How to cement zirconia crowns: which cement, step by step

Which cement should you use for a zirconia crown?

The cement for a zirconia crown comes down to how retentive the prep is. On a retentive prep, the crown can go in with a self-adhesive, conventional or adhesive cement; on a short or overtapered prep, the IPS e.max ZirCAD IFU (Ivoclar, 2025) lists adhesive cementation only, with a primer. In the same table, self-adhesive and conventional cementation skip the primer, while air abrasion and cleaning after try-in apply to all three.

A retentive prep has 10 to 20° of total occlusal convergence and at least 4 mm of occlusocervical height on molars and 3 mm on other teeth. Those are the values in Goodacre and colleagues’ classic review (The Journal of Prosthetic Dentistry, 2001); below them, the crown relies on the bond.

Adhesive versus conventional matters less for survival than you might expect. A systematic review from the American Academy of Fixed Prosthodontics (Maroulakos and colleagues, The Journal of Prosthetic Dentistry, 2019) pooled 17 clinical studies and 2,436 zirconia and lithium disilicate crowns. Zirconia crown survival ranged from 83.3% to 100% with adhesive cementation and from 82.0% to 100% with conventional cementation, and the authors rated the evidence as poor quality.

How do you treat the intaglio of a zirconia crown?

The intaglio of a zirconia crown gets alumina air abrasion and, for adhesive cementation, a phosphate-monomer primer such as MDP. Zirconia has no glass phase for hydrofluoric acid to dissolve: the Monobond Plus IFU (Ivoclar, 2023) calls for acid etching on glass-ceramics and air abrasion on zirconia.

Each manufacturer sets its own particle size and pressure:

• Ivoclar, for IPS e.max ZirCAD: 25–70 µm alumina at 1 bar (14.5 psi), or 70–110 µm at 1.5 bar.
• Kuraray, in the CLEARFIL CERAMIC PRIMER PLUS IFU: 30–50 µm at 1–4 bar, after try-in.
• 3M, in its RelyX U200 zirconia crown guide: 30 or 50 µm at 2 bar (30 psi), until the surface looks matte.

Quigley and colleagues’ systematic review (The Journal of Prosthetic Dentistry, 2021), on bonded zirconia prostheses, recommends 50 µm at 1–2.5 bar, a phosphate-monomer adhesive or cement, and rubber dam isolation. Kuraray’s universal primer, indicated for zirconia, metal and glass-ceramics, carries both monomers: MDP and silane.

With more translucent zirconia, air abrasion has a cost. Indergård and colleagues (Biomaterial Investigations in Dentistry, 2021) blasted crowns with 50 µm alumina at 2 bar: 5Y zirconia crowns fractured at lower loads than unblasted ones, while 3Y crowns lost no strength. The authors call for more research before a 5Y protocol is set; for multilayer or 5Y crowns, stay within the disc manufacturer’s particle size and pressure.

What contaminates zirconia at try-in, and how do you clean it?

Saliva and blood contaminate zirconia at try-in, and a water rinse doesn’t bring the bond back. In Tian and colleagues’ lab study (Journal of Dentistry, 2022), water removed most of the contamination, but resin cement bond strength stayed below that of clean zirconia. Phosphoric acid didn’t work either.

Silicone fit checker is another contaminant. The Ivoclean IFU contraindicates the paste on a restoration that has touched a silicone-based material; that leaves re-blasting after try-in, which is when Kuraray says to blast anyway.

After cleaning, prime again. The Monobond Plus IFU says the whole restoration treatment has to be repeated if it gets contaminated with saliva, blood or water.

How do you cement zirconia with RelyX U200?

RelyX U200 is 3M’s self-adhesive resin cement, and 3M’s zirconia crown guide for it has no primer step. The crown is air-abraded with 30 or 50 µm alumina at 2 bar, cleaned with alcohol and dried with oil-free air. If the lab blasted the crown before try-in, 3M says to remove saliva with about 5% sodium hypochlorite and rinse, without phosphoric acid.

