How a self-adhesive resin cement changed one doctor’s bias

For 25 years, Dr. Jonathan Ferencz, an experienced prosthodontist based in New York City, has carried around a bias against resin cements. His concerns were twofold-one, the process seemed more complicated with more steps, and two, his patients frequently complained of post-operative sensitivity.

Dr. Ferencz, who is a Clinical Professor of Prosthodontics and Occlusion in the Department of Advanced Education in Prosthodontics at the New York University College of Dentistry, where he has taught since 1972 and is Adjunct Professor of Restorative Dentistry at the University of Pennsylvania School of Dental Medicine since 2014, says he first used a zinc oxyphosphate cement. However, this cement has to be mixed precisely or it would cause patients to experience post-op sensitivity, he says.

“Because we had so many patients at NYU complaining soon after the crowns were cemented, we switched to a cement that was known as EBA cement, and suddenly the sensitivity stopped,” Dr. Ferencz says. “But after two years, crowns started to pop off. So, you can imagine how many crowns we were faced with that had come off and had to be recemented. So, that’s a really painful mistake."

But for Dr. Ferencz, that changed about three months ago when he finally relented and tried SpeedCEM Plus from Ivoclar Vivadent.
“Ivoclar finally convinced me to try this new version of cement, SpeedCEM Plus,” Dr. Ferencz says. “What amazed me was one it was incredibly simple to use because you didn’t have to etch, and then wash, use another bonding agent, and then mix the cement,” he says. “You basically just isolated the tooth…injected the cement into the crown and seated it.
“The beauty of SpeedCEM Plus is that there’s an initial cure, a pre-cure of, I believe it’s one second in four locations of the tooth,” Dr. Ferencz continues. “So it’s on the labial surface, a cure on the mesial labial, the distal labial, the mesial lingual, and the distal lingual, and it’s a very quick cure.”

Another feature of SpeedCEM Plus that got Dr. Ferencz and his team very excited was their ability to easily trim the cement. If let sit past its cure time, resin-reinforced glass ionomer can often feel like chipping concrete when removing excess cement, he says.

“When you cement a crown, you don’t put in just enough cement, because there, you are fearful you wouldn’t have enough,” Dr. Ferencz says. “You want to have some excess that extrudes at the crown margin. So, if the trim time is at the end of three minutes and you get distracted and go back in five minutes, it’s so hard to remove.”

After seating the crown and an eight-second cure, the clinician can then trim, he says. During the initial trim, he uses a curing light. Next, he checks the contacts with a piece of floss, using caution to keep it isolated until it comes to its final dual cure, which is about four minutes, he says.

Since switching to SpeedCEM Plus, Dr. Ferencz has zero reported instances of post-operative sensitivity. He’s been so impressed, that it’s replaced his day-to-day cement.

“I first started on a couple of endodontically treated teeth where there would be no post-op sensitivity, was so impressed with the ease of use I started using it on vital teeth,” Dr. Ferencz says. “I use it virtually every day.
“You save some time at the chair,” he continues, “it’s easier to treat the tooth, it’s easier to trim. The film thickness seems to be really, really good because I don’t have significant occlusal adjustments afterwards. If someone were looking over my shoulder and saying, ‘Why are you using it?’ I would say, ease of use is important, but it is the most retentive cement ever used in dentistry. I’ve not had any crowns come out after they have been cemented with SpeedCEM Plus. For me, the most important elements are excellent retention, ease of use, and no sensitivity.” 

SpeedCEM Plus

SpeedCEM Plus is a self-adhesive resin dual-cure cement well suited for the permanent cementation of zirconia and metal ceramic restorations. Its formulation is designed to be suitable for use in restorations with zirconium oxide and metal-ceramics and for the cementation of restorations on implant abutments. SpeedCEM Plus makes primer and adhesive unnecessary in zirconia and metal ceramic restorations thanks to its MDP-based formula.

Ivoclar Vivadent
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