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Fixed Pros I > Dental Cements > Flashcards

Dental Cements Flashcards

1
Q

what is a dental cement

A

a substance that hardens to act as a liner, base, restorative material or luting agent to bind devices and prostheses to tooth structure or to each other

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2
Q

what characteristics do we want a dental cement to have

A
  • needs to be biocompatible
  • needs to be inert and non-corrosive
  • insoluble to acid attack
  • dimensionally stable: minimal shrink upon setting and minimal expansion upon setting
  • needs to set quickly
  • has low surface tension
  • adapts and adheres to anatomy
  • insensitive to moisture during procedure
  • fluoride release
  • anti-microbial
  • radiopaque
  • cost effective
  • low film thickness
  • adequate strength
  • low solubility
  • reasonable setting time
  • adequate working time
  • cariostatic
  • adhesion to tooth structure and restorative material
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3
Q

what does low surface tension mean

A

flows well and handles well

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4
Q

what low film thickness are we wanting

A

less than 25 micrometers

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5
Q

what adequate strength do we want dental cement to have

A

70 Mpa

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6
Q

what low solubility do we want dental cement to have

A

0.2% maximum at 24 hours

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7
Q

what is the reasonable setting time we want for dental cement

A

2.5-8 minutes

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8
Q

what high values do we want for cement

A
  • high values for cyclic fatigue
  • high values for thermal cycling
  • high values for strength
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9
Q

what is cyclic fatigue

A

the stress, strain, and deformation induced in a material by cyclic loading

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10
Q

what is cyclic fatigue life

A

the number of loading cycles which produce a rupture or breakage in the material

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11
Q

what is a thermal cycle

A

any repetitive thermal test in which the temperature is regularly altered, touching a high temperature peak and a low temperature peak

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12
Q

what are the values for strength

A
  • tensile
  • compressive
  • flexural strength
  • shear
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13
Q

where do we use dental cement materials as cements

A
  • permanent and provisional indirect restorations
  • orthodontic brackets
  • cementing post and core build ups
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14
Q

where do we use dental cement materials as a restorative material

A

permanent and provisional direct restorations

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15
Q

where do we use dental cement material as liner and bases

A

pulp protection in deep cavity excavation

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16
Q

no one cement can fill _____ but can be used _____

A

all applications; off label

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17
Q

what is adhesive bonding

A

accomplished through substituting inorganic tooth materials with resin monomers
- essentially minerals in the enamel and/or dentin are replaced by resin monomers
- through polymerization these become micromechanically interlocked into the porosities

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18
Q

how can adhesive bonding procedures can be completed

A

-etch and rinse and
- self etch

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19
Q

what is cementation

A
  • cementation uses a good prep design and resistance to connect underlying tooth structure with a restoration
  • the cement creates a hard cement layer to adhere to the 2 surfaces
  • with cementation no matter how good the cement its critical that there is adequate preparation including good retention and resistance
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20
Q

when choosing a cement it is important to consider:

A

bond strength, preparation design, restorative material, ability to isolate, esthetics

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21
Q

what is the mechanism of action in adhesive bonding and what is the bond strength

A

-etched enamel leaves open the ability for resin to flow in and around the enamel rods creating resin tags
- creates micromechanical interlocking of resin with demineralized collagen of intertubular dentin
- creates a bond strength of 20-30 MPa

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22
Q

describe the mechanism of action of dental cement and what is the bond strength

A
  • locking of cement into microscopic irregularities in prepared tooth surface and irregularities in the internal of the crown
  • creates bond strength of 1-5MPa
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23
Q

how do cements work

A
  • physical bonding
  • chemical bonding
  • mechanical bonding
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24
Q

describe physical bonding

A

very weak interactions with secondary bonds
- van der waals forces and hydrogen bonds

