RelyX Unicem Technical Product Profilemultimedia.3m.com/mws/media/174266O/relyxtm-unicem-self-adhesive...5 1. Introduction RelyX™ Unicem cement is a dual-curing, self-adhesive universal

RelyX™ Unicem Clicker™

RelyX™ Unicem Aplicap™/Maxicap™

RelyX UnicemTechnical Product Profile

TM

2

Table of Contents1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

2. Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

3. History of Dental Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

4. Chemical Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

4.1. New Monomers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

4.2. New Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

4.3. New Initiator Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

5. Setting Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

6. Active Transformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

6.1. Hydrophilic – Hydrophobic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

6.2. Acidic – Neutral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

7. Mechanical Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

7.1. Linear Expansion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

7.2. Mechanical Properties Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

8. Clinical Application of RelyX™ Unicem Cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

9. Pretreatment of Restorative Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

10. Official Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

11. Study Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

11.1. Clinical in vivo Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Clinical Performance of Ceramic In- and Onlays after 3 years . . . . . . . . . . . . . . . . . . . . .13

Clinical Performance of Ceramic In- and Onlays after 1 year . . . . . . . . . . . . . . . . . . . . . .14

Clinical Performance of Composite, All-ceramic,

and PFM Restorations after 4 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Clinical Performance of Metal, Ceramic, and PFM Restorations after 2 years . . . . . . . .16

Clinical Performance of Endodontic Posts after 3 years . . . . . . . . . . . . . . . . . . . . . . . . . .17

Human Pulp Response to Resin Luting Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

11.2. In vitro Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Measuring Bond Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Shear Bond Strength of Different Classes of Luting Cements to Human Dentin . . . . . .22

Shear Bond Strength to Human Dentin and Enamel and Lava™ Ceramic

Immediately and After 24 Hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Tensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

Shear Bond Strength to Human Dentin and Enamel after 24 hours and

Thermocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Microtensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . .26

Tensile Bond Strength to Human Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Immediate Shear Bond Strength to Bovine Dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Tensile Bond Strength to Bovine Dentin and Enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Retentive Bond Strength of Lava™ Zirconia Crowns on Human Dentin . . . . . . . . . . . . .30

Shear Bond Strength to Zirconia Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Shear Bond Strength to Lava™ Zirconia Ceramic and Glass Ceramic . . . . . . . . . . . . . . .32

Shear Bond Strength to Alumina Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Retention Strength of Fiber Posts Cemented with two Different Cements . . . . . . . . . . . .34

Shear Bond Strength to Fiber Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

3

Table of ContentsMarginal Sealing in Fiber Post Treated Teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Marginal Adaptation of Ceramic Inlays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Interfacial Adaptation of Partial Ceramic Crowns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

pH Profile of Various Luting Cements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Shear Bond Strength to Core Build-Up Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

Shear Bond Strength to CAD/CAM Glass Ceramics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Shear Bond Strength to Metal, Composite, and Ceramic Restorative Materials . . . . . . .45

12. RelyX™ Unicem Field Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46

13. Excerpt from the Instructions For Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

14. Technique Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

14.1. RelyX™ Unicem Aplicap™ / Maxicap™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

14.2. Technique Guide RelyX™ Unicem Clicker™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

14.3. Technique Guide RelyX™ Fiber Post / RelyX™ Unicem Aplicap™ . . . . . . . . . . . . . . . . . . .51

15. Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52

16. Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55

17. Product Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56

4

5

1. IntroductionRelyX™ Unicem cement is a dual-curing, self-adhesive universal resin cement for adhesive

cementation of indirect ceramic, composite or metal restorations. When using RelyX Unicem

cement, bonding and conditioning of the tooth are no longer necessary. The cement is charac-

terized by a higher moisture tolerance, as compared to multi-step composite cements. RelyX

Unicem cement releases fluoride ions and is available in various shades. Among others, its

essential characteristics are high dimensional stability and very good adhesion to the tooth

structure.

RelyX Unicem cement is available in 3M™ ESPE™ Aplicap™ and Maxicap™ capsules and the

Clicker™ Dispenser.

Aplicap™ Capsules

Ideally suited for inlays, onlays, crowns and posts

Hygienic unidose (295 mg per capsule)

Consistent mix with triturator

RelyX™ Unicem Aplicap™

Elongation Tip available for virtually void-free cementation of posts

Available shades: A1, A2 Universal, A3 Opaque, White Opaque and Translucent

RelyX™ Unicem - Delivery choicesMaxicap™ Capsules

Ideally suited for multiple-unit bridges

Hygienic unidose (936 mg per capsule)

Consistent mix with triturator

Longer working time (2:30 min)

Available shades: A2 Universal, A3 Opaque and Translucent

Clicker™ Dispenser

Suited for all sizes of restorations

Choose amount dispensed; 11 g dispensable in 80 clicks (approx. 40 applications)

Delivers premeasured doses for consistent ratio of pastes; easy, economical mixing

No need for mixer, activator, appliers, mixing tips or other devices

Available shades: A2 Universal, A3 Opaque and Translucent

RelyX™ Unicem - Benefits

• Eliminates the need for etching, priming and bonding steps

• Strong, adhesive, esthetic and moisture-tolerant

• Easy to use for virtually all indications (except veneers and Maryland bridges)

• Low risk of postoperative sensitivities

• Clinically proven with years of scientific data and independent university studies available

• Releases fluoride over a long period of time

6

2. IndicationsRelyX™ Unicem Self-Adhesive Universal Resin Cement is indicated for the permanent cemen-

tation of inlays, onlays, crowns, bridges, posts, and screws made of ceramics, composite or

metals.

3. History of Dental CementsToday’s dental cements can be traced back to the 19th century. As early as 1856, Sorel was put-

ting together formulations for magnesium chloride cement. The continuous search for better

materials led to numerous developments over the years.

According to their chemical composition, today’s commonly used dental cements are classified

into the following groups:

• Zinc phosphate cements

• Polycarboxylate cements

• Glass ionomer cements

• Resin-modified glass ionomer cements

• Compomer cements

• Adhesive resin cements

• Self-adhesive resin cements

While conventional cements offer easy handling, adhesive resin cements (also referred to as

composite resin cements) are highly versatile and provide strong adhesion and high esthetics

which is especially important for the cementation of state-of-the-art all-ceramic restorations.

However, this comes at the expense of easy and fast application. Various pretreatment steps

(etching, priming, bonding) and the absolute exclusion of moisture (rubber dam) are necessary

to successfully use adhesive cements. Therefore, adhesive cementation is much more technique

sensitive than conventional cementation and the clinical success may be compromised by the

technical challenges it imposes on the dentist.

These drawbacks were resolved with the introduction of the first self-adhesive universal resin

cement RelyX Unicem in 2002.

Table 1: Strength and weak-nesses of commonly used dentalcements.

Conventional cements

Hybrid cements}}

} Composite resin cements

General overview of cement classes. Specific products may exhibit deviating characteristics.1 Ratings here refer to RelyX Unicem cement. Some other so-called self-adhesive cements may not exhibit the same characteristics.2 For some products a conditioning step is recommended.3 Some products belonging to this class may include a self-etch primer / bonding system.4 Not all resin cements are recommended for dark cure only.5 Not applicable / not recommended.

Bond strength

Typical pretreatment steps

Metal

Composite

Indications Glass-ceramic

High strengthceramics

Low solubility (insoluble)

Mechanical properties

Esthetics

Zinc phosphatecements

★

–

★★★

n. a.5

n. a.

n. a.

★

★

★

Cement classes

Properties

Polycar-boxylatecements

★

–

★★★

n. a.

n. a.

n. a.

★

★

★

Glassionomercements

★★

–2

★★★

n. a.

n. a.

★★

★

★★

★

Resin-modifiedglass ionomer

cements

★★

–

★★★

n. a.

n. a.

★★

★★

★★

★

Adhesive resincements

★★★

etching3, priming, bonding

★4

★★★

★★★

★★★

★★★

★★★

★★★

Self-adhesive universal resin

cements1

★★★

–

★★★

★★★

★★★

★★★

★★★

★★★

★★★

Compomercements

★★

conditioning

★★

★

n. a.

★

★★

★★

★★

7

4. Chemical CompositionRelyX™ Unicem cement is available in two formulations: as a powder / liquid system in the

3M ESPE Aplicap™ and Maxicap™ Capsules, as a paste / paste system in the 3M ESPE

Clicker™ Dispenser. The qualitative composition of both formulations is shown in Table 2.

The ideal combination of easy handling known from conventional cements plus a bond strength

comparable to that of adhesive resin systems demanded developing new monomers, new fillers,

and new initiators.

Fig. 1: RelyX™ Unicem cementcombines glass ionomer, adhe-sive and composite technology.

Table 2: Chemical composition ofRelyX™ Unicem cement in thecapsule and the Clicker version.

Bond strength value see chapter 11.2(p. 22)

• alkaline (basic) fillers• silanated fillers

• phosphoric acid modified methacrylate monomers• methacrylate monomers

• initiators

RelyX™ UnicemSelf-Adhesive Universal Resin Cement

Glass ionomer technology

Adhesive technology

Composite cement technology

Powder

Alkaline (basic) fillers

Silanated fillers

Initiator components

Pigments

Base paste (white)

Methacrylate monomers containing phosphoric acid groups

Methacrylate monomers

Silanated fillers


Stabilizers

Liquid

Methacrylate monomers containing phosphoric acid groups



Stabilizers

Catalyst paste (yellow)


Alkaline (basic) fillers

Silanated fillers


Stabilizers

Pigments

8

4.1. New Monomers

Dental cements have to excel in the following areas: adhesion, mechanical properties, long-

term stability, esthetics and biocompatibility. In order to provide RelyX™ Unicem cement with

optimal properties and self-adhesion, the adhesive monomers were optimized. Several phos-

phoric acid groups and carbon double bonds per molecule are characteristic for the acidic

methacrylate monomers in RelyX Unicem cement. Whereas the phosphoric acid groups con-

tribute to self-adhesion, the carbon double bonds bring about a high reactivity of the methacry-

late monomers with each other. Thus after setting of RelyX Unicem cement, the resin matrix

shows a high degree of cross-linking between the particular mono-mers. In this way good

mechanical properties (e.g. high compressive and flexural strength) and adhesive bonding with-

out pretreatment of the tooth structure can be achieved. Furthermore, a high degree of cross-

linking is one essential requirement for the long-term stability of the cement which is met by

RelyX Unicem.

4.2. New Fillers

Fillers have also an important impact on the cement’s properties. One part of the fillers in

RelyX Unicem cement is silanated and, thus, is chemically embedded into the cement matrix

during setting. Another part is alkaline (basic) and thereby able to react with the phosphoric

acid groups of the methacrylate monomers in a neutralization reaction. Therefore, during set-

ting the pH-value increases and lifts the initially acidic RelyX Unicem cement paste to a neutral

level. This avoids hydrolysis processes in the cement in the long run and is therefore another

important prerequisite for the long-term stability of any initially acidic cement. Additionally,

during the neutralization reaction fluoride ions are released from the fillers. RelyX Unicem

cement provides these ions to the tooth structure without containing soluble fluoride salts in the

cement matrix. The amount of inorganic fillers contained in RelyX Unicem cement approxi-

mates 70 percent by weight and 50% by volume with the grain particle size (d[90]=90% of the

fillers) being <12.5µm. The fillers also account for the cement’s radiopacity.

4.3. New Initiator Systems

In dental technology most initiator systems for self curing (= chemical / dark curing) are based

on alkaline (basic) amines. However, these are deactivated in an acidic environment which

would inhibit self curing. For this reason, a completely new dual-curing initiator system was

developed to function in the initially acidic RelyX Unicem cement paste. It is characterized by

moisture tolerance and the ability to effectively initiate the polymerization reaction in a wide

pH-range. This ensures that the first step on the way to a highly cross-linked cement matrix

proceeds most effectively. Thus, in addition to innovative monomers and fillers, the initiator

system, too, contributes to a permanently strong bond strength and stability of RelyX Unicem

cement.

5. Setting ReactionsThe setting of RelyX Unicem cement is started either by a curing light or by the chemical reac-

tion of the initiator system. The main setting reaction is a radical polymerization reaction by

which the single monomer molecules are chemically cross-linked to form a three-dimensional

polymer network. Simultaneously, but to a minor extent, neutralization reactions take place,

which are important for the properties of the set RelyX Unicem cement. The following figures

illustrate in a simplified way the reactions that occur simultaneously during the setting of

RelyX Unicem cement.

Mechanical properties see chapter 7(p. 9)

pH-profile see chapter 6.2 (p. 8)

Hydrophilicity see chapter 6.1 (p. 8)

Working and curing times see chapter 13 (p. 47)

9

Acidic methacrylatemonomers contain phosphor-ic acid groups and reactivecarbon double bonds whichare connected with each othervia a carbon backbone.

The main components ofRelyX™ Unicem cement are:

• Methacrylate monomers,partially containing phos-phoric acid groups

• Fillers, one part releasingions, another part is silanated

• Chemical initiator system

• Light initiator system

1

4

2

5

3

6

The remaining phosphoricacid groups of the methacry-late monomers are neutral-ized by ions, which arereleased from the fillers dur-ing the setting reactions.

After mixing, RelyX™ Unicemcement is very acidic (lowpH-value) and hydrophilic(water binding). Upon contactwith the tooth surface thenegatively charged phosphoricacid groups of the methacry-late monomers bond to Ca2+-ions in the tooth structure.Thus, the phosphoric acidgroups are neutralized (i.e.pH rises) and anchored at thetooth surface.

Next to the restoration materi-al enamel and dentin are thesubstrates to which dentalcement has to show safe andreliable adhesion. The toothsubstance (enamel and dentin)consists of inorganic apatite-crystals containing calciumand organic collagen fibers.Additionally, the tooth struc-ture contains water.

The released fluoride ions areabsorbed by the tooth struc-ture.

Methacrylate-monomers

Initiators

Fillerscontaining

Calcium-Ions

Alumina-Ions

Strontium-Ions

Fluoride-Ions

Calcium-Ions on tooth substance (apatite)

Reactive carbondouble bond

Phosphoric acidgroup

Carbon-backbone

The methacrylate monomersare chemically cross-linkedwith each other through theinteraction of reactive carbondouble bonds.

