1. Cements Luting materials from Ivoclar Vivadent

2. Why Use Cement
Cements are used in dentistry to join the restoration to the tooth structure (dentition) when a higher strength repair is needed in place of using a composite material.
The three main cement categories are:
Adhesive
Self-adhesive
Conventional

3. Terminology
The terms cementing, luting and bonding are used interchangeably within the industry.
Cementing is a generic term for joining two materials together.
Luting means no adhesive interaction between the surfaces.
The retentive form of the tooth (prep) and the crown allow the materials to “interlock” together using the cement as a filler between the two.
Bonding means the true adhesion between the two joining materials.

4. Terminology
Retentive – the ability to hold two things firmly together when they will not adhere (stick) to each other.
Retentive Prep
Preparation with parallel walls (taper less than 10) and minimum height (4 mm).
Non-retentive Prep
When there isn’t enough tooth structure remaining to account for maximum taper or minimum height.

5. Terminology Adhesive Luting-Composite Systems
Create adhesion between the restoration and the tooth structure.
Advantages
Highest bond strength when adequate retention is not possible.
Better marginal seal
Disadvantages
Most number of steps
Most expensive
Two types of adhesive luting-composite systems
Total Etch
Self Etch

6. Terminology Self Adhesive Resin Cements
Self-adhesive resin cements combine an easy conventional cementation technique, with the advantages of adhesive luting-composite systems.
Advantages
Increased strength vs. conventional cement, but less than adhesive luting-composite systems
Less steps than adhesive cementation
No adhesives required
Disadvantages
- Must have a retentive prep
Must use high-strength restoration with adequate thickness and tight fit

7. Terminology Conventional Cements
Conventional cements are referred to as “luting agents” since there is no chemical adhesion between surfaces.
Advantages
Most affordable
Least number of steps
Fluoride Release
Disadvantages
Must have a retentive prep and high strength material
Lowest to no bond strength

8. Terminology Light Cure Self Cure with Optional Light Cure Dual Cure
The cement must be polymerized with a curing light
Self Cure with Optional Light Cure
The cement can be left to polymerize on its own without a curing light or polymerization can be expedited by using a curing light.
Dual Cure
The cement will start to set but polymerization with a curing light is a must to completely cure.

9. When To Use What Type of Cements
Adhesive Situation
Non-retentive prep
Weaker restorative material (IPS Empress)
Adhesive cementation can be used with high strength materials (IPS e.max) to get the strongest combination of strength and esthetics.
Self Adhesive Situation
Retentive prep
High strength restorative material
Conventional Cement

10. How to Use Cement Adhesive luting composite systems High Level Bond
Enamel
Adhesive luting composite system
Restoration
Adhesive
Primer
Dentin
High Level Bond
Self-adhesive resin cements
Enamel
Self-adhesive resin cement
Lithium disilcate glass ceramic
Base metal alloys
Oxide ceramics [ZrO2, Al2O3]
Noble metal alloys
Primer
Dentin
Lower Level Bond
Conventional cements
Enamel
Conventional Cement
Restoration
Dentin
Lowest Level Bond

11. Cement Category Differences
* Highest bond strength
* Highest fracture toughness
* No retentive prep
* Most # of steps
Adhesive
Self Adhesive
Convention
Total Etch
Variolink II
Variolink Veneer
Self Etch
Multilink Automix
* Moderate bond strength
* Moderate fracture roughness
* Retentive prep
* Moderate # of steps
NO IV cement sold in North America
SpeedCEM
* Lowest bond strength
* Lowest fracture toughness
* Retentive prep
* Least # of steps

12. Competitors Adhesive Self Adhesive Conventional * RelyX Ultimate
* NX3
* Calibra
* Panavia
* BiFix QM
* Clearfil Esthetic Cement EX
* Insure
* Duo-Link
* RelyX Unicem 2
* RelyX Unicem
* MaxCEM Elite
* BiFix SE
* BisCem
* G-Cem
* Breeze
* Infinity
* iCem
* All Fuji Products
* RelyX Luting Plus
* Ceramir
* Ketac
Adhesive
Self Adhesive
Conventional
The largest competitor to Ivoclar Vivadent cements is 3M’s RelyX Ultimate (Multilink Automix), 3M RelyX Unicem 2 (Multilink Automix and SpeedCEM) and Kerr’s NX3 (Multilink Automix).

