Uses of Dental Cement
Protection Luting-Cementation Restorations Not one cement will work for all of your needs
irritation created by
Bacterial effects from caries Biologic response to chemicals in restorative materials Cutting tooth structure Thermal conductivity
with 5-15 seconds between layers Do not leave the lid off
Acts as a protective barrier between preparation and restoration Placed on the walls and floor of the prep Seal tubules Minimize leakage Solution of
• Natural resins (copal) • Synthetic resins dissolved in a solvent such as alcohol/chloroform
Apply 2-3 layers.
not used much today Dentin bonding agents have replaced
Product seals enamel tubules and dentin
Liner/Low Strength Base
hydroxide Commonly used
when dentin no longer covers
pulp Small pulp exposure is expected Stimulates secondary dentin and insulator
Due to alkali (pH is 9-11)
Paste: Base and catalyst. use = amounts
putty-like consistency (secondary consistency) Roll into a ball Thickness 0.Strength Base/Liner
when deep cavity leaves 2mm or less of dentin over the pulp Provides thermal insulation Support for restorations Cement used like base
mechanical support Used when excessive amount of tooth structure is removed Provides and reinforces foundation before crown
bridges. orthodontic brackets and bands. crowns.Luting-Cementation
Cementing 2 components together such as an indirect restoration cemented on or in a tooth. and posts and pins
and temporary luting
Fixed prosthesis Orthodontic bands
. veneers. such as inlays.
the restoration-tooth interface 10-2 Primary consistency
25m or less Oral fluids can cause dissolution of the cement
Bacterial plaque can accumulate beneath a crown and result in recurrent caries Chemical bonded cements are better at reducing this problem
flow to have a film thickness of .
like Sedative or provisional restoration
• Evaluate pulp
Also used for teeth waiting to be restored
Permanent or temporary Not frequently chosen for permanent
Lower strength Wear resistance Higher solubility Except for glass ionomer
• Releases fluoride. may be used for class V
Intermediate restorations (IRM)
Mix to secondary consistency Putty .
Provide protection Support
comfort Help control bleeding Mixed to a putty-like consistency which will harden over the tissue
Properties of Dental Cements
Strength Solubility Viscosity/Film
Thickness Biocompatability Retention Esthetics Ease of manipulation
you will weaken
. increase strength
Add too much.Strength
comprehensive strength Strongest
Zinc oxide eugenol (ZOE)
cements have different strength qualities Increase powder.
less likely to wash out) than amalgam)
Most tend to dissolve in fluids within oral cavity Causes mircroleakeage recurrent caries
cements (lower solubility (stronger.
of mixed cement is the measure of its ability flow under pressure
Needs to flow Mixed thin. crown and bridge
Slow setting time Gives more working time to clinician
.e. consistency of honey
• Primary consistency
Critical for seating and retaining indirect restorations (25m or less)
putty-like Roll in a ball Utilized as a base and restoration (perm or temp) More powder will increase strength and decrease the solubilty
consistency requires additional powder
cements represent combination of zinc oxide powder or powdered glass and an acid Eugenol has sedative effect Powered glass cements
Release fluoride-reduces secondary caries
pH of cement (due to acid)
This can cause irritability of the pulp
Attach one substance to another by bonding dissimilar materials by the attractive forces of atoms or molecules Mechanical adhesion
• Based on the interlocking of one material with another
• Occurs at the molecular level when atoms of the two materials swap atoms (ionic bonding) or share outer electrons (covalent bonding).
Mechanical and chemical can occur together
margins compromised = secondary caries
may be weakened
Differences in the coefficient of thermal expansion of the two materials Dimensional changes during setting of the adhesive agent Contamination of the substrates by water/saliva or by residual enamel and dentin debris (smear layer)
cement penetrates microscopic irregularities on all surfaces and restoration
Resistance to microleakage Highly retentive
Form weak chemical bonds
• Aid in retention • Reduce microleakage
available in variety of shades and opacities Would like a more translucent effect for light to pass through the restoration Mask the color of dentin
Follow manufacturer’s directions Hand mixed Pad or glass slab (room temp or cold?) Pre-dosed capsules Automixing cartridges
Chemical Light cured Combination
powder and liquid separate Fluff powder Level scoop of powder. not heaping Dispense uniform drops of liquid Close caps immediately after dispensing Incorporate
sides of spatula Mix in 8-figure motion Test viscosity
cement side down on the palm of your hand to dentist
.Loading the Restoration
cement from mixing surface with the blade of the spatula Wipe the blade against the margin of the crown Cover all the walls with a thin even coating of cement Pass the crown.
