Dental Cementing Materials KBAGD

8/10/2019 Dental Cementing Materials KBAGD

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Dr. Waleed AlTherban


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An agent used to adhere or unite objects to eachother, that upon hardening will fill a space (lutingagent).

Glossary of Prosthodontic Terms 8


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Primary uses to bond the following to a tooth:

Preformed restorations. Pins and posts. Provisional restorations.

Indirect restorations. Orthodontic appliances.


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Secondary uses:

Cavity liners. Bases. Provisional restorative material.


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Low surface tension.

Excellent f low.

Develop strong bond through mechanical interlockingor adhesion.

Low solubility.

Low film thickness. Adequate resistance to dissolution in the oral

environment.


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High strength.

Tough.

Good handling.

Dimensionally stable.

Color stability. Low toxicity.


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Most cements are powder-liquid materials.

Cements set by chemical reaction between theingredients, often an acid-base reaction or involve

polymerization of a monomeric components.


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The luting agent served primarily: To fill the gap.

Prevent entrance of fluids.


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When used on pitted surfaces, they can provideeffective micromechanical bonding.

The deep irregularities necessary for micromechanicalbonding can be produced on:

Enamel surface by etching with phosphoric acid. Ceramic by etching with hydrofluoric acid.

Metals by electrolytic etching, chemical etching orsandblasting.


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Molecular adhesion involves physical forces (bipolar,Van der Walls) and chemical bonds (ionic, covalent)between the molecules of two different substances.


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ADA Specification No. 4

Type I materials Suitable for cementation of precision castings.

Type II materials Suitable for all other uses.


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1.

Temporary cements1. Eugenol cements.2. Eugenol-free cements.3. Resin cements.

2. Permanent cements


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1. Phosphate-based1. Zinc phosphate.2. Zinc silicophosphate.


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2. Phenolate-based1. Calcium hydroxide silicylate.2. ZnO eugenol

1. Polymer.2. EBA.3. Alumina.


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3. Polyacrylate-based1. Zinc polycarboxylate.2. Glass ionomer.


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4. Resin-based1. PolymethylmethacrylateGlass ionomer + Polymethylmethacrylate = Hybrid

2. Dimethylacrylate

1. Filled.2. Unfilled.


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Phosphoric acid Polyacrylic acid

Zinc Oxide

Aluminosilicate

Glass

Van Meerbeek, 2001

Zinc Phosphate Polycarboxylate

Silicate

Glass Ionomer


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Oldest cement.

Few compositional changes since 1920s.

ADA Specification no. 8

Type I, fine grain. Type II, medium grain.


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Powder: Mainly ZnO.

Liquid: Aqueous solution of phosphoric acid.

H2O.


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Cool glass slab.

Incremental additions of powder into liquid.

90 second mix Due to exothermic reaction.

H2O content of liquid setting time.

Extended working time and shorter setting time can beachieved by use of a cold mixing slab.

The tooth and restoration must be wet.


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Controlled byManufacturer.:

Powder composition. Degree of calcination. Particle size. Buffering content of

liquid. Water content of

liquid.

Controlled by clinician:

P/L ratio. Rate of powder

addition. Mixing temperature. Manner of

spatulation. State of liquid.


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Advantages:

Introduced in 1878 Easy to mix and use Sets sharply Long working time

Low film thickness Good retention High rigidity Low cost

Disadvantages:

Irritant to the pulp Non-adhesive (No

bond to tooth) Soluble in oral fluids

Slow setting time Moisture sensitivity

during mixing No fluoride release


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Silicophosphates

Modified zinc phosphates


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Advantages: Better strength, toughness

and abrasion resistancethanzinc phosphate cemenent;

Fluoride release

Translucency

Low solubility Better bonding

Disadvantages:

Low pH- increasedpulp irritation

Manipulation is morecritical than with zincphosphate cements.


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Zinc oxide and eugenol

Modified ZOE materials


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Two types, ANSI/ADA Specification No. 30

Type I, temporary cementation.

Type II, permanent cementation.


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Powder composition ZnO. Rosin, smoothens mix. Zn stearate and Zn acetate, affects set.

Small amount of fillers, such as silica.


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Liquid composition

ZOE Eugenol.

Non-ZOE Various carboxylic acids.


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A chemical reaction occurs between zincoxide and eugenol, with the formation ofzinc eugenolate (eugenate)


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The working time is long because moisture isrequired for setting.

The set time is controlled by moistureavailability, accelerators, and the powder/ liquidratio.

