Dental Cements 5a2m4x

DENTAL CEMENTS Presented by; Snehal Sonarkar Department of conservative dentistry and endodontics

Terna Dental College. Nerul, Navi Mumbai.

Content; Introduction History Ideal properties of dental cements Classification of cements

RDT & Pulpal response Pulp protecting agents Cavity varnish Calcium hydroxide Zinc oxide eugenol cement

Fluoride releasing cements Silicate cement Zinc silicophosphate cement Glass ionomer cement

Luting agents Zinc phosphate cement Zinc polycarboxylate cement Resin cements

Miscellaneous Mineral Trioxide Aggregate Biodentine I Root BP

Properties of cements Conclusion References

Introduction Variety of cements are used for various purpose. Different applications make varying demands on  Manipulative properties.  working and setting time.  resistance to mechanical breakdown and

dissolution.

Materials are supplied  powder/liquid form and set by acid-base reaction,

but this is not universally true.

So, in dentistry word cement has been applied,

traditionally to powder/ liquid materials which are mixed to a paste consistency set to a hardness, and used clinically to restore teeth and attach preformed restorations, in or on the teeth.

History Period of mechanical improvement AD 1050 to 1122 - according to the Arabian

author Rhazes.  Carious teeth were filled with ground mastic, alum,

and honey or other substances.

Riviere (1589) mentioned Oil of cloves (eugenol)  applicable to dental operations, but may have been

used earlier (1562) by Ambroise Pare to alleviate toothache. Craig’s Restorative dental materials. 12th ed

1860 – Zinc oxychloride (filling and cementing

medium). 1879 – Zinc phosphate was introduced 1908 – Silicate cement was introduced in US.  Cruder

forms were used in europe in late 1800.

1947 – direct filling methyl methacrylate

Journal of History of Dentistry 2005;July, 53(2):63-72.

1960-70’s – Pit & fissure sealant introduced. 1970s - polycarboxylate 1971 – Wilson & kent – introduced GIC. 1993- Torabinejad introduced MTA 2008 – Prof. Abbot introduced Biodentine.

Definition Cement  Substance that hardens to act as a base, liner, filling material,

or adhesive to bind devices and prostheses to tooth structure or to each other. (Phillip’s)

 A non metallic material used for luting, filling permanent or

temporary restorative purposes, made by mixing components into a plastic mass that sets or as an adherent sealer in attaching various dental restorations in or on the tooth. (Craig)

Ideal Properties of DENTAL CEMENTS 1. Well adapted to living dental tissues 2. Non- toxic and non-irritant

3. Anticariogenic qualities 4. Low viscosity and film thickness reach areas

between restoration and tooth. 5. Resistant against mastication forces and pulling

forces formed through the effect of gummy foods

Contemporary Permanent Luting Agents Used in Dentistry: A Literature Review Ebru SÜMER, Yalçın DEĞER(Int Dent Res 2011;1:26-31)

6. Mechanical properties – meet the requirements for particular application. 7. Sufficient light transparency. 8. Heat insulation to protect living tooth from thermal effects. 9. sufficient working time and be easy to manipulate. 10. Bond to hard dental tissues. Contemporary Permanent Luting Agents Used in Dentistry: A Literature Review Ebru SÜMER, Yalçın DEĞER(Int Dent Res 2011;1:26-31)

11. Long shelf-life. 12. Antibacterial property 13. Biocompatible. 14. Chemically compatible with pulp and restorative material. 15. Should not discolor tooth and restorative material. 16. Should stabilize or diminish dentin permeability.

Operative Dentistry: Modern theory and practice. MA Marzouk. 2004

CLASSIFICATION

Classification…..

According to Phillip’s Fluoride-Releasing Cements for DirectFilling Restorations

Cements as Luting Agents

Agents for Pulp Protection

Silicate

Zinc phopshate

Cavity varnishes

Zinc Silicophosphate ZOE

Cavity liners

Glass ionomer

Cement bases

Zinc polycarboxylate Glass ionomer Resin- modified glass ionomer Compomer Resin cements

Phillip’s Science of dental material. 11th ed. 2002

Classification…..

According to reaction Acid Base Reaction

Light / Chemical –

Light / Chemical

activated

– activated

polymerization and

polymerization

acid base reaction

Zinc Phosphate cement

Resin modified glass

Compomers

Zinc polycarboxylate

ionomer cement

Resin cement.

cement Zinc oxide- eugenol cement Glass ionomer Phillip’scement Science of dental material. 11th ed. 2002

Classification…..

According to ingredients & application By Craig Water based cements

Application

 Glass and resin

 Class 5 restorations

modified glass

 Retention of alloy restorations

ionomer cement

 Retention of alumina or zirconia based all ceramic restoration  Retention of orthodontic bands  Provisional restorations

 Zinc Polyacrylate

Retention of alloy restorations Retention of orthodontic bands Retention of pediatric stainless steel crown

 Zinc phosphate

Retention of conventional restorations Retention of orthodontic bands Provisional restorations

Craig’s Restorative dental material. 12th ed. 2006

Classification….. Resin-Based cements

Application

Composites and

 Bonded conventional crowns and bridges,

Adhesive resins

veneers, inlays, and onlays  Bonded laboratory composites crowns and bridges, veneers, inlays, and onlays.  Bonded posts and cores.  Retention of provisional restorations  Retention of orthodontics bands

Compomers

 Bonded conventional alloy based restoration  Retention of alumina or zirconia-based all ceramic restoration.  Retention of orthodontic brackets  High-strength bases


Classification…..

Oil-based cements

Application

Zinc Oxide eugenol

 High-strength bases  Provisional restorations  Root canal sealers  Gingival tissue packs  Surgical dressings

Noneugenol-Zinc oxide

 Provisional restorations  Root canal sealers  Gingival tissue packs  Surgical dressings


Classification…..

According to O’Brien O’Brien classified dental cements by matrix bond type

O’Brien Dental material and their selection. 3rd ed. 2003

Classification…..

Type of matrix bond

Class of cement

Phosphate Zinc phosphate

Formulation

Zinc Zinc Zinc Zinc

phosphate phosphate fluoride phosphate copper oxide/salts phosphate silver salts

Zinc silico-phosphate Zinc silicophosphate Zinc silicophosphate mercury salts Phenolate

Zinc oxide-eugenol

Zinc oxide-eugenol Zinc oxide-eugenol polymer Zinc oxide-eugenol EBA/alumina

Calcium hydroxide salicylate

Calcium hydroxide salicylate


Classification…..

