resin bonded FDP

the practices of survey in northern germany revealed a relatively _____ rate of dentists used evidence-based dental techniques for bonding oxide ceramics

low (7-14%)

choosing a cement depends on…

the material being used for the restoration

how does mechanical strength change on this diagram

from left to right it will increase

how does optical translucency change on this diagram

from left to right will decrease

recall: lithium disilicate properties vs zirconia

• lithium disilicate: more translucent, pressable and CAD/CAM, laminated/monolithic, lower flexural strength 215-400 MPa

• zirconia: more reflective, only CAD/CAM, laminated/monolithic, higher flexural strength 900-1200 MPa

between ltihium disilicate and zirconia, which MUST be bonded and which does NOT require bonding

• lithium disilicate: MUST be bonded

• zirconia: does NOT require bonding

2 kinds of definitive cementation

• adhesively

• cohesively

types of cohesive luting cement

• zinc phosphate

• polycarboxylate

• resin-reinforced GI

• resin

definition of cohesive cement

• no adhesive interaction between the surfaces

• rely on the retentive form

definition of adhesive bonding cement

the true adhesion between the two joining materials

type of adhesive bonding cement

resin

why does lithium disilicate HAVE to be bonded but zirconia and be either cohesively or adhesively bonded

• lithium disilicate: mechanical strength is NOT enough

• zirconia: mechanical strength is usually strong enough to where you don’t need to bond→ but i fthis is compromised, then you should bond

rank the types of cohesive cements from greatest to least compressive strength

resin > RRGI > ZPC > PCC

why is temporary cement easy to break

bc it has a low compressive strength

advantages of zinc phosphate cement

• history of use

• adequate strength

• minimal film thickness

• easily remove excessive materail

disadvantages of zinc phosphate cement

• not translucent

• solubility

• mixing technique sensitive (will set if you mix too fast/slow)

indications for zinc phosphate cement

full coverage cast restorations (e.g. gold, pfm)

advantages of polycarboxylate cement

• relative biocompatible

• adhesion to dentin

• less technique sensitive

disadvantages of polycarboxylate cement

• not translucent

• solubility

• low strength (but more than temp cem.)

• high viscosity

indications for polycarboxylate cement

long term provisional restorations

examples of resin-reinforced GI cement

• relyX luting 3M

• fuji plus GC

• protec CEM (vivadent)

advantages of resin-reinforced GI cement

• higher strength (almost similar to resin)

• clean-up easy (water soluble)

• less early moisture susceptible

• translucency

disadvantages of resin-reinforced GI cement

expand during setting (so if crown material isn’t strong enough and this happens → fx)

contraindications for resin-reinforced GI cement

• glass all ceramic restorations: feldspathic porcelain, lithium disilicate

• post and core (unicem)

indications for resin-reinforced GI cement

• casting metal restorations

• metal ceramic restorations

• zirconia-based all ceramic restorations

classifications of resin cement

• self-adhesive resin

• dual-cure resini

• light-cure resin

what type of resin cement does not require the provider to follow bonding protocol

self-adhesive

what type of resin cement requires teh provider to follow bonding protocol

• dual-cured resin

• light-cured resin

types of light-cured resin

• relyx veneer (3M ESPE)

• variolink esthetics LC (ivoclar vivadent)

advantages of light cured resin

• superior bonding strength

• working time

• color stability

disadvantages of light cured resin

• strict bonding protocol

• clean up after setting

• critical need for light to ensure proper cure

indications for light cured resin

all ceramic veneers

after you remove the provisional on delivery day, what should you use to remove the residual bondings on the tooth

carbide bur w slow speed and clean prepped surfaces

after you try on veneers and your pt approves, what is the ceramic tx if the material is feldspathic porcelain

1. 10% hydrofluoric acid etch

2. put in 95% alcohol ultrasonic bath for 4 min

3. silanization

what does etching and alcohol ultrasonic bathing your porcelain do for you

makes the surface rough/inc surface tension and removes crystal to improve bonding

why must you put the etched veneer in put in 95% alcohol ultrasonic bath for 4 min

removes crystals → if you don’t do this → will dec bond strength by 40%

after you try on veneers and your pt approves, what is the tooth tx you must do to prepare for cementation

