A clinically focused discussion of luting materials

A luting agent's primary function is to fill the minute void between an indirect restoration (definitive or provisional) and tooth (or implant abutment) and mechanically lock the restoration in place to prevent dislodgement during function. The purpose of this paper is to provide a clinically focused discussion on the broad spectrum of luting materials currently available to help the general practitioner make appropriate choices. Resins are typically formulated for a specific function or restoration and offer strength, aesthetics, flexible working times, and very low solubility yet are technique sensitive, expensive and often hard to clean-up. Glass-ionomers offer good strength and optical properties plus the potential for fluoride release/recharge but may have short working times, are sensitive to moisture or dehydration early on, and take time to fully set. Resin-modified glass-ionomers are hybrid, dual-phase materials which are manipulated like glass-ionomer but set quicker and are stronger. Zinc phosphate cement, used successfully for over a century to lute well-fitting metal and metal-ceramic definitive restorations, is a very inexpensive, rigid material which displays very high early compressive strength yet acidity and solubility can be problems. Polycarboxylate cement (a hybrid of zinc phosphate) has lower compressive strength but high tensile strength and may be less injurious to the pulp. Zinc oxide eugenol and zinc oxide non-eugenol cements typically have good sealing abilities but their relatively low compressive and tensile strengths, inherent brittleness, and high solubility limit usage to provisional restorations or implant supported crowns. Claims for multi-purpose or universal use by manufacturers can be somewhat confusing and overwhelming. Even so, the busy general practitioner must have sufficient knowledge to help choose an appropriate luting agent for each unique clinical situation.