Loading the Restoration
Removal of Excess Cement
manufacturer’s instructions for appropriate consistency for removal
cement in bulk when possible Use an explorer or scaler to remove from smooth surfaces Use a piece of knotted floss to remove cement from interproximal areas (or scaler) Complete removal is essential to maintain gingival health
. rock hard.
oil of cloves
.Zinc Oxide Eugenol (ZOE)
or paste-paste system
Base. root-canal sealer. and intermediate restoration. base. surgical dressings Zinc oxide (may have resin enforces too) Eugenol
Distinct smell of cloves. catalyst
Zinc Oxide Eugenol
Wide variety of uses Sedative to pulp Easily manipulated Highly biocompatible
Cannot use under composites Low strength High solubility Cannot use under indirect restorations cemented with resin or glass ionomer
fluff powder Dispense liquid at one end and powder at other Incorporate in 2 increments or all at once.Zinc Oxide Eugenol (ZOE)
Mixing to primary consistency if using a paste Equal lengths about 1 inch Pad or glass slab Mix using both sides of the blade of the flexible spatula Lifts 1 inch up in air (ice cream)
Mixing to 2ndary consistency Glass slab Shake liquid. roll in a ball
Zinc Oxide Eugenol (Secondary Consistency)
thermal protection Incremental incorporation while mixing Mix over large area on glass slab Zinc oxide powder Liquid
Phosphoric acid + water
Oldest cement Not widely used today Powder-liquid system Luting. indirect restoration High strength base.
Long clinical hx Low film thickness Inexpensive High rigidity
Initial pulp irritation
• Low acidity
Mechanical bond only Technique-sensitive Relatively high solubility
liquid on other Increments of powder (see manu) Each mixed from 1015 secs Mix in a figure 8 motion over LARGE area (absorb heat from
. dispense on one end.Zinc Phosphate
Cool glass slab Shake powder.
Mix should string up 1 inch for primary luting consistency HARD to remove from spatula and glass slab. CLEAN BEFORE CEMENT SETS
to develop adhesive bond to tooth structure Final cementation of indirect restorations Powder-liquid Powder
Zinc oxide Polyacrylic acid
Bonds to tooth structure Nonirritating to the pulp Inexpensive Easy to use
Higher solubility Lower strength Shorter working time
Powder/liquid Slab or pad Use manu scoop and dropper Powder to liquid Mix 30-60 secs Short working time
Lose gloss and become stringy = cannot use anymore
. high strenth base. restorative.Glass Ionomers
– 1969 Continue to evolve Versatile Release fluoride
Aluminum fluorosilicate glass
Traditional Glass Ionomers
system Encapsulated to mix in amalgamator Powder
Calcium fluoralumionsicate glass with barium glass Polyacrylic acid copolymer in water
and liquid mix
Polyacid attacks the glass to release fluoride ions
Traditional Glass Ionomers
with pulp Over-drying of the prep and moisture contamination during first 24 hrs
Possible sources of sensitivity
release for life or restoration
isolate when using as a build up Use varnish on margins to protect from moisture (indirect restorations)
Traditional Glass Ionomer Cement
Chemical adhesion to the tooth Fluoride release Easy to mix Moderate strength
Hx of post operative sensitivity Moisture sensitive during setting
Hybrid Glass Ionomers
ionomer + resin Resin:
improves bond strength and compressive and tensile strength Reduces solubility
Hybrid Glass Ionomers
Good strength Fluoride release Insoluble Chemical adhesion to the tooth Less post op sens Excellent film thickness
Not recommended for all ceramic restorations
• Due to expansion of the material as it absorbs moisture after setting
leaving tooth moist. wait 15 seconds (Figure 1). rinse 10 seconds. Apply
3M Scotchbond etchant to enamel and dentin. Blot excess water with a 3M mini-sponge or moist cotton pellet.
Avoid excess adhesive on all prepared surfaces.
.Apply two consecutive coats of 3M Single Bond adhesive to enamel and dentin (Figure 2). Dry gently for five seconds.
Light-cure each surface for 10 seconds
Dry for five seconds
. Apply 3M RelyX ceramic primer (#2721) to etched porcelain and roughened metal surfaces.Roughen the bonding surfaces of indirect composite crowns with a diamond or air abrasion.
Dispense cement onto a mixing pad and mix for 10 seconds. Apply a thin layer of cement to the bonding surface of the restoration
Optional: If excess cement is removed immediately after seating.
. Remove excess cement approximately three to five minutes after seating.Slowly seat the restoration. light-cure margins for 40 seconds after clean-up.
margins may be lightcured for 40 seconds (Figure 7) or allowed to self-cure for 10 minutes from start of mix.
Once the crown is seated. Note: For porcelain and pre-cured composite crowns.
. margins must be light-cured for 40 seconds.
resin Adhesive resin Compomer
composite material Bonding indirect ceramic restorations
Light-cured Dual-cured Chemically cured
filler particle size Pigments are added for matching the tooth color Virtually insoluble Difficult to remove excess cement is difficult once completely set Low viscosity for crowns and bridges
chemical cure or dual cure
Requires additional steps
• in the etch and bonding procedure • in preparation of internal restoration surfaces
Removal of excess cement may be difficult
High strength Insoluble Low wear Excellent bond Esthetic shades available Light cure.