RelyX™ Unicem Clicker™
RelyX™ Unicem Aplicap™ / Maxicap™
Technical Product Profile
RelyX Unicem
TM
Table of Contents
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
2. Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
3. History of Dental Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
4. Chemical Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
4.1. New Monomers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
4.2. New Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
4.3. New Initiator Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
5. Setting Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
6. Active Transformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
6.1. Hydrophilic – Hydrophobic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
6.2. Acidic – Neutral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
7. Mechanical Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
7.1. Linear Expansion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
7.2. Mechanical Properties Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
8. Clinical Application of RelyX™ Unicem Cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
9. Pretreatment of Restorative Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
10. Official Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
11. Study Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
11.1. Clinical in vivo Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Clinical Performance of Ceramic In- and Onlays after 3 years . . . . . . . . . . . . . . . . . . . . .13
Clinical Performance of Ceramic In- and Onlays after 1 year . . . . . . . . . . . . . . . . . . . . . .14
Clinical Performance of Composite, All-ceramic,
and PFM Restorations after 4 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Clinical Performance of Metal, Ceramic, and PFM Restorations after 2 years . . . . . . . .16
Clinical Performance of Endodontic Posts after 3 years . . . . . . . . . . . . . . . . . . . . . . . . . .17
Human Pulp Response to Resin Luting Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
11.2. In vitro Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Measuring Bond Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Shear Bond Strength of Different Classes of Luting Cements to Human Dentin . . . . . .22
Shear Bond Strength to Human Dentin and Enamel and Lava™ Ceramic
Immediately and After 24 Hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Tensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Shear Bond Strength to Human Dentin and Enamel after 24 hours and
Thermocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Microtensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . .26
Tensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
Immediate Shear Bond Strength to Bovine Dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Tensile Bond Strength to Bovine Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Retentive Bond Strength of Lava™ Zirconia Crowns on Human Dentin . . . . . . . . . . . . .30
Shear Bond Strength to Zirconia Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Shear Bond Strength to Lava™ Zirconia Ceramic and Glass Ceramic . . . . . . . . . . . . . . .32
Shear Bond Strength to Alumina Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Retention Strength of Fiber Posts Cemented with two Different Cements . . . . . . . . . . . .34
Shear Bond Strength to Fiber Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
2
Table of Contents
Marginal Sealing in Fiber Post Treated Teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
Marginal Adaptation of Ceramic Inlays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Interfacial Adaptation of Partial Ceramic Crowns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
pH Profile of Various Luting Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Shear Bond Strength to Core Build-Up Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Shear Bond Strength to CAD/CAM Glass Ceramics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Shear Bond Strength to Metal, Composite, and Ceramic Restorative Materials . . . . . . .45
12. RelyX™ Unicem Field Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
13. Excerpt from the Instructions For Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
14. Technique Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
14.1. RelyX™ Unicem Aplicap™ / Maxicap™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
14.2. Technique Guide RelyX™ Unicem Clicker™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
14.3. Technique Guide RelyX™ Fiber Post / RelyX™ Unicem Aplicap™ . . . . . . . . . . . . . . . . . . .51
15. Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
16. Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
17. Product Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
3
4
1. Introduction
RelyX™ Unicem cement is a dual-curing, self-adhesive universal resin cement for adhesive
cementation of indirect ceramic, composite or metal restorations. When using RelyX Unicem
cement, bonding and conditioning of the tooth are no longer necessary. The cement is characterized by a higher moisture tolerance, as compared to multi-step composite cements. RelyX
Unicem cement releases fluoride ions and is available in various shades. Among others, its
essential characteristics are high dimensional stability and very good adhesion to the tooth
structure.
RelyX Unicem cement is available in 3M™ ESPE™ Aplicap™ and Maxicap™ capsules and the
Clicker™ Dispenser.
RelyX™ Unicem - Benefits
• Eliminates the need for etching, priming and bonding steps
• Strong, adhesive, esthetic and moisture-tolerant
• Easy to use for virtually all indications (except veneers and Maryland bridges)
• Low risk of postoperative sensitivities
• Clinically proven with years of scientific data and independent university studies available
• Releases fluoride over a long period of time
RelyX™ Unicem - Delivery choices
Aplicap™ Capsules
Maxicap™ Capsules
Clicker™ Dispenser
Ideally suited for inlays,
onlays, crowns and posts
Ideally suited for multipleunit bridges
Suited for all sizes of
restorations
Hygienic unidose (295 mg
per capsule)
Hygienic unidose (936 mg
per capsule)
Choose amount dispensed;
11 g dispensable in 80 clicks
(approx. 40 applications)
Consistent mix with triturator
Consistent mix with triturator
Delivers premeasured doses
for consistent ratio of pastes;
easy, economical mixing
RelyX™ Unicem Aplicap™
Elongation Tip available for
virtually void-free cementation
of posts
Longer working time (2:30 min)
No need for mixer, activator,
appliers, mixing tips or other
devices
Available shades: A1, A2
Universal, A3 Opaque,
White Opaque and Translucent
Available shades:
A2 Universal, A3 Opaque
and Translucent
Available shades:
A2 Universal, A3 Opaque
and Translucent
5
2. Indications
RelyX™ Unicem Self-Adhesive Universal Resin Cement is indicated for the permanent cementation of inlays, onlays, crowns, bridges, posts, and screws made of ceramics, composite or
metals.
3. History of Dental Cements
Today’s dental cements can be traced back to the 19th century. As early as 1856, Sorel was putting together formulations for magnesium chloride cement. The continuous search for better
materials led to numerous developments over the years.
According to their chemical composition, today’s commonly used dental cements are classified
into the following groups:
• Zinc phosphate cements
• Polycarboxylate cements
• Glass ionomer cements
• Resin-modified glass ionomer cements
• Compomer cements
• Adhesive resin cements
• Self-adhesive resin cements
}
}
}
Conventional cements
Hybrid cements
Composite resin cements
While conventional cements offer easy handling, adhesive resin cements (also referred to as
composite resin cements) are highly versatile and provide strong adhesion and high esthetics
which is especially important for the cementation of state-of-the-art all-ceramic restorations.
However, this comes at the expense of easy and fast application. Various pretreatment steps
(etching, priming, bonding) and the absolute exclusion of moisture (rubber dam) are necessary
to successfully use adhesive cements. Therefore, adhesive cementation is much more technique
sensitive than conventional cementation and the clinical success may be compromised by the
technical challenges it imposes on the dentist.
These drawbacks were resolved with the introduction of the first self-adhesive universal resin
cement RelyX Unicem in 2002.
Zinc
phosphate
cements
Polycarboxylate
cements
Glass
ionomer
cements
Resin-modified
glass ionomer
cements
Compomer
cements
Adhesive resin
cements
Self-adhesive
universal resin
cements1
Bond strength
★
★
★★
★★
★★
★★★
★★★
Typical pretreatment
steps
–
–
–
–
conditioning
etching ,
priming, bonding
–
Cement classes
Properties
3
★★★
★★★
★★★
★★
★4
★★★
5
n. a.
n. a.
n. a.
n. a.
★
★★★
★★★
Indications Glass-ceramic
n. a.
n. a.
n. a.
n. a.
n. a.
★★★
★★★
High strength
ceramics
n. a.
n. a.
★★
★★
★
★★★
★★★
Low solubility (insoluble)
★
★
★
★★
★★
★★★
★★★
Mechanical properties
★
★
★★
★★
★★
★★★
★★★
Esthetics
★
★
★
★
★★
★★★
★★★
Metal
Composite
Table 1: Strength and weaknesses of commonly used dental
cements.
6
2
★★★
General overview of cement classes. Specific products may exhibit deviating characteristics.
1
Ratings here refer to RelyX Unicem cement. Some other so-called self-adhesive cements may not exhibit the same characteristics.
2
For some products a conditioning step is recommended.
3
Some products belonging to this class may include a self-etch primer / bonding system.
4
Not all resin cements are recommended for dark cure only.
5
Not applicable / not recommended.
RelyX™ Unicem
Self-Adhesive Universal Resin Cement
• alkaline (basic) fillers
• silanated fillers
Glass ionomer
technology
• phosphoric acid modified methacrylate monomers
• methacrylate monomers
Adhesive
technology
• initiators
Composite cement
technology
Fig. 1: RelyX™ Unicem cement
combines glass ionomer, adhesive and composite technology.
4. Chemical Composition
RelyX™ Unicem cement is available in two formulations: as a powder / liquid system in the
3M ESPE Aplicap™ and Maxicap™ Capsules, as a paste / paste system in the 3M ESPE
Clicker™ Dispenser. The qualitative composition of both formulations is shown in Table 2.
Powder
Liquid
Alkaline (basic) fillers
Methacrylate monomers containing phosphoric
acid groups
Silanated fillers
Methacrylate monomers
Initiator components
Initiator components
Pigments
Stabilizers
Base paste (white)
Catalyst paste (yellow)
Methacrylate monomers containing phosphoric
acid groups
Methacrylate monomers
Methacrylate monomers
Alkaline (basic) fillers
Silanated fillers
Silanated fillers
Initiator components
Initiator components
Stabilizers
Stabilizers
Pigments
The ideal combination of easy handling known from conventional cements plus a bond strength
comparable to that of adhesive resin systems demanded developing new monomers, new fillers,
and new initiators.
Table 2: Chemical composition of
RelyX™ Unicem cement in the
capsule and the Clicker version.
Bond strength value see chapter 11.2
(p. 22)
7
4.1. New Monomers
Mechanical properties see chapter 7
(p. 9)
Dental cements have to excel in the following areas: adhesion, mechanical properties, longterm stability, esthetics and biocompatibility. In order to provide RelyX™ Unicem cement with
optimal properties and self-adhesion, the adhesive monomers were optimized. Several phosphoric acid groups and carbon double bonds per molecule are characteristic for the acidic
methacrylate monomers in RelyX Unicem cement. Whereas the phosphoric acid groups contribute to self-adhesion, the carbon double bonds bring about a high reactivity of the methacrylate monomers with each other. Thus after setting of RelyX Unicem cement, the resin matrix
shows a high degree of cross-linking between the particular mono-mers. In this way good
mechanical properties (e.g. high compressive and flexural strength) and adhesive bonding without pretreatment of the tooth structure can be achieved. Furthermore, a high degree of crosslinking is one essential requirement for the long-term stability of the cement which is met by
RelyX Unicem.
4.2. New Fillers
pH-profile see chapter 6.2 (p. 8)
Hydrophilicity see chapter 6.1 (p. 8)
Fillers have also an important impact on the cement’s properties. One part of the fillers in
RelyX Unicem cement is silanated and, thus, is chemically embedded into the cement matrix
during setting. Another part is alkaline (basic) and thereby able to react with the phosphoric
acid groups of the methacrylate monomers in a neutralization reaction. Therefore, during setting the pH-value increases and lifts the initially acidic RelyX Unicem cement paste to a neutral
level. This avoids hydrolysis processes in the cement in the long run and is therefore another
important prerequisite for the long-term stability of any initially acidic cement. Additionally,
during the neutralization reaction fluoride ions are released from the fillers. RelyX Unicem
cement provides these ions to the tooth structure without containing soluble fluoride salts in the
cement matrix. The amount of inorganic fillers contained in RelyX Unicem cement approximates 70 percent by weight and 50% by volume with the grain particle size (d[90]=90% of the
fillers) being <12.5µm. The fillers also account for the cement’s radiopacity.
4.3. New Initiator Systems
Working and curing times see
chapter 13 (p. 47)
In dental technology most initiator systems for self curing (= chemical / dark curing) are based
on alkaline (basic) amines. However, these are deactivated in an acidic environment which
would inhibit self curing. For this reason, a completely new dual-curing initiator system was
developed to function in the initially acidic RelyX Unicem cement paste. It is characterized by
moisture tolerance and the ability to effectively initiate the polymerization reaction in a wide
pH-range. This ensures that the first step on the way to a highly cross-linked cement matrix
proceeds most effectively. Thus, in addition to innovative monomers and fillers, the initiator
system, too, contributes to a permanently strong bond strength and stability of RelyX Unicem
cement.
5. Setting Reactions
The setting of RelyX Unicem cement is started either by a curing light or by the chemical reaction of the initiator system. The main setting reaction is a radical polymerization reaction by
which the single monomer molecules are chemically cross-linked to form a three-dimensional
polymer network. Simultaneously, but to a minor extent, neutralization reactions take place,
which are important for the properties of the set RelyX Unicem cement. The following figures
illustrate in a simplified way the reactions that occur simultaneously during the setting of
RelyX Unicem cement.
8
Methacrylatemonomers
The main components of
RelyX™ Unicem cement are:
Initiators
• Methacrylate monomers,
partially containing phosphoric acid groups
Fillers
containing
• Fillers, one part releasing
ions, another part is silanated
Calcium-Ions
• Chemical initiator system
Alumina-Ions
• Light initiator system
Reactive carbon
double bond
Phosphoric acid
group
Acidic methacrylate
monomers contain phosphoric acid groups and reactive
carbon double bonds which
are connected with each other
via a carbon backbone.
Carbonbackbone
Strontium-Ions
Fluoride-Ions
Calcium-Ions
on tooth substance
(apatite)
1
Next to the restoration material enamel and dentin are the
substrates to which dental
cement has to show safe and
reliable adhesion. The tooth
substance (enamel and dentin)
consists of inorganic apatitecrystals containing calcium
and organic collagen fibers.
Additionally, the tooth structure contains water.
3
The remaining phosphoric
acid groups of the methacrylate monomers are neutralized by ions, which are
released from the fillers during the setting reactions.
5
Simultaneously, setting of the
cement takes place through
the radical polymerization
reaction of the methacrylate
monomers.
2
After mixing, RelyX™ Unicem
cement is very acidic (low
pH-value) and hydrophilic
(water binding). Upon contact
with the tooth surface the
negatively charged phosphoric
acid groups of the methacrylate monomers bond to Ca2+ions in the tooth structure.
Thus, the phosphoric acid
groups are neutralized (i.e.
pH rises) and anchored at the
tooth surface.
4
The released fluoride ions are
absorbed by the tooth structure.
6
The methacrylate monomers
are chemically cross-linked
with each other through the
interaction of reactive carbon
double bonds.
The initiator system generates
the necessary starter radicals
through light-induced or
chemical activation.
7
RelyX™ Unicem cement is
cured by the radical polymerization reaction. Thus, successively a highly cross-linked
three-dimensional network
is formed consisting of
methacrylate molecules and
fillers. During this process the
cement matrix changes from
an initially hydrophilic to a
hydrophobic condition.