Type of matrix bond

Class of cement

Polycarboxylate

Zinc Zinc polycarboxylate polycarboxylate Zinc polycarboxylate fluoride

Dimethacrylate

Formulation

Glass ionomer

Calcium aluminum polyalkenoate Calcium aluminum polyalkenoate polymethacrylate

Acrylic Poly (methyl methacrylate)

Dimethacrylate unfilled Dimethacrylate filled

Adhesive

4-META

Polycarboxylate Hybrid & Dimethacrylate ionomers

Self cured Light cured


Classification…..

According to Sturdevant’s Traditional ceramic dental cement

Abbrevi ations

Liquid compon ent

Powder component

Reaction product matrix

Unmodified ZOE

ZOE

Eugenol

ZnO

Crystalline zinc eugenolate

Resin reinforced ZOE

R-ZOE

Eugenol

ZnO, polymer, Crystalline zinc eugenolate resin

EBA- modified ZOE

ZOE-EBA

Eugenol, EBA

ZnO, Al2O3, polymer

Crystalline zinc eugenolate Crystalline zinc ethoxybenzoate

Zinc phosphate

ZP

H3PO4, H2O

ZnO

Crystalline tertiary zinc phosphate

Silicate

SC

H3PO4, H2O

F-Al-Silicate glass

Amorphous silico phosphate

Zinc silicophosphate

ZSP

H3PO4, H2O

F-Al-Silicate glass, ZnO

Amorphous silico phosphate Crystalline tertiary zinc phosphate

Sturdevant’s Art and Science of dental materials. 5th ed. 2006

Polymer based dental cement

Abbr Liquid eviati compone ons nt

Powder compone nt

Reaction product matrix

Polycarboxyl ate

PC

PAA, H2O

ZnO

Amorphous zinc polyacrylate gel

Conventional GI GI

PAA, H2O

F-AlSilicate glass

Amorphous aluminopolyacrylate gel

Resin modified GI

RMGI

PAA, H2O, water soluble monomers

F-AlSilicate glass

Amorphous aluminopolyacrylate gel, cross linked polymer

Compomer

CM

Monomers

F-AlSilicate glass

Amorphous cross linked polymer, aluminolpolyacrylate gel

Composite (or resin)

Monomers

Silicate glass

Amorphous cross linked polymer


Classification…..

Donovan classified as; Conventional  Zinc phosphate,  Polycarboxylate,  Glass Ionomer

Contemporary  Resin-modified glass ionomers,  Resin based

Donovan TE, Cho GC. Contemporary evaluation of dental cements. Compend Contin Educ Dent 1999;20(3):197–219. taken from Dental Cements for Definitive Luting: A Review and Practical Clinical Considerations. Edward E. Hill, Dent Clin N Am 51 (2007) 643–658

According to function Function

Cements

Final cementation of completed restorations

Zinc phosphate, Zinc Silicophosphate, reinforced ZOE, Zinc polycarboxylate, Glass ionomer

Temporary cementation of completed restorations or cementation of temporary restoration

ZOE, noneugenol ZO

High strength bases

Zinc phosphate, reinforced ZOE, Zinc Polycarboxylate, Glass ionomer

Temporary fillings

Zinc phosphate, reinforced ZOE, Zinc Polycarboxylate

Low strength bases

ZOE, Calcium hydroxide

Liners

Calcium hydroxide in suspension

Varnishes

Resin in solvent

Classification of intermediary bases Varnishes A solution of natural gum, synthetic resins, or rosins

dissolved in a volatile solvent, such as acetone, ether, or chloroform. (Phillip’s)  Liner  Thin layer of cement, such as a calcium hydroxide suspension in an

aqueous or resin carrier (after evaporation), used for protection of the pulp; certain glass ionomer cements that are used as an intermediate layer between tooth structure and composite restorative material are also considered liners. (Phillip’s) Operative Dentistry: Modern theory and practice. MA Marzouk. 2004

Subbases Therapeutic material placed in deep portions of

cavity Posses specific pharmacological action.

Base  A layer of insulating, sometimes medicated, cement

placed in deep portion of the preparation to protect pulpal tissue from thermal and chemical injury.


Function of base The function of the cement base is to promote recovery

of the injured pulp and to protect it against further insult. The base serves as a thermal insulator and replaces

missing dentin when it is used under the metallic restoration. Galvanic shock and chemical irritation. Resist fracture under masticatory loads.

Dentistry for the Child and Adolescent. RALPH E. McDONALD. 8th ed. Phillip’s Science Of Dental Materials. 11th ed.

Pulp protection Chemical protection Electrical protection Thermal protection Pulpal medication

Schematic view of need for pulpal protection.(Sturdevant 5th ed)

Mechanical protection


Schematic examples of use of liners and bases for amalgam restoration. A – Shallow amalgam tooth preparation, varnish or sealer applied to walls. B – Moderate depth tooth preparation – liners may be placed for thermal protection and pulpal medication C – deep preparation – light cured calcium hydroxide is placed in deepest region in which infected dentin was excavated. Base- glass ionomer. Sturdevant’s Art and Science of dental materials. 5th ed. 2006

Remaining dentin thickness Importance of maximizing the RDT beneath cavity

preparations in reducing pulpal damage has long been established.

Preserving the Vital Pulp in Operative Dentistry: 3. Thickness of Remaining cavity Dentine as a Key Mediator of Pulpal Injury and Repair Responses. PETER E. MURRAY, PHILIP J. LUMLEY AND ANTHONY J. SMITH. Dental Update – May 2002

Pulp protecting agents…..

Minimal cavity RDT that does not cause unequivocal

pulp injury have been decreasing:  Stanley (1984) - RDT of 2 mm.

 Pameijer, Stanley and Ecker (1991) RDT of 1 mm or

more would protect the pulp tissue from the cytotoxic effects of luting process



RDT <0.3 mm persistent pulp inflammation

(pulpitis) Studies  RDTs between 0.25 mm and 0.50 mm.



Ability materials tested to maintain odontoblast

survival with RDT below 0.5 mm was as follows:  calcium hydroxide 100%;  polycarboxylate 81.1%;  zinc oxide eugenol 78.4%;  composite resin 74.2%;  enamel-bonded resin 48.3%;  resin-modified glass ionomer 43.1%. Preserving the Vital Pulp in Operative Dentistry: 3. Thickness of Remaining cavity Dentine as a Key Mediator of Pulpal Injury and Repair Responses. PETER E. MURRAY, PHILIP J. LUMLEY AND ANTHONY J. SMITH. Dental Update – May 2002


Mechanisms to stimulate formation of reactionary dentin:  cavity preparation trauma;  restorative dental procedures;  operator hand instrumentation;  pathogenic diseases;  caries;  attrition;  erosion;  chemicals;  restorative materials; and  bacterial microleakage.

Dental Update – May 2002


The rank order of reactionary dentine secreted in

preparations with an RDT below 0.5 mm was:  calcium hydroxide;  composite resin;  resin-modified glass ionomers;  zinc oxide eugenol;  polycarboxylate.

