copyright 2003, elsevier science (usa). all rights reserved. chapter 45 dental cements copyright...

Copyright 2003, Elsevier Science (USA). All rights reserved.

Chapter 45

Dental Cements Chapter 45

Dental Cements

Copyright 2003, Elsevier Science (USA).

All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher.

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Produced in the United States of America

ISBN 0-7216-9770-4


IntroductionIntroduction Dental cements are a classification of dental

materials that are continually used in dentistry. The American Dental Association and the International Standards Organization (ISO) have teamed up to classify dental cements according to their properties and their intended uses in dentistry.

Dental cements are a classification of dental materials that are continually used in dentistry. The American Dental Association and the International Standards Organization (ISO) have teamed up to classify dental cements according to their properties and their intended uses in dentistry.


Classification of CementsClassification of Cements

Type I: Luting agents that include permanent and temporary cements.

Type II: Restorative applications. Type III: Liner or base applications.

Type I: Luting agents that include permanent and temporary cements.

Type II: Restorative applications. Type III: Liner or base applications.


Luting AgentLuting Agent A material that acts as an adhesive to

hold together the casting to the tooth structure. Luting agents are designed to be either permanent or temporary.

A material that acts as an adhesive to hold together the casting to the tooth structure. Luting agents are designed to be either permanent or temporary.


Permanent CementPermanent Cement For the long‑term cementation of cast

restorations such as inlays, crowns, bridges, laminate veneers, and orthodontic fixed appliances.

For the long‑term cementation of cast restorations such as inlays, crowns, bridges, laminate veneers, and orthodontic fixed appliances.


Temporary CementTemporary Cement Temporary cements are used when the

restoration will have to be removed. Most commonly, temporary cement is selected for the placement of provisional coverage.

Temporary cements are used when the restoration will have to be removed. Most commonly, temporary cement is selected for the placement of provisional coverage.


Variables Affecting CementsVariables Affecting Cements Mixing time

• Make sure to follow the manufacture’s directions for the mixing time, working time, and delivery time.

Humidity • If the clinical area is warm or humid,

premature exposure of the cement to these environments can create a loss of water from the liquid or an addition of moisture to the powder.

Mixing time • Make sure to follow the manufacture’s

directions for the mixing time, working time, and delivery time.

Humidity • If the clinical area is warm or humid,

premature exposure of the cement to these environments can create a loss of water from the liquid or an addition of moisture to the powder.


Variables Affecting Cementscont’dVariables Affecting Cementscont’d Powder to liquid ratio

• Incorporating too much or too little powder will alter the consistency.

Temperature• Some types of cements put off an

exothermic reaction.

Powder to liquid ratio• Incorporating too much or too little

powder will alter the consistency. Temperature

• Some types of cements put off an exothermic reaction.


Mixing Dental Cements Mixing Dental Cements Before mixing, read and carefully follow the

manufacturer's directions for the brand being mixed.

Determine the use and then measure the powder and liquid according to the manufacturer's instructions.

Place the powder toward one end of the glass slab or paper pad and the liquid toward the opposite end (the space between allows room for mixing).

Before mixing, read and carefully follow the manufacturer's directions for the brand being mixed.

Determine the use and then measure the powder and liquid according to the manufacturer's instructions.

Place the powder toward one end of the glass slab or paper pad and the liquid toward the opposite end (the space between allows room for mixing).


Mixing Dental Cementscont’dMixing Dental Cementscont’d Divide the powder into increments. When increment sizes vary, the smaller

increments are used first. Incorporate each powder increment into

the liquid and then mix thoroughly.

Divide the powder into increments. When increment sizes vary, the smaller

increments are used first. Incorporate each powder increment into

the liquid and then mix thoroughly.


Types of CementsTypes of Cements Zinc-oxide eugenol Zinc phosphate Polycarboxylate Glass ionomer Composite resin

Zinc-oxide eugenol Zinc phosphate Polycarboxylate Glass ionomer Composite resin


Zinc Oxide Eugenol Zinc Oxide Eugenol Chemical Makeup

• Liquid: Eugenol, H2O, acetic acid,

zinc acetate, and calcium chloride. • Powder: Zinc oxide, magnesium

oxide, and silica.