9
Fig. 2: Simplified depiction of the setting reactions of RelyX™ Unicem cement.
8
The methacrylate monomers
and fillers are firmly linked
and permanently embedded in
the three-dimensional network
of the cement matrix.
10
9
Hydrophilic: water binding
Hydrophobic: water repelling
6. Active Transformation
6.1. Hydrophilic – Hydrophobic
Immediately after mixing RelyX™ Unicem, the cement paste is very acidic and has hydrophilic
properties. Therefore it shows a higher moisture tolerance than multi-step composite cements.
This together with the good adaptation to the hydrophilic tooth surface is the immediate advantage for the dentist during the very first steps of the clinical cementation procedure. The resulting high bond strength is one prerequisite for a long-lasting success of the restoration. During
setting of RelyX Unicem cement a strongly cross-linked cement matrix with hydrophobic properties develops through the proceeding radical polymerization and the subordinate neutralization reactions. A low linear expansion and low solubility are the results and lead to the clinically proven, long-term stability which plays a central role especially for all-ceramic restorations.
Thus, RelyX Unicem cement automatically changes its properties from hydrophilic to
hydrophobic during setting.
Good adaptation to
the tooth surface
moisture tolerance
Hydrophilic
Polymerization and
neutralization reactions
Low expansion
Low solubility
High long-term stability
Hydrophobic
Fig. 3: RelyX™ Unicem cement
changes its properties from
hydrophilic to hydrophobic
during setting.
6.2. Acidic – Neutral
Parallel to the change from a hydrophilic to a hydrophobic state the pH-value increases during
the setting of RelyX Unicem cement. Immediately after mixing RelyX Unicem, the cement
paste is very acidic. Within a few minutes the pH-value starts to increase and within 24 hours
reaches a neutral level. After application to the tooth, the low pH-value of RelyX Unicem
cement is pivotal for the self-adhesive mechanism, whereas the pH increase as well as the
hydrophobic condition are essential prerequisites for the long-term hydrolytic stability of the
cement.
14
alkaline
13
12
11
10
9
ph
8
7
6
5
4
3
Fig. 4: pH-profile of RelyX™
Unicem cement (3M ESPE
internal lab data, 2007).
RelyX™ Unicem Aplicap™
2
RelyX™ Unicem Clicker™
1
acidic
0
0
10
1
2
3
time after mixing [hours]
4
5
1
6
30
time after mixing [days]
7. Mechanical Properties
7.1. Linear Expansion
Dimensional stability of a cement is an important consideration especially when cementing allceramic restorations. In order to simulate the worst case scenario specimens of the cement to be
tested are immersed in water over months or years. In this way the counteracting effect of eventual initial polymerization shrinkage can be ruled out. RelyX™ Unicem cement both in the
Aplicap™ and in the Clicker™ Dispenser show comparable and low expansion values that prove
it to be safe for the cementation of all-ceramic restorations.
1,6
LIGHT / SELF cure
1,4
RelyX™ Unicem Aplicap™
RelyX™ Unicem Clicker™
1,2
[%]
1,0
0,8
0,6
0,4
Fig. 5: Linear expansion of
RelyX™ Unicem cement
(3M ESPE internal lab data, 2007).
0,2
0,0
0
6
12
18
24
30
36
42
48
54
time [months]
7.2. Mechanical Properties Overview
Delivery versions
RelyX™ Unicem
Aplicap™ – Maxicap™
(SELF – LIGHT cure)
RelyX™ Unicem
Clicker™
(SELF – LIGHT cure)
48 / 75
60 / 71
Compressive strength [MPa]
188 / 236
216 / 244
Modulus of elasticity [GPa]
4.9 / 8.4
3.9 / 6.3
Surface hardness [MPa]
202 / 280
195 / 220
2.43
1.79
18 / -
17 / -
Water sorption [µg/mm ]
39 / 25
42 / 25
Solubility [µg/mm ]
15 / -3
12 / 1
Properties
Flexural strength [MPa]
Radiopacity [mm Al]
Film thickness [µm]
3
3
Table 3: Mechanical properties
of RelyX™ Unicem cement.
11
8. Clinical Application of RelyX™
Unicem Cement
As discussed earlier, adhesive cementation poses a recurring technical challenge for dentists
and dental assistants. In comparison to RelyX Unicem cement, a composite cement with an
adhesive bonding system requires many more steps to securely bond a restoration to the tooth
structure.
Cementing Steps
Typical total-etch
resin cement system
Cementation with
RelyX™ Unicem Cement
Initial situation:
Provisional restoration
removed and prepared
tooth cleaned.
Etch with a phosphoric
acid etching gel.
Not Applicable
Thoroughly rinse with
water.
Not Applicable
Lightly dry with oil-free and
anhydrous air or blot dry
excess water. Do not overdry.
Not Applicable
Apply primer with a disposable applicator and rub
in thoroughly.
Not Applicable
Dry primer in a light air stream.
Avoid direct blowing, as excess
may coagulate.
Not Applicable
Apply adhesive with a
disposable applicator
and rub in thoroughly.
Not Applicable
Lightly thin or air dry adhesive evenly with an air stream.
Avoid coagulation of the
adhesive.
Not Applicable
Light cure adhesive if
indicated.
Not Applicable
Mix cement and apply to the
prepared restoration and/or
the prepared tooth. (Direct aplication with Applicap™ or Maxicap™
Capsule system possible)
Place the restoration.
Remove excess.
Light cure or allow to self
cure.
Final situation:
Adhesively cemented
ceramic crown.
12
9. Pretreatment of Restorative
Materials
Bond strength value see page 22
To assure optimal bond strength to the restoration 3M ESPE recommends the following procedures for the cementation with RelyX™ Unicem cement as long as not stated differently by the
manufacturer of the restorative material.
Please refer to the instructions for use supplied with each package of RelyX Unicem cement
before usage.
Restorative material type
Pretreatment
Metal (precious and non-precious)
Sandblast with aluminum oxide 40 µm
Clean with alcohol
Etchable Glass Ceramics
(e.g. ParadigmTM C, 3M ESPE;
Vitablocs® Mark II, Vident;
Authentic®, Microstar®;
IPS-Empress®, Ivoclar Vivadent;
ProCAD®, Ivoclar Vivadent)
Etch with hydrofluoric acid
Silanate (e. g. RelyXTM Ceramic Primer, 3M ESPE)
Non-etchable Zirconia and Alumina
Ceramics
(e. g. LavaTM, 3M ESPE;
Cercon®, Dentsply; Procera® AllCeram,
Nobel Biocare)
Alternative 1:
Sandblast with aluminum oxide 40µm
Clean with alcohol
Alternative 2:*
Coat (silicate) (e. g. CoJetTM Prep and CoJetTM Sand,
3M ESPE)
Silanate (e. g. RelyXTM Ceramic Primer, 3M ESPE)
Composite
(e. g. ParadigmTM MZ100, 3M ESPE;
Artglass, Heraeus Kulzer;
belleGlassTM NG, Kerr)
Sandblast with aluminum oxide 40µm
Clean with alcohol
RelyXTM Fiber Post (3M ESPE)
No pretreatment necessary if cemented with RelyX Unicem
cement
Other glass fiber reinforced posts
Clean with alcohol
Silanate
*While these pretreatment steps are essential for many composite resin cements, RelyX™ Unicem cement exhibits sufficient bond
strength also with the more simple alternative 1 (see study results, page 27 fig. 29).
10. Official Ratings
Since its market introduction in 2002 RelyX Unicem cement continually received high ratings
from several independent research institutes. Listed is a selection of the more recent awards:
RelyX Unicem Self-Adhesive Universal Resin Cement was selected “Most Innovative New
Product of the Year” for 2004 by REALITY.
RelyX Unicem Self-Adhesive Universal Resin Cement was rated 4-STARS by REALITY
since its first evaluation in 2003
(Reality Now, Vol. 17, No. 153, June 2003)
4-year Clinical Performance
4,000 indirect restorations of different types were cemented with RelyX Unicem cement and
evaluated after 4 years in service. THE DENTAL ADVISOR reconfirmed its top rating of 5+,
which were already awarded for the 1-, 2- and 3-year recall. It reports on outstanding results in
all evaluated categories: handling, sensitivity, microleakage and retention.
(THE DENTAL ADVISOR, Vol. 24, No. 4, May 2007)
13
RelyX™ Unicem Collection of Scientific
Results
11. Study Results
Along with the dentist's technical expertise and the restorative material's properties, the performance of the cement contributes significantly to the clinical success of indirect restorations.
The following properties are especially important for a universal cement, which is indicated for
cementation of metal, composite and ceramic restorations:
• High adhesion to the tooth structure and restorative materials
• High marginal quality
• Very good mechanical properties
• Low risk of postoperative sensitivities
• Very good long-term stability
Since the market introduction of RelyX™ Unicem cement in 2002 more than 80 studies have
been carried out internationally, which investigate these and other properties. The most important results are presented and discussed in the following chapter. It provides an overview on
clinical as well as in vitro studies.
11.1. Clinical in vivo Studies
Although in vitro tests are helpful in comparing and assessing a material’s properties, the final
proof for a dental material’s performance is clinical trials. The following pages provide an
overview of the clinical performance of RelyX Unicem cement.
Clinical Outcomes of Ceramic Inlays /
Onlays Luted With Two Bonding
Systems.
Denehy G., Stanford C., Cobb D.,
Vargas M. et al. 2007
University of Iowa, USA
unpublished study
Clinical Performance of Ceramic In- and Onlays
after 3 Years
Study design and results:
Posterior class I and II restorations in 30 patients were restored with ceramic in- and onlays
(Authentic®, Microstar) using either RelyX™ Unicem Self-Adhesive Universal Resin Cement
(Aplicap™) or the multi-step bonding system Syntac® Classic and Variolink® II incl. the multistep bonding system Syntac Classic (both Ivoclar Vivadent). Cementation was done according
to the cement manufacturers’ instructions for use. For the 3-year recall, 50 restored teeth were
evaluated following the modified Ryge criteria for clinical evaluations (see table 5).
100
[%]
80
60
Variolink® II
alpha scores
bravo scores
delta scores
RelyX™ Unicem
alpha scores
bravo scores
40
Fig. 6: Clinical performance after
3 years of ceramic in- and onlays
seated with RelyX™ Unicem cement (Aplicap™) and Variolink® II.
20
0
Marginal adaptation
14
Color match
Marginal
discoloration
Surface roughness
Absence of caries
Criteria
Alpha scores
Bravo scores
Marginal adaptation
Explorer does not catch
Explorer catches
Color match
Good match in color,
shade, and translucency
Slight mismatch in color,
shade, and translucency
Marginal discoloration
No discoloration evident at
margin
Slight staining at margin
Surface roughness
Smooth surface
Slightly rough or pitted
Alpha scores
Delta scores
No caries
Caries evident at the
margins of the restoration
Absence of caries
Table 5: Modified Ryge criteria
for the clinical evaluation of inand onlay restorations
Conclusions:
The authors of the study state: "The three year outcomes of this study suggest that there is
equivalent clinical performance of the self etching RelyX™ Unicem system relative to the comparison group. These clinical efficacy outcomes are important since the RelyX Unicem cement
system uses a simplified clinical set of procedures while providing equivalent outcomes to the
more complex, multi-step set of clinical procedures used in the Variolink® II group."
Clinical Performance of Ceramic In- and Onlays
after 1 Year
Study design and results:
IPS-Empress® (Ivoclar Vivadent) restorations (70 Class 2 inlays, 13 onlays / 47 premolars,
36 molars) were placed in 30 patients in a split mouth design. 43 inlays/onlays were seated with
RelyX Unicem cement (Maxicap™). The multi-step adhesive Syntac® Classic and Variolink II
low (both Ivoclar Vivadent) served as a control (n=40). The inlays were pretreated according to
the cement manufacturers’ instructions for use (HF-etching and silanating). Additionally, in the
Variolink group Heliobond™ (Ivoclar Vivadent) was applied to the restorations. After one year
the restorations were evaluated using modified Ryge criteria.
Ceramic Inlays Luted with a SelfAdhesive Cement After one Year
Taschner M., Frankenberger R.,
Petschelt A., Krämer N.
University of Erlangen, Germany
Published at the AADR 2006
abstract #1361
100
80
[%]
60
Variolink® II
alpha 1 scores
alpha 2 scores
bravo scores
RelyX™ Unicem
alpha 1 scores
alpha 2 scores
bravo scores
40
20
0
Marginal integrity
Integrity of tooth
Surface roughness
Fig. 7: Clinical performance of
ceramic in- / onlays seated
with RelyX™ Unicem cement
(Maxicap™) and Variolink® II
low after 1 year.
Proximal contact
15
Criteria
Alpha 1 scores
Alpha 2 scores
Bravo scores
Marginal integrity
Margin matches
restoration and
tooth perfectly in
shape and color
Margin does not
match perfectly but
can be polished
without causing
damage to do so
Marginal gap with
no negative longterm consequences
Integrity of tooth
Complete integrity
Minor enamel crack
or hair-line split
Clear enamel crack
with no negative
long-term consequences
Proximal contact
Physiological
contact
Contact is too weak
or too strong
Contact is far too
weak; but no indication of tissue
damage
Surface roughness
Smooth and
polished surface
Slightly rough
surface; can be
polished
Rough surface; can
not be polished
without causing
damage
Table 6: Modified Ryge criteria for
the clinical evaluation of in- and
onlay restorations
Conclusions:
After one year RelyX™ Unicem cement (Maxicap™) performed similar to the control.
Furthermore, this study highlights the lack of hypersensitivities both in the control group as
well as with RelyX Unicem cement.
3M™ ESPE™ RelyX™ Unicem SelfAdhesive Universal Resin Cement
4-year Clinical Performance
THE DENTAL ADVISOR, Vol. 4, No. 4,
May 2007
Clinical Performance of Composite, All ceramic, and
PFM Restorations after 4 Years
Study design and results:
Over 4,400 restorations have been cemented with RelyX Unicem cement (Aplicap™/Maxicap™)
between 2003 and 2006 by the evaluators of THE DENTAL ADVISOR. The distribution of
indications and materials was as shown in the chart below. 1,560 restorations were available for
recall and 230 of these have been cemented for 4 years.
Fig. 8: Indications and restorative material types cemented
with RelyX™ Unicem cement
(Aplicap™).
