhibited a tendency to increase the bond strength after 7 and 90 days of water storage, decreasing thereafter.

Introduction: As opposed to the cementation metal posts, the cementation of fiber posts has several details that can significantly influence the success of post retention. This study evaluated the effect of the relining procedure, the cement type, and the luted length of the post on fiber posts retention., Methods: One hundred eighty bovine incisors were selected to assess post retention; after endodontic treatment, the canals were flared with diamonds burs. Post holes were prepared in lengths of 5, 7.5, and 10 mm; the fiber posts were relined with composite resin and luted with RelyX ARC, RelyX Unicem, or RelyX Luting 2. All cements are manufactured by 3M ESPE (St. Paul, MN). Samples were subjected to a pull-out bond strength test in a universal testing machine; the results (N) were submitted to a three-way analysis of variance and the Tukey post hoc test (alpha = 0.05)., Results: The improvement of post retention occurred with the increase of the post length luted into the root canal; the relining procedure improved the pull-out bond strength. RelyX Unicem and RelyX ARC showed similar values of retention, both showing higher values than RelyX Luting 2., Conclusion: Post length, the relining procedure, and the cement type are all important factors for improving the retention of fiber posts., (Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters., Study Design: Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S(3) Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate-dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface., Results: Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. "Stretch mark"-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections., Conclusion: Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study., (2010 Wiley-Liss, Inc.)

Introduction: This study was conducted to evaluate the effect of applying early orthodontic force on the shear bond strength (SBS) of orthodontic brackets bonded with 4 adhesive systems., Methods: Eighty stainless steel brackets were bonded to the enamel surfaces of extracted premolars with 4 adhesive systems. For each adhesive, 10 brackets were bonded without application of force (groups 1, 3, 5, and 7), and another 10 were subjected to a 120-g force with a coil spring (groups 2, 4, 6, and 8). This force was applied 30 minutes after bonding and maintained for 24 hours. Groups 1 and 2 had Rely-a-bond primer and Rely-a-bond adhesive (Reliance Orthodontic Products, Itasca, Ill). Groups 3 and 4 had Transbond XT primer and Transbond XT adhesive (3M Unitek, Monrovia, Calif). Groups 5 and 6 had Transbond Plus Self Etching Primer and Transbond XT adhesive (3M Unitek). Groups 7 and 8 had RelyX Unicem (3M ESPE, Seefeld, Germany). After thermocycling, SBS testing was performed by using a universal testing machine (Type 500, Lloyd Instruments Ltd, Fareham Hants, UK). The results of SBS testing for all adhesives were analyzed by 2-way analysis of variance and the Duncan test. The unpaired Student t test was used to compare the effect of force on the SBS of each adhesive., Results: Transbond XT primer and its adhesive had the highest values (without force, 11.2 +/- 3.1 MPa; with force, 10.7 +/- 2.7 MPa), and RelyX Unicem had the lowest (without force, 5.8 +/- 1.5MPa; with force, 5.7 +/- 1.6 MPa). Application of force yielded nonsignificant reductions in SBS for all adhesives; this reduction was less pronounced with RelyX Unicem., Conclusions: For all studied adhesive systems, orthodontic force up to 120 g can be applied within the first hour after bonding with no deleterious effects on bond strength., (Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Unlabelled: Selection of a luting material for optimal cementation of indirect restorations requires the consideration of several factors relating to the properties of both the cement and of the restoration. Contemporary restorations (for example, dentine-bonded crowns or resin-retained bridges) often rely on bonding, and advances in dental materials science have resulted in simplified resin systems. Their ease of use and other favourable properties also offer advantages when used for more conventional restorations. Traditional luting cements remain commonplace and their benefits and shortcomings are discussed in terms of handling and clinical performance. Developments and trends in adhesive dentistry are explored., Clinical Relevance: Luting cement selection and application is integral to the optimal performance of indirect restorations.

