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16 June 2023

Adhesive cementation: an unknown world

Massimo Gagliani


A question from an old friend on the subject prompted me to write this editorial. In its ultimate sense it was also intriguing: do new materials have cementation problems? Has the advent of CAD/CAM changed the criteria for cementation?

My good fortune has always been to have good friends and teachers in the field. I learned from them how to reason and not about a specific product or technique. The latter go out of fashion and, above all, if they do not obey certain logic, they must be viewed with suspicion. 

Our publishing house has already produced, through the work of talented researchers, an excellent text about it but I don't want to advertise in this editorial.

I will limit myself to making two purely logical reflections which, more than 30 years after the advent of modern adhesive systems, must be a common heritage.

The first: the diversity of substrates, enamel and dentin, provides different adhesion values. This is an incontrovertible fact. 

The two substrates deserve specific treatment systems to provide the best conditions for "adhesion." Neglecting this peculiarity means ignoring the basic element for conducting a correct adhesive procedure. Ergo, limiting one's knowledge to a system sold as "faso tuto mi" — in a rough translation, “does everything” in English — would be akin to driving on slick tires when it snows.

A second aspect relates to the knowledge of materials. Each material, ceramic or resinous, has a surface treatment system that deserves due attention, which is not marginal and must be put into practice in the dental office. Without attention to these matters, the adhesive bond is fallacious, and everything vanishes.

I have heard the expression, "If something doesn't work, read the instructions." Our instructions are represented by books, articles and conferences which, if doubts remain, perhaps are not read often enough or in terms of events, are not attended enough.

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