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Intermediate restorative skills (Den 305) > Cementation > Flashcards

Cementation Flashcards

1
Q

Interfaces with cementation

A

Tooth-cement interface

Cement-restoration interface

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2
Q

UK Market Share total values 2006

-highest value of individual cement

A

~£1.5m

Composite resin: £758,584

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3
Q

Types of cement for Metal and metal-ceramic restorations

A

Conventional cementation:

  • zinc phosphate cement
  • zinc polycarboxylate cement
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4
Q

Types of cement for metal and ceramic endodontic posts

A

Conventanal cementation:

  • GIC
  • RMGIC
  • compomers
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5
Q

Types of cement for all-ceramic reinforced core ceramics

A

Conventional cementation:

  • GIC
  • RMGICs
  • compomers
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6
Q

Types of cement for resin bonded bridges

A

Etching and Gritblasting:

  • dark cure resins
  • adhesive resins
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7
Q

Types of cement for precious metal bonding e.g. intra-oral repair

A

Tin plating, silica coating and metal primers:

  • dark cure resins
  • adhesive resins
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8
Q

Types of cement for resin-bonded ceramics

A

HF etch + silane:

-aesthetic dual cure resins

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9
Q

Types of cement for

  • composite restorations
  • fibre reinforced resin bridges
  • fibre reinforced endodontic posts
A

Resin-to-resin bond:

  • aesthetic dual cure resins
  • adhesive resins
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10
Q

Conventional cementation is used for which cements?

A 
• Zinc cements
• Glass Ionomer Cements
• Resin-modified Glass Ionomer
Cements
• Polyacid-modified Resin
Composites
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11
Q

Presentation of zinc phosphate cement

A

White powder
-zinc oxide with up to 10% magnesium oxide (< reactivity)
Clear liquid
-45-64% aqueous solution of phosphoric acid

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12
Q

Advantages of zinc phosphate cement

A
  • They are easy to mix
  • They have a sharp, welldefined set
  • They are a low cost product
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13
Q

Disadvantages of zinc phosphate cement

A 
• They have a potential for
pulpal irritation due to low
pH and exothermic reaction
• They have no antibacterial action
• They are brittle
• They have no adhesive
qualities
• They are relatively soluble
in the oral environment
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14
Q

Types of zinc cements

A

– zinc phosphate cements

– zinc polycarboxylate cements e.g. Durelon

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15
Q

Presentation of zinc polycarboxylate cement

A 
White powder
-zinc oxide with up to 10%
magnesium oxide and
stannous fluoride
Clear liquid
-30-40% aqueous solution of polyacrylic acid
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16
Q

Advantages of polycarboxylate cement

A 
• They bond to enamel and
dentine as well as some of the
metallic cast restorations
• They have a low irritancy
• They have an antibacterial
action
• Low film thickness
• Fluoride release
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17
Q

Disadvantages of zinc polycarboxylate cement

A

• Their properties are highly dependent
upon handling procedures
• They have short working times and
long setting times
• An exacting technique is required to ensure bonding
• Clean up is difficult and timing is critical
• Strength and solubility are comparable to that of zinc phosphate cement

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18
Q

Types of GIC for conventional cementation

A

– Aqua-Cem (Dentsply De Trey)
– Fuji 1 (GC)
– Ketac-Cem (Espe)
– Glass ionomer Type I (Shofu)

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19
Q

Indications for GIC

A 
– 20 years of success
– fluoride release
– bond to tooth
– low expansion/contraction
– moderate strength
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20
Q

Problems with GIC

A

– some post-operative sensitivity

– water sensitive during setting

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21
Q

Popularity of GIC

A

– Moderate/high

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22
Q

Use suggestions for GIC

A

– good for routine use on crowns and bridges

– suggest the use of a preparation desensitiser

23
Q

Types of RMGIC for conventional cementation

A

– Fuji PLUS (GC)
– Rely-X Luting (3M)
– Protec-Cem (Ivoclar)

24
Q

Crack formation of all-ceramic crowns
dependent on different core build-up and
luting materials

A

“hygroscopic expansion of RMGIC/compomer
materials led to failure of all-ceramic crowns,
when the materials are used for both core
build-up or adhesive bonding.”

25
Q

Strengths of compomer cements

A 
– fluoride release (but low)
– bond to tooth with pre-treatment
– moderate - high strength
– no post-operative sensitivity
– low solubility
26
Q

Weaknesses of compomer cements

A

– Little long-term experience

– swelling

27
Q

Popularity of compomer cements

A

– low

28
Q

Use suggestions for compomer cements

A

– excellent for routine use on metal supported crowns and bridges, lab-manufactured composites
– Contraindicated for most ceramics

29
Q

Clinical applications of resin-to-metal bonding

A
  • Resin bonded bridge
  • Orthodontic bracket
  • Intra-oral repair
  • Fixed partial denture
  • Composite resin facings
  • Base metal alloy bonding
  • Precious metal alloy bonding
30
Q

Base metal alloy bonding

A

– Resin bonded bridge (Ni-Cr)
– Orthodontic bracket (S/Steel, Co-Cr, Ti)
– Composite resin facings (Ni-Cr, Co-Cr, Co-Ni-Cr,
Ti)