Chemical Makeup

• Liquid: Eugenol, H2O, acetic acid,

zinc acetate, and calcium chloride. • Powder: Zinc oxide, magnesium

oxide, and silica.


Types of Zinc-Oxide Eugenol Types of Zinc-Oxide Eugenol Type I

• Lacks strength and long‑term durability and is used for temporary cementation of provisional coverage.

Type II• Has reinforcing agents added and is

used for the permanent cementation of cast restorations or appliances.

Type I • Lacks strength and long‑term

durability and is used for temporary cementation of provisional coverage.

Type II• Has reinforcing agents added and is

used for the permanent cementation of cast restorations or appliances.


Supply of Zinc-Oxide EugenolSupply of Zinc-Oxide Eugenol Liquid/Powder

• Mixed on an oil‑resistant paper pad.• Mixing time ranges from 30 to 60 seconds. • Setting time in the mouth ranges from 3 to

5 minutes. Paste

• Supplied as a two‑paste system as temporary cement.

• Pastes are dispensed in equal lengths on a paper pad and mixed.

Liquid/Powder• Mixed on an oil‑resistant paper pad.• Mixing time ranges from 30 to 60 seconds. • Setting time in the mouth ranges from 3 to

5 minutes. Paste

• Supplied as a two‑paste system as temporary cement.

• Pastes are dispensed in equal lengths on a paper pad and mixed.


Zinc PhosphateZinc Phosphate Chemical Makeup

• Liquid: Phosphoric acid, aluminum phosphate, and water.

• Powder: Zinc oxide, magnesium oxide, and silica.

Chemical Makeup• Liquid: Phosphoric acid, aluminum

phosphate, and water.• Powder: Zinc oxide, magnesium

oxide, and silica.


Types of Zinc PhosphateTypes of Zinc Phosphate Type I (fine grain)

• Used for the permanent cementation of cast restorations such as crowns, inlays, onlays, and bridges. This material creates the very thin film layer that is necessary for accurate seating of castings.

Type II (medium grain) • Recommended for use as an insulating

base for deep cavity preparations.

Type I (fine grain) • Used for the permanent cementation

of cast restorations such as crowns, inlays, onlays, and bridges. This material creates the very thin film layer that is necessary for accurate seating of castings.

Type II (medium grain) • Recommended for use as an insulating

base for deep cavity preparations.


Supply of Zinc PhosphateSupply of Zinc Phosphate

Powder/liquid• Powder is divided into increments

that vary in size. • It is critical that the powder be added

to the liquid in very small increments.• Cement must be spatulated slowly

over a wide area of a cool, dry, thick glass slab to dissipate the heat.

Powder/liquid• Powder is divided into increments

that vary in size. • It is critical that the powder be added

to the liquid in very small increments.• Cement must be spatulated slowly

over a wide area of a cool, dry, thick glass slab to dissipate the heat.


Polycarboxylate Cements Polycarboxylate Cements Chemical Makeup

• Liquid: Polyacrylic acid, itaconic acid, maleic acid, tartaric acid, and water

• Powder: Zinc oxide

Chemical Makeup• Liquid: Polyacrylic acid, itaconic acid,

maleic acid, tartaric acid, and water• Powder: Zinc oxide


Use of PolycarboxylateUse of Polycarboxylate Used as a permanent cement for cast

restorations, stainless steel crowns, and orthodontic bands.

Used as a nonirritating base under both composite or amalgam restorations.

Used as an intermediate restoration.

Used as a permanent cement for cast restorations, stainless steel crowns, and orthodontic bands.

Used as a nonirritating base under both composite or amalgam restorations.

Used as an intermediate restoration.


Supply of Polycarboxylate Supply of Polycarboxylate

Powder/liquid• Liquid may be measured by using

either the plastic squeeze bottle or the calibrated syringe‑type liquid dispenser.