PFM
crowns/bridges
0%
20%
Post-Operative Sensitivity
(based on 1,560 restorations)
no post-operative
sensitivity 98,2%
all-ceramic
crowns/bridges
posts
post-operative
sensitivity 1,6%
40%
all-ceramic
in-/onlays
60%
80%
Microleakage
(based on 1,560 restorations)
no microleakage
95,8%
microleakage
4,2%
100%
Debonding
(based on 4,400 restorations)
no debonding
99,3%
debonding
0,7%
Fig. 9: Clinical performance of
restorations cemented with
RelyX™ Unicem cement (Aplicap™)
after 4 years.
Conclusions:
According to THE DENTAL ADVISOR “RelyX Unicem cement has proven to be an excellent
and reliable self-adhesive resin cement in the four years since its introduction”.
Overall, RelyX Unicem cement showed 98% positive clinical performance and received
5 plus – the highest rating by THE DENTAL ADVISOR.
16
Clinical Performance of Metal, Ceramic and PFM
Restorations after 2 Years
Study design and results:
90 restorations (mean age 21-months) in 82 patients have been seated by general dental practitioners and were available for recall. Four restorations were reported to have failed for reasons
(root fracture, porcelain fracture, and unrelated enamel chipping), deemed by the operator,
unconnected with the use of RelyX™ Unicem cement (Aplicap™).
all-metal
0%
PFM
20%
fiber post
40%
60%
Fig. 10: Types of restorative
materials used for restorations
seated with RelyX™ Unicem
cement (Aplicap™).
all-ceramic
80%
Two-year Performance of Restorations
Placed with a Self-Adhesive Luting
Material
Crisp R.J., Burke F.J.T., University of
Birmingham, UK
Published at the IADR 2006, abstract
#2098
100%
[%]
Marginal adaptation
0
20
40
60
80
100
Explorer does not
catch
Explorer catches, no
crevice visible
Crevice at margin,
enamel margin exposed‡
Obvious crevice at
margin, dentine or lute
exposed‡
Fig. 11: Marginal adaptation of
various restorations 2 years after
cementation with RelyX™ Unicem
cement (Aplicap™).
*
‡ clinically unacceptable
* none detected
[%]
Marginal staining
0
20
40
60
80
100
No discoloration
present
Slight staining present,
can be polished away
Obvious staining,
cannot be polished away
Gross staining‡
Fig. 12: Marginal staining of various
restorations 2 years after cementation with RelyX™ Unicem cement
(Aplicap™).
*
‡ clinically unacceptable
* none detected
Conclusions:
Over a mean 21-month observation time the RelyX Unicem self-adhesive universal resin
cement (Aplicap) was rated to perform well and no cement-related failures were observed.
17
FRC vs. Titanium Posts-Preliminary
Results of a RCT
Naumann M.1, Sterzenbach G.2,
Blankenstein F.2,
Lange K.-P.2
1
Humboldt-University Berlin, Charite University Medicine, Germany
2
Humboldt-University Berlin, Germany;
Published at the IADR 2006, abstract
#0077
Clinical Performance of Endodontic Posts after 3 Years
Study design and results:
45 patients were treated using a titanium post (Fiberpoints Root Pins Titanium) and 46 patients
received a glass fiber post (Fiberpoints Root Pins Glass, both Schuetz Dental Group). All posts
had a diameter of 1.4mm and a length of 13mm and were cemented with RelyX™ Unicem
cement (Aplicap™). All teeth received a core build-up. Patients were observed in regular intervals after post placement.
Conclusions:
After 1 to 3 years of clinical service all the restorations were still in place and no difference was
observed between the two post materials tested. Therefore, RelyX Unicem cement (Aplicap) is
very well suited for any kind of post cementation.
Human Pulp Response to Resin
Cements Used to Bond Inlay
Restorations
Costa C.A. de S.1, Hebling J.2,
Randall R.C.2
1
University Sao Paulo State-UNESP,
Sao Paulo, Brasilia
2
3M ESPE, St. Paul, USA
Journal of Dental Materials, No. 22,
2006, 954–962
Human Pulp Response to Resin Luting Cements
Study design and results:
Deep Class V cavities were prepared on the buccal surface of 34 sound human premolars.
Inlays were fabricated and cemented with either RelyX Unicem cement (Aplicap) or
Variolink® II / Excite® DSC (Ivoclar Vivadent). 60 days after cementation the teeth were
extracted and processed for histological assessment. In both control groups (group 1: cavity
was lined with Dycal®, Dentsply Caulk prior to cementation with RelyX Unicem cement;
group 2: teeth were left untreated), normal histological characteristics were observed.
100
RelyX™ Unicem Aplicap™
Variolink® II
80
[%]
60
40
Fig. 13: Inflammatory cell
response in the pulp area 60 days
after cementation of an inlay
(teeth per group = 6).
20
*
0
none
slight
moderate
*
severe
* none detected
Conclusions:
Teeth that had received an inlay cemented with the one-step RelyX Unicem cement showed a
lower inflammatory cell response than teeth treated with a multi-step resin cement.
11.2. In vitro Studies
Measuring Bond Strength
The following chapter provides an overview on in vitro studies mainly measuring bond strength
values to tooth structure or various restorative materials.
Although the output of most measurements is given in MPa (i.e. mega Pascal; Pascal is a measure for pressure equaling Newton (N) per m2) absolute numbers resulting from different studies
cannot simply be compared for severeal reasons. First and foremost, bond strength can be
18
determined using methodologies that differ in their experimental set-up. Second, even if the
same set-up is used, experimenters can come to differing results due to the influence of a number of factors such as:
• teeth from different species and / or different individuals
• way of securing the teeth for preparation and testing
• kind of surface preparation (grit of sandpaper)
• geometry of the substrate and the sample
• differences in the handling between operators
• cross-head speed of the testing machine
Therefore, absolute numbers should only be compared if retrieved in the same experiment. In
general, this calls for study designs where a broad range of products is investigated side by side
under the same conditions.
To determine the bond strength of a cement at different points of time after seating of the
restoration test samples can be subjected to different treatments. To examine immediate bond
strength, the cement is cured and the samples are tested. Simulation of long-term clinical performance and aging can include one or a combination of the following treatments:
• water storage over an extended period of time
• thermocycling
• mechanical loading.
The principle of a number of test methods is described briefly in the following. Only the very
basics of the particular method are given here and numerous modifications exist according to
requirements of the aim of the study and the operator.
Shear Bond Strength
In the studies cited here, the shear bond strength has been determined using two different
experimental set-ups. One set-up uses a wedge-like instrument (fig. 14) to shear off the luted
composite sample. The other method uses a wire loop (fig. 15). In both cases the shear force
is applied parallel to the sample surface.
Fig. 14: Simplified depiction of a
set-up to determine the shear
bond strength using a wedge
shaped instrument. The cement
is shown as red line.
• Extracted teeth are embedded
• A button like specimen (e. g.
• For determining the shear
into resin or impression material.
made from composite) with a
bond strength of the cement
• Teeth are cut with saws and/or
defined bonding surface area is
the test sample is mounted
ground with sandpaper to obtain
cemented to the tooth surface.
into a universal testing
a flat surface in either dentin or
In an alternative set-up the
machine.
enamel.
button–like specimen itself is
• If a wedge-like instrument is
• The tooth structure is prepared
made of the cement to be testused the force needed to shear
following the Instructions for Use
ed. To this end a cylindrical or
off the composite specimen at
given by the manufacturer of the
button-like mold is placed onto
a given speed is recorded and
particular cement to be tested.
the tooth surface and filled with
the corresponding bond
• Alternatively, bond strength to
the cement.
strength (pressure) is calcurestorative materials (e. g. metals, • Samples may be stored for diflated.
ceramics, composite) can be
ferent lengths of time and/or
determined if the tooth is
thermocycled according to the
replaced by a specimen of the
design of the experiment to
material under investigation.
simulate aging.
19
Fig. 15: Simplified depiction of a
set-up to determine the shear
bond strength using a wire loop.
see above
see above
The force needed to break off
the composite specimen is
recorded accordingly if a wire
loop is used.
Tensile Bond Strength
For tensile testing samples are prepared as described above for determining shear bond
strength. In this test, however, specimens are pulled off with the force applied perpendicular to
the sample surface.
Fig. 16: Simplified depiction of a
set-up to determine the tensile
bond strength.
see above
see above
The force needed to pull off
the composite specimen is
recorded and the corresponding bond strength (pressure)
calculated.
The tensile bond strength test method can be modified to determine the bond strength of
cements to root canal posts.
Fig. 17: Simplified depiction of
a set-up to determine the tensile
bond strength on root canal
posts.
A plastic carrier is slipped onto
the conical end of the post. Each
sample shows the same length of
the post tip.
20
A standardized mold on the
plastic carrier is used to apply
the same amount of cement to
each of the samples.
After curing, the cement disc is
pulled off in a universal testing
machine.
Microtensile Bond Strength
Fig. 18: Simplified depiction of a
set-up to determine the microtensile bond strength.
• The tooth is cut to either show
• After setting rectangular beams • Each beam is mounted into a
enamel or dentin surface. A comare cut out with a diamond
universal testing machine and
posite block is then cemented to
saw.
bond strength is determined.
the exposed tooth surface using
the cement to be tested.
Retentive Bond Strength of Full Crowns
This test is a variation of the tensile bond strength test.
Fig. 19: Simplified depiction of a
set-up to determine retentive
bond strength using full crowns.
The cement is shown as red line /
surface.
• Extracted (human) teeth are prepared for full crowns in a standardized manner. The root area
of the teeth is embedded into a
resin block for mounting into a
universal testing machine.
• Crowns with external retentions are fabricated and cemented using the cements to
be tested.
• The force necessary to pull off
each crown is measured. After
determining the retention surface of each individual tooth
the retentive bond strength is
calculated.
Retentive Bond Strength of Fiber Posts
Similar to a full crown test, the retention of a root canal post can be simulated. After extraction,
teeth are endodontically treated and the root canal is filled with guttapercha. In the second
preparation step the guttapercha filling is removed and a post is cemented into the root canal in
a standardized way. The force needed to extract the post from the tooth is recorded.
21
Dentin Shear Bond Strength of Various
Luting Cements
Piwowarczyk A.1, Lauer H.-Ch.1,
Sorensen J.A.2
1
Johann Wolfgang Goethe-University,
Frankfurt, Germany
2
Oregon Health & Science University,
Portland, USA
Published at the CED 2002, abstract
#0215
Shear Bond Strength of Different Classes of Cements
to Human Dentin
Study design and results:
The dentin of extracted human molars was prepared by grinding with sandpaper (600 grit).
Each cement system was used according to the manufacturer’s instructions for use. One half of
the samples was tested at 30 minutes the other half after 14 days of water storage and subsequent thermocycling (1,000 x 5/55°C) (experimental set-up see chapter 11.2.).
22
20
30 min
14d / thermocycling
18
LC: LIGHT cure
SC: SELF cure
16
[MPa]
14
12
10
8
6
4
Fig. 20: Shear bond strength to
human dentin after 30 min and
14 days / thermocycling.
2
na
Pa
AR
™
R
el
yX
vi
C
a™
/S
F
co
/E
tc
D
hb
™
yX
el
R
ta
Ke
(
Pr SC
im )
er
Va
™
rio
lin
(L
C
k®
)
I
C I/S
la y
R
ss nt
el
ic ac ®
yX
(L
™
C
U
)
ni
ce
m
Ap ( S C
lic )
ap
™
(L
C
)
(S
on C)
d™
1
(L
C
)
g
Lu
jiC
tin
EM
us
Fu
Fu
ji
Pl
™
l ic
c™
Fl
C
ec
k’s
em
™
Ap
ce
m
Fu
ap
ji
en
t
1
0
* zinc phosphate cement
Conclusions:
The one-step RelyX™ Unicem Self-Adhesive Universal Resin Cement (Aplicap™) shows
comparable results as the multi-step adhesive bonding system Panavia™ F. This is true for both
curing modes and for bond strength values measured 30 min after cementation and after
simulated aging.
Effect of One-day Storage on Bonding
of Self-Adhesive Resin Cements
Irie M.1, Richter B.2, Suzuki K.1
1
Okayama University Graduate School,
Okayama, Japan
2
3M ESPE, Seefeld, Germany
Published at the AADR 2006 abstract
#1839
22
Shear Bond Strength to Human Dentin and Enamel and
Lava™ Ceramic Immediately and after 24 Hours
Study design and results:
Polished surfaces (1,000 grit) of human dentin, enamel and Lava zirconia ceramic samples
were prepared. The Lava surface was sandblasted (50µm Al2O3). Composite inlays (Filtek™
Z250, 3M ESPE) were fabricated and luted to the substrate samples using the three resin
cements (RelyX Unicem cement (Aplicap), 3M ESPE; Maxcem™, Kerr; Panavia F 2.0,
Kuraray). The shear bond strength of the cementation was measured using a universal testing
machine immediately and after one-day storage (experimental set-up see chapter 11.2.).
25
Enamel
Maxcem™
Panavia™ F 2.0 / Porc. Activ. / Mega Primer
RelyX™ Unicem Aplicap™
20
Lava™
Dentin
[MPa]
15
10
Fig. 21: Shear bond strength to
human enamel and dentin, and
Lava™ ceramic immediately and
after 24 hours.
5
0
immediately
24hrs
immediately
24hrs
immediately
24hrs
Conclusions:
RelyX Unicem cement (Aplicap) shows bond strength values that are comparable to the multistep cement Panavia F2.0 and superior to Maxcem on dentin. Generally, cement bond strength
values improve after 24 hours storage making differences to Maxcem more obvious.
Tensile Bond Strength to Human Dentin and Enamel
Study design and results:
Extracted human third molars were grinded with sandpaper (600 grit) to expose dentin and
enamel surfaces. Composite specimens (Filtek™ Supreme, 3M ESPE) were cemented onto the
tooth structure following the cement manufacturers’ instructions for use. Three different selfadhesive resin cements were used: RelyX Unicem cement (Aplicap™) (3M ESPE), Maxcem™
(Kerr), and Embrace™ Wetbond™ (Pulpdent). After storing in water for 24 hours the tensile
bond strength was measured using a universal testing machine (experimental set-up see
chapter 11.2.).
50
Human Enamel
Human Dentin
40
[MPa]
In Vitro Bond Strength of Adhesive
Cements to Tooth Structure.
