J Indian Prosthodont Soc

DOI 10.1007/s13191-012-0219-5

ORIGINAL ARTICLE

A Study on Provisional Cements, Cementation Techniques,

and Their Effects on Bonding of Porcelain Laminate Veneers
G. Vinod Kumar • T. Soorya Poduval •

Bipin Reddy • P. Shesha Reddy

Received: 22 October 2012 / Accepted: 28 November 2012

Ó Indian Prosthodontic Society 2013

Abstract Minimal tooth preparation is required for porce- porcelain laminate veneers. For half of the teeth, the smear
lain laminate veneers, but interim restorations are a must to layer was removed before luting provisional restorations.
protect their teeth against thermal insult, chemical irritation, Veneer provisional restorations were fabricated and luted to
and to provide aesthetics. Cement remaining after the removal teeth with six bonding methods: varnish combined with glass
of the provisional restoration can impair the etching quality of ionomer cement (GIC), varnish combined with resin modified
the tooth surface and fit and final bonding of the porcelain GIC, varnish, spot etching combined with dual-cure luting
laminate veneer. This in vitro study examined the tooth sur- cement, adhesive combined with GIC, adhesive combined
face for remaining debris of cement after removal of a pro- with resin modified GIC, and adhesive, spot etching combined
visional restoration. Determine the presence of cement debris with dual-cure luting cement. After removal of provisional
on prepared tooth surface subsequent to the removal of pro- restorations 1 week later, the tooth surface was examined for
visional restoration. Determine the cement with the least residual luting material with SEM. Traces of cement debris
residue following the cleansing procedures. Determine the were found on all the prepared teeth surfaces for all six groups
effect of smear layer on the amount of residual luting cement. which were cemented with different methods. Cement debris
Eighty-four extracted natural anterior teeth were prepared for was seen on teeth subsequent to the removal of provisional’s.
Dual-cure cement had the least residue following the cleans-
ing procedures. Presence of smear layer had no statistical
G. Vinod Kumar (&)
significance in comparison with cement residue. With the use
Sri Sai Dental College & Research Institute, NTR Health
University, Vijayawada, India of adhesive the cement debris was always found to be more
e-mail: [email protected] than with the use of varnish. GIC showed maximum residual
cement followed by dual-cure.
G. Vinod Kumar
TNR’s Rukmini Residency, Door # 302, 16-2-674/5, Judge’s
Colony, New Malakpet, Hyderabad 500036, Andhra Pradesh, Keywords Porcelain laminates veneers  Luting cements 
India Scanning electron microscope (SEM)

T. Soorya Poduval
Bangalore Institute of Dental Sciences, Rajiv Gandhi University
of Health Sciences, Bangalore, India Introduction

T. Soorya Poduval The introduction of porcelain laminates by Pincus in the

1 A, Garden Homes, Aga Abbas Ali Road, Bangalore 560042,
1930 s ushered a new era in the treatment of aesthetic
Karnataka, India
restorations. Their present day applications have evolved
Bipin Reddy greatly. Laminates are a conservative alternative to full
The Oxford Dental College, Bangalore, India coverage crowns for improving the appearance of an
anterior tooth. The long time success of porcelain laminate
P. Shesha Reddy
Govt. Dental College, RIMS Kadapa NTR Health University, veneers depends on careful case selection, design of and
Vijayawada, India meticulous tooth preparation, laboratory fabrication and

