3 0 th A n n i v e r s a r y
REALITY
The information source for esthetic dentistry 2 0 1 6
The Ratings
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(4.8)
RESIN CEMENTS — DUAL-CURED-ONLY — SEP
Panavia V5 INTRODUCTION/MANUFACTURER’S CLAIMS
RAVES & RANTS
Latest and definitely the best version of Panavia. It’s still dual cured, but now it is amine-free, which presumably makes it OK for cementing even thin veneers without the usual yellowing effect of typical base/catalyst products. Half of the evaluators felt it was fine for veneers, while the other half still preferred a single-component, light-cured-only cement, mainly due to the longer working time and track record.
AVERAGE PARTICLE SIZE (μ)
+
Single-component primer that doesn’t require light curing
+
Really nice consistency for easy seating
-
Using it for veneers may be a stretch
Weight
61%
Name of restoration primer could be confusing
Volume
38%
-
MANUFACTURER
Kuraray www.kuraraydental.com Tooth Primer PRICES STANDARD KIT $70.00/4ml ($17.50/ml) $365.00/8.1g Clearfil Ceramic ($45.06/ml) Primer Plus REFILLS $120.00/4ml Cement ($30.00/ml) $164.00/8.1g ($20.25/ml) Try-in Paste $39.00/1.8ml ($21.67/ml)
SHELF LIFE 3 years (refrigerated)
0.01-12.0
FILLER CONTENT
PRIMER Tooth Primer Properly named so you are not tempted to use it on the intaglio of restorations. Contains MDP, HEMA, hydrophilic aliphatic dimethacrylate, accelerators, and water. Clearfil Ceramic Primer Plus for the aforementioned intaglios of restorations. Since it can be used for all types of restorations, the “ceramic” in its name may be confusing to some operators. Contains silane, MDP, and ethanol.
pH 2.0 (Tooth Primer)
Michael B. Miller, D.D.S. – President/Editor-in-Chief
Ingrid R. Castellanos, C.D. – Vice President/Publisher
Editorial Team: David L. Baird, D.D.S., Bellevue, WA; Robert W. Baker, Jr., D.M.D, Ithaca, NY; Nathan S. Birnbaum, D.D.S., Wellesley, MA; Alan A. Boghosian, D.D.S., Chicago, IL; Matthew Brock, D.D.S., C.A.G.S., M.S.D., Chattanooga, TN; Mitch A. Conditt, D.D.S., Fort Worth, TX; Juliana da Costa, D.D.S., M.S., Portland, OR; Marvin A. Fier, D.D.S., Pomona, NY; Daniel Fortin, D.M.D., M.S., Montreal, Canada; George A. Freedman, D.D.S., Toronto, Ont., Canada; Fay Goldstep, D.D.S.; Toronto, Ont., Canada; Gary Henkel, D.D.S., Horsham, PA; David S. Hornbrook, D.D.S., San Diego, CA; Mark E. Jensen, D.D.S., Ph.D., Slidell, LA; Thomas P. Keogh, M.D., D.D.S., Navarra, Spain; Timothy F. Kosinski, M.S., D.D.S., Bingham Farms, MI; So Ran Kwon, D.D.S., M.S., Ph.D., Iowa City, IA; Hannu O. Laamanen, D.D.S., M.S., Turku, Finland; Paul Landman, D.D.S., Chicago, IL; Clarence C. Lindquist, D.D.S., Washington, D.C.; Edward Lynch, M.A., B.D.Sc., Ph.D., Coventry, UK; Hans Malmstrom, D.D.S., Rochester, NY; Sandesh Mayekar, M.D.S., Mumbai, India; Steven McGowan, C.D.T., Seattle, WA; Michael K. McGuire, D.D.S., Houston, TX; Aikaterini Papathanasiou, D.D.S., Boston, MA; Christopher Pescatore, D.M.D., Danville, CA; Stephen D. Poss, D.D.S., Brentwood, TN; Robert G. Ritter, D.M.D., Juniper, FL; Andrew T. Shannon, D.D.S., Vancouver, BC, Canada; Liviu Steier, D.M.D., Mayen, Germany; Franklin Tay, B.D.Sc.(Hons), Ph.D., Augusta, GA; Marcos A. Vargas, D.D.S., M.S., Iowa City, IA; Charles Wakefield, D.D.S., Dallas, TX; Thomas G. Wilson, Jr., D.D.S., Dallas, TX; David Winkler, D.D.S., Windsor Berks, England. A publication member of the American Association of Dental Editors
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FILM THICKNESS (μ) 12
CONSISTENCY AND HANDLING Cement Viscosity was considered acceptable by all evaluators. One evaluator thought it was viscous enough to stay put and fluid enough to flow. Seating pressure was gauged to be easy by all evaluators. Try-In Pastes All evaluators who used them found their viscosity to be acceptable and easy to rinse off.
FLOW 4.5 (except 3.5-4.0 for A2) All shades except A2 are not runny at all, while A2 is slightly runny.
EXTRAORAL WORKING TIME About 2.0 minutes (directions say 1.0 minute intraorally). Most (71%) evaluators considered it to be acceptable even for 2+ restorations, while the other 29% were more conservative and only used it for 1 or 2 restorations at a time.
