An Insight into the Bioactive Luting Cement

A large number of luting agents (dental cements) are available and proper selection can be a daunting task and is usually based on a practitioner’s reliance, on their experience and preference. The literature continues to repeat that ‘‘No available product satisfies the requirements for an ideal luting agent and comprehensive patient care requires several materials…. the best choice is not always easy’’. Ceramic restoration in the form of indirect crowns and fixed partial dentures form the mainstay of oral rehabilitations.  However, their use has made luting procedures more challenging. The aim of cementation is to integrate the restorations with the dental hard tissues, especially with the dentin, supplying retention, marginal sealing, and esthetics. Zirconia FPDs can be luted with conventional cements (zinc phosphate cement and glass ionomer) but they show high solubility and low mechanical resistance in the presence of bioactivity and fluoride release. Commonly used resin luting agents are sensitive to moisture, undergo dimensional changes (polymerization and thermal), show minimum bacterial resistance, and lack dentin remineralization potential, fail to create a natural chemical bond to dentin and lack bioactivity to prevent microleakage. It is proposed that contemporary bioactive esthetic materials have the potential to reduce bacterial microleakage and enhance marginal integrity by showing recharge and renewal of restorative material constituents. The purpose of this article is to review various luting agents, their properties & associated clinical implications and to help the clinician to select an appropriate luting agent for a given clinical situation.