Today more than ever, we have plenty of choices to make when planning and delivering our indirect restorations. Chief among those decisions is whether to bond or cement our restorations.
For me, this decision starts at the treatment planning stage by keeping the following pros and cons in mind.
Pros of bonding restorations
- Very strong and predictable to enamel
- Increases the strength of the restoration
- Increased tolerance to decreased preparation resistance and retention form
- In many cases, enhanced strength of the final restoration
- Increased margin esthetics in supragingival areas
Cons of bonding restorations:
- Isolation is critical
- Decreased predictability on tooth surfaces other than healthy enamel
- Restorative materials must accept bonding to take advantage of many of the pros
- Anesthesia is typically needed for vital teeth
- Clean up can be very difficult
- Tends to be more time consuming
Pros of cementing restorations:
- Clean up is typically easy
- More predictable with preparations with little enamel
- Often no anesthesia is needed
- Tends to be less time consuming
Cons of cementing restorations:
- Does not tend to increase the strength of the final restoration
- More impacted by resistance and retention form of the preparation
- Can’t be used with materials that require bonding
There are a lot of clear pros and cons with both methods. In cases where you must choose bonding, it’s critical to maintain the ability to achieve excellent isolation at delivery and as much enamel as possible.
Assuming I’m using a material that can be either bonded or cemented, it’s necessary to keep in mind whether or not I can achieve excellent isolation; if I can’t, I eliminate bonding. Additionally, if sparse enamel or altered dentin is in my final preparation, I’m going to lean towards cementation. Also, if I don’t need the increased strength, retention, or the marginal esthetics that bonding provides, I’ll select cementation due to its simplicity.
While it’s impossible to discuss all the scenarios for bonding vs. cementing here, I hope this article has given you or reminded you of some things to think about when planning your next case.
John R. Carson, DDS, PC, Spear Visiting Faculty and Contributing Author [www.johnrcarsondds.com]