Simultaneously, setting of thecement takes place throughthe radical polymerizationreaction of the methacrylatemonomers.

The initiator system generatesthe necessary starter radicalsthrough light-induced orchemical activation.

The methacrylate monomersand fillers are firmly linkedand permanently embedded inthe three-dimensional networkof the cement matrix.

RelyX™ Unicem cement iscured by the radical polymer-ization reaction. Thus, succes-sively a highly cross-linkedthree-dimensional networkis formed consisting ofmethacrylate molecules andfillers. During this process thecement matrix changes froman initially hydrophilic to ahydrophobic condition.

7 8

109

Fig. 2: Simplified depiction of the setting reactions of RelyX™ Unicem cement.

10

6. Active Transformation

6.1. Hydrophilic – Hydrophobic

Immediately after mixing RelyX™ Unicem, the cement paste is very acidic and has hydrophilic

properties. Therefore it shows a higher moisture tolerance than multi-step composite cements.

This together with the good adaptation to the hydrophilic tooth surface is the immediate advan-

tage for the dentist during the very first steps of the clinical cementation procedure. The result-

ing high bond strength is one prerequisite for a long-lasting success of the restoration. During

setting of RelyX Unicem cement a strongly cross-linked cement matrix with hydrophobic pro-

perties develops through the proceeding radical polymerization and the subordinate neutraliza-

tion reactions. A low linear expansion and low solubility are the results and lead to the clinical-

ly proven, long-term stability which plays a central role especially for all-ceramic restorations.

Thus, RelyX Unicem cement automatically changes its properties from hydrophilic to

hydrophobic during setting.

6.2. Acidic – Neutral

Parallel to the change from a hydrophilic to a hydrophobic state the pH-value increases during

the setting of RelyX Unicem cement. Immediately after mixing RelyX Unicem, the cement

paste is very acidic. Within a few minutes the pH-value starts to increase and within 24 hours

reaches a neutral level. After application to the tooth, the low pH-value of RelyX Unicem

cement is pivotal for the self-adhesive mechanism, whereas the pH increase as well as the

hydrophobic condition are essential prerequisites for the long-term hydrolytic stability of the

cement.

ph

alkaline

acidic

time after mixing [days]



0

1

2

3

4

5

6

7

8

9

10

11

12

13

14

0 1 2 3 4 5 1 6 30

time after mixing [hours]

HydrophilicGood adaptation tothe tooth surfacemoisture tolerance

Low expansionLow solubilityHigh long-term stability

Hydrophobic

Polymerization and neutralization reactions

Hydrophilic: water binding

Hydrophobic: water repelling

Fig. 3: RelyX™ Unicem cementchanges its properties fromhydrophilic to hydrophobic during setting.

Fig. 4: pH-profile of RelyX™

Unicem cement (3M ESPE internal lab data, 2007).

11

7. Mechanical Properties

7.1. Linear Expansion

Dimensional stability of a cement is an important consideration especially when cementing all-

ceramic restorations. In order to simulate the worst case scenario specimens of the cement to be

tested are immersed in water over months or years. In this way the counteracting effect of even-

tual initial polymerization shrinkage can be ruled out. RelyX™ Unicem cement both in the

Aplicap™ and in the Clicker™ Dispenser show comparable and low expansion values that prove

it to be safe for the cementation of all-ceramic restorations.

7.2. Mechanical Properties Overview

[%]

0,0

0,2

0,4

0,6

0,8

1,0

1,2

1,4

1,6

0 6 12 18 24 30 36 42 48 54

time [months]



LIGHT / SELF cure

Fig. 5: Linear expansion of RelyX™ Unicem cement (3M ESPE internal lab data, 2007).

Table 3: Mechanical properties of RelyX™ Unicem cement.

Flexural strength [MPa]

Compressive strength [MPa]

Modulus of elasticity [GPa]

Surface hardness [MPa]

Radiopacity [mm Al]

Film thickness [µm]

Water sorption [µg/mm3]

Solubility [µg/mm3]

RelyX™ Unicem Aplicap™ – Maxicap™

(SELF – LIGHT cure)

48 / 75

188 / 236

4.9 / 8.4

202 / 280

2.43

18 / -

39 / 25

15 / -3


(SELF – LIGHT cure)

60 / 71

216 / 244

3.9 / 6.3

195 / 220

1.79

17 / -

42 / 25

12 / 1

Delivery versions

Properties

12

8. Clinical Application of RelyX™

Unicem CementAs discussed earlier, adhesive cementation poses a recurring technical challenge for dentists

and dental assistants. In comparison to RelyX Unicem cement, a composite cement with an

adhesive bonding system requires many more steps to securely bond a restoration to the tooth

structure.

Typical total-etch resin cement system

Cementing Steps

Initial situation:Provisional restorationremoved and preparedtooth cleaned.

Thoroughly rinse withwater.

Etch with a phosphoricacid etching gel.

Lightly dry with oil-free andanhydrous air or blot dryexcess water. Do not overdry.

Apply primer with a dis-posable applicator and rubin thoroughly.

Dry primer in a light air stream.Avoid direct blowing, as excessmay coagulate.

Apply adhesive with adisposable applicatorand rub in thoroughly.

Light cure adhesive ifindicated.

Mix cement and apply to theprepared restoration and/orthe prepared tooth. (Direct apli-cation with Applicap™ or Maxicap™

Capsule system possible)

Lightly thin or air dry adhesi-ve evenly with an air stream.Avoid coagulation of theadhesive.

Place the restoration.

Remove excess.

Light cure or allow to selfcure.

Final situation:Adhesively cementedceramic crown.

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Cementation withRelyX™ Unicem Cement

13

9. Pretreatment of RestorativeMaterials

To assure optimal bond strength to the restoration 3M ESPE recommends the following proce-

dures for the cementation with RelyX™ Unicem cement as long as not stated differently by the

manufacturer of the restorative material.

Please refer to the instructions for use supplied with each package of RelyX Unicem cement

before usage.

*While these pretreatment steps are essential for many composite resin cements, RelyX™ Unicem cement exhibits sufficient bondstrength also with the more simple alternative 1 (see study results, page 27 fig. 29).

10. Official RatingsSince its market introduction in 2002 RelyX Unicem cement continually received high ratings

from several independent research institutes. Listed is a selection of the more recent awards:

RelyX Unicem Self-Adhesive Universal Resin Cement was selected “Most Innovative New

Product of the Year” for 2004 by REALITY.

RelyX Unicem Self-Adhesive Universal Resin Cement was rated 4-STARS by REALITY

since its first evaluation in 2003

(Reality Now, Vol. 17, No. 153, June 2003)

4-year Clinical Performance

4,000 indirect restorations of different types were cemented with RelyX Unicem cement and

evaluated after 4 years in service. THE DENTAL ADVISOR reconfirmed its top rating of 5+,

which were already awarded for the 1-, 2- and 3-year recall. It reports on outstanding results in

all evaluated categories: handling, sensitivity, microleakage and retention.

(THE DENTAL ADVISOR, Vol. 24, No. 4, May 2007)

Bond strength value see page 22

Restorative material type

Metal (precious and non-precious)

Etchable Glass Ceramics(e.g. ParadigmTM C, 3M ESPE;Vitablocs® Mark II, Vident;Authentic®, Microstar®;IPS-Empress®, Ivoclar Vivadent;ProCAD®, Ivoclar Vivadent)

Non-etchable Zirconia and AluminaCeramics(e. g. LavaTM, 3M ESPE;Cercon®, Dentsply; Procera® AllCeram,Nobel Biocare)

Composite(e. g. ParadigmTM MZ100, 3M ESPE;Artglass, Heraeus Kulzer;belleGlassTM NG, Kerr)

RelyXTM Fiber Post (3M ESPE)

Other glass fiber reinforced posts

Pretreatment

Sandblast with aluminum oxide 40 µmClean with alcohol

Etch with hydrofluoric acidSilanate (e. g. RelyXTM Ceramic Primer, 3M ESPE)

Alternative 1:Sandblast with aluminum oxide 40µmClean with alcoholAlternative 2:*Coat (silicate) (e. g. CoJetTM Prep and CoJetTM Sand, 3M ESPE)Silanate (e. g. RelyXTM Ceramic Primer, 3M ESPE)

Sandblast with aluminum oxide 40µmClean with alcohol

No pretreatment necessary if cemented with RelyX Unicemcement

Clean with alcoholSilanate

14

11. Study ResultsAlong with the dentist's technical expertise and the restorative material's properties, the per-

formance of the cement contributes significantly to the clinical success of indirect restorations.

The following properties are especially important for a universal cement, which is indicated for

cementation of metal, composite and ceramic restorations:

• High adhesion to the tooth structure and restorative materials

• High marginal quality

• Very good mechanical properties

• Low risk of postoperative sensitivities

• Very good long-term stability

Since the market introduction of RelyX™ Unicem cement in 2002 more than 80 studies have

been carried out internationally, which investigate these and other properties. The most impor-

tant results are presented and discussed in the following chapter. It provides an overview on

clinical as well as in vitro studies.

11.1. Clinical in vivo Studies

Although in vitro tests are helpful in comparing and assessing a material’s properties, the final

proof for a dental material’s performance is clinical trials. The following pages provide an

overview of the clinical performance of RelyX Unicem cement.

Clinical Performance of Ceramic In- and Onlays after 3 Years

Study design and results:

Posterior class I and II restorations in 30 patients were restored with ceramic in- and onlays

(Authentic®, Microstar) using either RelyX™ Unicem Self-Adhesive Universal Resin Cement

(Aplicap™) or the multi-step bonding system Syntac® Classic and Variolink® II incl. the multi-

step bonding system Syntac Classic (both Ivoclar Vivadent). Cementation was done according

to the cement manufacturers’ instructions for use. For the 3-year recall, 50 restored teeth were

evaluated following the modified Ryge criteria for clinical evaluations (see table 5).

Marginal adaptation Color match Marginaldiscoloration

Surface roughness Absence of caries0

20

40

[%] 60

80

100

Variolink II®

alpha scores

delta scores

RelyX™ Unicem alpha scores bravo scores

bravo scores

RelyX™ Unicem Collection of ScientificResults

Clinical Outcomes of Ceramic Inlays /Onlays Luted With Two BondingSystems.Denehy G., Stanford C., Cobb D.,Vargas M. et al. 2007University of Iowa, USAunpublished study

Fig. 6: Clinical performance after3 years of ceramic in- and onlaysseated with RelyX™ Unicem ce-ment (Aplicap™) and Variolink® II.

15

Conclusions:

The authors of the study state: "The three year outcomes of this study suggest that there is

equivalent clinical performance of the self etching RelyX™ Unicem system relative to the com-

parison group. These clinical efficacy outcomes are important since the RelyX Unicem cement

system uses a simplified clinical set of procedures while providing equivalent outcomes to the

more complex, multi-step set of clinical procedures used in the Variolink® II group."

Clinical Performance of Ceramic In- and Onlays after 1 Year


IPS-Empress® (Ivoclar Vivadent) restorations (70 Class 2 inlays, 13 onlays / 47 premolars,

36 molars) were placed in 30 patients in a split mouth design. 43 inlays/onlays were seated with

RelyX Unicem cement (Maxicap™). The multi-step adhesive Syntac® Classic and Variolink II

low (both Ivoclar Vivadent) served as a control (n=40). The inlays were pretreated according to

the cement manufacturers’ instructions for use (HF-etching and silanating). Additionally, in the

Variolink group Heliobond™ (Ivoclar Vivadent) was applied to the restorations. After one year

the restorations were evaluated using modified Ryge criteria.

0

20

40

[%]

60

80

100

Marginal integrity Integrity of tooth Surface roughness Proximal contact

Variolink II®

alpha 1 scores alpha 2 scores bravo scoresRelyX™ Unicem

alpha 1 scores alpha 2 scores bravo scores

Table 5: Modified Ryge criteriafor the clinical evaluation of in-and onlay restorations

Ceramic Inlays Luted with a Self-Adhesive Cement After one YearTaschner M., Frankenberger R.,Petschelt A., Krämer N.University of Erlangen, GermanyPublished at the AADR 2006abstract #1361

Fig. 7: Clinical performance ofceramic in- / onlays seated with RelyX™ Unicem cement(Maxicap™) and Variolink® II low after 1 year.

Criteria

Marginal adaptation

Color match

Marginal discoloration

Surface roughness

Absence of caries

Alpha scores

Explorer does not catch

Good match in color, shade, and translucency

No discoloration evident atmargin

Smooth surface

Alpha scores

No caries

Bravo scores

Explorer catches

Slight mismatch in color, shade, and translucency

Slight staining at margin

Slightly rough or pitted

Delta scores

Caries evident at the margins of the restoration

16

Criteria

Marginal integrity

Integrity of tooth

Proximal contact

Surface roughness

Alpha 1 scores

Margin matches restoration andtooth perfectly inshape and color

Complete integrity

Physiological contact

Smooth and polished surface

Alpha 2 scores

Margin does not match perfectly but can be polished without causing damage to do so

Minor enamel crack or hair-line split

Contact is too weak or too strong

Slightly rough surface; can be polished

Bravo scores

Marginal gap withno negative long-term consequences

Clear enamel crack with no negativelong-term conse-quences

Contact is far tooweak; but no indi-cation of tissuedamage

Rough surface; can not be polishedwithout causingdamage

Table 6: Modified Ryge criteria forthe clinical evaluation of in- andonlay restorations

Conclusions:

After one year RelyX™ Unicem cement (Maxicap™) performed similar to the control.

Furthermore, this study highlights the lack of hypersensitivities both in the control group as

well as with RelyX Unicem cement.

Clinical Performance of Composite, All ceramic, andPFM Restorations after 4 Years


Over 4,400 restorations have been cemented with RelyX Unicem cement (Aplicap™/Maxicap™)

between 2003 and 2006 by the evaluators of THE DENTAL ADVISOR. The distribution of

indications and materials was as shown in the chart below. 1,560 restorations were available for

recall and 230 of these have been cemented for 4 years.

