In this day and age, there are myriad options for placing an indirect restoration. If the mechanical retention form is adequate (i.e. 4mm of coronal prep height, 100% of the circumference), we can consider luting with a RMGIC cement. The downside is that to attain this often you need to prepare more aggressively, violating not only the enamel rim but often pericervical dentin. This is an interesting case where the old restoration on the mesial extended well subgingival leaving virtually no enamel rim (i.e. a traditional prerequisite for bonding predictability) yet there was copious enamel and pericervical dentin on the facial and palatal aspects of this tooth (#14/2.6). I chose in this case to retain as much of an enamel rim on the B and P but still some significant vertical elements to the prep design and yes, I try to bond everything, all the time. Dr. Neil Jessop (Ultradent Products, Inc.) has shown now simulated in vivo dentin shear bond strengths in excess of 60MPa 12 years later.
We shouldn’t be afraid of bonding to dentin in this modern age. Thanks to Yohei for your cool anatomy on this #IPS #emaxMT restoration.
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