Pinzon L.M., Powers J.M.
University of Texas Dental branch at
Houston, USA
THE DENTAL ADVISOR, Research
Report, No. 1, June 2005
SELF cure
LIGHT cure
30
20
Fig. 22: Tensile bond strength to
human enamel and dentin after
24 hours.
10
0
Embrace™* Maxcem™
Wetbond™
RelyX™
Unicem
Aplicap™
Embrace™ Maxcem™
Wetbond™
RelyX™
Unicem
Aplicap™
* Enamel cemented with Embrace Wetbond (Pulpdent) was etched with phosphoric
acid following manufacturer’s directions
Conclusions:
RelyX Unicem cement showed the same bond strength values in both curing modes. On human
dentin RelyX Unicem cement performed better than Embrace Wetbond and Maxcem.
23
Shear Bond Strength to Human Dentin and Enamel after
24 Hours and Thermocycling
Study design and results:
Extracted human molars were ground flat with sandpaper (600 grit) to expose dentin and
enamel surface. For cementation, RelyX™ Unicem cement in the Aplicap™ Capsule and the
Clicker™ Dispenser (3M ESPE) as well as Maxcem™ (Kerr) were used both in self and light
cure mode. One subgroup was tested after 24 hours water storage at 37°C; the other subgroup
was stored 14 days and subsequently thermocycled (1,000 x 5/55°C). Shear bond strength was
determined in a universal testing machine (experimental set-up see chapter 11.2.).
12
12
Human Enamel
Human Dentin
24hrs
10
24hrs
10
14d+TC
14d+TC
8
Fig. 23: Shear bond strength to
human enamel (left) and dentin
(right) after 24 hours and thermocycling
SELF cure
LIGHT cure
TC: thermocycling (1,000x 5/55°C)
SELF cure
RelyX™ Unicem
Aplicap™
RelyX™ Unicem
Clicker™
MaxCem™
0
RelyX™ Unicem
Aplicap™
0
RelyX™ Unicem
Clicker™
2
MaxCem™
2
RelyX™ Unicem
Aplicap™
4
RelyX™ Unicem
Clicker™
4
RelyX™ Unicem
Aplicap™
6
MaxCem™
[MPa]
6
MaxCem™
[MPa]
8
RelyX™ Unicem
Clicker™
Bond Strength of Self-Adhesive
Cementing Agents to Dentin and
Enamel
Piwowarczyk A., Bregulla J., Lauer H.-C.
Johann Wolfgang Goethe-University
Frankfurt, Germany
Published at the IADR 2007, abstract
#1540
LIGHT cure
TC: thermocycling (1,000x 5/55°C)
Conclusions:
RelyX Unicem cement both from the Aplicap Capsule and the Clicker Dispenser show similar
performance. RelyX Unicem cement bond strength values do not decrease after thermocycling.
Hikita K.1,2, De Munck J.1,2, Ishijima T.2,
Maida T.2, Lam-brechts P.1,2, Van
Meerbeek B.1,2
1
Catholic University of Leuven,
Netherlands
2
Health Sciences University of
Hokkaido, Sapporo, Japan
Published at the IADR 2004,
abstract #3175
Bonding Effectiveness of Adhesive
Luting Agents to Enamel/Dentin
24
Microtensile Bond Strength to Human Dentin and
Enamel
Study design and results:
Extracted human third molars were flattened using a diamond bur to expose enamel or dentin
surfaces. Composite specimens (Paradigm™ MZ100, 3M ESPE) were luted to the tooth substrate using four different cements requiring an adhesive bonding system: Linkmax (GC),
Nexus® 2™ (Kerr), Variolink® II (Ivoclar Vivadent), Panavia™ F (Kuraray) and one self-adhesive
universal resin cement: RelyX Unicem (Aplicap). All cementations were done following the
manufacturers' instructions for use. The specimens were stored for 24 hours in distilled water
at 37°C prior to testing in a universal testing machine (experimental set-up see chapter 11.2.).
40
70
Human Dentin
Human Enamel
60
30
[MPa]
[MPa]
50
40
30
20
20
**
10
*
10
0
0
Linkmax
Nexus® 2™ Variolink® II Panavia™ F RelyX™
Unicem
Aplicap™
Linkmax
Nexus® 2™ Variolink® II Panavia™ F RelyX™
Unicem
Aplicap™
* 10 out of 12 smaples failed before testing (Variolink II)
** 1 out of 10 samples failed before testing (RelyX Unicem)
Conclusions:
All cements in the test showed equally good adhesion to dentin (see note for Variolink®).
All luting cements that require additional priming / bonding pretreatment steps showed higher
adhesion values to enamel.
Tensile Bond Strength to Human Dentin and
Enamel
Study design and results:
Enamel and dentin specimens were prepared from non-carious third human molars (600 grit).
Composite cones (Filtek™ Z250, 3M ESPE) were cemented according to the cement manufacturers’ instructions for use using two resin cements that use adhesive bonding systems
(Calibra®) and the self-adhesive resin cement RelyX™ Unicem (Aplicap™). Cements were light
cured (40 sec) or self cured (15 min at 37°C). Tensile bond strength was determined using a
universal testing machine after 24 hours storage (experimental set-up see chapter 11.2.).
Human Enamel
Human Dentin
LIGHT cure
SELF cure
35
30
30
25
25
20
[MPa]
[MPa]
Bonding of a Novel Self-Adhesive
Cement to Tooth Substrates
Trajtenberg C.P., Pinzon L.M., Powers
J.M.
University of Texas Dental Branch at
Houston, USA
Published at the AADR 2003, abstract
#1197 revised
40
40
35
Fig. 24: Microtensile bond
strength to human enamel (left)
and dentin (right) after 24 hours.
20
15
15
10
10
5
5
0
0
Calibra®/
Variolink® II/
RelyX™ Unicem
Prime & Bond® NT™ Syntac® Classic
Aplicap™
LIGHT cure
SELF cure
Calibra®/
Variolink® II/
RelyX™ Unicem
Prime & Bond® NT™ Syntac® Classic
Aplicap™
Conclusions:
The bond strength of RelyX Unicem cement is almost independent of the curing mode. RelyX
Unicem cement shows an especially high performance on dentin.
Fig. 25: Tensile bond strength to
human enamel (left) and dentin
(right) after 24 hours.
25
3M ESPE internal lab data (2006)
Immediate Shear Bond Strength to Bovine Dentin
Study design and results:
Bovine anterior teeth were ground flat with sandpaper (320 grit). Composite discs (Paradigm™
MZ 100, 3M ESPE) were cemented to the dentin according to the cement manufacturers’
instructions for use. All cements were light cured for 20 sec from each side. 5 minutes after
cement mixing the shear bond strength was measured using a universal testing machine
(experimental set-up see chapter 11.2.).
10
8
[MPa]
6
Fig. 26: Shear bond strength to
bovine dentin 5 min after cementation.
4
2
0
Maxcem™ Monocem
Multilink
Automix
Calibra®
Panavia™ F RelyX™
2.0
Unicem
Clicker™
RelyX™
Unicem
Aplicap™
Conclusions:
RelyX™ Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show the same
shear bond strength which prove to be among the highest of the cements tested.
3M ESPE internal lab data (2006)
Tensile Bond Strength to Bovine Dentin and Enamel
Study design and results:
Bovine teeth were ground flat with sandpaper (320 grit) to expose dentin and enamel surface.
The cements tested were applied to the tooth structure according to the cement manufacturers’
instructions for use forming a button-like structure. Tensile bond strength was determined after
24 hours storage using a universal testing machine (experimental set-up see chapter 11.2.).
7
Bovine Enamel
6
LIGHT cure
SELF cure
[MPa]
5
4
3
2
Fig. 27: Tensile bond strength of
different luting cements to bovine
enamel after 24 hours.
1
0
n.a.
n.a.
Harvard
Fuji I
n.a.
FujiCEM
conventional cements
26
Maxcem™
RelyX™
Unicem
Aplicap™
RelyX™
Unicem
Clicker™
self-adhesive cements
4
Bovine Dentin
LIGHT cure
SELF cure
[MPa]
3
2
1
n.a.
0
n.a.
Harvard
Fig. 28: Tensile bond strength of
different luting cements to bovine
dentin after 24 hours.
n.a.
Fuji I
FujiCEM
Maxcem™
RelyX™
Unicem
Aplicap™
RelyX™
Unicem
Clicker™
self-adhesive cements
conventional cements
Conclusions:
RelyX™ Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show far superior
bond strength compared to the conventional cements tested.
Retentive Bond Strength of Lava™ Zirconia Crowns on
Human Dentin
Study design and results:
Full crown preparations were performed on extracted human teeth in a standardized manner
simulating clinical conditions (experimental set-up see chapter 11.2.). The resin cements and
the adhesive system were used according to manufacturers' instructions for use. With dualcuring systems, only the self-curing approach was conducted. The crowns inner surfaces were
sandblasted (Rocatec™ Pre, 3M ESPE). After thermocycling (5,000 x 5/55°C), the bond
strength of 50% of the cemented ceramic crowns was determined using a universal testing
machine. The remaining samples were tested after 1 year of water storage. The retention surface was determined individually for each tooth and retentive strength was calculated.
In Vitro Retentive Strength of ZirconOxide all Ceramic Crowns
Ernst C.-P., Askoy E., Stender E.,
Willershausen B.
Johannes Gutenberg University Mainz,
Germany
Published at the IADR PEF 2006,
abstract #0248
10
9
TC
8
TC+1yr water storage
[MPa]
7
6
5
4
3
Fig. 29: Retentive strength of
Lava™ crowns on human dentin
after thermocycling and 1 year
water storage
2
1
lic
R
ap
Ap ely
™
lic X™
ap U
™ n
i
/R ce
oc m
at
ec
™
Pl
us
m
ce
ax
M
bars represent 25th and 75th percentile
R
U ely
ni X
ce ™
m
Ap
™
/
x
ix
/
M
M ulti
on lin
ob k
on Au
d tom
S
i
0
2.
columns show median values
M
M ulti
et lin
al k
Pr Au
im to
er m
F
™
vi
a
na
Pa
Va
r
io
lin
k®
II/
Fu
Sy
jiC
nt
a
EM
c®
0
TC: thermocycling (5,000x 5°C/55°C)
Conclusions:
Lava™ crowns cemented with RelyX Unicem cement showed the highest median retentive
strength initially and after 1 year in this clinically relevant study design. (Rocatec™ pretreatment
is not needed to improve RelyX Unicem cement retentive strength.)
27
Shear Bond Strength of the
Zirconia/Resin Interface
Behr M., Rosentritt M., Kolbeck C.,
Lang R., Handel G.
University of Regensburg, Germany
Published at the IADR 2007 #2627
Shear Bond Strength to Zirconia Ceramic
Study design and results:
Zirconia specimens (Cercon®, Dentsply) were bonded to metal (CoCr) cylinders. All bonding
areas were first sandblasted (110µm Al2O3). Alloy-Primer (Kuraray) was applied on all metal
bonding surfaces. The following resin cements and bonding agents were used: Calibra® / Silane
/ Prime & Bond® NT™ and SRC (Dentsply), Maxcem™ (Kerr), Multilink® Automix / SR-Link
(Ivoclar Vivadent) , Multilink® Xpress (Ivoclar Vivadent), Panavia™ F 2.0 (Kuraray), RelyX™
Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser (3M ESPE), Rocatec™ silicoating (3M ESPE). All cements were self cured at 37°C. The shear bond strength was determined after 24 hours, 30 days of water storage, and after 12,000 thermal cycles (5/55°C, 17d)
(experimental set-up see chapter 11.2.).
45
24 hrs
thermocycling (12,000 x 5/55°C)
30 d water storage
40
35
[MPa]
30
25
20
15
10
5
Fig. 30: Shear bond strength of
various resin cements (self cure)
to zirconia ceramics at 24 hours,
after thermocycling, and after
30 days water storage.
28
P
(n ana
o v
pr ia™
im
er F2
)
.0
Va
rio
lin
k®
(R
oc
at
ec
)
co
n
no tr
pr ol (
im V
er ari
) oli
nk
®
,
R
e
C ly
lic X
ke ™
r™ U
n
(n ice
o m
pr
im
R
er
Ap ely
)
X
lic ™
ap U
™ n
(n ice
o m
pr
im
er
R
)
e
A ly
si plic X™
lic a
oa p™ Un
tin ( ic
g) Ro em
ca
te
c
s
M
(n ulti
o lin
pr k
im X
er pre
)
s
C
Pr alib
im ra ®
e
& (S
Bo ila
nd ne
+
®
N
T™
+S
M
R
ax
C
ce
)
m
™
(n
o
pr
im
er
)
M
u
(S lti
R lin
-L k
in A
k) ut
om
ix
0
Conclusions:
Regarding the shear bond strength of the zirconia / resin cement interface, both RelyX Unicem
self-adhesive universal resin cement in the Aplicap capsule and the Clicker dispenser performed at a similarly high level. The shear bond strength of RelyX Unicem cement is less
susceptible to change after thermocycling and long-term water storage than most other
cements tested.
Shear Bond Strength to Lava™ Zirconia Ceramic and
Glass Ceramic
The Shear Bond Strength Between
Luting Cements and Zirconia Ceramic
after two Pretreatments.
Piwowarczyk A., Lauer H. C.,
Sorensen J. A.
Oper Dent. 2005 May-Jun; 30(3):
382-8
Study design and results:
Lava™ (3M ESPE) zirconia samples were air-abraded (100µm Al2O3). IPS Empress® 2 (Ivoclar
Vivadent) leucite-reinforced glass ceramic samples were etched with hydrofluoric acid and
silanated (Monobond S, Ivoclar Vivadent). Composite samples were cemented onto the specimens using different luting cements according to the cement manufacturers’ instructions for
use. Shear bond strength was tested in a universal testing machine after 30 min and after
14 days water storage and subsequent thermocycling (1,000 x 5/55°C) (experimental set-up
see chapter 11.2.).
In Vitro Shear Bond Strength of
Cementing Agents to Fixed Prosthodontic Restorative Materials
Piwowarczyk A., Lauer H. C.,
Sorensen J. A.; Johann Wolfgang
Goethe University of Frankfurt,
Germany
J Prosthet Dent. 2004 Sep; 92(3):
265-73
22
20
30 min
14d / thermocycling
18
LC: LIGHT cure
SC: SELF cure
16
[MPa]
14
12
10
8
Fig. 31: Shear bond strength of
different luting cements to
leucite-reinforced glass ceramic
IPS Empress® 2 (Ivoclar Vivadent) initially and after 14 days
water storage and thermocycling
(1,000 x 5/55°C).
