Indirect and Direct Restorative Protocols - Caulk

› “SmartCem2 is a valuable addition to my practice
because of the effi ciency and time savings it affords me
as well as my patient during the seating appointment.”
Ronald A. Feinman, DMD
Private practice, Atlanta, GA.
Figure 3. A coat of the resin cement (ie, SmartCem2, DENTSPLY
Caulk, Milford, DE) is applied to all surfaces that will contact the prepared
tooth to eliminate any voids that may occur during the seating of
the restoration (Courtesy: R.A. Feinman, Atlanta, GA).
Figure 4. A tack cure of the cement can often allow the clinician to
remove gross excess prior to fi nal curing of the luting cement without
dislodging the restoration. Interproximal fl ossing can complete removal
of excess cement prior to fi nal curing.
› Recommendations
for Cement Selection
and Application
■ The resin cement and
adhesive should have
compatible activation
mechanisms (eg, dualcured
resin with
dual-cured adhesive);
■ Conventional resin
cements are often indicated
for less-retentive
tooth preparations;
■ Postoperative sensitivity
can be minimized
through agents such
as Calm-It Desensitizer
(DENTSPLY Caulk,
Milford, DE); and
■ The radiopacity of the
cement should enable
subsequesnt evaluation
for marginal decay.
can opt for Prime & Bond® NT or XP
BOND (DENTSPLY Caulk, Milford, DE)
prior to light curing and application of
the resin cement. Each of these materials
provides versatility for use in light- and
dual-cured indications and favorable
bond strengths that surpass those of similar
etch-and-rinse adhesives. For a less
technique-sensitive adhesive procedure,
a self-etching system such as Xeno® IV
(DENTSPLY Caulk, Milford, DE) may be
employed to facilitate bonding.
A resin-based, self-adhesive cement
such as SmartCem2 (DENTSPLY
Caulk, Milford, DE) might also be
selected for its high strength and
convenience. Bonding is generally unnecessary
with self-adhesive cements.
This cement can be dispensed either
via automix syringe or automix digit
targeted delivery system according to
the clinician’s preference; SmartCem2
eliminates the time and inconveniences
often associated with mixing or capsule
activation. Its excellent retentive and mechanical
strengths to dentin and enamel
ensure that the cement bonds effectively
to porcelain, composite, and metal
restorations, and that SmartCem2
effectively seals margins.
Once SmartCem2 is applied to the
restoration and placed on the prepared
tooth (Figure 3), the restoration may be
gently manipulated into place for optimal
seating. The “gel phase” of SmartCem2
(DENTSPLY Caulk, Milford, DE) starts
approximately one to two minutes thereafter
and lasts about one additional
minute—providing the clinician with a
favorable working time chairside. A tack
cure of less than 10 seconds can also be
used to initiate the gel phase. A scalpel
and floss can then be used to remove any
excess cement material (Figure 4). When
the final curing has been completed, the
indirect restoration can be smoothed
lightly with a carbide finishing bur
(eg, Midwest® Esthetic Finishing Bur,
DENTSPLY Professional, York, PA) and
then polished to the desired appearance,
with the clinician taking care to ensure
its final luster and finish. ■
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