Subject: Dental Materials First Semester AY.

2014-2015
Topic: 113 Dental Cements UPCD Batch 2018
Lecturer: Dr. Angie Atienza
Date: Sept. 08, 2014



I. Uses of Cements
II. Types of Cavities (from lecture)
III. Classification of Cements
IV. Chief Constituents of Ac id - Base Reaction Cements
V. Requirements of Dental Cements
A. As a Cavity Liner/ Base/
Temporary Restoration
B. As a Luting Cement
VI. Kinds of Cements



Dr. Atienzas handout
Dr. Atienzas lecture
Anusavice, Kenneth J.: Phillips Science of
Dental Materials, 10
th
Edition. Pennsylvania,
W.B. Saunders Company, 1996



Cavity Liner (indirect)
such as cavity varnish or dentin
bonding agents
Protect pulp against further trauma
such as thermal conduction
Protect pulp tissue against the effects
of certain components of restorative
materials and against micro leakage
Pattern of application: Calcium
Hydroxide (cavity liner) > base > final
restoration

*Pulp Capping if pulp is already exposed
(direct)
*Direct applied on top of pulp; exposed
*Indirect almost exposed

Insulating Base

Thicker protective layer of cement that
are placed under restorations
Serves as a replacement or substitute
of the protective dentin that has been
destroyed by caries, cavity prep, or
both.

Temporary & Intermediate Restorations
Temporary & Permanent Luting Agent
Luting = glue, adhesive, use of a
moldable substance to seal a space or
to cement two components together
Anterior and Conservative Posterior
Restorations
Root Canal Restorations
Periodontic Bandage
Pit and Fissure Sealant


Class I pits and fissures
- buccal and occlusal of premolars and molars
Class II proximal surface of posterior teeth
Class III proximal surface of anterior teeth
Class IV incisal edges / angle of anterior teeth
Class V cervical areas of anterior and posterior
teeth



Acid Base Reaction Cements
Zinc Oxide
Ion-leachable glasses
Polymerizing materials / Resin Cements
Cyanoacrylates
Dimethyacrylate polymers
Polymer-ceramic composites
Other Materials
Calcium Hydroxide
Varnishes
Mineral Trioxide Aggregates

Type of Cement Cement Powder (+
acceptor/ base)
Cement Liquid
(+ donor/ acid)
IV.CHIEF COMPONENTS OF ACID-BASE
REACTION CEMENTS
III.CLASSIFICATION OF CEMENTS
II.TYPES OF CAVITIES
I.USES OF CEMENTS
REFERENCES
OUTLINE
Zinc Oxide Eugenol Zinc Oxide Eugenol
Zinc Phosphate Zinc Oxide Aqueous soln of
Phospohoric Acid
Zinc Polycarboxylate Zinc Oxide Aqueous soln of
polyacrylic acid
Silicate Elements Fluorine with
aluminosilicate glass
Aqueous soln of
Phospohoric Acid
Glass Ionomer Fluorine with
aluminosilicate glass
Aqueous soln of
polyacrylic acid or
coplymer



A. As a Cavity Liner / Base / Temporary Restoration
Provide protection to the pulp
Thermal Insulation
Chemical protection (vs. microleakage)
Electrical Insulation (vs. galvanism)
Galvanic Shock = pain sensation by electric
current generated by a contact between
two dissimilar metals, forming a battery in
the oral environment
Good mechanical properties (e.g. strength and flow).
o Depends on:
1. The degree of set achieved at the time
the filling material is placed.
2. The strength of set material and its
thickness (more set, more strength)
3. The degree of support from
surrounding structures (more support,
stronger)
4. The type of cavity
5. The pressure exerted during the
placement of the filling material
6. The choice of correct operative
technique
Biocompatibility to the tooth and surrounding
tissues
1 . Non-toxic and non-irritating
2. Obtundent (sedative) effect on the pulp
(tooth ache drops: based on eugenol)
3. Bacteriostatic (makes bacteria dormant) /
Bactericidal (kills the bacteria)
Should be compatible with the filling material placed
above it (e.g. ZOE is not compatible with composite
resins)
Should have sufficient mixing and working time
followed by rapid setting
Insoluble to fluids
o However, there are no cements which are
insoluble because of the environment
inside the oral cavity, if soluble, it will leave
a gap on where the cement used to be
Radio-opaque