Dental Update – May 2002


 Light micrograph of a dentin

bridge that has formed between a material and the pulp in a monkey.

Craig’s Restorative dental materials. 13th ed


Initially, the pulp of the tooth was purposely exposed (top right)

with a bur. The exposure was covered with a calcium hydroxide pulp-capping

agent for 5 weeks before histological evaluation. A layer of secondary dentin has formed at the site of the pulp

exposure, forming a dentin bridge. Some inflammatory cells are evident under the bridge, but the

pulpal response is generally favourable.

Remaining dentin thickness calculation

Effective depth in radiograph enamel thickness in radiograph

=

Actual effective depth =

actual effective depth actual enamel thickness

Effective depth in radiograph x actual enamel thickness Enamel thickness in radiograph.


Other methods for calculation of RDT Ultrasonic pulse-echo techniques may allow for such a

determination of RDT.

A – Plastic delay line, B – retaining sleev, C- Ultrosonic transducer, D – electrical connector In Vitro and In Vivo Measurement of Remaining Dentin Thickness. Hatton JF, Pashley DH, Shunk J, Stewart GP. J Endod;1994:20;12:580-84

Pulp protecting agents

Pulp protecting agents Cavity varnish Calcium hydroxide Zinc oxide eugenol cement


Agents for pulp protection Metallic restorations, which are excellent thermal

conductors  thermal sensitivity during drinking of hot and cold foods or beverages Cavity varnishes, liners, and bases are used as

adjuncts.

Phillip’s Science Of Dental Materials. 11thed.

Pulp protection procedure (Medicament/liner/ sealer)

Material

Shallow excavation (RDT >2mm)

Moderate Deep excavation Excavation (RDT 0.5-2mm) (RDT<0.5mm)

Amalgam

No/no/sealer

No/base/ sealer

CH/base/sealer

Composite

No/no/DBS

No/no/DBS

CH/no/DBS

Gold inlays and onlays

No/no/cement

No/base/cement

CH/base/cement

Ceramic

No/no/DBS, CC

No/no/DBS, CC

CH/no/DBS, CC

Sealer – GLUMA. Base – vitrebond cement – RMGI CC – composite cement. CH – dycal liner. DBS – dentin bonding system. Sturdevant’s Art and Science of dental materials. 5th ed. 2006


Cavity varnish Definition; A solution of natural gum, synthetic resins, or rosins dissolved

in a volatile solvent, such as acetone, ether, or chloroform. (Phillip’s) A cavity varnish is used to provide a barrier against the

age of irritants from cements or other restorative materials and to reduce the penetration of oral fluids at the restoration-tooth interface into the underlying dentin. (Craig’s) Phillip’s Science of Dental material 11th ed 2003 Craig’s Restorative dental materials. 12th ed

Composition;

Resins

Medicinal agents Volatile solvents

natural gums, synthetic resins, or rosin. (Copal and nitrated cellulose natural gum and synthetic resin). chlorobutanol, thymol, and eugenol evaporate quickly  leaving a thin resin film.


Liners  Solution liners – varnishes – 2-5μm 

Thin layer 2-5 μm is formed

 Suspension liners – 20-25 μm 

Thick layer 20-25 μm



Applied  thin consistency  Using brush or a small pledget of cotton or sable

hair brush.  Disposable applicator be used and discarded  Solvent loss occurs – 8-10sec (Sturdevant’s)

Phillip’s Science Of Dental Materials. 11th ed.

Small cotton pledget formed by few fibres bent over on themselves.

Small cotton applicator prepared on long handled endodontic file or reamer bent in angle.

Principles and practice of operative dentistry. Charbeneau. 2nd ed.1981.

First layer dries  small pinholes usually develop.  55% of surface is covered (Sturdevant’s)

A second or third application  fills in most of

these voids.  80-85% of surface is covered. (Sturdevant’s)

Copalite varnish partially occluding dentinal tubule

SEM – two layer of varnish

SEM – one layer of varnish



Application Dentinal surfaces to minimize the penetration of acid from zinc

phosphate cements. Enamel and dentinal walls to reduce the penetration of oral fluids

around metallic restorations. Retard penetration  discolored corrosion products from dental

amalgam into dentin. Cavity varnish is applied to the dentinal walls of those tubules in

direct with the pulp when a base of zinc phosphate cement. Craig’s Restorative dental materials. 12th ed


When therapeutic action is expected;  Action - Base or liner

material

Then, cavity varnish is not used on the

underlying dentin. Varnish - applied over the cement base.



Contraindication Not used under composite restoration 

Bonding agents effectively seal dentinal tubules.

Cavity Liners


Definition; Thin layer of cement, such as a calcium hydroxide suspension in

an aqueous or resin carrier (after evaporation), used for protection of the pulp; certain glass ionomer cements that are used as an intermediate layer between tooth structure and composite restorative material are also considered liners. (Phillip’s)

Also referred as; Intermediary bases Pulp-Capping agents


Functions Accelerates formation of reparative dentin. Adhesion at tooth restoration interface. Sealing dentin from influx of microorganism and

irritants.



Materials used;

Calcium hydroxide Hermann in 1920. Properties  Antibacterial, antiseptic  Intracanal medicament

Cohen’s Pathways of Pulp. 10th ed. pg254


 Ca(OH)2 mixed with sterile water or saline.  Commercially available as;  Calcium hydroxide  Dycal (Dentsply Caulk, Milford,DE, USA)

Cohen’s Pathways of Pulp. 10th ed. pg254


Base

Catalyst

Disalicylate (ester of 1,3, butylene glycol) Calcium hydroxide Calcium phosphate Ethyl toluenesulfonamide Calcium tungstate Zinc sterate Zinc oxide Titanium dioxide Iron oxide Zinc oxide Iron oxide

www.dentsplymea.com


Indication  Application to exposed, vital pulp tissue (direct pulp

capping).  Protective barrier between restorative materials and deep

vital dentin (indirect pulp capping)

www.dentsply.com

Manipulation


 Dry cavity preparation  Dispense equal volumes of base and catalyst pastes on paper

pad provided.  Thoroughly mixed until a uniform color is achieved.  Mixing ratio – Base and catalyst- 1.17gm:1gm  Mixing time -10 seconds.

www.dentsply.com

 Place the mix on the exposed pulp and cavity dentin judged

to be less than 1.0mm remaining thickness in a thin layer.  Material thickness - 0.8mm-1mm.  Working time – 2min 20seconds  Setting time- 2-3 minute  shorter in the mouth due to moisture and temperature.

www.dentsply.com

Biological property It can be irritant to pulp. Depth an effective biological reaction;  100μm < healthy reparative reaction.  100μm > unhealthy reparative reaction.  Direct with pulp – chemical necrosis.