Conclusions:

According to THE DENTAL ADVISOR “RelyX Unicem cement has proven to be an excellent

and reliable self-adhesive resin cement in the four years since its introduction”.

Overall, RelyX Unicem cement showed 98% positive clinical performance and received

5 plus – the highest rating by THE DENTAL ADVISOR.

0% 20% 40% 60% 80% 100%

Microleakage(based on 1,560 restorations)

no microleakage 95,8%

microleakage 4,2%

Post-Operative Sensitivity(based on 1,560 restorations)

post-operative sensitivity 1,6%

no post-operative sensitivity 98,2%

Debonding(based on 4,400 restorations)

debonding no debonding 99,3% 0,7%

PFMcrowns/bridges

all-ceramiccrowns/bridges

all-ceramicin-/onlays

posts

3M™ ESPE™ RelyX™ Unicem Self-Adhesive Universal Resin Cement 4-year Clinical PerformanceTHE DENTAL ADVISOR, Vol. 4, No. 4,May 2007

Fig. 8: Indications and restora-tive material types cemented with RelyX™ Unicem cement(Aplicap™).

Fig. 9: Clinical performance ofrestorations cemented withRelyX™ Unicem cement (Aplicap™)after 4 years.

17

Clinical Performance of Metal, Ceramic and PFM Restorations after 2 Years


90 restorations (mean age 21-months) in 82 patients have been seated by general dental practi-

tioners and were available for recall. Four restorations were reported to have failed for reasons

(root fracture, porcelain fracture, and unrelated enamel chipping), deemed by the operator,

unconnected with the use of RelyX™ Unicem cement (Aplicap™).

Conclusions:

Over a mean 21-month observation time the RelyX Unicem self-adhesive universal resin

cement (Aplicap) was rated to perform well and no cement-related failures were observed.

[%]0 20 40 60 80 100

No discoloration

Marginal staining

present

Slight staining present,can be polished away

Obvious staining,cannot be polished away

Gross staining‡ *

* none detected‡ clinically unacceptable

[%]

Marginal adaptation0 20 40 60 80 100

Explorer does notcatch

Explorer catches, nocrevice visible

Crevice at margin,enamel margin exposed‡

Obvious crevice atmargin, dentine or lute exposed‡

* none detected‡ clinically unacceptable

*

0% 20% 40% 60% 80% 100%

all-metal PFM fiber post all-ceramic

Two-year Performance of RestorationsPlaced with a Self-Adhesive LutingMaterialCrisp R.J., Burke F.J.T., University ofBirmingham, UKPublished at the IADR 2006, abstract#2098

Fig. 10: Types of restorative materials used for restorationsseated with RelyX™ Unicem cement (Aplicap™).

Fig. 11: Marginal adaptation of various restorations 2 years aftercementation with RelyX™ Unicemcement (Aplicap™).

Fig. 12: Marginal staining of variousrestorations 2 years after cementa-tion with RelyX™ Unicem cement(Aplicap™).

18

Clinical Performance of Endodontic Posts after 3 Years


45 patients were treated using a titanium post (Fiberpoints Root Pins Titanium) and 46 patients

received a glass fiber post (Fiberpoints Root Pins Glass, both Schuetz Dental Group). All posts

had a diameter of 1.4mm and a length of 13mm and were cemented with RelyX™ Unicem

cement (Aplicap™). All teeth received a core build-up. Patients were observed in regular inter-

vals after post placement.

Conclusions:

After 1 to 3 years of clinical service all the restorations were still in place and no difference was

observed between the two post materials tested. Therefore, RelyX Unicem cement (Aplicap) is

very well suited for any kind of post cementation.

Human Pulp Response to Resin Luting Cements


Deep Class V cavities were prepared on the buccal surface of 34 sound human premolars.

Inlays were fabricated and cemented with either RelyX Unicem cement (Aplicap) or

Variolink® II / Excite® DSC (Ivoclar Vivadent). 60 days after cementation the teeth were

extracted and processed for histological assessment. In both control groups (group 1: cavity

was lined with Dycal®, Dentsply Caulk prior to cementation with RelyX Unicem cement;

group 2: teeth were left untreated), normal histological characteristics were observed.

Conclusions:

Teeth that had received an inlay cemented with the one-step RelyX Unicem cement showed a

lower inflammatory cell response than teeth treated with a multi-step resin cement.

11.2. In vitro Studies

Measuring Bond Strength

The following chapter provides an overview on in vitro studies mainly measuring bond strength

values to tooth structure or various restorative materials.

Although the output of most measurements is given in MPa (i.e. mega Pascal; Pascal is a meas-

ure for pressure equaling Newton (N) per m2) absolute numbers resulting from different studies

cannot simply be compared for severeal reasons. First and foremost, bond strength can be

FRC vs. Titanium Posts-PreliminaryResults of a RCTNaumann M.1, Sterzenbach G.2,Blankenstein F.2,Lange K.-P.2

1Humboldt-University Berlin, Charite -University Medicine, Germany2Humboldt-University Berlin, Germany;Published at the IADR 2006, abstract#0077

Human Pulp Response to ResinCements Used to Bond InlayRestorationsCosta C.A. de S.1, Hebling J.2,Randall R.C.2

1University Sao Paulo State-UNESP,Sao Paulo, Brasilia23M ESPE, St. Paul, USAJournal of Dental Materials, No. 22,2006, 954–962

Fig. 13: Inflammatory cellresponse in the pulp area 60 daysafter cementation of an inlay(teeth per group = 6).

[%]

0

20

40

60

80

100

none slight moderate severe

RelyX™ Unicem Aplicap™Variolink II

* none detected

* *

®

19

determined using methodologies that differ in their experimental set-up. Second, even if the

same set-up is used, experimenters can come to differing results due to the influence of a num-

ber of factors such as:

• teeth from different species and / or different individuals

• way of securing the teeth for preparation and testing

• kind of surface preparation (grit of sandpaper)

• geometry of the substrate and the sample

• differences in the handling between operators

• cross-head speed of the testing machine

Therefore, absolute numbers should only be compared if retrieved in the same experiment. In

general, this calls for study designs where a broad range of products is investigated side by side

under the same conditions.

To determine the bond strength of a cement at different points of time after seating of the

restoration test samples can be subjected to different treatments. To examine immediate bond

strength, the cement is cured and the samples are tested. Simulation of long-term clinical per-

formance and aging can include one or a combination of the following treatments:

• water storage over an extended period of time

• thermocycling

• mechanical loading.

The principle of a number of test methods is described briefly in the following. Only the very

basics of the particular method are given here and numerous modifications exist according to

requirements of the aim of the study and the operator.

Shear Bond Strength

In the studies cited here, the shear bond strength has been determined using two different

experimental set-ups. One set-up uses a wedge-like instrument (fig. 14) to shear off the luted

composite sample. The other method uses a wire loop (fig. 15). In both cases the shear force

is applied parallel to the sample surface.

• Extracted teeth are embeddedinto resin or impression material.

• Teeth are cut with saws and/orground with sandpaper to obtaina flat surface in either dentin orenamel.

• The tooth structure is preparedfollowing the Instructions for Usegiven by the manufacturer of theparticular cement to be tested.

• Alternatively, bond strength torestorative materials (e. g. metals,ceramics, composite) can bedetermined if the tooth isreplaced by a specimen of thematerial under investigation.

• A button like specimen (e. g.made from composite) with adefined bonding surface area iscemented to the tooth surface.In an alternative set-up the button–like specimen itself ismade of the cement to be test-ed. To this end a cylindrical orbutton-like mold is placed ontothe tooth surface and filled withthe cement.

• Samples may be stored for dif-ferent lengths of time and/orthermocycled according to thedesign of the experiment tosimulate aging.

• For determining the shearbond strength of the cementthe test sample is mountedinto a universal testingmachine.

• If a wedge-like instrument isused the force needed to shearoff the composite specimen ata given speed is recorded andthe corresponding bondstrength (pressure) is calcu-lated.

Fig. 14: Simplified depiction of aset-up to determine the shearbond strength using a wedgeshaped instrument. The cement is shown as red line.

20

The force needed to break offthe composite specimen isrecorded accordingly if a wireloop is used.

see above see above

Fig. 15: Simplified depiction of aset-up to determine the shearbond strength using a wire loop.

Fig. 17: Simplified depiction of a set-up to determine the tensilebond strength on root canalposts.

Fig. 16: Simplified depiction of aset-up to determine the tensilebond strength.

Tensile Bond Strength

For tensile testing samples are prepared as described above for determining shear bond

strength. In this test, however, specimens are pulled off with the force applied perpendicular to

the sample surface.

The tensile bond strength test method can be modified to determine the bond strength of

cements to root canal posts.

The force needed to pull offthe composite specimen isrecorded and the correspon-ding bond strength (pressure)calculated.

A plastic carrier is slipped ontothe conical end of the post. Eachsample shows the same length ofthe post tip.

A standardized mold on the plastic carrier is used to applythe same amount of cement toeach of the samples.

After curing, the cement disc ispulled off in a universal testingmachine.

see above see above

21

Fig. 18: Simplified depiction of aset-up to determine the microten-sile bond strength.

Fig. 19: Simplified depiction of aset-up to determine retentivebond strength using full crowns.The cement is shown as red line /surface.

Microtensile Bond Strength

Retentive Bond Strength of Full Crowns

This test is a variation of the tensile bond strength test.

Retentive Bond Strength of Fiber Posts

Similar to a full crown test, the retention of a root canal post can be simulated. After extraction,

teeth are endodontically treated and the root canal is filled with guttapercha. In the second

preparation step the guttapercha filling is removed and a post is cemented into the root canal in

a standardized way. The force needed to extract the post from the tooth is recorded.

• Extracted (human) teeth are pre-pared for full crowns in a stan-dardized manner. The root area of the teeth is embedded into aresin block for mounting into auniversal testing machine.

• Crowns with external reten-tions are fabricated and ce-mented using the cements tobe tested.

• The force necessary to pull offeach crown is measured. Afterdetermining the retention sur-face of each individual tooththe retentive bond strength iscalculated.

• The tooth is cut to either showenamel or dentin surface. A com-posite block is then cemented tothe exposed tooth surface usingthe cement to be tested.

• After setting rectangular beamsare cut out with a diamondsaw.

• Each beam is mounted into auniversal testing machine andbond strength is determined.

22

Shear Bond Strength of Different Classes of Cements to Human Dentin


The dentin of extracted human molars was prepared by grinding with sandpaper (600 grit).

Each cement system was used according to the manufacturer’s instructions for use. One half of

the samples was tested at 30 minutes the other half after 14 days of water storage and subse-

quent thermocycling (1,000 x 5/55°C) (experimental set-up see chapter 11.2.).

Conclusions:

The one-step RelyX™ Unicem Self-Adhesive Universal Resin Cement (Aplicap™) shows

comparable results as the multi-step adhesive bonding system Panavia™ F. This is true for both

curing modes and for bond strength values measured 30 min after cementation and after

simulated aging.

Shear Bond Strength to Human Dentin and Enamel andLava™ Ceramic Immediately and after 24 Hours


Polished surfaces (1,000 grit) of human dentin, enamel and Lava zirconia ceramic samples

were prepared. The Lava surface was sandblasted (50µm Al2O3). Composite inlays (Filtek™

Z250, 3M ESPE) were fabricated and luted to the substrate samples using the three resin

cements (RelyX Unicem cement (Aplicap), 3M ESPE; Maxcem™, Kerr; Panavia F 2.0,

Kuraray). The shear bond strength of the cementation was measured using a universal testing

machine immediately and after one-day storage (experimental set-up see chapter 11.2.).

[MP

a]

Fleck’s

™ ce

men

t

Fuji 1

Ketac

™ C

em A

plica

p™

Fuji P

lus

FujiCEM

RelyX™

Lut

ing (SC)

(LC)

RelyX™

Unic

em A

plica

p™(SC)

(LC)

Panav

ia™ F

/ ED P

rimer

™

Variol

ink® II

/ Syn

tac®

Classic

(LC)

(SC)

(LC)

RelyX™

ARC /

Scotch

bond

™ 1

0

2

4

6

8

10

12

14

16

18

20

22

30 min14d / thermocycling

* zinc phosphate cement

LC: LIGHT cureSC: SELF cure

Dentin Shear Bond Strength of VariousLuting CementsPiwowarczyk A.1, Lauer H.-Ch.1,Sorensen J.A.2

1Johann Wolfgang Goethe-University,Frankfurt, Germany2Oregon Health & Science University,Portland, USAPublished at the CED 2002, abstract#0215

Fig. 20: Shear bond strength tohuman dentin after 30 min and 14 days / thermocycling.

Effect of One-day Storage on Bondingof Self-Adhesive Resin CementsIrie M.1, Richter B.2, Suzuki K.1

1Okayama University Graduate School,Okayama, Japan23M ESPE, Seefeld, GermanyPublished at the AADR 2006 abstract#1839

23

Conclusions:

RelyX Unicem cement (Aplicap) shows bond strength values that are comparable to the multi-

step cement Panavia F2.0 and superior to Maxcem on dentin. Generally, cement bond strength

values improve after 24 hours storage making differences to Maxcem more obvious.

Tensile Bond Strength to Human Dentin and Enamel


Extracted human third molars were grinded with sandpaper (600 grit) to expose dentin and

enamel surfaces. Composite specimens (Filtek™ Supreme, 3M ESPE) were cemented onto the

tooth structure following the cement manufacturers’ instructions for use. Three different self-

adhesive resin cements were used: RelyX Unicem cement (Aplicap™) (3M ESPE), Maxcem™

(Kerr), and Embrace™ Wetbond™ (Pulpdent). After storing in water for 24 hours the tensile

bond strength was measured using a universal testing machine (experimental set-up see

chapter 11.2.).

Conclusions:

RelyX Unicem cement showed the same bond strength values in both curing modes. On human

dentin RelyX Unicem cement performed better than Embrace Wetbond and Maxcem.

