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Dental Cements Flashcards

1
Q

What is a dental cement?

A

A dental cement is 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 or expansion upon setting)
-Needs to set up quickly
-Has low surface tension (Flows well and handles well)
-Adapts and adheres to anatomy
-Insensitive to moisture during procedure
-Fluoride release
-Anti-microbial
-Radiopaque (can be seen on an x-ray)
-Cost effective
-Low film thickness (<25 micrometers) (an average human hair is 75 micrometers)
-Adequate strength (70 Mpa or above)
-Low Solubility (0.2% maximum at 24hrs)
-Reasonable Setting time (2.5 – 8.0 minutes)
-Adequate working time
-Cariostatic
-Adhesion to tooth structure AND restorative material

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3
Q

What should the film thickness be for a dental cement?

A

low (<25 micrometers)

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4
Q

What should the strength be of a dental cement?

A

adequate strength (70 Mpa or above)

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5
Q

What should the solubility be of a dental cement?

A

low (0.2% maximum at 24 hours)

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6
Q

What should the setting time be of a dental cement?

A

2.5-8.0 minutes

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7
Q

What is cyclic fatigue?

A
  • the stress, strain, and deformation induced in a material by cyclic loading
  • Cyclic fatigue life is the number of loading cycles which produce a rupture or breakage in the material.
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8
Q

You want _____ values for cyclic fatigue for a dental cement

A

high

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9
Q

You want _____ values for thermal cycling for a dental cement

A

high

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10
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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11
Q

A dental cement in should have a high value of strength in what ways?

A

-Tensile
-Compressive
-Flexural Strength
-Shear

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12
Q

Where do we use dental cement materials in cements?

A
  • Permanent and Provisional indirect restorations
  • Orthodontic brackets
  • Cementing Post and Core Build Ups
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13
Q

Where do we use dental cements in restorative materials?

A

Permanent and Provisional direct restorations

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14
Q

Where do we use dental cements in liners and bases?

A

Pulp protection in deep cavity excavation

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15
Q

What is adhesive bonding?

A

This is 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 resulting porosities. These adhesive bonding procedures can be completed through 2 different approaches: etch-and-rinse and self-etch.

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16
Q

What is cementation?

A

Cementation uses good prep design and resistance to connect underlying tooth structure with a restoration. Essentially, the cement creates a hard cement layer to adhere to the 2 surfaces. With cementation, no matter how good the cement, it’s critical that there is adequate preparation, including good retention form and resistance.

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17
Q

When choosing a cement, it is important to consider the numerous factors such as…

A

bond strength, preparation design, restorative material, ability to isolate, and importance of esthetic

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18
Q

Are adhesive bonding and dental cementation the same thing?

A

NO

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19
Q

What is the bond stength of adhesive bonding?

A

20-30 MPa

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20
Q

What is the bond stength of dental cement?

A

1-5 MPa

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21
Q

What does adhesive bonding lock into?

A
  • Etched enamel leaves open the ability for resin to flow in and around the enamel rods creating resin tags
  • This also creates a micromechanical interlocking of resin with demineralized collagen of inter-tubular dentin as well
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22
Q

What does the dental cement lock into?

A
  • Locking of cement into microscopic irregularities in prepared tooth surface and irregularities in the internal of the crown
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23
Q

What type of bonds do cements have?

A
  • physical bond
  • chemical bond
  • mechanical bond
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24
Q

What do physical bonds do in dental cement?

A

Very weak interactions with Secondary Bonds (ex - Van Der Waals Forces and Hydrogen Bonds)

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25
Q

What do chemical bonds do in dental cement?

A

Strongest bond with Primary Bonds
(ex – Composite Bond to Adhesive Bond Agent)

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26
Q

What do mechanical bonds do in dental cement?

A
  • Interlocking undercuts, surface irregularities
  • Micromechanical retention
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27
Q

What are the six categories of dental cements?

A

-Zinc Oxide (At UMKC = IRM and TempBond)
-Zinc Phosphate
-Zinc Polycarboxylate (At UMKC = Durelon and UltraTemp)
-Glass Ionomer
-Resin-Modified Glass Ionomer (At UMKC = Rely-X Luting)
-Resin Cements (At UMKC = Variolink or SpeedCem

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28
Q

What is zinc oxide called at UMKC?

A

IRM and Tempbond

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29
Q

What is zinc polycarboxylate called at UMKC?

A

Durelon and Ultratemp

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30
Q

What is resin-modified glass ionomer called at UMKC?

A

Rely-X Luting

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31
Q

What is resin cements called at UMKC?

A

Variolink and SpeedCem

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32
Q

What is the setting mechanism for zinc oxide, zinc polycarboxylate, zinc phosphate, and glass ionomer?