Light cured calcium hydroxide Prisma® VLC Dycal® - Dentsply Caulk

COMPOSITION  Calcium Hydroxide;  Barium Sulfate;  Urethane Dimethacrylate Resin;  photoinitiator;  stabilizer;  pigments

www.dentsplymea.com

INDICATIONS Direct pulp capping Protective barrier between restorative materials and

deep vital dentin (indirect pulp capping).

CONTRAINDICATIONS Patients who have a history of severe allergic reaction to methacrylate resins.

www.dentsplymea.com

STEP-BY-STEP DIRECTIONS Direct Pulp Capping complete cavity preparation Rinse the cavity and exposure site Gently dry preparation with cotton pellet. Avoid

desiccation. Liner directly on the exposed pulp and cavity dentin

judged to be less than 1mm remaining thickness in a thin layer.

www.dentsplymea.com

 Material thickness should be approximately 0.8mm-1mm.  Light cure – spectral output containing 470 nm.  Minimum light output must be at least 300mW/cm2

exposure for at least 20 seconds.  Remove any material excess from retention areas,

enamel, and/or margins with a sharp spoon excavator or a bur.  Pulp vitality assessed in next appointment

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Properties of liners

Calcium hydroxide

ZnO cements

Lining deep cavities/ Direct pulp capping

In deep cavities to retard penetration of acids and reduce discomfort to pulp

Antibacterial action

Zinc Oxide and Eugenol based Formulated as; Powder and liquid Two paste system

Craig’s. Restorative Dental Material. 12th ed

Indication Temporary cement Thermal insulating base Root canal filling

COMPOSITION Powder

Function Gm (Phillips 7th ed)

Weight(%) (Craig 12th ed)

Zinc oxide

70gm

69

Principal ingredient

Rosin

28.5

29.3

Reduce brittleness of set cement

Zinc stearate

1

1

Plasticizer

Zinc acetate

0.5

0.7

Improve strength of set cement

Skinner’s Science of dental materials. 7th ed. Craig’s restorative dental material. 12th ed

Liquid

Eugenol Olive oil

(Phillips 7th ed)

(Craig 12th ed)

Function

85

85

Eugenol with olive oil act as plasticizer.

15

Formulation and uses by ADA specification no. 30 Types

Uses

Type I

Temporary cementation

Type II

Permanent cementation

Type III

Temporary filling material and thermal insulating base

Type IV

Cavity liners Phillip’s Science Of Dental Materials. 11th ed.

Powder Zinc hydroxide Zinc carbonate 300°C

Zinc oxide Carbonate 300- 500°C

Magnesium oxide Phillip’ s science of dental material. 7th ed.

Manipulation of ZOE Powder - incorporated into dispensed amount of liquid

until a suitable consistency is achieved for the operation. Considerable amount of powder - incorporated into the

liquid by heavy spatulation with a stiff spatula. More powder - stronger the cement and the more

viscous the mixed cement.


Bulk of powder – incorporated in liquid. P/L – 4:1 or 6:1 Initial step,  mix is thoroughly spatulated, and a series of smaller

amounts is then added until the mix is complete.  mix is thoroughly kneaded with the spatula (a stiff bladed

steel spatula is the most effective type).


Setting reaction Setting  chelation reaction  zinc

eugenolate.


Setting reaction - accelerated by increases in

temperature or humidity. EBA also forms a chelate with zinc oxide, and its

presence allows some crystalline zinc eugenolate to form, which provides additional strength. Accelerators

Retarders

Water, alcohol, glacial acetic acid

Glycol/ glycerine


Factors affecting setting time Incorporating chemical accelerators in mix Reducing particle size. Increasing P/L. Increasing percentage of fillers. Increasing temperature/ humidity. Adding water to original mix. Introducing greater energy in mixing procedure.


Specification requiremment of ZOE and ZnO – noneugenol cements


Other properties Least amount of shrinkage 0.1% by volume. CTE – 11 ppm/°C

Biological properties Least irritating to pulp-dentin organ. Create impervious layer to elements normally

present in oral environment. Applied in 0.5mm thickness. Decreases hardness of very minimal thickness of

underlying dentin CTE and thermal diffusivity- less then tooth

structure. (0.25) Operative Dentistry: Modern theory and practice. MA Marzouk. 2004

Bonding to composites Inhibitory effect of methoxyphenols such as eugenol on the

polymerization of methacrylate resins is of clinical importance.

Eugenol is considered a free-radical scavenger(presence of the allyl

group) Act as a degradative chain-transfer agent (i.e., when activated, it

preferably undergoes primary radical termination, rather than propagation).

Temporary cements containing eugenol may negatively affect the

polymerization of methylmethacrylate used in provisional restorations. Craig’s. Restorative Dental Material. 13th ed

Non-eugenol cement TNE-Temrex Non-Eugenol Temporary

Cement(Temrex) Dentsply Integrity TemGrip Non-Eugenol Temporary Cement(Morita) PowerTemp (kerr dental)

Composition Integrity TempGrip  Organic acids;  Zinc oxide;  Methacrylates;  Catalyst;  Stabilizer

www.dentsply.es

Indication Temporary cementation of provisional acrylic and

composite indirect restorations. Provisional or trial cementation (limited time) of

ceramic, porcelain, composite, PFM (porcelain fused to metal) and all metal crowns and bridges.

EBA and other chelate cements

Modified ZOE  EBA alumina- modified cements provisional restorations.  Has improved carvability prevented chipping during

trimming  symptomatic teeth without pulp exposure showed no

symptoms.  EBA low solubility in water, disintegrated and wore excessively

in the mouth.



Application These materials have been used  cementation of inlays, crowns, and fixed partial

dentures  for provisional restorations  base or lining materials.

O’Brien. Dental material and their selection. 3rd ed.(2002)


Composition Powder

Liquid

Zinc oxide

Ethoxybenzoic acid -

Aluminum oxide or other

50% to 66% with the

mineral fillers-20% to 30% .

remainder eugenol.

Polymeric reinforcing agents poly(methyl methacrylate), may also be present



Setting The setting mechanism has not been fully elucidated. It appears to involve chelate salt formation between

the EBA, eugenol, and zinc oxide. The setting is accelerated by the same factors that are

operative for zinc oxide-eugenol cements.


Manipulation Cement is dispensed according to the

instructions kneaded for 30 seconds,

and then stropped for

60 seconds to develop a creamy consistency. Oil of orange can be used to clean eugenol

cements from instruments.

Craig’s restorative dental material. 11th ed.

