How to Proceed With Hybrid Zirc Abutment

[Ethan Thompson]

Afternoon, folks. So, the situation I find myself in today is this; After many years of shying away from hybrid zirconia abutments, in favor of either full Zirc or, when this isn't an option, gold shaded titanium, I find myself yielding to one of our accounts and giving a couple a shot. I'm currently waiting on the abutments to arrive and have no idea how to go about cementing the abutment to the base. I've ordered the manufacturer-prefered bonding material (Ivoclar Multilink, the hybrid abutment variety). Though after looking into it a bit more on here, it seems some people also use a primer as well. Initially I had planned to simply blast it with some 50micron ALOX, cement it all, and call it a day. Can anyone elaborate on why they would or would not use the primer? Any other info you think I should be aware of would also be appreciated.

also, if it makes any difference , the abutments are a 4.5 and 3.0 BioHorizons Hybrid Zirconia

 

[Contraluz]

Any other info you think I should be aware of would also be appreciated

Get the kit version of the cement. You will find Monobond (bonding agent you apply to the ti-base and zirconia crown) and other useful info in it. Then, follow the protocol!

M

 

[Mike2]

Ditto, I use the Bisco Duo Link with Z-Prime

 

[Sevan P]

I use ivoclar multilink with monobond plus. Never had a debond in over 3years if using it.

When ready to cement, I same blast the ti base, and inside the abutment or screw retained crown. Now some ti bases don't need sand blasting theuh have a special coating on them.

Then I steam if both parts and blow with air. Apply monobond plus to the side of zr and ti base. Let sit for 30 to 60 seconds. Mix the multilink by hand not using the provided tips cause if excessive waste. Apply the cement to the ti base and stick into zr. Extra cement will come out the bottom of the zr wipe off with tissue. Place back on model immediately and let sit to dry. Polish if needed , done.

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[user name]

I use ivoclar multilink with monobond plus. Never had a debond in over 3years if using it.

When ready to cement, I same blast the ti base, and inside the abutment or screw retained crown. Now some ti bases don't need sand blasting theuh have a special coating on them.

Then I steam if both parts and blow with air. Apply monobond plus to the side of zr and ti base. Let sit for 30 to 60 seconds. Mix the multilink by hand not using the provided tips cause if excessive waste. Apply the cement to the ti base and stick into zr. Extra cement will come out the bottom of the zr wipe off with tissue. Place back on model immediately and let sit to dry. Polish if needed , done.

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I thought we aren't supposed to wipe any off...? The stuff in contact with the air wont cure, so if you do wipe off, theres some product they make to cover the joint and seal out the air so everything will cure. Could use Vaseline.

@Patrick Coon Settle this please.

 

[Patrick Coon]

I thought we aren't supposed to wipe any off...? The stuff in contact with the air wont cure, so if you do wipe off, theres some product they make to cover the joint and seal out the air so everything will cure. Could use Vaseline.

@Patrick Coon Settle this please.

If what Sevan is doing is working for him, I wouldn't change it, but. . .

Our official instructions say to allow the Multilink set for 2-3 minutes until it gets to the "gel" state, then use a sharp instrument to break off the excess. At that point we would advise to apply LiquidStrip or SR Gel to the cement gap to prevent the air inhibited layer and to allow to finish curing for seven (7) minutes. Rinse off the gel and finalize by polishing the cement gap using silicone polishers.

 

[Sevan P]

I thought we aren't supposed to wipe any off...? The stuff in contact with the air wont cure, so if you do wipe off, theres some product they make to cover the joint and seal out the air so everything will cure. Could use Vaseline.

@Patrick Coon Settle this please.

Or let is set then take a knife and clean it off. Never habe an issue, if the stuff in contact with the air doesn't cure then why does the left over cement on the mixing plate cure?

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[rkm rdt]

are we talking about the multilink hybrid opacious cement /

 

[Patrick Coon]

You will notice a sticky surface, this is the air inhibited layer. If left alone for a day, it too will cure fully, but all composites get this layer, which needs to be cured or ground through to achieve a smooth polish so plaque and bacteria are less likely to adhere

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[Patrick Coon]

are we talking about the multilink hybrid opacious cement /

Specifically yes, but all composites or resin cements have similar cure properties.

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[rkm rdt]

I used to wipe off the cement but found that the crown can move enough to create voids.
I cement on the model now and carve off the cured residue .

I wish there was an intra oral opacious cement though. I would prefer that the dr cement in the mouth.

 

[Sevan P]

If what Sevan is doing is working for him, I wouldn't change it, but. . .

Our official instructions say to allow the Multilink set for 2-3 minutes until it gets to the "gel" state, then use a sharp instrument to break off the excess. At that point we would advise to apply LiquidStrip or SR Gel to the cement gap to prevent the air inhibited layer and to allow to finish curing for seven (7) minutes. Rinse off the gel and finalize by polishing the cement gap using silicone polishers.

Huh, in the instruction sheet that came with my kit it doesn't say to do that, makes sense but didn't say to apply a inhibitor maybe in the newer kits they say so. The kit I got was 3 years old and basically outlined for dentists. I think the newer kits are for emax abutments.

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[Sevan P]

You will notice a sticky surface, this is the air inhibited layer. If left alone for a day, it too will cure fully, but all composites get this layer, which needs to be cured or ground through to achieve a smooth polish so plaque and bacteria are less likely to adhere

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On at abutment after cementing they are still in the lab for at least 24hours cause we still have to make the crown i
On top of it. Screw retained crowns het cemented then shopped so there is some time for it to fully cure up. May even sit at the office for a day for two.

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[Patrick Coon]

On at abutment after cementing they are still in the lab for at least 24hours cause we still have to make the crown i
On top of it. Screw retained crowns het cemented then shopped so there is some time for it to fully cure up. May even sit at the office for a day for two.

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Not being argumentative here, but think of it this way. . .

Are you waiting for 24 hrs before you polish? Probably not. So when you polish the not fully cured surface some of the material will smear and not fully polish, leaving small areas for the bacteria to stick and grow.

As for the IFU not stating it, I've been working and teaching it some we released the technique (using chairside cement) and have always seen it in the manuals and instructions. Even the doctors are instructed to use it when cementing crowns and veveers.

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