The purpose of this split-mouth study was to compare the efficacy of using Bio-active
cement versus Packable glass ionomer for cementation of posterior zirconia pediatric
crowns.

Influence of Luting Cement on the Clinical Outcomes of Zirconia Pediatric Crowns

Deep Caries

Restoration of pulp treated or badly broken down deciduous teeth with full coverage
restoration have shown superior success rate to all other restorative materials.

Restoration of deciduous teeth with esthetic full coverage restoration has been a
challenging aim especially for the more functionally loaded posterior teeth. Due to the
continuous increase in socio-economic standards; restoring posterior teeth with esthetic
restoration is on high demand nowadays.

The recently introduced zirconia pediatric crowns have been very promising in terms of
strength and toughness. Clinical trials on maxillary incisors have shown very high
success rates in terms of retention and gingival health.

The problem of restoring posterior deciduous teeth with pre-fabricated zirconia crowns is
that its retention is only and totally dependent on luting cement, in addition to the
problem of the deteriorated gingival condition around crowns in general.

Being recently introduced to the market; there have not been any clinical trials studying
retention of zirconia posterior pediatric crowns published yet.

Recently introduced bio-active cement [NuSmile® BioCem™] is claimed by the manufacturer
to be the solution of this problem due to the shock absorbing effect, bioactive
components, and antimicrobial effect making it tougher than traditional cements and more
gingival friendly.

Also, experienced clinicians have found that packable glass ionomer gives very acceptable
results for retention of zirconia pediatric crowns. This may be due to the fact that,
pre-fabricated pediatric crown is not well adapted to the prepared tooth creating a
greater gap between the prepared tooth and the crown, resulting in a greater film
thickness of luting cement, which may benefit from the stronger, tougher and less soluble
packable glass ionomer rather than the conventional glass ionomer cement for cementation
of zirconia crowns.

There is no clear evidence whether it's better to cement zirconia based crowns with
conventional or adhesive cement; and to the investigator's knowledge, there is no data
available for the best clinical practice in cementation of zirconia pediatric crowns; and
so, this study was carried out to compare the effectiveness of bio-active cement with
packable glass ionomer when used for cementation of zirconia pediatric crowns.

Bio-active cement

Packable glass ionomer

Influence of Luting Cement on the Clinical Outcomes of Zirconia Pediatric Crowns. A 3 Year Split-Mouth Randomized Controlled Trial

Binary outcome (debonded/not debonded), assessed by examination

Lecturer of Pediatric Dentistry, Faculty of Dentistry, Fayoum University

Binary outcome (Fractured/not fractured), assessed by examination

Bio-active cement dispensed into the crown, and the crown was properly positioned over
the tooth, cement was allowed to self-set for 20 seconds while maintaining gentle
pressure on the crown, then flash cured using a light curing unit to remove excess
cement, buccal and lingual surfaces were light cured for extra 10 seconds each.

Dentin conditioner was applied to the prepared crown surfaces for 20 sec, then rinsed,
and dried. Capsule was activated, mixed for 10 seconds in an amalgamator, then loaded
into the capsule applier to extrude cement directly into the crown, the crown was
properly positioned over the tooth, cement was allowed to self-set for 2 minutes while
maintaining gentle pressure on the crown, excess cement was removed before complete
setting of cement.

Influence of Luting Cement on the Clinical Outcomes of Zirconia Pediatric Crowns

About this trial

Study ID

Status

Type

Phase

Placebo

Accepting

Trial Timing

What is this trial about?

What are the participation requirements?