Properties  Setting time ; 7 and 13 minutes.  The EBA cements show viscoelastic properties with very low strength

and large plastic deformation at slow (0.1 mm/min) rates of deformation and at oral temperature (37°C).  Solubility similar to - polymer-reinforced zinc oxide-eugenol materials in

distilled water, although loss of eugenol also occurs.  The resistance to solubility in organic acids appears to be greater than

that of the zinc phosphate cements.  When exposed to moisture, greater oral dissolution occurs than for other

cements. O’Brien. Dental material and their selection. 3rd ed.(2002)

Zinc oxide Film eugenol Thickn ess(m m)

Setting time (min)

Solubility (wt%)

Compres sive (MPa)

Tensile (MPa)

Modulus of elasticity

Unmodified 25-35

2-10

1.5

2-25

1-2

-

Polymer reinforced

35-45

7-9

1

35-55

5-8

2-3

EBAalumina

40-60

7-13

1

55-70

3-6

3-6


Advantages and Disadvantages Advantages  easy mixing, long working time, good flow characteristics, and

low irritation to pulp.  Strength and film thickness can be comparable to those of zinc

phosphate cements.

Disadvantages  Critical proportioning, hydrolytic breakdown in oral fluids,

liability to plastic deformation, and poorer retention than zinc phosphate cements.

Resin reinforced ZOE Used cementing agents for crowns and fixed partial

dentures cavity liners and base materials provisional restorative materials.


Powder

Liquid

Zinc oxide- 10% to 40%

Eugenol

natural or

accelerators - acetic

synthetic resins (eg,

acid, antimicrobial

colophony [pine resin],

agents - thymol or 8-

poly[methyl methacrylate],

hydroxyquinoline.

polystyrene, or polycarbonate) together with accelerators.


Manipulation  More powder is required for a cementing mix than with other

cements.  The mixing pad or slab should be thoroughly dry.  The powder is mixed into the liquid in small portions with vigorous

spatulation until the correct amount has been incorporated.  Adequate time should be allowed for setting without disturbance

of the cement. Both powder and liquid containers should be kept closed and stored under dry conditions.


Properties Because of the presence of the resin, the

solubility of these cements appears to be somewhat lower than that of zinc oxide-eugenol materials.


Advantages and Disadvantages Advantages  Minimal biologic effects, good initial sealing properties, and

adequate strength for final cementation of restorations.

Disadvantages  Lower strength, higher solubility, and higher disintegration

compared to zinc phosphate cements; hydrolytic instability; and the softening and discoloration of some resin restorative materials.


Fluoride releasing dental cements These material have Low strength – resin based

composites and amalgam  low stress areas.  Temporary and intermediate restorations.

Use of dental cements began with silicate cement.


Anticariogenic mechanism of fluoride:  Increased acid resistance of enamel  Enhancement of remineralization,  Inhibition of carbohydrate metabolism by the acidogenic

plaque microflora.


Cements as luting agents The word luting implies the use of a moldable

substance to seal a space or to cement two components together.

Phillip’s Science Of Dental Materials. 11thed.

Microscopic image of the abutment prosthesis interface

A – irregular surface

B – two surface pressed against each other

C – continuous interface with third material

D – voids generation


Procedure for luting Placement of cement Seating the prosthesis Removing excess cement.

Placement of cement Cement paste should coat  Inner surface of the crown

and extend slightly over the margin. The occlusal aspect of the tooth preparation must be

free of voids - to ensure no air entrapment. If voids remain in the occlusal region  excessive

tensile stress in the ceramic and a greater risk for fracture.


Seating  Moderate finger pressure - displace excess cement.  Marginal gap evaluated with explorer at three or more

points.  Patient is asked to bite on a piece of cotton roll to ensure

complete seating.


Removal of excess cement Brittle state  does not adhere to the surrounding

surfaces, the tooth and the prosthesis  removed after it sets. Zinc phosphate and ZOE cements.

Glass ionomer, zinc polycarboxylate, and resin

cements adhere both chemically and/or physically surfaces can be coated  separating medium to inhibit cement adherence Phillip’s Science Of Dental Materials. 11th ed.

Mechanism of Retention  Retained  mechanical or chemical  Cement fills the irregular crevice cement/prosthesis and

cement/tooth  exhibit a void-free sealed  cement layer can resist shear stress acting along the interface

Mechanism through which dental cement provides mechanical retention of a gold inlay. Cement penetrates into irregularities in the tooth structure and the casting. Phillip’s Science Of Dental Materials. 11th ed.

Dislodgement of Prosthesis Fixed prostheses can debond because of biological

factors, physical reasons, or a combination of the two. Secondary caries forms the biological reason. Modes of failure;  Fracture of cement  Leakage along the interface


Materials for luting Zinc phosphate cement Zinc polycarboxylate cement Resin cements Glass ionomer cements ZOE

Zinc phosphate Oldest - luting cements Commercial names 

Harvard cement

Introduced by PIERCE 1879.  Temporary restoration  Luting agent

Supplied as powder and liquid form. Cements are classified according to the particle size  Type I – fine grained – 25 μm  Type II – medium particle size – 40 μm

Textbook of Operative Dentistry. Vimal Sikri. 1st ed. 2006

Powder Composition Weight (%)

Function

ZnO

90.2

Principal ingredient

MgO

8.2

To reduce temperature of Calcination process

SiO,

1.4

inactive filler

Bi203

0.1

Impart a smoothness to the freshly mixed cement mass, in large amounts it may also lengthen the setting Time

Misc. BaO, Ba,S04, CaO

0.1

Tannin fluoride may be added to provide a source of fluoride ions in some products.


Liquid Composition

Weight (%)

H3P0,(free acid)

38.2

H3P04 (combined with Al and Zn)

16.2

Al

2.5

Zn

7.1

H20

36.0


Manufacture of powder Main ingredients of powder are sintered at

temperatures between 1000 °C – 1400 °C. Then ground to powder. Particle sizeSmaller the particle size – faster set of the

cement.


Setting reaction POWDER

LIQUID

Phosphoric acid attacks the surface of particles and release zinc ions.

Zinc reacts with aluminium to form zinc alumino-phosphate gel

The set cement consist of unreacted zinc oxide particles in amorphous matrix of zinc aluminophosphate. Phillip’s Science Of Dental Materials. 11th ed.

Mixing slab  Combination of powder/ liquid is an exothermic reaction.  Cooled slab – 18-20°C

Powder/liquid ratio  Filling – 2.5:1  Luting – 1.5:1

Textbook of Operative Dentistry. Vimal Sikri. 1st ed. 2006

Care of the Liquid  Exposure of zinc phosphate cement liquid humid atmosphere

 absorb water  Exposure to dry air  loss of water.  addition of water more rapid reaction shorter setting time.  loss of water from the liquid lengthened setting time.  Tightly close bottle.  Polyethylene squeeze bottles.


