Dental Cements: Luting Agents Flashcards

1
Q
Why use \_\_\_\_\_\_? 
 Caries
 Fractures
 Misalignment
 Prolong the life of the pulp in the war against 
oral bacteria- using protective coatings
Varnish
Base
Liner
Pits & Fissure sealants
A

Dental Cements

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2
Q

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

A

Dental cement

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3
Q

What do we want a Dental

Cement to be?

A
① Biocompatible- long-term
② Non-corrosive & Inert
③ Immune to acid attack
• insoluble
④ Dimensionally stable-
• no cracking of tooth or device by 
expansion 
• no leaking because of shrinkage
5) Sets during the dental procedure
6) Low surface tension; Handles & places easily
7) Adapts & adheres to anatomy
8) Insensitive to moisture during procedure
9) Anti-microbial/ F- release
10) Radiopaque- able to see it on a radiograph
11) “Cost-effective” 
 HIGH values needed for:
13) Cyclic fatigue
14) Thermal cycling
15) STRENGTH
a. Tensile
b. Compressive
c. Flexural Strength
d. Shear
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4
Q

Applications of _______

  1. Luting cements
    a. Permanent & provisional indirect restorations
    b. Orthodontic brackets
    c. Post and cores
  2. Restorative materials
    a. Permanent & provisional direct restorations
  3. Cavity liners & Bases
    a. Pulp protection
  4. Multiple applications
    a. No one cement can fulfill all requirements
A

Dental cements

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5
Q

Viscous material that fills the
microscopic space between the abutment-
prosthesis interface; upon setting, it forms a
solid that seals the space and retains the
prosthesis.

A

Luting cement/agent

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6
Q

What are the 8 ideal properties of a permanent luting agent?

A
  1. *Low film thickness (25 m)
  2. *Adequate strength (minimum 70 MPa)
  3. *Low solubility (0.2% max. @ 24h)
  4. *Reasonable setting time (2.5-8.0 min)
  5. Adequate working time
  6. Biocompatible, does not irritate pulp
  7. Cariostatic
  8. Adhesion to tooth structure and restorative materials
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7
Q

_____ bonding
 very weak interaction, 2bonds
 Van der Waals forces, hydrogen bonds

A

Physical bonding

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8
Q

_____ bonding
 : strongest bond, 1bonds
 Limited occurrence, dissimilar materials
 Example: composite bond to adhesive bond agent

A

Chemical bonding

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9
Q
\_\_\_\_\_ bonding
:interlock undercuts, surface irregularities
Micromechanical retention
Examples:
 Luting agent/tooth/crown 
 Adhesive bond agent/tooth
A

Mechanical bonding

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10
Q

 Cement locking into microscopic irregularities in prepared
tooth surface and the internal surface of the crown
 Non-resin cements
 Very low bond strength, 1-5 MPa

A

Luting cement:

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11
Q

 Enamel: resin tags into etched enamel
 Dentin: hybrid layer
 Interdiffusion or micromechanical interlocking of resin with demineralized collagen of interbulular dentin
 20-30 MPa bond strength

A

Adhesive bond agent/tooth:

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12
Q

Is the liquid or powder the acidic component of cement?

A

Liquid

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13
Q

Is the liquid or powder the basic component of cement?

A

Powder

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14
Q

_____ cement:
 Indications
 Temporary / intermediate
cementation

A

Zinc oxide eugenol

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15
Q
  1. Composition:
    a. Powder: Zn Oxide Liquid: Eugenol
    b. Modifications:
    1) Polymer-reinforced: IRM
    2) EBA (ethoxy-benzoic acid), Alumina
  2. Low strength (MPa):
  3. Uses: temporary or provisional cement
    and restorations
    a. Eugenol acts as sedative, obtundent
  4. ZOE unmodified, TempBond
    a. Temporary cement
  5. ZOE polymer-reinforced
    a. IRM: Intermediate Restorative Material
    1) Temporary cement: Retention or time
    2) Provisional/intermediate restoration
  6. Not use prior to resin-based permanent cement,
A