[MP

a]

0

5

10

15

20

25

immediately 24hrs immediately 24hrs immediately 24hrs

Maxcem™Panavia™ F 2.0 / Porc. Activ. / Mega PrimerRelyX™ Unicem Aplicap™

Enamel Dentin Lava™

0

10

20

30

40

50

Embrace™*Wetbond™

Maxcem™ RelyX™UnicemAplicap™

Embrace™Wetbond™

Maxcem™ RelyX™UnicemAplicap™

SELF cure

LIGHT cure

Human DentinHuman Enamel

[MP

a]

* Enamel cemented with Embrace Wetbond (Pulpdent) was etched with phosphoric acid following manufacturer’s directions

Fig. 21: Shear bond strength tohuman enamel and dentin, andLava™ ceramic immediately andafter 24 hours.

In Vitro Bond Strength of AdhesiveCements to Tooth Structure.Pinzon L.M., Powers J.M.University of Texas Dental branch atHouston, USATHE DENTAL ADVISOR, ResearchReport, No. 1, June 2005

Fig. 22: Tensile bond strength tohuman enamel and dentin after24 hours.

24

Shear Bond Strength to Human Dentin and Enamel after24 Hours and Thermocycling


Extracted human molars were ground flat with sandpaper (600 grit) to expose dentin and

enamel surface. For cementation, RelyX™ Unicem cement in the Aplicap™ Capsule and the

Clicker™ Dispenser (3M ESPE) as well as Maxcem™ (Kerr) were used both in self and light

cure mode. One subgroup was tested after 24 hours water storage at 37°C; the other subgroup

was stored 14 days and subsequently thermocycled (1,000 x 5/55°C). Shear bond strength was

determined in a universal testing machine (experimental set-up see chapter 11.2.).

Conclusions:

RelyX Unicem cement both from the Aplicap Capsule and the Clicker Dispenser show similar

performance. RelyX Unicem cement bond strength values do not decrease after thermocycling.

Microtensile Bond Strength to Human Dentin andEnamel


Extracted human third molars were flattened using a diamond bur to expose enamel or dentin

surfaces. Composite specimens (Paradigm™ MZ100, 3M ESPE) were luted to the tooth sub-

strate using four different cements requiring an adhesive bonding system: Linkmax (GC),

Nexus® 2™ (Kerr), Variolink® II (Ivoclar Vivadent), Panavia™ F (Kuraray) and one self-adhesive

universal resin cement: RelyX Unicem (Aplicap). All cementations were done following the

manufacturers' instructions for use. The specimens were stored for 24 hours in distilled water

at 37°C prior to testing in a universal testing machine (experimental set-up see chapter 11.2.).

Rel

yX™

Uni

cem

C

licke

r™

Rel

yX™

Uni

cem

Apl

icap

™

Max

Cem

™

Rel

yX™

Uni

cem

C

licke

r™

Rel

yX™

Uni

cem

Apl

icap

™

Max

Cem

™

Rel

yX™

Uni

cem

C

licke

r™

Rel

yX™

Uni

cem

Apl

icap

™

Max

Cem

™

Rel

yX™

Uni

cem

C

licke

r™

Rel

yX™

Uni

cem

Apl

icap

™

Max

Cem

™

0

2

4

6

8

10

12

SELF cure LIGHT cure

24hrs

14d+TC

24hrs

14d+TC

0

2

4

6

8

10

12

SELF cure LIGHT cure

TC: thermocycling (1,000x 5/55°C)

Human Enamel Human Dentin

TC: thermocycling (1,000x 5/55°C)

[MP

a]

[MP

a]

Bond Strength of Self-AdhesiveCementing Agents to Dentin andEnamelPiwowarczyk A., Bregulla J., Lauer H.-C.Johann Wolfgang Goethe-UniversityFrankfurt, GermanyPublished at the IADR 2007, abstract#1540

Fig. 23: Shear bond strength tohuman enamel (left) and dentin(right) after 24 hours and thermo-cycling

Hikita K.1,2, De Munck J.1,2, Ishijima T.2,Maida T.2, Lam-brechts P.1,2, VanMeerbeek B.1,2

1Catholic University of Leuven,Netherlands2Health Sciences University ofHokkaido, Sapporo, JapanPublished at the IADR 2004,abstract #3175Bonding Effectiveness of AdhesiveLuting Agents to Enamel/Dentin

25

Conclusions:

All cements in the test showed equally good adhesion to dentin (see note for Variolink®).

All luting cements that require additional priming / bonding pretreatment steps showed higher

adhesion values to enamel.

Tensile Bond Strength to Human Dentin and Enamel


Enamel and dentin specimens were prepared from non-carious third human molars (600 grit).

Composite cones (Filtek™ Z250, 3M ESPE) were cemented according to the cement manufac-

turers’ instructions for use using two resin cements that use adhesive bonding systems

(Calibra®) and the self-adhesive resin cement RelyX™ Unicem (Aplicap™). Cements were light

cured (40 sec) or self cured (15 min at 37°C). Tensile bond strength was determined using a

universal testing machine after 24 hours storage (experimental set-up see chapter 11.2.).

Conclusions:

The bond strength of RelyX Unicem cement is almost independent of the curing mode. RelyX

Unicem cement shows an especially high performance on dentin.

[MP

a]

0

10

20

30

40

50

60

70

Linkmax Nexus® 2™ Variolink® II Panavia™ F RelyX™UnicemAplicap™

Human Enamel

[MP

a]

0

10

20

30

40

Linkmax Nexus® 2™ Variolink® II Panavia™ F RelyX™UnicemAplicap™

Human Dentin

* 10 out of 12 smaples failed before testing (Variolink II)

** 1 out of 10 samples failed before testing (RelyX Unicem)

*

**

[MP

a]

[MP

a]

0

40

35

30

25

20

15

10

5

RelyX™ UnicemAplicap™

Calibra®/Prime & Bond® NT™

Variolink® II/Syntac® Classic

0

40

35

30

25

20

15

10

5


Calibra®/Prime & Bond® NT™

Variolink® II/Syntac® Classic

LIGHT cureSELF cure

LIGHT cureSELF cure

Human Enamel Human Dentin

Fig. 24: Microtensile bondstrength to human enamel (left)and dentin (right) after 24 hours.

Fig. 25: Tensile bond strength tohuman enamel (left) and dentin(right) after 24 hours.

Bonding of a Novel Self-AdhesiveCement to Tooth SubstratesTrajtenberg C.P., Pinzon L.M., PowersJ.M.University of Texas Dental Branch atHouston, USAPublished at the AADR 2003, abstract#1197 revised

26

Immediate Shear Bond Strength to Bovine Dentin


Bovine anterior teeth were ground flat with sandpaper (320 grit). Composite discs (Paradigm™

MZ 100, 3M ESPE) were cemented to the dentin according to the cement manufacturers’

instructions for use. All cements were light cured for 20 sec from each side. 5 minutes after

cement mixing the shear bond strength was measured using a universal testing machine

(experimental set-up see chapter 11.2.).

Conclusions:

RelyX™ Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show the same

shear bond strength which prove to be among the highest of the cements tested.

Tensile Bond Strength to Bovine Dentin and Enamel


Bovine teeth were ground flat with sandpaper (320 grit) to expose dentin and enamel surface.

The cements tested were applied to the tooth structure according to the cement manufacturers’

instructions for use forming a button-like structure. Tensile bond strength was determined after

24 hours storage using a universal testing machine (experimental set-up see chapter 11.2.).

[MP

a]

0

2

4

6

8

10

Maxcem™ Monocem MultilinkAutomix

Calibra® Panavia™ F2.0

RelyX™UnicemClicker™

RelyX™UnicemAplicap™

[MP

a]

0

1

2

3

4

5

6

7

Harvard Fuji I FujiCEM Maxcem™ RelyX™UnicemAplicap™


LIGHT cure

SELF cure

n.a. n.a. n.a.

self-adhesive cementsconventional cements

Bovine Enamel

3M ESPE internal lab data (2006)

Fig. 26: Shear bond strength tobovine dentin 5 min after cemen-tation.


Fig. 27: Tensile bond strength ofdifferent luting cements to bovineenamel after 24 hours.

27

Conclusions:

RelyX™ Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show far superior

bond strength compared to the conventional cements tested.

Retentive Bond Strength of Lava™ Zirconia Crowns on Human Dentin


Full crown preparations were performed on extracted human teeth in a standardized manner

simulating clinical conditions (experimental set-up see chapter 11.2.). The resin cements and

the adhesive system were used according to manufacturers' instructions for use. With dual-

curing systems, only the self-curing approach was conducted. The crowns inner surfaces were

sandblasted (Rocatec™ Pre, 3M ESPE). After thermocycling (5,000 x 5/55°C), the bond

strength of 50% of the cemented ceramic crowns was determined using a universal testing

machine. The remaining samples were tested after 1 year of water storage. The retention sur-

face was determined individually for each tooth and retentive strength was calculated.

Conclusions:

Lava™ crowns cemented with RelyX Unicem cement showed the highest median retentive

strength initially and after 1 year in this clinically relevant study design. (Rocatec™ pretreatment

is not needed to improve RelyX Unicem cement retentive strength.)

[MP

a]

0

1

2

3

4

Harvard Fuji I FujiCEM Maxcem™ RelyX™UnicemAplicap™


n.a. n.a.n.a.

LIGHT cure

SELF cure

Bovine Dentin

self-adhesive cementsconventional cements

[MP

a]

Variol

ink® II

/Syn

tac®

Panav

ia™ F

2.0

Mult

ilink A

utom

ix /

Met

al Prim

er

Mult

ilink A

utom

ix /

Mon

obon

d S M

axce

m™

RelyX™

Unicem

Apli

cap™

RelyX™

Unic

em

Aplica

p™/R

ocat

ec™

Plus

FujiCEM

0

1

2

3

4

5

6

7

8

9

10

TC

TC+1yr water storage

columns show median values bars represent 25th and 75th percentile TC: thermocycling (5,000x 5°C/55°C)

Fig. 28: Tensile bond strength ofdifferent luting cements to bovinedentin after 24 hours.

In Vitro Retentive Strength of Zircon-Oxide all Ceramic CrownsErnst C.-P., Askoy E., Stender E.,Willershausen B.Johannes Gutenberg University Mainz,GermanyPublished at the IADR PEF 2006,abstract #0248

Fig. 29: Retentive strength ofLava™ crowns on human dentinafter thermocycling and 1 yearwater storage

28

Shear Bond Strength to Zirconia Ceramic


Zirconia specimens (Cercon®, Dentsply) were bonded to metal (CoCr) cylinders. All bonding

areas were first sandblasted (110µm Al2O3). Alloy-Primer (Kuraray) was applied on all metal

bonding surfaces. The following resin cements and bonding agents were used: Calibra® / Silane

/ Prime & Bond® NT™ and SRC (Dentsply), Maxcem™ (Kerr), Multilink® Automix / SR-Link

(Ivoclar Vivadent) , Multilink® Xpress (Ivoclar Vivadent), Panavia™ F 2.0 (Kuraray), RelyX™

Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser (3M ESPE), Rocatec™ sili-

coating (3M ESPE). All cements were self cured at 37°C. The shear bond strength was deter-

mined after 24 hours, 30 days of water storage, and after 12,000 thermal cycles (5/55°C, 17d)


Conclusions:

Regarding the shear bond strength of the zirconia / resin cement interface, both RelyX Unicem

self-adhesive universal resin cement in the Aplicap capsule and the Clicker dispenser per-

formed at a similarly high level. The shear bond strength of RelyX Unicem cement is less

susceptible to change after thermocycling and long-term water storage than most other

cements tested.

Shear Bond Strength of theZirconia/Resin InterfaceBehr M., Rosentritt M., Kolbeck C.,Lang R., Handel G.University of Regensburg, GermanyPublished at the IADR 2007 #2627

Fig. 30: Shear bond strength ofvarious resin cements (self cure)to zirconia ceramics at 24 hours,after thermocycling, and after 30 days water storage.

Calibr

a® (S

ilane

+

Prime

& Bon

d® N

T™+S

RC)

Max

cem

™ (n

o pr

imer

)

Mult

ilink A

utom

ix

(SR-L

ink)

Mult

ilink X

pres

s

(no

prim

er)

Panav

ia™ F

2.0

(no

prim

er)

Variol

ink® (R

ocat

ec)

cont

rol (

Variol

ink® ,

no p

rimer

)

RelyX™

Unic

em

Clicke

r™ (n

o pr

imer

)

RelyX™

Unic

em

Aplica

p™ (n

o pr

imer

)

RelyX™

Unic

em

Aplica

p™ (R

ocat

ec

silico

ating

)

[MP

a]

0

5

10

15

20

25

30

35

40

45

24 hrs thermocycling (12,000 x 5/55°C) 30 d water storage

29

Shear Bond Strength to Lava™ Zirconia Ceramic andGlass Ceramic


Lava™ (3M ESPE) zirconia samples were air-abraded (100µm Al2O3). IPS Empress® 2 (Ivoclar

Vivadent) leucite-reinforced glass ceramic samples were etched with hydrofluoric acid and

silanated (Monobond S, Ivoclar Vivadent). Composite samples were cemented onto the speci-

mens using different luting cements according to the cement manufacturers’ instructions for

use. Shear bond strength was tested in a universal testing machine after 30 min and after

14 days water storage and subsequent thermocycling (1,000 x 5/55°C) (experimental set-up

see chapter 11.2.).

Conclusions:

Within the group of cements tested the shear bond strength of RelyX™ Unicem cement to zirco-

nia and glass ceramic is among the highest when light cured. Light curing is the preferred cur-

ing mode for all-ceramic restorations.