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25
Q

describe chemical bonding and give example

A

strongest bond with primary bonds
- ex: composite bond to adhesive bond agent

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26
Q

describe mechanical bonding

A
  • interlocking undercuts, surface irregularities
  • micromechanical retention
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27
Q

what are the 6 categories of dental cements

A
  • zinc oxide
  • zinc phosphate
  • zinc polycarboxylate
  • glass ionomer
  • resin modified glass ionomer
  • resin cements
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28
Q

what is zinc oxide at UMKC

A

IRM and TempBond

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29
Q

what dental cement is not used at UMKC

A

zinc phosphate

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30
Q

what is zinc polycarboxylate at UMKC

A

Durelon and Ultratemp

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31
Q

what is resin modified glass ionomer at UMKC

A

Rely- X luting

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32
Q

what is resin cements at UMKC

A

Variolink or SpeedCem

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33
Q

what setting mechanism does Zinc oxide eugenol use

A

acid-base

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34
Q

what setting mechanism does modified Zinc oxide eugenol use

A

acid-base

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35
Q

what setting mechanism does Zinc oxide non- eugenol use

A

acid- base

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36
Q

what setting mechanism does Zinc polycarboxylate

A

acid-base

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37
Q

what setting mechanism does Zinc phosphate

A

acid- base

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38
Q

what setting mechanism does glass ionomer

A

acid- base

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39
Q

what setting mechanism does resin modified GI use

A

acid base and polymerization

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40
Q

what setting mechanism does resin cement unfilled or filled use

A

polymerization

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41
Q

what do acid base cements use

A

a powder and liquid combination

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42
Q

what are the liquid (acid) components

A
  • eugenol/non eugenol oils
  • polycarboxylate acid
  • phosphoric acid
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43
Q

what are the powder (base) components

A
  • zinc oxide
  • fluoraluminasilicate glass (FAS)
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44
Q

what are the polycarboxylic acid cements

A
  • zinc polycarboxylate cement
  • glass ionomer cement
  • resin modified glass ionomer cement
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45
Q

what are the resin based cements

A
  • resin modified glass ionomer cement
  • unfilled resin cement
  • filled resin - composite resin cement
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46
Q

what are the types of zinc oxide eugenol cement

A
  • regular ZOE
  • reinforced ZOE
  • ZOE with ethoxy benzoic acid - increased compressive strength
47
Q

what are the indications for zinc oxide eugenol cement

A
  • temporary cement
  • intermediate cement
48
Q

what is the powder and liquid of zinc eugenol cement

A
  • powder- zinc oxide
  • liquid- eugenol
49
Q

polymer reinforced ZOE is _____

A

IRM

50
Q

what is the difference in compressive and tensile strength in ZOE and modified ZOE

A

ZOE modified has higher compressive and tensile strength

51
Q

what is zinc eugenol cement made of

A
  • ZO powder is 99% ZO and 1% radiopaque fillers
  • ZOE liquid is oil of cloves (85% eugenol)
52
Q

what is the zinc oxide and eugenol reaction

A
  • zinc oxide + eugenol = zinc eugenolate
  • needs water to set up
53
Q

eugenol acts as a ____

A

sedative

54
Q

ZOE is marketed as ______

A

TempBond

55
Q

is eugenol a pulpal irritant

A

no

56
Q

when is ZOE reinforced/IRM used as

A
  • temporary cement if there is decreased retention or if you need more time in a temporary situation
  • used as a provisional or intermediate restoration
57
Q

what is the downside of eugenol in ZOE

A

the eugenol can inhibit the polymerization of resin products

58
Q

what are the disadvantages of zinc eugenol cement

A
  • slow setting time
  • excess eugenol can be an irritant
  • cement does shrink as it sets
  • low strength
  • high solubility
59
Q

describe zinc oxide non-eugenol cements

A
  • temporary cements
  • does not have sedative effect on pulp
  • eugenol is replaced with other oils
60
Q

when is zinc oxide non- eugenol cements used

A

prior to permanent resin based cement

61
Q

what is the brand name for zinc oxide non-eugenol cements and what are the characteristics of it

