Clinical Workflow for Cementing Indirect Ceramics with Panavia F2.0
For optimal bonding of indirect ceramic restorations with Panavia F2.0, apply a resin coating layer to the prepared dentin before cementation, as this significantly improves long-term bond strength and reduces microleakage compared to the manufacturer's standard protocol. 1, 2
Tooth Preparation Steps (Chairside - First Appointment)
1. Initial Cavity Preparation and Moisture Control
- Achieve absolute moisture control before any adhesive procedures - moisture contamination is the primary cause of restoration failure with resin-based materials 3
- Use high-velocity air evacuation and proper patient positioning to maintain a completely dry field 3
- Ensure all surfaces are completely dry before applying any adhesive materials 4, 3
2. Apply Resin Coating to Prepared Dentin (Critical Step)
- Apply ED Primer II to the prepared dentin surface according to manufacturer instructions 1, 2
- Coat the ED-primed dentin with an additional resin bonding layer (such as Clearfil Protect Bond) 1, 2
- For deeper preparations, consider adding a flowable resin composite layer (such as Protect Liner F) over the bonding agent for maximum bond strength 2
- This resin coating step significantly reduces microleakage at gingival margins after 6 months compared to standard Panavia F2.0 protocol 1
- Light cure the resin coating layer completely 2
3. Temporization
- Place temporary restoration for 1 day minimum while indirect restoration is fabricated 2
Indirect Restoration Steps (Laboratory/Chairside - Second Appointment)
4. Ceramic Restoration Preparation
- Sandblast ceramic intaglio surface with 50-μm Al2O3 for optimal adhesive retention 4
- Ensure ceramic surface is completely clean and dry 4, 3
5. Final Cementation Protocol
Critical cementation sequence:
- Remove temporary restoration and clean tooth surface
- Re-apply ED Primer II to the resin-coated dentin (groups that used ED Primer II before cementation showed optimal results) 1, 2
- Mix Panavia F2.0 according to manufacturer instructions 1, 5
- Apply the least amount of cement necessary to avoid excess material pooling that could cause complications 4, 3
- Seat the restoration with firm, sustained pressure
- Remove excess cement immediately while still in gel phase
- Light cure through the restoration if thickness permits (irradiance decreases significantly: 600 mW/cm² at 0mm, 200 mW/cm² at 1mm, 90 mW/cm² at 2mm, undetectable at 3mm) 6
- Allow self-cure polymerization for full setting time per manufacturer instructions 6
Key Clinical Considerations
Why Resin Coating Matters
The resin coating technique significantly improves outcomes because:
- Reduces microleakage at gingival margins after 6 months of water storage 1
- Increases microtensile bond strength to cavity floor dentin compared to standard Panavia F2.0 protocol 2
- Creates a more stable hybrid layer that resists degradation over time 1, 2
Curing Mode Considerations
- Panavia F2.0 performs adequately in both dual-cure and self-cure modes 6
- For restorations >2mm thick, rely primarily on self-cure polymerization as light penetration is minimal 6
- Dual-cure mode provides higher bond strength when adequate light reaches the cement 6
Common Pitfalls to Avoid
- Never proceed without complete dryness - moisture will prevent proper adhesion and lead to restoration failure 3
- Do not skip the resin coating step - standard ED Primer II alone shows significantly more microleakage than the resin coating technique 1, 2
- Avoid excessive cement application that could pool in margins 4, 3
- Do not rely solely on light curing for thick restorations (>2mm) as irradiance becomes insufficient 6
Performance Data
- Panavia F2.0 shows the least microleakage among tested cements (0.18mm closed margin, 0.64mm open margin) 5
- Clinical trials demonstrate acceptable 5-year performance with no restoration loss or recurrent caries 7
- Gingival margins consistently show more microleakage than occlusal margins, making the resin coating technique particularly important for subgingival preparations 1