Simplified and Predictable Aesthetic Adhesive Cementation of Indirect Restorations

Howard S. Glazer, DDS, FAGD
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Choosing an appropriate adhesive resin cement for definitive cementation of indirect restorations can be challenging for patients requiring restorative treatment. Ideal bond strength is necessary to ensure functional treatment durability. Likewise, cement shade stability is also important for long-term aesthetics; the color of adhesive resin cements affects how the shade of tooth substrates interacts with the optical properties of restorative materials and also affects shade matching with adjacent restorations or natural teeth.

To simplify durable and aesthetic cementation of indirect restorations, a universal dual-cure adhesive resin cement system can be used (G-CEM LinkForce [GC America]). G-CEM LinkForce is a 3-component system for predictably and securely placing ceramic, resin, and metal-based inlay, onlay, crown, and bridge restorations. Ideal when adhesive bonding is required to ensure adequate strength of stacked feldspathic ceramic, pressed leucite ceramic, and/or lithium disilicate restorations (eg, GC Initial LiSi Press High Density Micronization (HDM) high-strength pressable lithium disilicate), it is also beneficial when a lack of retention form prevents mechanical retention—as with partial coverage, inlay, onlay, or veneer restorations—regardless of restorative material.

The G-CEM LinkForce self-cure mode is advantageous in situations in which restorations are thick, opaque, or located in areas that cannot confidently be thoroughly light cured. It is also indicated for the cementation of metal, ceramic, and fiber posts, as well as cast post and cores. Its universal application also includes permanent cementation of crowns and bridges on implant abutments.

Figure 1. View of the intaglio surface of the full cast gold crown for tooth No. 31 prior to micro air abrasion/etching. Figure 2. View of the intaglio surface of the full cast gold crown after micro air abrasion.
Figure 3. To begin loading cement into the crown, the nozzle was placed at the base. Figure 4. Using the nozzle to paint the internal walls of the restoration with cement, the cement was introduced into the crown.
Figure 5. Postoperative view of the crown restoration following cementation, with excess cement removed and ready for full function.

Unlike other dual- and self-cure cements that color shift over time, G-CEM LinkForce remains color stable, exhibits tooth-like fluorescence, and is available in corresponding try-in pastes. This allows dentists and patients to accurately preview aesthetics before permanent cementation.
The G-CEM LinkForce system includes (1) G-CEM LinkForce Resin Cement; (2) G-Multi Primer for stable chemical adhesion, coupling between adhesive-treated and restoration surfaces; (3) G-Premio BOND universal adhesive bonding agent for self-etch, selective-etch, and/or total-etch adhesive bonding; and (4) G-Premio BOND Dual Cure Activator for achieving high bond strengths when self-curing is required.

In the case of a 71-year-old male patient, G-CEM LinkForce was ideal for cementing a full-cast gold crown restoration to treat tooth No. 31. Prior to delivery, the intaglio surface of the restoration was properly prepared chairside with micro air abrasion (Etchmaster [Groman]).

At the cementation appointment, the provisional restoration was removed and the preparation thoroughly cleaned. The definitive restoration was tried in. After confirming patient approval, the restoration was removed and dried. G-Multi Primer was applied to the intaglio surface of the restoration and dried with an air syringe.

Meticulous isolation was established, the preparation was rinsed and dried, and then the preparation was selectively etched and dried. When light-curing, G-Premio BOND is applied, allowed to set for 10 seconds, air dried for 5 seconds, and light cured for 10 seconds. When using dual-cure mode, G-Premio Bond and DCA are applied in a 1:1 ratio, allowed to set for 20 seconds, and air dried for 5 seconds.

G-CEM LinkForce in Shade A2 was extruded directly into the restoration, which was immediately seated onto the preparation while maintaining pressure. The cement was tack cured for 2 to 4 seconds to facilitate easier, atraumatic cleanup by allowing for easy peeling off of the excess. The restoration was then light cured from each surface/margin for 20 seconds. Overall, using G-CEM LinkForce contributed to a more comfortable patient experience during a simplified cementation appointment while simultaneously ensuring a secure, aesthetically predictable restoration.
For more information, call GC America toll-free at (800) 323-7063 or visit gcamerica.com.