A Simplified Process for Bonding e.max and Other Glass Ceramic Restorations

This is a process where it is best that the clinician takes control.

Generally, clinicians prefer their laboratory technicians etch their glass ceramic restoration before it is sent to the dental office. Questions arise such as what acid was used, how long was it on the surface, should the surface of the ceramic appear “chalky,” was the surface contaminated after the etching process, etc. If the laboratory only steam cleans the restoration before it is sent to the clinician and an etchant is used that will not over-etch the ceramic, a more predictable outcome may be achieved. 

Follow these simple steps to achieve an optimal bond to your e.max or other glass ceramic restorations. 

1. Try the restoration on the tooth to confirm the marginal integrity, interproximal contacts and esthetic appearance. 
2. Rinse for 10 seconds with a water-air spray … oil-free of course. Better yet, steam clean the restoration.

   

3. Apply Monobond Etch & Prime (Ivoclar-Vivadent) to the intaglio surface only, for a total of 60 seconds.
   1. The first 20 seconds, agitate the surface with a micro-brush, and for the next 40 seconds let the liquid react with the surface of the ceramic.
   2. The Monobond Etch & Prime will clean, etch and prime any glass ceramic surface with which it comes into contact. If it is applied to the external surface of the restoration, the adhesive and resin cement will adhere.
4. After 60 seconds, rinse and dry the surface.
5. Follow the manufacturers’ recommendations for steps in bonding the restoration to the tooth.  

The advantage of using Monobond Etch & Prime is that it will not over etch the ceramic if a second application is used or needed. The test results from Ivoclar show it provides a better bond to glass ceramic compared to the traditional hydrofluoric acid and silane application approach. 

(Click this link to read more dentistry articles by Dr. Bob Winter.)

Bob Winter, D.D.S., Spear Faculty and Contributing Author