CEMENTATION PROCEDURES IN FIXED PARTIAL DENTURES

CONTENTS:

-Introduction

-Ideal requirements

-Types of cement

-Factors affecting the clinical performance of cements

-Characteristics of abutment prosthesis interface

-Procedure for cementation of prosthesis

-Placement of cement

-Seating

-Removal of excess cement

-Post cementation

-Mechanism of retention

-Dislodgement of prosthesis

-Review of literature

-Summary and Conclusion

-References

1
Introduction:

The clinical success of fixed prostheses is heavily dependent on the

cementation procedure. Loss of crown retention was found to be the

second leading cause of failure of traditional crowns and fixed partial

dentures.

Although the establishment of- optimal resistance and retention forms

in the tooth preparation are of primary importance, a dental cement

must be used to act as a barrier against microbial leakage, sealing the

interface between the tooth and the restoration and holding them

together through some form of surface attachment.

The above is possible only if correct cementation procedures are used

in order to utilize the optimal properties of the cement, which are

critical to the long term success of the prostheses.

Cement:

A binding element or agent used as a substance to make objects

adhere to each other or something serving to firmly unite OR

A material that on hardening will fill a space or bind adjacent objects.

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Cementation:

The process of attaching parts by means of cement.

Luting agent:

Any material used to attach or cement indirect restorations to

prepared teeth.

Ideal luting materials should:

1. Be biocompatible with the tissues that it contacts i.e. tooth and

periodontal tissues.

2. Adhere to tooth substance and restoration; either chemically,

mechanically or both.

3. Prevent leakage by good marginal seal.

4. Have sufficient mechanical properties to resist the forces

transmitted to the lute through the restoration. This should include

high tensile and compressive strengths, high fracture toughness and

fatigue strength, and a modulus of elasticity which is appropriate for

stress absorption.

5. Be cariostatic

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6. Be insoluble in the dilute organic acids found in plaque- which

may collect at the gingival margins of poorly contoured/poorly fitting

indirect restorations or in patients with suboptimal oral hygiene.

7. Resist water sorption.

8. Be available in a sufficient range of shades if the luting material

contributes to the overall shade of the restoration.

9. Achieve optimal physical properties as quickly as possible.

10. Allow easy removal of excess and clean-up.

11. Have sufficiently low film thickness so that the restoration may

seat fully.

12. Have radiopacity similar to or greater than dentine.

Additionally:

-Technique insensitive.

-Capable of easy and accurate proportioning if presented in

powder/liquid form, although encapsulation may be considered ideal

from the aspect of producing a reproducible mix.

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Luting materials play an important role in indirect dentistry by aiding

the retention of restorations and in the prevention of leakage at the

margins.

These may be classified according;

1. To the material from which they are formed; and

2. More generally as Active and Passive.

Active luting materials by being bonded to both the tooth and

restoration, make the restoration and tooth synergistic, and thereby

play a role in the retention of the restoration, as well as sealing its

margins and filling the space between the restoration and the tooth;

while…

Passive luting materials merely fill the gap between the indirect

restoration and the tooth, with no chemical adhesion at the

restoration/lute and/or tooth/lute interfaces.

‘Active luting materials therefore can be used in restorations in

which there is limited retention.’

Principles of cementation:

The properties of various cements differ from each other. Hence, the

choice of cement is governed to a large degree by functional and

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biologic demands of the particular clinical situation. If optimal

performance is to be attained, physical and biologic properties, and

the handling characteristics such as working and setting time and ease

of removing excess material must be considered in selecting a cement

for a specific task.

Principles of cementation:

-The properties of various cements differ from each other. Hence, the

choice of cement is governed to a large degree by functional and

biologic demands of the particular clinical situation.

- If optimal performance is to be attained, physical and biologic

properties, and the handling characteristics such as working and

setting time and ease of removing excess material must be considered

in selecting a cement for a specific task.