Statement of Problem: Despite recent advances in adhesive dentistry, resin cement/dentin adhesive combinations are not able to prevent microleakage in ceramic inlays. Marginal quality of tooth-colored restorations in large Class II cavities is satisfactory in enamel margins, but microleakage in dentin margins remains a concern., Purpose: The purpose of this study was to evaluate the microleakage of all-ceramic inlays luted with 2 dual-polymerizing resin cements or 1 autopolymerizing resin cement in combination with different dentin adhesives., Material and Methods: One hundred and twenty extracted human mandibular third molars were used in this study. Teeth were prepared to receive Class II MOD inlays with enamel gingival margins on 1 proximal surface and dentin gingival margins on the other surface. One hundred and twenty prepared teeth were divided into 3 groups of 40; 1 group for each resin cement: RelyX ARC, Variolink II, or Panavia 21. Each of the 3 groups were further divided into 4 dentin adhesive groups; Single Bond, ExciTE DSC, ED Primer, or Admira Bond. Each of the resin cements were used in combination with the 4 dentin adhesives, and IPS Empress ceramic inlays were placed with 12 different cement/adhesive combinations. After 1000 thermal cycles in a 5 degrees -55 degrees C water bath with a dwell time of 30 seconds, all specimens were subjected to cyclic axial mechanical loading. Then the restored teeth were stored in 0.5% basic fuchsin solution for 24 hours. The extent of dye penetration along the margins was measured with a stereomicroscope at x40 magnification. The data were evaluated statistically using repeated-measures ANOVA and Duncan tests (alpha=.05)., Results: Microleakage at dentin margins was greater than that at enamel margins (P<.05) for all groups. Variolink II and RelyX ARC resin cements showed significantly lower microleakage results than Panavia 21 with all dentin adhesives in enamel margins. For dentin margins, Variolink II/Admira Bond combination showed the lowest microleakage value in dentin (P<.05)., Conclusions: The overall microleakage at the enamel margins was significantly less than at the dentin margins (P<.05). Panavia 21 showed higher microleakage values than Variolink II and RelyX ARC in enamel margins.

For more than 30 years, Compendium has provided its readers with university-based continuing education and editorial, demonstrating the latest advances in clinical procedures and techniques. Using the same peer-reviewed format and influence/direction from Compendium's distinguished editorial board, Special Report will provide insight on the latest advances in product technologies and the resulting benefits to both you and your patients. A discussion by the author on new clinical/laboratory research and product development strategies, as well as what the results could mean for dental treatment, will also be included. Focusing on one product category per issue provides a detailed review of the category and a comprehensive resource to help guide your treatment planning process.

Background: Cement-retained restorations are commonly used on dental implants. Residual excess cement after placement of fixed partial dentures has been associated with clinical and radiographic signs of peri-implant disease. The purpose of this study was to explore the relationship between excess dental cement and peri-implant disease using the dental endoscope., Methods: Thirty-nine consecutive patients with implants exhibiting clinical and/or radiographic signs of peri-implant disease were studied. Patients were enrolled in the study during a 5-year period in a private periodontal practice. Twelve of these patients had similar implants without signs of inflammation; these implants served as controls. There were 20 controls and 42 test implants. All were evaluated using a dental endoscope initially, and all but one implant was evaluated at a 30-day follow-up. Results from both groups were assessed by two trained operators and recorded., Results: None of the controls and all 42 of the test implants had clinical signs of peri-implant disease at initial treatment. Excess cement was found in none of the controls and 34 of the test sites. Thirty days after cement removal, 25 of 33 test sites from which the cement was removed had no clinical or endoscopic signs of inflammation., Conclusions: Excess dental cement was associated with signs of peri-implant disease in the majority (81%) of the cases. Clinical and endoscopic signs of peri-implant disease were absent in 74% of the test implants after the removal of excess cement.

Mastery of the bonding stage of treatment is clearly a critical step in the clinical practice of orthodontics. There is such a wide variety of products available in orthodontics that a reasoned assessment of bonding systems is a practical necessity. Composite plastics, associated with hydrophobic or hydro-compatible adhesive systems, and the CVIMAR represent the two principal types of bonding agents used in dentistry. They are categorized according to their constituents into a wide range of products whose nuanced differences are sometimes difficult to discern. This paper first focuses on the development of the composition of the various materials, a depiction of the fundamental parameters of adhesion, and a detailed terminology to help the reader reach a basic understanding. Bonding systems are designed to fulfill the requirements of specific clinical situations. A description of their modes of adhesion, of their composition, and of their advantages and disadvantages will be presented in the second part of this article.

