Cementing Zirconia Veneers

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SDS_SMC

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Hi,

Knowing that zirconia isn't often used on veneers due to low/no mechanical retention, some doctors still request it from time to time. A doctor asked us for the best cement for zirconia veneers, but zirconia manufacturers aren't willing to "recommend" any cement due to the aforementioned reason.

I did some quick researching and put together this recommended procedure based off of a research paper, and some material IFUs. It seems excessive, but may give the veneer the best chance of retaining adhesion/bond.

Would you, please, review the procedure and offer your constructive criticism?


Cementation of Zirconia Veneers
After dry-fitting:

Zirconia Veneer
  • Thoroughly rinse and dry the intaglio surface of the veneer.
  • Apply Ivoclean (Ivoclar Vivadent) to intaglio surface of veneer with brush. Let react for 20 seconds. Then thoroughly rinse and dry.
  • Abrade intaglio surface of veneer with silica coated aluminum oxide (Rocatec, 3M ESPE) for 20 seconds. Then dry.
  • Apply silane (Monobond Plus, Ivoclar Vivadent),let react for 60 seconds, then disperse excess with strong stream of air. Let dry.
Tooth Surface
  • Perform prophylaxis of the tooth surface with pumice and water. Then thoroughly wash and dry.
  • Etch with 35% Phosphoric Acid for 20 seconds. Then thoroughly wash and dry.
  • Treat with application of adhesive system (Excite F, Ivoclar Vivadent).
Cementation
  • Apply resin cement (Variolink Esthetic DC, Ivoclar Vivadent) to veneer. Place veneer on abutment. Remove excess cement with brush and floss.
  • Light cure (≥ 1,000 mW/cm²) for 40 seconds on veneer surface.
  • Apply glycerin gel/air block (Liquid Strip, Ivoclar Vivadent) to cervical and incisal regions of veneer.
  • Light cure (≥ 1,000 mW/cm²) for another 40 seconds.
  • Rinse off glycerin gel/air block. Remove excess cured cement with scalpel blade.
 
Last edited:
Patrick Coon

Patrick Coon

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Hi,

Knowing that zirconia isn't often used on veneers due to low/no mechanical retention, some doctors still request it from time to time. A doctor asked us for the best cement for zirconia veneers, but zirconia manufacturers aren't willing to "recommend" any cement due to the aforementioned reason.

I did some quick researching and put together this recommended procedure based off of a research paper, and some material IFUs. It seems excessive, but may give the veneer the best chance of retaining adhesion/bond.

Would you, please, review the procedure and offer your constructive criticism?


Cementation of Zirconia Veneers
After dry-fitting:
(Saliva must not be allowed to come in contact with tooth or veneer surfaces during this process)

Zirconia Veneer
  • Thoroughly rinse and dry the intaglio surface of the veneer.
  • Apply Ivoclean (Ivoclar Vivadent) to intaglio surface of veneer with brush. Let react for 20 seconds. Then thoroughly rinse and dry.
  • Abrade intaglio surface of veneer with silica coated aluminum oxide (Rocatec, 3M ESPE) for 20 seconds. Then dry.
  • Apply silane (Monobond Plus, Ivoclar Vivadent),let react for 60 seconds, then disperse excess with strong stream of air. Let dry.
  • Treat with application of adhesive system (Excite F, Ivoclare Vivadent),without curing.
Tooth Surface
  • Perform prophylaxis of the tooth surface with pumice and water. Then thoroughly wash and dry.
  • Etch with 35% Phosphoric Acid for 20 seconds. Then thoroughly wash and dry.
  • Treat with application of adhesive system (Excite F, Ivoclar Vivadent).
Cementation
  • Apply resin cement (Variolink Esthetic, Ivoclar Vivadent) to veneer. Place veneer on abutment. Remove excess cement with brush and floss.
  • Light cure (≥ 1,000 mW/cm²) for 40 seconds on veneer surface.
  • Apply glycerin gel/air block (Liquid Strip, Ivoclar Vivadent) to cervical and incisal regions of veneer.
  • Light cure (≥ 1,000 mW/cm²) for another 40 seconds.
  • Rinse off glycerin gel/air block. Remove excess cured cement with scalpel blade.
A couple things:

1. Don't use the Excite F on the veneer, that is for the tooth surface. The MDP 10 in the Monobond plus is all you need on the veneer.

2. Variolink Esthetic is a great choice, but be sure to use the Variolink Esthetic DC (Dual Cure). That way, if there is an area of the restoration that is a little more opaque (and the light can't cure it completely),it will continue to self-cure over the next 10 minutes.

3. If they are going to use Ivoclean, they don't need to be so worried about the saliva touching the restoration or the tooth. What we worry about in the saliva is the phospho-lipoids. These phospho-lipoids are attracted to and attach the to zirconia molecules, preventing the MDP10 from attaching to the zirconia, hence eliminating any chemical bond. Ivoclean is actually a simple product and contains round zirconia pieces suspended in an alkaline base. These round zirconia pieces have a lower surface tension and will actually pull the phospho-lipoids from the surface of the restoration, leaving a perfectly clean surface ready for bonding.
 
