Allcem is a radiopaque and dual-curing permanent resin cement. It allows for a variety of applications in indirect restorations.
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Description

Allcem is composed of a base paste and catalyst base. The base paste is responsible for the pigmentation of the product and is mixed with the catalyst paste, initiating the chemical cure of the resin cement. It is available in the colors A1, A2, A3 and Trans, which presents a colorless appearance with high translucency, suitable for the cementation of intraradicular posts.
To accelerate the curing process, the product can be light cured – resulting in the dual cure. The product is designed so that when the pastes are mixed in the proportion 1:1 by weight it generates increased adhesive strength, high flexural strength and a high degree of conversion of both in the chemical and dual cure.
Allcem has excellent adhesive and mechanical properties as well as ease of application due to the dual-body syringe, which guarantees the extrusion of the product in the correct proportions (1:1). The self-mixing nozzles guarantee the homogeneity of the pastes and prevent the inclusion of air bubbles.

Presentation

• 1 packaging with 1 double-body syringe with 5g, available in colors: A1, A2, A3 orTrans.

• 5 mixing nozzles.

• 1 syringe with 2.5g in colors: A1, A2, A3 (Universal) and Trans.

• 1 syringe with 2.5g.

• Packaging containing 20 units of mixing nozzles.

Characteristics and Advantages

  • • Dual cure: light and chemically curing, ensuring curing even in the total absence of light. Allcem guarantees maintenance of the same mechanical properties for both the chemical and dual cures.
  • • Optimized rheological properties provide the product with adequate handling and application.
  • • High adhesive strength on different surfaces (indirect restorations with composites, ceramics, metal-ceramic, metals, fiberglass posts and ceramic or metal endodontic cores).
  • • Guaranteed mixing of pastes without the inclusion of bubbles with the use of the self-mixing nozzle.
  • • Excellent mechanical properties in the chemical curing mechanism as well as in the dual curing.
  • • The is product is easy to use due to its dual-body syringe that guarantees the proportion of 1:1 (base and catalyst pastes);
  • • Available in colors: Trans, A3 (universal), A1 and A2.
  • • Broad application range.
  • • The Whitepost, Prosil and Allcem combination presents perfect compatibility, resulting in excellent clinical performance.

Indications

• Bonding of indirect restorations to the dental structure. May be used for the cementation of:
–  Full porcelain crowns and bridges or fused to precious, semi-precious or non-precious metals (metal-ceramic) pieces.
– Inlays, onlays, crowns and veneers made of porcelain or composite resin.
– Fiberglass, ceramic or metallic intraradicular posts.
– Maryland Bridges (adhesive prosthesis).

Step by Step

Step by step
Tooth preparation

Step 1

Isolate the tooth and use a retraction system when the margin is subgingival to ensure that no contamination occurs during preparation.

Step 2

Properly clean the preparations with pumice and cup for prophylaxis, condition the enamel and dentin for 15 seconds with 37% phosphoric acid (Condac 37, FGM). Wash with plenty of water for 10 seconds. After making sure that all the acid has been removed, dry the preparation slightly with air leaving the dentin tissue moistened.

Step 3

Apply adhesive (with a brush or micro applicator) and proceed to light cure according to the manufacturer’s instructions. Allcem is not compatible with one-step self-etching acid adhesives. The high acidity of such adhesives may prevent the chemical cure of the resin.

Cementation of full metal-free, metal-ceramic or resin crowns.

Step 1

The metal-free porcelain or metal-ceramic piece must be previously submitted to treatment after application of aluminum oxide by the laboratory to generate superficial micro porosity as well as in the case of full resin pieces. Prepare the porcelain piece by applying 5 or 10% hydrochloric acid gel (Condac Porcelana, FGM) for the time indicated by the ceramics manufacturer on the inner surface of the piece that will be in contact with the resin cement. Wash with plenty of water until complete removal of the acid and then dry.

Step 2

Silanization of the piece: apply silane (Prosil, FGM) on the piece with the help of a disposable micro applicator (Cavibrush, FGM) and wait 1 minute. Dry the surface with light jets of air.