On the tooth, the guide calls for mechanical cleaning with pumice and removal of any temporary cement, desensitizer or disinfectant residue, with no hydrogen peroxide, EDTA or bicarbonate. The prep is rinsed and lightly dried, left moist: according to 3M, overdrying can cause postoperative sensitivity.

With the crown seated under finger pressure, 3M calls for a 1–2 second tack cure per surface and excess removal while you hold the crown in place. The final cure is 20 seconds per surface, or 6 minutes of self-cure from the start of mixing. Tack-curing longer hardens the excess and makes cleanup harder.

U200 is a self-adhesive cement, and Ivoclar’s zirconia table ties self-adhesive cementation to a retentive prep. On a short prep, the indication switches to adhesive cementation.

Can you cement zirconia with zinc phosphate?

Yes, on a retentive prep: zinc phosphate holds a zirconia crown by friction, without bonding to it. The limit is the crown’s strength. In Indergård and colleagues’ study (2021), 3Y zirconia crowns cemented with zinc phosphate fractured at lower loads than those cemented with a self-adhesive resin cement, with or without air abrasion.

It’s a lab study, with unaged crowns on resin die replicas, and the authors note the values probably run higher than in the mouth. When crown strength is a concern, as with a thin crown or limited clearance, resin cement is what the study supports.

What about a zirconia crown on a cast post and core?

A zirconia crown on a cast metal post and core is cemented as it would be on a tooth: retention comes from the form of the core, and the crown’s intaglio gets the same air abrasion. With a retentive core, a self-adhesive or conventional cement works.

With adhesive cementation, the metal core counts too. Kuraray’s MDP primer is indicated for metal and zirconia, and Ivoclar advises against cleaning metal surfaces with phosphoric acid, for the same reason as zirconia.

What changes on the Rx is shade. Ivoclar says to pick the block by the shade of the prep at its most discolored area; with a metal core, tell the lab and send that stump shade. We found no clinical study comparing cements for zirconia crowns on metal cores, so the choice follows the retention of the core.

How do you cement a zirconia crown on an implant abutment?

For a cement-retained zirconia crown on an implant abutment, what matters most in choosing a cement is being able to remove all of the excess. Staubli and colleagues’ systematic review (Clinical Oral Implants Research, 2017) covered 1,010 cemented restorations. Peri-implant disease affected 1.9% to 75% of the implants, and 33% to 100% of those cases were associated with excess cement.

The authors recommend a crown margin at the mucosal level with access for cleanup, mature soft tissue before cementation and early follow-up; excess cement was more frequent with healing periods under 4 weeks. Abutment type and cement type had no significant influence.

To reduce the excess, Reda and colleagues’ review (Methods and Protocols, 2022) points to extraoral cementation, with the excess removed on an abutment replica before the crown goes in. The same authors favor a eugenol-free zinc oxide provisional cement, but only three clinical studies made it into their analysis.

The numbers for both retention types are in screw- vs cement-retained implant crowns. Bonding a crown to a Ti-base outside the mouth is a separate procedure, covered in what is a Ti-base abutment.

What makes a zirconia crown debond?

The errors that most compromise zirconia cementation happen after try-in and in matching the cement to the prep.

What comes from the lab, and what goes on the Rx?

A zirconia crown leaves the lab sintered, stained and glazed; try-in, intaglio cleaning, primer and cementation happen chairside. Ask the lab whether the intaglio comes air-abraded: even if it does, it gets contaminated at try-in and needs the cleaning above.

On the Rx, include:

• The cement you plan to use (adhesive, self-adhesive or conventional), especially if the prep is short or overtapered.
• Whether the tooth has a metal core or is discolored, with the stump shade.
• For an implant crown, whether it will be cemented on an abutment and the margin height relative to the mucosa.
• Whether the case calls for a more translucent zirconia (4Y, 5Y or multilayer), where air abrasion changes.

If the space falls short of the material’s minimum thickness, we contact you before milling. We check every case when it arrives and on eight points before it ships. Material choice is covered in monolithic, multilayer zirconia or e.max, and the crowns on the zirconia crown and zirconia implant crown pages. For e.max, the protocol is different: see how to cement e.max crowns and onlays.