The choice of cement plays a crucial role in the success of dental crown procedures. It determines the long-term stability, strength, and aesthetics of the crown restoration. With numerous options available in the market, it can be overwhelming for both dentists and patients to determine the best cement to use. In this article, we will explore ten aspects to consider when choosing the ideal cement for dental crowns.
1. Bonding Strength
The bonding strength of the cement is vital for the long-term success of dental crowns. It ensures proper retention and stability of the crown on the prepared tooth. Resin-based cements, such as resin-modified glass ionomers and self-adhesive resin cements, have shown excellent bonding capabilities, providing reliable results.
However, it is crucial to consider the substrate material and follow manufacturers' guidelines for optimal bonding. This ensures compatibility between the cement and crown material, achieving the highest bonding strength possible.
2. Esthetics
The esthetic outcome of dental crown restorations greatly depends on the cement used. Tooth-colored cements, such as resin-based cements or translucent glass ionomers, offer superior esthetics, especially for anterior teeth. These cements can mimic natural tooth shades, blending seamlessly with the surrounding dentition.
While esthetics is subjective, choosing a cement that closely matches the patient's tooth color enhances the overall appearance of the crown restoration.
3. Biocompatibility
Biocompatibility ensures the cement's compatibility with the oral environment and surrounding tissues. It is essential to choose a cement that minimizes the risk of adverse reactions or inflammation. Most modern dental cements are biocompatible, but it is advisable to check for any known allergies or sensitivities a patient may have.
It is worth noting that resin-based cements may have a higher incidence of postoperative sensitivity compared to traditional cements. Dentists should assess the patient's oral health and sensitivity history before selecting the cement type.
4. Retrievability
In some cases, the ability to retrieve or remove the dental crown is necessary. Retrieving a crown can be challenging if it is cemented with a strong adhesive. Resin cements generally provide higher retention but can make crown removal difficult.
When retrievability is a concern, using temporary cement can be a suitable option. Temporary cement offers lower retention but allows easier removal if needed. However, it is essential to consider the long-term durability and potential for temporary cement washout, which may lead to crown dislodgment.
5. Durability
The durability of the cement is crucial to ensure the long-term success of dental crowns. Factors such as chewing forces, parafunctional habits, and oral hygiene practices can impact cement longevity. Resin cements generally offer better durability due to their superior strength and resistance to wear.
It is important to note that different materials and cement combinations may have varying long-term durability. Dentists should consider the patient's specific habits, needs, and the crown location when selecting a cement with optimal durability.
6. Flexibility
The flexibility of the cement affects stress distribution and can prevent potential damage to the tooth or crown. Resin cements often exhibit better flexibility compared to traditional cements, reducing the risk of crown or tooth fractures.
When considering cement flexibility, it is essential to assess factors such as the patient's occlusion, parafunctional habits, and any existing tooth or crown deficiencies that may increase stress or strain on the restoration.
7. Average Cost and Price Range
The cost of dental cement can vary depending on factors such as brand, type, and quantity. On average, dental cements range from $30 to $100 per unit. The price range may vary depending on geographic location and supplier pricing.
It is advisable to discuss the cost of the cement with the dentist or dental laboratory to ensure transparency and adherence to the patient's budget.
8. Ease of Use
The ease of use of the cement can influence the efficiency and predictability of the dental crown procedure. Some cements require multiple steps and meticulous attention to detail, while others offer simpler application techniques.
Self-adhesive resin cements, for example, simplify the cementation process by combining bonding agents within the cement. This eliminates the need for separate bonding steps and reduces the chances of errors. However, it is crucial to ensure proper isolation, moisture control, and follow the manufacturer's instructions for optimal results.
9. Setting Time
The setting time of the cement affects the working time available for proper crown placement and cleanup. Fast-setting cements may offer shorter working times, which can be advantageous for time-sensitive procedures. However, it is crucial to work efficiently to ensure accurate positioning and minimize excess cement cleanup.
Alternatively, slower-setting cements provide extended working times, allowing more flexibility during crown placement. This can be beneficial for complex cases or when additional adjustments are necessary.
10. Clinical Research and Recommendations
Staying updated with current clinical research and recommendations can assist in selecting the most suitable cement. Professional organizations, such as the American Dental Association and dental journals, often provide guidelines and research findings on cement selection and best practices.
Regularly reviewing literature and attending professional development courses ensures that dentists are applying evidence-based approaches and incorporating the latest advancements in dental cement technology.
Frequently Asked Questions
Q: Is the choice of cement the sole factor determining the success of dental crown restorations?
A: No, the choice of cement is one of several crucial factors involved in the success of dental crowns. Proper tooth preparation, accurate impression techniques, crown material selection, and appropriate laboratory fabrication also play significant roles.
Q: Can any cement be used for all types of dental crowns?
A: No, different types of crowns may require specific cement types. For example, all-zirconia crowns often require resin cements with higher bond strengths, while metal-based crowns may utilize traditional cements.
Q: Can patients experience any allergic reactions to dental cements?
A: While rare, patients may experience allergic reactions to components of dental cements. It is essential to review the patient's medical history and perform proper testing, if necessary, to avoid adverse reactions.
