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Inside Dentistry
March 2021
Volume 17, Issue 3

Optimizing Indirect Restoration

The Roundtable video series is a forum for discussion and debate on key topics, trends, and techniques in dentistry. For each edition, Inside Dentistry's editor-in-chief, Robert C. Margeas, DDS, and a panel of experts examine a subject to help expand your knowledge and improve your practice. This month, our panel takes a look at indirect restoration.

The conversation begins with a debate on whether clinicians should have a dedicated primer for zirconia and another for glass ceramics or if there is a single primer that can be used to effectively bond to both materials.

The panel then discusses whether or not cleaning zirconia restorations with a surface cleaner after try-in is always necessary. "Yes and no," says Gary Radz, DDS. "It depends on your technique, the clinical workflow, and the manufacturer's instructions." Clint Stevens, DDS, agrees but also notes that using a cleaning agent is a foolproof way for him to ensure that he doesn't have a contaminated intaglio surface.

Regarding self-adhesive cements, the panel agrees that they are not all created equal. Nathaniel Lawson, DMD, PhD, who has done a significant amount of research on the topic, notes that the self-adhesive cements with MDP in them are promising because MDP can bond to zirconia, calcium, and tooth structure, so these tend to be more retentive. Radz concurs that when he's using a self-adhesive cement with MDP, his confidence level goes up.

The Roundtable wraps up with a discussion about what's involved in the choice of cements for different clinical applications. For veneers, the panel emphasizes taking into account working time, color stability, and the viscosities of the different materials. For crown and bridge cases, Stevens explains the importance of considering the restorative material that is being used, how much remaining tooth structure the patient has, and if the remaining structure is dentin or enamel. Ultimately, the panel agrees that when choosing cements, it comes down to the clinical situation, material, and technique.

Watch the full video on AEGIS TV at

What You'll Learn

Best practices for working with zirconia

A review of self-adhesive cements and their optimal substrates

Techniques to ensure predictable success with indirect materials

Meet the Panel

Nathaniel Lawson, DMD, PhD, is the director of the Division of Biomaterials at the University of Alabama at Birmingham School of Dentistry in Birmingham, Alabama.

Gary Radz, DDS, is the owner of Cosmetic Dentistry of Colorado in Denver, Colorado, and the director of industry relations for Smile Source.

Clint Stevens, DDS, is a fellow of the Academy of General Dentistry and the International College of Oral Implantologists. He maintains a private practice in Tulsa, Oklahoma.

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