All-Ceramic Cementation and Bonding

All-ceramic crowns are typically cemented adhesively using glass ionomer cement. They can also be bonded with composite resin cement. Selecting the correct cement when fitting an all-ceramic crown is important for long term success.

There are two different types of all-ceramic crowns: silicate ceramics and oxide ceramics. Silicate ceramics include lithium disilicate ceramics like IPS e.max and leucite-reinforced porcelain, which includes IPS Empress. Oxide ceramics include zirconia oxide. Zirconia used in dentistry is strong and extremely durable.

Cementing e.Max, IPS Empress and lithium disilicate or Leucite-reinforced ceramics

When cemented with composite resin cement, silicate ceramics can be etched with hydrofluoric acid to enable better bonding. When silicate ceramics are acid etched and bonded, it helps to improve the physical properties of the porcelain. This is because silicate ceramics tend to be more brittle in nature, and using an adhesive composite resin cement helps to strengthen the etched porcelain because it locks into the microscopically-roughened surface, preventing microcracks from permeating through the porcelain. All-ceramic crowns that are made from leucite-reinforced ceramic and can be cemented or dual-cured, self-cured, or light-cured. Crowns made from lithium disilicate are slightly more opaque compared to leucite-reinforced ceramic crowns. It is best to cement these crowns using self-adhesive, dual-cured, or self-cured resin cement. Due to the thickness and opacity of lithium disilicate crowns, light-cured resin cement is generally not advised.

Cementing Zirconia type restorations

The crowns are made using metal oxides and are highly resistant to fracturing. Oxide ceramics are also resistant to being etched, but sandblasting the surface can help to make it more adhesive. Usually, oxide ceramics such as zirconia crowns can be cemented in place with the same types of cement used for PFM restorations. These include dual-cured composite resins, glass ionomer cement, and self-cured composite resin, as well as a self-adhesive composite resin cement. One of the easiest and most forgiving cements is resin-modified glass ionomer or alternatively-adhesive composite resin cement. With these materials, there isn’t any need to use a separate bonding agent, although some manufacturers do provide a surface primer to be used before seating a crown with composite resin cement.

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