ANSWERS

Do you bond or cement an all-ceramic crown?

It depends on the ceramic. Lithium disilicate and feldspathic crowns get adhesively bonded with resin cement for retention and strength. Monolithic zirconia crowns with adequate prep retention can be conventionally cemented using resin-modified glass ionomer or self-adhesive resin cement.

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THE FULL PICTURE

Why it works this way

The short version: ceramic type drives the protocol

The decision is not crown versus crown, it is ceramic versus ceramic. Glass-based ceramics (lithium disilicate, feldspathic porcelain, leucite-reinforced) rely on the resin bond for their clinical strength. A 2021 Journal of Prosthetic Dentistry systematic review of lithium disilicate restorations found adhesive bonding produced significantly higher fracture resistance than conventional cementation across thin-walled preps. For these materials, bond.

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Can I cement a lithium disilicate crown with RMGI instead of bonding?

You can, but you give up clinical performance. Lithium disilicate gets a measurable strength boost from the adhesive bond to tooth structure, which is part of why the material is rated for thinner wall thicknesses than zirconia. Conventional cementation with RMGI is acceptable only on highly retentive preps with full axial coverage and no esthetic margin concerns. For anterior cases, thin-walled posteriors, or any onlay, bond with resin cement after HF etch and silane.

What cement do you recommend for monolithic zirconia crowns?

For retentive preps, a self-adhesive resin cement (RelyX Unicem 2, Panavia SA, SpeedCEM Plus) is the workhorse. It tolerates moisture, requires no separate primer if it contains MDP, and bonds adequately to both tooth and zirconia after air abrasion. For non-retentive preps or full-arch zirconia hybrids, step up to a dual-cure resin cement with a dedicated MDP primer such as Panavia V5 with Clearfil Ceramic Primer Plus. Avoid traditional zinc phosphate on zirconia.

Do I need to air abrade zirconia chairside if your lab already finished the intaglio?

Yes. Saliva contamination during try-in deactivates the zirconia surface for bonding, and phosphate ions in saliva block MDP from coupling to the zirconia. After try-in, clean the intaglio with Ivoclean (20 seconds, rinse) or re-air-abrade lightly at 1 bar with 50-micron alumina. Then apply your MDP primer or proceed with an MDP-containing self-adhesive cement. Our cases ship with the intaglio prepared, but chairside re-cleaning is part of the protocol every time.

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This answer is one piece of a larger workflow. The pillar page covers materials, turnaround, and how we build the case to your specification.

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