Clinical case: Protocol for the adhesive cementation of posts, abutments and crowns

In restorative dentistry, simplifying clinical protocols has become a priority for improving efficiency without compromising quality. The use of universal materials makes it possible to reduce the number of steps, minimise errors and optimise clinical outcomes.

In this context, we present a clinical case by Dr Giuseppe Chiodera involving the rehabilitation of an endodontically treated molar in a 45-year-old male patient, through the placement of a fibre post, adhesive core build-up and the cementation of a monolithic zirconia crown.

The procedure was carried out using a simplified workflow involving:

• RelyX Universal, used for both post and crown cementation.
• Scotchbond Universal Plus, used as an adhesive.
• Filtek One Bulk Fill, for the reconstruction of the stump.

This approach allows for working with fewer products and greater versatility, whilst maintaining reliable and long-lasting clinical results.

Step-by-step clinical protocol

1. Post fit test: The fibre post is inserted into the root canal to check its fit and length. This step is crucial to ensure correct retention and positioning.
2. Application of cement to the canal: RelyX Universal resin cement is applied inside the canal using an extension cannula. This allows for uniform distribution of the material.
3. Post insertion and light curing: The post is positioned, excess cement is removed, and initial light curing is performed to stabilise the restoration.
4. Application of the adhesive: Solventum Scotchbond Universal Plus is applied to the tooth structure to prepare the surface for the core build-up.
5. Drying of the adhesive: Gentle air is applied to evaporate the solvents from the adhesive and improve its penetration into the dental substrate.
6. Light-curing of the adhesive: The adhesive is cured, forming a stable hybrid layer that ensures effective adhesion.
7. Application of the composite: The composite Filtek One Bulk Fill by Solventum is placed on the area to be reconstructed, allowing work to be carried out in large increments.
8. Reconstruction of the stump: Following light curing, the stump is shaped to achieve an anatomical form suitable for the future crown.
9. Final preparation: The final shaping of the stump is carried out, adjusting the form and margins for correct prosthetic fit.
10. Cleaning the preparation: At the cementation appointment, the preparation is carefully cleaned to remove debris and contaminants.
11. Rinsing and drying: The surface is rinsed with water and air-dried, ensuring a clean field prior to cementation.
12. Sandblasting of the crown: The inner surface of the zirconia crown is sandblasted to improve micromechanical retention.
13. Application of cement to the crown: Solventum’s RelyX Universal resin cement is applied to the interior of the restoration prior to placement.
14. Placement of the crown: The crown is positioned over the abutment, allowing for proper seating and the release of excess cement.
15. Initial light-curing of the excess: A brief curing is performed to facilitate the gelation of the cement and simplify its removal.
16. Removal of excess cement: Remnants of cement are removed with a probe, ensuring clean and well-defined margins.
17. Final result (buccal view): The aesthetic integration of the restoration into the dental arch is assessed from a frontal view.
18. Final result (occlusal view): The occlusal anatomy and functional fit of the crown on the masticatory surface are checked.

The use of universal materials in restorative dentistry significantly simplifies clinical procedures without compromising on high-quality results. This case demonstrates how an optimised protocol facilitates the dentist’s daily work, reducing treatment times and improving predictability.

The combination of a versatile resin cement, a universal adhesive and a high-performance composite allows multiple indications to be addressed with a single workflow, offering reliable solutions for both post cementation and core build-up and crown retention. In short, less complexity and greater clinical efficiency to meet the current demands of dental practice.

We hope you found this post useful. To stay up to date, follow us on social media, where we’ll share more articles, useful information, offers and promotions from the dental sector. We look forward to seeing you there!