Prof. Paulo Cesar's Lecture at Nova Southeastern in Jan 2015

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    University of So Paulo

    School of Dentistry

    Department of Biomaterials and Oral Biology

    Associate Prof. Paulo Francisco Cesar

    Dental biomaterials science: building long la

    aesthetic restorations

    Collaborators:

    Prof. Lucas Hian da Silva

    Prof. Susana Salazar-Marocho

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    [email protected]

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    Universidade de So Paulo

    Faculdade de Odontologia

    Departamento de Biomateriais e Biologia Oral

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    1.1. What are the options?

    1.Ceramics

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    1.1. What are the options?

    1. Ceramics

    Porcelains

    Glass-ceramics

    Glass-infiltrated composites

    Polycrystalline ceramics

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    Porcelains

    Porcelains

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    Porcelains

    1 2 3

    45 6

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    Glass-ceramics (leucite or lithium disilicate)

    1 2

    3 4 5

    Gonzaga, 2007

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    Glass-infiltrated composite

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    Polycrystalline

    Y-TZP

    Alumina

    1 2 3

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    1 2 3

    4 5 6

    http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663
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    a) Leque de opes

    b) O material de escolha

    c) Novas perspectivas

    1.2. Material of choice

    1.Ceramic

    http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663
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    1.2. Material of choice

    1. Ceramics

    Veneers

    Inlays /Onlays

    Crowns

    Fixed partial dentures

    Abutments

    Large infra-structures for implants

    http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663
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    Porcelains or Glass-cer Veneers

    D

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    Inlay/OnlayPorcelains or Glass-c

    1 2 3 4

    5 6

    Porcelains

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    Crowns

    Glass-ceramics coping+veneering ceramic or monolithic)

    High translucency:

    1 2 3 4

    5 6

    coping+ven

    eeringceramic

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    Glass-ceramics monolithic)

    1 2 3

    4 5

    D

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    Glass-ceramic monolithic)

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    Glass-ceramic monolithic)

    D

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    Fixed partial denturesY-TZP

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    Abutments Y-TZP

    Dr. Susanne Scherrer (Univ of Geneva)

    1 2

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    D

    3 4

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    Large infra-structures over implants

    Lohb

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    Loh

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    Failed from a stress concen

    tip of the zirconia framework

    Crack moved in a downward

    A secondary edge chip on th

    zirconia framework was inci

    related to the final failure.

    Lohbauer et al., 2010

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    Dr. Susanne Scherrer (Un

    Large infra-structures over implants

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    Dr.

    1 2

    3 4

    Large infra-structures over implants

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    Secondary caries/marginal discoloration/

    wear of cement line/ minor edge chippings

    Debonding

    Fractures

    Veneers/Inlay/Onlay/Crowns

    Fixed partial dentures FPDs)

    1.2.1. Clinical failures

    Dr. Susan

    Secondary caries/marginal discoloration/wear of cement line/minor

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    Secondary caries/marginal discoloration/wear of cement line/ minor

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    Due to the posterior location of the restorations, these time-

    dependent degradation processes were not of concern clinically

    and were only observed by the examiners.

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    Debonding

    Evaluation of Tensile Retention of Y-TZP Crowns Cemented on Resin Compo

    of the Cement and Y-TZP Surface Conditioning.

    Rippe M, Amaral R, Oliveira F, Cesar PF, Scotti R, Valandro L, Bottino M.

    Oper Dent. 2015 Jan-Feb;40(1):E1-E10.

    Evaluation of tensile retention of Y-TZP crowns after long-term aging: effect o

    substrate and crown surface conditioning.

    Amaral R, Rippe M, Oliveira BG, Cesar PF, Bottino MA, Valandro LF.

    Oper Dent. 2014 Nov-Dec;39(6):619-26.

    1

    2

    1

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    1

    2

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    2

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    After 42 months one debonding

    occurred in each group;

    No effect of resin cement: Panavia 21

    versus Multilink.

