A split-mouth randomized clinical trial of single crowns retained with resin-modified glass-ionomer and zinc phosphate luting cements

Purpose: This study compared the influence of two luting cements on the clinical performance of single crowns. Materials and Methods: Twenty patients received 39 pairs of metal-ceramic and Procera crowns cemented with zinc phosphate and resin-modified glass-ionomer luting cement (Vitremer) in a split-mouth randomized pattern blinded to the recipient. The crowns were examined immediately after cementation, after 2 weeks, after 6 months, and then yearly. Clinical performance was scored according to CDA criteria, Silness and Loe criteria, patient satisfaction, and operator-appraised general clinical criteria. Three clinicians in private general practice carried out all procedures. Results: During the observation period, which varied between 80 and 104 months, seven clinical events were recorded. Two abutments fractured vertically, two underwent retrograde endodontic surgery, and one developed pulp necrosis. Two crowns were recemented. Estimated survival, defined as no negative events observed, was 89% at 102 months (85% for crowns cemented with zinc phosphate and 93% for crowns cemented with resin-modified glass-ionomer). Estimated survival, defined as no recementation or loss of pulp vitality, was 96% at 102 months (95% with zinc phosphate and 97% with resin-modified glass-ionomer). The differences between cements were not statistically significant. Conclusion: A resin-modified glass-ionomer luting cement was at least as good as zinc phosphate cement to retain single crowns over a 102-month observation period.