A

acid-base

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33
Q

What is the setting mechanism for resin-modified GI?

A

acid-base
and
polymerization

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34
Q

What is the setting mechanism for resin cement (RC)?

A

polymerization

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35
Q

Many of the cements we use and have used in the past are _____________ reactions

A

Acid-Base Reactions

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36
Q

New cements have added ______________ as an aspect of setting to remove the risks and negatives of an acid base cement system.

A

Polymerization

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37
Q

What are acid-base cements?

A
  • utilize a powder and liquid combination
    -mix the powder and liquid into a mixture with desired characteristics
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38
Q

What are the liquid (acid) components of an acid-base cement?

A
  • Eugenol/Non-Eugenol oils
  • Polycarboxylic Acid
  • Phosphoric Acid
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39
Q

What are the powder (base) components of an acid-base cement?

A
  • Zinc Oxide
  • Fluoroaluminasilicate glass (FAS)
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40
Q

What are the types of polycarboxylic acid cements?

A
  • Zinc Polycarboxylate cement
  • Glass Ionomer Cement
  • Resin-Modified Glass Ionomer cement
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41
Q

What are the types of resin based cements?

A
  • Resin-Modified Class Ionomer cement
  • Unfilled Resin cement
  • Filled Resin – Composite Resin Cement
42
Q

What are the different types of zinc oxide eugenol cement?

A
  • Regular ZOE
  • Reinforced ZOE
    —IRM
  • ZOE with Ethoxy Benzoic Acid
    — increased compressive strength
43
Q

What are the indications for zinc oxide eugenol cements?

A
  • Temporary
  • Cement Intermediate
  • provisional cement
44
Q

What is the powder part of zinc eugenol cement?

A

zinc oxide

45
Q

What is the liquid part of zinc eugenol cement?

A

eugenol

46
Q

What is the strength of a typical zinc eugenol cement?

A

compressive = 2-15
tensile = 1-2

47
Q

What is the strength of a modified zinc eugenol cement?

A

compressive = 40-50
tensile = 3-5

48
Q

ZO powder is __% ZO and __% radiopaque filler

A

99%
1%

49
Q

ZOE liquid is Oil of _________

A

Cloves (85% eugenol)

50
Q

What is the reaction of zinc eugenol cement?

A

Zinc Oxide + Eugenol = Zinc Eugenolate

51
Q

Eugenol acts as a _________. Therefore is not a pulpal irritant.

A

sedative

52
Q

ZOE is marketed as…

A

TempBond

53
Q

What are the uses of ZOE reinforced IRM?

A
  • Intermediate Restorative Material
  • Temporary cement /restoration if there is decreased retention or if you need more time in a temporary situation. Used as a provisional or intermediate restoration
54
Q

*The Eugenol in ZOE can inhibit the ______________ of resin products.

A

polymerization
- Therefore, forethought is needed if using resin cement after provisionalization.

55
Q

What are the disadvantages of zinc eugenol cements?

A

-Slow setting time
-Excess Eugenol can be an irritant
-Cement does shrink as it sets
-Low Strength
-High Solubility

56
Q

What are the features of zinc oxide non-eugenol cement?

A
  • Temporary cement
  • Eugenol is replaced with other oils
  • Used prior to permanent Resin-Based cement
57
Q

What are the disadvantages of zinc oxide non-eugenol cements (Tempbond NE)

A

Slow set still
Low retention

58
Q

What is the oldest cement in dentistry?

A

zinc phosphate cement

59
Q

What is the reaction for zinc phosphate cement?

A

Zinc Oxide (Powder) + Phosphoric Acid (Liquid) = Zinc Phosphate

60
Q

What are the benefits of zinc phosphate cement?

A
  • Easy to manipulate
  • Working time is 3 – 6 minutes
  • Setting time is up to 14 minutes
  • Indicated for Fixed Prosthodontics
  • High compressive strength
  • Low Film Thickness
61
Q

How does zinc phosphate cement to the tooth?

A

Creates micromechanical bond to preparation surface and crown internal surface.

62
Q

What is the compressive strength of zinc phosphate cement?

A

4.5 Mpa

63
Q

Is zinc phosphate still a major cement today?

A

No longer a major cement in the market as others have
improved on the characteristics of this cement.

64
Q

What is critical when using zinc phosphate?

A

Preparation retention and resistance form critical

65
Q

What is zinc phosphate considered for?

A

implant crowns due to radiographic visibility, ease of removal

66
Q

What is the gold standard cement?

A

zinc phosphate cement

67
Q

The powder of zinc phosphate cement is made of…

A

> 75% Zinc Oxide and <13% Magnesium Oxide with radiopaque fillers

68
Q

The liquid of zinc phosphate cement is made of…

A

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

69
Q

What should you know about zinc phosphate when mixing/cementing?