6
4
2
C
)
)
k®
II
(S
Va
C
rio
)
lin
k®
R
el
II
yX
(L
™
C
)
U
ni
ce
R
el
m
yX
(S
™
C
)
U
ni
ce
m
(L
C
)
R
(L
(S
lin
F
Va
rio
el
Pa
Pa
na
na
vi
vi
a™
a™
F
C
AR
™
yX
™
yX
el
R
C
C
(L
(S
C
AR
™
yX
el
R
)
)
C
g
tin
Lu
jiC
Fu
Fu
ji
Pl
us
EM
0
14
30 min
14d / thermocycling
10
LC: LIGHT cure
SC: SELF cure
[MPa]
12
8
6
4
2
el
R
* zinc phosphate cement
yX
™
)
C
U
ni
ce
m
(L
Ap (SC
lic )
ap
™
(S
C
lin )
k®
II
(L
C
)
io
Va
r
na (SC
vi )
a™
F
(L
C
)
Pa
yX (S
™ C)
AR
C
(L
C
)
el
X™
el
y
R
R
Lu
t
in
g
EM
iC
Fu
j
us
Pl
ji
C
c™
ta
Fu
EM
1
ji
Fu
Ke
Fl
ec
k’s
™
ce
m
en
t*
0
Conclusions:
Within the group of cements tested the shear bond strength of RelyX™ Unicem cement to zirconia and glass ceramic is among the highest when light cured. Light curing is the preferred curing mode for all-ceramic restorations.
Fig. 32: Shear bond strength of
different luting cements to Lava™
zirconia ceramic initially and after
14 days water storage and thermocycling (1,000 x 5/55°C).
29
In Vitro Shear Bond Strength of
Cementing Agents to Fixed
Prosthodontic Restorative Materials
Piwowarczyk A., Lauer H. C.,
Sorensen J. A.; Johann Wolfgang
Goethe University of Frankfurt,
Germany
J Prosthet Dent. 2004 Sep; 92(3):
265-73
Shear Bond Strength to Alumina Ceramic
Study design and results:
Procera® AllCeram (Nobel Biocare) specimens were air-abraded (100 µm Al2O3). Composite
samples were cemented onto the specimens using different luting cements according to the
cement manufacturers’ instructions for use. Dual cure cements were light cured. Shear bond
strength was tested in a universal testing machine at 30 min and after 14 days water storage and
subsequent thermocycling (1,000 x 5/55°C) (experimental set-up see chapter 11.2.).
10
9
30 min
14d / thermocycling
8
7
[MPa]
6
5
4
Fig. 33: Shear bond strength
of different luting cements to
high-strength alumina ceramics
initially and after 14 days water
storage and thermocycling
(1,000 x 5/55°C).
3
2
1
lin
io
R
el
yX
Va
r
™
Ap Un
lic ice
ap m
™
k®
II
F
a™
Pa
na
vi
™
el
R
yX
el
yX
™
Fu
Lu
AR
tin
C
g
EM
jiC
us
Fu
c™
ji
C
Pl
em
1
ji
Fu
Fl
ec
R
k’s
Ke
™
ta
ce
m
en
t*
0
* zinc phosphate cement
Conclusions:
After 14 days water storage and thermocycling Panavia™ F and RelyX™ Unicem cement
(Aplicap™ Capsule) showed the strongest bonding to air-abraded alumina ceramic among the
cements tested.
Retention of Fiber Posts Cemented
with a New Delivery System
Del Mastro M., Armoush Z.,
Aboushala A., Doherty E., Kugel G.
Tufts University, Boston, MA, USA
Published at the IADR 2007, abstract
#1553
Retention Strength of Fiber Posts Cemented with
2 Different Cements
Study design and results:
Human teeth were decoronated and roots received endodontic treatment using guttapercha. Post
spaces were prepared using the RelyX™ Fiber Post system drills (3M ESPE). RelyX Fiber Posts
were cemented using RelyX ARC (n=20) and RelyX Unicem cement (Aplicap) (n=20) according to the cement manufacturer's instructions for use. Pull-out force was determined at 30 minutes and at 24 hours using a universal testing machine (experimental set-up see chapter 11.2.).
250
30 min
24 hrs
200
[N]
150
100
50
Fig. 34: RelyX™ Fiber Post retention values in human teeth 30 min
and 24 hours after cementation.
0
RelyX™ ARC
RelyX™ Unicem Aplicap™
Conclusions:
The multi-step RelyX ARC cement and the one-step RelyX Unicem cement (Aplicap) show
similar retentive strengths to RelyX Fiber Post and the tooth structure.
30
Tensile Bond Strength to Fiber Post
3M ESPE internal lab data (Dec 2007)
Study design and results:
For determining the bond strength to RelyX Fiber Post the cements were applied to the post
surface in a disc shape at the conical part of the post. RelyX™ Fiber Post was either left untreated pretreated as described in the chart: etching, silanating (e. g. RelyX Ceramic Primer,
3M ESPE, or Monobond S, Ivoclar Vivadent), or a combination of silicatization (Rocatec
System, 3M ESPE) and silanating. Cements were either light cured for 40 seconds (RelyX
Unicem Aplicap and Clicker, 3M ESPE; Maxcem™, Kerr) or for 60 seconds (Multilink
Automix and Variolink® II, Ivoclar Vivadent) or self cured (1 hr at 36°C / >95% r. h.). After
water storage (24 hrs at 36°C) bond strength was measured in a pull-off test (experimental setup see chapter 11.2.).
30
LIGHT cure
25
SELF cure
[MPa]
20
*
15
10
Fig. 35: Tensile bond strength of
different cements to RelyX™ Fiber
Post after light and self curing
and with different post pretreatments.
5
0
Maxcem™
(no pretreatment)
Variolink® II &
Monobond S
Multilink Automix &
Monobond S
RelyX™ Unicem
Aplicap™
(no pretreatment)
RelyX™ Unicem Clicker™
(no pretreatment)
* The manufacturer does not recommend self curing for Variolink II
30
25
[MPa]
20
15
10
Fig. 36: Tensile bond strength (24
hrs) of RelyX™ Unicem Cement to
RelyX™ Fiber Post with and without fiber post pretreatment.
5
0
No
RelyX™ Ceramic Rocatec™
Phosphoric
Pretreatment
Primer
System &
Acid Etching
RelyX™ Ceramic
Gel
Primer
Monobond S
Conclusions:
RelyX Unicem cement shows consistently same high bond strength to RelyX Fiber Post, independent of curing mode and pretreatment steps - even without any pretreatment. Thus pretreatment such as silanisation is not necessary for this system.
For further information see RelyX™
Fiber Post Technical Product Profile
31
Sealing Ability and Microscopic
Aspects of a Self-adhesive Resin
Cement used for Fiber Post Luting into
Root Canals
Simonetti M., Coniglio I., Magni E.,
Cagidiaco M.C., Ferrari M.
Dept. Dental Materials, Faculty of
Dentistry, University of Siena, Italy
International Dentistry SA Vol. 8, No.
5, Sept./Oct. 2006
Fig. 37: SEM pictures of the canal
wall (top) / cement (middle) /
fiber post (bottom) interface. Left:
RelyX™ Fiber Post cemented with
RelyX™ Unicem cement (Aplicap™)
Right: RelyX™ Fiber Post cemented with Multilink Automix
Marginal Sealing in Fiber Post Treated Teeth
Study design and results:
Extracted human anterior teeth were endodontically treated with guttapercha and a resin sealer
(AH-25, DeTrey). Post spaces were prepared using the RelyX™ Fiber Post system drills.
Cementation of the post was done according to the cement manufacturers’ Instructions for Use
using the following resin cements: RelyX™ Unicem cement (Aplicap™) (3M ESPE), Multilink
Automix / Primer A&B (Ivoclar Vivadent), Maxcem™ (Kerr), and Calibra® / Prime & Bond®
NT™ (Dentsply). RelyX Unicem cement was applied directly into the root canal using the
RelyX Unicem Aplicap Elongation Tip (3M ESPE). All other cements were applied to the post
and/or the root canal using a lentulo spiral. After one week water storage microleakage between
the canal wall and the cement layer was determined using methylene blue dye. Additionally,
SEM pictures of the cement layer were taken.
dentin
dentin
RelyX Unicem cement
Multilink Automix
RelyX Fiber Post
RelyX Fiber Post
RelyX™ Unicem Aplicap™
Multilink / Primer A&B
Fig. 38: Microleakage between
the cement layer and the canal
wall at the apical level of the root.
Calibra® /
Prime & Bond® NT™
Maxcem™
0
1
2
3
4
microleakage (median scores)
0: no leakage
1: < 0.5mm
2: 0.5 - 1mm
3: 1 - 2mm
4: > 2mm
Conclusions:
RelyX Unicem cement in combination with RelyX Unicems Aplicap elongation tip and RelyX
Fiber Post shows a marginal sealing superior to other cement systems tested in this study.
According to the authors a good marginal seal is pivotal for the long-term success of the
endodontic and the prosthetic restoration by inhibiting bacterial infiltration.
32
Marginal Adaptation of Ceramic Inlays
Study design and results:
All-ceramic inlays (IPS Empress® 2, Ivoclar Vivadent) were cemented in MOD Class 2 cavities with cervical margins located both in dentin and in enamel. Three cements were tested:
Panavia™ F 2.0 / ED Primer (Kuraray), RelyX™ Unicem cement in the Aplicap™ Capsule and
the Clicker™ Dispenser (3M ESPE), and Maxcem™ (Kerr). Marginal adaptation was determined
using scanning electron microscopy (SEM) before and after thermocycling / mechanical loading (TCML 6,000 x 5/55°C, 2min each cycle; 1,200,000 x 50N).
Marginal Adaptation of Ceramic Inlays
Using Different Cements
Rosentritt M.1, Hahnel S.2, Behr M.1,
Handel G.1
1
University of Regensburg, Germany
2
University Medical Centre
Regensburg, Germany
Published at the IADR 2007, abstract
#1516
100
80
[%]
60
40
20
Fig. 39: Marginal adaptation (% perfect margin) of ceramic inlays to
enamel before and after TCML.
0
Maxcem™
Panavia™ F2.0
Perfect Margin to Enamel
before TCML
after TCML
RelyX™ Unicem
Clicker™
RelyX™ Unicem
Aplicap™
TCML: thermocycling (6,000x 5/55°C) &
mechanical loading (1,200,000x 50N)
100
80
[%]
60
40
20
Fig. 40: Marginal adaptation (% perfect margin) of ceramic inlays to
dentin before and after TCML.
0
Maxcem™
Panavia™ F2.0
RelyX™ Unicem
Clicker™
RelyX™ Unicem
Aplicap™
Perfect Margin to Dentin
before TCML
after TCML
TCML: thermocycling (6,000x 5/55°C) &
mechanical loading (1,200,000x 50N)
Conclusions:
Both RelyX Unicem cement in the Aplicap capsule and the Clicker dispenser show both very
good marginal adaptation before and after thermocycling/mechanical loading.
33
Proximal Adaptation of Partial Ceramic
Crowns with Different Luting
Techniques/Materials
Federlin M., Hiller K.-A., Reinhard H.,
Fritzsch D., Schmalz G.
University of Regensburg, Germany
Published at the IADR PEF 2006,
abstract #0562
Interfacial Adaptation of Partial Ceramic Crowns
Study design and results:
Partial ceramic crown preparations were performed on 48 extracted human molars. Crowns
were fabricated using the CEREC® 3 system and Vitablocs® Mark II (Vident). Cementation
was done according to the manufacturers’ instructions for use using different luting systems:
Syntac® Classic / Variolink® II, Multilink Primer A&B / Multilink Automix (Ivoclar Vivadent)
and RelyX™ Unicem cement (Aplicap™). All cements were light cured. Thermocycling/
mechanical loading (TCML) was applied (5,000 x 5/55°C, 30s/cycle; 500,000 x 72.5N/1.6Hz).
Marginal adaptation was assessed by SEM margin analysis on replicas and by silver staining on
multiple tooth sections.
100
Perfect Margin to
80
Ceramic before TCML
Ceramic after TCML
Dentin before TCML
Dentin after TCML
[%]
60
40
Fig. 41: Perfect margin of partial
ceramic crowns before and after
thermocycling and mechanical
loading determined by SEM
analysis.
20
0
Syntac® Classic &
Variolink® II
Multilink Primer A,B &
Multilink Automix
columns show median values
bars represent 25th and 75th percentile
RelyX™ Unicem Aplicap™
TCML: thermocycling (5,000x 5°C/55°C) &
mechanical loading (500,000x 72.5N/1.6Hz)
Conclusions:
Among the cements tested in this study, RelyX Unicem self-adhesive universal resin cement
showed the best interfacial adaptation, while being the least technique sensitive.
34
pH Profile of Various Luting Cements
Study design and results:
pH values were measured using a flat-surface pH electrode at different times after mixing the
cement.
Mechanical and Physical Properties of
Self-etching Resin Luting Cements
Sakalauskaite E., Tam L.E., McComb D.
University of Toronto, Canada
Published at the AADR 2006,
abstract #1894
9
8
7
ph
6
5
4
3
RelyX™ Unicem* LIGHT cure
RelyX™ Unicem* SELF cure
Maxcem™ LIGHT cure
Maxcem™ SELF cure
2
1
0
0
0.5
1.0
1.5
2.0
4.0 6.0
Time after mixing [hours]
Fig. 42: pH profile of
RelyX™ Unicem cement (Aplicap™) and
Maxcem™ cement
after mixing.
24.0
*measured with the RelyX™ Unicem capsule version
9
8
7
ph
6
5
4
3
2
Fig. 43: pH profiles
of various luting cements after mixing.
1
0
0
0.5
1.0
1.5
2.0
4.0 6.0
24.0
RelyX™ Unicem LIGHT cure *
RelyX™ Unicem SELF cure
*
™
Maxcem LIGHT cure
Maxcem™ SELF cure
Embrace™ Wetbond™ LIGHT cure
™
™
Embrace Wetbond SELF cure
adhesive and
conventional cements
self-adhesive cements
Time after mixing [hours]
RelyX™ Luting Plus
Linkmax LIGHT cure
Linkmax SELF cure
Fuji Plus
RelyX™ ARC LIGHT cure
RelyX™ ARC SELF cure
*measured with the RelyX™ Unicem capsule version
Conclusions:
RelyX™ Unicem cement shows a rapid rise in initial pH and reaches the neutral level of pH 7
which is considered to be an important prerequisite for long-term stability.
