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PANAVIA SA CEMENT Two-year Clinical Performance Report

LONG-TERM CLINICAL PERFORMANCE

RATINGS: Excellent + + + + + Very Good + + + + +++ Good

Kuraray America
(800) 879-1676 www.kuraraydental.com

Description
PANAVIA SA CEMENT is a self-adhesive, dual-cured resin cement with fluoride release. It is based on the PANAVIA and CLEARFIL SE BOND adhesive technology and has a reported film thickness of approximately 20 microns. It is indicated for cementation of crowns and bridges made of metal or ceramic, inlays/onlays, and metal and fiber posts. It is packaged in handmix and automix syringes in Universal (A2) and White shades. CLEARFIL CERAMIC PRIMER is a single-bottle, silane/acidic adhesive monomer (MDP)-based coupling agent for use with indirect porcelain, ceramic, and composite restorations. It may also be used for intraoral porcelain or composite repairs. CLEARFIL CERAMIC PRIMER bonds to feldspathic porcelain, zirconia, alumina, lithium disilicate, and leucite-reinforced ceramics. No hydrofluoric acid etching is necessary for ceramics before using this product. Instructions recommend a single coat followed by air-drying. This product combination received a 98% clinical rating.

Consultants Comments
"Very little marginal discoloration was exhibited during the two years, indicating a strong bond strength" "Applying the ceramic primer during placement was easy and it appears to have enhanced the bond of the cement to the restoration. In most cases, debonds resulted in all residual cement on the internal surface of the crown.

Patients Comment
"My crown feels great." "My crown looks as good today as the day it was cemented." "My bridge chipped but the cement was so strong, it did not come off and the dentist only had to smooth the rough area."

Clinical Evaluation Protocol

A total of 274 restorations were cemented with PANAVIA SA CEMENT. Restorations included: 145 zirconia-based restorations, 121 lithium disilicate restorations, six leucite-reinforced restorations, and two ceramic-metal restorations. Restorations were placed on 236 posterior and 38 anterior teeth. - CLEARFIL CERAMIC PRIMER was applied to the internal surface of the lithium disilicate and leucite-reinforced restorations. - Zirconia restorations were not primed.
Results at Placement
Handling of cement and ease of clean up of excess PANAVIA SA CEMENT received an excellent rating for ease of removal of excess after placement. Fit of restoration All restorations cemented with PANAVIA SA CEMENT had excellent marginal fit. The contacts and occlusion were ideal before cementation. Shade match/esthetics The optimal esthetics of the restorations was maintained after cementing the restorations with PANAVIA SA CEMENT.

Marginal integrity The viscosity of the cement allowed passive cementation of the restorations resulting in preservation of the ideal marginal fit of the restorations.

Initial sensitivity The majority of the teeth exhibited no sensitivity after cementation of the restorations.

THE DENTAL ADVISOR 3110 West Liberty, Ann Arbor, Michigan 48103 (800) 347-1330 info@dentaladvisor.com

2012 Dental Consultants, Inc. #DADV09

LONG-TERM CLINICAL PERFORMANCE

PANAVIA SA CEMENT Two-year Clinical Performance Report + + + + +

A total of 257 restorations, cemented with PANAVIA SA CEMENT, were available for evaluation of clinical performance up to two years after placement. Restorations included: 133 zirconia-based restorations, 116 lithium disilicate restorations, six leucitereinforced restorations, and two ceramic-metal restorations (Figure 1). Restorations observed at recall ranged in age from less than six months to nearly three years (Figure 2). Restorations were evaluated on a 1 5 rating scale: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.
FIGURE 1: Types of Restorations Evaluated at Recall. FIGURE 2: Age of Restorations at Recall.

Zirconia-based Restorations Lithium disilicate Restorations Leucite-Reinforced Restorations Ceramic-metal Restorations

<0.5 Years 0.5-1.5 Years

133 116

44% 34%
5%

1.5-2.5 Years 2.5-3.0 Years

17%

2 6

Clinical Observations
Retention Retention at two years was excellent (Figure 3). Ten posterior crowns (3.9%) debonded during service between four months and 2.5 years and required recementation. Esthetics Esthetics at two years was excellent (Figure 3). The shade of PANAVIA SA CEMENT blended well with the restoration at placement. No shade shift was noted. Resistance to Marginal Staining Resistance to marginal staining at two years was excellent (Figure 3). Three restorations exhibited marginal staining at two years. One restoration had to be remade due to poor marginal fit.
FIGURE 3: Results of PANAVIA SA CEMENT at Two-year Recall
5

4.9

4.9

Lack of Sensitivity 1 Retention Very few patients reported sensitivity (Figure 3). A small number of patients experienced mild sensitivity lasting 2-4 weeks. Five restorations caused mild-moderate sensitivity and two crowns had to be removed as a result of prolonged significant sensitivity.

Esthetics

Resistance to Marginal Staining

Lack of Sensitivity

Resistance to Fracture/ Chipping

Resistance to Fracture/Chipping Resistance to chipping and fracture at two years was excellent (Figure 3). Two crowns and one bridge had to be replaced as a result of fracture. Five crowns exhibited slight chipping that could be polished between one and two years.

Summary
Two hundred fifty-seven restorations, cemented with PANAVIA SA CEMENT, were observed at two years. All restorations received excellent ratings for esthetics, resistance to marginal staining, lack of sensitivity, resistance to fracture/chipping, and retention.

Editors Note
PANAVIA SA CEMENT was initially branded as CLEARFIL SA CEMENT.
THE DENTAL ADVISOR 3110 West Liberty, Ann Arbor, Michigan 48103 (800) 347-1330 info@dentaladvisor.com 2012 Dental Consultants, Inc.