ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Conjunction With Zirconia Restorations, Resin Cements Exhibit Superior Qualities in Comparison to Other Luting Agents
Clinical Question When placing zirconia restorations, does using resin luting agents yield more beneficial results than conventional cements (Glass ionomer, polycarboxylate)?
Clinical Bottom Line Zirconia implants and zirconium oxide ceramic restorations used with resin cement luting agents have higher retention and tensile strength in comparison with other luting agents such as glass ionomer cements.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22092303Nejatidanesh/2011Twenty ITI solid abutmentsLaboratory study
Key resultsThis article compared the retention values of different luting agents in conjunction with zirconium ceramic copings. The sample size for the study was 90 ceramic copings; these copings were then grouped into ten. The cements that were included in the study were: resin cements (Clearfil SA, Panavia F2.0, Fuji Plus), conventional cements (Fleck’s, Poly F, Fuji I), and temporary cements (Temp Bond, GC free eugenol, TempSpan). These cements were incubated, conditioned with saliva and thermal cycled. The value was then recorded for the amount of force it took to dislodge the coping from the abutment. The recorded values showed a significant difference between the mean rank retention values of different luting agents (P < 0.001). The resin cements showed the highest retention (Clearfil SA, 203.49 ± 52.86; Fuji Plus, 190.61 ± 48.00; Panavia F 2.0, 172.16 ± 70.76 N).
#2) 16429187Marchan/2005Thirty- two extracted, caries-free, unrestored teethLaboratory study
Key resultsIn this comparative study endodontically treated teeth were randomly assigned into two groups (n=16). These teeth were then decornated and prepped to 10 mm in depth, each tooth received a zirconium dioxide post that measured 1.4 mm in diameter. The teeth were then cemented to a resin block using either resin cement (Variolink II) or glass ionomer cement (Fuji I). The mean stress value of both groups was tested for statistical differences p< 0.05. The mean peak forces at failure (N) and the standard deviation for the tested cements were recorded as follows: Fuji I = 121.8 (±17.4) and Variolink II = 228.1 (±36.8). The data that was recorded verified that the posts luted with resin cement exhibited higher tensile bonding strength than the posts that were luted with glass ionomer cement (p<0.05).
Evidence Search ("zirconium oxide"[Supplementary Concept] OR "zirconium oxide"[All Fields] OR "zirconia"[All Fields]) AND different[All Fields] AND ("dental cements"[MeSH Terms] OR ("dental"[All Fields] AND "cements"[All Fields]) OR "dental cements"[All Fields] OR ("luting"[All Fields] AND "agents"[All Fields]) OR "luting agents"[All Fields])
Comments on
The Evidence
The substantial findings of Nejatidanesh et al. supports the retentive properties of resin cements. This study evaluated nine different cements by testing the dislodging force it required for the coping to be separated from the abutment. The testing included environmental stresses and factors that implants would be subjected to on an everyday basis such as saliva and thermal cycling. In the study done by Marchan et al. the teeth were randomly divided into two groups and were treated the same except for the cement that was used as the luting agent. Tensile force was applied to all teeth until failure occurred. Although the zirconia cement posts were recorded as having higher tensile strength they also had a higher failure rate. This outcome may be overcome through techniques such as air abrasion. Due to the fact that these studies were preformed in vitro, randomized clinical trials in human subjects would be needed in order to confirm the outcomes reported.
Applicability Proper selection of a luting agent is a critical step in the restorative process. This selection can be the determining factor in the longevity of a restoration. With the plethora of different luting agents available it can be difficult to choose a product that exhibits adequate compatibility as well as desirable physical properties. Resin cements have been proven to be highly successful luting agents for zirconia restorations. Research has shown that surface treatment techniques such as airborne particle abrasion increases the bond strength between the two materials. It is important to keep in mind that in order to insure the cement will perform to its optimal level clinically, adequate resistance and retention form is always necessary.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Resin cements, luting, zirconia, tensile strength, retention
ID# 3022
Date of submission: 04/12/2016spacer
E-mail melendezlm@livemail.uthscsa.edu
Author Lauren Melendez
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kevin J. Donly, DDS, MS
Faculty mentor/Co-author e-mail DONLY@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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