Purpose: Although surface roughness of axial walls could contribute to precision of a cast restoration, it is unclear how the roughness of tooth preparation affects marginal fit of the restoration in clinical practice. The purpose of this study was to describe the morphologic features of dentin surfaces prepared by common rotary instruments of similar shapes and to determine their effects on the marginal fit for complete cast crowns., Materials and Methods: Ninety crowns were cast for standardized complete crown tooth preparations. Diamond, tungsten carbide finishing, and crosscut carbide burs of similar shape were used (N = 30). The crowns in each group were subdivided into three groups (n = 10) for use with different luting cements: zinc phosphate cement (Fleck's), glass ionomer cement (Ketac-Cem), and adhesive resin cement (Panavia 21). Marginal fit was measured with a light microscope in a plane parallel to the tooth surface before and after cementation between four pairs of index indentations placed at equal distances around the circumference of each specimen. Difference among groups was tested for statistical significance with analysis of variance (ANOVA) followed by Ryan-Einot-Gabriel-Welsch Multiple Range Test (alpha= 0.05)., Results: Analysis of measurements disclosed a statistically significant difference for burs used to finish tooth preparations (p < 0.001); however, luting cement measurements were not significantly different (p= 0.152). Also, the interaction effect was not significantly different (p= 0.685). For zinc phosphate cement, the highest marginal discrepancy value (100 +/- 106 microm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (36 +/- 30 microm) was for tooth preparations refined with finishing burs. For glass ionomer cement, the highest marginal discrepancy value (61 +/- 47 microm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (33 +/- 40 microm) was for tooth preparations refined with finishing burs. For adhesive resin cement, the highest marginal discrepancy value (88 +/- 81 microm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (19 +/- 17 microm) was for tooth preparations refined with finishing burs., Conclusions: Marginal fit of complete cast crowns is influenced by tooth preparation surface characteristics, regardless of the type of luting agent used for cementation. Tooth preparations refined with finishing burs may favor the placement of restorations with the smallest marginal discrepancies, regardless of the type of cement used.

Objective: The hypothesis was that low grade variations of mixing ratios of luting agents have negligible influence, while high grade variations cause severe property changes independent from the cement type used., Material and Methods: A zinc oxide phosphate, carboxylate, glass ionomer, resin-modified glass ionomer, dual-curing composite and self-adhesive composite cement were mixed using various mixing ratios. Beside the recommended ratio, samples were mixed with ratios between 10 and 25% (low grade) up to 60% (high grade) variation of powder/liquid, respectively base/catalyst pastes. The samples underwent a Vickers hardness, flexural strength and three-body abrasion test. Their extent of cure reaction was characterized using differential scanning calorimetry., Results: This study indicates that dual-curing composite cements and resin-modified glass ionomers have a wide therapeutic range, followed by zinc oxide phosphate, carboyxlate and classical glass ionomer cements. Dual-curing composite cement showed less property changes, if they were exclusively light-cured in contrast to dark-curing. The classic glass ionomer and the carboxylate cements reacted more sensible to higher liquid content than higher powder content, while zinc oxide phosphate cement was lower sensitive to higher powder content. The investigated self-adhesive composite cement reacted very sensitive even to low grade mixing errors., Conclusions: . Most of the established luting agents seem to tolerate low grade mixing errors, while this is not the case for recently developed self-adhesive composite cement.

Objective: To investigate the effects of application time and rubbing action of self-etching adhesives on resin-dentin bond strength and interface morphology in vitro., Methods: Caries-free human third molars were wet ground to expose dentin surface. Three self-etching bonding agents were applied with varying application time and with/without rubbing. The microtensile bond strength and interface morphology were evaluated., Results: When etching time was shortened, normal and prolonged, the bond strength was bonding agent 1 (Adper Prompt): (16.30 +/- 2.59), (23.13 +/- 2.56), (22.28 +/- 2.83) MPa, bonding agent 2 (Xeno III): (15.17 +/- 6.07), (34.50 +/- 3.64), (24.87 +/- 7.01) MPa, bonding agent 3 (Clearfil SE Bond): (29.92 +/- 3.32), (42.21 +/- 6.28), (41.07 +/- 3.93) MPa. When etching was applied with and without rubbing, the bond strength was bonding agent 1 (23.13 +/- 2.56), (12.53 +/- 3.73) MPa, bonding agent 2 (23.98 +/- 3.86), (34.50 +/- 3.64) MPa, bonding agent 3 (48.37 +/- 4.95), (42.21 +/- 6.28) MPa., Conclusions: Shortening application time decreased bond strength of self-etching adhesives, while prolonging application time did not increase bond strength of self-etching adhesives. Not all self-etching adhesives applied with rubbing showed increased bond strength to dentin, which is product-dependent. Manufactures' instructions should be followed to achieve optimum bonding.