Manipulation initially small portions of powder into the liquid,

minimal heat is liberated and dissipated.

Long, narrow-bladed stainless steel spatula

Spread the cement  large area (control the temperature of the mass and its setting time) Craig’s Restorative dental materials. 11th ed

Manipulation of zinc phosphate Skinner’s Science of Dental Materials. 7th ed. 1973

 Small increments at start – partial neutralization  Later large increments – in the middle of mixing period  Finally small increments are added.  Mixing procedure begins (slow maturation) and ends

(critical consistency) with small increments  Mixing – 60-90seconds


Frozen Slab Method  Glass slab cooled in a refrigerator at 6°C-10°C.  Amount of powder -frozen slab method is 50% to 75%

more than with the normal procedures.  Compressive and tensile strengths  not significantly

different.  Incorporation of condensed moisture into the mix in the

frozen slab method counteracts the higher powder/liquid ratio.


The advantages of the frozen slab method are  Increase in working time (4 to 11 minutes) of the mix on the

slab.  Shorter setting time (20% to 40% less) of the mix after

placement into the mouth.  Cementation of bridges with multiple pins.


Setting time Manufacturing process  Higher sintering temperature - cement set slowly  Presence of water in liquid  Larger particle size – less rapid reaction – decreased surface

of powder and liquid.

Skinner’s Science of Dental Materials. 7th ed. 1973

Factors under the control of dentist  Lower temperature during mixing.  Rate of addition of powder in liquid.  Longer mixing time – longer setting time.  More liquid in ratio to powder – slower setting time.


Acidity  During the formation of zinc phosphate  change in pH.  3minutes after start of mixing pH – 3.5.  24- 48hours – pH comes to neutrality.(6.6 – 6.8)  7 – 28day – pH is 6.9  Thin mix – both initial and 28days are approximately 0.5 unit

lower than thick mixes.


Precautions include the use of  resinous, film forming, cavity varnishes; calcium hydroxide

and zinc oxide suspensions; ZOE or calcium hydroxide bases; and, more recently, dentin bonding agents.


Consistency

Temperature of slab - 18°C

Temperature of slab – 29.5°C

Two mixes of cement prepared with identical P/L


Standard consistency is determined by Modified SLUMP

test. (ADA specification no 8)

Luting

Base

Retain alloy restoration

Thermal and chemical insulation

Cement string from the slab on spatula 2-3cm

Higher P/L


Retention No adhesion between tooth structure and zinc

phosphate cement. Mechanical retention. Thickness of film between inlay and tooth - thinner


Strength  Mixture of standard consistency consist of 1.4gm of powder and

0.5ml of liquid


75 % of maximal strength attained during 1hour.


Strength influenced by; Initial P/L Manner of mixing and handling Compressive strength develops rapidly with luting

consistency reaching 2/3rd of final strength within 1 hour.


Solubility and Disintegration  Cemented cast restoration, solubility of cement is important

consideration.  Thin line of cement is always exposed to oral fluid at margins  Cement line thicker then 50 micrometers.  ADA specification no 8  Solubility immersed in distilled water for 24hrs should not exceed

0.20%.


Solubility of Zinc phosphate cement in solution of varying pH for 1 week. Skinner’s Science of Dental Materials. 7th ed. 1973

Dimensional Stability  Cement exhibits shrinkage on hardening.  Normal dimensional change  properly mixed cement is

brought into with water  slight initial expansion,  Expansion  slight shrinkage on the order of 0.04% to

0.06% in 7 days.


Thermal and Electrical Conductivity Primary uses of zinc phosphate cement  insulating

base beneath metallic restorations. Presence of moisture  not have a significant effect on

the thermal conductivity of cement But, moisture present under clinical conditions 

greatly reduces the good electrical insulating.


Biocompatibility Cytotoxicity studies  Zinc phosphate cements are cytotoxic immediately after

mixing.  After complete setting - almost no cell damage is seen

Implantation studies  Rats and guinea pigs showed that subcutaneous

implanted zinc phosphate cements cause a pronounced inflammatory reaction immediately after mixing, which disappeared after a few weeks Biocompatibility of Dental Materials. Gottfried Schmalz, Dorthe Arenholt-Bindslev. 2009

Histopathological studies When used as base is not a highly toxic material. Some displacement of odontoblast layer, and

infiltrating inflammatory cells is countable, implying the presence of a moderate lesion. After 36 days - no signs of inflammation were

present

Biocompatibility of Dental Materials. Gottfried Schmalz, Dorthe Arenholt-Bindslev. 2009

Application Zinc phosphate cement is used most commonly luting permanent metal restorations base. Other applications include cementation of

orthodontic bands

Zinc polycarboxylate Developed - late 1960s. Zinc polyacrylate cements (or zinc polycarboxylate) Supplied as a powder and a liquid The liquid is a water solution of polyacrylic acid Mixed cement - Classified as pseudoplastic.

O’Brien. Dental Material and their Selection. 3rd ed.

On the basis of their composition, polycarboxylate

cement are of three types Type I – powder contains 90% zinc oxide and 10%

magnesium oxide. Type II – 30-40% alumina replaces zinc oxide

powder Type III – polyacrylic acid is freeze dried and

incorporated in powder. Textbook of Operative Dentistry. Vimal Sikri. 1st ed. 2006

Applications  Used for the cementation of cast alloy and porcelain  Restorations  Orthodontic bands  Cavity liners or base materials  Provisional restorative materials.

O’Brien. Dental Material and their Selection. 3rd ed.

Setting reaction

Zinc polycarboxylate

Figure – setting reaction It occurs through the chelation of zinc of powder by the carboxylate group of polyacrylic acid. Adhesion to the tooth occurs through chelation of calcium.


Manipulation P/L  1.5:1 (Weight) – Phillip’s  1:2 to 2:1. (Craig)

 Powder & liquid dispensed just before mixing.  Mixed on – non absorptive surface, such as a glass slab


Powder is rapidly incorporated into the liquid in large

quantities. Mixing time 30-40sec. Loss of luster and stringy consistency – setting reaction

has progressed – film thickness and proper wetting of tooth cannot take place.


Typical consistency for water mix polycarboxylate and glassionomer cements. (O’Brien 3rd ed)

Consistency of zinc polycarboxylate cement upon completion of 30 sec of mixing. If the mixing time is prolonged or the mix is allowed lo remain on the slab, the cement becomes dull in appearance and the material becomes tacky to the touch.


Mechanical properties Values Compressive strength

55-67MPa (Phillip’s)

DTS

8-12 Mpa (O’Brien)

Modulus of elasticity

6 Gpa (O’Brien)

Solubility

0.1% to 0.6% (O’Brien)

Bond strength Enamel

3.4 to 13 MPa,

Dentin

2.1 MPa.


Solubility  Low solubility in water  When exposed to organic acid pH <4.5, solubility

increases.  Reduction in P/L – increases solubility and disintegration.


