The values, however, are significantly poorer than the combination of Visalys® Restorative Primer and Visalys® CemCore.

Bonding test (ISO 29022)
Visalys® Tooth Primer applied to the surface for 20 seconds (see below), then air-dried, followed by curing of Visalys® CemCore without a polymerisation lamp.

Results (averages of 10 specimens):
Metal 1 (titanium): 10.5 MPa
Metal 2 (non-precious metal, NPM): 12.0 MPa
Oxide ceramic (zirconium dioxide, ZrO2): 7.3 MPa
Glass ceramic (lithium disilicate): 5.8 MPa

Summary:
The combination of Visalys® Tooth Primer and Visalys® CemCore achieves sufficient bonding strength on all surfaces (≥ 5 MPa for this setup).
On glass ceramics, adhesion is only minimally above the threshold value of 5 MPa, as without the silane contained in Visalys® Restorative Primer, proper bonding is not possible.

Recommendation:
The bonding values are sufficient, so the respective laboratory need not be concerned about debonding of the connections.
Nevertheless, this combination is contraindicated and is not mentioned in the instructions for use.
In future, choose the correct material combination (Visalys® Tooth Primer for tooth substrate only, Visalys® Restorative Primer for restorative materials).

It is important to determine whether the bonding failed on the tooth side (with residual composite cement on the resin-bonded bridge) or on the restoration side (with residual composite cement on the tooth surface).

Resin-bonded bridges can be somewhat challenging, as they require high bond strength while at the same time offering only a limited surface for adhesion. In this specific case, we recommend selectively etching the enamel surface (see the information in the instructions for use).

For the resin-bonded bridge itself, we recommend following the established procedures, depending on the material from which the bridge is made:

• In the case of zirconium dioxide: sandblasting.
• In the case of silicate ceramic: etching with hydrofluoric acid.

In both cases, Visalys® Restorative Primer is then applied as usual.

The pretreatment of the restoration surface / resin-bonded bridge is very important, as increasing the surface area (through sandblasting or hydrofluoric acid etching) is the key factor for successful bonding.

Before cementation with Visalys® CemCore, Visalys® Tooth Primer is first applied to the tooth surface.

Resin-bonded bridges can be somewhat challenging, as they require high bond strength while at the same time offering only a limited surface for adhesion. In this specific case, we recommend selectively etching the enamel surface (see the information in the instructions for use).

For the resin-bonded bridge itself, we recommend following the established procedures, depending on the material from which the bridge is made:

• In the case of zirconium dioxide: sandblasting.
• In the case of silicate ceramic: etching with hydrofluoric acid.

In both cases, Visalys® Restorative Primer is then applied as usual.

The pretreatment of the restoration surface / resin-bonded bridge is very important, as increasing the surface area (through sandblasting or hydrofluoric acid etching) is the key factor for successful bonding.

Before cementation with Visalys® CemCore, Visalys® Tooth Primer is first applied to the tooth surface.

Thanks to the extremely low water absorption properties of Visalys® CemCore, the risk of tooth fracture is reduced. Visalys® CemCore is a 2-in-1 dual-curing adhesive composite cement and core build-up material. Less material, lower costs and more time. Visalys® CemCore has excellent dimensional stability and, thanks to its unique Active-Connect Technology, guarantees optimal adhesion. Predictable cementation thanks to optimised adhesive bonds for all indirect restorations. Visalys® CemCore is free from bisphenol A.

Want to get acquainted with Visalys® CemCore? Choose the Visalys® CemCore Starter Pack and watch the step-by-step user videos at www.dental4.nl, in which Benelux colleagues talk about their working methods and experiences. Predictable cementation of all indirect restorations, as well as for the fabrication of stump build-ups and build-up fillings. We are happy to share up-to-date and educational information with your team. This can be done online or on location!

Visalys® CemCore from Kettenbach Dental is a dual-curing, reliable adhesive composite cement for the predictable cementation of all indirect restorations. Visalys® CemCore is a 2-in-1 product that can also be used for the fabrication of core build-ups and build-up fillings. Optimised adhesive bonds thanks to the unique Active-Connect Technology. Visalys® CemCore has excellent flow properties, is radiopaque, bisphenol-A-free and ready for use.