CLEAN-UP TIME (SELF-CURED MODE) About 2.0 minutes from the beginning of mixing (directions say 3.0 minutes).
SIMULATED INTRAORAL SET TIME About 3.0 minutes from the beginning of mixing (directions say three minutes after seating restoration). All evaluators, however, tack light-cured it and found removing the excess in the gel state to be easy. One evaluator noted that it sets very hard and just like most other resin cements, it is difficult to remove the excess if you allow it to polymerize beyond the gel phase.
SHADES 5 Clear, Universal (A2), Opaque, White and Brown (A4). Most (67%) evaluators considered these shades to be acceptable, while the other 33% wanted a better selection, especially if you were intending to use it for veneers. For the Try-In Pastes, most (75%) evaluators thought they matched the cements closely, while the other 25% found some matched but others did not.
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Shade
Description
Clear
Virtually colorless
Universal (A2)
Close match to Vita A2
Opaque
Off-white
Brown (A4)
Darker than A4
White
White
TRANSLUCENCY/OPACITY (T/O) Shade
T/O Rating (%)
Clear
5.4
Universal (A2)
7.6
Opaque
87.6
Brown (A4)
11.2
White
70.8
Clear is very translucent, while Universal and Brown are also very translucent. If you are using it for crowns and/or onlays, Clear should be sufficient. If you plan to cement thin veneers, you may also want to get Universal and Brown or even White for tetracycline cases. If you still provide metal-based, resin-bonded bridges, you may want to purchase Opaque to block out metal shine-through.
OPTIMAL LEVEL OF MOISTURE Moist/Dry. Most (57%) evaluators used it moist, while the other 43% dried the preps. For those who advocated the dry technique, several qualified that by stating “dry” did not mean “desiccated”. Those using “moist” qualified that by describing it as “damp”. One evaluator stated he eliminated excess water with a short blast of air.
PRIMER/ADHESIVE Tooth Primer. Apply for 20 seconds using gentle agitation, followed by gentle air to evaporate the solvent. When a prep also included enamel — think onlay — most (85%) evaluators etched the enamel with phosphoric acid all the time before applying the Tooth Primer, while the other 15% used it selectively. One evaluated noted that he used phosphoric acid
PANAVIA V5 2016
on the uncut enamel, presumably to ensure a better marginal seal. Most (61.5%) evaluators applied it for 20 seconds, while 31% chose at least 20 seconds but usually extended that for an additional 10 seconds or so and 7.5% felt comfortable applying it for only 10 seconds. For the application technique, half of the evaluators used gentle agitation, while 29% felt the let sit protocol was acceptable and 21% preferred rubbing/scrubbing. One evaluator noted he applied several continuous layers to ensure a lower pH for better penetration. From a viscosity perspective, all evaluators except one found it to be acceptable, while the lone holdout felt it was too runny. The primer’s odor was considered about the same as other primers by most (71%) evaluators, while the other 29% found it to be less offensive. As far as causing any untoward effects on soft tissue, most (75%) evaluators reported none, while the other 25% found minor irritation, such as turning the tissue white that typically quickly normalizes.
push-type syringe with a thin, angled tip. There are two types of mixing tips, one is conventional for delivering cement inside crowns and the other already has fine gauge ends for accessing postholes. Most evaluators liked the organization in the tackle box, but one evaluator was critical of the lack of space for the additional shades (only one comes in the kit).
DIRECTIONS There are two formats for the directions. The main one, as usual, is multi-language on plain paper in the annoying foldout design. Confusing at first glance — you need to search for the procedure you are doing. One evaluator criticized the nano-sized font as hard to read. Spanish version had a number of poorly translated sections. There is also a plastic-laminated, foldout technique card that is easier to follow compared to the paper version, with color illustrations and good hints. Most evaluators praised this card, although one evaluator noted that the cementation technique of onlays was missing.
DISLODGEMENTS All evaluators reported no dislodgements.
POST-CEMENTATION SENSITIVITY All evaluators except one reported no sensitivity, with the lone holdout reporting a few cases.
PACKAGING The kit comes in a cardboard box shrink-wrapped for security. Product identification is on top, front, one side, and back. Expiration date and shade are on a sticker on one side. Inside the box is a gray, classylooking plastic tackle box with two tiers of blue plastic trays. The top tray includes the cement, primers, and auxiliary items, while the bottom tray has the try-in paste, etchant, and other auxiliary items. The syringe of cement is typical dual-barrel with a moisture-resistant label containing the expiration date and the shade in two, color-coded areas for easy identification. The try-in paste comes in a clear, PANAVIA V5 2016
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REALITY STRENGTHS
No dislodgements and virtually no post-cementation sensitivity reported. Easy to seat restorations. One step primer that doesn’t require light curing. Viscosity and handling very good — not runny. Adequate working time and shades. Very complete kit with ceramic primer included that allows you to cement virtually any type of restoration. Cures well even without light curing. Nice packaging.
WEAKNESSES
Using it for veneers may be a stretch. Directions in Spanish need better translation. Having “ceramic” in the name of the restoration primer may be confusing since it works with all types of restorations.
BOTTOM LINE Resin cement of choice for virtually any type of restoration, although using it for veneers may be questionable.
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PANAVIA V5 2016