Friday, December 13, 2013
Traditional luting cements remain to this day the staple of every dental practice. As a general practitioner, rarely a day goes by that I do not need a cement I can trust to maintain anything from a fixed indirect restoration to something as simple as a space maintainer for my younger patients.
Thinking back to my first years of clinical practice, the materials I use today for these tasks are a quantum leap over the zinc phosphates and polycarboxylates I used then. Most would agree that we don’t pay as much attention to these products in this era of “adhesive-resin cements,” but it goes without saying traditional cements are still a most-valuable commodity.
I have used many products that some dentists still use today with varying levels of satisfaction and clinical efficacy. Often my choices were based on recommendations from colleagues, what I used in dental school, and what I was willing to try in hopes of producing predictable outcomes. When choosing a long-term cement, I look for the following properties:
- Adaptable to most clinical needs for routine no adhesive fixture placement
- Low film thickness
- Kind to the pulp
- Good compressive strengths
- Easy to use (mix vs. no mix)
- A natural affinity for tooth substrate
- Relative insolubility when exposed to fluids
- Cariostatic activity
- Controlled setting times with adequate working time
- Easy cleanup
Over the years I never found a product that possessed all these properties until I converted to 3M™ ESPE™ RelyX™ Luting Plus Cement. My reason for converting to this product was based on previous use of glass-ionomer cements, which indeed have a natural adherence to tooth substrate, but were not the easiest to use with mixing pads and the fact that they were much too soluble. Polycarboxylates behaved more like temporary cements and the zinc phosphates were fairly limited in clinical applications.
Along with the above criteria, RelyX Luting Plus cement includes additional benefits such as a self-mixing tip on a dual barrel cartridge. Also, the product has a built-in light reactive mechanism that allows for the acceleration of the gel phase on demand with a 5-second LED or Halogen curing light per surface. I find this to be highly practical, particularly with our routine use of implant crowns where any residual material left behind puts the patient at risk of peri-implantitis. By doing my cement cleanup first, and allowing for the self-set mechanism to occur, the workflow is greatly improved after full set has occurred in a 5 minute timeframe. This product is also available in a clicker dispenser, which requires hand spatulation.
While I have not measured the film thickness, post adjustments are rare, and the restorations seat completely. I have used this cement successfully for pediatric crowns and bands, full metal crowns, orthodontic bands and long-term temporaries. I know the adhesion is there because when removing the temps, the material adheres strongly to the tooth, which while not the easiest to remove, fulfills the criteria I need for long-term provisionalization, or in situations where I want to minimize sensitivity and promote cariostatic activity due to its sustained-fluoride release.
To be honest, cementation was something I never really enjoyed, but RelyX Luting Plus cement has changed that and has eliminated the need for a larger portfolio of cements. As a best-in-class product that is easy to use with assured outcomes, I’m glad I made the switch.
Review Synopsis
Product
Dental Product Review: 3M™ ESPE™ RelyX™ Luting Plus Cement
The Good
A long-term cement that meets and exceeds all the requirements I need.
The Bad
The cement adheres so well to tooth structure it is not the easiest to remove.
The Bottom Line
RelyX Luting Plus Cement does everything I need a cement to do and eliminates the need to keep multiple cements on hand.