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Dentists frequently encounter the need to cement indirect restorations in clinical situations that are less than ideal, and the longevity and predictability of the indirect restorative materials used in such cases is largely predicated on the chemical and/or mechanical bond formed between the natural tooth or abutment and the cement. These non-ideal scenarios have been a significant driver in the continued evolution of self-adhesive resin cements (SARCs) with added functional monomers, such as 10-MDP. This article discusses three real-world case studies in which a newly developed universal SARC was utilized and combined with the use of an optional adhesive-enhancing primer that employs a proprietary "touch-cure" technology, or a light-cured adhesive, to improve the bond strength of the resin cement and enhance patient outcomes.

This case report describes the nonsurgical endodontic management of a distolingual floor perforation in a mandibular first molar using an internal matrix and mineral trioxide aggregate (MTA) cement. The pulp chamber was properly cleaned, and after placement of a synthetic collagen material that served as a barrier at the level of furcation, MTA was used to repair the perforation defect. Root canal treatment was completed and the tooth was restored with a composite restoration followed by a porcelain-fused-to-metal crown.

Adequate bonding between tooth structure and a composite is among the factors affecting long-term clinical success. Adhesives contain solvents, which are known to evaporate. The researchers sought to determine whether bond strength could be adversely affected when a package of a popular adhesive was left open during a patient visit.

Zirconia has become one of the most popular materials in dentistry. New high-translucent zirconia ceramics have favorable optical properties and can be applied as monolithic full-contour restorations in various clinical indications for posterior and anterior teeth. However, having reliable cementation protocols is fundamental for clinical success of indirect ceramic dental restorations, including those made from zirconia materials. Resin bonding supports ceramic restorations and is necessary for onlays, laminate veneers, and resinbonded fixed dental prostheses. The APC zirconia-bonding concept is based on decades of research on how to achieve high and long-term durable bond strengths to high-strength ceramics. It includes three practical steps: (A) airparticle abrasion, (P) zirconia primer, and (C) adhesive composite resin. This article discusses the history and development of high-translucent zirconia and explains the necessity for proper cementation. The rationale and science behind a simplified zirconia-bonding concept is explained and illustrated with a clinical case presentation.

Recently, hybrid materials have been introduced to the dental market. Together with computer-assisted design/computer-assisted manufacturing (CAD/CAM) composite resins, they form a new class of dental CAD/CAM materials that combine the positive effects of ceramics and composites. As bonding is essential for their clinical longevity, it is crucial to have a good understanding of their material properties and cementation protocols. This review offers clinicians an overview of available hybrid materials and recommendations for their respective adhesive placements.

The quality of the bond at the tooth-restoration interface is crucial to the clinical success of composite restorations. Not only is the adhesive crucial, but equally or even more important is the application. This article addresses pitfalls in the bonding technique, such as over-wetness/over-dryness, over-etching, airthinning, and evaporation. Dental adhesives that are considered forgiving are less technique sensitive, thus potentially yielding more reliable bonding under various clinical conditions.

This longitudinal study evaluated the clinical performance of 97 direct class I resin composite restorations after 3 years. The restorations were performed using 2 types of adhesive systems: (1) Adper™ Single Bond Plus (SB) (3M ESPE, 3mespe.com), which is a two-step etch-and-rinse system, and (2) Adper Scotchbond™ SE (SE) (3M ESPE), which is a two-step self-etching system. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The materials were applied following the manufacturer's instructions, and 15 patients received at least one of the two adhesive systems. The restorations were evaluated 7 days after placement (baseline) and again after 3 years. Statistical analysis was performed using a proportion t-test at a significance level of 5% (P < .05). At baseline, all restorations received an Alpha score for the variable marginal discoloration and marginal integrity. After 3 years, marginal discoloration received an Alpha score for 53.19% of the restorations performed with SB and 52.08% with SE. Marginal integrity was rated as Alpha for 65.96% and 68.75% of the restorations with SB and SE systems, respectively. The remaining restorations received Bravo scores for all variables. Eight restored teeth presented postoperative sensitivity at baseline (5 SB; 3 SE), but no sensitivity was found after 3 years. No secondary caries was verified. No statistically significant differences were observed between the teeth restored with the SB and SE systems for marginal discoloration (P = .7880) and marginal integrity (P = .8132) after 3 years. Direct class I resin composite restorations performed with a two-step etch-and-rinse and a two-step self-etching adhesive system demonstrated satisfactory clinical performance after 3 years.

Traditionally, many clinicians tend to forego esthetic considerations when full-coverage restorations are indicated for pediatric patients with primary dentitions. However, the availability of new zirconia pediatric crowns and reliable techniques for cementation makes esthetic outcomes practical and consistent when restoring primary dentition. Two cases are described: a 3-year-old boy who presented with severe early childhood caries affecting both anterior and posterior teeth, and a 6-year-old boy who presented with extensive caries of his primary posterior dentition, including a molar requiring full coverage. The parents of both boys were concerned about esthetics, and the extent of decay indicated the need for full-coverage restorations. This led to the boys receiving treatment using a restorative procedure in which the carious teeth were prepared for and restored with esthetic tooth-colored zirconia crowns. In both cases, comfortable function and pleasing esthetics were achieved.

Apexification is a procedure well recognized and accepted by clinicians and researchers alike. Calcium hydroxide has long been used as an apexification material. The newly developed mineral trioxide aggregate (MTA) has also been shown to be effective in artificial root-end closure. The major problem in cases of a wide open apex is the need to limit the apexification material at the apex, thus avoiding the extrusion of a large amount of material into the periodontal tissue. The use of a matrix is advisable because its placement in the area of bone destruction provides a base on which the sealing material, especially MTA, can be placed and packed. This article presents a case report in which an internal matrix was formed using absorbable collagen sponge to provide a base for MTA placement at the apex.