Clinical Techniques: Cementation

Summary

In this video, the speaker discusses the ideal cement to use for seating easy pedo or zirconia crowns, emphasizing the benefits of Zlock Ultra for its mechanical retention. He shares his personal preference for hand-mixed glass ionomer cement (Keetac S KXM) over autmix systems due to its cost-effectiveness, faster set time, and resistance to moisture. The speaker demonstrates how to mix the cement and fill the crowns, while also addressing misinformation about cementing zirconia crowns. The video offers practical tips and insight into a proven cementing technique for dental professionals.

Takeaways

• 😀 Zlock Ultra offers strong mechanical retention, allowing the use of various types of cement, including glass ionomer and resin-modified glass ionomer.
• 😀 The speaker's personal preference for cementing stainless steel crowns is hand-mixed glass ionomer, based on years of successful use.
• 😀 Hand-mixed glass ionomer allows for a thicker mix, leading to a faster set time and improved stability during initial set, which is crucial for adhesion.
• 😀 Hand-mixed glass ionomer is more forgiving if the dentin gets wet compared to resin-modified glass ionomer, which improves success rates.
• 😀 Hand-mixed glass ionomer is about 1/3 the cost of an automix delivery system, making it more affordable, especially for multiple posterior units.
• 😀 The cementing process involves filling the crown completely to displace blood or saliva, which is essential for proper seating.
• 😀 The speaker demonstrates the technique for hand-mixing Keetac S KXM, a powder-liquid cement system, with the recommended ratio of two scoops of powder to four drops of liquid.
• 😀 It's advised to practice mixing the cement according to the manufacturer's instructions before adjusting the consistency to personal preference.
• 😀 For mixing, a metal spatula is recommended over the plastic spatula provided in the kit, as it is more effective at mixing the cement.
• 😀 Misinformation about Keetac S not being effective for zirconia crowns is addressed, emphasizing its strong bond and mechanical retention for crowns, including easy pedo crowns.

Q & A

What cement is recommended for cementing easy pedo or zirconia crowns?

The video suggests that with Zlock Ultra, which offers high mechanical retention, you can use any glass ionomer or resin-modified glass ionomer. The speaker's personal preference is hand-mixed glass ionomer.

Why is hand-mixed glass ionomer preferred by the speaker?

Hand-mixed glass ionomer is preferred because it provides a thicker mix than an automix system, which leads to faster set times and better stability during initial setting, especially in the presence of moisture.

What is the benefit of a thicker mix of glass ionomer cement?

A thicker mix of glass ionomer cement helps in faster setting and provides better stability for the restoration during the initial setting, which is crucial for adhesion to the dentin.

How does hand-mixed glass ionomer compare to resin-modified glass ionomer in terms of moisture tolerance?

Hand-mixed glass ionomer is more forgiving when the dentin gets wet compared to resin-modified glass ionomer.

Why is the cost of an automix delivery system a concern?

The automix delivery system is costly, especially if you need to fill the crown completely to displace blood or saliva during seating, which can become significant when seating multiple posterior units.

How do you mix the glass ionomer cement for this procedure?

To mix the cement, use two scoops of powder with four drops of liquid, following the manufacturer's recommendation. The speaker prefers a slightly thicker mix than the recommended one.

What tools are needed for mixing the cement in this process?

The tools required include the powder, liquid (with a dropper), a measuring scooper, a spatula (preferably metal), and a disposable mixing pad.

What is the issue with the spatula provided in the kit?

The plastic spatula included in the kit is not very effective, so the speaker recommends replacing it with a metal spatula for better mixing.

How much cement is needed to fill one posterior or two anterior crowns?

Two scoops of powder are enough to fill one posterior crown or two anterior crowns. If more cement is needed, three scoops of powder are used.

Is the idea that KX Sim is not suitable for zirconia crowns true?

No, the claim that KX Sim is not a good cement for zirconia crowns due to mechanical retention is false. KX Sim bonds effectively with zirconia crowns, as demonstrated in the video.