The clinical success of adhesive restorations depends on knowing the materials and how they are used in indicated areas. This article is designed to help clinicians understand the various protocols that are best suited for different clinical cases by discussing contemporary dental adhesive systems. The article also presents rationales for selecting adhesive systems for specific cavity classes, highlights the working principles underlying each clinical procedure, and explains technique problems in dental adhesive procedures. Clinical preventive measures to ensure longevity of direct adhesive restorations also are discussed.

Dental cement used to attach an indirect restoration to a prepared tooth is called a luting agent. A clinically relevant discussion of conventional and contemporary definitive luting agents is presented in this article. Physical properties are listed in table form to assist in comparison and decision-making. Additional subtopics include luting agent requirements, classifications, retention and bonding, cement considerations for implant-supported teeth, and fatigue failure.

Length of resin tags yielded by utilization of an one-step conventional adhesive system and self-etching adhesive system on unground enamel was observed. In study Groups I and III, the enamel surface was etched for 60 seconds with 35% phosphoric acid gel and adhesive systems PQ1 (Ultradent Products, Inc) and Adper Prompt L Pop (3M/ESPE) were applied. Adper Prompt L Pop (3M/ESPE) was also applied in Group II in accordance with the manufacturer's recommendations. After application of these adhesive systems to dental enamel, specimens were prepared for light microscopy analysis to ascertain degree of penetration (x400). The results were submitted to an analysis of variance at the 5% level; whenever there was significance, the Tukey test was applied at the 5% level. It was found that acid etching prior to application of conventional and self-etching adhesive materials provided higher penetration of the adhesive into the unground enamel surface compared to that achieved solely by application of self-etching adhesive.

The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.

The purpose of the study was to evaluate the shear bond strength of stainless steel orthodontic brackets directly bonded to extracted human premolar teeth. Fifty teeth were randomly divided into five groups: (1) System One (chemically cured composite resin), (2) Light Bond (light-cured composite resin), (3) Vivaglass Cem (self-curing glass ionomer cement), (4) Fuji Ortho LC (light-cured glass ionomer cement) used after 37% orthophosphoric acid-etching of enamel (5) Fuji Ortho LC without orthophosphoric acid-etching. The brackets were placed on the buccal and lingual surfaces of each tooth, and the specimens were stored in distilled water (24 hours) at 37 degrees C and thermocycled. Teeth were mounted on acrylic block frames, and brackets were debonded using an Instron machine. Shear bond strength values at fracture (Nw) were recorded. ANOVA and Student-Newman-Keuls multiple comparison tests were performed (P < .05). Bonding failure site was recorded by stereomicroscope and analyzed by Chi-square test, selected specimens of each group were observed by scanning electron microscope. System One attained the highest bond strength. Light Bond and Fuji Ortho LC, when using an acid-etching technique, obtained bond strengths that were within the range of estimated bond strength values for successful clinical bonding. Fuji Ortho LC and Vivaglass Cem left an almost clean enamel surface after debracketing.

Having successfully negotiated the planning, preparation, impression and prescription of your crown, the cementation stage represents the culmination of all your efforts. This stage is not difficult, but a successful outcome needs as much care as the preceding stages. Once a restoration is cemented there is no scope for modification or repeat You have to get it right first time. Decemented crowns often have thick layers of residual cement suggesting problems with either initial seating or cement handling. When the fate of restorations costing hundreds of pounds depends on correct proportioning of cements and the quality of the mix, the value of a well-trained and experienced dental nurse is easy to see. Both dentist and nurse need a working knowledge of the materials they are handling.

