One such material that has taken hold is the non-silica-based ceramic zirconia. In fact, in 2018, 77.6 percent of all indirect restorations were zirconia based, according to Glidewell Laboratories.1 This represents a huge shift in restorative dental materials over the past 10 to 15 years.

A commonly encountered clinical problem with the use of zirconia-based components is the cementation. Additionally, clinicians have widely debated bonding of zirconia. Because of its formulation, zirconia cannot be etched. Etching of a traditional ceramic restoration, along with the use of an Methacryloyloxydecyl Dihydrogen Phosphate- (MDP) based primer, is considered paramount to success in bonding. This is not the case with zirconia-based restorations. Additionally, many clinicians misunderstand the chemistry of zirconia and cements, raising questions over the proper way to cement zirconia and zirconia-based restorations.

About the product
Premier Dental Products is introducing a new cement in the U.S. market that they claim to be revolutionary. The company says the new cement, ZR-Cem, is “an innovative self-adhesive universal resin cement specially formulated for zirconia restorations.” The manufacturer boasts excellent bond strengths, inclusion of the MDP monomer in the chemistry, and formulation with a unique benzoyl peroxide-(BPO), amine-free initiator system that ensures long-term color stability.

Premier also notes that the product is easy to use. Pretreatment of the restoration prior to cementation is not necessary, nor are separate etching or bonding steps for the preparation. The cement also has an optimal viscosity which allows for easy dispensing, placement, and cleanup. ZR-Cem can also be stored at room temperature, with no need for refrigeration, and will still perform as intended.2

The evaluationPremier reached out to Catapult Education to evaluate this cement. Catapult is a group of speakers, reviewers, and practice growth experts throughout North America dedicated to advancing dentistry through education. In addition, the group participates in product evaluations to constantly improve the quality of dentistry that clinicians provide and to give valuable feedback to manufacturers to enhance product development.

For this assessment, 17 evaluators participated. In total, the evaluators use 20 different cements on a regular basis. They were provided with samples of ZR-Cem and asked to participate in a survey. The responses were extremely favorable.

All evaluators felt this new cement performed as well as, if not better than current self-adhesive resin cements used in their practices. While Premier does not offer any other definitive cements, the evaluators noted that this would not deter them from trying ZR-Cem. The latter is the result of the reputation that Premier maintains in the dental marketplace.

The survey asked evaluators about switching cements and incorporating a new cement into their practices. Although they felt that key opinion leader recommendations were important, sample testing, physical testing data, and color stability all ranked high as reasons to switch. According to the manufacturer, the bond strengths and color stability differentiate this cement from others in the same category.

The evaluators were given a list of characteristics that a cement could or should have and were asked to rank them in order of most to least important. In order of greatest importance, the evaluators noted strong, superior bond strength; ease of use/great handling; and fast and easy cleanup. Premier claims that ZR-Cem has all three of the characteristics deemed most important to the evaluators.

At the conclusion of the evaluation, the evaluators were asked a series of questions regarding their initial impression of ZR-Cem. The responses were overwhelmingly favorable. All evaluators felt that this cement performed as described and intended. Additionally, not one evaluator experienced a complication. Furthermore, the vast majority of evaluators felt this cement would enter the market at a great price point for the practicing clinician.

In line with the most important characteristics of a cement noted above, many of the comments from evaluators were related to ease of use/dispensing, ease of cleanup, and overall handling. Not one evaluator reported a single instance of postoperative sensitivity. All evaluators also agreed that the cement warranted regular use in the office.

The evaluators’ final question was, “Would you recommend the product to your peers or include it in your lectures?” The answer again was a resounding and unanimous yes.

Premier has produced a much-needed cement for the largest prescribed classification of indirect restorations in dentistry. Although the cement is marketed toward zirconia-based restorations, this is truly a universal self-adhesive resin cement that performs very well compared with the competition. As such, the evaluators took great pleasure in giving ZR-Cem the Catapult Education Vote of Confidence.