ZOE

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16
Q
 + Obtundent
 –+ Slow setting
 – Excess eugenol is irritant
 Cytotoxic
 Potential allergen
 – Shrinkage
 – Low strength
 – Solubility
A

ZOE

17
Q
 Temporary cement
 Eugenol replaced with other oils
 Used prior to permanent resin-based cement
 TempBond NE
 Slow set
 Low retention
A

ZnO non eugenol

18
Q
\_\_\_\_ cement:
 Low strength: 
 Compressive, 55-67 MPa (ADA spec 96 minimum = 70 MPa)
 Tensile, 6-8 Mpa
 Biological considerations
 Initial pH ~3, similar or lower than ZnPO4
 Minimal pulp reaction, large molecule not enter tubules
 Dentin bond strength: ~2 MPa
 Chelation interaction: cement carboxylate (COO-) and Ca+ on tooth surface
 Physical bond: interaction between – and + charges
5. Advantages:
 Low pulpal irritation
 Adhesion to tooth structure
 More with enamel than dentin,  Why?
6. Disadvantages:
 Low strength
 More viscoelastic
 Prosthesis dislodgement over time
7. Marketed as a temporary cement
 UltraTemp
 Can be used prior to resin cement
 No polymerization inhibition, Why?
 UltraTemp REZ: resin-based
A

Zinc Phosphate cement

19
Q
\_\_\_\_\_\_\_\_\_ cement
 Oldest, still in use
 “Gold Standard” for new cements
 Easy to manipulate
 Working time 3-6 min
 Setting time < 14 min
 Indications: Luting (non-adhesive cementation)
 fixed prosthodontics
A

Zinc Phosphate cement

20
Q

____ cement:
 Introduced 1878
 Micromechanical bond to preparation surface and crown
internal surface micro-irregularities
 No chelation interaction
 Bond strength: 0.5-1.5 MPa
 Preparation retention and resistanceform critical
 No longer a major luting agent
 Possible current use: cement-retained implant crowns
 Radiographic visibility, easier removal with less damage to Ti
implant surface

A

Zinc phosphate

21
Q
\_\_\_\_\_\_\_ cement
 Powder
>75%  zinc oxide <13% magnesium oxide
 Radiopaque fillers
 Liquid= aqueous solution of
38 – 59% H3PO4
2-3% Al phosphate  
<9% Zn phosphate
 Reaction Products
 Amorphous Zn3(PO4)2·4H2O matrix 
 Zinc aluminophosphate matrix
 Residual ZnO particles
 EXOTHERMIC
 Use chilled glass slab
 Mix over large area of slab
 Mix in increments
 Create stringy consistency
 Remove excess after set
A

Zinc Phosphate

22
Q
\_\_\_\_\_\_\_\_\_ Cement
+Thermally protective
 –Acidic
 –Exothermic reaction
 – Some solubility w/ acids
A

Zn Phosphate

23
Q

______ cement
 Composition:
 Powder: Fluoroaluminosilicate glass (FAS)
 Liquid: Polycarboxylic acid/H2O
 Strength:
 Compressive: 90-140 MPa
 Tensile: 6-7 Mpa
 Fluoride release (from what component?)
 Bond strength: 3-5 MPa
 Chelation, cement carboxyl and Ca+ in apatite

A

Glass Ionomer

24
Q
 Post-cementation 
hypersensitivity
Early protection 
(varnish) to 
prevent 
hydration and 
dehydration of 
initially set 
cement
A

Glass ionomer

25
Q
\_\_\_\_\_ cement:
polycarboxylate/acrylic reaction
 Glass Powder: Ca-F-Al-silicate
 Optional Ba, Sr for radiopacity
 Optional Ag, Zn
 Powder size <25 μm
 Liquid- water solution of
 ~50% Polyacrylic-itaconic copolymer
 Optional water-soluble polymer
 Citric, maleic & tartaric acids
A