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adhesive bonding procedures. The need for temporization Group 4 (B) Prepared tooth surface treated with adhesive
of tooth preparation in porcelain laminate veneers is and provisional cementation done using
advocated for the unchanged patient appearance; and for luting GIC after smear layer was removed.
the overall success of the restoration. Subsequent to the Group 5 (A) Prepared tooth surface treated with adhesive
removal of provisional restorations, debris of the temporary and provisional cementation done using
cement remains on the prepared tooth surfaces. The pres- resin modified GIC with smear layer intact.
ence of this debris hinders the maximum cementing ability Group 5 (B) Prepared tooth surface treated with adhesive
of the final cement and hence there is always the need to and provisional cementation done using resin
find out the extent of cement left after the removal of the modified GIC after smear layer was removed.
provisional restoration. There are few documented evi- Group 6 (A) Prepared tooth surfaces treated with adhesive
dences which support the presence or absence of cement and provisional cementation done using dual
debris after removal of provisional restorations and have cure luting cement with smear layer intact.
any effect on bonding of porcelain laminate veneers. Hence Group 6 (B) Prepared tooth surface treated with adhesive
the present study was designed to analyze the prepared and provisional cementation done using dual
tooth surfaces and evaluate the presence of cement debris cure luting cement after smear layer was
with the help of scanning electron microscope following removed.
the removal of the provisional restorations.
To evaluate whether the smear layer may have any
influence on the remaining cement debris on the tooth
surface, two sub-groups were formed for each method.
Methodology In sub-groups A the smear layer was not removed, in
sub-groups B the smear layer was removed before luting
Eighty-four intact human central incisors were individually the provisional restoration. To remove smear layer the
mounted, to a level just below the cemento-enamel junction, prepared tooth was treated with cotton pellets soaked
in an acrylic base in an upright position. They were randomly with EDTA–sodium salt solution (Nice Chemicals Pvt.
divided into six groups, based on luting method, which has Ltd.) for 60 s. All the six groups were assigned a stan-
14 teeth in each group, and each group will be further divided dard tooth preparation for receiving porcelain laminate
into sub-groups consisting of seven teeth in each sub-group. veneers.
Grouping is done based on the following criteria:
Group 1 (A) Prepared tooth surface treated with varnish Cementation
and provisional cementation done using
luting glass ionomer cement (GIC) with The teeth were taken out of distilled water at the time of
smear layer intact. provisional cementation and each provisional was cemen-
Group 1 (B) Prepared tooth surface treated with varnish ted at a time.
and provisional cementation done using For cementation of the provisional’s three different
luting GIC after smear layer was removed. luting cements were used, GIC Type-I (Ketac CemTM, 3 M
Group 2 (A) Prepared tooth surface treated with varnish ESPE), resin modified cement (Rely XTM LUTE, 3 M
and provisional cementation done using ESPE), and dual cure composite (Calibra, Densply Caulk).
resin modified GIC with smear layer intact. All the teeth were grouped depending upon the removal
Group 2 (B) Prepared tooth surface treated with varnish and non-removal of smear layer, teeth treated with biflu-
and provisional cementation done using oride-12 varnish (Voco, Germany) and bonding agent
resin modified GIC after smear layer was (adhesive) that has been used (Calibra, Densply Caulk).
removed. The cementation was carried out using the manufac-
Group 3 (A) Prepared tooth surface treated with varnish turer’s instruction in the following manner.
and provisional cementation done using dual Group 1, 2, and 3 were treated with varnish and
cure luting cement with smear layer intact. cemented with GIC Type-I, resin modified cement, and
Group 3 (B) Prepared tooth surface treated with varnish and dual cure composite.
provisional cementation done using dual cure With the tooth in group 1 (A) following procedures were
luting cement after smear layer was removed. followed. The tooth surface was cleaned with the help of
Group 4 (A) Prepared tooth surface treated with adhesive Pele Tim foam pellets, and bifluoride 12 resp was applied
and provisional cementation done using and allowed to soak in for 10–20 s. After the tooth surface
luting GIC with smear layer intact. was treated with varnish the recommended powder-to-