[MP

a]

0

2

4

6

8

10

12

14

16

18

20

22

Fuji P

lus

FujiCEM

RelyX™

Lut

ing

RelyX™

ARC (S

C)

RelyX™

ARC (L

C)

Panav

ia™ F

(SC)

Panav

ia™ F

(LC)

Variol

ink® II

(SC)

Variol

ink® II

(LC)

RelyX™

Unic

em (S

C)

RelyX™

Unic

em (L

C)



The Shear Bond Strength BetweenLuting Cements and Zirconia Ceramicafter two Pretreatments.Piwowarczyk A., Lauer H. C.,Sorensen J. A.Oper Dent. 2005 May-Jun; 30(3):382-8

In Vitro Shear Bond Strength ofCementing Agents to Fixed Prost-hodontic Restorative MaterialsPiwowarczyk A., Lauer H. C.,Sorensen J. A.; Johann WolfgangGoethe University of Frankfurt,GermanyJ Prosthet Dent. 2004 Sep; 92(3):265-73

Fig. 31: Shear bond strength ofdifferent luting cements toleucite-reinforced glass ceramicIPS Empress® 2 (Ivoclar Viva-dent) initially and after 14 dayswater storage and thermocycling(1,000 x 5/55°C).

[MP

a]

0

2

4

6

8

10

12

14

Fleck’s

™ ce

men

t *

Fuji 1

Ketac

™ C

EM

Fuji P

lus

FujiCEM

RelyX™

Lut

ing (SC)

(LC)

RelyX™

Unic

em A

plica

p™(SC)

(LC)

Panav

ia™ F

(SC)

(LC)

Variol

ink® II

(SC)

(LC)

RelyX™

ARC



* zinc phosphate cement Fig. 32: Shear bond strength ofdifferent luting cements to Lava™

zirconia ceramic initially and after14 days water storage and ther-mocycling (1,000 x 5/55°C).

30

Shear Bond Strength to Alumina Ceramic


Procera® AllCeram (Nobel Biocare) specimens were air-abraded (100 µm Al2O3). Composite

samples were cemented onto the specimens using different luting cements according to the

cement manufacturers’ instructions for use. Dual cure cements were light cured. Shear bond

strength was tested in a universal testing machine at 30 min and after 14 days water storage and

subsequent thermocycling (1,000 x 5/55°C) (experimental set-up see chapter 11.2.).

Conclusions:

After 14 days water storage and thermocycling Panavia™ F and RelyX™ Unicem cement

(Aplicap™ Capsule) showed the strongest bonding to air-abraded alumina ceramic among the

cements tested.

Retention Strength of Fiber Posts Cemented with 2 Different Cements


Human teeth were decoronated and roots received endodontic treatment using guttapercha. Post

spaces were prepared using the RelyX™ Fiber Post system drills (3M ESPE). RelyX Fiber Posts

were cemented using RelyX ARC (n=20) and RelyX Unicem cement (Aplicap) (n=20) accord-

ing to the cement manufacturer's instructions for use. Pull-out force was determined at 30 min-

utes and at 24 hours using a universal testing machine (experimental set-up see chapter 11.2.).

Conclusions:

The multi-step RelyX ARC cement and the one-step RelyX Unicem cement (Aplicap) show

similar retentive strengths to RelyX Fiber Post and the tooth structure.

In Vitro Shear Bond Strength ofCementing Agents to FixedProsthodontic Restorative MaterialsPiwowarczyk A., Lauer H. C.,Sorensen J. A.; Johann WolfgangGoethe University of Frankfurt,GermanyJ Prosthet Dent. 2004 Sep; 92(3):265-73

Fig. 33: Shear bond strength of different luting cements to high-strength alumina ceramics initially and after 14 days waterstorage and thermocycling (1,000 x 5/55°C).

Retention of Fiber Posts Cementedwith a New Delivery SystemDel Mastro M., Armoush Z.,Aboushala A., Doherty E., Kugel G.Tufts University, Boston, MA, USAPublished at the IADR 2007, abstract#1553

Fig. 34: RelyX™ Fiber Post reten-tion values in human teeth 30 minand 24 hours after cementation.

[MP

a]

Fuji 1

Ketac

™ C

em

Fuji P

lus

FujiCEM

RelyX™

Lut

ing

RelyX™

ARC

Panav

ia™ F

Variol

ink® II

RelyX™

Unic

em

Aplica

p™

0

1

2

3

4

5

6

7

8

9

10

Fleck’s

™ ce

men

t *


* zinc phosphate cement

[N]

0

50

100

150

200

250

RelyX™ ARC RelyX™ Unicem Aplicap™

30 min

24 hrs

31

Tensile Bond Strength to Fiber Post


For determining the bond strength to RelyX Fiber Post the cements were applied to the post

surface in a disc shape at the conical part of the post. RelyX™ Fiber Post was either left untreat-

ed pretreated as described in the chart: etching, silanating (e. g. RelyX Ceramic Primer,

3M ESPE, or Monobond S, Ivoclar Vivadent), or a combination of silicatization (Rocatec

System, 3M ESPE) and silanating. Cements were either light cured for 40 seconds (RelyX

Unicem Aplicap and Clicker, 3M ESPE; Maxcem™, Kerr) or for 60 seconds (Multilink

Automix and Variolink® II, Ivoclar Vivadent) or self cured (1 hr at 36°C / >95% r. h.). After

water storage (24 hrs at 36°C) bond strength was measured in a pull-off test (experimental set-

up see chapter 11.2.).

Conclusions:

RelyX Unicem cement shows consistently same high bond strength to RelyX Fiber Post, inde-

pendent of curing mode and pretreatment steps - even without any pretreatment. Thus pretreat-

ment such as silanisation is not necessary for this system.

[MP

a]

0

5

10

15

20

25

30

NoPretreatment

RelyX™ CeramicPrimer

Rocatec™System &

RelyX™ CeramicPrimer

PhosphoricAcid Etching

Gel

Monobond S

[MP

a]

* The manufacturer does not recommend self curing for Variolink II

0

5

10

15

20

25

30

Maxcem™ (no pretreatment)

Variolink® II & Monobond S

Multilink Automix &Monobond S

RelyX™ Unicem Aplicap™ (no pretreatment)

RelyX™ Unicem Clicker™ (no pretreatment)

SELF cure

LIGHT cure

*

3M ESPE internal lab data (Dec 2007)

Fig. 35: Tensile bond strength ofdifferent cements to RelyX™ FiberPost after light and self curingand with different post pretreat-ments.

Fig. 36: Tensile bond strength (24hrs) of RelyX™ Unicem Cement toRelyX™ Fiber Post with and with-out fiber post pretreatment.

For further information see RelyX™

Fiber Post Technical Product Profile

32

Marginal Sealing in Fiber Post Treated Teeth


Extracted human anterior teeth were endodontically treated with guttapercha and a resin sealer

(AH-25, DeTrey). Post spaces were prepared using the RelyX™ Fiber Post system drills.

Cementation of the post was done according to the cement manufacturers’ Instructions for Use

using the following resin cements: RelyX™ Unicem cement (Aplicap™) (3M ESPE), Multilink

Automix / Primer A&B (Ivoclar Vivadent), Maxcem™ (Kerr), and Calibra® / Prime & Bond®

NT™ (Dentsply). RelyX Unicem cement was applied directly into the root canal using the

RelyX Unicem Aplicap Elongation Tip (3M ESPE). All other cements were applied to the post

and/or the root canal using a lentulo spiral. After one week water storage microleakage between

the canal wall and the cement layer was determined using methylene blue dye. Additionally,

SEM pictures of the cement layer were taken.

Conclusions:

RelyX Unicem cement in combination with RelyX Unicems Aplicap elongation tip and RelyX

Fiber Post shows a marginal sealing superior to other cement systems tested in this study.

According to the authors a good marginal seal is pivotal for the long-term success of the

endodontic and the prosthetic restoration by inhibiting bacterial infiltration.

Sealing Ability and MicroscopicAspects of a Self-adhesive ResinCement used for Fiber Post Luting intoRoot CanalsSimonetti M., Coniglio I., Magni E.,Cagidiaco M.C., Ferrari M.Dept. Dental Materials, Faculty ofDentistry, University of Siena, ItalyInternational Dentistry SA Vol. 8, No.5, Sept./Oct. 2006

Fig. 37: SEM pictures of the canalwall (top) / cement (middle) /fiber post (bottom) interface. Left:RelyX™ Fiber Post cemented withRelyX™ Unicem cement (Aplicap™)Right: RelyX™ Fiber Post cement-ed with Multilink Automix

Fig. 38: Microleakage betweenthe cement layer and the canalwall at the apical level of the root.

0 1 2 3 4

Maxcem™

Calibra® / Prime & Bond® NT™

Multilink / Primer A&B


microleakage (median scores)

0: no leakage 1: < 0.5mm 2: 0.5 - 1mm 3: 1 - 2mm 4: > 2mm

dentin

RelyX Unicem cement

RelyX Fiber Post

dentin

Multilink Automix

RelyX Fiber Post

33

Marginal Adaptation of Ceramic Inlays


All-ceramic inlays (IPS Empress® 2, Ivoclar Vivadent) were cemented in MOD Class 2 cavi-

ties with cervical margins located both in dentin and in enamel. Three cements were tested:

Panavia™ F 2.0 / ED Primer (Kuraray), RelyX™ Unicem cement in the Aplicap™ Capsule and

the Clicker™ Dispenser (3M ESPE), and Maxcem™ (Kerr). Marginal adaptation was determined

using scanning electron microscopy (SEM) before and after thermocycling / mechanical load-

ing (TCML 6,000 x 5/55°C, 2min each cycle; 1,200,000 x 50N).

Conclusions:

Both RelyX Unicem cement in the Aplicap capsule and the Clicker dispenser show both very

good marginal adaptation before and after thermocycling/mechanical loading.

[%]

[%]

0

20

40

60

80

100

Maxcem™ Panavia™ F2.0 RelyX™ UnicemClicker™


before TCML

after TCMLTCML: thermocycling (6,000x 5/55°C) & mechanical loading (1,200,000x 50N)

Perfect Margin to Enamel

before TCML

after TCMLTCML: thermocycling (6,000x 5/55°C) & mechanical loading (1,200,000x 50N)

Perfect Margin to Dentin

0

20

40

60

80

100

Maxcem™ Panavia™ F2.0 RelyX™ UnicemClicker™


Marginal Adaptation of Ceramic InlaysUsing Different CementsRosentritt M.1, Hahnel S.2, Behr M.1,Handel G.1

1University of Regensburg, Germany2University Medical CentreRegensburg, GermanyPublished at the IADR 2007, abstract#1516

Fig. 39: Marginal adaptation (% per-fect margin) of ceramic inlays to enamel before and after TCML.

Fig. 40: Marginal adaptation (% per-fect margin) of ceramic inlays todentin before and after TCML.

34

Interfacial Adaptation of Partial Ceramic Crowns


Partial ceramic crown preparations were performed on 48 extracted human molars. Crowns

were fabricated using the CEREC® 3 system and Vitablocs® Mark II (Vident). Cementation

was done according to the manufacturers’ instructions for use using different luting systems:

Syntac® Classic / Variolink® II, Multilink Primer A&B / Multilink Automix (Ivoclar Vivadent)

and RelyX™ Unicem cement (Aplicap™). All cements were light cured. Thermocycling/

mechanical loading (TCML) was applied (5,000 x 5/55°C, 30s/cycle; 500,000 x 72.5N/1.6Hz).

Marginal adaptation was assessed by SEM margin analysis on replicas and by silver staining on

multiple tooth sections.

Conclusions:

Among the cements tested in this study, RelyX Unicem self-adhesive universal resin cement

showed the best interfacial adaptation, while being the least technique sensitive.

Proximal Adaptation of Partial CeramicCrowns with Different LutingTechniques/MaterialsFederlin M., Hiller K.-A., Reinhard H.,Fritzsch D., Schmalz G.University of Regensburg, GermanyPublished at the IADR PEF 2006,abstract #0562

Fig. 41: Perfect margin of partialceramic crowns before and afterthermocycling and mechanicalloading determined by SEManalysis.

[%]

0

20

40

60

80

100

Syntac® Classic &Variolink® II

Multilink Primer A,B &Multilink Automix


columns show median valuesbars represent 25th and 75th percentile

TCML: thermocycling (5,000x 5°C/55°C) & mechanical loading (500,000x 72.5N/1.6Hz)

Ceramic before TCMLCeramic after TCML

Dentin before TCML

Dentin after TCML

Perfect Margin to

35

pH Profile of Various Luting Cements


pH values were measured using a flat-surface pH electrode at different times after mixing the

cement.

Conclusions:

RelyX™ Unicem cement shows a rapid rise in initial pH and reaches the neutral level of pH 7

which is considered to be an important prerequisite for long-term stability.

Mechanical and Physical Properties ofSelf-etching Resin Luting CementsSakalauskaite E., Tam L.E., McComb D.University of Toronto, CanadaPublished at the AADR 2006,abstract #1894

Fig. 42: pH profile ofRelyX™ Unicem ce-ment (Aplicap™) andMaxcem™ cementafter mixing.

Fig. 43: pH profiles of various luting ce-ments after mixing.

0

1

2

3

4

5

6

7

8

9

0 0.5 1.0 1.5 2.0

Time after mixing [hours]

Time after mixing [hours]

ph

ph

*measured with the RelyX™ Unicem capsule version

RelyX™ Unicem* LIGHT cure

RelyX™ Unicem* SELF cure

Maxcem™ LIGHT cure

Maxcem™ SELF cure

4.0 6.0 24.0

0

1

2

3

4

5

6

7

8

9

0 0.5 1.0 1.5 2.0 4.0 6.0 24.0

*measured with the RelyX™ Unicem capsule version

RelyX™ Unicem LIGHT cure

RelyX™ Unicem SELF cure

Maxcem™ LIGHT cure

Maxcem™ SELF cure

Embrace™ Wetbond™ LIGHT cure

Embrace™ Wetbond™ SELF cureself-

adhe

sive

cem

ents

adhe

sive

and

conv

entio

nal c

emen

ts RelyX™ Luting Plus

Linkmax LIGHT cure

Linkmax SELF cure

Fuji Plus

RelyX™ ARC LIGHT cure

RelyX™ ARC SELF cure

*

*

36

Adhesion of Self-adhesive ResinCements to Various Core Build-upMaterialsWiedig C.A., Porsfeld V.N., Hecht R.,Raia G.3M ESPE, Germany, Seefeld, GermanyPublished at the IADR 07, abstract#2449

Fig. 45: Shear bond strength ofdifferent luting cements (lightcure) to core build-up materialsafter 24 hours and thermocycling(240 x 5/55°C).