35
Adhesion of Self-adhesive Resin
Cements to Various Core Build-up
Materials
Wiedig C.A., Porsfeld V.N., Hecht R.,
Raia G.
3M ESPE, Germany, Seefeld, Germany
Published at the IADR 07, abstract
#2449
Shear Bond Strength to Core Build-Up Materials
Study design and results:
Composite buttons (Filtek™ Z250) were cemented onto core build-up discs finished with 320
grit sandpaper. Cementation was performed according to the cement manufacturers' instructions for use. After 24 hours storage and thermocycling (240 x 5/55°C) the shear bond strength
was measured in a universal testing machine (experimental set-up see chapter 11.2.).
35
Ketac™ Molar
Core Paste
Luxa Core
Tetric Evo Ceram
Filtek™ Supreme XT
30
[MPa]
25
20
*
*
*
*
15
*
*
*
10
Fig. 45: Shear bond strength of
different luting cements (light
cure) to core build-up materials
after 24 hours and thermocycling
(240 x 5/55°C).
*
*
5
0
Maxcem™
RelyX™ Unicem Aplicap™
RelyX™ Unicem Clicker™
* fractures mainly in core build-up material
35
Ketac™ Molar
Core Paste
Luxa Core
Tetric Evo Ceram
Filtek™ Supreme XT
30
[MPa]
25
Fig. 45: Shear bond strength of
different luting cements (light
cure) to core build-up materials
after 24 hours and thermocycling
(240 x 5/55°C).
*
*
*
*
*
20
*
15
*
*
*
*
10
5
0
Maxcem™
RelyX™ Unicem Aplicap™
RelyX™ Unicem Clicker™
* fractures mainly in core build-up material
Conclusions:
Both RelyX™ Unicem Self-Adhesive Universal Resin Cement in the Aplicap™ Capsule and the
Clicker™ Dispenser show comparable results in both curing modes and to all materials tested.
The majority of fractures occurs in the core-build-up material.
Effect of Surface Treatment on the
Shear Bond Strength of Three Resin
Cements to a Machinable Feldspatic
Ceramic.
Reich S.M.1, Wichmann M.1,
Frankenberger R.2, Zajc D.2
1
Department of Prosthetic Dentistry
36
Shear Bond Strength to CAD/CAM Glass Ceramics
Shear Bond Strength to Vitablocs® Mark II
Study design and results:
Disc shaped specimens were milled from Vitablocs® Mark II (Vident), HF-etched and silanated
(Monobond S, Ivoclar Vivadent; Silane Coupling Agent, Dentsply). The cements to be tested
(Calibra®, Dentsply; Variolink® II, Ivoclar Vivadent; RelyX Unicem Aplicap, 3M ESPE) were
applied to the prepared specimens in a cylindrical mold and light cured according to the manufacturers’ instructions for use. After storing in water (37°C) for 24 hours and after thermocycling (10,000 x 5/55°C) the shear bond strength was determined in a universal testing machine
(experimental set-up see chapter 11.2.).
30
2
Department of Operative Dentistry
and Periodontology, University of
Erlangen-Nuremberg, Erlangen,
Germany
J Biomed Mater Res B Appl Biomater.
2005 Aug;74(2), 740-6
24 hours
25
TC (10,000 x 5/55°C)
[MPa]
20
15
10
Fig. 46: Shear bond strength of
three luting cements (light cure)
to Vitablocs® Mark II specimens
after 24 hours and after thermocycling (10,000 x 5/55°C).
5
0
Calibra®
Variolink® II
RelyX™ Unicem Aplicap™
Conclusions:
This study shows that RelyX™ Unicem cement performs comparable to Variolink® II. RelyX
Unicem cement bond strength to HF-etched and silanated glass ceramics even improves after
thermocycling in this study.
Shear Bond Strength to Paradigm™ C and
Vitablocs® Mark II
Study design and results:
Specimens of the glass ceramic materials (Paradigm™ C, 3M ESPE; Vitablocs® Mark II, Vident)
were HF-etched and silanated (RelyX Ceramic Primer, 3M ESPE). The cements to be tested
(Variolink II, Ivoclar Vivadent; Panavia™ F2.0, Kuraray; RelyX ARC, and RelyX Unicem
Aplicap™, both 3M ESPE) were applied to the prepared specimens in a cylindrical mold and
light cured according to the manufacturers’ Instructions for Use. After storing in water (24 hrs
at 36°C) and after thermocycling (1,500 x 5/55°C) the shear bond strength was determined in a
universal testing machine (experimental set-up see chapter 11.2.).
Shear Bond Strength of RelyX™ Unicem
and RelyX™ ARC to an Experimental
Glass Ceramic Material
Fischer J.
University of Bern, Switzerland, 2006
unpublished study
Vitablocs® Mark II
40
Paradigm™ C
[MPa]
30
20
Fig. 47: Shear bond strength (light
cure) to Vitablocs® Mark II and
Paradigm™ C specimens after 24
hours and after thermocycling
(1,500 x 5/55°C).
10
0
Variolink® II
Panavia™ F2.0
RelyX™ ARC
RelyX™ Unicem
Aplicap™
Conclusions:
This study shows that RelyX Unicem cement achieves shear bond strength values to the tested
glass ceramic materials that are in the same range as those of adhesive cements requiring additional pretreatment steps.
37
3M ESPE internal lab data (2007)
Shear Bond Strength After 10 min and After
Thermocycling
Study design and results:
Glass ceramic samples (Paradigm™ C, 3M ESPE; Vitablocs® Mark II, Vident; ProCAD®,
Ivoclar Vivadent) were etched with hydrofluoric acid and silanated (RelyX™ Ceramic Primer,
3M ESPE). Composite buttons (Filtek™ Z250, 3M ESPE) were cemented according to the
cement manufacturers’ instructions for use using the following luting cements: Panavia™ F 2.0
(Kuraray), Multilink Automix (Ivoclar Vivadent), RelyX Unicem in the Aplicap™ and in the
Clicker™ (3M ESPE). All cements were light cured. Shear bond strength was determined in a
universal testing machine at 10 minutes, 24 hours, and after thermocycling (5,000 x 5/55°C)
(experimental set-up see chapter 11.2.).
30
25
Paradigm™ C
10 min
24 hrs
thermocycling
[MPa]
20
15
10
Fig. 48: Shear bond strength
(wire-loop test) of four resin
cements (light cured) to
Paradigm™ C over time (10 min,
24 hrs) and after thermocycling
(5,000 x 5/55°C)
5
0
Panavia™ F2.0
Multilink Automix
RelyX™ Unicem
Clicker™
RelyX™ Unicem
Aplicap™
40
35
Paradigm™ C
Vitablocs® Mark II
ProCAD®
30
[MPa]
25
20
15
Fig. 49: Shear bond strength
(wire-loop test) of four resin
cements (light cured) to different
glass ceramic blocks for CAD/CAM systems 24 hours after
cementation.
10
5
0
Panavia™ F2.0
Multilink Automix
RelyX™ Unicem Clicker™ RelyX™ Unicem Aplicap™
40
35
Paradigm™ C
Vitablocs® Mark II
ProCAD®
30
[MPa]
25
20
15
Fig. 50: Shear bond strength
(wire-loop test) of four resin
cements (light cured) to glass
ceramic blocks for CAD/CAM
systems after thermocycling
(5,000 x 5/55°C).
10
5
0
Panavia™ F2.0
38
Multilink Automix
RelyX™ Unicem Clicker™ RelyX™ Unicem Aplicap™
Conclusions:
There is no significant difference in bond strength to glass ceramics for RelyX Unicem in the
Aplicap and the Clicker dispenser when measured immediately, after 24 hours or after thermocycling.
Shear Bond Strength to Metal, Composite, and Ceramic
Restorative Materials
3M ESPE internal lab data (2007)
Study design and results:
All restorative material samples were prepared for cementation according to the cement manufacturers’ Instructions for Use. Briefly, for cementation with RelyX™ Unicem cement samples
were treated as follows. Metal, strengthened core ceramic (Lava™ and alumina ceramic), and
composite samples (Paradigm™ MZ 100) were sandblasted with Rocatec™-Pre (3M ESPE) and
cleaned with ethanol. Etchable glass ceramics (Vitablocs® Mark II, Vident) were etched with
hydrofluoric acid and silanated using RelyX Ceramic Primer (3M ESPE). Rely Fiber Post were
not pretreated. Shear bond strengths of the particular cements (RelyX Unicem cement,
3M ESPE; Panavia™ F2.0, Kuraray; Maxcem™, Kerr) were determined using a universal testing
machine (experimental set-up see chapter 11.2.).
20
Panavia™ F 2.0 SELF cure
Maxcem™ SELF cure
18
RelyX™ Unicem Aplicap™ SELF cure
RelyX™ Unicem Clicker™ SELF cure
16
14
[MPa]
12
10
8
6
4
Fig. 51: Shear bond strength to
various metal restorative materials in the self cure mode.
2
0
Gold alloy
Degulor M
(sandblasted)
Titanium
(sandblasted)
Stainless steel
Wironit
(sandblasted)
22
20
LIGHT / SELF cure
18
RelyX™ Unicem Aplicap™
RelyX™ Unicem Clicker™
Panavia™ F 2.0
Maxcem™
16
[MPa]
14
12
10
8
6
**
4
*
2
•
0
Vitablocs® Mark II
(HF etching + silanating)
Lava™
(sandblasted)
* 3 pretest failures with Maxcem
Alumina ceramic
(sandblasted)
** cohesives failures in all tests except for Maxcem self cure
Paradigm™ MZ 100
(sandblasted)
•
•
•
RelyX™ Fiber Post
(untreated)
• self cure not measured
Conclusions:
RelyX Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show consistently
good performance in all curing modes and to a wide variety of restorative materials.
Fig. 52: Shear bond strength to
various composite and ceramic
restorative materials in the self
cure and the light cure mode.
39
12. RelyX™ Unicem Field Testing
As all new 3M ESPE products RelyX Unicem cement both in the Aplicap™ Capsule and in the
Clicker™ Dispenser were tested in dental offices before market introduction.
The RelyX Unicem Aplicap field test was carried out in 2001 and involved almost 50 dentists
from Germany and Switzerland that placed more than 800 restorations during the 8 week test
period. RelyX Unicem Clicker was tested in 2006 with almost 100 dentists in Germany,
Poland, and Italy cementing almost 2,000 restorations. In both tests the restorations placed were
fabricated from a wide variety of restorative materials and covered the complete list of indications of RelyX Unicem cement.
56
43
CEREC®
163
Bridges, Onlays
Crowns,
94
ceramic
322
metall, PFM
107
composite
CEREC®
5
86
224
147
ceramic
106
Inlays
77
329
metall, PFM
71
composite
72
Posts
69
2
Fig. 53: Indications and restorative material types of restorations
placed during the RelyX™ Unicem
Aplicap™ (left) and the RelyX™
Unicem Clicker™ (right) field tests.
RelyX™ Unicem Aplicap™
field test 2001
780
™
™
Other RelyX Unicem Clicker
field test 2006
The reported post-operative sensitivities during the field trials were very low: approximately
0.4% for the Aplicap and 0.7% for the Clicker dispenser (see also chapter 11.1).
Although RelyX Unicem cement represented a cement class entirely new to the evaluators in
2002, RelyX Unicem cement’s features and handling characteristics largely met dentists’ needs.
The same percentage of dentists participating in the RelyX Unicem Clicker field test in 2006
intended to buy and use RelyX Unicem cement in the Clicker dispenser. This also reflects the
high level of satisfaction with RelyX Unicem cement in the new paste / paste formulation.
50
evaluators [%]
40
30
20
10
Fig. 54: Satisfaction level of evaluators in the 2006 RelyX™ Unicem
Clicker™ field test.
0
very satisfied
40
satisfied
undecided
unsatisfied
very unsatisfied
41
13. Excerpt from the Instructions
For Use
The following provides a brief overview of how to use RelyX™ Unicem Self-Adhesive
Universal Resin Cement in the Aplicap™/Maxicap™ Capsule and in the Clicker™ Dispenser.
The state of the information presented below is as of printing this booklet.
Before working with RelyX Unicem cement, please refer to the Instructions for Use delivered
with each package of RelyX Unicem cement for the complete and most up-to-date product
information.
Indications
• Final cementing of inlays, onlays, crowns, bridges, made of all-ceramic, composite, or metal
• Final cementing of posts and screws
Pretreatment of the Cavity/Tooth Stump
• Prior to final cementation, clean the prepared stump or the cavity thoroughly with pumice
slurry, rinse with a water spray, and lightly air dry in only 2-3 intervals with air free of water
and oil, or use cotton pellets to dry it off.
• Do not overdry!
The cavity should be just dry enough that the surface has a slightly glossy appearance. As is
the case with any permanent cement, over-drying can lead to post-operative sensitivity.
• Do not use substances such as desensitizers, disinfectants, astringents, dentin sealants, rinsing
solutions containing EDTA, etc., after the final cleaning with pumice slurry and water. Their
residues may have a detrimental effect on the bonding strength and setting reaction of the
cement.
Pretreatment of the Root Canal
• Clean the root canal with a 2.5%-5.25% solution of sodium hypochlorite (NaOCl) as the last
step before final cementation.
• Rinse immediately with water and dry with paper points.
• We recommend the use of a rubber dam during the cementation of posts.
Pretreatment of Restorative Materials
Please refer to chapter 9 (page 11) for a brief overview.
Times
RelyX Unicem Clicker
min:sec
Mixing:
00:20
Working time from start of mixing:
02:00
Light curing:
- single surface, from occlusal
00:20
- any other surface additional
00:20
Self-curing:
Polymerization start after start of mixing
02:00
Setting time after start of mixing
05:00
42
RelyX™ Unicem Aplicap™ / Maxicap™
Mixing:
In high-frequency mixer (e.g. CapMix)
In the RotoMix rotary mixer
Working time from the start of mixing:
Light-curing:
Single surface, from occlusal
Any other surface, additional
RelyX Fiber Post posts, from occlusal
Self-curing:
Intraoral clean-up time after start of mixing
Set time after start of mixing
Aplicap
min:sec
00:15
00:10
02:00
Maxicap
min:sec
00:15
00:10
02:30
00:20
00:20
00:40
00:20
00:20
00:40
02:00
05:00
02:30
06:00
Removal of Excess From Restorations
• Excess cement is best removed after brief light exposure (approximately 2 sec with a conventional polymerization device) or during self hardening (starting 2 min after beginning of mixing in the “gel phase”) with an appro-priate instrument (e.g. scaler). Excess material of larger
volume is easier to remove!
