Bonding Emax- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

This is #19 with an old Heliomolar OL composite that she finally crushed, fracturing the mesial marginal ridge and part of the MB cusp. I did a 3/4 crown style prep as the lingual extention was wide. I'm using Interface, Surpass, Clean and Boost, and A2 Anchor.

Thomas W. Mitchell, DDS, FAGD
Heliomolar composite OL restoration done in 2009 with Simplicity andTitan Flowable. The mesial marginal ridge and part of the MB cusp were fractured off with decay.
Thomas W. Mitchell, DDS, FAGD
A classic 3/4 crown prep for me, extending the lingual margin to just above tissue (the lingual extension of the composite was wide) and leaving the buccal margin about 1/2 way to the tissue.
Thomas W. Mitchell, DDS, FAGD
Standard for me is overzealous (I know) resistance/retension grooving. That may be unnecessary for some, but not me.
Thomas W. Mitchell, DDS, FAGD
Regardless of what I ask for my lab treats the internal surface with some kind of acid.
Thomas W. Mitchell, DDS, FAGD
So I sandblast it off as I want a clean, roughened surface for maximum cement bonding directly to the Emax.
Thomas W. Mitchell, DDS, FAGD
Then let Interface dwell on that surface for 10 secs, dry it and place some Surpass 2, air thin/dry that completely and light cure that for 10 secs.
Thomas W. Mitchell, DDS, FAGD
Then isolate the prep, apply Clean and Boost to clean it, wash and dry and apply Surpass 1,2,and a very thin coat of 3. Light cure that for 10 secs,.
Thomas W. Mitchell, DDS, FAGD
Then squirt Anchor A2 into the crown and seat it. Pulse cure with 3 secs of light from buccal and lingual and clean off the excess. Then keep pulse curing two or three more times and when I'm brave enough I'll floss the contacts. Then check the occlusion (it was slightly high in 2 spots) and adjust. Here I adjusted the opposing PFM crown.
Thomas W. Mitchell, DDS, FAGD
And we're done. Margins were just fine, close to what I see with gold. I did final 10 second cures from each direction.
Thomas W. Mitchell, DDS, FAGD
From the occlusal everything looks good.

Conclusion: 

Even though posterior Emax crowns can be cemented (same technique as Zirconia crowns) I prefer to bond them when I can easily get great isolation. Dr. John Kanca and the guys at Apex have created such great products and logical techniques that these relatively difficult procedures can be accomplished in a reasonable amount of time with easy precision. Hope this helps

Case by: 

Thomas W. Mitchell, DDS, FAGD