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Hi,

Knowing that zirconia isn't often used on veneers due to low/no mechanical retention, some doctors still request it from time to time. A doctor asked us for the best cement for zirconia veneers, but zirconia manufacturers aren't willing to "recommend" any cement due to the aforementioned reason.

I did some quick researching and put together this recommended procedure based off of a research paper, and some material IFUs. It seems excessive, but may give the veneer the best chance of retaining adhesion/bond.

Would you, please, review the procedure and offer your constructive criticism?


Cementation of Zirconia Veneers
After dry-fitting:
(Saliva must not be allowed to come in contact with tooth or veneer surfaces during this process)

Zirconia Veneer
  • Thoroughly rinse and dry the intaglio surface of the veneer.
  • Apply Ivoclean (Ivoclar Vivadent) to intaglio surface of veneer with brush. Let react for 20 seconds. Then thoroughly rinse and dry.
  • Abrade intaglio surface of veneer with silica coated aluminum oxide (Rocatec, 3M ESPE) for 20 seconds. Then dry.
  • Apply silane (Monobond Plus, Ivoclar Vivadent),let react for 60 seconds, then disperse excess with strong stream of air. Let dry.
  • Treat with application of adhesive system (Excite F, Ivoclare Vivadent),without curing.
Tooth Surface
  • Perform prophylaxis of the tooth surface with pumice and water. Then thoroughly wash and dry.
  • Etch with 35% Phosphoric Acid for 20 seconds. Then thoroughly wash and dry.
  • Treat with application of adhesive system (Excite F, Ivoclar Vivadent).
Cementation
  • Apply resin cement (Variolink Esthetic, Ivoclar Vivadent) to veneer. Place veneer on abutment. Remove excess cement with brush and floss.
  • Light cure (≥ 1,000 mW/cm²) for 40 seconds on veneer surface.
  • Apply glycerin gel/air block (Liquid Strip, Ivoclar Vivadent) to cervical and incisal regions of veneer.
  • Light cure (≥ 1,000 mW/cm²) for another 40 seconds.
  • Rinse off glycerin gel/air block. Remove excess cured cement with scalpel blade.
You can easily cement zirconia wether it is a veneer or not. We do veneer with translucent zirconia and they look Great. You can bond zirconia too, just ask you dental supplier.
 
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Thank you so much for the great feedback, Patrick! I've made changes accordingly.
Appreciate the wisdom~
 
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You can easily cement zirconia wether it is a veneer or not. We do veneer with translucent zirconia and they look Great. You can bond zirconia too, just ask you dental supplier.
That good to hear. What procedures and materials do you often use?
 
Affinity

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Ask yourself, if you have a decent understanding of zirconia, ceramic, and bonding, if you would cement a veneer in your own mouth. This is ignorance and malpractice. Whether or not it stays on is only a matter of time. Show me one scientific research paper on bonding zirconia veneers because I can show you volumes on bonding ceramic to dentin.
 
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You can easily cement zirconia wether it is a veneer or not. We do veneer with translucent zirconia and they look Great. You can bond zirconia too, just ask you dental supplier.
Bisco has a bonding agent for zirconia.
 
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Can't add to this thread other than asking why use zirconia on veneers when LD works so well when bonded ?
For anyone doing zirconia veneers I would like an explanation on why you think zirconia is better and we can rule out translucency from the start.
 
Affinity

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Bisco have any scientific data on bonding? I can stick a piece of gum under the table and say its bonded.
 
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Can't add to this thread other than asking why use zirconia on veneers when LD works so well when bonded ?
For anyone doing zirconia veneers I would like an explanation on why you think zirconia is better and we can rule out translucency from the start.
The edges will never chip, more predictable ending VS pressing or LD. We did e-max for 15 years and every now and then either the ring cracks or the oven goes down. And finally why not?
 
Affinity

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Well without getting into a boring discussion on fluorescence and the actual mechanism of adhesive bonding, those would be my main two reasons not to. But I will agree that I dont do much LD anymore, zirconia has all but replaced everything but veneers for me. I just looked and last year LD was 3% of my total gross revenue... Faster and stronger isnt better in every scenario, veneers would be #1 on that list.
 
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FASTFNGR

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Well without getting into a boring discussion on fluorescence and the actual mechanism of adhesive bonding, those would be my main two reasons not to. But I will agree that I dont do much LD anymore, zirconia has all but replaced everything but veneers for me. I just looked and last year LD was 3% of my total gross revenue... Faster and stronger isnt better in every scenario, veneers would be #1 on that list.
Most glaze products are fluorescent, 3M added fluorescent into zirconia mix and there is more than 4 companies that do zirconia bonding. Make your life easier.
 
Affinity

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I use fluourescent glaze, there are also fluo infiltrating liquids from IDS. Not the same. The only way my life could be any easier is if I didnt have so much bloody work.
 
Affinity

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Not sure of the shade, probably bl4/1m1 something like that.. These are pressed GC veneers, I dont waste my time on zr veneers.
 
rkm rdt

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zr veneers require milling = drill compensation= thick incisals = crap
send the damn case to Affinity
he knows what he's doing.
 
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