Direct from the Operatory: Cementation Made Simple

By Dr. 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 microgaps 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.

Shows crown preparation ready for cementation
Shows gel stage

The details of my procedure for cementing with Activa cement are:

1. Clean and sandblast the intaglio surface of the crown.

2. Etch the tooth, remoisten with Microprime G (Danville/Zest), apply AllBond Universal (Bisco) but do not cure. Place ACTIVA BioACTIVE-CEMENT in the crown (no need to overfill).

3. 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).

4. Tack cure for just 1-2 seconds in each direction after the gel stage is reached. Use an interproximal carver to slice off excess from tack-cured gel stage. Slicing off the excess prevents pulling out the cement that might be filling any slightly open gaps at the margin.

5. 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.

6. 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.

Shows use of interproximal carver to slice off excess
Cemented crown after clean-up

About Dr. Marty Zase
Dr. Marty Zase received a B.A. from Boston University and his D.M.D. from Tufts University School of Dental Medicine.  A former clinical instructor in restorative dentistry at Tufts, he is guest lecturer in cosmetic dentistry. He has published over sixty dental articles, has served on the editorial or review boards of The Journal of Cosmetic Dentistry, Contemporary Esthetics, and General Dentistry magazines, and lectures internationally on cosmetic dentistry. 

He is one of only about a dozen dentists in the world to have both a Mastership from the Academy of General Dentistry and an Accreditation in Cosmetics from the American Academy of Cosmetic Dentistry. He practices in the Colchester Dental Group and is the only dentist in the greater Hartford area Accredited by the AACD. 

Dr. Zase has developed numerous techniques and instruments that are currently used in modern cosmetic dentistry.  He has been strongly recognized for his contributions to dentistry and dental education.  Dr. Zase has been selected by Dentistry Today magazine as one of the Top Clinicians in Dental Continuing Education for the last eleven years in a row.