• Liquid has a limited shelf life because it thickens as its water evaporates.

• Mixed on a nonabsorbent paper pad.

Powder/liquid• Liquid may be measured by using

either the plastic squeeze bottle or the calibrated syringe‑type liquid dispenser.

• Liquid has a limited shelf life because it thickens as its water evaporates.

• Mixed on a nonabsorbent paper pad.


Glass IonomerGlass Ionomer Chemical Makeup

• Liquid: Itaconic acid, tartaric acid, maleic acid, and water.

• Powder: Zinc oxide, aluminum oxide, and calcium.

Chemical Makeup• Liquid: Itaconic acid, tartaric acid,

maleic acid, and water.• Powder: Zinc oxide, aluminum oxide,

and calcium.


Types of Glass IonomerTypes of Glass Ionomer

Type I• For the cementation of metal restorations

and direct‑bonded orthodontic brackets. Type II

• Designed for restoring areas of erosion near the gingiva.

Type III • Used as liners and dentin bonding

agents.

Type I• For the cementation of metal restorations

and direct‑bonded orthodontic brackets. Type II

• Designed for restoring areas of erosion near the gingiva.

Type III • Used as liners and dentin bonding

agents.


Benefits of Glass IonomerBenefits of Glass Ionomer Powder is an acid‑soluble calcium. The

slow release of fluoride from this powder aids in inhibiting recurrent decay.

Causes less trauma or shock to the pulp than many other types of cements.

Low solubility in the mouth. Adheres to a slightly moist tooth surface. Has a very thin film thickness, which is

excellent for seating ease.

Powder is an acid‑soluble calcium. The slow release of fluoride from this powder aids in inhibiting recurrent decay.

Causes less trauma or shock to the pulp than many other types of cements.

Low solubility in the mouth. Adheres to a slightly moist tooth surface. Has a very thin film thickness, which is

excellent for seating ease.


Supply of Glass IonomerSupply of Glass Ionomer Powder/liquid

• Mixed manually on a paper pad or a cool, dry glass slab.

• Glass slab increases the working time of the cement.

Premeasured capsules• Triturated and expressed through a

dispenser.

Powder/liquid• Mixed manually on a paper pad or a

cool, dry glass slab. • Glass slab increases the working time

of the cement. Premeasured capsules

• Triturated and expressed through a dispenser.


Composite Resin Composite Resin Chemical Makeup

• Physical properties are comparable to those of composite resins.

• Low film thickness. • Insoluble in the mouth.

Chemical Makeup• Physical properties are comparable to

those of composite resins. • Low film thickness. • Insoluble in the mouth.


Uses of Composite ResinUses of Composite Resin Cementation of ceramic or resin inlays

and onlays. Cementation of ceramic veneers. Cementation of orthodontic bands. Direct bonding of orthodontic brackets. Cementation of all metal castings.

Cementation of ceramic or resin inlays and onlays.

Cementation of ceramic veneers. Cementation of orthodontic bands. Direct bonding of orthodontic brackets. Cementation of all metal castings.


Supply of Composite ResinSupply of Composite Resin Powder and liquid mix Syringe-type applicator Base and catalyst Light cure/dual cure system

• Recommended portions of either application are dispensed onto a paper pad and mixed rapidly with a spatula.

Powder and liquid mix Syringe-type applicator Base and catalyst Light cure/dual cure system

• Recommended portions of either application are dispensed onto a paper pad and mixed rapidly with a spatula.


Cement RemovalCement Removal Operator preparedness and

knowledge• Instruments selected for the procedure:

Explorer, mouth mirror, black spoon.• Use of a fulcrum.• Use of dental floss in and around the

embrasure areas.

Operator preparedness and knowledge• Instruments selected for the procedure:

Explorer, mouth mirror, black spoon.• Use of a fulcrum.• Use of dental floss in and around the

embrasure areas.

copyright 2003, elsevier science (usa). all rights reserved. chapter 45 dental cements copyright...

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