Bonding Protocols for Indirect All-Ceramic Restorations
Silica based ceramics (feldspathic, leucite-reinforced, lithium disilicate):
- Try-in restoration. Adjust as needed
- Hydrofluoric-acid etching
- Silane coupling agent
- Composite resin
Non-silica-based (alumina and zirconia):
Adequate resistance and retention form?
- 10-20 deg. TOC
- Minimal OC height = 4 mm for molars
- Minimal OC Height = 3 mm for all other teeth
- OC-FL dimension ratio of 0.4 or greater
Standard Cementation Protocol using:
- Self-adhesive resin cement
- Resin-modified glass-ionomer
- Try-in restoration adjust as needed
- A – Air-particle abrasion using 50-micron aluminum oxide at 2-bar
- P – Phosphate monomer (MDP) air dry
- C – Composite resin (dual or self-cure)
- Goodacre CJ, Campagni WV, Aquilino SA. Tooth preparations for complete crowns: An art form based on scientific principles. J Prosthet Dent 2001;85:363-376.
- Blatz MB, Alvarez M, Sawyer K, Brindis M. How to Bond Zirconia: The APC Concept. Compend 2016;37(9):611-618.
- Sulaiman TA, Altak A, Awab A, Rodgers B, Lawson N. Cleaning Zirconia Surface Prior to Bonding: A Comparative Study of Different Methods and Solutions. J Prosthodont 2022;3:239-244.
- Malament KA, Margvelashvili-Malament M, Natto ZS et al. Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate class ceramic complete and partial coverage restorations in posterior teeth: Performance and outcomes as a function of tooth position, age, sex, and thickness of ceramic material. J Prosthet Dent 2020; In press.
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