It’s not surprising that many dentists have an armamentarium of cements for direct or indirect restorations, and they likely have their favorites depending on the procedure at hand. They may or may not agree that using a cement and bonding agent from the same manufacturer is a “necessity.” However, it’s important to keep in mind that companies formulate products to work together in a simplified protocol for reliable outcomes, and material choice can make a difference in achieving predictable long-term results.
The cement decision becomes trickier for indirect restorations, depending on whether it’s a non-retentive or retentive procedure. Dentists may be inclined to make technique decisions based on whether the restoration material is zirconia or e.max, and try to make their go-to cement work. However, it might be wiser to lead with the cement depending on whether or not the procedure is non-retentive or retentive. Understanding “why” comes down to understanding material composition.
Take, for instance, KaVo Kerr’s protocol with Maxcem Elite or Maxcem Elite Chroma cements plus OptiBond Universal bonding agent. Working together, they’re formulated to provide bond compatibility with various dental substrates for all indirect procedures, and to ensure high strength and a simplified protocol for more confident results.
Below, we’ll discuss some of the unique properties of these products. We’ll also discuss how their formulations make them well-suited to work together in an indirect, non-retentive preparation, in which cement will retain the majority of the retention.
Maxcem Elite and Maxcem Elite Chroma
Maxcem Elite is a self-etch, self-adhesive resin cement. It offers high bond strengths, predictable handling and ease-of-use, with excellent adhesion. It’s compatible with all indirect restorations, anterior or posterior ceramics, PFMs, metal restorations, and CAD/CAM block materials.
Following the success of Maxcem Elite, Kerr introduced Maxcem Elite Chroma, which provides an added advantage of a Smart Color Cleanup Indicator, in which the pink color fades at the gel state, allowing for optimal time to clean up excess cement. Additionally, Maxcem Elite Chroma offers long-term color stability for highly esthetic results.
Both Maxcem and Maxcem Elite Chroma offer the brand-proprietary “One-Peel cleanup” to ensure easier and consistent cleanup. Additional advantages include dual cure, no hand mixing, and no refrigeration required.
OptiBond Universal in a Non-Retentive Preparation
While Maxcem Elite products can be used on their own as self-adhesive cements, they can also be paired with OptiBond Universal, a single-component universal adhesive, for added strength when needed on a non-retentive preparation. This is because OptiBond Universal can be used as a silane surface treatment. Silane coupling agents are synthetic hybrid inorganic-organic compounds used to promote adhesion between dissimilar materials.
OptiBond Single-Component Adhesive combines KaVo Kerr's patented GPDM Monomer technology and Ternary Solvent System to effectively etch enamel while promoting the priming and sealing of dentin. It delivers excellent penetration into dentinal tubules to ensure maximum bond strength and protection against microleakage and postoperative sensitivity, with an application time of 30 seconds.
Maxcem Elite paired with OptiBond Universal’s patented GPDM Monomer offers more effective and reliable adhesion than other systems, according to company data on file. This comparison specified that the material was used in self-etch mode with adhesive light-cure and cement self-cure. However, a product manager at KaVo Kerr also told Dental Product Shopper that Maxcem Elite/Maxcem Elite Chroma and OptiBond Universal can be used together in “dark cure”—without light-curing the adhesive—to save a step. “The result is virtually no film thickness, fewer seating issues, and imperceptible margins,” she added.
For more information about procedure, including a technique guide, consult OptiBond Universal product documentation.
Choosing the Right Cement
When it comes to cement choice in indirect procedures, Dr. Greg Gillespie of Vancouver, WA, has found success by letting his prep design be the key determinant of which cement he should use.
He divides prep design into two categories: retentive and non-retentive. For retentive prep designs, almost any cement will work, he says, because he’s relying on the tooth for the majority of the retention, whereas for non-retentive prep designs, he relies on cement to retain the restoration on the tooth.
“So let the prep design determine what type of cement you’re going to use and then determine how you’re going to get that cement to work with the restoration you have, whether it be e.max or zirconia,” Dr. Gillespie advises.
Click on the video screenshot below and fill out the form to view Dr. Gillespie’s sequence on choosing the right cement every time.
