Technique

The Overlay (Occlusal Veneer) Case Bonding Protocol

May 03, 2022

As part of a year-long celebration to mark BISCO's 40th anniversary, we asked dentists to submit their best cases featuring BISCO products. We hope this case continues to inspire you and your team!  To view all the cases selected and published click on BISCO's BEST: Cases to Inspire You

Case Study: The Overlay (Occlusal Veneer) Case Bonding Protocl
A conservative minimally invasive approach to preserve tooth structure.

Courtesy of Jorge Luna, DDS

Case Description: With this case, I took a conservative approach to preserving tooth structure using an overlay bonding restoration. A 42-year-old female patient came to my of?ce after receiving root canal treatment. Once the tooth was treated, cuspids were preserved to avoid possible fracture of the remaining structure. Cusps were prepped by reduction of 1 mm at the occlusal surface, a VPS impression was taken, and the dental laboratory milled a lithium disilicate overlay (occlusal veneer).

Once we tried in the restoration, ZirClean cleaning gel was applied and then rinsed with water/air. AQUACUT QUATTRO was used on the ceramic surface. Etching was completed with Porcelain Etchant 4% Buffered Hydrofluoric Acid Gel and rinsed with air/water. The double etch technique was used with Select HV Etch 35% phosphoric acid etchant with benzalkonium chloride, then rinsed with air/water. Steam cleaner was applied around the surface to eliminate acid excess and then dried with clean air. Silanization was completed with Porcelain Primer pre-hydrolized silane primer. A heat dryer was used to keep it safe and avoid light and dust. 
 
A rubber dam was placed, and the enamel surface was etched with phosphoric acid, rinsed with air/water, and the surface was gently dried. Two consecutive coats of All-Bond Universal were applied and rubbed. The solvent was then evaporated with air and light curing was performed. 
 
For the bonding stage, eCEMENT dual cured resin cement was applied on the intaglio of the restoration. The restoration was delivered over the tooth surface, with gentle pressure applied, tack cured, then cleaned and flossed. Each tooth was light-cured. Glycerine gel was applied and light-cured. The rubber dam was removed and the restoration polished. 
 
 
After try-in, the restoration is etched with HF acid.
Figure 1: After try-in, the restoration is etched with HF acid.
 
Porcelain Primer is applied to the intaglio of the restoration.  Porcelain Primer is applied to the intaglio of the restoration.
Figures 2A-B: Porcelain Primer is applied to the intaglio of the restoration.
 
Select HV Etch and All-Bond Universal are used in the selec-tive etch technique to bond to the restoration.  Select HV Etch and All-Bond Universal are used in the selec-tive etch technique to bond to the restoration.
Figures 3A-B: Select HV Etch and All-Bond Universal are used in the selec-tive etch technique to bond to the restoration.
 
Restoration is delivered and cemented with Duo-Link Universal.
Figure 4: Restoration is delivered and cemented with Duo-Link Universal.
 
The cemented restoration post-op.
Figure 5: The cemented restoration post-op.
 
Tags: All-Bond Universal, Bonding, Duo-Link Universal, ZirClean