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Figure 50: Ironically, perhaps the worst thing
you can do to clean out zirconia-based crowns
after try-in is to use phosphoric acid to clean
them. As you might imagine, phosphoric acid
is full of phosphate groups, and in your attempt
to clean the salivary phosphate groups still
bonded to the zirconia, using phosphoric acid
will flood the area with phosphates and occupy
every receptor site on the zirconia. It is only by
flooding the crowns with zirconia oxide that
we can decontaminate the internal surfaces in
preparation for cementation.
Figure 51: Now that we have freed up the
bonding sites on the zirconia with the Ivoclean,
there is no better way to cement a BruxZir crown
than with a cement that contains the same
phosphate groups that bond to zirconia. That
cement is Ceramir ® (Doxa Dental Inc.; Newport
Beach, Calif.). Doxa Dental recently finished its
clinical trials with the Dental Advisor to
show that Ceramir does in fact bond to BruxZir.
Here I am activating the Ceramir capsule in
the activator by holding the handle down for
three seconds.
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Figure 52: It’s a good thing I didn’t get rid of
my triturator! Next, I place the Ceramir capsule
in the 3M ESPE RotoMix capsule mixer for
10 seconds to ensure a complete mix. I know
this method of dispensing this cement seems
a little 1980s compared to modern paste-paste
cements, but I find it to be well worth the little
bit of extra effort. Just the ease of cleanup alone
makes Ceramir a no-brainer for me. Unlike most
resin-modified glass ionomer cements, Ceramir
has a “putty” stage that allows you peel it all off
in one piece. In fact, my dental assistant never
has to call me in anymore to dig out chunks
interproximally that have set rock hard.
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