B. As a Luting Cement
Biocompatible, non-irritating, non-toxic
Provide thermal and electrical insulation
Insoluble to fluids
o However, there are no cements which are
insoluble because of the environment
inside the oral cavity, if soluble, it will leave
a gap on where the cement used to be
Radio-opaque
Good optical properties (so will not be seen if used
in veneers)
**Veneers for anterior teeth when there is a
discoloration; such as a laminate on wood surface
Setting Characteristics:
1. Sufficient mixing and working time
even at mouth temperature to permit
placement of restoration.
2. Low initial viscosity or psuedoplastic (so
it could flow)
3. Low film thickness (thick layers can
displace the tooth upward, disrupting
occlusion; thing enough so it could slip
through spaces for efficient adhesion)
Ideally adhesive to enamel and dentin as well as to
gold alloys, porcelain, and acrylics, but not to dental
instruments.
o Retention of restoration depends on:
1. Design of restoration (more resistant if
parallel walls of cavity prep; more
converging walls have less retetion)
2. Accuracy of restoration
3. Strength of cement



Types of Cements:

I. ZINC PHOSPHATE CEMENTS

A. Composition

Powder Zinc Oxide


Other metallic
oxides
Approx. 90% as main
ingredients

Approx. 10%
Liquid Aqueous
solution of
phosphoric acid


50%-60%
concentration



VI.KINDS OF CEMENTS

V.REQUIREMENTS OF DENTAL CEMENTS

AlPO4
Zn3(PO4)2

Water
Up to 10% as buffers


33+ 5%


B. Setting Reaction and Setting Characteristics

3ZnO + 2H
3
PO
4
+ H
2
O Zn
3
(PO
4
)
2
+ heat

Slow setting reaction.
Very sensitive to moisture contamination.
(Products should be sealed; tooth should be
isolated)
When desiccated, surface becomes opaque
and cracks.
Vulnerable to erosion.

C. Properties of ZnPO4

1. Has sufficient working time
Working time = 5 minutes
Setting time = 5 9 minutes

2. Ideal film thickness of 35 40 m
dependent on:
a. Powder / Liquid ratio
b. Particle size (smaller, less thick)
c. Design of the restoration

3. Provides for adequate thermal and
electrical barrier.

4. Compressive strength:
a. Relatively high (80 140 MPa) -
dependent on P:L ratio
b. Initial hardening occurs within 5 9 min
c. Affected by manipulative variables

5. Very low tensile and transverse strength

6. Low impact strength
7. Brittle material
8. Soluble in water
9. Opaque due to high concentration of
unreached Zn

D. RETENTION
1. No adhesion to tooth structure
a. By mechanical interlocking
b. Surface roughness
c. Controlled by cavity design
2. Film thickness
3. Physical properties of the cement

E. BIOLOGICAL PROPERTIES
1. Low pH. Has an initial pH of 2 4.
2. Exothermic reaction
3. Pulpal protection recommended. Degree of
irritation depends on:
a. Depth of cavity
b. Thickness of residual dentin

F. MANIPULATION
1. Powder / Liquid consistency can vary with
purpose
2. Incremental mixing
Small to big portions
Delays the set slightly; more working time
Circular motion, mixed over a wide area
(to dissipate heat)
Consistency will depend on use (bases:
thick; luting agent: thin)
3. Can alter setting time:
P/L ratio
Mixing technique
Use a cool glass slab (below dew point)
4. Avoid moisture contamination
Prevent premature contact w/
moisture/water
Tooth is dry but not desiccated
5. Seating of the restoration
Seat before matrix formation occurs
Hold under pressure until it sets
Venting to prevent air entrapment
6. Storage & Dispensing
Keep in cool dry place
Shake powder; swirl liquid before use
Dispense only when ready to mix
Discard cloudy liquid

G. INDICATIONS FOR USE
1. Cavity base
2. Luting cement
3. Temporary filling material

II. ZINC POLYCARBOXYLATE CEMENTS

A. Composition

1. Powder



Liquid
Zinc Oxide
Magnesia, Tin oxide, Bismuth Oxide, Alumina
Stannous fluoride

Aqueous solution of polyacrylic acid or co-
polymer with Itaconic acid
2. Powder





Liquid
Zinc Oxide
Magnesia, Tin oxide, Bismuth Oxide, Alumina
Stannous fluoride
Freeze-dried Polyacrylic acid


Distilled water

B. PROPERTIES
1
st
cement w/ chemical bond to tooth structure
Compressive strength 55 MPa

Tensile strength higher than ZnPO

4

Modulus of elasticity lower than ZnPO

4
More soluble than ZnPO
4
, silicophosphates, & glass
ionomers
Set cement is opaque (not used for restorative
purposes)
Less sensitive that ZnPO
4
to small fluctuations in P:L
ratio