• If the excess is removed during the self-curing, a suitable instrument must be used to hold the
restoration in position.
• Tip for removing excess composite cement: If the excess cement is re-moved with a sponge
pellet or similar implement immediately after the restoration is seated, the remaining minimal
excess cement should be light-cured briefly or covered with glycerine gel. If light-curing or
glycerine gel is not used, an oxygen inhibition layer will form on the cement surface during
polymerization; the layer is removed during polishing and can, depending on the thickness of
the layer, leave behind a deficit.
Removal of Excess From Posts
• Remove the cement with a suitable instrument or a cotton pellet.
43
14. Technique Guides
14.1. RelyX™ Unicem Aplicap™ / Maxicap™
44
14.2. Technique Guide
RelyX™ Unicem Clicker™
45
14.3. Technique Guide
RelyX™ Fiber Post / RelyX™ Unicem Aplicap™
46
15. Frequently Asked Questions
Q 1. Since when has RelyX™ Unicem cement been used clinically?
The first restorations were cemented with RelyX Unicem cement (Aplicap™) in 2001. Since
then more than 25 million capsules (as of April 2007) have been sold world wide. The excellent
clinical experience reported by the users is consistent with the results of numerous in vivo studies by independent researchers that confirmed the high performance of the RelyX Unicem
cement.
Clinical studies see page 13
Q 2. Does RelyX™ Unicem cement in the Aplicap™ / Maxicap™ and the Clicker™ have the
same chemical composition?
Yes. RelyX Unicem cement in its two delivery versions has the same chemical compositions
and exhibits the same performance. Both, the capsule and the Clicker version are based on the
identical methacrylate monomers and therefore feature the same chemical bonding and setting
reactions. Designing an easy to handle cement paste and, at the same time, a highly reactive
and long-term stable chemical system were the tasks to be met during the development of
RelyX Unicem Clicker. All chemical components from the RelyX Unicem cement capsule version had therefore to be distributed appropriately between the base and the catalyst pastes. To
assure that RelyX Unicem cement in both delivery systems offers optimal handling the amount
of fillers and the grain particle size were adapted for each system.
Study results see page 13
3M ESPE application test see page 46
Q 3. What is the expansion value for RelyX Unicem cement?
RelyX Unicem cement shows low expansion values making it safe to use for the cementation
of glass ceramic restorations and posts. This was proven in long term in vivo and in vitro studies by independent external researchers (e.g. “expansion less than or equal to 1%”: CRA
Newsletter, October 2004). These results are corroborated by the clinical experience of the dental community since the introduction of the cement in 2001.
Expansion value see page 9
Q 4. How should indirect restorations be pretreated before cementation with
RelyX Unicem cement?
Please refer to chapter 9 (page 11) to find a short overview and to the Instructions for Use provided with each package RelyX Unicem cement for detailed information.
Q 5. How should I pretreat my CEREC® Restoration?
The materials used with CEREC are either etchable glass ceramics (e.g. Paradigm™ C,
3M ESPE; Vitablocs® Mark II, Vident; ProCAD®, Ivoclar Vivadent) or composite material (e.g.
Paradigm™ MZ100, 3M ESPE). For pretreatment recommendations see Q 4.
An important consideration for using RelyX Unicem cement for bonding CEREC restorations
is to make sure that the tooth surface is completely clean prior to placing the cement. The scanning process for the CEREC system requires that a scan powder with or without a separate liquid adhesive be placed on the tooth to obtain a good digital image. It is imperative that the scan
powder be completely removed from the tooth surface prior to placement of the restoration.
RelyX Unicem cement must be able to directly interact with the clean tooth surface in order to
demineralize the surface and penetrate into the tooth. Any residue from the liquid or powder
may affect the bond of the RelyX Unicem cement to the tooth. This may result in marginal
staining or failure of the restoration. A simple water spray or rinse may not completely remove
the residue. It is advisable to physically remove the powder/liquid residue from the tooth by
brushing the surface with aqueous pumice slurry followed by a thorough water rinse.
Restorative material pretreatment see
page 11
47
Q 6. How do I prepare the root canal before cementation of a post with RelyX™ Unicem
cement?
Remove the existing (Guttapercha) root filling and clean the root canal with a 2.5-5.25% sodium hypochlorite solution (NaOCl). Rinse immediately with water and dry with paper points;
do not overdry. RelyX Unicem cement proved to bond as securely to root dentin as to crown
dentin (Walter R. et. al., IADR 2003, Gothenburg Sweden, #1463)
Q 7. How should I dry the tooth prior to cementing my restoration with RelyX Unicem
cement?
Lightly dry in only 2-3 second intervals with oil-free and anhydrous air, or use cotton gauze to
dry off excess water. Do not overdry! The tooth should be just dry enough that the surface has
a slightly glossy appearance. As is the case with any fixation cement, over drying can lead to
post-operative sensitivity.
Q 8. May I use desensitizing agents before cementing restorations with RelyX Unicem
cement?
The unique chemistry of RelyX Unicem cement demineralizes and penetrates into the tooth
surface without utilizing a separate acid etching step. This greatly reduces the potential for
patient tooth sensitivity when compared to a typical total-etch resin cement system. Therefore,
the use of an additional desensitizing step has NOT been deemed beneficial. We recommend
that cleaning the prepared tooth with an aqueous pumice slurry and water as the final treatment
before cementing the restoration with RelyX Unicem cement.
Q 9. Will fit checker materials have an affect on the bond strength of the cement?
Yes. Contamination of the tooth surface with fit checker of material could be detrimental to any
bond. If a fit checker or any oil-based product is used during try-in use, an aqueous pumice
slurry and water spray rinse is recommended to ensure a clean tooth surface prior to cementation.
Q 10. Can etching help to increase bond strength?
Bond strength values see page 22
RelyX Unicem cement shows good bond strength to enamel and very high bond strength to
dentin without any pretreatment. If enamel is selectively etched the bond strength to enamel
can be improved to a degree. However, etching of dentin does NOT increase bond strength,
whereas it generates the risk of post-operative sensitivities and microleakage. Therefore, if
selective etching of enamel is desired, care ought to be taken not to etch adjacent dentin.
Q 11. Is RelyX Unicem cement compatible with core build-up materials?
Bond strength values see page 40
RelyX Unicem cement provides a secure bond to all types of core build-up materials. However,
composite core build-up materials are the preferred material type with respect to its physical
properties and esthetics. Therefore, composite core build-up materials are the best match for
ceramic restorations and for RelyX Unicem cement. The surface of the core build-up material
should be roughened. Use alcohol to clean and dry.
Q 12. Is there a recommended waiting time before light curing RelyX Unicem cement?
Immediate bond strength values see
page 23ff
48
No. In contrast to certain resin cements by other manufacturers for which some waiting time is
recommended, RelyX Unicem cement can be light-cured immediately and high bond strengths
will be achieved. The reason lies within the highly efficient and fast initiator system in combination with the unique adhesive technology.
Q 13. Is RelyX™ Unicem cement too viscous?
RelyX Unicem cement exhibits a so-called thixotropic behavior. It flows easily under pressure
yet increases in viscosity when left undisturbed. This means that when placing a restoration
with the usual pressure, a low film thickness and an exact placement is achieved. The benefit of
higher viscosity in the absence of pressure is that RelyX Unicem cement stays put. It does not
flow away from the prepared tooth, restoration or instrument and makes excess removal easier.
Q 14. Why is RelyX Unicem cement not indicated for cementing veneers?
RelyX Unicem is a dual curing cement and, once the capsule is activated and mixed, there is a
limited amount of working time. It could be difficult for the dentist to load up multiple veneers
and seat them properly before the working time is up.
For cementing veneers, the light cure RelyX™ Veneer cement has been specifically designed,
and perfectly complements RelyX Unicem cement.
Q 15. How can occasional marginal discoloration be avoided?
1. Do not use iron-containing liquids with translucent all-ceramic crowns. A gray discoloration
may develop underneath the translucent restoration a few weeks after cementation. Do not
use ferrous liquids at the impression appointment or seating appointment.
2. After final cleaning with aqueous pumice slurry and water spray, avoid using desensitizers,
disinfectants, astringents, hydrogen peroxide, dentin sealants, and rinsing solutions containing EDTA, etc. These treatments can leave chemical residues which may have a detrimental
effect on the bond strength and setting reaction of the cement.
Hydrogen peroxide is a strong oxidizing agent that decomposes chemical initiating systems.
Hydrogen peroxide is not easily removed from the tooth surface by a water spray. Generally,
its use should be avoided with any resin cement.
3. Make sure to pretreat the restoration as described in the RelyX Unicem cement instructions
for use. For details see also Q3 and Q4.
Q 16. Are try-in pastes available for RelyX Unicem cement?
Yes, there are RelyX™ Try-In Pastes, available individually or as part of the RelyX Veneer
cement intro kit. They are designed to fit both RelyX Unicem cement and RelyX Veneer
cement shades.
49
16. Index of Technical Terms
Numbers refer to pages
Adaptation to tooth structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
see also “Margin, adaptation to ~”
Adhesion, see “Bond strength”
Adhesive values, see “Bond strength”
Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22
see also “Water storage”, “Thermocycling”, and “Mechanical load”
Air (-particle) -abraded, see “Sandblast”
Alpha Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15
Alumina ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 30, 39
see also “Ceramic”
Application, ~clinical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 44-46
Artificial aging, see “Aging”
Bacterial penetration, see “Microleakage”
Biocompatibility, see “Pulp compatibility”
Bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8, 10, 13, 18-31, 36-39
immediate ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 23, 26, 38, 48
see also “Tensile Bond Strength”, “Microtensile
bond strength”, “Retentive bond strength”
Bovine dentin, ~ enamel, ~ teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26, 27
Bravo Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-16
CAD/CAM glass ceramic, see “Glass ceramic”
see also “CEREC®”
Caries, absence of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15
Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 10-17, 19, 22, 23, 27-30, 33, 34, 36-40, 42, 47-49
Ceramic in-/onlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14-16, 40, 42
CEREC® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34, 40, 47
see also “Glass ceramic”
Chemical cure mode, see “SC = self cure mode”
Clinical
~ experience (see also “Study”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40, 47
~ performance, see “Performance”
~ study, see “Study”
Composite
restorative material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 13, 14, 16, 22, 40, 42, 47, 48
test specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 20, 23-26, 29, 30, 36, 38, 39
Compomer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Compressive strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Conditioning, ~ of tooth structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6
see also “Pretreatment”
Color match . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15
Customer acceptance test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40
Curing (see also “LC = light cure”, “SC = self cure”)
dual ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 27, 30, 49
~ times . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 42, 43
Core build-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 36, 48
Coronal dentin, see “Crown dentin”
Crown dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Cytotoxicity, see “Pulp compatibility”
DC = dark cure, see “SC = self cure”
Debonding (see also “Pretreatment of restorative material, and of tooth structure”) . . . . . . . .16
50
Delta scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Dentin bond strength, see “Bond strength”
Desensitizing agent, desensitizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42, 48, 49
Digital scan powder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Dimensional stability, see “Stability”
Discoloration, marginal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-17, 49
Ease of use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40
Elasticity, Modulus of ~ (= E-modulus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Enamel bond strength, see “Bond strength”
Endodontic posts, see “Posts”
Etchable glass ceramic, see “Glass ceramic”
Etching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 12, 15, 39, 48
Excess removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 43, 44-46, 49
Expansion, ~ value, linear ~, long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10, 11, 47
Fiber (reinforced) posts, see “Posts”
Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 47
Film thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 49
Fit checking products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Flexural Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 11
Fluoride ions, ~ release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 9
Glass ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 13, 29, 36-39, 47
see also “CEREC”
Glass ionomer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 22, 26, 27, 29, 30
Glass fiber (reinforced) posts, see “Posts”
Gold alloy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Guttapercha, see “Posts”
Handling test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40
Human
~ dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22-25, 27
~ enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23-25
~ pulp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
~ teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 21-25, 27, 30, 32, 34
Hydrophilicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 10
Hydrolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
see also “Stability, hydrolytic ~”
Immediate bond strength, see “Bond strength”
In vivo / In vitro Study, see “Study”
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 16, 17, 40, 42, 44-46
Initiator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 48, 49
Inlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14, 15, 18, 22, 23, 33, 40, 42
Lava™, see “Zirconia ceramic”
LC = light cure (mode) . . . . . . . . . . . . . . . . . . . . . . .8, 9, 11, 12, 22-27, 29-31, 34-39, 43, 48, 49
Long-term performance, see “Performance”
Long-term stability, see “Stability”
Margin,
Adaptation to ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15, 17, 33, 34
Discoloration of ~, staining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15, 17, 47, 49
Integrity of ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-17
Marginal adaptation, see “Margin”
Marginal discoloration, see “Margin”
Marginal sealing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Mega Pascal (MPa) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Mechanical
~ load . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 33, 34
~ properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 8, 11, 14
51
Metal, ~ restoration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14, 17, 19, 28, 39, 40, 42
Methacrylate monomer molecule, see “Monomer molecules”
Microleakage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 16, 32, 48
Microtensile bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21, 24, 25
Mixing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 9, 10, 26, 35, 42, 43
Modulus of elasticity, see “Elasticity”
Monomer molecules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 47
Multi-step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 10, 14, 15, 18, 22, 23, 30
Neutral pH level, neutralization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 35
Onlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 40, 42
see also “Ceramic in-/onlay”
Performance, clinical ~, long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-18, 24, 25, 39, 47
pH profile, ~ value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 35
Phosphoric acid groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9
Polymerization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-11, 42, 43
Porcelain, “Ceramic”
Posts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 13, 16-18, 20, 21, 30-32, 39, 40, 42, 43, 46-48
Post-operative sensitivities, ~ pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 13, 14, 16, 42, 48
Pretest failures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25, 39
Pretreatment
~ of restorative materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 42, 47
~ of root canal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
~ of tooth structure / prepared tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 12, 8, 42, 48
Pulp compatibility, ~ response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
see also “Post-operative sensitivities”
Pumice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42, 44, 45, 47-49
Radicals, Radical polymerization reaction, see “Polymerization”
Radiopacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 11
Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 15
Removal of excess cement, see “Excess removal”
Resin modified, resin-reinforced glass ionomer . . . . . . . . . . . . . . . . . . . .6, 22, 26, 27, 29, 30, 35
Retention (bond strength) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 21, 27, 30
see also (“Bond strength”)
Rocatec-Pre, see “Sandblast”
Rocatec Plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
see also “Silicoating”
Root canal (posts), see “Posts”
Root (canal) filling, see “Posts”
Root dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Sandblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 22, 27, 28-30, 39
SC = self cure (mode) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 22-29, 31, 35, 36, 39
Scan Powder, see “Digital scan powder”
Secondary caries, see “Caries”
Sensitivity, see “Post-operative sensitivities”
Setting, ~ reaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 21, 42, 47, 49
Setting times, see “Curing time”
Shades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 49
Shear bond strength, see “Bond Strength”
Silicoating (= silicating & silanating) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 28
Simulated Aging, see “Aging”
Solubility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 10, 11
Stability
dimensional ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 11
hydrolytic ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 10, 11, 14, 35
52
Stainless steel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Strength
see “Bond Strength”, “Compressive ~”, “Flexural ~”,
“Microtensile Bond ~”, “Tensile Bond ~”,
Stress testing, stress simulation, see “Thermocycling”, “Mechanical load”
Study,
~ clinical, ~ in vivo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-18, 47
~ design, experimental design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
~ in vitro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-39
~ long-term . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-39
Surface
~ roughness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-16
~ hardness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
TCML = thermocycling & mechanical loading
see “Thermocycling” and “Mechanical load”
Tensile bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20, 21, 23, 25-27, 31
Thermal cycling, see “Thermocycling”
Thermocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 24, 27-30, 33, 34, 36-38
Times, see “Working time”, “Curing time”, “Mixing”
Titanium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 39
Total etch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 48
see also “Multi-step”
Tribochemical surface treatment, see “Silicoating”
Try-in pastes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Veneers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 49
Viscosity, viscous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Water
~ sorption (see also “Hydrophilicity”, “Hydrolysis”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
~ storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 24, 27-32
Wire loop test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 20, 38
Working time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 42, 43, 49
Zinc phosphate cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 22, 26, 27, 29, 30
Zirconia ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 22, 23, 27-29, 39
TC =
TCML =
LC =
SC =
thermocycling
thermocycling & mechanical loading
light cure
self cure (= dark cure, DC)
53
17. Literature
Literature on RelyX™ Unicem Cement
3M™ ESPE™ RelyX™ Unicem Self-Adhesive Universal Resin Cement 4-year Clinical
Performance
THE DENTAL ADVISOR, Vol. 24, No. 4, May 2007
Adhesion of RelyX™ Unicem Aplicap™ on RelyX Fiber Post
Popp E.-M., Peez R., Porsfeld V., Lachermeier B.