    1.2.1. Clinical Failures

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    Zhang et al., 201

    Fractures

    Inlay/Onlay/Crowns

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    Zhan

    Inlay/Onlay/Crown

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    Defects on the cementation surface

    Thompson eDicor crown in a premolar

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    Inlay/Onlay/Crowns

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    Marginal defects

    Procera crowns (alumina coping + veneering porcelain)

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    Fractographic Analy

    premolars and 11 mo

    All fractures initiated

    the crowns and usu

    area close to the

    curvature of the marg

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    Zhan

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    Inlay/Onlay/Crown

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    Cone cracks (NO attrition)

    Inlay/Onlay/Crown

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    Cone crakcs (NO attrition)

    Inlay/Onlay/Crown

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    Cone crakcs (NO attrition)

    Fard

    Inlay/Onlay/Crown

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    Cone cracks (NO attrition)

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    Zhang

    Inlay/Onlay/Crowns

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    Partial cone cracks (WITH attrition)

    Optical (a) surfa(bottomY-TZP ssphere under noKim et al., 2008 Kim et al., 2010

    Inlay/Onlay/Crown

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    Partial cone cracks (WITH attrition)

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    In vitroIn vivo

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    Zhan

    h

    Inlay/Onlay/Crown

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    Chipping Fracture of the porcelain layer (Procera Alumina after 4 years.

    Sche

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    Sch

    Chipping

    Inlay/Onlay/Crown

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    Porcelain fused to metal fractured after 2 months. Cour

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    compression curl

    Court

    Compression

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    Compression

    curl

    2 blunt contacts

    Courtesy

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    Courtesy

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    In the chipping area a small b

    veneering material (size 1 x 0.

    The chipping occurred 7 mont

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    K

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    Chipping/incisal edge Ch

    Fracture Mu

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    Critical crack initiated at the incisal c

    propagated gingivally;

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    propagated gingivally;

    The estimated stresses were lower t

    strength of the veneer materials;

    Contact damage, fatigue, and proce

    veneer lead to chipping of veneering

    lithium disilicate and glass-infiltrated

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    Fractography: Y-TZP coping veneered with glass-ceramic.Authors: Rodrigo Souza, Susana Salalar-Marocho and Paulo Cesar

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    Age: 22 years;

    Gender: female;

    No parafunctional habits;

    Metal post;

    Luting cement: U100 (3M)

    Lifetime: 1 year;

    Slow cooling;

    Y-TZP Coping: Lava (3M); Veneering ceram: Emax Ce

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    Origin is here (occlusal).

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    Arrest lines indicate direction of crack propagation.

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    Roughness of occlusal s

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    Multiple damage.

    Wear of the

    Area without loss of glazelayer (but a bit porous)

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    Multiple hack

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    Origin

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    Conclusion

    Origin on occlusal surface;

    Relationship with cumulative damage on

    Delamination was observed;

    Problem with coping design.

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    Cour

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    Cour

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    Cour

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    Fracture rates (%) of the venering porcelain applied over Y-TZP in clinica

    Study Year %Fracture

    Larsson 2013 88.9

    Beuer 2010 7

    Tinschert 2008

    Continued...

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    Koenig et al., 2007

    Larsson 2013 88.9

    Rinke 2013 28.8

    Zembic 2012 0

    Ortorp 2012 3Vigolo 2012 7.7

    Lops 2013 10.8

    Burke 2013 24.2

    Sailer 2007 15

    Schmitter 2012 26.7

    Schmitt 2012 28Molin 2008 0

    Sagirkaya 2012 0.9

    Pelaez 2012 10

    Salido 2012 29.1

    Rinke 2013 5

    Sailer 2009 33

    Edelhoff 2008 9Beuer 2009

    Schmitt 2010 5

    Papaspyridakos 2012 31

    Raigrodski 2006 2

    Pospiech 2003 2

    Esquivel-Upshaw 2013 16

    Tsumita 2010 14Cehreli 2009

    Ohlmann 2012 2

    Bornemann 2003 3

    Ohlmann 2008 1

    Larsson 2006 5

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    grade 1 = small chip that does not demand any action, except polishing.

    grade 2 = moderate chip that can be repaired.

    grade 3 = large chip that leads to replacement of the prosthesis.

