What are the advantages and disadvantages of self-adhesive resin cements for crown & bridge cementation?
This question was submitted to us by a practising dentist: What are the pros and cons of self-adhesive resin cements (i.e.: RelyX, Unicem 2) and resin modified glass ionomers (i.e.: FujiCEM 2) in crown and bridge cementation? Are they equally reliable?
Dr. Omar El-Mowafy, Head of Restorative Dentistry at the University of Toronto provided this initial response:
Advantages of self-adhesive resin cements
1. Eliminate the need for etching tooth structure or application of primer/bonding agent; and as a result, dramatically reduce the potential for post-operative sensitivity .
2. Dual-cured: excess cement can be briefly light-cured for ease of use. When used with a non-metallic crown, light-curing can be performed through the crown material for faster initial set.
3. Majority of products are provided in a double-barrel tube with auto-mixing tip which eliminates the potential for air bubble incorporation and allows direct delivery into crown or retainer.
Disadvantages of self-adhesive resin cements
1. Has lower bond strength to tooth structure as compared to resin cements that use etch and rinse steps.
2. Should not be used in situations where mechanical retention is compromised.
3. Not all self-adhesive resin cements perform in the same way. Dentists must pick and choose products with documented reliability.
Resin-modified glass ionomer cements have the added potential of fluoride release and chemical bonding to tooth structure. Unfortunately, I haven’t had the chance to test Fuji CEM 2.
Suggested readings
Kandil M, De Souza G, Alkumru H, El-Mowafy O. Microtensile bond strength of self-adhesive resin cements to e-Max crowns. Paper accepted for presentation at IADR in Seattle, March 2013. (Abstract provided here).
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Would rather refer advantages of self-adhesive resin cements over their cons! Benefits of removal of imprinting tooth structure and any other bonding agents are really good. Their practice with a non-metallic crown will certainly ensure a light-curing performance through the crown materials; no more post-operation sensitivities, much favorable!