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liquid mixing ratio of 3.8:1 w/w, was used, and mixing was cement were visible on the tooth preparation surfaces of all
done under room temperature, and then provisional’s were teeth. However, these particles were partly removed with the
loaded with cement that had to be cemented. excavator. According to the clinical procedures, specimens
With the teeth in group 1 (B) the same above procedure were polished with pumice until no cement particles were
was followed except the teeth were treated with EDTA to visible macroscopically. Teeth were gold coated in a sputter to
remove the smear layer before cementation. make the specimens electrically conductive for scanning
With tooth in the group 2 (A) following procedures were electron microscope examination and evaluated under 159,
followed. After the tooth was treated with varnish, the 509, and 1009 levels of magnification.
tooth was left to dry for 10–20 s. For cementation work,
thin layer of cement was loaded into the provisional’s that Statistical Analysis
had to be cemented and seated in place with light pressure.
Excess cement was removed after 2 min. The hypothesis, whether there is an association between the
With the teeth in group 2 (B) the same above procedures methods group 1, 2, 3, 4, 5, 6, and the cement particles, was
were followed except the teeth were treated with EDTA to tested with the generalization of v2 test (r 9 c test). In
remove the smear layer before cementation. addition, to determine whether the distribution of samples
With tooth in group 3 (A) following procedures were within the sub-groups 1A and B, 2A and B, 3A and B, 4A
followed, after the tooth was treated with varnish, the tooth and B, 5A and B, 6A and B was independent of cement
was left to dry for 10–20 s. For cementation work, the debris, Fisher’s test was applied.
internal surface of the provisional restoration was thor-
oughly cleaned with water spray and air dry and the cou-
pling agent applied to the provisional restoration and the Results
tooth surface on the incisal one third of the tooth, a spot
with average diameter of 2.5 mm was etched for 30 s, with SEM examination revealed that for group 1 (var-
37 % phosphoric acid gel and rinsed for 10 s and blot dried nish ? GIC Type-I) 12 out of 14 specimens exhibit parts of
to keep away moisture. A dimple was created opposite to cement that present over the prepared surface (Fig. 1a).
the etched spot in the veneer provisional restoration. The The cement residual appeared flattened (Fig. 1b) as a result
desired amount of the cement was dispensed on to the of polishing with pumice and water but were not com-
prepared provisional’s, and loaded in place. Excess cement pletely removed. The resin modified GIC, cemented on the
was removed from gingival margin with a blunt instrument teeth (14) subjected to group 2; covered most of the tooth
and only the gingival margin was light cured to tack the surface, 10 out of 14 teeth that were examined has shown
provisional restoration in place and then finally the provi- the cement residual (Fig. 2). Of (14) specimens of group 3,
sional restoration on the whole was cured for 20 s each out of 14 teeth only three teeth showed cement residual or
from facial, lingual, and proximal surfaces. varnish on the prepared tooth surface.(Figs. 3a, b) clean
With the teeth in group 3 (B) the same above procedures prepared tooth surface has been achieved.
were followed except that the teeth were treated with For group 4 (adhesive ? GIC Type-I) 13 of 14 specimens
EDTA to remove smear layer before cementation. showed cement residual on the tooth surface, the specimens
The same procedure was used for the teeth in group 4, 5, showed flattened remains (Fig. 4) as a result of cleansing
and 6; that have been treated with adhesive. After the procedures that had been carried out, but complete removal
cementation procedure the teeth were stored in saline at a of the cement was not achieved. In the group 5, specimens
temperature of 37 °C. One week later, the provisional resto- (adhesive ? resin modified GIC) which covered most of the
rations were removed with an excavator; parts of temporary prepared tooth surface, 11 of 14 specimens showed a

Fig. 1 SEM picture showing

residual cement, GIC Type-I
group 1 (A, B)

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Fig. 2 SEM picture showing cement adhered in roughened areas in Fig. 4 SEM picture showing bulk of cement present in some areas
group 2 (A) even after the cleansing procedures were carried out in group 4 (A)

significant amount of remains of adhesive that adhered only

to the roughened tooth preparation. On the other hand i.e., the
specimens in the group 2, showed no remains of varnish on
the prepared tooth surface, and in the last and final group 6
(adhesive ? dual cure composite) only 5 specimens out of
14 examined showed minute remains of adhesive that
adhered only to the surface were the surface was roughened
while tooth cutting (Fig. 5). However, these areas could not
be detected on the smoothened margins of the tooth prepa-
ration. On the contrary, in the group 3, the specimens did not
show any varnish or composite on the prepared tooth surface
(Fig. 3a).
Tables 1 and 2 presents the results of the study. A total
of 56 specimens (66.67 %) exhibited residual luting Fig. 5 SEM picture showing areas of adhesive in group 6, visible as
black spots on the roughened areas of prepared surfaces
material, whereas 28 specimens (33.33 %) showed no
traces of luting material.
Table 1 Fisher exact test
Statistical Methods Class 1 Class 2 Total

95 % confidence interval has been used to find the signif- Sample 1 A B a?b
icance of proportion of remaining cement ‘No’, v2/Fisher Sample 2 C D c?d
exact test has been used to find the significance of pro- Total a?c b?d n
portion of remaining of cement between the sub groups.
1. v2 test 2. Fisher Exact Test
P P
ðOiEiÞ2 Fisher exact test statistic = p ¼ ðaþbÞ!ðcþdÞ!ðaþcÞ!ðbþdÞ!
v2 ¼ ; n!
Ei P 1
where Oi is observed frequency and Ei is expected a!b!c!d!
frequency

Fig. 3 SEM picture showing

cement reminents present only
in area where the tooth
preparations are rough in group
3 (A, B)

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Table 2 Comparison of
Groups Total Remaining of cement 95 % CI (No)
remaining of cement between
6 groups Present Absent