Mechanism of retention:

1. Non-adhesive (mechanical) luting:

- Latin (lutum = mud) , luting agent primarily served to fill the gap

and prevent the entrance of fluids.

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Eg. Zinc phosphate cement: holds the restoration in place by

engaging small irregularities on the surface of both the tooth and the

restoration.

2. Micromechanical bonding:

- eg. Resin cements when used on pitted surfaces can provide

effective micromechanical bonding

-deep irregularities are produced on the surface of enamel,ceramic or

metal….

3. Molecular adhesion:

-involves physical forces (bipolar, Van der Waals and chemical bonds

(ionic, covalent) between the molecules of two different substances.

Eg. Glass ionomer cements , zinc polycarboxylate cements.

Factors affecting the clinical performance of cements:

-The correct seating of a restoration is important to occlusal function,

esthetics and durability of the cement, especially in relation to
securing the thinnest set cement between restoration and tooth.

-Another factor that influences the material performance is the taper

and marginal geometry of the restoration.

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Characteristics of abutment – Prosthesis interface:

When two relatively flat surfaces are brought into contact, Analogous
to a fixed prosthesis being placed on a prepared tooth, a space exists
between the substrates on a microscopic scale. As shown is Fig 1
typical prepared surfaces on a microscopic scale are rough that is
there are peaks and valleys. When two surfaces are placed against
each other, there are only point contacts along the peaks (Fig2). The
areas that are not in contact then become open space. The space
created is substantial in terms of oral fluid flow and bacterial
invasion.

One of the main purposes of a cement is to fill this space completely.

One can seal the space by placing a soft material, such as an
elastomer, between the two surfaces that can conform under pressure
to the “roughness”. The current approach is to use the technology of
adhesives. Adhesive bonding involves the placement of a third
material, often called a cement, that flows within the rough surfaces
and set to a solid from within a few minutes (Fig 3). The solid matter
not only seals the space but also retains the prosthesis. If the third
material is not fluid enough or is incompatible with the surfaces,
voids can develop around deep, narrow valleys (Fig 4) and undermine
the effectiveness of the cement.

Procedure for cementation of prosthesis: to be effective cement

must be fluid and be able to flow into continuous film of 25mm thick
or less without fragmentation. The procedure consists of placing the

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cements on the internal surface of the prosthesis and extending
slightly over the margin, seating it on the preparation, and removing
the excess cement at an appropriate time. Cementation of a single
crown as an example is described with (Fig 5a).

Placement of cement: The cement paste should coat the entire inner
surface of the crown and extend slightly beyond the margin. It should
fill about half of the interior crown volume (Fig 5b).

The clinician should make certain that the occlusal aspect of the tooth
preparation is free of voids to ensure that there is no air entrapment in
the critical area during the early stage of the seating.

Seating: Variables that facilitate seating include using a cement of

lower viscosity, increasing the taper, and decreasing the height of the
crown preparation and creating vibration by tapping on the prosthesis
as the pressure is applied

Moderate finger pressure to displace the cement and seat the crown
on the prepared tooth is used.

An alternatively method is to use a vibrational instrument to facilitate

the seating of the prosthesis without creating excess pressure and also
introducing escape vents on the occlusal aspect of the prosthesis has
been advocated.

After the marginal gap area is evaluated for closure with an explorer
the patient may be asked to complete the seating by biting on a soft

9
piece of wood which is static method and a round stick rolling on the
crown which is called as dynamic method.

During this stage, the last increment of excess cement is expelled

through the space between the prosthesis and the tooth as the
prosthesis reaches its final position on the preparation.

Evaluate the marginal gap area and the occlusion to confirm the
seating of the crown.

The data of Hoard et al using a model full crown die system showed
that the most fluid cement (zinc oxide eugenol) generated least
hydraulic pressures during seating followed by polycarboxylate, with
zinc phosphate exhibiting greatest peak and residual hydraulic
pressure.

Both Eames and associates and Hembree and Coworkers have

confirmed that venting is a satisfactory method of achieving minimal
film thickness under crowns.

