To what extent does the longevity of fixed dental prostheses depend on the function of the cement? Working Group 4 materials: cementation

AIMS/BACKGROUND: The objective of this review was to define the impact of cementation mode on the longevity of different types of single tooth restorations and fixed dental prostheses (FDP). METHODS: Literature search by PubMed as the major database was used utilizing the terms namely, adhesive techniques, all-ceramic crowns, cast-metal, cement, cementation, ceramic inlays, gold inlays, metal-ceramic, non-bonded fixed-partial-dentures, porcelain veneers, resin-bonded fixed-partial-dentures, porcelain-fused-to-metal, and implant-supported-restorations together with manual search of non-indexed literature. Cementation of root canal posts and cores were excluded. Due to lack of randomized prospective clinical studies in some fields of cementation, recommendations had to be based on lower evidence level (Centre of Evidence Based Medicine, Oxford) for special applications of current cements. RESULTS: One-hundred-and-twenty-five articles were selected for the review. The primary function of the cementation is to establish reliable retention, a durable seal of the space between the tooth and the restoration, and to provide adequate optical properties. The various types of cements used in dentistry could be mainly divided into two groups: Water-based cements and polymerizing cements. Water-based cements exhibited satisfying long-term clinical performance associated with cast metal (inlays, onlays, partial crowns) as well as single unit metal-ceramic FDPs and multiple unit FDPs with macroretentive preparation designs and adequate marginal fit. Early short-term clinical results with high-strength all-ceramic restorations luted with water-based cements are also promising. Current polymerizing cements cover almost all fields of water-based cements and in addition to that they are mainly indicated for non-retentive restorations. They are able to seal the tooth completely creating hybrid layer formation. Furthermore, adhesive capabilities of polymerizing cements allowed for bonded restorations, promoting at the same time the preservation of dental tissues.