A
  • TempBond NE
  • slow set still
  • low retention
62
Q

what is the oldest cement in dentistry and when was it made

A
  • zinc phosphate cement
  • 1878
63
Q

what is zinc phosphate cement made of

A
  • zinc oxide powder + phosphoric acid (liquid)
64
Q

what are the characteristics of zinc phosphate cement

A
  • easy to manipulate
  • working time is 3-6 minutes
  • setting time is up to 14 minutes
  • indicated for fixed pros
  • high compressive strength
  • low film thickness
65
Q

describe the bonding of zinc phosphate cement

A
  • creates micromechanical bond to preparation surface and crown internal surface
  • bond strength 0.5-1.5Mpa
  • preparation retention and reistance form is critical
66
Q

when is zinc phosphate cement used and why

A

implant crowns due to radiographic visibility and ease of removal

67
Q

what is the gold standard cement

A

zinc phosphate cement

68
Q

describe the powder of zinc phosphate cement

A
  • greater than 75% zinc oxide and less than 13% magnesium oxide with radiopaque fillers
69
Q

describe the liquid in zinc phosphate cement

A

solution of 59% H3PO4, 23% Al phosphate and Zn Phosphate

70
Q

describe the process of mixing zinc phosphate cement

A
  • when mixedd, cement becomes exothermic
  • must mix it on a chilled glass slab to allow for working time
  • creates a stringy consistency
  • remove excess cement once set
  • mixed cement is acidic and can cause pulpal irritation
  • once set, the cement can act as a thermal insulator
  • cement is soluble in acids
71
Q

what makes zinc polycarboxylate

A

Zn Oxide - polyacrylic acid and carboxylic acid

72
Q

describe zinc polycarboxylate

A
  • low strength overall but can form a chemical bond to tooth structure
  • polyacrylic acid is less acidic than phosphoric acid, so pulpal irritation was reduced with this cement
73
Q

what is the brand name for zinc polycarboxylate

A

UltraTemp

74
Q

can zinc polycarboxylate be used prior to resin cement

A

yes

75
Q

what is the bond strength of zinc polycarboxylate

A

2MPa

76
Q

what is the powder and liquid in glass ionomer cements

A
  • powder- fluoroaluminosilicate glass (FAS)
  • polycarboxylic acid
77
Q

glass ionomer cements are a combination of:

A

Ca, F, Al silicates with polycaboxylate/acrylic reactions

78
Q

what is the bond strength of glass ionomer cements

A

3-5 MPa

79
Q

what is a benefit of glass ionomer cements

A

releases fluoride over time

80
Q

what are the downfall of glass ionomer cements

A
  • some cases of delayed hypersensitivity with GI cements
  • requires strict isolation during setting
81
Q

what are glass ionomer cements used for now

A

mostly for ortho bands

82
Q

describe how to work with glass ionomer cements

A
  • fluidity like zinc phosphate
  • needs a chilled glass slab
  • do not let liquid component stand for long or it will evaporate and change your cement mixture
  • remove smear layer left by burs first
  • cement needs tooth to not be dry but not be wet
  • cement excess should be removed immediately
83
Q

what are the characteristics of glass ionomer cements

A
  • low solubility
  • can chemically bond to metal restorations
  • retention strength similar to zinc phosphate
  • dont dehydrate the tooth- a dry tooth combined with the initial low pH of GI cements can lead to hypersensitivity
84
Q

what are the liquid (Acid) components

A
  • eugenol/non- eugenol oils
  • polycarboxylate acid
  • phosphoric acid
85
Q

what are the powder (base) components

A
  • zinc oxide
  • fluoroaluminasilicate (FAS) glass
86
Q

what is the powder and liquid in resin modified glass ionomer cement

A
  • powder: fluoroaluminasilicate glass
  • liquid: polycarboxylate acid with resin monomers (Bis GMA or HEMA)
  • also includes photo activator
87
Q

what type of reaction do resin modified glass ionomer cements use

A

acid base and monomer polymerization via chemical, light and dual cure

88
Q

what are the characteristics of resin modified glass ionomer cements

A
  • strong cement
  • bond strength 5-10 MPa
  • fluoride release
  • low solubility- so ideal for difficult to isolate cases
  • low micro leakage- cement swells slightly upon setting to seal margins
89
Q

