Functionality and Esthetics in an RMGI Cement
Inside Dentistry provides the latest in endodontics, implantology, periodontics, and more, with in-depth articles, expert videos, and top industry insights.
December 1, 2020
Volume 16, Issue 12, December 2020
Page(s): p. 50
There is a significant number of dentists who may be, at times, uncomfortable maintaining good isolation for adhesive dentistry in the posterior region of the mouth, and they need a high-performance option. "I love adhesive dentistry, and I do a ton of it," says Robert Ritter, DMD. "However, in situations in which the patient has some functional issues and has to have teeth restored, the ability to access the posterior of the mouth for nonadhesive dentistry and feel really confident about the long-term success of the restorations is a tremendous advantage for dentists. I think there is a place for resin-modified glass ionomers (RMGIs) in these situations."
In a recent discussion with Product Talk, Ritter recounted his experience using GC America's GC FujiCEM® Evolve, a highly radiopaque resin-reinforced glass-ionomer cement with a syringe delivery system. It can be used for the cementation of different types of indirect restorations to a variety of substrates. With an excellent, stable bond strength, it is ideal for the cementation of zirconia, porcelain-fused-to-metal (PFM), and lithium disilicate restorations. The addition of a photoinitiator to the GC FujiCEM Evolve formula facilitates the ability to tack cure the cement, which is a favorite feature for many users.
"It's a great feature," Ritter explains. "Having the ability to traditionally cement my zirconia restorations, without having to go through multistep procedures to adhesively bond them to tooth structure, is a huge upgrade. The process is less stressful and very predictable."
GC America recommends a 3-second tack cure time for GC FujiCEM Evolve, although clinicians may want to experiment with that in different situations. "I go for 3 seconds, but I'm also making sure that the power level on my curing light is set to regular or lower power," Ritter says. "If you have it on high power or at high intensity power, you could almost get this to set completely, and that would result in a slightly more difficult cleanup. Although RMGIs are typically pretty easy to clean up, I would always check the intensity of your light before you start."
GC FujiCEM Evolve offers ergonomic syringe delivery with no need for a dispenser, and its improved radiopacity results in easy visualization on x-ray images. Users note that it possesses a more natural shade than the opaque white of many other RMGIs, which is more esthetic under zirconia and at the margins. "I absolutely love the natural tooth color," Ritter says. "It helps blend the restoration at the margin. You don't get the potential for white lines when supragingival. It also sometimes helps to tone down the overall brightness of the restoration, which can be high value these days because we're using more high-value ingots with zirconia and other pressables. So definitely, I'm really pleased with the A2 shade. It's a great improvement."
Another advantage of GC FujiCEM Evolve is that it doesn't require clinicians to significantly change their practice workflows. For example, GC America notes that clinicians definitely don't need a zirconia primer when using GC FujiCEM Evolve, but if one is used, it won't negatively affect the bond strength. If clinicians have always had success using a zirconia primer, they can continue to do so. For the dental team, being able to learn one workflow for every time that zirconia is placed, regardless of the cement used, is an efficiency advantage. "We have two workflows in the practice: one for the ceramics that are etchable/bondable and one for the ceramics that are not truly etchable," Ritter explains. "But we still use a primer on the inside of the restoration in each one of them. It keeps it simple."
Robert Ritter, DMD, maintains a private practice in Jupiter, Florida, and has been speaking for more than 20 years on topics including dental technology and social media for the dental practice.
