Cements
There’s more to cements than meets the eye. Informed reps can best meet their customers’ needs.
When it comes to choosing the right cement, the answer is not written in stone. Your dental customers have several options to choose from and, as their sales rep and consultant, you can steer them to the solution that best suits their needs.
The earliest cement, a zinc phosphate (made of phosphoric acid) was introduced in the late 1800s, and some dentists still use it today. Although it does not technically qualify as a cement, it can be used as such. In the 1970s, polycarboxylates (made of carboxylic acid) were introduced for use as both temporary and permanent cements. This product continues to be used as well. In recent years, the industry has introduced a couple of newer solutions – glass ionomer and straight resin cements – designed to meet the most current challenges of dental practitioners.
Glass ionomer cements
Glass ionomer cements, which are produced from the reaction of polyalkenoic acid and silicate glass powder, are a dental restorative material used for filling teeth. They provide a fluoride release to help keep the tooth strong over time. Originally developed for anterior teeth, certain glass ionomer cements (e.g., Class III and Class V) are said to be well suited for high caries and non-stress bearing areas as well.
They are used primarily for cementing metal or porcelain-fused-to-metal (PFM) crowns, bridges, inlays and stainless-steel crowns. Sometimes glass ionomer cements are used for orthodontia appliances, such as bands and brackets, and in other cases, they may be used as a base or liner. They are packaged as capsules, paste paks and in syringes.
Resin cements
Resin cements, which also provide a fluoride release, are well suited for metals, ceramic and PFM. They can be conveniently stored, as they do not need to be refrigerated. In addition, at least one product, when expressed out of a tube, doesn’t set until it is placed on the tooth, providing the dentist with greater working time.
Features
Cements vary in their strength. Generally, dentists are interested in three strength features: tensile, compressive and retentive. Tensile strength addresses the crown’s breaking point when it is pulled. Compressive strength refers to the crown’s ability to withstand biting action, and retentive strength is the crown’s ability to withstand being pulled off.
Other features dentists should look for in a cement are:
- Film thickness. Thinner film enables the dentist to set the tooth more easily.
- Solubility. Cements should be hydrophilic so that the process does not call for extra primers.
- Post-operative sensitivity. Cements with a hydrophilic chemistry are less apt to upset the "smear" layer of the tooth, thereby reducing post-operative sensitivity.
In the past, cements were sold as kits, which included powders, liquids, primers and bonding agents, and involved a lot of mixing on the part of the dentist. But, today they are packaged much more conveniently. Newer auto syringes can save the practitioner time, and cost between $13/ml and $40/ml. Each syringe provides cement applications for 25 to 80 crowns.
How to sell
There are a number of probing questions sales reps can ask their dental customers to gauge their interest in, and need for, new cement products. Dentists may be using several types of cements, whereas they only need to be using one or two. Nevertheless, reps need to avoid undermining their customers’ past decisions. So, rather than asking dentists what type of cement they currently use, reps should begin with an open-ended question, such as the following:
- "Would you be interested in a cement that can be prepared in three or four steps, and work stronger and more efficiently in the long run?"
Follow-up questions reps should ask are:
- "Are you looking for a material that saves you time and continually releases fluoride?"
- "Are you interested in a material that becomes stronger over time?"
- "Do you typically use an etching or bonding agent with your cement?"
Your customers will appreciate the advantages of today’s cements, both to them and their patients.
First Impressions would like to acknowledge the contribution of Shofu Dental Corp. and GC America.
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