1. retraction cords → 1 is enough

2. pumic powder to clean tooth surface

3. 37% phosphoric acid etch → rinse and dry

   1. enamel: 30 sec → most likely this since veneer prep is mostly enamel

   2. dentin: 15/20 sec

4. apply bond → air thin → DONT light cure

purpose of retraction cord prior to veneer cementation

1. micro moisture control → from gingival fluid

2. cleaning of cementation

silanization primers goes onto…

the ceramic side

purpose of adding silanization primer on ceramic

• improve wettability

• improve bond strength

silanization primer contributes to ________ bond

covalent

silanization primer helps w the formation of _________ bond w OH group on porcelain

siloxane

when you are ready to cement your veneer, how and where do you dispense the cement

thin layer on the veneer side

what to do after you seat the cemented veneer

1. tack cure

2. remove excess

3. do adjacent

4. complete curing

5. remove retraction cords

types of self-adhesive resin

• relyx unicem (3M ESPE)

• speedcem (ivoclar vivadent)

advantages of self-adhesive cement

• superior mechanical properties

• simplicity

• versatility

disadvantages of self-adhesive cement

relative less bonding strength

indications for self-adhesive cement

• all ceramic crowns a proper retention form

• unicem → post and core

what allows self-adhesive cement to not require other bonding protocols

has a functional monomer MDP → this has a hydrophilic group that:

• is a low acid → self-etch → acidity for decalcifications

• form chemical bond w Ca (bc it is a neg and ca is pos)

• form chemical bond w zirconia and metal

why can’t you use a self-adhesive cement for a partial coverage restoration

you don’t have enough retentive features so you cannot rely on bonding; charts show adhesive and resin cements have higher shear bond strength than self-adhesive resin cements when on dentin

examples of dual cured resin cement

• variolink esthetics DC (ivoclar vivadent)

• relyx ultimate (3M ESPE)

advantages of dual-cured resin cement

• superior mechanical strength

• superior bond strength

• less critical need for light to insure proper cure

disadvantages of dual-cured resin cement

• strict bonding protocol

• working time- v limited

• clean up after setting

indications for dual-cured resin cement

• all ceramic crowns

• ceramic onlays/inlays

• resin-bonded FPDs

after rubber dam isolations, what is the tooth surface tx for seating when using DC resin cement

clean tooth surface

• 27 micro abraded, 40 psi

• pumice powder

after cleaning the tooth surface, how do you etch the tooth if you are doing a total etch technique

37% phosphoric acid

• enamel: 30 sec

• dentin: 15 sec

after cleaning the tooth surface, how do you etch the tooth if you are doing a selective etch technique

37% phosphoric acid: enamel 30 sec

bonding application protocol for scotchbond after etching

• apply w rubbing motion for 20 sec

• air thin for 5 sec

• optional light cure

bonding application protocol for adhese universal

• apply for 20 sec

• air thin

• light cure for 10 sec (required)

ceramic surface treatment for etching feldspathic porcelain

9.6% HF for 2-3 min

ceramic surface treatment for etching leucite-reinforced glass (Empress)

5% HF for 1 min

ceramic surface treatment for etching lithium disilicate (emax)

5% HF, 20 sec

mechanical ceramic surface tx for lithium disilicate

etch w HF acid

chemical ceramic surface tx for lithium disilicate

silane primer

protocol for ceramic primer application

apply and react for 60 sec → air dry

after loading resin cement in restoration, what do you do upon seating

1. immediately remove the excess

2. 60 sec light cure from each surface

3 main steps for zirconia surface tx

1. clean

2. roughening

3. activation

why do we need to clean zirconia prior to roughening

ivoclean…

protocol for zirconia roughening

aluminum-oxide air abraded, 50 microns, .2 MPa, for 5 sec

how to “activate” step of zirconia

MDP ceramic primer adhesion to zirconia

should you still etch and bond on the tooth when doing zirconia

YES

5 yr success rate of resin-bonded bridges w metal framework vs non-metal framework

metal framework > non-metal framework

w the 5 yr success rate of resin-bonded bridges done w metal framework, what was the success of 1 vs 2 retainers

1 > 2

w the 5 yr success rate of resin-bonded bridges done w/o metal framework, what was the success between in-ceram alumina vs zirconia vs fiber-reinforced composite

in-ceram alumina > zirconia > fiber-reinforced composite

technical complications found w resin-bonded bridges

• debonding of frameworj 82%

• fracture of framework 15%

biological complications found w resin-bonded bridges

• caries 1.7%

• periodontal disease .6%

5 yr clinical performance of resin-bonded bridges is ______ to the performance of conventional PFM bridges (94.4%) and implant-support crowns (93.8%)

similar

resin-bonded bridges is an esthetic and conservative ____________ (interim/permanent) tx option that can be successfully done utilized in favorable clinical situations

interim

why is it important to ensure full growth on a pt is done prior to implant placement

• pts w vertical growth patterns might have had a prolonged period of facial growth in the vertical plane

• single tooth implant in a subject w this patter could be placed layer than in a person w a horizontal growth pattern