Brush & Bond and SEcure Adhesive System
With proven success with 4-META technology, Parkell, Inc. introduces a solid cementation system that offers a complete solution for bonding porcelain restorations.
Porcelain’s strength is enhanced by a strong, reliable bond or fusing to a strong substrate. In porcelain-fused-to-metal and zirconia restorations, the resulting strength is enough to require only conventional cementation methods. Other all-porcelain systems directly supported by tooth structure either require or can benefit from the use of a resin bonding cement to enhance the strength of the porcelain.
Parkell’s SEcure® resin cement has proven to be a predictable and reliable bonding method. Furthermore, substituting SEcure’s own bonding agent with Parkell’s Brush&Bond® results in an even stronger bond. Both products are based on the proven 4-META bonding technology (Figure 1).
Brush&Bond prevents sensitivity by sealing the tubules with a tripolymer layer that also protects against potential microleakage. Studies have shown that it prevents decalcification even if the tooth is subjected to strong acids. SEcure’s similar 4-META chemistry and biocompatibility creates a reliable bond between the tooth and the crown, guarding against bacterial infiltration.
A patient presented with the mesial-buccal cusp of tooth No. 14 completely fractured off to the gingival margin. A bonded IPS e.max® Press Porcelain onlay (Ivoclar Vivadent, www.ivoclarvivadent.com) was recommended to take advantage of any resistance and retention form of an onlay preparation, the higher strength of the IPS e.max porcelain system, and the durable and predictable 4-META bonding technology.
After removal of the provisional restoration, the onlay was checked for fit and proper occlusion and adjusted accordingly. Isopropyl alcohol 70% was used to clean off the occlusal surface.
The intaglio surface, which had been etched at the dental laboratory with hydrofluoric acid, was thoroughly roughened and cleaned with a microetcher filled with 50-µm aluminum oxide and 32% phosphoric-acid etchant and then rinsed with water and air-dried.
Parkell’s Etch-Free® silane porcelain primer, which forms a strong bond to unetched porcelain surfaces and is specially formulated to work with 4-META products, was applied directly to the intaglio surface and allowed to air-dry for 2 to 3 minutes. In the meantime, Parkell’s BluSep™ releasing agent was applied to the interproximal surface of the restoration and gently air-dried for ease in the clean-up of excess bonding cement after curing. The restoration was set aside and kept clean of any contaminants.
The prepared surfaces of the tooth were cleaned with a microetcher and then rinsed thoroughly with water and air-dried. Brush&Bond was dispensed and mixed with the supplied brush as directed and then applied to the preparation surfaces, making sure that they stayed moist with the bonding agent for 20 seconds. Afterward, the surfaces were gently air-dried for 10 seconds before being light-cured for 5 seconds with a halogen curing light. Alternatively, the bond strength to cut enamel and sclerotic dentin could have been enhanced with a short 5- to 10-second phosphoric-acid etching prior to the application of Brush&Bond.
SEcure Translucent shade cement cartridge was previously bled to ensure a patent equal flow of each component cement, and a supplied mixing tip was installed. A small amount of cement was dispensed onto a mixing pad to ensure the elimination of an incomplete mix that sometimes occurs initially. The cement was dispensed directly onto the intaglio surfaces of the restoration, which was being held by an adhesive stick, and the restoration was immediately seated onto the tooth (Figure 2). While holding the restoration firmly in place with an instrument to ensure complete seating, one surface was light-cured for 2 to 3 seconds.
The consistency of this partially cured cement makes clean-up relatively easy. Partial curing and clean-up of the other surfaces was completed (Figure 3). To prevent the unintentional bonding of the proximal surfaces, the interproximal contacts were flossed in a gingival direction while the restoration was being held in place with an instrument.
Full set occurs in 3 to 5 minutes without final light-curing depending on the intraoral temperature. In this case, each surface was light-cured for 30 seconds to speed the setting time prior to final clean-up. Occlusion was adjusted, finished, and polished (Figure 4).
As with any new technique, the learning curve can sometimes hinder one from even trying the technique, much less continuing with it until it becomes routine. This author has tried several other bonding cement systems but ultimately found the transition to SEcure and Brush&Bond easily learned due to its user-friendly characteristics.
The clinical work presented in this article was done by the authors, Drs. Leo Arellano of San Francisco, California, and Eric Yabu of Oakland, California.
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