GI

26
Q
 Affixing devices
 Orthodontic bands
 + Fluoride release 
 – Requires protection from 
dilution or evaporation during 
setting
A

GI Cement

27
Q
\_\_\_\_\_\_ cement clinical features
 Fluidity like ZnPO4
 Chill the powder and slab
 Avoid liquid evaporation
 Remove smear layer created by preparation 
instruments
 Don’t dehydrate tooth
 Protect cement from excess or deficiency of H2O 
during set
 Apply Copalite on exterior
 Remove excess immediately
 Avoid adhesion in unwanted areas
A

GI

28
Q
\_\_\_\_\_ cement:
 Composition:
 Powder: Fluoroaluminosilicate glass (same as GI)
 Liquid
 Polycarboxylic acid/ H2O (same as GI)
 Resin monomers, vary with products
 HEMA, Bis-GMA
 Replace some of the H20 of conventional GI
 Photoactivator (Light-activated only)
 Setting reactions (2)
 Acid-base reaction: same as GI
 Monomer polymerization: chemical-, light- , dual-activated
A

RMGI

29
Q
\_\_\_\_\_\_\_ cement:
3. Strength (MPa): 
 Compressive: 150-200; Tensile: 13-24
4. Fluoride release (from what component?)
5. Bond strength: 5-10 Mpa
6. Powder/Liquid System
 Potential for dispensing error
 Brands:
Rely X (3M ESPE) 
Fuji Plus (GC) 
CX Plus (Shofu)
7. Paste/Paste systems
a. 2-tube dispenser
b. Mix on pad
c. Quicker dispensing
d. Less dispensing error
e. Mix within 30 sec
f. Brands: 
1) RelyX Plus
2) Fuji Cem
A

RMGI

30
Q

What is the working time for RMGI?

A

2.5 minutes

31
Q
Gently shake powder bottle to fluff powder
 Dispense powder before liquid
 Equal number powder scoops 
and liquid drops
 3 level scoops for crown, 6 for FPD (2 abutments)
 Hold bottle vertically to dispense 
liquid
 Mix powder into liquid 
within 30 sec
6. Load the crown with cement
 Spread cement onto all internal surfaces
7. Working time is 2.5 minutes
8. Seat the crown
 Maintain pressure on restoration while cement is setting
 Maintain dry field: cotton rolls, suction
10. Wait at least 3 minutes after 
placement 
11. After cement is completely set, 
remove excess
 Scaler, Explorer, Knotted floss
12. Gingival crevice, remaining cement 
 Any cement that is not removed 
will be very irritating to the tissue.
A

RMGI placement

32
Q
\_\_\_\_\_\_ indications:
 Cavity liners, base
 Pit & Fissure sealants
 Core buildups 
 Restorative
 Adhesive
 Orthodontic brackets, 
crowns
 repair amalgam
 Retrograde root filling materials
A

RMGI

33
Q
\_\_\_\_\_\_ cements
 Start in 1950s; takeoff 1970s
 Based on methyl methacrylate
 Chemical (self) cure
 Light cure
 Dual-cure
A

Resin cements

34
Q
\_\_\_\_\_ cements:
 + Look esthetic, translucent, 
shades to match tooth
 + Insoluble
 + Fast-curing or slow-curing 
formulas
 + Good for all-ceramic 
restorations
 Strong & insoluble
 – Shrinkage: Leakage
 –Higher film thickness
 More complex clinically
 – Incomplete conversion 
of monomer
 – Poorer strength, 
more irritation
 –Odor, allergies
 – Wear of resin
A

Resin cements

35
Q

 Combination of Resin cement with a “dash” of GIC
 Polyacid liquid monomers & resin monomers
 Water-free
 Usually light-curing

A

Compomers