Group 1 14 12 (85.7 %) 2 (14.3 %) 4.01–39.94

Group 2 14 10 (71.4 %) 4 (28.7 %) 11.72–54.55
Group 3 14 3 (21.4 %) 11 (78.6 %) 52.41–92.43
Group 4 14 13 (92.9 %) 1 (7.1 %) 1.27–31.47
Group 5 14 11 (78.6 %) 3 (21.4 %) 7.57–47.59
Group 6 14 5 (35.7 %) 9 (64.3 %) 38.76–83.67
Inference Group 3 (varnish ? dual cure) had significantly more number of specimens with out
cement debris compared to other groups, varnish and adhesive (P \ 0.001)

3. 95 % Confidence Interval, P ± 1.96* SE (P), where There have been few studies accounting for the tem-
pffiffiffi
SE (P) is the standard error of proportion = P  Q= n porary cementation techniques and fabrication of provi-
4. Significant figures sionals [2–4] some on effects of using dentin
?Suggestive significance 0.05 \ P \ 0.10 desensitizers, and adhesives for cementation [5, 6] and
* Moderately significant 0.01 \ P B 0.05 few studies on retention of provisional crowns fabricated
** Strongly significant P B 0.01 with different materials with use of different luting
cements [7], but few documented evidence is present for
the effects of provisional restoration techniques on the
Statistical Software
final bonding of the porcelain laminate veneers. Hence
this study is designed to study the effects of different
The statistical software namely SPSS 11.0 and Systat 8.0
cements and cementation techniques on the bonding of
were used for the analysis of the data and Microsoft word
porcelain laminate veneers. This study also determines
and Excel have been used to generate graphs, tables, etc.
and compares the amount of cement debris present on
the prepared tooth surface after the provisional were
Study Design A comparative study with 84 teeth divided
removed followed by cleansing techniques and which
into six groups, each with 14 teeth is undertaken to study
cement has least residual left on the prepared tooth
the significance of remaining of cement.
surface.
Statistical differences were analyzed by using 95 %
confidence interval and Fisher exact test. 95 % confidence
Discussion
interval is used to find out the upper and lower limits of the
interval that has to be estimated. They are called confi-
The use of porcelain laminate veneers for conservative
dence interval because they are determined in accordance
esthetic restorations of anterior teeth is a new treatment
with a specified or conventional level of confidence, that
option. Porcelain veneers are claimed to be durable resto-
these limits will infact include the parameter being esti-
rations with superior esthetic properties for appropriate
mated. There fore in general, after we do a significance test
indications and for adequately selected patients.
and reject null hypothesis that a mean is really the same as
The success of porcelain veneers is greatly determined
an expected mean, we then wish to estimate confidence
by the strength and durability of the formed bond between
interval for the true value. Some times we have data that
three different components of the bond veneer complex,
can be summarized in a 292 contingency table, but these
namely the tooth surface, the luting agent, and the porce-
data are derived from very small samples. The v2 test is not
lain veneer.
an appropriate method of analysis if minimum expected
Dumfahrt [1] proposed that many patients treated with
frequency requirements are not met. A test that may be
porcelain laminate veneers expect to receive interim res-
used when the size requirements of the v2 test are not met,
torations that provide acceptable esthetics, comfort, and
the test is called as Fisher exact test. It is called exact
protection. This demand can only be met by provisional
because, if desired, it permits us to calculate the exact
restorations that adhere to the prepared teeth by cement
probability of obtaining the observed results or results that
because no primary retention form is achieved during tooth
are more extreme.
preparation. The cementation technique of provisional
Eighty-four intact human central incisors were individ-
restoration can affect the quality of the final bonding of
ually mounted, to a level just below the cemento-enamel
porcelain laminate veneers.

