Panavia SA: Choosing the Right Cement in a Monolithic World
The most recent trend in crown-and-bridge restorative options is a shift toward a 'monolithic' type of crown material and away from multilayered materials such as PFM or porcelain-fused-to-zirconia restorations.Clinicians often find themselves struggling to cement these new materials without overcomplicating their chairside techniques. Find out why Mark McOmie believes Kuraray's Panavia SA simplifies the transition from traditional to monolithic restorations, saves time, and eliminates confusion at chairside.
The most recent trend in crown-and-bridge restorative options is a shift toward a 'monolithic'-type of crown material and away from-multilayered-materials such as porcelain-fused-to-metal (PFM) or porcelain-fused-to-zirconia restorations. The reason-for this shift is multifaceted.
A Restorative Option
An inherent problem with a multilayered material is the bond strength from one layer to the next. We have all experienced the dreaded porcelain fracture of a PFM or porcelain-fused-to-zirconia restoration. These restorations rely on the bond strength of weak veneering porcelain combined with a strong substructure material. Until recently, these restorations were often our only option.Technological advancement in material science and fabrication methods now allow for the use of new monolithic materials, namely IPS e.max (lithium disilicate) and BruxZir (solid zirconia restorations).
The combined versatility of these materials has dentists shifting away from bilayered materials. According to Matt Winstead, vice president of Oral Arts Laboratory, a large commercial laboratory located in Huntsville, AL, "Over the past 18 to 24 months, we have seen monolithic metal-free restorations become more than 60% of our fixed case load. We're actually doing as many solid zirconia restorations as we are PFMs alone. More dentists are using IPS e.max on anteriors and BruxZir for posterior singles and bridges at the exclusion of nearly all other materials."
Another reason for the increasing popularity of monolithic restorations is that they lend themselves to the latest CAD/CAM fabrication methods adopted by many laboratories. Lab use of CAD/CAM technology in conjunction with monolithic materials is resulting in more precise margins and fit, as well as consistent morphology.
The Perfect Cement
Clinicians often find themselves struggling to cement these new materials without overcomplicating their chairside techniques. I use Panavia SA Cement from Kuraray and have found that it simplifies the transition from more traditional materials like PFMs to IPS e.max or BruxZir.
Panavia SA Cement (formerly known as Clearfil SA Cement) is a self-adhesive, dual-cured resin cement with fluoride release. It is packaged in handmix and automix syringes in Universal (A2) and White shades, and it can be used with PFMs, and full gold crowns, zirconia crowns, and lithium disilicate. A ceramic primer such as Clearfil Ceramic Primer (also from Kuraray) should be used when cementing lithium disilicate
(IPS e.max) and leucite-reinforced restorations (IPS Empress). Ceramic veneers, however, should still be bonded in place using a full resin.
Simplicity Is Key
As clinicians seek to remain current with the best restorative options, it is critical to find a cement, such as Panavia SA, that offers simplicity and versatility to save time and eliminate confusion at chairside.