In addition to venting, provision of a 30mm relief space or etching

away the interior of the casting have been suggested. Eames et al
found better seating of full crowns using 10 and 20° convergence
angles and recommended the most satisfactory technique for allowing
escape of cement to be a die relief method.

A thick layer of cement (increased viscosity poses two problems:

1. The prosthesis may be in hyper occlusion.

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2. The thicker cement gap may increase the risk for marginal ditching
which may occur when using a hard scaling and root planing
instrument.

Removal of Excess cement:

The excess cement accumulates around the marginal area at the

completion of seating. Its removal depends on the properties of the
cement used. If the cement sets to a brittle state and does not adhere
to the surrounding surfaces, the tooth and the prosthesis, it is best
removed after it sets. This applies to zinc phosphate, silicophasphate,
and ZoE cements. For glass ionomer cements, polycarboxylate
cements and resin based cements that are potentially capable of
adhering both chemically and physically to the surrounding surfaces
the protocol of excess cement removal varies. One can coat the
surrounding surface with a separating medium such as petroleum
jelly, thereby inhibiting the materials adherence to the surfaces, and
remove the excess after the cement sets. Another technique involves
the removal of excess cement as soon as the seating is completed,
thus preventing the material from adhering to the adjacent surfaces.

Post cementation:

Aqueous based cements continue to mature over time well after they
have passed the defined setting time. If they are allowed to mature is
an isolated environment, that is free of contamination from
surrounding moisture and free from loss of water through
evaporation, the cements will acquire additional strength and become

11
more resistance to dissolution. It is recommended that coats of
varnish or a bonding agent should be placed around the margin before
the patient is discharged.

Dislodgement of prosthesis:

Fixed prostheses can debond because of biologic or physical reasons

or a combination of the two. Recurrent caries results from a biologic
origin. Disintegration of the cements can result from fracture or
erosion of the cement. For brittle prostheses, such as glass ceramic
crowns, fracture of the prosthesis also occurs because of physical
factors, including intraoral forces, flaws within the crown surfaces,
and voids with in the cement layer.

In the oral environment cementation agents are immersed in an

aqueous solution. In this environment the cement layer near the
margin can dissolve and erode leaving a space (Fig 7). This space can
be susceptible to plaque accumulation and recurrent caries; therefore,
the margin should be protected with a coating (if possible) to allow
continues setting of the cement. There are two basic modes of failure
associated with cements. Cohesive fracture of the cement (Fig 8a);
and separation along the interface (Fig 8 b) because the cement layer
is the weakest link of the entire assembly, one should favor higher
strength cements to enhance retention and prevent prosthesis
dislodgement by providing a firm support base against applied forces.

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Factors influencing the retention of fixed prosthesis:

1. Film thickness:

It is believed that thinner film has lesser flaws compared with a

thicker one.

2. Cement should have high strength required to dislodge appliances

cemented with cements that have higher tensile strengths than with
cements of low tensile strengths.

3. Dimensional changes occurring in the cement during setting should

be minimized.

4. A cement with the potential of chemically bonding to the tooth and

prostheses surface or bond enhancing intermediate layer may be used
to reduce the potential of separation of the interface and maximize the
effect of the inherent strength.

Cementation procedures:

Passive luting materials:

1. Cementation with zinc phosphate cement:

-Oldest of currently available luting materials having been available,

unchanged, for 100 years.

-Main component of powder- zinc oxide.

-Liquid contains aqueous solution of phosphoric acid (upto 60%)

concentration.

Setting reaction:

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Surfaces of zinc oxide react with phosphoric acid to form an insoluble
phosphate.

Cementation with zinc phosphate:

Isolation:

The field must be kept dry during the final placement of the
restoration and hardening of the cement. The quadrant containing the
tooth being restored is isolated with cotton rolls and a suction device
such as a saliva ejector for the maxillary arch and a svedopter for the
mandibular arch.

