Dental materials continue to evolve and improve in many areas. Zirconia restorative materials are one of the fastest evolving ceramic materials currently in dentistry. There are a few very common questions asked to me during my lectures and to laboratories regarding the cementation and adhesion process of zirconia ceramic restorations. The first thing that needs to be done is to check that the ceramic restoration has been properly etched by the laboratory. In the case of zirconia restorations they are not etched nor do they need to be, however they should be sandblasted with 50 micron aluminum oxide particles at a pressure of 35-50psi followed by steam cleaning or placement in an ethanol ultrasonic bath. All other ceramics will need to be etched prior to tryin and silanated. The second task that will need to be done prior to trying in any ceramic restoration is to properly silanate any ceramic restoration if either a resin modified glass ionomer cement or an adhesive resin cement is to be used. The only exceptions to this would be if you were to use a traditional glass ionomer cement or a calcium aluminate cement (Ceramir by Doxa). Once again, if you use a resin modified glass ionomer cement, a self etching dual cured resin cement, or a light or dual cured resin cement with an adhesive you need to silanate the ceramic. Silanating a restoration prior to try-in is done to facilitate less steps at the delivery appointment and minimize the clean up process after try-in. Numerous silanes are on the market, some are prehydrolyzed and some are not. Silanes and adhesives that have MDP chemistry have been shown in some research to provide better long term adhesion to ceramics as well as tooth structure.
After trying the restoration in the mouth it must be cleaned properly. This will be the focus of the next Blog Posting.