Adhesive luting cements--classes, criteria, and usage

Clinical studies have shown that recurrent decay and lack of retention are the major causes of traditional crown and bridge failure. Optimal marginal accuracy and preparation retention form are important pre-requisites for longevity, as well as good patient oral hygiene. In an effort to provide improved clinical success, new classes of luting agents with improved physical properties and new therapeutic capabilities have been developed. Conventional glass ionomer cements provide fluoride release and adhesive properties. Recently introduced resin-modified glass ionomer luting materials add the potential for increased resistance to dissolution and improved physical and biological attributes. The resin luting cements are more difficult to use but provide greatly increased bonding capabilities and are necessary for strength requirements of all-ceramic restorations. This article describes the three classes of adhesive luting materials, provides a comparison of biological and physical properties, describes the indications and limitations of each class, and makes recommendations for clinical usage.