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Dental Cements
By completing this survey, you give Pulpdent Corporation permission to use the information you provide below for quality assurance and compliance purposes.
1) How often do you personally use dental cements?
0-2 times per
week
3-5 times per
week
More than 5 times per
week
*
2) Which cement material do you use regularly? (Please select only one for this survey)
(Required.)
Activa BioACTIVE-CEMENT
Embrace WetBond Resin Cement
Kleer Veneer
GlassLute Glass Ionomer Cement
GlassLine Glass Ionomer Lining Material & Post Cement
PolyCarb WaterSet, Anhydrous Polycarboxylate Cement
Other (please specify)
*
3) How long have you been using this material?
(Required.)
0-1
year
1-3
years
More than 5
years
4) What do you like most about this product?
*
5) Please rate the characteristics of the material you chose
(Required.)
Excellent
Good
Fair
Poor
N/A
Marginal Integrity
Excellent
Good
Fair
Poor
N/A
Flowability
Excellent
Good
Fair
Poor
N/A
Handling
Excellent
Good
Fair
Poor
N/A
Setting Time
Excellent
Good
Fair
Poor
N/A
Ease of cleaning
Excellent
Good
Fair
Poor
N/A
Durability
Excellent
Good
Fair
Poor
N/A
Strength
Excellent
Good
Fair
Poor
N/A
6) For any answer of fair or poor, please explain:
*
7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?
(Required.)
No
Yes , please specify
If yes, please rate the severity of the issue
Temporary mild
Temporary moderate
Temporary severe
Required medical attention
*
8) How often have you had to recement the same crown done with this material?
(Required.)
None for life time
1 time per every
4 years
More than 1 time per
4 years
9) If you have had to recement the same crown done with this material, how many were replaced within
4 years
1 time per every
4 years
2-3 time per every
4 years
More than 3 time per
4 years
10) What are the main reasons you have had to recement the same crown done with this material?
The crown is coming loose
Sensitivity due to cement
Other (please specify)
Comments:
*
Are you a dental healthcare provider?
(Required.)
Yes
No
*
I give Pulpdent consent to follow up in 6 months
(Required.)
Agree
Disagree
We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.
Name
Company
Email Address
Phone Number
Internal use only