Thorsten Bockª / Mutlu Özcanᵇ
IAAD WORKING INSTRUCTIONS[^32]
Question: What is the best cleaning method to remove saliva, blood, and silicone disclosing medium contaminants from etched and silanized bonding surfaces of glass ceramic restorations?
Answer: During intraoral try-in of ceramic restorations, the bonding surfaces may come in contact with saliva or occasionally blood.¹,⁵ The resulting persistent protein contamination from saliva in particular was shown to hinder adhesion of resin cements to glass ceramics.¹,⁵⁻⁷,⁹ Similarly, the use of silicone-based materials during checking the fit of indirect glass ceramic restorations contaminates the bonding surfaces with silicone residues, also impeding adhesion of resin cements.⁵,¹⁰,¹¹ Water spray, alcohol, and acetone do not seem effective in removing saliva residues from glass ceramics,¹,⁵,⁷ but 35% to 37% phosphoric acid gel application presented effective cleaning.¹,³⁻⁵ Several studies also demonstrated that cleaning pastes with particles (eg, Ivoclean) could also remove saliva contaminants from both glass and oxide-based ceramic surfaces.²⁻⁴ Since durable adhesion of glass-ceramic restorations is crucial, especially in minimally invasive restorations, the following surface cleaning sequence can be recommended to eliminate contaminants from ceramic surfaces, based on the available scientific reports.