Protection:

If the tooth is vital it is customarily protected from the acidity of the

cement. It has been reported that nearly 18% of teeth restored with
cores and full crowns later experienced pulpal necrosis. More often
than not, a tooth receiving a crown has already been subjected to
multiple insults from caries and previous restorations, in addition to
the crown preparation and impression procedures. Possible trauma
from zinc phosphate cement should be minimized.

Partial protection of the pulp can be provided by the application of

two thin layers of cavity varnish.

It is applied to the dry tooth with cotton pellets and lightly blown dry
after each application. This partially seals the dentinal tubules and
protects the pulp from the phosphoric acid. The fact that the cement is
irritating the pulp is evidenced by the pain an un-anesthetized patient
sometimes experiences when a crown is cemented over a vital,

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unvarnished tooth. Because varnish does reduce the retention of a
crown, it should not be used on non-vital teeth or with other types of
cements. A bonding agent can also be used for this purpose.

Procedure:

1. Mixing: Place powder on one end of a glass slab that has been
cooled in tap water and wiped dry. At the center of the slab, measure
out approximately six drops of liquid for each unit to be cemented.
The composition of the liquid may be altered by prolonged exposure
to air. Both the loss and gain of water adversely affect the properties.

Use a spatula to divide the powder into small increments

approximately 3mm on a side. Move one increment across the slab
and incorporate it into the liquid, mixing it for 20 seconds across a
wide area. This will aid in neutralizing the acid and retarding the
setting time. Continue to add small increments of powder, mixing
each for 10 to 20 seconds using a circular motion and covering a wide
surface area of the slab. During mixing zinc phosphate liberates heat
that can unduly accelerate its setting. Therefore, it must be mixed
slowly on a wide surface area on a cool glass slab to insure that a
maximum amount can be incorporated into a mix that is still
workable. On the other hand, if the mixture becomes too thick, the
restoration may be prevented from seating completely.

2. Setting: The setting time can be controlled by the rate at which

powder is incorporated into the mix. If powder is added slowly, the
setting time will be prolonged. If powder is added more rapidly, the

15
setting time will be shortened, less powder will be incorporated and
resultant cement will be weaker and more acidic.

3. Consistency: Check the consistency by slowly lifting the spatula.

When the consistency is right, it will string out about 10mm between
the spatula and slab before it runs back onto the slab. If it runs
quickly off the spatula, it is too thin, and if it must be nudged off the
spatula, it is too thick. A mixture that is too thick cannot be salvaged
by adding more liquid. Clean the slab and start over.

4. Loading the cement: Quickly load the clean, dry restoration with
cement, brush or wipe cement on the inner surfaces of the restoration.
Brushed on cement produced a seating discrepancy one-third less
than that resulting from filling the crown completely full. If there are
recessed features on the preparation, such as box forms or grooves,
apply some cement directly on the preparation with a plastic
applicator. Insert cement into the pin holes with a small lentulo-spiral
or the tip of a periodontal probe. Place cement directly into inlay
cavity preparation. At this time the tooth should still be dry. If there is
persistent contamination from gingival fluids, it may be necessary to
place retraction cord in the sulcus for a few minutes and make a fresh
mix of cement.

5. Seating: Seat the restoration on the tooth and , if it is a posterior

tooth with uniform occlusion, have the patient apply force to the
occlusal surface of the restoration by closing on –a plastic wafer, or
an orange wood stick .

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6. Post cementation: After the restoration is completely seated, keep
the field dry until the cement has hardened. The solubility of zinc
phosphate is greatly increased by premature contact with moisture. If
the patient salivates heavily, the suction device mustbe left in place
during seating of the restoration and hardening of the cement.

No attempt should be made to remove excess cement while it is soft.

The excess cement helps protect the margins during setting.
Furthermore, large masses of hardened cement will break away more
easily and cleanly than will thin, smeared films. Once the cement has
completely set, remove all excess with a scaler, explorer, and knotted
dental floss. Cement left in the gingival crevice can be very irritating
to the tissue. The entire crevice should be checked with an explorer
several times to insure that all of the cement has been removed.