13. Surface Treatment of Restorative Materials
Cleaning & Silanating All-Ceramic Restorations

14. Ivoclean
Universal cleaning paste effectively cleans the bonding surfaces of prosthetic restorations after intraoral try-in. Creates optimum pre-requisites for the adhesive luting procedure.
* Phosphoric Acid should never be used to clean Metal or Zirconia restorations.
There are several different ways dentists can clean out a restoration after it’s been tried in the mouth ie water, phosphoric acid, alcohol, steam cleaner, ultrasound machine. They are all options but they yield different results. The most effective way to completely remove ALL of the contaminants off the surface of the restoration and prepare it for ADHESIVE or SELF-ADHESIVE cementation is to use Ivoclean.

15. Ivoclean® Universal Restorative Cleaning Agent
Simple Application
Rinse & dry restoration after try-in
Apply Ivoclean to restoration and allow to react for 20 seconds.
Rinse & dry

17. + Monobond® Plus One primer for all materials In the past …
different primers for different materials were required.
Now …
one primer can be used for all the different restorative materials. +
Glass-Ceramics
Oxide Ceramics
Metal-Ceramics
Metal

18. Monobond® Plus One primer for all materials
Simple Application
Apply Monobond Plus to restoration and allow to react for 60 seconds
Air dry

19. Ivoclean/Monobond Plus Competition
Main Competitor’s
Ivoclean- Phosphoric Acid
Monobond Plus- Scotchbond Universal
Ivoclean’s Main Competitive Advantage
Only universal cleaning agent
Monobond Plus Main Competitive Advantage
Used specifically on all types of restorative materials for superior performance compared to an all in one system (tooth and restorative primer) which yields limited performance.
SpeedCEM maintains a consistent bond strength when stored properly (refrigeration) for the full 2 years of its shelf life even after you remove it from the clear plastic package.
- Unicem 2- once taken out of the silver package, has a shelf life of only 6 months. This is stated in their own IFU’s:
                    Storage and Stability
Store RelyX Unicem 2 Automix in the pouch at 15°-25 °C/59°-77 °F. After removal from the pouch, use the product within 6 months and before the
lapse of the expiration date. Constantly high humidity accelerates the setting and must be avoided.
- This is a big deal especially at a university where they may open several syringes and let them sit there over time.
We have also found in our own applied testing center that when using an “older” syringe of Unicem 2 the bond strengths to drop. A freshly opened syringe is around 15 MPa but an older one is around 8-10.
On the syringe there is a place to write down the date when you open the silver package- that’s saying something!

20. Variolink® II Esthetic Adhesive Resin Cement
For more than 25 years, this product has
clinically proven itself in more than
20 million restorations worldwide.
Dual Cure
Excellent clinical long-term results.
Based on Total Etch adhesive technology for higher bond strengths to Enamel (e.g. veneers, inlays/onlays)
Available in 6 shades in 4 degrees of translucency and 2 consistencies:

21. Variolink® II Esthetic Adhesive Resin Cement
Application
Etch tooth with phosphoric acid. (15s on dentin/30s on enamel). Rinse and dry leaving surface moist.
Apply Excite F DSC to to moist preparation and agitate for 10 seconds. Air dry.
Mix base and catalyst cement and load cement into pre-treated restoration & seat
Remove excess
Light-cure

22. Variolink® II Esthetic Adhesive Resin Cement
Main Competitors
Calibra
Clearfil Esthetic Cement EX
Insure
Variolink II Main Competitive Advantage
Higher radiopacity
Longer working time

23. Variolink® Veneer Adhesive Resin Cement
Total Etch system
Light-cure only. Amine-free for optimal shade stability.
Available in 7 "Value shades" designed specifically for highly esthetic veneers.
Matched Try-In shades
Fast, easy clean-up
Indicated for Veneers, inlays and onlays with a low thickness (< 2.0 mm) and a high degree of translucency.