The compresive and tensile strength is very low.

The solubility is high.


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The eugenol gives the anodyne and obtundenteffect on pulp in the deep cavities.

The sealing capacity and antibacterial actionappear to facilitate pulpal healing.

When in direct contact with connectivetissues, the material is an irritant.


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Advantages:

Easy to mix Good short-term

sealer obtundent effect to

the pulp Good resistance to

marginal penetration

Disadvantages:

Direct contactirritates pulpal tissue

Little anticariogenicreaction

Eugenol can beallergenic

Low strength andabrasion resistance High solubility and

desintegration in oralfluids


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Temp Bond (Kerr)

Procem (ESPE)


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These materials have been used as cementing agents forcrowns and fixed partial dentures, cavity liners andbase materials and provisional restorative materials.


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The powder consists of zinc oxide with finely dividednatural or sunthetic resins together with acceslerators.

The liquid is eugenol, which may also contain dissolvedresins and accelerators as well as antimicrobial agents.

The setting reaction is similar to zinc oxide eugenolcements.


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Advantage: Good sealing

properties

Disadvantages: Low strength

Higher solubility

Higherdesintegrationcompared with zincoxide- eugenol

cements Softening and

discoloratio of someresin restorativematerials


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Modified ZOE cements EBA-alumina modified Polymer modified


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EBA = ETHOXYBENZOIC ACID.

These materials are used for cementation ofinlays, crowns, and fixsed partial dentures, forprovisional restorations, and as base or lining

material.


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Powder

ZnO

Al2O3 PMMA

Liquid

Eugenol O-Ethoxybenzoic acid (EBA)


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Advantages:

Easy mixing

Long working time

Good flowcharacteristics

Low irritation to thepulp

Disadvantages:

High solubility

Poorer retention thanzinc phosphate

cements


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The value of calcium hydroxide as a pulp- cappingmaterial that facilitates the formation of reparativedentin has long been recognized.

This action appears to be largely attributable to itsalkaline pH and consequent antibacterial and protein-lyzing effect.

The materials are used as iliners in deep cavitypreparation.


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They are usually formulated as two pastes:

1. One paste contains calcium hydrocide, zinc oxide, andzinc salts in ethylene toluene sulphonamide.

2. The other contains calcium sulfate, titanium dioxide,

and calcium tungstate in a liquid disalicylate ester ofbutane-1,3-diol.


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Advantages: Easy to manipulate

Rapid hardening inthin layers

Good sealingcharacteristics

Beneficial effects oncarious dentine andexposed pulp

Disadvantages:

Low strength

Low modulus ofelasticity

High marginalleakage


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Powder

ZnO PMMA

Liquid

Eugenol


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Advantages

Easy to mix Obtunds pain May allow for

removal ofprosthesis

Disadvantages

Low strength May soften or

discolor resinrestorations

High solubility


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Zinc polycarboxylates

Glass ionomers


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Combines the strength of zinc phosphate with the

biologic compatibility of phenolate-based materials.

Used for the cementation of cast alloys and porcelainrestorations and orthodontic bands, as cavity or base

materials, and as provisional restorative materials.


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Powder:

ZnO.

Tin or magnesium oxides . Filler.

Liquid:

Polyacrylic acid.


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The zinc oxide reacts with the polyacrylis acid,

forming a cross-linked structure of zincpolyacrylate.

Zinc oxide +polycrylic acid=zinc polyacrylate


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Advantages:

High strength Low solubility Film thickness similar

to zinc phosphate Low irritation to the

pulp

Adhesion potential totooth structure andalloys

Easy manipulation Fluoride release

Disadvantages:

Accurate proportioning

required for optimalproperties

Thixotropic Short working time

Low compressivestrength


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Durelon (ESPE-Premier)

Liv Cenera (GC)

Tylok Plus (Caulk)

Hy-Bond (Shofu)

Polycarboxylate Cement (Schein)


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Introduced in 1970s

Classification:

Type I for precision castings

Hydrous Anhydrous

Powder is freeze-dried polyacid on glass


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Used for the cementation of cast-alloys and porcelainrestorations and orthodontic bands, as cavity or basematerials, and as restorative materials.


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Powder: Calcium fluoroaluminosilicate glass.

Liquid:

50% aqueous solution of Polyacrylic or polymaleic /itaconic acid copolymer.


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CHCHCOO-

Two stages

Initial set Ca2+from glass powder interacts with two

COOH to bind chains. Occurs 5-10 minutes after gelation.