Cementation with polycarboxylate cement:

Isolation:

Similar to zinc polycarboxylate. In addition,

-Sandblast the inside of the casting to ensure maximum retention.

-Coat the outside of the casting with petrolatum to prevent the cement
from sticking where it is not needed.

Procedure:

1. Mixing: The powder-liquid ratio for this type of cement is 1.5 parts
powder to 1.0 part liquid. Dispense one measure of powder for each
restoration to be cemented.

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Express 1.0ml of liquid from the graduated syringe for each measure
of powder and begin mixing immediately. The powder must be
incorporated immediately and the spatulation must be completed
within 30 seconds.

2. Isolating: Coat the inside of the casting with cement, and place
some on the tooth while the cement is still glossy. Place the casting
on the tooth with finger pressure. Then instruct the patient to bite on a
plastic wafer or a wooden stick. If the cement becomes dull in
appearance before the casting is cemented, remove the cement from
the casting and repeat the procedure. There is approximately 3 min. of
working time after the 30 seconds spatulation is completed.

3. Post cementation: Remove cement from the casting in the mouth

before it becomes rubbery, or after it has set. Removing the cement
while it is in its elastic semi-set stage may pull some out from under
the margin of the restoration, leaving a void in the cement near the
margin. Keep the restored tooth isolated and dry until the cement has
set completely.

Cementation with glass ionomer cement:

The glass ionomer luting cements were developed in 1978. These

cements contain an ion-leachable fluoro-alumino-silicate glass which
reacts with a water soluble polymeric acid acqueous
poly(alkenoic)acid.

The outer layers of the glass particles are decomposed, leading to

release of Ca, Al and F ions.

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 The set cement is therefore a core of unreacted glass particles
sheathed by a siliceous hydrogel bound together by the reaction
products.

-Isolation: Similar to zinc polycarboxylate cement.

-Procedure:

1. Tooth preparation:

-Dry and clean the tooth.

-Do not apply varnish and do not etch the tooth.

2. Mixing:

-Powder-liquid ratio is one scoop of powder for two drops of liquid.

-Shake the bottle and then place two level scoops of powder and four
drops of liquid onto a glass slab. Mix the cement as quickly as
possible.

-Mix rapidly over smaller surface area. Mix within 60 seconds and
should have a creamy consistency.

-At first, a properly proportioned mixture will appear too thick, but as
the particles dissolve it will become less viscous.

3. Seating:

-Similar to zinc polycarboxylate cement.

4. Post cementation:

-Remove excess cement after it has completely set

-Remove with a scaler, explorer and floss.

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-Protect against moisture-varnish, petrolatum.. before dismissing the
patient.

Van Zeghbroeck, when reviewing luting materials, stated that glass

ionomer luting materials performed less well than expected, and that
these reports of high solubility and hypersensitivity scared the dental
profession back to the more trusted zinc phosphate. These problems
were largely solved by the introduction of resin-modified glass
ionomer materials.

Resin modified glass ionomer luting cements (RMGI):

-Were developed in order to overcome some of the shortcomings of

traditional glass ionomer cements, such as poor tensile strength.

-In addition to the components of glass ionomer materials these

materials also contain a monomer such as 2-hydroxyethyl
methacrylate HEMA or BisGMA. They do not contain any
photoinitiator, so are not capable of light curing.

-They set by typical acid-base reaction.

Advantages over conventional glass ionomer materials include:

-Improved biocompatibility

-Better fluoride release.

-Improved adhesion to tooth.

-Improved physical properties , particularly tensile strength

20
In addition these cements go through a rubbery phase on setting
which facilitates clean-up.

Eg. Fuji- Plus (GC Co, Tokyo, Japan), Fuji Cem (GC) with its novel
dispenser and RelyX (3M ESPE, Seefeld Germany).

