Dental Cement Guide: Understanding the science behind the products

Dr. John C. Comisi, DDS, MAGD;

Dental Cement Guide: Understanding the science behind the products

August 28, 2013

Dental Products Report, Dental Products Report-2013-08-01, Issue 8

With the use of newer materials on the rise, the world of cements (luting agents) in dentistry has rapidly evolved to meet the needs of today’s practitioners. It’s more critical now to understand the science behind the products and behind the materials, and to know just what you can expect from the products you use.

The world of cements (luting agents) in dentistry is rapidly evolving. Years ago we had it fairly simple. There were three basic types of cements; cements based on Zinc Oxide (ZOE, ZOP and Polycarboxylate), cements based on Alumino-Silicates (glass ionomers and silicate cements), and eventually resin cements.

Life also was simpler because the substrates we were trying to cement to tooth structure were basically one of two types: metal (castings/porcelain fused to metal casting) or “Porcelain Jacket” (PJC) type crowns. These PJCs were brittle and problematic, but they were certainly a leap forward, from an esthetic viewpoint.

Resin cements gained favor over the course of time because they worked well for both retentive and “non-retentive” preparations. But they also had their inherent challenges as well, because some bonding agents and resin cements created, in some cases, sensitivity.

Fast forward to today. With the introduction and use of our newer ceramics (lithium disilicate, zirconia, etc.) to add to our traditional full cast and PFM crowns we have added a bit of complexity. We now need to understand the steps necessary to get the lithium disilicate- or zirconia-based crowns to properly adhere to the luting cements we are using.

How best do we prepare the intaglio surface and the prepared tooth for cementation and which type of luting agent would be best? In addition to the three luting agents previously mentioned, the recent addition of many new resin modified cements, continued improvements to our resin cements/bonding systems and the introduction of a “nanostructurally integrating cement” bring many new interesting considerations to the cementation equation.

Which claims are valid? How easy or difficult are these materials to work with? What type of longevity can we expect from them? Understanding the science behind the products and behind the materials we intend to use are more important than ever.

Bottom line: 1) Understand if your preparation is a retentive or non-retentive type. 2) Understand how to prepare the intaglio surface properly before cementation. 3) When in doubt, read the instructions. That is what they are there for.

Below, you’ll find links to articles where you’ll find some of newest and best cements available, along with testimonials from clinicians and industry insights from some of the manufacturers.