C. RETENTION (both chemical and mechanical)
Forms an adhesive bond with enamel and dentin due
to carboxyl group reacting with Ca of hydroxyapatite
Bond strength greater in enamel than in dentin
Mechanical interlocking
Design of tooth preparation
Weak bond with gold
No perceptible bond with porcelain
Strong bond with stainless steel

D. BIOLOGICAL PROPERTIES
pH comparable to ZnPO
4
, but more compatible with
the pulp due to larger size of the polyacrylic acid
molecule (doesnt go through dentin tubules)
Anticariogenic properties due to presence of
Stannous Fluoride (only 15-20% the amount
compared to GIC)
Provides good thermal insulation

E. MANIPULATION
Mixing technique big to small increments, rapidly
incorporated
Shorter working time 2 5 minutes
Shake bottle before dispensing
Dispense only when ready to mix, water evaporates
fast

More viscous than ZnPO

4
Tooth surface should be thoroughly cleaned and
saliva free for better adhesion

F. SEATING OF THE RESTORATION
Seat as soon as possible due to short working time
Remove excess cement only after it has set (if not
yet set, it will become stringy and create a space
because it will remove whatever is inside)
No longer useful if:
a. There is loss of luster
b. Becomes stringy

G. STORAGE
Liquid is unstable either at high or low temperature
Dont cool liquid, it increases the viscosity
Can cool the powder to increase the setting time

III. ZINC EUGENOL CEMENTS


A. Composition
Components Function
Powder Zinc oxide

Zinc acetate (1-5%)
Primary reactive ingredient

Accelerator
Liquid Eugenol

Olive oil (5-15%)
Primary reactive ingredient

To control viscosity

B. TYPES
1. Type I temporary restoration
2. Type II reinforced ZOE, permanent cementation
3. Type III temporary filling, cavity base
4. Type IV cavity liners
5. Non-eugenol ZOE short term cementation of
acrylic restorations

C. PROPERTIES
Adequate working time with rapid setting after
placement
Low compressive strength:
- Unreinforced: 20 MPa
- Reinforced : 40 MPa
Overall mechanical properties are inferior to those
of other cements
Inhibits polymerization of unfilled resins or
composites
Highly soluble
Opaque
High film thickness

D. RETENTION
Poor retention due to inherent property
No adhesion to tooth structure
Dependent on mechanical retention

E. BIOLOGICAL PROPERTIES
Biocompatible has a pH of 7 (to counteract the
acidity of cavities)
Sedating effect
Bacteriostatic

F. MANIPULATION
Powder / Liquid system or Paste / Paste system
Proportioning dependent of purpose
Bulk mixing technique (no particular mixing
technique)
Long working time
Setting time: Dependent on:
a. Powder : Liquid ratio
b. Moisture
c. Temperature

G. INDICATIONS FOR USE
Temporary filling
Temporary luting cement
Cavity base (reinforced ZOE)
Root canal sealer (usually Type I because it has
longer working time)

IV. Other Materials
A. Calcium Hydroxide
B. Varnishes
C. Mineral Trioxide Aggregates (MTA)

Calcium Hydroxide
1. Composition

Component Function
Paste 1 Calcium Hydroxide (50%)
Zinc Oxide (10%)

Zinc stearate (0.5%)

Ethyl toluene
sulphonamide (39.5%)
Primary reactive
ingredients

Accelerator

Oily compound, acts as
carrier
Paste 2 Glycol Salycilate (40%)

Titanium Dioxide
Calcium sulphate
Calcium tungstate
Primary reactive
ingredient
Inert fillers, pigments, and
radiopacifiers

B. INDICATIONS FOR USE
As a cavity liner direct & indirect
Vital pulpotomy procedures on deciduous teeth
Root canal medicament

C. PROPERTIES
Very low compressive strength 20 MPa
Very weak cement
Low viscosity
Setting time varies
Highly soluble
Forms an effective chemical barrier

D. BIOLOGICAL PROPERTIES
Biocompatible with the pulp
Alkaline pH
a. Antibacterial effect
b. Able to initiate calcification and formation
of secondary dentin

Varnishes
Composed of natural gums - copal, rosins, synthetic
resins dissolved in an organic solvent (acetone,
chloroform or ether)
Forms a thin coating on the tooth as the solvent
evaporates
Reduces micro leakage and lessens pulpal irritation
Reduces discoloration from corrosion products of
amalgam
Not indicated for GICs or resin based composites

Mineral Trioxide Aggregates (MTA)
1. 1990s
2. Based on Portland cement (used in
construction)
3. Combines calcium oxide (calcia, CaO),
aluminum oxide (alumina, Al
2
O
3
), and
silicon dioxide (silica, SiO
2
) into hydraulically
active ceramic compound.