The Keys to Strong Zirconia Restorations

As Dr. Robert Mokbel puts it, “Dentistry is a lifetime learning experience. Over the years, the industry has constantly evolved—introducing new materials and techniques while consistently striving to improve clinicians’ daily workflows.”

This includes ushering in a new era of restorative materials. Despite gold and porcelain-fused-to-metal being the standard of care for decades, zirconia has become an increasingly popular material choice thanks to its durability, strength, and esthetics.

Fortunately, BISCO offers a full suite of products designed to optimize the success of zirconia bonding procedures, including ZirClean, Z-Prime Plus, All-Bond Universal, and Duo-Link Universal—all of which have become trusted staples in Dr. Mokbel’s practice in Fountain Valley, CA.

“BISCO has made zirconia cementation very simple and very reliable,” he assured. “With an understanding of proper chemical procedures and bonding protocols, today’s dentists have access to everything they need to reliably provide great quality zirconia restorations.” 

Cleaned and Primed for Success

One of the most important steps in ensuring strong, reliable zirconia restorations occurs early in the bonding procedure: properly cleaning the restoration after intraoral try-in. Even if the restoration is rinsed with water, ethanol, or acetone, only solutions that are alkaline in nature will effectively remove remaining contaminants, which can inhibit bond strength.

Enter ZirClean—an alkaline, nonabrasive cleaning gel for decontaminating the bonding surface of restorations following intraoral try-in. Available in a user-friendly syringe with disposable mixing tips for easy placement, ZirClean eliminates the phosphate contaminants from saliva within just 20 seconds. Then, it can be easily rinsed off with water before applying an MDP-containing primer like Z-Prime Plus.

“I usually sandblast all my crowns and use an ultrasonic bath before trying them in the patient’s mouth,” Dr. Mokbel said. “Using ZirClean and Z-Prime Plus, I feel more confident in my bonding technique. It adds only 30 seconds to my cementation technique to ensure that bonding doesn’t fail.”

A convenient, single-component priming agent used to enhance adhesion between indirect restorative materials and composite resin cements, Z-Prime Plus features a unique combination of 2 active monomers that creates a synergistic effect—ultimately resulting in improved bond strength.

With over a decade of experience using Z-Prime Plus, one of the dental industry’s first primers dedicated to zirconia restorations, Dr. Mokbel added, “While many speakers and dental schools were saying that bonding to zirconia was impossible, I was routinely using Z-Prime Plus on all my zirconia crown cases and found it very reliable.”

The Ultimate Restorative 'Dream Team'

Dr. Mokbel recalled a particular case where he was recementing 2 zirconia crowns on a patient with short teeth that measured just 3 mm. After checking the occlusion and making sure the crowns were still in good condition, he knew exactly which products to use: All-Bond Universal and Duo-Link Universal.

All-Bond Universal is a versatile, single-bottle universal adhesive compatible with all curing modes and any bonding technique. It can be used on wet, dry, or moist tooth structure and bonds to all substrates, including zirconia. “I like that All-Bond Universal doesn’t need an activator,” Dr. Mokbel said. “It also doesn’t cause any sensitivity, even in deep preparations.”

Duo-Link Universal is a dual-cure adhesive resin cement compatible with all dental materials. Pairing perfectly with All-Bond Universal, it is specifically formulated for the cementation of all indirect restorations. With that, this innovative duo simplifies adhesive cementation procedures with fewer products while also delivering durable, esthetic treatment outcomes, especially when used with Z-Prime Plus.

“I cleaned and sandblasted the crowns to remove any remnants of the previous cement, placed them in an ultrasonic, and allowed them to air dry before treating them with Z-Prime Plus and setting them aside,” Dr. Mokbel explained. “Next, I placed an isolation system, cleaned the teeth with a cavity cleaner, and then applied All-Bond Universal and injected Duo-Link Universal into the crowns to seat them on the preparation.”

He continued, “Needless to say, it all went well. We tacked the cement with a curing light for a few seconds on each side, and the rest was history. Cleanup was very easy and quick, and the patient was very pleased.”