Fig. 45: Shear bond strength ofdifferent luting cements (lightcure) to core build-up materialsafter 24 hours and thermocycling(240 x 5/55°C).

Shear Bond Strength to Core Build-Up Materials


Composite buttons (Filtek™ Z250) were cemented onto core build-up discs finished with 320

grit sandpaper. Cementation was performed according to the cement manufacturers' instruc-

tions for use. After 24 hours storage and thermocycling (240 x 5/55°C) the shear bond strength

was measured in a universal testing machine (experimental set-up see chapter 11.2.).

Conclusions:

Both RelyX™ Unicem Self-Adhesive Universal Resin Cement in the Aplicap™ Capsule and the

Clicker™ Dispenser show comparable results in both curing modes and to all materials tested.

The majority of fractures occurs in the core-build-up material.

Shear Bond Strength to CAD/CAM Glass Ceramics

Shear Bond Strength to Vitablocs® Mark II


Disc shaped specimens were milled from Vitablocs® Mark II (Vident), HF-etched and silanated

(Monobond S, Ivoclar Vivadent; Silane Coupling Agent, Dentsply). The cements to be tested

(Calibra®, Dentsply; Variolink® II, Ivoclar Vivadent; RelyX Unicem Aplicap, 3M ESPE) were

applied to the prepared specimens in a cylindrical mold and light cured according to the manu-

facturers’ instructions for use. After storing in water (37°C) for 24 hours and after thermocy-

cling (10,000 x 5/55°C) the shear bond strength was determined in a universal testing machine


[MP

a] **

*

*

*

*

*

*

*

0

5

10

15

20

25

30

35

Maxcem™ RelyX™ Unicem Aplicap™ RelyX™ Unicem Clicker™

* fractures mainly in core build-up material

Ketac™ Molar Core Paste Luxa Core Tetric Evo Ceram Filtek™ Supreme XT

[MP

a]

*

***

*

*

*

0

5

10

15

20

25

30

35

Maxcem™ RelyX™ Unicem Aplicap™ RelyX™ Unicem Clicker™

* fractures mainly in core build-up material

***

Ketac™ Molar Core Paste Luxa Core Tetric Evo Ceram Filtek™ Supreme XT

Effect of Surface Treatment on theShear Bond Strength of Three ResinCements to a Machinable FeldspaticCeramic.Reich S.M.1, Wichmann M.1,Frankenberger R.2, Zajc D.2

1Department of Prosthetic Dentistry

37

Conclusions:

This study shows that RelyX™ Unicem cement performs comparable to Variolink® II. RelyX

Unicem cement bond strength to HF-etched and silanated glass ceramics even improves after

thermocycling in this study.

Shear Bond Strength to Paradigm™ C and Vitablocs® Mark II


Specimens of the glass ceramic materials (Paradigm™ C, 3M ESPE; Vitablocs® Mark II, Vident)

were HF-etched and silanated (RelyX Ceramic Primer, 3M ESPE). The cements to be tested

(Variolink II, Ivoclar Vivadent; Panavia™ F2.0, Kuraray; RelyX ARC, and RelyX Unicem

Aplicap™, both 3M ESPE) were applied to the prepared specimens in a cylindrical mold and

light cured according to the manufacturers’ Instructions for Use. After storing in water (24 hrs

at 36°C) and after thermocycling (1,500 x 5/55°C) the shear bond strength was determined in a

universal testing machine (experimental set-up see chapter 11.2.).

Conclusions:

This study shows that RelyX Unicem cement achieves shear bond strength values to the tested

glass ceramic materials that are in the same range as those of adhesive cements requiring addi-

tional pretreatment steps.

[MP

a]

0

5

10

15

20

25

30

Calibra® Variolink® II RelyX™ Unicem Aplicap™

24 hours

TC (10,000 x 5/55°C)

[MP

a]

Vitablocs® Mark II

Paradigm™ C

0

10

20

30

40

Variolink® II Panavia™ F2.0 RelyX™ ARC RelyX™ UnicemAplicap™

2Department of Operative Dentistryand Periodontology, University ofErlangen-Nuremberg, Erlangen,GermanyJ Biomed Mater Res B Appl Biomater.2005 Aug;74(2), 740-6

Fig. 46: Shear bond strength ofthree luting cements (light cure)to Vitablocs® Mark II specimensafter 24 hours and after thermo-cycling (10,000 x 5/55°C).

Shear Bond Strength of RelyX™ Unicemand RelyX™ ARC to an ExperimentalGlass Ceramic MaterialFischer J.University of Bern, Switzerland, 2006unpublished study

Fig. 47: Shear bond strength (lightcure) to Vitablocs® Mark II andParadigm™ C specimens after 24hours and after thermocycling(1,500 x 5/55°C).

38


Fig. 48: Shear bond strength(wire-loop test) of four resincements (light cured) toParadigm™ C over time (10 min,24 hrs) and after thermocycling(5,000 x 5/55°C)

Fig. 50: Shear bond strength(wire-loop test) of four resincements (light cured) to glassceramic blocks for CAD/CAM systems after thermocycling(5,000 x 5/55°C).

Fig. 49: Shear bond strength(wire-loop test) of four resincements (light cured) to differentglass ceramic blocks for CAD/-CAM systems 24 hours aftercementation.

Shear Bond Strength After 10 min and AfterThermocycling


Glass ceramic samples (Paradigm™ C, 3M ESPE; Vitablocs® Mark II, Vident; ProCAD®,

Ivoclar Vivadent) were etched with hydrofluoric acid and silanated (RelyX™ Ceramic Primer,

3M ESPE). Composite buttons (Filtek™ Z250, 3M ESPE) were cemented according to the

cement manufacturers’ instructions for use using the following luting cements: Panavia™ F 2.0

(Kuraray), Multilink Automix (Ivoclar Vivadent), RelyX Unicem in the Aplicap™ and in the

Clicker™ (3M ESPE). All cements were light cured. Shear bond strength was determined in a

universal testing machine at 10 minutes, 24 hours, and after thermocycling (5,000 x 5/55°C)


Conclusions:

There is no significant difference in bond strength to glass ceramics for RelyX Unicem in the

Aplicap and the Clicker dispenser when measured immediately, after 24 hours or after thermo-

cycling.

[MP

a]

0

5

10

15

20

25

30

35

40

RelyX™ Unicem Aplicap™RelyX™ Unicem Clicker™ Panavia™ F2.0 Multilink Automix

Paradigm™ CVitablocs® Mark IIProCAD®

[MP

a]

0

5

10

15

20

25

30

35

40

RelyX™ Unicem Aplicap™RelyX™ Unicem Clicker™Panavia™ F2.0 Multilink Automix

Paradigm™ CVitablocs® Mark IIProCAD®

[MP

a]

Paradigm™ C

0

5

10

15

20

25

30

Panavia™ F2.0 Multilink Automix RelyX™ UnicemAplicap™

RelyX™ UnicemClicker™

10 min24 hrsthermocycling

39

Shear Bond Strength to Metal, Composite, and CeramicRestorative Materials


All restorative material samples were prepared for cementation according to the cement manu-

facturers’ Instructions for Use. Briefly, for cementation with RelyX™ Unicem cement samples

were treated as follows. Metal, strengthened core ceramic (Lava™ and alumina ceramic), and

composite samples (Paradigm™ MZ 100) were sandblasted with Rocatec™-Pre (3M ESPE) and

cleaned with ethanol. Etchable glass ceramics (Vitablocs® Mark II, Vident) were etched with

hydrofluoric acid and silanated using RelyX Ceramic Primer (3M ESPE). Rely Fiber Post were

not pretreated. Shear bond strengths of the particular cements (RelyX Unicem cement,

3M ESPE; Panavia™ F2.0, Kuraray; Maxcem™, Kerr) were determined using a universal testing

machine (experimental set-up see chapter 11.2.).

Conclusions:

RelyX Unicem cement in the Aplicap™ Capsule and the Clicker™ Dispenser show consistently

good performance in all curing modes and to a wide variety of restorative materials.

0

2

4

6

8

10

12

14

16

18

20

22

Vitablocs® Mark II(HF etching + silanating)

Lava™

(sandblasted)Alumina ceramic

(sandblasted)Paradigm™ MZ 100

(sandblasted)RelyX™ Fiber Post

(untreated)

**

*

LIGHT / SELF cure RelyX™ Unicem Aplicap™ RelyX™ Unicem Clicker™

Panavia™ F 2.0 Maxcem™

• • • •

[MP

a][M

Pa]

0

2

4

6

8

10

12

14

16

18

20

Gold alloyDegulor M

(sandblasted)

Titanium

(sandblasted)

Stainless steelWironit

(sandblasted)

Panavia™ F 2.0 SELF cure

Maxcem™ SELF cure

RelyX™ Unicem Aplicap™ SELF cure

RelyX™ Unicem Clicker™ SELF cure

* 3 pretest failures with Maxcem ** cohesives failures in all tests except for Maxcem self cure • self cure not measured


Fig. 51: Shear bond strength tovarious metal restorative materi-als in the self cure mode.

Fig. 52: Shear bond strength tovarious composite and ceramicrestorative materials in the selfcure and the light cure mode.

40

12. RelyX™ Unicem Field TestingAs all new 3M ESPE products RelyX Unicem cement both in the Aplicap™ Capsule and in the

Clicker™ Dispenser were tested in dental offices before market introduction.

The RelyX Unicem Aplicap field test was carried out in 2001 and involved almost 50 dentists

from Germany and Switzerland that placed more than 800 restorations during the 8 week test

period. RelyX Unicem Clicker was tested in 2006 with almost 100 dentists in Germany,

Poland, and Italy cementing almost 2,000 restorations. In both tests the restorations placed were

fabricated from a wide variety of restorative materials and covered the complete list of indica-

tions of RelyX Unicem cement.

The reported post-operative sensitivities during the field trials were very low: approximately

0.4% for the Aplicap and 0.7% for the Clicker dispenser (see also chapter 11.1).

Although RelyX Unicem cement represented a cement class entirely new to the evaluators in

2002, RelyX Unicem cement’s features and handling characteristics largely met dentists’ needs.

The same percentage of dentists participating in the RelyX Unicem Clicker field test in 2006

intended to buy and use RelyX Unicem cement in the Clicker dispenser. This also reflects the

high level of satisfaction with RelyX Unicem cement in the new paste / paste formulation.

94

329

269

106

5

163

56 86

322

780

72

71

77

147

107

224

43CEREC®

ceramic

metall, PFMC

row

ns,

Brid

ges,

Onl

ays

Inla

ys

composite

CEREC®

ceramic

metall, PFM

composite

Posts

Other

eval

uato

rs [

%]

0

10

20

30

40

50

very satisfied satisfied undecided unsatisfied very unsatisfied

Fig. 53: Indications and restora-tive material types of restorationsplaced during the RelyX™ UnicemAplicap™ (left) and the RelyX™

Unicem Clicker™ (right) field tests.

Fig. 54: Satisfaction level of evalu-ators in the 2006 RelyX™ UnicemClicker™ field test.


field test 2001RelyX™ Unicem Clicker™

field test 2006

41

42

13. Excerpt from the Instructions For Use

The following provides a brief overview of how to use RelyX™ Unicem Self-Adhesive

Universal Resin Cement in the Aplicap™/Maxicap™ Capsule and in the Clicker™ Dispenser.

The state of the information presented below is as of printing this booklet.

Before working with RelyX Unicem cement, please refer to the Instructions for Use delivered

with each package of RelyX Unicem cement for the complete and most up-to-date product

information.

Indications

• Final cementing of inlays, onlays, crowns, bridges, made of all-ceramic, composite, or metal

• Final cementing of posts and screws

Pretreatment of the Cavity/Tooth Stump

• Prior to final cementation, clean the prepared stump or the cavity thoroughly with pumice

slurry, rinse with a water spray, and lightly air dry in only 2-3 intervals with air free of water

and oil, or use cotton pellets to dry it off.

• Do not overdry!

The cavity should be just dry enough that the surface has a slightly glossy appearance. As is

the case with any permanent cement, over-drying can lead to post-operative sensitivity.

• Do not use substances such as desensitizers, disinfectants, astringents, dentin sealants, rinsing

solutions containing EDTA, etc., after the final cleaning with pumice slurry and water. Their

residues may have a detrimental effect on the bonding strength and setting reaction of the

cement.

Pretreatment of the Root Canal

• Clean the root canal with a 2.5%-5.25% solution of sodium hypochlorite (NaOCl) as the last

step before final cementation.

• Rinse immediately with water and dry with paper points.

• We recommend the use of a rubber dam during the cementation of posts.

Pretreatment of Restorative Materials

Please refer to chapter 9 (page 11) for a brief overview.

Times

RelyX Unicem Clicker min:sec

Mixing: 00:20

Working time from start of mixing: 02:00

Light curing:

- single surface, from occlusal 00:20

- any other surface additional 00:20

Self-curing:

Polymerization start after start of mixing 02:00

Setting time after start of mixing 05:00

43

RelyX™ Unicem Aplicap™ / Maxicap™ Aplicap Maxicap

Mixing: min:sec min:sec

In high-frequency mixer (e.g. CapMix) 00:15 00:15

In the RotoMix rotary mixer 00:10 00:10

Working time from the start of mixing: 02:00 02:30

Light-curing:

Single surface, from occlusal 00:20 00:20

Any other surface, additional 00:20 00:20

RelyX Fiber Post posts, from occlusal 00:40 00:40

Self-curing:

Intraoral clean-up time after start of mixing 02:00 02:30

Set time after start of mixing 05:00 06:00

Removal of Excess From Restorations

• Excess cement is best removed after brief light exposure (approximately 2 sec with a conven-

tional polymerization device) or during self hardening (starting 2 min after beginning of mix-

ing in the “gel phase”) with an appro-priate instrument (e.g. scaler). Excess material of larger

volume is easier to remove!

• If the excess is removed during the self-curing, a suitable instrument must be used to hold the

restoration in position.