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    Heintz

    Technologies to overcome the problem of c

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    Pressing the veneering ceramic over Y-TZP

    CAD-on system

    Rapid layer technique

    Pressing the veneering ceramic over Y-TZP

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    http://sayakaattitude.blogspot.com/2011/07/ema

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    A

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    A

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    A

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    Sintered

    Sintered

    +Fibers

    Hot-pressed

    Ho

    Flexural strength(MPa)

    51.3 4.9c 65.2 4.4b 67.1 7.9b 76

    A

    Sintered Sintered + Fibers

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    Hot-Pressed Hot-Pressed + Fibers

    A

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    CAD-on system

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    Source: w

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    http://www.v

    1 2

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    3 4

    http://www.vita-zahnfa

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    1.2.1. Clinical failures

    Fractures

    FPDs

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    Zhang et al., 20

    FPDs

    Zhang et al., 2014

    Fractures

    FPDs

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    Borba et al., 2015, a

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    FRACTURE ORIGIN AT THE INTERFACE(ALUMINA + VM7)

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    Borb

    Dent Mater. 2008 Aug;24(8):1077-82

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    Primary fractures in clinically fa

    FPDs initiated from the veneer su

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    Interfacial delamination in glascore bilayer dental ceramic stru

    the secondary fracture initiation

    stresses in Y-TZP-based fixed par

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    Proper treatment planning is needed to ensure an adequate con

    height of 4 mm or more on allceramic prostheses made with a

    disilicatebased core ceramic.

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    1.3. The future

    1. Ceramics

    http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791
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    Monolithic zirconia

    Lithium silicate with zirconia particles

    Interpenetrating ceramic-resin composite network

    Monolithic zirconia (Lava Plus, 3M)

    http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791
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    Edmara Berga

    Advisor: Altair

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    Edmara Berga

    Advisor: Altair

    O

    N

    T

    R

    O

    L

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    G

    D

    Edmara Berga

    Advisor: Altair

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    Edmara Berga

    Advisor: Altair

    Lithium silicate with zirconia particles (Suprinity, Vita)

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    Nathlia Carvalho, Master Thesis, 2014

    Advisor: Renata Melo (UNESP/Brazil)

    Interpenetrating ceramic-resin composite network (Enamic, Vita)

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    Nathlia Carvalho, Master Thesis, 2014

    Advisor: Renata Melo (UNESP/Brazil)

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    Denry

    Monolithic Y-TZ Lithium silicate (Suprinity)

    2.1. What are the options?

    2. Surface treatments

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    Acid etching

    Silanes

    Sandblasting with aluminaparticles

    Sandblasting with aluminaparticlescovered with silica (Tribo-ch Ceramic primers

    Acid etching Hidrofluoric acid HF)

    Micromechanical bonding between ceramic and adhesive/resin cemen

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    1 2

    Silane

    Bi-functional molecule(bondsto silicaand resin composites)

    It isused in association with HForTribo-chemical treatment

    Brands: Monobond-s (IvoclarVivadent), Prosil (FGM),Silane (Ultradent).

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    Sandblasting with alumina particles

    Parameters:

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    Particle size:50to 150m

    Pressure:2.8bar

    Time:10s

    Distance:10mm

    Que

    Bond strength between resin cement and Y-TZP

    Sandblasting with alumina particles

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    Am

    Creation of critical flawsv sus compressive layer Y-TZP)

    Sandblasting with alumina particles

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    Zha

    3M ESPE

    Compression layer

    Sandblasting with alumina particles covered wit

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    Impacton thesurfaceat high v

    Formationof silica layer.

