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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
Strengths of compomer cements
``` – fluoride release (but low) – bond to tooth with pre-treatment – moderate - high strength – no post-operative sensitivity – low solubility ```
26
Weaknesses of compomer cements
– Little long-term experience | – swelling
27
Popularity of compomer cements
– low
28
Use suggestions for compomer cements
– excellent for routine use on metal supported crowns and bridges, lab-manufactured composites – Contraindicated for most ceramics
29
Clinical applications of resin-to-metal bonding
* Resin bonded bridge * Orthodontic bracket * Intra-oral repair * Fixed partial denture * Composite resin facings * Base metal alloy bonding * Precious metal alloy bonding
30
Base metal alloy bonding
– Resin bonded bridge (Ni-Cr) – Orthodontic bracket (S/Steel, Co-Cr, Ti) – Composite resin facings (Ni-Cr, Co-Cr, Co-Ni-Cr, Ti)
31
Precious metal alloy bonding
– Intra-oral repair (Au and Pd alloys) – Adhesive FPD (Au and Pd alloys) – Composite resin facings (Au and Pd alloys)
32
Cements for 'Maryland' Bridge
Conventional Bis-GMA type resins | •Chemical/dark cure, e.g. Comspan (Kerr)
33
Cements for resin-bonded bridge
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
Properties of self-adhesive resin cements: cleaning
Easy to clean
35
Properties of self-adhesive resin cements: Dual Cure
Need light cure as well as chemical cure to ensure full conversion
36
Properties of self-adhesive resin cement: Colour
• MaxCem Elite and SmartCem2 claim better translucency and better colour stability • Panavia SA Cement may be too opaque
37
Properties of self-adhesive resin cement: enamel bond
Significantly better with acid etching, thus not ideal for veneers, inlays, onlays, RBBs and orthodontic brackets
38
Properties of self-adhesive resin cement: dentine bond
* Not as good as that obtained with DBAs * Acid etching compromises the bond * Bond may be enhanced by pre-treatment with PAA
39
Properties of self-adhesive resin cement: bond to fibre posts
Enhanced when using a silane
40
Properties of self-adhesive resin cements: bond to zirconia
Enhanced by using a ceramic primer
41
Silica coating types
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
CoJet
``` 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
Silane coupling agent: bonding mechanism
Hydrophilic surface --> methacrylate surface
44
Silane coupling agent: glass-silane-resin interface
Silica glass surrounded by OH group - silane - MA
45
Fracture strength of all-ceramic crowns
Resin-bonded > GIC > Zinc phosphate
46
Tensile bond strength for variolink II using CoJet
Stronger than control for Au, Pd and Ni-Cr
47
Aesthetic resin luting cements
``` Light activated --> veneers • Porcelite Dual cure --> ceramic crowns, onlays, inlays • Mirage FLC • Nexus • Calibra • Variolink • Rely-X ARC ```
48
Resin-to-resin bond
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
Cementing temporary restorations
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
Functions of temporary cementation
* Provide a seal * Prevent marginal leakage * Prevent pulpal irritation * Low strength to allow easy removal * Protect preparation
51
Ideal properties of temporary cement
* 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
Temporary cementation materials
• 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
Advantages of ZoE for temporary cementation
* Easy removal thus enabling reuse of restoration * Acceptable sealing properties * Obtundent effect on pulp * Ease of use
54
Disadvantages of ZoE for temporary cementation
• 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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