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junction, in an acrylic base in an upright position. They Table 3 Comparison of residual cement between 6 sub-groups
were randomly divided into six groups, based on luting Groups Subgroups Total Remaining of cement P value
method, which has fourteen teeth in each group, and each
group will be further divided into sub-groups consisting of Present Absent
seven teeth in each sub-group. A standard veneer prepa- Group 1 A 7 5 (71.47 %) 2 (28.6) 0.462
rations were made on the labial surfaces of all the teeth, B 7 7 (100.0 %) 0
and once the preparation got over the teeth were treated Group 2 A 7 6 (85.7 %) 1 (14.3 %) 0.559
with varnish that is in group 1, 2, and 3 and cemented with B 7 4 (57.1 %) 3 (42.9 %)
GIC Type-I, resin modified GIC, and dual-cure simulta- Group 3 A 7 1 (14.3 %) 6 (85.7 %) 0.867
neously. Teeth in groups 4, 5, and 6 were treated with B 7 2 (28.6 %) 5 (71.4 %)
adhesive which is also a dentin protector and cemented Group 4 A 7 7 (100.0 %) 0 0.909
with the luting cements used in this study and were stored B 7 6 (85.7 %) 1 (14.3 %)
in saline for 1 week, the provisionals were removed and Group 5 A 7 6 (85.7 %) 1 (14.3 %) 0.867
cleansing procedures were carried out to make sure that all
B 7 5 (71.4 %) 2 (28.6 %)
the cement debris is removed macroscopically and then
Group 6 A 7 4 (57.1 %) 3 (42.9 %) 0.266
were examined under SEM. The amount of cement residual
B 7 1 (14.3 %) 6 (85.7 %)
left over on the prepared tooth surface in subsequent to the
removal of provisional restorations were observed and
determined which cement left least residual on the tooth layer had no significance. Luting of provisional’s with GIC
surface and whether the presence or absence of smear layer along with adhesive showed more specimens with cement
had any significance. residual than those treated with varnish (group 1). Even in
In the present study, it is seen that all the luting cements group 2 the presence or removal of smear layer had made
used left cement residual on the tooth surface no matter no much difference.
whether smear layer was removed or left intact. These Varnishes are primarily used to protect the pulp from
results are in agreement with the study made by Herbert chemical irritation by reducing the permeability of the
Dumfahrt and Georg Gobel [1]. Where they stated that exposed dentine. Irritations may come directly from the
traces of cement debris were found in provisionally pre- luting material as with luting agents. Varnishes aids in
pared teeth for all the three methods used and the presence reduction of post operative sensitivity when applied to
of smear layer caused less distinction between the methods. dentinal surfaces under newly inserted restorations. Var-
Sufficient adhesion of provisional restorations can be nishes are most popular because they are convenient to
achieved initially but minute debris that persisted after use. They can be applied rapidly and they dry instantly. In
polishing, documented by SEM, can impair etching and addition they are applied in thin coat and therefore do not
final bonding of the porcelain laminate veneers. Clinical affect the structural strength of the restoration [5]. Bi-
experience has shown that provisional restorations may fluoride 12 varnish was used in this study, it is fast drying
debond because of solubility and the opacity of cement and which adheres well to the dry tooth enamel and dentine and
compromise esthetics. can form a water light protective film insulating against
The results from the present study showed application of thermal and chemical influences. Obviously, the result of
provisional restoration with GIC, showed cement residual this study cannot accurately predict the in vivo perfor-
on the prepared tooth surface even after polishing, docu- mances of the varnish because of the complexity of the
mented by scanning electron microscope. (Table 3; actual conditions in the mouth. But the testing methods,
Graph 3) But GIC when exposed to water in the initial however; hoped that the conclusions drawn could still be
stages of setting reaction the cement gets eroded because closely related to actual clinical performances.
of water absorption. Water changes the setting reaction of In this study, the teeth in group 2 and 5, were cemented
the GIC forming cations are washed out and water is with resin modified GIC, the only difference in the prop-
absorbed, leading to erosion. In this study all precaution erties between GIC and a resin modified GIC is the micro
were taken while seating the provisional restorations. mechanical adhesion with the under laying tooth structure
Removal of smear layer showed a difference in the speci- and that is achieved following etching. For the better
mens which had cement residual on them. Specimens in adhesion between the luting cement and the tooth surface it
which smear layer is intact, showed less amount of cement is suggested to remove smear layer, which in turn develop
residual on the tooth surface when compared with those in maximum ion-exchange adhesion, that helps to expose
which smear layer has been removed and when confidence dentinal tubules and remove dentine plugs that are oblit-
interval used to find out significance of presence or absence erating lumen, but when cementation of the crown possi-
of smear layer it shows removal and non-removal of smear bilities of developing hydraulic pressure, which may allow

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RESIDUAL CEMENT PRESENT ABSENT can effect the final cementation of porcelain laminate
veneers. In a well designed study, Lepe et al. [7] compared
110
100 the retention properties of two provisional resin materials
90 and four temporary luting agents, at 24 h. The marginal fit
80
Percentage