Ca2+

-OOCCHCH

CHCHCOO-

Ca2+

-OOCCHCH


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Final set

Al3+binds three carboxyl groups, takes longerto react due to steric hindrances.

Dual polymerizing systems have a mphoroquinone/ 3o amine system


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Fluoroaluminosilicate Glass

COO- H+

COO- H+

COO- H+

Polyacrylic Acid

Mn+

Mn+

Mn+H+

H+

H+

COO-

COO-

COO-

M1+

M2+M3+

COO-

COO-

COO-

COO-

COO-

COO

-

COO-

COOH COOH

COOH

COOH COO-

COO-

COO-

COO-

Ca2+

Ca2+

Tooth

Conventional Glass-Ionomer Setting Reaction

Davidson, GI Cements

1999


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Anhydrous formulations

Lower initial pH

Deep preparation

Desiccation

Manipulation

Smear layer


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Bonds well to enamel, stainless steel, tin-oxide

plated Pt and gold alloy

Moderate compressive strength Low film thickness Cariostatic potential Desirable thermal expansion Lowest solubility of all cements Long term clinical success


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easy mixing

Good seal

Fluoride release

Adequate strength

Good adhesive properties

Translucency


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Sensitive to both moisture and

desiccation Low initial pH Post cementation pulpal sensitivity

potential Slow setting time


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Fuji Cap 1 (GC Dental) Ketac-Cem (ESPE-Premier) Glassic (Strafford-Cookson) Glasslute (Pulpdent) Ketac-Cem Aplicap Glasionomer (Shofu) CX-Plus (Shofu)


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Sometimes they are called Hybrid Ionomers.

Uses: Liners. Bases.

Core buildups. Luting cement.


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Two concurrent events Acid-base reaction between polyacid and glass

powder.

Photoinitiated or chemically initiated

polymerization of methacrylate.


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Strong.

Adhesion is similar to GI.

Bonds to resin.

Less susceptible to moisture during set.

Bonding is not required, low film thickness.


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Advantages:

Ease of mixing andhandling Multiple bonding steps

are not required Adheres to enamel and

dentin Fluoride release Less soluble than GI Not affected by eugenol

Dual cure Higher flexural strength

than glass-ionomercements

Easy to handling

Good bonding


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Introduced in 1970s.

Variations of BIS-GMA and other methacrylates.

Resin-based types include:

Resin cements. Compomers.


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Polymerization achieved 3 ways:1. Autopolymerizing

Chemical catalyst added to cement

No VLC required

2. Light polymerizing Light energy required for polymerization

3. Dual polymerizing


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Two component system.

Requires mixing a base and catalyst paste.

Chemical activation is slow, provides extendedworking time.

Photoinitiation rapidly solidifies cement.


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Enamel Micromechanical interlocking with

hydroxyapatite crystals and rods.

Dentin Resin penetrates collagen fibrillar layer

and into open dentinal tubules.

Restoration Micromechanical retention.


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Bonds chemically to resins and ceramics

that can be etched and silanated.

Bonds micromechanically and/orchemically to sand-blasted base metals and

tin plated noble metals.


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Polymers Bis GMA. Urethane dimethacrylate. Monomers with functional groups that can bond to

tooth structure HEMA, hydroxyethyl methacrylates. 4-META, 4-methacrylethyl trimellitic anhydride. Organophosphonates.

Fillers Quartz or silica. Silane treated.


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Advantages:

High compressive

strength Low solubility Bonds to etched

enamel

Good optical qualities Dual cure capabilities Can bond to metals

Disadvantages:

Relatively short-term

clinical experience Technique sensitive Multi-step process Clean up

Short working times Expensive


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C & B Luting Composite (Bisco) C & B Metabond(Parkell) Flexi-Flo (EDS) Geristore (Den-Mat) MegaBond (Bosworth) Clearfil CR Inlay (J. Morita) Micro-Bridge (Roydent) Cement-It! (Jeneric/Pentron) Chemlock (Roydent) Panavia 21 (J. Morita USA)

Resiment (Septodent) Resiment w/Fluoride (Septodent) Imperva Dual Bond (Shofu) Resinomer (Bisco) RelyX ARC (3M ESPE) Universal Post Cementation Kit

(Komet/Brasseler) Resilute Resin Cement (Pulpdent)


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Properties

Vary greatly from one product to another. Insoluble in oral fluids. Set quickly. Irritating to pulpal tissues.


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Dental Cementing Materials KBAGD