Biological property pH of the cement liquid is approximately 1.7 Liquid is rapidly neutralized powder pH of the mix rises rapidly as setting reaction

proceeds. pH of polycarboxylate cement is higher than zinc

phosphate cement at various time interval. Phillip’s Science Of Dental Materials. 11th ed.

 Initial acidic nature of zinc polycarboxylate cements -

minimal irritation to pulp.  Because of larger size of the polyacrylic acid molecule

compared with phosphoric  may limit diffusion through the dentinal tubules  Excellent biocompatibility with the pulp is a major factor in

the popularity of this cement system.


Resin cement Resin cement has become attractive as a luting agent

because of the development of direct-filling resins with improved properties, the benefit of the acid-etch technique Resin cements are essentially flowable composites of low

viscosity.


ADA specification no 27 describes 3 classes of

composite cements.  Class I – Self cured materials  Class II – Light cured materials  Class III – Dual cured materials


Chemically activated resin  Commercially available as  Two component systems  Powder- liquid  Paste-paste


 The two components are combined by mixing on a paper

pad for 20 to 30 sec.  Removal of the excess cement is difficult if it is delayed

until the cement has polymerized  It is best to remove the excess cement immediately after

the prosthesis is seated.  This cement is suitable for all types of prostheses


Light curable  Single -component systems.  Available as RelyX™ Unicem Self-Adhesive Resin Cement. Variolink

II resin cement. Ivoclar.  Indicated  Cementation of thin ceramic prostheses  Resin-based prostheses  Direct bonding of ceramic and plastic orthodontic brackets when

the thickness of the appliance in the bonded area is less than 1.5 mm


 Through the ceramic restoration, Exposure of light –

not less than 40sec.  Excess cement removed as soon as seating is

completed.

Dual cure cements  Self cure and light cure.  Available as PANAVIA F 2.0 by Kurray America Inc.

Scotchbond Resin cement 3M Co. St. Paul, MN, USA.  Chemical activation is very slow and provides extended

working time until the cement is exposed to the curing light, at which point the cement hardens rapidly.


 Dual -cure cements should not be used with light

transmitting prostheses thicker than 2.5 mm; anything thicker than 2.5 mm should be bonded with chemically curable cement.  Removal of excess cement may proceed upon completion of

seating


Miscellaneous Mineral trioxide aggregate Biodentine I Root BP

MINERAL TRIOXIDE AGGREGATE

MINERAL TRIOXIDE AGGREGATE  Introduced by TORABINEJAD (1993).  Commercially MTA is available (ProRoot MTA; Tulsa Dental

Products, Tulsa, OK, USA) in grey and white forms.  MTA was first described in the dental scientific literature in 1993  Approved for endodontic use by the U.S. Food and Drug

istration in 1998.

Torabinejad M, Watson TF and Ford TRP. Sealing Ability of a Mineral Trioxide Aggregate When Used As a Root End Filling Material. J endod 1993;19(12) 591-5.

Indications  Pulp capping with MTA on human primary (Farsi et al. 2005, Maroto et al. 2005, 2006)

and permanent

(Farsi et al. 2006)

 Other indications  Apexification  Apexogenesis  Internal and external resorption  Close iatrogenic perforations of roots (Lee et al. 1993)  Lateral or furcation involvement  Retrograde filling of root ends (Torabinejad et al. 1995)  Furcations (Pitt Ford et al. 1995).

Composition Mineral trioxide aggregate (MTA)  Portland cement (75%)  Bismuth oxide (20%)  Gypsum (5%).  Contains trace amounts of SiO2, CaO, MgO, K2SO4 and

Na2SO4.

Roberts HS, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: A review of the literature. Dental materials 24(2008) 149–164.

Composition Major content is a mixture of  Dicalcium silicate  Tricalcium silicate  Tricalcium aluminate  Gypsum  Tetracalcium aluminoferrite

On addition of water the cement hydrates to form silicate

hydrate gel - solidifies to a hard structure in less than 4 hours. Roberts HS, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: A review of the literature. Dental materials 24(2008) 149–164.

Asgary S, Parirokh M, Egbbal MJ, Brink F. Chemical differences between white and gray mineral trioxide aggregate. J Endod 2005;31:101–3.

Manipulation Torabinejad 1995;  Product high alkalinity, whose  pH is 10.2 during manipulation  12.5 after 3 hours.

MTA powder mixed with sterile water Ratio 3:1.


 Mixture  with exposure using a Dovgan carrier.  Compress the mixture against the exposure site  moist

cotton pellet.  Place a moist cotton pellet temporarily placed over the MTA

left until a follow-up appointment. Upon hydration, MTA materials form a colloidal gel that

solidifies to a hard structure in approximately 3–4h.


The setting process is described as  Hydration reaction of tricalcium silicate (3CaO·SiO2) and

dicalcium silicate (2CaO·SiO2), which the latter is said to be responsible for the development of material strength.

Although weaker than other materials used for similar

purposes, MTA compressive strength has been reported to increase in the presence of moisture for up to 21 day


 Studies have shown  MTA stimulates dentin bridge formation adjacent to the

dental pulp because of its property of; 

sealing ability



Biocompatibility



alkalinity.

Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, and Kawashima I. Physicochemical Basis of the Biologic Properties of Mineral Trioxide Aggregate. J Endod 2005;31:2:97-100

A Cut face of the mesial half of a 28 with remnants of the capping () and restorative material (white plug in the cavity preparation and pulp chamber). x7

B Histological section of the specimen. Note the cavity opening into the pulp chamber, remnants of the capping material () and healthy remaining pulp (PU). x18

Pulpal response to mineral trioxide aggregate (MTA) capping after 1 week observation. Distal macrophotographic view Nair PNR, Duncan HF, Pitt Ford TR & Luder HU. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J. 2008:41;128–150.

C

D The rectangular areas demarcated in (b) and (c) are magnified in (c) and (d) respectively. Note the pulp–cap interface with fibrous encapsulation (arrowheads) and absence of pulpal inflammation. Original magnifications: C - x90, D- x220

MTA

Results

1week

 Presence of a fibrous capsule  Absence of pulpal inflammatory cells.  Signs of Necrosis and Mild hyperaemia was evident in some of the sample  Exposed pulp tissue direct revealed a mild inflammation with mixed inflammatory cell infiltrate.

