March 3, 2020
by Marty Zase
Pulpdent’s dual-cure ACTIVA BioACTIVE-CEMENT is a game changer. As a bioactive product, the cement not only is a superb adhesive agent but also mimics nature and utilizes saliva as a source of minerals to aid in the natural development of crystalline structure by recharging calcium, phosphates and fluoride along the margins of the crown. These apatite-like deposits fill micro-gaps between the crown and tooth and can help maintain marginal integrity over time. Although the use of bonding agents is stated as optional, I routinely use them on the etched and remoistened tooth preparation. The success of adhesion with this technique is at least partially due to the inclusion of a highly phosphonated eighth generation bonding agent containing MDP, which matches extremely well with Activa’s highly phosphonated resin. This means adhesion is predictable and ideal. Flow is excellent and cleanup is a breeze.
The details of my procedure for cementing with Activa cement are:
Prepare the Crown
Clean and sandblast the inside surface of the crown. Etch the tooth, remoisten with Micro-prime G (Danville/Zest), apply AllBond Universal (Bisco) but do not cure. Place ACTIVA BioACTIVE-CEMENT in the crown (no need to overfill).
Insert the crown
Check margins with an explorer to confirm full seat. ACTIVA BioACTIVE-CEMENT is so flowable, I just have to insert the crown, press down, and hold for two minutes. After two minutes, the ACTIVA BioACTIVE has now self-cured into a semi-solid (gel stage).
Tack cure for just 1-2 seconds in each direction after the gel stage is reached.
Remove excess: Use an interproximal carver to slice off excess from tack-cured gel stage. Unlike using an explorer, slicing off the excess prevents pulling out the cement that might be filling any slightly open gaps at the margin. Use Glide floss (Oral-B) to slice through interproximal excess. Floss again. If there is resistance, use a ContacEZ white serrated separator (ContacEZ).
Fully light cure all margins.
Use a sharp scaler to remove any leftover excess.
RESULTS: Very fast, minimal excess after trimming at gel stage, easy clean up.
I have not had a single crown come off after cementation.
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Disclaimer: The author reports honorarium support from Pulpdent for this article.
About the Author
Marty Zase is an Accredited Member, Accreditation Examiner and Past-President of the AACD, a Master in the AGD, and President-Elect of the New England Academy of Cosmetic Dentistry. He is a Diplomate of the American Board of Aesthetic Dentistry. An international lecturer in cosmetic dentistry, he is well-published and is a reviewer for many dental magazines. He has been honored with both the AGD’s Lifelong Learning and Service Recognition award and the AACD’s Lifetime Achievement Award. Practicing in Connecticut at the Colchester Dental Group, he can be reached at Martyzase@aol.com