Step 3

Select the suitable Allcem color for cementation of the piece.
Single body syringes: dispense the appropriate amount of the Allcem resin cement on the mixing block at the 1:1 proportion and mix the pastes for 10 seconds with a plastic spatula.
Dual-body syringe: place the mixing nozzle on the indicated location. Push the plunger and direct the nozzle to the inner part of the piece to be cemented. The nozzle should be disposed after use.

Step 4

Apply a thin layer of cement on the inside of the prosthetic piece or the dental cavity covering the entire surface.

Step 5

Place the piece in the tooth carefully allowing the cement to drain slowly from all the margins.

Step 6

Keep the piece in position and begin cleaning the excess cement after about 3-5 minutes from the start of mixing of the pastes. If excess cement is removed immediately after the positioning of the piece the edges should be light cured to prevent the effect of the layer inhibited by oxygen.

Step 7

In the case of minimally retentive restorations, position the piece and keep it fixed during the excess cement cleaning process.

Step 8

After allowing the chemical cure for 3-5 minutes and removing the excess cement, light cure each surface and the edges for 40 seconds or allow the chemical cure to continue up to 10 minutes after mixing the pastes.

Note: For porcelain and composite resin pices, the edges must be light cured for 40 seconds to ensure the immediate fixation of the piece.

Step 9

Proceed with polishing for the final finish.

Note: After light curing the restorations and edges, remove the excess with the aid of a scalpel blade. The use of rotating instruments should be avoided before the complete hardening of the cement.

Step 10

Instruct the patient not to exert force on the restoration within 15 minutes after fixing the piece.

Cementation of intraradicular posts

Step 1

Prepare the endodontically treated tooth to receive the post by dimensioning the root canal and the post.

Step 2

Etch the enamel and the dentin for 15 seconds with 37% phosphoric acid gel (Condac 37, FGM). Rinse with plenty of water and check that all of the acid has been removed. Dry the canal with the aid of a paper cone.

Step 3

Apply the adhesive with the aid of a disposable micro applicator (Cavibrush, FGM) rubbing it in the root canal for 15 seconds to cover the walls with a thin layer of adhesive.

Check if there are no deposits of adhesive within the root canal. Follow the manufacturer’s instructions for evaporation of the solvent with air and light curing time.

Step 4

Prepare the intraradicular post (Whitepost, FGM) applying a layer of Prosil (FGM) and wait 1 minute for evaporation. Dry the surface with light jets of air.

Step 5

Dispense the appropriate amount of the Allcem resin cement in a proportion of 1:1 on the mixing block. Mix the two pastes with a plastic spatula for 10 seconds or in the case of the dual body syringe, attach the applicator nozzle and push the plunger. Apply a thin layer of the mixture over post or apply the cement to the root canal with the aid of appropriate instruments.

Step 6

Position the post in the root canal. Start the cleaning process approximately 3-5 minutes after the insertion of the cement. Light cure for 40 seconds on the occlusal surface to fix the post in position. The use of translucent posts facilitates the passage of light inside the conduit and curing the resin cement along the post.

Step 7

Proceed with reconstruction of the coronal part of the tooth.

FAQ

What is the size of the resin cement particles?

Allcem contains 40nm nanoparticles and microparticles with a size from 0.6 to 2 µm with an average size of 0.9 µm.

Can we use self-etching adhesive with the resin cement?

No. Self-etching adhesives are acid and alter the tertiary amine, which is a substance present in resin cements, preventing the chemical cure and decreasing the adhesive strength.

What color of Allcem resin cement is recommended for cementation of a Whitepost? Why?

Whitepost may be cemented in the Allcem colors A1, A2, A3 and Trans as the resin cement is dual curing. Full curing of the cement occurs through the chemical cure.

What is the advantage of using a dual body syringe with the aid of the self-mixing nozzle?

The dual-body syringe guarantees the 1:1 proportion of pastes. However, there is an alternative to using the self-mixing nozzle. This nozzle should be attached to the syringe and, when expelling the product, the cap will ensure the mixing of the pastes, allowing the product to be applied to the piece and preventing the inclusion of air bubbles. However, the self-mixing nozzle is disposed of after use, as the product undergoes the chemical curing process inside it.

Is it important for the layer to be thin in the Allcem cementation process?