• Tip for removing excess composite cement: If the excess cement is re-moved with a sponge

pellet or similar implement immediately after the restoration is seated, the remaining minimal

excess cement should be light-cured briefly or covered with glycerine gel. If light-curing or

glycerine gel is not used, an oxygen inhibition layer will form on the cement surface during

polymerization; the layer is removed during polishing and can, depending on the thickness of

the layer, leave behind a deficit.

Removal of Excess From Posts

• Remove the cement with a suitable instrument or a cotton pellet.

44

14. Technique Guides14.1. RelyX™ Unicem Aplicap™ / Maxicap™

45

14.2. Technique Guide RelyX™ Unicem Clicker™

46

14.3. Technique Guide RelyX™ Fiber Post / RelyX™ Unicem Aplicap™

47

15. Frequently Asked QuestionsQ 1. Since when has RelyX™ Unicem cement been used clinically?

The first restorations were cemented with RelyX Unicem cement (Aplicap™) in 2001. Since

then more than 25 million capsules (as of April 2007) have been sold world wide. The excellent

clinical experience reported by the users is consistent with the results of numerous in vivo stud-

ies by independent researchers that confirmed the high performance of the RelyX Unicem

cement.

Q 2. Does RelyX™ Unicem cement in the Aplicap™ / Maxicap™ and the Clicker™ have the

same chemical composition?

Yes. RelyX Unicem cement in its two delivery versions has the same chemical compositions

and exhibits the same performance. Both, the capsule and the Clicker version are based on the

identical methacrylate monomers and therefore feature the same chemical bonding and setting

reactions. Designing an easy to handle cement paste and, at the same time, a highly reactive

and long-term stable chemical system were the tasks to be met during the development of

RelyX Unicem Clicker. All chemical components from the RelyX Unicem cement capsule ver-

sion had therefore to be distributed appropriately between the base and the catalyst pastes. To

assure that RelyX Unicem cement in both delivery systems offers optimal handling the amount

of fillers and the grain particle size were adapted for each system.

Q 3.What is the expansion value for RelyX Unicem cement?

RelyX Unicem cement shows low expansion values making it safe to use for the cementation

of glass ceramic restorations and posts. This was proven in long term in vivo and in vitro stud-

ies by independent external researchers (e.g. “expansion less than or equal to 1%”: CRA

Newsletter, October 2004). These results are corroborated by the clinical experience of the den-

tal community since the introduction of the cement in 2001.

Q 4. How should indirect restorations be pretreated before cementation with

RelyX Unicem cement?

Please refer to chapter 9 (page 11) to find a short overview and to the Instructions for Use pro-

vided with each package RelyX Unicem cement for detailed information.

Q 5. How should I pretreat my CEREC® Restoration?

The materials used with CEREC are either etchable glass ceramics (e.g. Paradigm™ C,

3M ESPE; Vitablocs® Mark II, Vident; ProCAD®, Ivoclar Vivadent) or composite material (e.g.

Paradigm™ MZ100, 3M ESPE). For pretreatment recommendations see Q 4.

An important consideration for using RelyX Unicem cement for bonding CEREC restorations

is to make sure that the tooth surface is completely clean prior to placing the cement. The scan-

ning process for the CEREC system requires that a scan powder with or without a separate liq-

uid adhesive be placed on the tooth to obtain a good digital image. It is imperative that the scan

powder be completely removed from the tooth surface prior to placement of the restoration.

RelyX Unicem cement must be able to directly interact with the clean tooth surface in order to

demineralize the surface and penetrate into the tooth. Any residue from the liquid or powder

may affect the bond of the RelyX Unicem cement to the tooth. This may result in marginal

staining or failure of the restoration. A simple water spray or rinse may not completely remove

the residue. It is advisable to physically remove the powder/liquid residue from the tooth by

brushing the surface with aqueous pumice slurry followed by a thorough water rinse.

Clinical studies see page 13

Restorative material pretreatment seepage 11

Expansion value see page 9

3M ESPE application test see page 46

Study results see page 13

48

Q 6. How do I prepare the root canal before cementation of a post with RelyX™ Unicem

cement?

Remove the existing (Guttapercha) root filling and clean the root canal with a 2.5-5.25% sodi-

um hypochlorite solution (NaOCl). Rinse immediately with water and dry with paper points;

do not overdry. RelyX Unicem cement proved to bond as securely to root dentin as to crown

dentin (Walter R. et. al., IADR 2003, Gothenburg Sweden, #1463)

Q 7. How should I dry the tooth prior to cementing my restoration with RelyX Unicem

cement?

Lightly dry in only 2-3 second intervals with oil-free and anhydrous air, or use cotton gauze to

dry off excess water. Do not overdry! The tooth should be just dry enough that the surface has

a slightly glossy appearance. As is the case with any fixation cement, over drying can lead to

post-operative sensitivity.

Q 8. May I use desensitizing agents before cementing restorations with RelyX Unicem

cement?

The unique chemistry of RelyX Unicem cement demineralizes and penetrates into the tooth

surface without utilizing a separate acid etching step. This greatly reduces the potential for

patient tooth sensitivity when compared to a typical total-etch resin cement system. Therefore,

the use of an additional desensitizing step has NOT been deemed beneficial. We recommend

that cleaning the prepared tooth with an aqueous pumice slurry and water as the final treatment

before cementing the restoration with RelyX Unicem cement.

Q 9.Will fit checker materials have an affect on the bond strength of the cement?

Yes. Contamination of the tooth surface with fit checker of material could be detrimental to any

bond. If a fit checker or any oil-based product is used during try-in use, an aqueous pumice

slurry and water spray rinse is recommended to ensure a clean tooth surface prior to cementa-

tion.

Q 10. Can etching help to increase bond strength?

RelyX Unicem cement shows good bond strength to enamel and very high bond strength to

dentin without any pretreatment. If enamel is selectively etched the bond strength to enamel

can be improved to a degree. However, etching of dentin does NOT increase bond strength,

whereas it generates the risk of post-operative sensitivities and microleakage. Therefore, if

selective etching of enamel is desired, care ought to be taken not to etch adjacent dentin.

Q 11. Is RelyX Unicem cement compatible with core build-up materials?

RelyX Unicem cement provides a secure bond to all types of core build-up materials. However,

composite core build-up materials are the preferred material type with respect to its physical

properties and esthetics. Therefore, composite core build-up materials are the best match for

ceramic restorations and for RelyX Unicem cement. The surface of the core build-up material

should be roughened. Use alcohol to clean and dry.

Q 12. Is there a recommended waiting time before light curing RelyX Unicem cement?

No. In contrast to certain resin cements by other manufacturers for which some waiting time is

recommended, RelyX Unicem cement can be light-cured immediately and high bond strengths

will be achieved. The reason lies within the highly efficient and fast initiator system in combi-

nation with the unique adhesive technology.

Bond strength values see page 22

Immediate bond strength values seepage 23ff

Bond strength values see page 40

49

Q 13. Is RelyX™ Unicem cement too viscous?

RelyX Unicem cement exhibits a so-called thixotropic behavior. It flows easily under pressure

yet increases in viscosity when left undisturbed. This means that when placing a restoration

with the usual pressure, a low film thickness and an exact placement is achieved. The benefit of

higher viscosity in the absence of pressure is that RelyX Unicem cement stays put. It does not

flow away from the prepared tooth, restoration or instrument and makes excess removal easier.

Q 14.Why is RelyX Unicem cement not indicated for cementing veneers?

RelyX Unicem is a dual curing cement and, once the capsule is activated and mixed, there is a

limited amount of working time. It could be difficult for the dentist to load up multiple veneers

and seat them properly before the working time is up.

For cementing veneers, the light cure RelyX™ Veneer cement has been specifically designed,

and perfectly complements RelyX Unicem cement.

Q 15. How can occasional marginal discoloration be avoided?

1. Do not use iron-containing liquids with translucent all-ceramic crowns. A gray discoloration

may develop underneath the translucent restoration a few weeks after cementation. Do not

use ferrous liquids at the impression appointment or seating appointment.

2. After final cleaning with aqueous pumice slurry and water spray, avoid using desensitizers,

disinfectants, astringents, hydrogen peroxide, dentin sealants, and rinsing solutions contain-

ing EDTA, etc. These treatments can leave chemical residues which may have a detrimental

effect on the bond strength and setting reaction of the cement.

Hydrogen peroxide is a strong oxidizing agent that decomposes chemical initiating systems.

Hydrogen peroxide is not easily removed from the tooth surface by a water spray. Generally,

its use should be avoided with any resin cement.

3. Make sure to pretreat the restoration as described in the RelyX Unicem cement instructions

for use. For details see also Q3 and Q4.

Q 16. Are try-in pastes available for RelyX Unicem cement?

Yes, there are RelyX™ Try-In Pastes, available individually or as part of the RelyX Veneer

cement intro kit. They are designed to fit both RelyX Unicem cement and RelyX Veneer

cement shades.

50

16. Index of Technical TermsNumbers refer to pages

Adaptation to tooth structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

see also “Margin, adaptation to ~”

Adhesion, see “Bond strength”

Adhesive values, see “Bond strength”

Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22

see also “Water storage”, “Thermocycling”, and “Mechanical load”

Air (-particle) -abraded, see “Sandblast”

Alpha Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15

Alumina ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 30, 39

see also “Ceramic”

Application, ~clinical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 44-46

Artificial aging, see “Aging”

Bacterial penetration, see “Microleakage”

Biocompatibility, see “Pulp compatibility”

Bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8, 10, 13, 18-31, 36-39

immediate ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 23, 26, 38, 48

see also “Tensile Bond Strength”, “Microtensile

bond strength”, “Retentive bond strength”

Bovine dentin, ~ enamel, ~ teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26, 27

Bravo Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-16

CAD/CAM glass ceramic, see “Glass ceramic”

see also “CEREC®”

Caries, absence of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15

Ceramic . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 10-17, 19, 22, 23, 27-30, 33, 34, 36-40, 42, 47-49

Ceramic in-/onlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14-16, 40, 42

CEREC® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34, 40, 47

see also “Glass ceramic”

Chemical cure mode, see “SC = self cure mode”

Clinical

~ experience (see also “Study”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40, 47

~ performance, see “Performance”

~ study, see “Study”

Composite

restorative material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 13, 14, 16, 22, 40, 42, 47, 48

test specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 20, 23-26, 29, 30, 36, 38, 39

Compomer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Compressive strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Conditioning, ~ of tooth structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6

see also “Pretreatment”

Color match . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15

Customer acceptance test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40

Curing (see also “LC = light cure”, “SC = self cure”)

dual ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 27, 30, 49

~ times . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 42, 43

Core build-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 36, 48

Coronal dentin, see “Crown dentin”

Crown dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

Cytotoxicity, see “Pulp compatibility”

DC = dark cure, see “SC = self cure”

Debonding (see also “Pretreatment of restorative material, and of tooth structure”) . . . . . . . .16

51

Delta scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Dentin bond strength, see “Bond strength”

Desensitizing agent, desensitizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42, 48, 49

Digital scan powder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Dimensional stability, see “Stability”

Discoloration, marginal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-17, 49

Ease of use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40

Elasticity, Modulus of ~ (= E-modulus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Enamel bond strength, see “Bond strength”

Endodontic posts, see “Posts”

Etchable glass ceramic, see “Glass ceramic”

Etching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 12, 15, 39, 48

Excess removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 43, 44-46, 49

Expansion, ~ value, linear ~, long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10, 11, 47

Fiber (reinforced) posts, see “Posts”

Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 47

Film thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 49

Fit checking products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Flexural Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 11

Fluoride ions, ~ release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 9

Glass ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 13, 29, 36-39, 47

see also “CEREC”

Glass ionomer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 7, 22, 26, 27, 29, 30

Glass fiber (reinforced) posts, see “Posts”

Gold alloy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Guttapercha, see “Posts”

Handling test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 40

Human

~ dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22-25, 27

~ enamel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23-25

~ pulp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

~ teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 21-25, 27, 30, 32, 34

Hydrophilicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 10

Hydrolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

see also “Stability, hydrolytic ~”

Immediate bond strength, see “Bond strength”

In vivo / In vitro Study, see “Study”

Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 16, 17, 40, 42, 44-46

Initiator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 48, 49

Inlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14, 15, 18, 22, 23, 33, 40, 42

Lava™, see “Zirconia ceramic”

LC = light cure (mode) . . . . . . . . . . . . . . . . . . . . . . .8, 9, 11, 12, 22-27, 29-31, 34-39, 43, 48, 49

Long-term performance, see “Performance”

Long-term stability, see “Stability”

Margin,

Adaptation to ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15, 17, 33, 34

Discoloration of ~, staining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14, 15, 17, 47, 49

Integrity of ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-17

Marginal adaptation, see “Margin”

Marginal discoloration, see “Margin”

Marginal sealing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Mega Pascal (MPa) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Mechanical

~ load . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 33, 34

~ properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 8, 11, 14

52

Metal, ~ restoration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 14, 17, 19, 28, 39, 40, 42

Methacrylate monomer molecule, see “Monomer molecules”

Microleakage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 16, 32, 48

Microtensile bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21, 24, 25

Mixing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 9, 10, 26, 35, 42, 43

Modulus of elasticity, see “Elasticity”

Monomer molecules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9, 47

Multi-step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 10, 14, 15, 18, 22, 23, 30

Neutral pH level, neutralization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 35

Onlay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 40, 42

see also “Ceramic in-/onlay”

Performance, clinical ~, long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-18, 24, 25, 39, 47

pH profile, ~ value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 35

Phosphoric acid groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9

Polymerization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-11, 42, 43

Porcelain, “Ceramic”

Posts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 6, 13, 16-18, 20, 21, 30-32, 39, 40, 42, 43, 46-48

Post-operative sensitivities, ~ pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 13, 14, 16, 42, 48

Pretest failures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25, 39

Pretreatment

~ of restorative materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 42, 47

~ of root canal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42

~ of tooth structure / prepared tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 12, 8, 42, 48

Pulp compatibility, ~ response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

see also “Post-operative sensitivities”

Pumice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42, 44, 45, 47-49

Radicals, Radical polymerization reaction, see “Polymerization”

Radiopacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 11

Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 15

Removal of excess cement, see “Excess removal”