24. Variolink® Veneer Adhesive Resin Cement
Application
Apply phosphoric acid to tooth (15s on dentin/30s on enamel). Rinse and dry leaving surface moist.
Apply Excite F (bonding agent) to moist preparation and agitate for 10 seconds.
Disperse to a thin layer and light cure for 10 seconds.
Load cement into pre-treated restoration & seat
Remove excess
Light-cure

25. Variolink® Veneer Adhesive Resin Cement
Main Competitors
RelyX Veneer
Variolink Veneer Main Competitive Advantage
One less step
Additional adhesive not required

26. Multilink® Automix Universal Adhesive Resin Cement
High-immediate bond strengths to ALL types of restorative materials.
Easy clean-up.
Self-etching, self-curing primer for reduced sensitivity.
Self-cure with optional light-cure
High-level radiopacity
Room temperature storage
Available in 4 shades

27. Multilink® Automix Universal Adhesive Resin Cement
Simple Application
Coat prep with self-etching primer.
Then scrub primer into preparation for 30 seconds starting with enamel and working toward dentin
Air dry
Load cement into pre-treated restoration & seat
Remove excess
Light-cure or self-cure

28. Multilink Automix Competition
Main Competitors
3M’s RelyX Ultimate
Kerr’s NX3
Multilink’s Main Competitive Advantage
Easier Clean-up
Long term/PROVEN clinical success
Over 10 million restorations placed since 2004
99% survival rate
Proven combination with IPS e.max
SpeedCEM maintains a consistent bond strength when stored properly (refrigeration) for the full 2 years of its shelf life even after you remove it from the clear plastic package.
- Unicem 2- once taken out of the silver package, has a shelf life of only 6 months. This is stated in their own IFU’s:
                    Storage and Stability
Store RelyX Unicem 2 Automix in the pouch at 15°-25 °C/59°-77 °F. After removal from the pouch, use the product within 6 months and before the
lapse of the expiration date. Constantly high humidity accelerates the setting and must be avoided.
- This is a big deal especially at a university where they may open several syringes and let them sit there over time.
We have also found in our own applied testing center that when using an “older” syringe of Unicem 2 the bond strengths to drop. A freshly opened syringe is around 15 MPa but an older one is around 8-10.
On the syringe there is a place to write down the date when you open the silver package- that’s saying something!

29. SpeedCEM® Self-Adhesive Resin Cement
SpeedCEM features an integrated adhesion promoter (MDP- monomer), which creates a chemical bond to:
dentin & enamel
metals
zirconium oxide
Therefore, no separate adhesives or bonding
agents are required.
Available in 3 shades (transparent, yellow and opaque)
MDP = 10-Methacryloyl-
oxydecyl-Dihydrogen-Phosphates
Self-adhesive systems combine the adhesive and the resin to minimize steps. This “dilutes” the efficiency of the adhesive resulting in lower bond strength. 29

30. SpeedCEM Competition Main Competitors RelyX Unicem 2 RelyX Unicem
Maxcem
Ceramir
SpeedCEM’s Main Competitive Advantage
Radiopacity
Consistently high bond strength
SpeedCEM maintains a consistent bond strength when stored properly (refrigeration) for the full 2 years of its shelf life even after you remove it from the clear plastic package.
- Unicem 2- once taken out of the silver package, has a shelf life of only 6 months. This is stated in their own IFU’s:
                    Storage and Stability
Store RelyX Unicem 2 Automix in the pouch at 15°-25 °C/59°-77 °F. After removal from the pouch, use the product within 6 months and before the
lapse of the expiration date. Constantly high humidity accelerates the setting and must be avoided.
- This is a big deal especially at a university where they may open several syringes and let them sit there over time.
We have also found in our own applied testing center that when using an “older” syringe of Unicem 2 the bond strengths to drop. A freshly opened syringe is around 15 MPa but an older one is around 8-10.
On the syringe there is a place to write down the date when you open the silver package- that’s saying something!

31. Sales Tools Brochures • Cementation Navigation System
Sell sheets • Demonstration Aids
Step by step guides • Scientific Report
Videos

32. Additional Resources
Scientific Documentation
IFU’s
FAQ’s

33. Cements Luting materials from Ivoclar Vivadent
Thank you