Dental cements and resins are used intraorally to secure fixed orthodontic devices. Although cements are still used, the popularity of resin and resin-cement hybrid materials is increasing because of their improved physical properties and low solubility in oral fluids. Some cements bond chemically to enamel, but bond strengths are low because cements are brittle and fracture cohesively. Resin adhesives penetrate micropores in etched enamel and mechanical retentions in orthodontic devices, resulting in higher bond strengths because resins are more fracture resistant than cements. Resins, however, do not bond well in the presence of moisture, and their attachment to surfaces is primarily mechanical. Hybridized materials combine the advantages of cements and resins but also have certain disadvantages. Optimal material selection and application require an understanding of the chemical differences and physical limitations of today's orthodontic cements, resins, and hybrid materials.

Purpose: The objective of this research study was to test the effects of (1) crown margin type, (2) cement type, (3) cement thickness, (4) loading direction, and (5) loading magnitude on stress levels and distributions within luting cement that might lead to cement microfracture using three-dimensional Finite Element Analysis techniques., Materials and Methods: Thirty-two three-dimensional computer models, as well as models for standards, were generated for a mandibular first premolar. Crown preparations exhibited shoulder or chamfer margin configurations, and zinc phosphate, zinc polycarboxylate, glass ionomer, and resin cements were used in thicknesses of 25 or 100 microm. Modeled crowns were loaded axially or obliquely at 10 and 100 MPa. Areas and levels of stress concentrations within the cement were determined., Results: Stresses in the cement were low for all situations except 100 MPa oblique stressing. Stresses at the margins of crowns with chamfer marginal configuration were higher than those with shoulder margins. Stresses under oblique stressing were 10 to 150 times higher than under axial stressing. Except for Zn phosphate cement, cement thickness minimally affected stress levels and distributions. Greater stresses were found in cements with the greater Young's modulus., Conclusions: Although the chamfer margin design could lead to greater stresses near the margins that places the cement at risk for microfracture and possible crown failure, glass-ionomer and composite resin cements have more favorable mechanical properties for resisting microfracture., (Copyright 2000 by The American College of Prosthodontists.)

This paper explains the reasons why a new adhesion concept was developed, how it was conceived and what properties and test results were achieved with the product Prompt L-Pop that follows this new concept. Therefore, a short historical introduction into the development of adhesive materials is given followed by a summary of today's state-of-the-art techniques. The requirements for the new adhesion concept are pointed out and the outcome of the effort in the development is explained in more detail. In vitro and in vivo test results of Prompt L-Pop support the new concept by revealing excellent bond strength values in combination with good marginal adaptation and a significantly reduced post operative sensitivity. Finally, further developments regarding the new concept are discussed, such as the use of Prompt L-Pop in combination with plasma curing lights or indirect restorations.

Purpose: To evaluate the effect of fatigue loading on the quality of the cement around the margins of adhesive ceramic MOD inlays., Materials and Methods: Non-metal IPS Corum porcelain inlays were made and cemented either with the resin-based composite Variolink, the compomer Dyract-Cem or the glass-ionomer cement Ketac-Cem. For each system, half of the specimens were subjected to thermal and mechanical load cycling to simulate fatigue loading. All teeth were then sectioned and evaluated by SEM on topography and by optical microscopy for dye penetration., Results: Before loading, all systems showed good marginal integrity. After loading, inlays cemented with Variolink and Dyract-Cem showed no significant (P > 0.05) increase in marginal break down, however restorations cemented with Ketac-Cem, showed a significant (P < 0.05) deterioration at the margins.

Today, the clinician has numerous dental cements available for luting of restorations to prepared teeth. Compared to traditional cements, many of the newer cements have improved physical properties. In this article, we analyze available cements in terms of these physical properties based on scientific data and attempts to determine their effect on long-term clinical performance. We conclude that these improved physical properties do not necessarily result in improved clinical performance. We also conclude that although these newer cements have specific clinical applications, they should not be routinely used for the cementation of metal castings because they are clearly more technique-sensitive than traditional luting agents. Zinc-phosphate cement remains the cement of choice for cementing cast gold and metal-ceramic restorations.