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HATTERSHEIM AM MAIN, Germany: Prosthodontic treatment concepts have evolved greatly over the past decades. Whereas porcelain-fused-to-metal crowns and bridges used to be placed whenever a defect was too large for a direct restoration, the current trend is towards less invasive therapies using highly aesthetic, tooth-coloured materials.
These modern treatment concepts can lead to reliable outcomes when a high-performance resin cement system is used to establish a durable bond to both the tooth structure and the restoration. The reason for this is that a less invasive treatment often means that restorations have minimal or no retentive elements and extremely thin walls, and a strong chemical bond can hold them in place over time. Depending on the type of restoration, the aesthetic properties of the cementation system can also be extremely important as the typically highly translucent, thin restorations reveal the appearance of the structures underneath to a certain extent.
To streamline clinical procedures in restorative dentistry, several manufacturers have developed resin cements that work with fewer components and are applicable across a large number of indications. PANAVIA SA Cement Universal is a popular example. The self-adhesive, dual-cure resin cement from Kuraray Noritake Dental is the only product of its category that works without the need for a separate primer even when used on glass ceramics.
The need for specialist cement systems
There are specific clinical situations, however, that require more working time than a dual-cure resin cement can offer. This is the case whenever multiple non-retentive restorations are to be placed simultaneously—a technique that is recommended for veneers. The greatest benefits of placing the thin and highly aesthetic restorations lie in the proper positioning of the restorations and in the minimised risk of contamination. When the veneers are placed one after the other, a slightly incorrectly placed and already fixed veneer might hinder proper positioning of the adjacent restorations, and bleeding and debris occurring owing to excess cement removal or finishing of the margin could contaminate the working field. When all veneers are placed simultaneously, repositioning is possible, whereas excess removal and polishing are accomplished in a moment when contaminants will no longer endanger the integrity of the restorations. This increases security during the whole procedure. A light-curing veneer specialist completes this task best.
Required properties of veneer cements
The key feature of a specialist resin cement system is to possess a working time sufficient for simultaneous cementation of multiple restorations. Its consistency and handling properties are also important, however, as they can help users overcome the challenge of accurate positioning and reduce the time and effort involved in veneer placement. And finally, the system needs to provide excellent bond strength over time and support long-lasting aesthetics. Luckily, PANAVIA Veneer LC offers all those features.
The system consists of PANAVIA V5 Tooth Primer, which establishes a strong bond to enamel and dentine, PANAVIA Veneer LC Paste, which is the cement, and CLEARFIL CERAMIC PRIMER PLUS. The latter has been part of PANAVIA V5 cementation system and provides high bond strength to all types of restorative materials.
Mastering the working time challenge
The light-curing cement paste offers a long working time of 200 seconds* owing to its excellent stability under ambient light. As a consequence, dental practitioners are able to place multiple veneers simultaneously. Polymerisation may be started whenever the user is ready. The one-component, self-etching tooth primer (PANAVIA V5 Tooth Primer) does not contain any photo initiators and does not cure alone. When applied, it etches and penetrates into the tooth surface for 20 seconds and is ready to strongly bond to PANAVIA Veneer LC Paste. The integrated touch-cure technology is the key feature safeguarding the strength of its bond to tooth structure without affecting working time.
Providing for precise placement
In order to streamline the clinical seating procedure from cement application to polishing, PANAVIA Veneer LC has been equipped with well-balanced handling properties. Newly developed spherical silica fillers in the cement mean that it stays put where applied but flows well when the veneer is seated on the tooth. This provides for easy placement without drifting or sagging. During application, the resin cement does not stick to the syringe’s tip, a property achieved by the addition of nanocluster filler technology. The special design of this tip optimises cement application, and excess cement may be easily removed in one piece using an explorer after a one-second tack-cure.
Hiding the margins
Being extremely thin, highly translucent and mainly used to restore teeth in the exposed anterior region of the maxilla, veneers have to be placed with a cement that is, and remains, undetectable underneath the restoration and at its margins. PANAVIA Veneer LC is available in four highly aesthetic shades with matching try-in pastes, so that a precise shade match with the restoration can be achieved and verified in the patient’s mouth. Additional features contributing to undetectable margins are the resin cement’s flowability and low film thickness. These enable users to produce an evenly distributed, thin cement layer for aesthetic outcomes. For those afraid that coffee, tea, acidic drinks or constant toothbrushing might reveal margins over time, there is good news. PANAVIA Veneer LC offers high polish retention and colour stability thanks to its well-balanced formulation and touch-cure technology.
The above features make PANAVIA Veneer LC well worth testing. Additional arguments are the fact that its primers are tried and tested components of the highly popular PANAVIA V5 system and that Kuraray Noritake Dental is a proven expert in the production of dental adhesives. The company developed the original MDP monomer in 1981 and introduced the first adhesive resin cement containing this monomer in 1983. Since then, it has developed technologies and improved formulations that, together, have ultimately resulted in the current line-up of cementation solutions covering every need and indication.
* Working time under ambient light on PANAVIA V5 Tooth Primer (8,000 Lux): 200 seconds.