    Chemical bondsbetween silica

    3M ESPE

    Brands:

    Rocatec Plus (particlesof 110m)

    Sandblasting with alumina particles covered wit

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    Cojet orRocatec Soft (particlesof 30m)

    Bond strength between resin cement and Y-TZP

    Sandblasting with alumina particles covered wit

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    0

    5

    10

    15

    20

    25

    30

    controle envelhecido controle envelhecido

    Jateamento Silicatizao

    Bondstrength(MPa)

    Aged

    Sandblasting Alumina+ silica

    Control ControlAged

    Primers for ceramic materials

    Phosphate-based monomers(MDP,VBATDT)

    Chemical bondsbetween metallicoxides (e.g.,ZrO2) and resin cement.

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    Brands:

    Metal/ZirconiaPrimer (Ivoclar Vivadent),Porcelain Primer (Bisco),

    Clearfil Ceramic Primer (Kuraray).

    Bond strength between resin cement and Y-TZP after therm

    Primers for ceramic materials

    6

    Koizumi et al., 2012

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    0

    1

    2

    3

    4

    5

    6

    Sem TC Com TC

    MZ Primer + Multilink

    Bondstrength(MPa

    )

    Control Aged

    Best results were seen when primers are associated to other surfac

    Y-TZP-after Cojet

    Primers for ceramic materials

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    Tanaka et al., 2008

    35

    51

    35

    48

    SILANO SILANO+MDP SILANO SILANO+MDP

    CONTROLE ENVELHECIDO

    Bon

    dstrength

    (MPa

    )

    Control Aged

    Silane SilaneSilane + MDP Silane+ MDP

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    Porcelains and Glass-ceramics

    HF + S

    Ceramic group Time

    HF concentration: 8 to 10%

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    Glass-ceramics

    (lithium disilicate)20 to 30 s

    Porcelains 1 to 2 min

    Glass-ceramics

    (leucite)1 min

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    2.3. The future

    2. Surface treaments

    http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791
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    Glaze layer on the internal surface of Y-TZP crowns

    Internal glaze layer

    Application of glaze layer on theinternal surfaceof Y-TZP crowns.

    Makesthesurfacesusceptibleto HF

    http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791
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    Vanderlei et al.,

    glazespray glazepowder/liquid H

    Internal glaze layer

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    Glaze

    Vanderlei et al., 2013

    3.1. What are the options?

    3. Cements

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    Resin modified GICs

    Resin cements:

    Conventional

    Conventional + self-etching primer

    Self-adhesives

    Zinc phosphate Conventional glass-ionomer cements (GIC)

    Resin modified GICs

    Fluoride release and control of setting time

    Brands: RelyX Luting 2 ou Plus Automix (3M ESPE)

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    Resin cements

    Conventional +

    Self etching primer

    onventional

    Self-adhes

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    Photo-activated

    Dual Dual Dual

    Chemically

    activated

    Chemically

    activated

    Resin Cements

    Conventional +

    Self etching primer

    onventional

    Self-adhes

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    acid + primer + bond

    cement cement

    Self-etching primer

    cement

    Conventional resin cement

    Photo-cured

    Less quantity of amines (chemical activators) = better color stability

    Brands: RelyXVeneer (3M ESPE) e VariolinkVeneer (Ivoclar)

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    Conventional resin cement

    Dual

    Stable bond strength to dental tissues: interaction with the best adhesive s

    Brands: RelyXARC (3M ESPE), Variolink II (Ivoclar) and EnForce (Dentsply)

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    Resin Cements

    Conventional +

    Self etching primer

    onventional

    Self-adhes

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    acid + primer + bond

    cement cement

    Self-etching primer

    cement

    Conventional resin cement+ Self-etching primer

    Dual

    Brands: PanaviaF 2.0 (Kuraray) e Multilink (Ivoclar)

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    MDP:

    10-methacryloxydecyl dihydrogen

    MDP

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    Resin

    composite

    Resin Cements

    Conventional +

    Self etching primer

    onventional

    Self-adhes

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    acid + primer + bond

    cement cement

    Self-etching primer

    cement

    Self-adhesive cements

    Dual

    One step, less technique sensitive.