Active luting materials:

1. Resin-based luting materials:

Although glass ionomer materials bond to enamel and dentine they

are not capable of active luting because they do not achieve a bond to
the fitting surface of restorations.

This is only currently achievable with resin composite luting

materials which may bond to the prepared tooth by the use of a
dentine bonding agent. Self adhesive are available. These materials
may also be bonded to ceramic surface which has been rendered
micromechanically retentive by treatment with acids such as
hydrofluoric acid, while bonding to metal surfaces may be achieved
by oxidizing or tin-plating gold surfaces.

Contain- silanated filler and a resin such as Bis GMA.

Physical properties include:

Excellent compressive and tensile strengths and fatigue toughness.

Low solubility in oral fluids.

Low potential for microleakage when bonded to the tooth by an

intermediary bonding system.

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High biocompatibility when used with dentin bonding system.

Different shades available.

Cementation with resin cements:

Step-step procedure panavia resin cement.

Special considerations:

-Gold inlays

-Custom cast dowel cores.

-All ceramic restorations i.e. crowns and laminates.

-Metal ceramic crowns.

-Fixed partial dentures.

Cementation of veneers:

Clean the prepared tooth with nonfluoride pumice and try in the
porcelain veneers. Verify the marginal fit. A drop of water or
glycerine will help the veneer stay in place on the tooth during try-in.
If there is an overhang, trim it with a fine-grit diamond. After
verifying the marginal fit, evaluate the proximal contacts.

The final appearance of a veneer is affected by the shade of cement

used. Isolate the teeth with Mylar strips. Determine the correct shade
or blend of shades by seating the veneer or inlay on the un-etched

22
tooth with resin cement. Avoid exposure to high-intensuty light to
prevent bonding at this time.

Now clean the veneer with a solvent such as acetone. Pumice the
teeth to remove any traces of polymerized composite resin.

Apply a 30% phosphoric acid etchant gel to the prepared tooth and
allow it to remain 1min. Thoroughly rinse the tooth with a steady
stream of water for 30 seconds and dry with air.

Check that the tooth surface has the dull, frosted-white appearance of
properly etched enamel.

Apply the silane coupling agent or primer to the inside surface of the
veneer and allow it to remain in contact with the etched porcelain for
1 min.

-Dry veneer with an air syringe.

-Apply the previously selected luting cement to the internal surface of

the veneer and carefully seat it on the etched tooth; applying gentle
finger pressure. Excessive pressure could fracture the veneer.

-Apply a visible light-curing unit for 10 sec. Again verify the

position. Remove the flash carefully before the resin is completely
polymerized. Continue the polymerization first lingual side ( so that
shrinkage will occur towards the tooth then labial (60 sec each side).

-Once the luting has polymerized, fine grit flame diamonds may be
used to trim the excess composite cement. Check occlusion, which
should be adjusted only after the veneer is bonded to the tooth.

-Finally finish the porcelain.

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-Proximal areas can be finished using mylar strips.

Ceramic crown cementation:

Review of literature:

Russell W. Bassett(1966) in his article on solving the problems of

cementing the full veneer cast crown has listed three fundamental
principles to aid in the seating and sealing of full crown restorations.

These principles are-

-Internal surface relief.

-Perforation of the crown to provide a vent for escape of the cement.

-Over waxing the gingival margins of the crown.

‘The findings of this study indicated that using both internal relief for
the cement, plus a vent for escape of cement permitted minimal
gingival discrepancy following cementation.’

E.Ricardo Schwedheim, Xavier Lepe and Tar Chee Aw (2003)

described a venting technique or cement escape for the cementation
of implant supported restoration. A wax pattern on the die was
prepared and cut back was done for porcelain veneering, following
which an 18-gauge metal stainless steel rod was used to create a vent
for escape of cement.

The casting was performed with conventional method. The crown

was cemented and before the cement could set a stainless steel rod
was inserted to block the vent. A mention has also been made for the

24
use of permanent restorative material such as gold foil, amalgam or
composite resin to fill the vent instead of stainless steel.