3M ESPE AG, Seefeld, Germany
PEF 2006, abstract #0067
Adhesion of Self-adhesive Resin Cements to Various Core Build-up Materials
Wiedig C.A., Porsfeld V.N., Hecht R., Raia G.
3M ESPE, Germany, Seefeld, Germany
IADR 2007, abstract #2449
Adhesion of Various Adhesive Resin Cements to RelyX™ Fiber Post
Porsfeld V., Peez R., Lachermeier B.
3M ESPE AG, Seefeld, Germany
PEF 2006, abstract #0068
Bonding Effectiveness of Adhesive Luting Agents to Enamel / Dentin
Hikita K.1,2, De Munck J.1,2, Ishijima T.2, Maida T.2, Lambrechts P.1,2, Van Meerbeek B.1,2
1
Catholic University of Leuven, Netherlands
2
Health Sciences University of Hokkaido, Sapporo, Japan
IADR 2004, abstract #3175
Bonding effectiveness of adhesive luting agents to enamel and dentin
Hikita K., Van Meerbeek B, De Munck J., Ikeda T., Van Landuyt K., Maida T., Lambrechts P.,
Peumans M.
Dent Mater. 2006 Jan 16
Bonding of a Novel Self-Adhesive Cement to Tooth Substrates
Trajtenberg C.P., Pinzon L.M., Powers J.M.
University of Texas Dental Branch at Houston, USA
AADR 2003, abstract #1197 revised
Bonding of an auto-adhesive luting material to enamel and dentin
De Munck J., Vargas M., Van Landuyt K., Hikita K., Lambrechts P., Van Meerbeek B.
Dent Mater. 2004 Dec;20(10):963-71
Bond Strength of Self-Adhesive Cementing Agents to Dentin and Enamel
Piwowarczyk A., Bregulla J., Lauer H.-C.
Johann Wolfgang Goethe-University Frankfurt, Frankfurt/Main, Germany
IADR 2007, abstract #1540
Ceramic Inlays Luted with a Self-Adhesive Cement After one Year
Taschner M., Frankenberger R., Petschelt A., Krämer N.
University of Erlangen, Germany
AADR 2006, abstract #1361
54
Clinical Outcomes of Ceramic Inlays / Onlays Luted With Two Bonding Systems.
Denehy G., Stanford C., Cobb D., Vargas M. et al.
University of Iowa, USA, 2007, unpublished study
Clinical Performance of a Self-adhesive Universal Resin Cement; Initial Findings
Burke J.J.T., R.J. Crisp, B. Richter
Abstract #0564, IADR meeting 2005 Baltimore
Comparison of titanium dowel retention using four different luting agents
Balbosh A., Ludwig K., Kern M.
J Prosthet Dent. 2005 Sep; 94(3):227-33
CRA Status Report: Understanding Cement Use in 2004
CRA Newsletter, Volume 28, Issue 10, October 2004
Dentin Shear Bond Strength of Various Luting Cements
Piwowarczyk A.1, Lauer H.-Ch.1, Sorensen J.A.2
1
Johann Wolfgang Goethe-University, Frankfurt, Germany
2
Oregon Health & Science University, Portland, USA
CED 2002, abstract #0215
Effect of One-day Storage on Bonding of Self-Adhesive Resin Cements
Irie M.1, Richter B.2, Suzuki K.1
1
Okayama University Graduate School, Okayama, Japan
2
3M ESPE, Seefeld, Germany
AADR 2006 abstract #1839
Effect of Surface Treatment on the Shear Bond Strength of Three Resin Cements to a
Machinable Feldspatic Ceramic.
Reich S.M.1, Wichmann M.1, Frankenberger R.2, Zajc D.2
1
Department of Prosthetic Dentistry
2
Department of Operative Dentistry and Periodontology, University of Erlangen-Nuremberg,
Erlangen, Germany
J Biomed Mater Res B Appl Biomater. 2005 Aug; 74(2), 740-6
Effect on thermocycling on bond strength of luting cements to zirconia ceramic
Luthy H., Loeffel O., Hammerle CH
Dent Mater. 2006 Feb; 22(2):195-200.
FRC vs. Titanium Posts - Preliminary Results of a RCT
Naumann M.1, Sterzenbach G.2, Blankenstein F.2, Lange K.-P.2
1
Humboldt-University Berlin, Charite - University Medicine, Germany
2
Humboldt-University Berlin, Germany;
IADR 2006, abstract #0077
Human Pulp Response to Resin Cements Used to Bond Inlay Restorations
Costa C.A. de S.1, Hebling J.2, Randall R.C.2
1
University Sao Paulo State-UNESP, Sao Paulo, Brasilia
2
3M ESPE, St. Paul, USA
Journal of Dental Materials, No. 22, 2006, 954–962
Influence of different adhesive resin cements on the fracture strength of aluminum oxide
ceramic posterior crowns.
Komine F, Tomic M, Gerds T, Strub JR.
J Prosthet Dent 2004 Oct;92(4):359-64
In Vitro Bond Strength of Adhesive Cements to Tooth Structure.
Pinzon L.M., Powers J.M.
University of Texas Dental branch at Houston, USA
THE DENTAL ADVISOR, Research Report, No. 1, June 2005
55
In vitro evaluation of wall-to-wall adaptation of a self-adhesive resin cement used for
luting gold and ceramic inlays
Fabianelli A., Goracci C., Bertelli E., Monticelli F., Grandini S., Ferrari M.
J Adhes Dent. 2005 Spring;7(1):33-40.
In vitro retentive strength of zirconium oxide ceramic crowns using different luting agents
Ernst CP., Cohnen U., Stender E., Willershausen B.
J Prosthet Dent. 2005 Jun;93(6):551-8.
In Vitro Retentive Strength of Zircon-Oxide all Ceramic Crowns
Ernst C.-P., Askoy E., Stender E., Willershausen B.
Johannes Gutenberg University Mainz, Germany
Published at the IADR PEF 2006, abstract #0248
In Vitro Shear Bond Strength of Cementing Agents to Fixed Prosthodontic Restorative
Materials
Piwowarczyk A., Lauer H. C., Sorensen J. A.
Johann Wolfgang Goethe University of Frankfurt, Germany
J Prosthet Dent. 2004 Sep; 92(3): 265-73
Long-term bond between dual-polymerizing cementing agents and human hard
dental tissue
Piwowarczyk A., Bender R., Ottl P., Lauer HC.
Dent Mater. 2006 Feb 20;
Marginal Adaptation of Ceramic Inlays Using Different Cements
Rosentritt M.1, Hahnel S.2, Behr M.1, Handel G.1
1
University of Regensburg, Germany
2
University Medical Center Regensburg, Germany
IADR 2007, abstract #1516
Marginal adaptation in dentin of a self-adhesive universal resin cement compared
with well-tried systems
Behr M., Rosentritt M., Regnet T., Lang R., Handel G.
Dent Mater. 2004 Feb;20 (2):191-7.
Mechanical and Physical Properties of Self-etching Resin Luting Cements
Sakalauskaite E., Tam L.E., McComb D.
University of Toronto, Canada
AADR 2006, abstract #1894
Mechanical Properties of luting cements after water storage
Piwowarczyk A., H-C Lauer
Johann Wolfgang Goethe University of Frankfurt, Germany
Operative Dentistry, 2003, 28-5,535-542
Microleakage of various cementing agents for full cast crowns
Piwowarczyk A., Lauer HC., Sorensen JA
Dent Mater. 2005 May;21(5):445-53
Microtensile Bond Strength of Luting Materials to Coronal and Root Dentin
Walter Ricardo DDS, Patricia A. Miguez DDS, MS, Patricia N.R. Pereira, DDS,PhD
J Esthet Restor Dent 17:165-171, 2005
56
Micro-tensile bond strength of three luting resins to human regional dentin
Yang B., Ludwig K., Adelung R., Kern M.
Dent Mater. 2006 Jan; 22(1):45-56. Epub 2005 Jul 22
Proximal Adaptation of Partial Ceramic Crowns with Different Luting
Techniques/Materials
Federlin M., Hiller K.-A., Reinhard H., Fritzsch D., Schmalz G.
University of Regensburg, Germany
IADR PEF 2006, abstract #0562
Retention of Fiber Posts Cemented with a New Delivery System
Del Mastro M., Armoush Z., Aboushala A., Doherty E., Kugel G.
Tufts University, Boston, MA, USA
IADR 2007, abstract #1553
Retention of quartz-fibre endodontic posts with a self-adhesive dual cure resin cement
Bateman G.J., Lloyd CH, Chadwick RG, Saunders WP
Eur J Prosthodont Restor Dent. 2005 Mar; 13(1):33-7
Sealing Ability and Microscopic Aspects of a Self-adhesive Resin Cement used for
Fiber Post Luting into Root Canals
Simonetti M., Coniglio I., Magni E., Cagidiaco M.C., Ferrari M.
Dept. Dental Materials, Faculty of Dentistry, University of Siena, Italy
International Dentistry SA Vol. 8, No. 5, Sept./Oct. 2006
Shear Bond Strength of RelyX™ Unicem and RelyX™ ARC to an Experimental Glass
Ceramic Material
Fischer J.
University of Bern, Switzerland, 2006, unpublished study
Shear Bond Strength of the Zirconia / Resin Interface
Behr M., Rosentritt M., Kolbeck C., Lang R., Handel G.
University of Regensburg, Germany
Published at the IADR 2007 #2627
The adhesion between fiber posts and root canal walls: comparison between microtensile
and push-out bond strength measurements
Goracci C., Tavares AU, Fabianelli A., Monticelli F., Raffaelli O., Cardoso PC, Tay F., Ferrari M.
Eur J Oral Sci. 2004 Aug; 112(4):353-61
The Shear Bond Strength Between Luting Cements and Zirconia Ceramic after two
Pretreatments.
Piwowarczyk A., Lauer H. C., Sorensen J. A.
Johann Wolfgang Goethe University of Frankfurt, Germany
Oper Dent. 2005 May-Jun; 30(3): 382-8
Trends in Indirect Dentistry: 3. Luting Materials
Burke FJ Trevor
Restorative Dentistry, June 2005
Two-year Performance of Restorations Placed with a Self-Adhesive Luting Material
Crisp R.J., Burke F.J.T.
University of Birmingham, UK
IADR 2006, abstract #2098
57
General Literature on Dental Cements
Adhesive Cements and Cementation
White S.N.,
CDA Journal 1993, 21, 30-37
Contemporary Evaluation of Dental Cements
Donovan T.E., George C.C.,
Compendium 1999, 20, 197-219
Current status of luting agents for fixed prosthodontics
Diaz-Arnold A.M., Vargas M.A., Haselton D.R.,
J. Prosth. Dent. 1999, 81 (2), 135-141
Dental luting agents: A review of current literature
Rosenstiel S.F., Land M.F., Crispin B.J.,
J. Prosth. Dent. 1998, 80 (3), 280-301
in: Phillips’ Science of Dental Materials
Anusavice K. J.,
W.B. Saunders, 10. edition, Philadelphia, 1996
in: Ullmann’s Encyclopedia of Industrial Chemistry, Dental Materials (chapter: cements)
Stefan K.,
Electronic Release, Wiley, 2000.
Mechanical properties of dental luting cements
Li Z.C., White S.N.,
J. Prosth. Dent. 1999, 81, 597-609
Trends in Indirect Dentistry: 3. Luting Materials
Burke F.J.T,
Restorative Dentistry, June 2005
58
59
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