The Pros and Cons of Bonding or Cementing Restorations

Today, more than ever, we have plenty of choices when planning and delivering our indirect restorations. Chief among those decisions is whether to bond or cement our restorations.

For me, this decision starts at the treatment planning stage by considering the following pros and cons.

Bonding restorations

Pros

• Very strong and predictable to enamel
• Increases the strength of the restoration
• Increased tolerance to decreased preparation resistance and retention form
• In many cases, enhanced strength of the final restoration
• Increased margin esthetics in supragingival areas

Cons

• Isolation is critical
• Decreased predictability on tooth surfaces other than healthy enamel
• Restorative materials must accept bonding to take advantage of many of the pros
• Anesthesia is typically needed for vital teeth
• Cleanup can be very difficult
• Tends to be more time consuming

Cementing restorations

Pros

• Cleanup is typically easy
• More predictable with preparations with little enamel
• Often, no anesthesia is needed
• Tends to be less time-consuming

Cons

• Does not tend to increase the strength of the final restoration
• More affected by resistance and retention form of the preparation
• Can’t be used with materials that require bonding

Both methods have many clear pros and cons. In cases where you must choose bonding, it’s critical to maintain the ability to achieve excellent isolation at delivery and as much enamel as possible.

Assuming I’m using a material that can be either bonded or cemented, it’s necessary to keep in mind whether or not I can achieve excellent isolation; if I can’t, I eliminate bonding. Additionally, if sparse enamel or altered dentin is in my final preparation, I’m going to lean toward cementation. Also, if I don’t need the increased strength, retention, or marginal esthetics that bonding provides, I’ll select cementation due to its simplicity.

While it’s impossible to discuss all the scenarios for bonding vs. cementing here, I hope this article has given you or reminded you of some things to think about when planning your next case.