Luting Agents Flashcards

1
Q

What properties of a luting agent should be considered?

A

• Viscosity and film thickness • Ease of Use • Radiopaque • Marginal seal • Aesthetics • Solubility • Cariostatic • Biocompatible • Mechanical properties

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2
Q

What is the viscosity and film thickness dependent on?

A

the size of powder or filler particles in the material

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3
Q

What do you want the viscosity to ideally be like in a luting agent?

A
  • Viscosity must be low to allow seating of the restoration on the prep you have made and not change this prep (not interfere with prep)
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4
Q

What happens to the viscosity of the materials as they set? Why is this relevant for luting agents and the procedure?

A

Viscosity increases as material sets -must seat restoration quickly and maintain pressure

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5
Q

What should the film thickness of a luting agent ideally be?

A

As thin as possible but at least 25um or less

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6
Q

In terms of ease of use, you want the luting agent to what?

A

• Be easy to mix (many products are encapsulated and have a clicker system) • Have a long working time to allow for the seating of the restoration • Have a short setting time (command set is always the best)

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7
Q

Why do you want a radiopaque luting agent?

A

Some ceramic crowns are radiolucent so you want a luting agent that is radiopaque. This makes it easier to see if there is any secondary caries or marginal breakdown.

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8
Q

What would the ideal marginal seal of a luting agent be like?

A

Ideally the luting agent should bond chemically to the tooth and the indirect restoration with a permanent and impenetrable bond. Some newer materials are getting close to this but none have yet reached this.

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9
Q

In terms of aesthetics, how do you want the material to look?

A

You want the material to be tooth coloured and come in various shades and translucencies while also being non-staining.

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10
Q

What do you want the solubility of a luting agent to be like?

A

You want LOW solubility so it does not wash away under the influence of saliva.

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11
Q

Why do you want a luting agent to be cariostatic?

A

to help prevent secondary caries around crown margins etc

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12
Q

In terms of biocompatibility, how do you want a luting agent material to act?

A

Be non-toxic Not damaging to the pulp -Appropriate pH -Don’t release heat on setting Have low thermal conductivity (Many restorations/crowns are metal based so you want the material to have a low thermal conductivity to help protect the pulp)

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13
Q

What do you want the mechanical properties of a luting agent to be like?

A

Similar to that of tooth structure

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14
Q

What are the different luting agent material types you can get?

A

Dental Cement

  • Zinc Phosphate -
  • Zinc polycarboxylate

Glass ionomer Cement

  • Conventional
  • Resin modified Composite resin luting agents
  • Total etch for use with DBA
  • Self-etch
  • Requires etch but has own bonding agent incorporated
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15
Q

What are the main components of zinc phosphate? (the powder and liquid)

A

powder: -zinc oxide -magnesium dioxide -other oxides Liquid -phosphoric acid -oxides -zinc oxide

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16
Q

Describe the types of reactions that happen to form zinc phosphate cement.

A

An acid base reaction followed by a hydration reaction

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17
Q

What are the problems with zinc phosphate cement? (7)

A
  • Low initial pH approx. 2 (Can cause pulpal irritation as pH can take 24hrs to return to neutral)
  • Exothermic setting reaction
  • Not adhesive to tooth or restoration (Retention may be slightly micromechanical due to surface irregularities on prep and restoration)
  • Not cariostatic
  • Final set takes 24hrs
  • Brittle
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18
Q

What is the difference between zinc phosphate cement and zinc polycarboxylate cement?

A

Phosphoric acid replaced by polyacrylic acid

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19
Q

What are the advantages of Zinc Polycarboxylate?

A

• It can bond to tooth structure in a similar way to GIC’s (Only to a small extent though) • Less of a heat reaction than zinc phosphate • pH is low to begin with but returns to neutral more quickly and longer chain acids do not penetrate the dentine as easily • Cheap v

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20
Q

What are the disadvantages of Zinc polycarbonate?

A

• Difficult to mix • Difficult to manipulate (is jelly like) • Lower modulus and compressive strength than Zinc Phosphate • Opaque • More soluble in the mouth/oral environment Note: Zinc phosphate/polycarboxylate cements are mainly historic. More modern materials utilise bonding to the tooth structure and may can also bone to the indirect restoration as well.

21
Q

What is the main difference between GIC that is used as a filling material and GIC that is used as a luting agent?

A

The particle size of the glass is smaller in luting agent to allow for suitable film thickness (less than 20um)

22
Q

What kind of reaction occurs to form GIC?

A

acid base reaction between glass and acid The reaction goes through the same dissolution, gelation and hardening stages

23
Q

How does GIC cement bond to the tooth surface?

