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Play It Safe and Choose Your Cement Wisely

By: Dental Product Shopper

10/16/2023

No matter the restoration, BISCO has a strong and reliable cement ready for the job

Direct composite restorations are the bread and butter of any general practice. By the same token, the average dental office places around 13 crowns a month—a small slice of the over 15 million crowns that Americans live with at any given time. With so many restorations in demand and so little time to get them all placed, what’s a general dentist to do?

They should turn to BISCO for a menu of restoratives designed to tackle any material, restoration, or technique. “BISCO has some great scientists who know what they’re doing in resin-based chemistry,” noted Dr. Steven Rabedeaux.

Indeed, BISCO's marriage of science, technology, and clinical know-how has led to the creation of several flagship cementation systems—all of which ensure your restorations are successful today, tomorrow, and for years to come.

But First, Preparation

Before diving into cementation, it’s important to treat the surface of the restoration—especially if that surface is made of zirconia. After try-in, phosphate contaminants from saliva can weaken bond strengths, which is where ZirClean comes in. A gel designed for nonabrasive cleaning of zirconia restorations after try-in, ZirClean is easy to place and clean up, effectively removing saliva to ensure reliable adhesive cementation.*

Available in a 5-gram syringe with disposable mixing tips, ZirClean is easy to dispense and place exactly where it’s needed. After placement, it takes 20 seconds for the material to perform its cleaning protocol and is then rinsed off with water. “I want the best bond possible,” said John Leitner, DDS. “Using ZirClean gives me peace of mind knowing I am doing all I can to ensure a strong bond.”

Next, it’s prime time. When cementing porcelain, it can be achieved with BISCO’s Bis-Silane, a 2-part silane coupling agent, or Porcelain Primer, a single-component, prehydrolyzed, no-mix silane primer—both of which are designed to improve bonding between porcelain substrate and resin cements.

For zirconia-, metal-, or alumina-based restorations, an MDP-containing primer like Z-Prime Plus is ideal, as it increases bond strengths to zirconia via MDP and BPDM monomers.** “The added benefit of using Z-Prime Plus means that the crowns I cement rarely, if ever, debond,” shared Dr. Steven Edelson.

Next, Cementation!

No matter what restorative material you choose to build your crowns and bridges, it’s a safe bet that BISCO has a cement for it. For zirconia crowns where the tooth prep is short or non-retentive, it’s recommended to use an adhesive procedure on the tooth in combination with a cement like Duo-Link Universal, which has a high degree of conversion in both light- and self-cure modes. It’s a product that Dr. Rabedeaux relies on regularly in his Iowa practice—both to repair failing crowns and older dental work, as well as to ensure that the new crowns he places won’t fail.“

Duo-Link Universal is my depend-able go-to cement,” said Dr. Rabedeaux. “I have found that it performs just as indicated, and I’ve been very happy with the results. It’s a great tool to have in the toolbox.”

For preps with greater retention, a self-adhesive, dual-cured resin cement like TheraCem will do the trick—plus, it offers the added benefit of continuous calcium and fluoride release, while transitioning from an acidic to an alkaline pH in minutes.1,2“

TheraCem bonds very well to zirconia and has streamlined the cementation process by eliminating the etching step,” noted Dr. George Reskakis, who has been using TheraCem since it came to market. “It has simplified what can be a challenging step in achieving restorative excellence.”

When it comes to cementing lithium disilicate, eCEMENT is up for the job, as it’s specifically formulated to meet the requirements for bonding to ceramics and is available in varying shades to restore esthetics. And, as veneers become more popular among patients looking for picture-perfect smiles, Choice 2 light-cured luting cement is an excellent “choice,” as it’s formulated for color stability and high esthetics, and will not shade shift over time.

“I love using the Milky Bright shade; it’s perfect for my veneer cases,” said Adriana Vasquez, DDS. “Choice 2 has a low film thickness to ensure the veneers are completely seated and is highly filled to ensure the veneers will stand up to daily stress over time.”

She added, “I’ve been using BISCO cements and bonding agents for as long as I’ve been practicing cosmetic dentistry. Not only will they do everything I need them to do from a bonding perspective, but I trust that I can consistently achieve a natural-looking result for my patients.”

_References

_{*As compared to untreated samples. Data on file.}

_{**Data on fi le. BISCO, Inc.}

_{1. ADA definitions for direct and indirect pulp capping: www.ada.org/en/publications/cdt/glossary-of- dental-clinical-and-administrative-ter}

_{2. Okabe T, Sakamoto M, Takeuchi H, Matsushima K. Effects of pH on mineralization ability of human dental pulp cells. J Endod.2006;32(3):198–201.}