A 24 month Clinical Evaluation of a Self-Adhesive Resin Cement

Newer generation cement systems, known as self-adhesive cements, use low pH resin primers to simultaneously demineralize and penetrate the mineralized tooth surfaces. Objectives: The purpose of this study is to evaluate the clinical performance of a newly developed self-adhesive cement (SmartCem2 Dentsply –Caulk) for bonding indirect restorations over 24 months. Methods: A total of 20 subjects in need of 35 indirect restorations were recruited for the study. 18 Reinforced Ceramic Crowns (Empress – Ivoclar Vivadent), 10 Zirconia crowns (Cercon –Dentsply Caulk) and 7 inlays and onlays (Empress- Ivoclar Vivadent) were placed by one experienced clinician. Two trained and calibrated examiners (kappa value 0. 8) other than the operating clinician performed all efficacy assessments. Clinical assessments were done for marginal integrity, marginal discoloration, recurrent caries, restoration integrity, sensitivity and gingival index (per Silness and Loe). If there was a disagreement the examiners established a consensus by reviewing and discussing their findings. Results: At 24 months the marginal integrity was rated Alpha in all 34 remaining restorations. Marginal discoloration was rated Alpha in 31 restorations, Bravo in 1 and Charlie in 2. 33 restorations were rated Alpha for recurrent caries and 1 Bravo. All 34 restorations were rated Alpha for integrity and for sensitivity (6 had root canals). Gingival score was rated 1 around 28 restorations and 2 around 6. Conclusion: The SmartCem2 performed satisfactorily after 24 months. It would be expected that this cement can be used with good results when cementing indirect pressed porcelain and zirconia restorations.