Choices Abound for Restoration Placement
CHARLOTTE ? Developments in recent years have given clinicians an array of cementation options for providing the best treatment for their patients, according to a speaker at the Updates in Contemporary Dentistry Meeting, held here recently.
Robert. G. Ritter, DMD, noted that cementation has had a literally messy history, with older options such as zinc phosphate, zinc oxyphosphate, zinc polycarboxylate, or original traditional glass ionomer cement posing challenges for clinicians, including difficulty mixing, poor bonding, postoperative sensitivity and, with the exception of glass ionomer cements, also lack of fluoride release.
However, with the more recent introduction of resin-modified glass ionomers, clinicians have choices that offer ease of use and low postoperative sensitivity. Calling attention specifically to the RelyX line, Dr. Ritter noted that this luting cement line was introduced by 3M ESPE in 1994 and quickly gained popularity for its easy clean-up and low incidence of sensitivity. He noted that this cement has been tested and the data suggest that this it has held up in areas of use such as porcelain-fused-to-metal (PFM) crowns and bridges; metal crowns, bridges, inlays, and onlays; as well as other areas such as prefabricated or cast posts and orthodontic appliances, which makes it a solid choice.
Elaborating on areas of use, Dr. Ritter called out RelyX Unicem 2, which he noted has shown improved dentin bond, lower wear, improved flexural strength, and color stability over the previous version. He also noted an improved bond to Lava restorations, which he said is key, and called out the product?s availability in a Clicker Dispenser, which he said makes it even easier to use.
Etching and Adhesive Choices
Discussing different types of etching and adhesive techniques, Dr. Ritter noted that while total-etch adhesives require phosphoric acid etching and are applied in 1 or 2 layers, the self-etch adhesives have the acid built into the adhesive. The etch-and-rinse category includes both 3-step and 2-step adhesives that remove the smear layer, whereas the self-etch category includes 2- and 1-step adhesives that modify the smear layer without removal. He shared this pearl with the audience: for anterior cements, light-cure should be used to ensure no color shift; for posterior cements, he said, dual cure is appropriate.
Summarizing his presentation, Dr. Ritter advised the audience that it is important to consider all of the options for patient treatment, weighing in strengths, technique sensitivity, and finally, esthetics for a good overall result.