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(Ivoclar Vivadent). Do you use SpeedCEM
to cement feldspathic porcelain veneers?
Would you etch with hydrofluoric acid if the
lab has already done so?
– Marea White, DDS
Bedford, Texas
Dear Marea,
Nice to hear from you! I am a fan of
SpeedCEM, which is a self-adhesive
resin cement similar to RelyX Unicem
or Maxcem Elite (Kerr Corp.; Orange,
Calif.). While these cements are strong
enough for inlays, retentive onlays and
retentive crown preps, they are not
strong enough to bond low-retention
restorations such as veneers.
Every veneer manufacturer I have
spoken with still recommends the
total-etch (now called etch and rinse)
technique for luting veneers, including
higher strength veneers like IPS e.max.
There is one lecturer I know of, Dr. Jose
Luis-Ruiz, who mentioned to me in an
interview for Chairside magazine that
he is using self-etch to place veneers.
However, he is doing it using a cement
with a separate self-etch solution.
PANAVIA F2.0 (Kuraray America; New
York, N.Y.) and Multilink Automix are
two good examples of self-etching
resin cements with separate self-etch
primers.
The standard of care today is to use
the total-etch (etch and rinse) technique
with a light-cured resin cement
to place veneers.
The research I have seen does not
show any improvement in bond
strength if you re-etch the veneers
with hydrofluoric acid in your office
after try-in, although it is acceptable
to clean the veneer with phosphoric
acid.
– Mike
Dear Dr. DiTolla,
I practice general dentistry in Petaluma,
Calif. A few months ago, I attended one
of your CE courses through our local
dental society, Redwood Empire Dental
Society (REDS). I enjoyed your lecture and
your sense of humor. Most importantly, I
really liked all of your practical tips and
information. I have been practicing since
2000, and have taken many CE classes, but
your lecture has made the biggest impact
on my practice so far. Your preparation and
impression techniques have helped me
achieve perfect impressions and my crown
cement appointments are so enjoyable now.
My dental lab technician had always told me
that my preps and impressions were very
good, but the small changes I made since
attending your course have helped me
achieve excellent and consistent results. I
wanted to thank you and let you know how
useful your tips have been to my practice
and to me. I hope you return to this area to
lecture again.
– Nadia Navid, DDS
Petaluma, Calif.
Dear Nadia,
Thank you so much for your kind letter.
I love hearing stories like yours,
and I know your lab techs will be
thrilled with your preps and impressions
as well. They will love you even
more if you send a digital photograph
with all anterior cases! I keep playing
with new products and techniques,
looking for ways to help dentists get
better results in a simple, predictable
fashion. I will be sure to pass any of
those your way, and I hope I get a
chance to make it back to your neck
of the (red)woods soon!
– Mike
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