A

Ion exchange with the calcium in enamel and dentine Hydrogen bonding with the collagen in the dentine

24
Q

There is no chemical bond between GIC and the restoration surface. What needs to be done to overcome this?

A

The surface of the restoration should be sandblasted to allow mechanical adhesion.

25
Q

What are the advantages of GIC as a luting agent?

A

• Clinically easy to use and durable cement • Low shrinkage • Long term stability. • Relatively insoluble once fully set (but this can take up to weeks to happen) • Aesthetically better than ZnPhos. • Self-adhesive to tooth substance. • Fluoride release. • Cheap

26
Q

What is the main difference between GIC luting agent and RMGI luting agent?

A

The powder component of the RMGI contain a hydrophilic monomer (HEMA)

27
Q

Why must the monomer in the cement be hydrophilic?

A

Because GIC is water based

28
Q

Describe the reaction process of GIC cement

A

• The same acid base reaction occurs as with conventional GIC’s • Light activation causes polymerisation of the HEMA and any copolymers in the material leading to a rapid initial set. • The acid base reaction then continues for some time. • Some materials have a secondary cure via a REDOX reaction (This allows ‘Dark Curing’ where material not exposed to light will cure.)

29
Q

Why do we need some RMGI materials that have a secondary cure by a REDOX reaction?

A

Because if you are setting a restoration that is made from something like metal, light won’t penetrate well through it so it needs to be able to set in the dark

30
Q

What are the advantages of incorporating resin into GIC’s?

A

• Shorter setting time • Longer working time • Higher compressive and tensile strengths • Higher bond strength to tooth • Decreased solubility (because of the resin) • Cheap

31
Q

What are the disadvantages/problems with RMGI?

A

• HEMA is cytotoxic o Very important that no monomer remains as it can damage the pulp. • HEMA swells, it expands in a wet environment (because it is hydrophilic) o It cannot be used to cement conventional porcelain crowns as they may crack due to the swelling and pressure created by this o It shouldn’t be used to cement posts as it may split the root • No bond to indirect restoration

32
Q

What are temporary cements?

A

cements that are used to cement temporary restorations in place while the permanent restoration is fabricated (can also be used as a trial luting agent for a permanent restoration to allow assessment by the patient or clinician)

33
Q

Describe the basic properties of temporary cements.

A

-soft to allow easy removal (some dont set at all) -doesnt bond so the tooth prep needs to be retentive

34
Q

Describe the composition of temporary cements (what is found in them)

A

They are supplied as a two-paste system which is a base and a catalyst/accelerator: -Base contains ZnO, starch and mineral oil -Acceleration contains resin, eugenol or ortho-EBA and carnauba wax

35
Q

What is the purpose of the wax in these cements?

A

Weakens the structure of the cement to make it easier to remove NOTE: the material can be modified to make it weaker still by incorporating petroleum jelly into the mixture

36
Q

What are the 2 main types of temporary cements?

A

those containing eugenol and those that do not contain eugenol

37
Q

When should temporary cements containing eugenol not be used? Why?

A

If the permanent restoration will be cemented with a resin cement -Because any residual eugenol may interfere with the setting of resin luting agents

38
Q

What must composite luting agents be used in conjunction with?

A

a suitable dentine bonding agent

39
Q

How can composite luting agents be cured?

A

Either light cured or dual cured

40
Q

How to composite luting agent properties compare to dental cements and GIC/RMGI?

A

have better physical properties, lower solubility and better aesthetics BUT are technique sensitive

41
Q

How does composite bond to indirect composite/what has to be done?

A
  • composite will bond to composite
  • the bond us microchemical to the rough internal surface of the inlay
  • it is also a chemical bond to the remaining C=C bonds on the fitting surface of the inlay note: a dual curing cement should be used as light penetration through inlay will be poor

Note: in the pic can see DBA is required. This is becasue the tooth is hydrophilic and comp is hydrophobis. The DBA makes the tooth hydorophobic

42
Q
A
43
Q

What is porcelain treated with before being seated on a prep and why?

A

Hydrofluoric acid to etch the surfcea nd make it rough and retentive

44
Q

What is needed to bond porcelain to a tooth?

A

tooth - DBA (to make tooth hydrophobic) - composite resin - silane coupling agent - porcelain

NOTE- the silane coupling agent (wetting agent) makes the porcelain hydrophoic so it can chemically bond with the composite resin

45
Q

Describe the silane coupling agent and how it works.

A

oxide groups bond to etched porcelain surface

The C+C react with the composite luting agent

46
Q

What is used to bond a precioius metal to a tooth?

A

Composite luting agents with a metal bonding agent incorporated (panavia most common one)

47
Q

For bonding a non-precious metal to a tooth, what is required?

A
  • DBA
  • composite luting resin
  • metal bondign agent
48
Q

What luting agent do you use where?

A