Dr. Mark Latta, Dean and Professor of General Dentistry at
the University of Creighton School of Dentistry, discussed
the adhesive cementation of ceramic and composite based
substrates. Cementation is a critical step in the process of
assuring retention, marginal seal and long-term survivability
of indirect restorations. While traditional “luting” cements are
still widely used, more recently resin derived adhesive cements
have been developed to promote enhanced retention and
sealing of crowns, bridges, inlays and onlays. The selection of
the proper cement depends on the operator’s evaluation of
several key variables. These include the restorative material
(conventional ceramic, oxide ceramic, lithium di-silicate,
composite resin, metal), the retention and resistance form of
the tooth preparation, the tooth substrate condition, the ability
to isolate the tooth or teeth in question and the caries risk of
the patient. While resin cements have many superior physical
properties compared to conventional luting materials (high
tensile and compression strength, low solubility for example)
and are esthetic, they can be subject to technique sensitivity
especially when maximum adhesion is needed for a given
clinical situation. Careful attention is required to follow all the
steps in proper order and with the recommended time for
each step for assuring clinical success.
Dr. Rick Walter, Clinical Associate Professor of Restorative
Dentistry at the University of North Carolina School of Dentistry
ended the morning session with an excellent evidenced based
review of adhesion protocols for post and core strategies for the
endodontically treated tooth. There were several important take
home pearls from this presentation. When minimal to no tooth
structure is present coronally, a post is required to secure the
foundational buildup. Adhesion down the post canal is more
challengin