I’m so glad it’s humpday! This was a very difficult “I got ambushed” case with crown replacement on tooth 24 and conventional crown buildup on a structurally-compromised and severely-overfilled 25. There was a spot of localised mild cervical abrasion on the 25 which had not changed in the years that I had known this 81 year old woman, so we decided to leave that out of the preparation. To cement these IPS e-max LT crowns, we tried them in and assessed marginal integrity and potential shade integration before using 5% hydrofluoric acid to etch the intaglio surface, margins and slightly on the B aspect of the margin for 20 seconds. Clearfil Ceramic Primer was used in a 60 second dwell before using oil-free air to ensure complete evaporation. The teeth were micro air abraded using 27 micron aluminum oxide and #0 cord (Ultradent) soaked in Viscostat Clear (AlCl3) and packed beyond the margin for retraction and hemostasis. Before selectively etching the enamel margins for 15 seconds, a 30 second dwell of 15% EDTA was used to negate the insoluble precipitate caused by the AlCl3 (aq), which interferes with maximal bond strength. The tooth was soaked or rewet with 2% CHX (aq) and the dentin puffed moist before application of Clearfil’s new Universal Bond Quick. This adhesive is seriously the strongest bond I have ever used to date – it was simple to apply and with a dwell time of 3 seconds, there is no waiting whatsoever. It cures with Panavia SA Plus Cement without any need for a dark cure activator. This one-two combo features one of the highest tensile bond strengths of the materials I have tested and should theoretically be more stable long-term as water sorption is minimized with inclusion of the new amide monomer from Kuraray, a first in the field. That, paired with the original “Godfather” 10-MDP makes for a virtually invincible combination.
#Kuraray #Clearfil #UniversalBondQuick #PanaviaSAPlus