1month

 Some showed complete hard tissue  pulpal cells lining the hard tissue barrier were mostly cuboidal, but also columnar cells were seen  TEM examination revealed cytoplasmic processes projecting into the bridge  No evidence of necrosis or inflammation

3months

 complete hard tissue bridge.  Some showed  complete bridges were devoid of pulpal inflammation.  one with an incomplete bridge  light microscopic evidence of tubule formation at the pulpal aspect of the dentine bridge,that was lined by mostly cuboidal cells.  TEM examination revealed structures reminiscent of dentinal tubules in early stages of development containing cytoplasm of the lining cells

Calcium hydroxide Amorphous  Precipitations of coarse calcium granulations, constituting the so

called superficial granular zone, which is associated with the initial synthesis and deposition of disorganised dentin matrix.

Reston EG and de Souza Costa CA. Scanning electron microscopy evaluation of the hard tissue barrier after pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA) or ProRoot MTA. Aust Endod J 2009; 35: 78–84

Mixed type –  External layer is irregular and atubular, the internal layer

exhibits the typical dentinal characteristics with pre-dentin and irregular, tortuous, randomly distributed tubules,similar to those present in the reparativedentin

Localisation of barrier - Peripheral


MTA  Hard tissue barriers with predominance of dentinal tubules.  Mixed hard tissue barriers were also found.  Localisation of the barriers - occurred in the

centroperipheral area.


Morphology. Example of an amorphous Ca(OH)2-induced hard tissue barrier.

Morphology. Example of a tubular ProRoot mineral trioxide aggregateinduced hard tissue barrier. 3000x


BIODENTINE

www.septodont.com

 Introduced in 2005 by Prof. About, University of Marseille,

.  Indirect pulp capping in rat molars- Prof. Michel Goldberg

(2009)  Direct pulp capping - Prof. Gilles Koubi (2011)  Endodontic application – Prof. Pierre Machtou(2011)

www.septodont.com

Composition  Tricalcium silicate powder  Aqueous calcium chloride solution

Properties  It is a bioactive dentine substitute  Mechanical properties similar to the sound dentine and can

replace it both in the crown and in the root.  Contains mainly high-purity, monomer-free mineral

ingredients.

www.septodont.com

Mixing instruction  Take a capsule and gently tap it on a hard surface to loosen

the powder.  Open a capsule and place it on the stand.  Detach a single-dose container of liquid and gently tap on

the sealed cap to force all the liquid down the container. Twist cap to open.  Squeeze out the entire contents of the single-dose container

into the capsule. Close the capsule.

 Place the capsule on a mixing device, such as Technomix, Tac

400 (Lineatac), Silamat, CapMix, Rotomix, Ultramat etc., at a speed of 4000 – 4200 rotations/min, and mix for 30sec.  Open the capsule and collect Biodentine® material with a

suitable instrument.  Rapidly rinse and clean the instruments to remove any

residual material.  Mixing time – 6min, Setting time – 6min

Indications When used in the crown: 

Temporary enamel restorative material.



Permanent dentine restorative material.



Restoration of deep and/or large coronal carious lesions (sandwich technique).



Restoration of deep cervical and/or radicular lesions.



Pulp capping.



Pulpotomy.

www.septodont.com

When used in the root:

- Repair of root perforations. - Repair of furcation perforations. - Repair of perforating internal resorptions. - Repair of external resorption - Apexification. - Root-end filling in endodontic surgery (retrograde filling).

I Root BP

http://www.veriodent.com

 Working time of 30+ minutes, iRoot BP.  Material is available in preloaded syringes and in a moldable

putty form  Application Uses:  Pulp Capping  Apexification  Repair of Root Perforation  Repair of Root Resorption  Root End Filling


Properties:  Highly Bioactive & Biocompatible  Hydrophilic  High Ph >12 / Antibacterial  Compressive Strength - 70~90 Mpa  Excellent Radiopacity


Properties of dental cements 1.

Film thickness and consistency

Typically in range of 25-150μm. (Phillip’s) Determination of film thickness  Well mixed, non-granular

Craig’s Restorative dental materials. 12th ed Phillip’s Science of Dental Material. 11th ed.

Factors affecting film thickness  Particle size of powder  Concentration of powder in liquid  Viscosity of the liquid  Consistency of the cement  Amount of force during cementation  Manner in which force is applied in restoration


Consistency  Heavier Consistency more, Thickness is more  Leading to less complete seating of the restoration.



2. Viscosity  Increase by increase in temperature and time.  Prompt cementation after completion of mixing.  Delay cause; Increase in film thickness Insufficient seating of restoration.


3. Setting time Determined by ANSI/ADA Specification No. 96. A sufficient period of time  after mixing  To seat and finally adapt the margins of a casting,  To seat and adjust a series of orthodontic bands, or  To properly contour a base or provisional restoration


 Adequate working time is expressed by proper net setting

time,  2.5 and 8 minutes at a body temperature of 37°C.

 60 to 90 seconds – consumed by mixing the powder and

liquid.  Net setting time is the time at which cement is sufficiently

hard to resist indentation by standard indenter.


4. Strength Standard luting cement - 24-hour compressive strength of 70 MPa.


5. Solubility Water and oral fluids Water based cements > resin/oil based



Bibliography  Skinner’s Science Of Dental Materials. 7th ed.  Craig’s. Restorative Dental Material. 13th ed  Craig’s. Restorative Dental Material. 12th ed  Phillip’s Science Of Dental Materials. 11th ed.  O’Brien dental material and their selection. 3rd ed.2002  An atlas of glass ionomer cement. GJ Mount. 3rd ed. 2002.

 Sturdevant’s art and science of dental materials. 4th ed.  Sturdevant’s art and science of dental materials. 5th ed.  Principles and practice of operative dentistry. Charbeneau. 2 nd

ed.1981.  Textbook of Operative Dentistry. Vimal Sikri. 1st ed. 2006  Biocompatibility of Dental Materials. Gottfried Schmalz, Dorthe

Arenholt-Bindslev. 2009

Referred articles  Journal of History of Dentistry 2005;July, 53(2):63-72.

 Contemporary Permanent Luting Agents Used in Dentistry: A Literature

Review Ebru SÜMER1, Yalçın DEĞER2(Int Dent Res 2011;1:26-31)

 Preserving the Vital Pulp in Operative Dentistry: 3. Thickness of

Remaining cavity Dentine as a Key Mediator of Pulpal Injury and Repair Responses. PETER E. MURRAY, PHILIP J. LUMLEY AND ANTHONY J. SMITH. Dental Update – May 2002

 Torabinejad M, Watson TF and Ford TRP. Sealing Ability of a Mineral

Trioxide Aggregate When Used As a Root End Filling Material. J endod 1993;19(12) 591-5.

 Mohammadi &Dummer; properties and applications of calcium

hydroxide in endodontics and dental traumatology. Int Endod J:2011;44,697-730.

 Nair PNR, Duncan HF, Pitt Ford TR & Luder HU. Histological,

ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J. 2008:41;128– 150.

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