31
Q

Precious metal alloy bonding

A

– Intra-oral repair (Au and Pd alloys)
– Adhesive FPD (Au and Pd alloys)
– Composite resin facings (Au and Pd alloys)

32
Q

Cements for ‘Maryland’ Bridge

A

Conventional Bis-GMA type resins

•Chemical/dark cure, e.g. Comspan (Kerr)

33
Q

Cements for resin-bonded bridge

A

Adhesive resin cements
• Phosphonated resin, e.g. Panavia 21 (Kuraray)
• 4-META based resin, e.g. Superbond (Sun Medical)
Self-Adhesive Resin-Cements: e.g. Rely-X Unicem, SmartCem2,
Maxcem Elite, G-Cem Link-Ace, Speedcem, Panavia SA Cement

34
Q

Properties of self-adhesive resin cements: cleaning

A

Easy to clean

35
Q

Properties of self-adhesive resin cements: Dual Cure

A

Need light cure as well as chemical cure to ensure full conversion

36
Q

Properties of self-adhesive resin cement: Colour

A

• MaxCem Elite and SmartCem2 claim better translucency and better
colour stability
• Panavia SA Cement may be too opaque

37
Q

Properties of self-adhesive resin cement: enamel bond

A

Significantly better with acid etching, thus not ideal for veneers, inlays, onlays, RBBs and orthodontic brackets

38
Q

Properties of self-adhesive resin cement: dentine bond

A
  • Not as good as that obtained with DBAs
  • Acid etching compromises the bond
  • Bond may be enhanced by pre-treatment with PAA
39
Q

Properties of self-adhesive resin cement: bond to fibre posts

A

Enhanced when using a silane

40
Q

Properties of self-adhesive resin cements: bond to zirconia

A

Enhanced by using a ceramic primer

41
Q

Silica coating types

A

SEE DIAGRAM
•Silicoater
•Tribochemical coating: advancing particle to point of impact on metal surface leaves silicatized metal surface (effective in enhancing bond strength to any alloy but technique sensitive - many steps)
‒Rocatec
‒Cojet (CoJet-material, ESPE-Sil, Visio-Bond, Sinfony Opaquer)

42
Q

CoJet

A 
Repair of exposed metal:
! Pretreat with CoJet
! Apply ESPE-Sil
! Cover exposed metal surfaces
thinly with Sinfony Opaquer
! Light cure 10 sec.
! Apply Visio-Bond, light cure 20
sec.
! Complete with LC-composite
! Light-cure
! Finish as usual
43
Q

Silane coupling agent: bonding mechanism

A

Hydrophilic surface –> methacrylate surface

44
Q

Silane coupling agent: glass-silane-resin interface

A

Silica glass surrounded by OH group - silane - MA

45
Q

Fracture strength of all-ceramic crowns

A

Resin-bonded > GIC > Zinc phosphate

46
Q

Tensile bond strength for variolink II using CoJet

A

Stronger than control for Au, Pd and Ni-Cr

47
Q

Aesthetic resin luting cements

A 
Light activated --> veneers
• Porcelite 
Dual cure --> ceramic crowns, onlays, inlays
• Mirage FLC
• Nexus
• Calibra
• Variolink
• Rely-X ARC
48
Q

Resin-to-resin bond

A

Incremental build-up of direct composites
– oxygen inhibited surface layer of some 10-50
µm thick
Prefabricated resin composites
– composite inlays, fibre reinforced bridges and
endodontic posts
• grit blasting or grinding
• HF etching
• silane coupling agent
• tribochemical coating

49
Q

Cementing temporary restorations

A

Temporary inlays, onlays crowns & bridges must remain
cemented for the duration of their placement.
Loss or failure of the temporary leads to:
• Pain
• Over eruption & loss of space
• Drifting of proximal teeth
• Damage to core preparations

50
Q

Functions of temporary cementation

A
  • Provide a seal
  • Prevent marginal leakage
  • Prevent pulpal irritation
  • Low strength to allow easy removal
  • Protect preparation
51
Q

Ideal properties of temporary cement

A
  • Ability to seal against leakage of oral fluids
  • Strength consistent with intentional removal
  • Low solubility
  • Biocompatibility
  • Chemical compatibility with provisional polymer
  • Easy of use
  • Ease of eliminating excess
  • Adequate working and setting times
  • Compatibility with definitive luting agent
52
Q

Temporary cementation materials

A

• Fine particle zinc oxide eugenol cement
– Tempbond (Kerr USA)
• Non-eugenol cements
– TempbondNE
• Zinc phosphate, zinc polycarboxylate and GIC
too high strength – difficult removal, damage to
preparation

53
Q

Advantages of ZoE for temporary cementation

A
  • Easy removal thus enabling reuse of restoration
  • Acceptable sealing properties
  • Obtundent effect on pulp
  • Ease of use
54
Q

Disadvantages of ZoE for temporary cementation

A

• Free eugenol acts as plasticizer of
methacrylate resin and reduces surface
hardness and strength
• Eugenol can interfere with bond strength of
resin cements
• Must ensure all cement removed prior to using
a definitive resin cement
• Eugenol free zinc oxide available e.g Temp
Bond NE, Nogenol

Intermediate restorative skills (Den 305) (16 decks)

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