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A quick visual technique guide for using Tokuyama Dental's Universal Bond System to place multiple crowns in the same seating appointment. The dentistry in this case is performed by Robert A. Lowe, DDS, FAGD, FICD, FADI, FACD.
A view of the mandibular ceramic restorations on the master model before cementation. The restorations are fabricated from IPS e.max from Ivoclar Vivadent.
First, each restoration is etched with 9% hydrofluoric acid Porcelain Etchant from BISCO for 30 seconds.
Next, the hydrofluoric acid etchant is rinsed thoroughly from the inside of the restorations, then air-dried.
In the next step, a phosphoric acid etch such as Ultra-Etch from Ultradent, is placed on the preparations and after 15 seconds is rinsed off with water for at least another 15 seconds. Next, the preparations are thoroughly air-dried.
Now Consepsis 2% chlorhexidine solution from Ultradent, is used to disinfect the preparation,
Before the excess chlorhexidine is removed using a high volume suction so the tooth structure remains hydrated.
With the preps etched, rinsed, and cleaned, Tokuyama Universal Bond is then applied to the preparations.
The bonding agent is air thinned, which is done to evaporate the solvent.
After placing a coat of Tokuyama Universal Bond on the inside of the restorations, they are then loaded with EsteCem II resin cement from Tokuyama Dental America.
The mandibular incisor restorations are being held in place and positive pressure is applied to express excess cement around the periphery of the margins.
A No. 2 Keystone flat brush from Patterson Dental is bent at a 45-degree angle using a hemostat. It is then used to remove excess cement from the marginal areas of the seated restoration.
Next, the restorations are tacked to place with a curing light so the remaining excess cement can be cleaned away without dislodging the restorations.
Dental tape is now used to remove cement excess from the interproximal areas.
Once cement removal is complete, the restorations are light-cured according to the manufacturer’s instructions.
Here is a facial retracted view of the cemented mandibular ceramic restorations.
Here, a protrusive excursion shows separation of all posterior teeth.
A right lateral working excursion displays separation of all posterior teeth on the patient’s right side.
A left lateral excursion shows separation of all posterior teeth on the patient’s left side. Note that because of the post orthodontic positions of the teeth, the cuspids do not line up. Anterior coupling of the remaining anterior teeth protects the posterior teeth during the functional movement.
The case finished, here is a retracted full arch view of the completed cementation in centric occlusion.
In conclusion here is a retracted full arch view of the completed cementation in centric occlusion at a 1-year postoperative visit.