Resin modified, resin-reinforced glass ionomer . . . . . . . . . . . . . . . . . . . .6, 22, 26, 27, 29, 30, 35

Retention (bond strength) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 21, 27, 30

see also (“Bond strength”)

Rocatec-Pre, see “Sandblast”

Rocatec Plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

see also “Silicoating”

Root canal (posts), see “Posts”

Root (canal) filling, see “Posts”

Root dentin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

Sandblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 22, 27, 28-30, 39

SC = self cure (mode) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11, 12, 22-29, 31, 35, 36, 39

Scan Powder, see “Digital scan powder”

Secondary caries, see “Caries”

Sensitivity, see “Post-operative sensitivities”

Setting, ~ reaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-10, 21, 42, 47, 49

Setting times, see “Curing time”

Shades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 49

Shear bond strength, see “Bond Strength”

Silicoating (= silicating & silanating) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 28

Simulated Aging, see “Aging”

Solubility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 10, 11

Stability

dimensional ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 11

hydrolytic ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

long-term ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 10, 11, 14, 35

53

Stainless steel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Strength

see “Bond Strength”, “Compressive ~”, “Flexural ~”,

“Microtensile Bond ~”, “Tensile Bond ~”,

Stress testing, stress simulation, see “Thermocycling”, “Mechanical load”

Study,

~ clinical, ~ in vivo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-18, 47

~ design, experimental design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

~ in vitro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-39

~ long-term . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-39

Surface

~ roughness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-16

~ hardness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

TCML = thermocycling & mechanical loading

see “Thermocycling” and “Mechanical load”

Tensile bond strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20, 21, 23, 25-27, 31

Thermal cycling, see “Thermocycling”

Thermocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 24, 27-30, 33, 34, 36-38

Times, see “Working time”, “Curing time”, “Mixing”

Titanium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18, 39

Total etch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12, 48

see also “Multi-step”

Tribochemical surface treatment, see “Silicoating”

Try-in pastes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Veneers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 49

Viscosity, viscous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Water

~ sorption (see also “Hydrophilicity”, “Hydrolysis”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

~ storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 22, 24, 27-32

Wire loop test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 20, 38

Working time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 8, 42, 43, 49

Zinc phosphate cement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6, 22, 26, 27, 29, 30

Zirconia ceramic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13, 22, 23, 27-29, 39

TC = thermocycling

TCML = thermocycling & mechanical loading

LC = light cure

SC = self cure (= dark cure, DC)

54

17. LiteratureLiterature on RelyX™ Unicem Cement

3M™ ESPE™ RelyX™ Unicem Self-Adhesive Universal Resin Cement 4-year Clinical

Performance

THE DENTAL ADVISOR, Vol. 24, No. 4, May 2007

Adhesion of RelyX™ Unicem Aplicap™ on RelyX Fiber Post

Popp E.-M., Peez R., Porsfeld V., Lachermeier B.

3M ESPE AG, Seefeld, Germany

PEF 2006, abstract #0067

Adhesion of Self-adhesive Resin Cements to Various Core Build-up Materials

Wiedig C.A., Porsfeld V.N., Hecht R., Raia G.

3M ESPE, Germany, Seefeld, Germany

IADR 2007, abstract #2449

Adhesion of Various Adhesive Resin Cements to RelyX™ Fiber Post

Porsfeld V., Peez R., Lachermeier B.

3M ESPE AG, Seefeld, Germany

PEF 2006, abstract #0068

Bonding Effectiveness of Adhesive Luting Agents to Enamel / Dentin

Hikita K.1,2, De Munck J.1,2, Ishijima T.2, Maida T.2, Lambrechts P.1,2, Van Meerbeek B.1,2

1Catholic University of Leuven, Netherlands2Health Sciences University of Hokkaido, Sapporo, Japan


Bonding effectiveness of adhesive luting agents to enamel and dentin

Hikita K., Van Meerbeek B, De Munck J., Ikeda T., Van Landuyt K., Maida T., Lambrechts P.,

Peumans M.

Dent Mater. 2006 Jan 16

Bonding of a Novel Self-Adhesive Cement to Tooth Substrates

Trajtenberg C.P., Pinzon L.M., Powers J.M.

University of Texas Dental Branch at Houston, USA

AADR 2003, abstract #1197 revised

Bonding of an auto-adhesive luting material to enamel and dentin

De Munck J., Vargas M., Van Landuyt K., Hikita K., Lambrechts P., Van Meerbeek B.

Dent Mater. 2004 Dec;20(10):963-71

Bond Strength of Self-Adhesive Cementing Agents to Dentin and Enamel

Piwowarczyk A., Bregulla J., Lauer H.-C.

Johann Wolfgang Goethe-University Frankfurt, Frankfurt/Main, Germany


Ceramic Inlays Luted with a Self-Adhesive Cement After one Year

Taschner M., Frankenberger R., Petschelt A., Krämer N.

University of Erlangen, Germany

AADR 2006, abstract #1361

Clinical Outcomes of Ceramic Inlays / Onlays Luted With Two Bonding Systems.

Denehy G., Stanford C., Cobb D., Vargas M. et al.

University of Iowa, USA, 2007, unpublished study

55

Clinical Performance of a Self-adhesive Universal Resin Cement; Initial Findings

Burke J.J.T., R.J. Crisp, B. Richter

Abstract #0564, IADR meeting 2005 Baltimore

Comparison of titanium dowel retention using four different luting agents

Balbosh A., Ludwig K., Kern M.

J Prosthet Dent. 2005 Sep; 94(3):227-33

CRA Status Report: Understanding Cement Use in 2004

CRA Newsletter, Volume 28, Issue 10, October 2004

Dentin Shear Bond Strength of Various Luting Cements

Piwowarczyk A.1, Lauer H.-Ch.1, Sorensen J.A.2

1Johann Wolfgang Goethe-University, Frankfurt, Germany2Oregon Health & Science University, Portland, USA

CED 2002, abstract #0215

Effect of One-day Storage on Bonding of Self-Adhesive Resin Cements

Irie M.1, Richter B.2, Suzuki K.1

1Okayama University Graduate School, Okayama, Japan23M ESPE, Seefeld, Germany

AADR 2006 abstract #1839

Effect of Surface Treatment on the Shear Bond Strength of Three Resin Cements to a

Machinable Feldspatic Ceramic.

Reich S.M.1, Wichmann M.1, Frankenberger R.2, Zajc D.2

1Department of Prosthetic Dentistry2Department of Operative Dentistry and Periodontology, University of Erlangen-Nuremberg,

Erlangen, Germany

J Biomed Mater Res B Appl Biomater. 2005 Aug; 74(2), 740-6

Effect on thermocycling on bond strength of luting cements to zirconia ceramic

Luthy H., Loeffel O., Hammerle CH

Dent Mater. 2006 Feb; 22(2):195-200.

FRC vs. Titanium Posts - Preliminary Results of a RCT

Naumann M.1, Sterzenbach G.2, Blankenstein F.2, Lange K.-P.2

1Humboldt-University Berlin, Charite - University Medicine, Germany2Humboldt-University Berlin, Germany;


Human Pulp Response to Resin Cements Used to Bond Inlay Restorations

Costa C.A. de S.1, Hebling J.2, Randall R.C.2

1University Sao Paulo State-UNESP, Sao Paulo, Brasilia23M ESPE, St. Paul, USA

Journal of Dental Materials, No. 22, 2006, 954–962

Influence of different adhesive resin cements on the fracture strength of aluminum oxide

ceramic posterior crowns.

Komine F, Tomic M, Gerds T, Strub JR.

J Prosthet Dent 2004 Oct;92(4):359-64

In Vitro Bond Strength of Adhesive Cements to Tooth Structure.

Pinzon L.M., Powers J.M.

University of Texas Dental branch at Houston, USA

THE DENTAL ADVISOR, Research Report, No. 1, June 2005

56

In vitro evaluation of wall-to-wall adaptation of a self-adhesive resin cement used for

luting gold and ceramic inlays

Fabianelli A., Goracci C., Bertelli E., Monticelli F., Grandini S., Ferrari M.

J Adhes Dent. 2005 Spring;7(1):33-40.

In vitro retentive strength of zirconium oxide ceramic crowns using different luting agents

Ernst CP., Cohnen U., Stender E., Willershausen B.

J Prosthet Dent. 2005 Jun;93(6):551-8.

In Vitro Retentive Strength of Zircon-Oxide all Ceramic Crowns

Ernst C.-P., Askoy E., Stender E., Willershausen B.

Johannes Gutenberg University Mainz, Germany

Published at the IADR PEF 2006, abstract #0248

In Vitro Shear Bond Strength of Cementing Agents to Fixed Prosthodontic Restorative

Materials

Piwowarczyk A., Lauer H. C., Sorensen J. A.

Johann Wolfgang Goethe University of Frankfurt, Germany

J Prosthet Dent. 2004 Sep; 92(3): 265-73

Long-term bond between dual-polymerizing cementing agents and human hard

dental tissue

Piwowarczyk A., Bender R., Ottl P., Lauer HC.

Dent Mater. 2006 Feb 20;

Marginal Adaptation of Ceramic Inlays Using Different Cements

Rosentritt M.1, Hahnel S.2, Behr M.1, Handel G.1

1University of Regensburg, Germany2University Medical Center Regensburg, Germany


Marginal adaptation in dentin of a self-adhesive universal resin cement compared

with well-tried systems

Behr M., Rosentritt M., Regnet T., Lang R., Handel G.

Dent Mater. 2004 Feb;20 (2):191-7.

Mechanical and Physical Properties of Self-etching Resin Luting Cements

Sakalauskaite E., Tam L.E., McComb D.

University of Toronto, Canada

AADR 2006, abstract #1894

Mechanical Properties of luting cements after water storage

Piwowarczyk A., H-C Lauer


Operative Dentistry, 2003, 28-5,535-542

Microleakage of various cementing agents for full cast crowns

Piwowarczyk A., Lauer HC., Sorensen JA

Dent Mater. 2005 May;21(5):445-53

Microtensile Bond Strength of Luting Materials to Coronal and Root Dentin

Walter Ricardo DDS, Patricia A. Miguez DDS, MS, Patricia N.R. Pereira, DDS,PhD

J Esthet Restor Dent 17:165-171, 2005

57

Micro-tensile bond strength of three luting resins to human regional dentin

Yang B., Ludwig K., Adelung R., Kern M.

Dent Mater. 2006 Jan; 22(1):45-56. Epub 2005 Jul 22

Proximal Adaptation of Partial Ceramic Crowns with Different Luting

Techniques/Materials

Federlin M., Hiller K.-A., Reinhard H., Fritzsch D., Schmalz G.

University of Regensburg, Germany

IADR PEF 2006, abstract #0562

Retention of Fiber Posts Cemented with a New Delivery System

Del Mastro M., Armoush Z., Aboushala A., Doherty E., Kugel G.

Tufts University, Boston, MA, USA


Retention of quartz-fibre endodontic posts with a self-adhesive dual cure resin cement

Bateman G.J., Lloyd CH, Chadwick RG, Saunders WP

Eur J Prosthodont Restor Dent. 2005 Mar; 13(1):33-7

Sealing Ability and Microscopic Aspects of a Self-adhesive Resin Cement used for

Fiber Post Luting into Root Canals

Simonetti M., Coniglio I., Magni E., Cagidiaco M.C., Ferrari M.

Dept. Dental Materials, Faculty of Dentistry, University of Siena, Italy

International Dentistry SA Vol. 8, No. 5, Sept./Oct. 2006

Shear Bond Strength of RelyX™ Unicem and RelyX™ ARC to an Experimental Glass

Ceramic Material

Fischer J.

University of Bern, Switzerland, 2006, unpublished study

Shear Bond Strength of the Zirconia / Resin Interface

Behr M., Rosentritt M., Kolbeck C., Lang R., Handel G.

University of Regensburg, Germany

Published at the IADR 2007 #2627

The adhesion between fiber posts and root canal walls: comparison between microtensile

and push-out bond strength measurements

Goracci C., Tavares AU, Fabianelli A., Monticelli F., Raffaelli O., Cardoso PC, Tay F., Ferrari M.

Eur J Oral Sci. 2004 Aug; 112(4):353-61

The Shear Bond Strength Between Luting Cements and Zirconia Ceramic after two

Pretreatments.

Piwowarczyk A., Lauer H. C., Sorensen J. A.


Oper Dent. 2005 May-Jun; 30(3): 382-8

Trends in Indirect Dentistry: 3. Luting Materials

Burke FJ Trevor

Restorative Dentistry, June 2005

Two-year Performance of Restorations Placed with a Self-Adhesive Luting Material

Crisp R.J., Burke F.J.T.

University of Birmingham, UK


58

General Literature on Dental Cements

Adhesive Cements and Cementation

White S.N.,

CDA Journal 1993, 21, 30-37

Contemporary Evaluation of Dental Cements

Donovan T.E., George C.C.,

Compendium 1999, 20, 197-219

Current status of luting agents for fixed prosthodontics

Diaz-Arnold A.M., Vargas M.A., Haselton D.R.,

J. Prosth. Dent. 1999, 81 (2), 135-141

Dental luting agents:A review of current literature

Rosenstiel S.F., Land M.F., Crispin B.J.,

J. Prosth. Dent. 1998, 80 (3), 280-301

in: Phillips’ Science of Dental Materials

Anusavice K. J.,

W.B. Saunders, 10. edition, Philadelphia, 1996

in: Ullmann’s Encyclopedia of Industrial Chemistry, Dental Materials (chapter: cements)

Stefan K.,

Electronic Release, Wiley, 2000.

Mechanical properties of dental luting cements

Li Z.C., White S.N.,

J. Prosth. Dent. 1999, 81, 597-609

Trends in Indirect Dentistry: 3. Luting Materials

Burke F.J.T,

Restorative Dentistry, June 2005

59

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Documents

RelyX Unicem Technical Product Profilemultimedia.3m.com/mws/media/174266O/relyxtm-unicem-self-adhesive...5 1. Introduction RelyX™ Unicem cement is a dual-curing, self-adhesive universal