Yes, less than 50 microns, according to the ADA (American Dental Association) standard. This is for better adaptation and to prevent excessive curing shrinkage, with higher strength. A prosthetic restoration should provide, in addition to aesthetics, satisfactory function and retention, and a perfect fit to the prepared tooth, thereby ensuring suitable sealing of the edges. Incomplete settling of prosthetic crowns may be caused by thick layers of cement that accumulate at the surface of the tooth preparation. Therefore, to minimize the marginal gaps and occlusal discrepancies, the cementing agents should be able to achieve an optimal film thickness during cementation (Donovan & Cho, 1999). Among the factors that influence the thickness of the final layer of cement we can mention: the angle of the axial walls of the preparations, the space for the cement, the force applied during cementation, the type of cement selected, ease of handling, the setting powder, working time, viscosity and amount of particles present (Augustine et al, 2000; Rosenstiel et al, 1998.).

What are the advantages of adhesive cementation in relation to conventional cementation?

Zinc phosphate cement has traditionally been the first choice for the cementation of metal pieces, making it quite popular, although it has some disadvantages such as solubility and lack of adhesion. However, we currently have adhesive cements on the market representing a gain in mechanical properties in general as well as physical properties because they have a lower solubility in the oral environment and, as the technical name says, there is greater adherence to the remaining tooth structure, better distribution of forces and a lower risk of fracture. They allow improved aesthetics, especially in cases of full ceramic. Furthermore, they present:
· High mechanical strength;
· Hardness;
· Micro mechanical bond to enamel and dentin;
· Prevention of micro leakage compared to conventional cements (zinc phosphate, for example);
– Reduced risk of fractures because they distribute the forces exerted on the restored tooth better.

Why is the use of self-etching adhesives contraindicated when using dual or chemically activated cement?

In dual and chemically activated cements, self-etching adhesives in a single bottle should not be used because this decreases the strength of the bond between the resin cement and dentin. Resin cements have a substance (tertiary amine) which contributes to the chemical curing process. The acid adhesives alter this substance preventing the chemical curing process. This is a feature of all resin cements on the market.

What precautions should be taken when using an adhesive cement?

The preparation needs to be carefully assessed, evaluating the preparation depth, so that there is no pulpal hyperemia that may be compounded with the acid attack. It is important to control moisture during the cementation, as well as the removal of any excesses, which is more difficult to perform.

Are there differences in relation to the retention strength of resin cement and conventional cements, considering a preparation without a retention form?

Comparing an in-vitro study and preparations without a retention form, the resin cement retention strength was 9.4MPa, glass ionomer cement was 5MPa and zinc phosphate cement was 3.1MPa. The resin cement was significantly more resistant. Therefore, when the ideal height of the preparation wall or the preparation convergence angle are unfavorable, it is likely that the prosthetic restorations cemented with a resin cement will result in better displacement than those cemented with a conventional cement (Browning et al., 2002 ).

How does the bond between the surface of the tooth and the prosthetic piece occur during adhesive cementation?

The surfaces of the tooth and prosthetic piece require prior treatments that aid the bond between the dental tissue and resin cement, and between the resin cement and restorative material. The bond between the tooth and the resin cement is created through adhesive systems, following the same principles of direct restorations of composite resin, given that the resin cement is a composite with the fluidity required for cementation. The bond between the resin cement and the restoration will depend on the kind of treatment made on the internal surface of the restoration. The different surface treatment techniques include roughening with diamond tips, aluminum blasting, etching with hydrofluoric acid and silanization.

 

The first four methods aim to create micro retentions on the internal surface of the prosthetic piece. Silanization improves the wetting of the surface by the bonding agent. The silane acts as a bridge aiding the chemical bonding of the resin cement to the surface of the ceramic restorations through the silica present in them, bonding to the organic matrix of resin cements.

What is the best surface treatment in indirect restorations?

In ceramic restorations with high silica content, blasting or treatment with hydrofluoric acid etching followed by the application of silane has demonstrated good results. In the In_Ceram and Procera All_Ceram ceramic system mechanical treatment, blasting, hydrofluoric acid etching and silanization are indicated. In Whitepost fiberglass posts, we recommend the use of silane.