    Brands: U200 (3M ESPE), SmartCem 2 (Dentsply) and Panavia SA (Kuraray)

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    De Muncket al., 2004

    Unicem 3M ESPE)

    U200 3M ESP

    3.2. Material of choice

    3. Cements

    A di h b

    http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663
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    According to the substrate:

    Metal cores

    Resin composites (fiber posts)

    Tooth substrate

    3.2. O material de escolha

    3. Cimentos

    http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663http://www.google.com/url?sa=i&rct=j&q=choosing&source=images&cd=&cad=rja&docid=Vr6FWwSy_nkoLM&tbnid=ZIABKMj1sbgd5M:&ved=0CAUQjRw&url=http://www.realizzazione-sito-internet.biz/index/software-ecommerce-cms/grafica-personalizzata.html&ei=HHISUp6mCNLh4APIjoHoDg&psig=AFQjCNE8d9-bgBA_4wkJwl2fhHjvs4o8uw&ust=1377026969294663
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    Resin composites Metal Tooth

    Glass-ceramic crowns

    Polycrystalline crowns

    Thin Veneers, Inlays, Onlaysof porcelain or g

    Thick Crowns, Inlays e Onlaysof porcelain or

    Polycrystalline crowns

    Metal cores

    Conventional resin ce

    Self-etching primer M

    Self-adhesive

    Glass-ceramic crown

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    Conventional resin cement+

    Self-etching primer (MDP)

    Chemical bond to metallic oxides of the post

    Good hybrid layer on remaining dentin tissue

    Self-adhesive

    Easy to use

    Less technique sensitive

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    Substrate resin composite or tooth

    Thin Veneers, Inlays, Onlaysof

    porcelain or glass-ceramic

    Conventional re

    activated only.

    11

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    0

    1

    2

    3

    Rely X ARC Variolink II Rely X Veneer Variolink Veneer Filtek Flow

    DUAL S FOTO FLOW

    Colorchange(DeltaE,

    Lab)

    Color change as a function of the cement

    Archegasetal.,2011

    Photo-cured only.

    Thick Crowns, Inlays e Onlays of

    porcelain or glass-ceramic

    Conentional resin ceme

    Self-adhesive small area

    Substrate resin composite or tooth

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    Luhrs et al., 2010

    Polycrystalline crowns

    Synergic effect of Coje

    Substrate resin composite or tooth

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    Conventional resin cement +

    Self-etchng primer MDP)

    *Additional acid etching of enamel with

    phosphoric acid is necessary

    Y-TZ

    Silane

    Synergic effect of Cojet + silane + MDP

    1 Cojet

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    Y-TZ

    Y-T

    1.Cojet

    2.Silaneapplication

    3.Ceramicprimer

    3.3. The future

    3. Cements

    http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791http://www.google.com/url?sa=i&rct=j&q=future%20holds&source=images&cd=&cad=rja&docid=e6UDqxli78iPpM&tbnid=MRsH7jgHtrO5QM:&ved=0CAUQjRw&url=http://smpsboston.wordpress.com/2011/06/07/what-the-future-holds-for-the-industry/&ei=TG4SUo3uBtPh4AOp14CYDw&psig=AFQjCNFPXRACyd2DHkB_bQT2hdLbhk4VlQ&ust=1377025954849791
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    Universal adhesives

    3

    Universal adhesives

    Dual resin cement+ Universal adhesive

    Indicated for all materials

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    Cojet Scotchbond Universal

    RelyX Ult1

    23

    acid/primer/adhesive + silane + MDP)

    500

    600

    700

    800

    Lava Zirconia Crown Retention to Human Tooth

    Detachment Load (N) after Thermocycling and Fatigue

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    3M 2011. All Rights Reserved.

    0

    100

    200

    300

    400

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