Product Evaluation

BISCO

Z-Prime Plus

Z-Prime Plus significantly enhances bond strengths to zirconia, alumina, and metal restorations

It’s a simple truth. Sometimes a restoration fails to remain cemented in a patient’s mouth. After discovering that some of his patients’ zirconia crowns were debonding and failing after only 2 or 3 years, Michael Slomnicki, DMD, became worried about the long-term retention of zirconia crowns. Like most dentists, Dr. Sean Grady experienced a similar problem, explaining, “There is sometimes inadequate retention of final restorations with resin cement.”

How can these dentists increase their confidence that restorations will remain securely adhered for years?

The answer is BISCO’s Z-Prime Plus, a single-component priming agent that enhances the bond strength of resin cements to zirconia, alumina, and metal substrates. After giving Z-Prime Plus a trial run in their practices for a few weeks, both dentists said they have more confidence in the long-term retention of their restorations.

“I can be assured that Z-Prime Plus adheres to the crown, because I can see it shine on the crown just like bond does to dentin,” said Dr. Slomnicki. Z-Prime Plus “gives me confidence that it strengthens the resin cement’s ability to bind the crown to the tooth,” he added. Although long-term retention could not be measured in this short-term evaluation, Dr. Grady shared, “As a bond enhancer, my hope is it will allow for long-term retention of restorations seated with resin cement. With increased confidence you feel as though you are doing a better job.”

Ease of Use

Available in 2-mL and 4-mL bottles, Z-Prime Plus is easy to dispense and apply from a single bottle. “BISCO’s Z-Prime Plus is extremely easy to apply to my crowns,” said Dr. Slomnicki, and Ken Bendik, DMD, called it “very easy to use,” noting that he especially liked the room temperature storage. Dr. Adriana Rodriguez identified “size of the bottle and ease of use” as her favorite features, and Sherwood Tucker, DDS, said he appreciated its ease of use and dual-cure compatibility along with no need for mixing and no refrigeration required.

After seating 4 anterior zirconia crowns that were pre-treated with Z-Prime Plus, Dr. Grady said, “It was easily applied and did not interfere with the cementation protocol. It really didn’t require any extra time to apply during the luting process.” Kari Haganman, DDS, agreed that applying Z-Prime Plus did not increase chair time while seating zirconia crowns. Describing it as easy to dispense and quick to use, with no additional time required, Dr. Anthony Schwartz said the material’s “excellent viscosity” was his favorite feature.

Versatility

Suitable for a range of different substrates, Z-Prime Plus is versatile and compatible with both light- and dual-cured resin luting cements. “I liked that I could use it for so many different procedures [and with] so many materials,” said Paul Olenyn, DDS. “By adding this extra step and using Z-Prime Plus, we were able to increase the bond strength of zirconia restorations,” shared Dr. Sheldon Seidman. Dr. Haganman described a successful outcome after “placement of a 4-unit zirconia bridge with short abutment teeth,” and Dr. Slomnicki commented, “It especially gives me more faith in the ability to retain crowns in minimal height crown preps. My cements are just more adhesive.” When asked about potential improvements, Dr. Grady said, “It would be nice to have a universal product that will work equally well with resin and glass ionomer cements.”

Bonding/Retention

Z-Prime Plus is formulated with a unique combination of MDP and BPDM, which produces a synergistic effect, resulting in high bond strengths to zirconia, alumina and metal substrates, according to BISCO. “I don’t know the chemistry, but the cement bond is incredibly strong in just a minute,” said Dr. Schwartz, who explained that it “enhances retention in nonretentive cases.” With Z-Prime Plus, Dr. Rodriguez said she had “no sensitivity or lack of retention reported” and found it beneficial “in every crown that has been placed.” Dr. Haganman did not have to rebond any restoration on which she used Z-Prime Plus, and Dr. Grady said it’s a great feeling “when you are confi dent the restorations will bond better to the preparations.”

Dr. Slomnicki said Z-Prime Plus increases his confidence in the long-term retention of his crowns. He explained that other primer-type products evaporate, “leaving the clinician to just have faith that it will work,” but this is not the case with Z-Prime Plus. “It leaves a great shine on the crown, [which] reassures me that it was applied correctly and will work.”

Overall Satisfaction

Most of the evaluators said they would purchase Z-Prime Plus in the future, including Dr. Slomnicki, who said, “[Z-Prime Plus gives me] reassurance that resin cements on zirconia crowns will have a high success rate.” Acknowledging that it’s hard to predict the long-term success of a product in a short evaluation period, Dr. Seidman concluded, “If it does what it says, it will be a great addition to our luting procedures.” Dr. Bendik agreed and said, “If the product works as advertised in the long term, [it will be] a must-have product.”

"[Z-Prime Plus gives me] reassurance that resin cements on zirconia crowns will have a high success rate."
-Michael Slomnick, DMD
Woodmere, NY

Takeaways

•Enhances bond strengths to zirconia, alumina, metal restorations, and other resin cements
•Unique combination of MDP and BPDM produces a synergistic effect, resulting in high bond strengths
•Versatile and durable with a range of substrates
•Single-bottle delivery for easy dispensing and application
•Compatible with light- and dual-cured resin luting cements