Consuel Caeg, Karl E. Leinfelder, William R. Lacefeild and

William Bell (1990) conducted a study to assess the effectiveness of
various surface preparation methods on increasing the bond strength
of resin luting agents to several dental casting alloys( T3, Vitallium
and N72).

The alloys were:

-Electrolytically etched

-Silica treated

-Electrolytically etched and silica treated.

In conclusion they found that the silica-treating process provides a

significantly higher resin-metal bond strength than electrolytic
etching procedure. The simplication of bonding process and
elimination of variables that are involved in etching techniques gives
this procedure an added advantage.

Anthony H.L. et al (1992) conducted a study to evaluate the sealing

ability of a new resin cement (Panavia EX) used in cementation of
cast gold complete crown restorations as compared with those
cemented with standard zinc phosphate cement.

In conclusion they found that, the crowns cemented with Panavia EX

exhibited less marginal leakage than those cemented with zinc
phosphate.

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Sergio Gorodovsky and Omar Zidan (1992) measured the retention
of crowns cemented or bonded with five methods using a zinc
phophate cement, a glass ionomer cement, a resin cement, a with a
dental bonding agent and an adhesive resin cement.

They concluded that there was statistically significant difference

between the groups, attributed to the elevated retentive strength of the
adhesive resin cement.

Jean C. Wu and Peter Wilson (1994): conducted a study to

investigate the cement space necessary for optimal seating of the
crowns cemented with resin luting cements. Zinc phosphate was used
as an acceptable standard against which other luting agents- Panavia
EX and C&B Metabond were compared.

They concluded that increasing the amount of die spacing resulted in

decreased seating discrepancies for all cements.

Summary and Conclusion:

Luting agents possess varied, complex chemistries that affect their

physical properties, longetivity and suitability in different clinical
situations.

It is readily apparent that no single type of cement satisfies all the

characteristics required; and that will suffice in the modern day
practice. One system may be better than the other. One must be aware
of the virtues and shortcomings of each cement type and select them
appropriately.

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References:

1.Ana M.diaz-Arnold et al: Current status of luting agents in fixed

prosthodontics. Jpd(1999);81:135-141.

2.Anthony H.L. Tjan, Dr. Dent, James R. Dunn and Ben E. Grant:
Marginal leakage of cast gold crown luted with an adhesive resin
cement. Jpd (1992);67:115.

3.Anusavice: Phillips science of dental materials. 11th edition;

Saunders 2003.

4.Burke Trevor FJ: Trends in indirect dentistry:3. Luitn Materials.

Dent Update 2005;32:251-260.

5.Consuelo Caeg, Karl E. Leinfelder, William R. Lancefield and

William Bell:Effectiveness of a method used in bonding resins to
metal. Jpd (1990);64:1.

6.E.Ricardo Schwedhelm, Xvier Lepe, Tar Chee Aw: A crown

venting technique for the cementation of implant-supported
crowns.Jpd(2003);89:89-90.

7.Mitchell C.A: Selection of materials for post cementation. Deant

Update (2000);27:350-354.

8.Rosensteil S.F. et al: Denatl luting agents: A review of the current

literature. Jpd (1998);80:280-301.

9.Russel W. Bassett: Solving the problem of cementing the full

veneer cast gold crown.Jpd (1966);45:400-404.

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10.Sergio Gorodovsky and Omar Zidan: Retentive strength,
disintegration and marginal quality of luting cements. Jpd
(1992);68:269-274.

11.Shane N. White and Zhaokun Yu: Film thickness of new luting

agents. Jpd 1992;67:782-785. -Shillinberg H.T. et al: Fundamentals of
fixed prosthodontics. Chicago 1997, Quintessence Publishing Co.

12.Tylmans Theory and Practice of Fixed Prosthodontics 8th

Edition;U.S.A.2000.

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