resin modified glass ionomer cements are ideal for all restorations EXCEPT

A
  • highly esthetic cases- the cement is bright white
  • all ceramic crowns with margins less than 1mm thick. swelling of cement on setting can cause marginal fracture
  • inlays and onlays
90
Q

what are the steps to using the RMGI cement

A
  • shake powder bottle
  • dispense powder before liquid
  • equal number of scoops to liquid drops
  • hold liquid bottle vertically when dispensing
  • mix powder INTO liquid within 30 seconds of dispensing
  • load crown with cement
  • working time once mixed is 2.5 min
  • seat the crown
  • maintain pressure on restoration while cement is setting
  • maintain dry field duringg setting
  • wait 3 minutes
  • after cement has set, remove excess
91
Q

describe resin cements

A
  • high translucency
  • insoluble
  • high retention due to bonding
  • low film thickness
  • can be light cure or self cure or both
  • higher incidence of post op sensitivity due to etching process and the failure to seal the dentinal tubules
92
Q

when are resin cements used

A

inlay, onlay and all ceramic restorations

93
Q

what do resin cements require

A
  • bonding agent and an etchant
  • either self etch or total etch
94
Q

which cement becomes incredibly hard to remove after cured

A

resin cements

95
Q

what does incomplete mixing result in

A
  • weaker cement or thicker harder to seat cement which can lead to hyper occlusion
96
Q

what are the problems with dental cements

A
  • incomplete mixing
  • incomplete seating
  • excess drying of the tooth
  • incomplete removal of excess
97
Q

what does excess drying of the tooth lead to and how do you combat this

A
  • leads to post op sensitivity
  • use gluma (2x 60 second coats) prior to crown seat to decrease sensitivity
98
Q

what happens if there is incomplete removal of excess

A

gingival bleeding, irritation, bone loss, and possible gingival surgery

99
Q

what cement would you use for short prep and worried about retention

A

resin cement

100
Q

what cement would you use for normal prep and crown seat in posterior

A

RMGI

101
Q

what cement would you use when you are worried about recurrent decay

A

RMGI

102
Q

what dental cement would you use with an anterior ceramic crown

A

resin cement

103
Q

which material have the lowest film thickness to the highest

A

glass ionomer (Lowest) > polycarboxylate > RMGI > zinc phosphate > self adhesive resin based > resin based

104
Q

which materials have the longest working time in order or longest to shortest

A

zinc phosphate (Longest) > RMGI > glass ionomer > polycarboxylate > resin based = self adhesive resin based

105
Q

which materials have the shortest setting time in order of shortest to longest

A

RMGI (shortest) > glass ionomer = polycarboxylate > resin based = self adhesive resin based > zinc phosphate

106
Q

which materials have the highest compressive strength in order of highest to lowest

A

resin based > self adhesive resin based > glass ionomer > RMGI > zinc phosphate > polycarboxylate

107
Q

which materials have the highest tensile strength in order of highest to lowest

A

self adhesive resin based > resin based > RMGI > polycarboxylate > glass ionomer > zinc phosphate

108
Q

which materials have the closest elastic modulus to dentin

A

zinc phosphate > glass ionomer > self adhesive resin based > resin based > RMGI > polycarboxylate

109
Q

which materials cause the lowest pulpal irritation

A

polycarboxylate > zinc phosphate > glass ionomer = RMGI = resin based = self adhesive resin based

110
Q

which materials have the lowest solubility

A

RMGI = resin based = self adhesive resin based > glass ionomer > polycarboxylate = zinc phosphate

111
Q

which materials have the lowest microleakage

A

RMGI = resin based = self adhesive resin based >glass ionomer > zinc phosphate > polycarboxylate

112
Q

which material is the easiest to remove excess material

A

zinc phosphate > polycarboxylate = glass ionomer = RMGI > resin based > self adhesive resin based

113
Q

which materials have the highest retention

A

resin based > self adhesive resin based > glass ionomer > RMGI = zinc phosphate > polycarboxylate

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