70 of composite provisional restoration is superior to that of

60
50 poly methyl methacrylate, but also stated that, it was not
40
30 the only factor affecting the retention of the crown.
20
10 Because of amount of polymerization shrinkage, provi-
0 PRESENT
Gr I Gr II Gr III Gr IV Gr V Gp VI sional restorations made with poly methyl methacrylate
resin may have tighter fit than those made with composite.
Graph 1 Showing the percentage distribution of residual of cement Because the shrinkage is volumetric, it may influence over
between six groups
all fit of the restoration on the axial walls. The powder/
liquid ratio of the cement mix effects the physical proper-
CEMENT DEBRIS PRESENT ABSENT ties of the set cement, in particular, its compressive
strength, which in most situations will result in increase
110 cement retention.
100
90
The permeability of dentine to adhesive agents is of
Percentage

80
70
60 crucial importance in obtaining good dentinal bonding. In
50
40
30
those systems that remove the smear layer, the opportunity
20 exists for resin to infiltrate both tubules and inter tubular
10 PRESENT
0
V A V A V A dentine. Resin penetration into tubules can effectively seal
the tubules and can contribute to bond strength if the resin
Graph 2 Shows cement residual percentage between varnish and bonds to the tubule wall. Adhesive restorations better
adhesive treated teeth with three different luting cements
transmit and distribute functional stresses across the
bonding interface to the tooth, with the potential to rein-
penetration of polyacrylate acid into the tubules, leading to force weakened tooth structure.
undue irritation to the pulp tissue and post insertion sen- In direct restorative procedures usually require tempo-
sitivity. So it is desirable to seal the dentine surface rather rary restoration for protection of the pulp and for restoring
than removing the smear layer. But in the present study, the patient aesthetics and functional needs. Acid etched
surface treated with varnish and intact smear layer showed technique, composite luted indirect provisional restoration
more number of specimens with residual cement and it was [8] resulted in composite bulk adhering to etched enamel.
more in group 5 when compared, in which the surface was This bulk can be removed only by instrumentation with
treated with adhesive (Graph 2), but the presence or great force or with the use of a bur [9]. Kurtz [9] described
removal of smear layer had shown no much significant porcelain laminate veneers provisional restoration fabri-
difference on the presence or absence of residual cement. cated directly on the prepared tooth and etched enamel that
(Table 3; Graph 3) were fractured from the teeth during removal. This
In the present study, the results indicate that there were approach risked enamel or tooth fracture and should be
no significant difference in retention obtained with the avoided.
luting agents and this was tested by removing the provi- In the present study, the provisional’s which were made
sional restorations only with the help of an excavator. That indirectly were seated with dual-cure composite in groups
means the amount of cement residual on the tooth surface 3 and 6, which showed significantly less residual cement

Graph 3 Showing the RESIDUAL CEMENT PRESENT ABSENT

percentage distribution of
residual of cement ‘No’ [10, 11] 110
100
90
Percentage

80
70
60
50
40
30
20
10
0 PRESENT
A B A B A B A B A B A B
Gr I Gr. II Gr.III Gr.IV Gr. V Gr. VI

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 J Indian Prosthodont Soc

than the other groups. This result was worse when the whether the presence or absence of smear layer had any
smear layer was removed before cementation procedures significance. Within the limitations of the study the fol-
[1], traces of adhesive discovered on six specimens (85 %) lowing conclusions could be derived:
of group 6 (B) indicating that this material can adhere to
1. Cement debris were seen on all prepared teeth
rough surfaces of prepared teeth if the smear layer is
subsequent to the removal of provisional’s.
removed. (Tables 2, 3; Graphs 1, 3) In group 6 (A), where
2. Dual-cure cement had the least residue following the
the smear layer was not removed, bonding of adhesive to
cleansing procedures.
the prepared tooth surface was not as strong as to the group
3. Presence of smear layer had no statistical significance
6 (B). The provisional restorations subjected to teeth that
in comparison with cement residue.
are treated with varnish and cemented with dual-cure
4. With the use of adhesive the cement debris was always
cement were removed in bulk, which left a clean prepa-
found to be more than with the use of varnish.
ration for 11 of 14 teeth.
5. GIC showed maximum residual cement followed by
Smear layer produced by instrumentation should be
dual-cure.
removed, because bacteria may have dentinal tubules.
Smear layer constitutes a negative influence as the sealing
ability of the obturated tubules, since it is porous and
weakly adherent interface between the luting material and
dentinal wall. Takeda et al. [12], made a comparative study References
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