CATEGORY 124 AUSTRALASIAN DENTIST Effective dental luting is critical to the long-term success and stability of indirect dental restorations. To achieve best-practice dental luting, dentists must practise careful assessment and decisionmaking throughout the luting process. Ensuring proper patient assessment, balancing aesthetics and function, selecting the right curing type, and paying attention to viscosity are all critical success factors in the dental luting workflow. 1. Assessing the patient The luting workflow begins in the initial patient assessment. Evaluate the patient’s requirements and the current condition of the oral cavity. Consider factors such as tooth preparation, aesthetic demands, and substrate selection. “The choice of restoration material, its placement in the mouth, and the patient’s treatment priorities will all impact the choice of luting cement,” explains Dr RL Castillo, Professional Development Manager at GC Australasia Dental. “Additionally, decisions on when to bond or cement the restoration should consider factors like retentive preparation, isolation, caries susceptibility, and aesthetic demands.” 2. Balancing aesthetics and function The weight you put on the aesthetic appearance versus the practical function of the restoration may differ depending on its position in the mouth. As anterior teeth are prominently visible, these restorations are likely to focus on aesthetics as a priority. On the other hand, aesthetics may be less critical for posterior teeth where functional aspects like chewing efficiency may take precedence. However, it’s possible to achieve both excellent aesthetics and superior function with proper dental luting. Dr Castillo says universal cements like GC’s G-CEM ONE universal self-adhesive resin cement offer the versatility to address both aesthetic and functional needs. “Depending on the preparation, with G-CEM ONE you could choose from either a simplified self-adhesive cementation or full adhesive application,” she explains. “In the case of full adhesive application, G-CEM ONE offers two simple options – Adhesive Enhancing Primer (AEP) with our unique touch cure technology, or G-Premio BOND for all direct and indirect workflows. “The advantage of using AEP is that the use of a rubber dam is optional. The surfactant included in AEP will transform the salivary proteins into micelles, which will be blown away during the strong air drying step. This means that in the case of saliva contamination, AEP will be able to dissolve the salivary proteins and avoid a negative impact on the bonding performance. “Also, the difference between AEP and G-Premio BOND is that AEP is not lightcured and G-Premio BOND must be lightcured.” 3. Choosing the right curing method Curing is an essential step in a successful dental luting workflow, and choosing the appropriate curing method is paramount. Light-only curing and dual-cured cements are the two primary options. Dr Castillo explains that light curing is effective for thinner restorations – such as veneers – while dual-cured cements are suitable for thicker restorations that require a reliable set. “Light-only curing allows for extended working time, making it preferred for veneers and aesthetic procedures,” she says. “Dual-cured cements offer the advantage of setting even in areas where light penetration is limited, such as beneath opaque restorations. Considering the opacity of the restoration material is crucial in selecting the appropriate curing type. “G-CEM ONE has a strong dark cure reaction and offers a high degree of conversion so the adhesion is excellent.” 4. Ensuring proper viscosity The viscosity of the luting cement you’re using also has an significant impact on the long-term success of the restoration. Viscosity should be correctly balanced to enable good flow under pressure while restricting overflow. The right viscosity largely eliminates clean-up headaches, and prevents issues such as staining or marginal wearing over time. “The ideal cement should have a balance of viscosity that allows it to flow under pressure without excessive flowing or thickness,” Dr Castillo explains. “The excess cement should be easily removable to achieve a precise fit and patient comfort. It’s always best to use a cement that has excellent wear and stain resistance around the margins. It should offer simplicity without compromise.” u Avant Dental designs and manufactures a wide range of direct and indirect restorations. Call 1800 287 336 or visit www.avantdental.com.au for more information. Dental luting for dentists: How to optimise your workflow By Ian Feigen, Technical Services Director, Avant Dental Dental luting can make or break the quality of your indirect restorations. Here are four key considerations to ensure luting success. Dr RL Castillo LABS
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