What are the curing methods of the cements?

The cement may have different forms of curing such as:
– Chemical Curing: mixing the two components (base and catalyzer) causes curing. Also called self-curing.
– Light Curing: use of a light-curing device.
– Dual Curing: when chemical and light curing occurs. Dual cements are mainly indicated when the filling material has a thickness greater than three millimeters, or when they are very opaque, preventing light from being transmitted to the resin cement. Thus, chemical curing, which begins when mixing the cement, guarantees suitable curing.

What is the advantage of using a dual-curing resin cement?

Dual-curing cements cure chemically and, if the dental surgeon wishes to accelerate the curing process, they can light cure the product. Therefore, there are two curing mechanisms.

What are the main characteristics of the Allcem dual-curing resin cement?

- Two curing mechanisms: light and chemically activated, ensuring the curing of the product even in the total absence of light.
– Wide application spectrum.
– High bond strength on different surfaces.
– High mechanical performance properties both in the chemical and dual curing mechanisms.
– Easy to dispense the product from the double body syringe, ensuring the 1:1 proportion of base and catalyst pastes.
– Ensuring mixture of the pastes without inclusion of bubbles using the self-mixing tip.
– Colors: A1; A2; A3 (Universal), Extra-opaque (Opaque Pearl) and Trans.
– Rheological properties adjusted to facilitate handling and application of the product.

 

References

  1. MAIA, L.G.; VIEIRA, L.C.C. Cimentos resinosos: uma revisão da literatura. J Bras Dent Estét 2003, Curitiba; JUL/SET; 2(7): 258-262.2. VARJÃO, F.M.; SEGALLA, J.C. Estudo sobre espessura de película de quatro cimentos resinosos. Ver. Odontol. UNESP, São Paulo, 31(2): 171 – 177 2002.3. BROWNING, WD et al. Comparison of luting cements for minimally retentive crown preparations. Quintessence Int 2002; 33(2):95-100.

Are Allcem self-mixing nozzles disposable?

Yes. After mixing the base and catalyst pastes, the cement bonds to the inside of the nozzle.

Information for the Professional

Precautions and Contraindications

This product contains contraindications. Consult the Instructions for Use.

• Protect the dental pulp with a lining material and cavity base if there is pulp exposure.
The product may cause some level of irritation if in contact with the dental pulp and/or very close to it.
In the event of allergic reactions to the product, suspend its use.
• Allcem resin cement contains curing monomers that can cause skin sensitization (allergic contact dermatitis) in susceptible individuals. After contact, wash the area immediately with soap and water.
• Allcem contains methacrylates that could be irritant to the eyes. In case of contact, rinse immediately with plenty of water and seek medical attention. To avoid cross infection, do not reuse applicator nozzles. Be sure to close the lid of the packaging after use.
• Do not use materials containing eugenol as a base in order to avoid insufficient curing on the surface.
• To accelerate the curing process, light cure for at least 40s with Halogen or LED equipment with power density equal or superior to 450mW/cm² and emission of spectrum of blue light (400-500 nm).
• Wear protective eyewear when using a light-curing unit.
• Allcem is not compatible with one-step self-etching acid adhesives.
• The high acidity of such adhesives may prevent the chemical cure of the resin.
• Adjust the reflector light so that it does not focus directly on the porcelain veneer during the color selection. This procedure may cause premature light curing of the cement.

Preservation and Storage

• The packaging of the product should be closed immediately after use.
• Store the product in a clean and dry location in its original packaging.
• Do not expose the product to high temperatures or direct sunlight.
• Store the product at temperatures between 5ºC and 20 ºC.
• Do not freeze the product.
• The validity period of the product is 2 years from the production date.
• Do not use the product after its expiration date.
• Follow the legislation of your country for disposal of the product.
• Do not reuse empty packaging.
• Keep out of reach of children.
• Protect the product from external contamination.

Side effects

• The product may cause some level of irritation if in contact with the dental pulp and/or very close to it. In the event of allergic reactions to the product, suspend its use.

Advertências

• Do not use the product after its expiration date.
• Follow the legislation of your country for disposal of the product.
• Do not reuse empty packaging.
• Keep out of reach of children.