A

-When mixed, cement becomes exothermic.
-Must mix it on a chilled glass slab to allow for working time
-Create 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

70
Q

What is zinc polycarboxylate?

A

-Zn Oxide – Polyacrylic acid and Carboxylic Acid = ZN Polycarboxylate

71
Q

Although zinc polycarboxylate has low strength what does it do instead?

A

form a chemical bond to tooth structure (cement liquid and calcium in the hydroxyapatite bond)

72
Q

Polyacrylic acid is less acidic than phosphoric acid, so pulpal irritation is…

A

reduced with zinc polycarboxylate cement

73
Q

What is the compressive strength of zinc polycarboxylate?

A

6.3 MPa

74
Q

What is zinc polycarboxylate marketed as?

A

UltraTemp

75
Q

What is the powder for glass ionomer?

A

Fluoroaluminosilicate Glass (FAS)

76
Q

What is the liquid for glass ionomer?

A

Polycarboxylic Acid

77
Q

What is glass ionomer?

A

Combination of Ca, F, Al Silicates with Polycarboxylate/acrylic reactions

78
Q

What is the compressive strength of glass ionomer?

A

3-5MPA

79
Q

What are the features of glass ionomer?

A
  • Low Solubility
  • Can chemically bond to metal restorations
  • Releases Fluoride over time
  • Requires strict isolation during setting
  • Needs a chilled glass slab
  • Do not let liquid component stand for long or it will evaporate and change your cement mixture
80
Q

There are some cases of delayed _________________ with glass ionomer cements

A

hypersensitivity

81
Q

Where are glass ionomer cements used?

A

Not used commonly. Mostly used for Ortho bands now due to fluoride release.

82
Q

What are the steps for using glass ionomer?

A
  • 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 can happen if you dehydrate a tooth and use glass ionomer?

A

A dry tooth combined with the initial low pH of GI cements can lead to hypersensitivity

84
Q

What are the liquid (acid) components of acid-base cements?

A
  • Eugenol / Non-Eugenol oils
  • Polycarboxylate Acid
  • Phosphoric Acid
85
Q

What are the powder (base) components of acid-base cements?

A
  • Zinc Oxide
  • Fluoroaluminasilicate (FAS) Glass
86
Q

What is the powder of resin-modified glass ionomer?

A

Fluoroaluminasilicate glass (same as GI)

87
Q

What is the liquid of resin-modified glass ionomer?

A

Polycarboxylate acid with resin monomers (Bis GMA or HEMA)

88
Q

What does resin-modified glass ionomer cement need besides the powder/liquid?

A

photo activator

89
Q

What are the features of resin-modified glass ionomer?

A

-Strong Cement
-Compressive Strength 24 Mpa
-Fluoride release
-Low Solubility = so ideal for difficult to isolate cases
-Low Micro Leakage = Cement swells slightly upon setting to seal margins

90
Q

What is the compressive strength of resin-modified glass ionomer?

A

24 Mpa

91
Q

Resin-modified glass ionomer cement is ideal for all restorations except…

A

-Highly esthetic cases. Cement is bright white. IF margin is visible, you might see the cement.
-All Ceramic crowns with margins less than 1mm thick. Swelling of cement on setting can cause marginal fracture.
-Inlays and Onlays are contraindicated for this cement.

92
Q

How do you use resin-modified glass ionomer?

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 m
-Seat the Crown
-Maintain Pressure on the restoration while cement is setting
-Maintain dry field during setting
-Wait 3 minutes
-After cement has set, remove excess

93
Q

Resin cements require a very _________ sensitive protocol

A

technique

94
Q

What does resin cement require?

A

bonding agent and an etchant
These are either separate or combined.
-Self-Etch
-Total-Etch

95
Q

Why does resin cement have a high incidence of post op sensitivity?

A

due to etching process and the failure to seal the dentinal tubules

96
Q

What does incomplete mixing of a dental cement cause?

A

either leads to weaker cement, or thicker harder to seat cement which can also lead to hyper occlusion

97
Q

What does incomplete seating of a dental cement cause?

A

hard to tell if restoration is down all the way with cement excess

98
Q

What does excess drying of a tooth before cementing cause?

A

Leads to post-op sensitivity. Use Gluma (2 x 60 second coats) prior to crown seat to decrease sensitivity.

99
Q

What does incomplete removal of excess after cementing cause?

A

gingival bleeding, irritation, bone loss, and possible gingival surgery to remove excess if access is not available

100
Q

What are the general characteristics of non-adhesive cements?

A
101
Q

What are the general characteristics of adhesive cements?

A

Fixed (13 decks)

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