Professional Documents
Culture Documents
DENTAL CEMENTS
Traditionally dental cements were inorganic zinc oxide–based materials but nowadays
polyacid-based materials predominate.
They are used as direct filling materials and luting agents for indirect dental restorations.
1. Filling materials
1) Permanent (e.g., GIC)
2) Temporary (e.g., ZOE)
2. Base/liner cements (calcium hydroxide cement)
3. Luting cements
1) Permanent (e.g., zinc phosphate cement, GIC, RMGIC)
2) Temporary (e.g., ZOE, EBA, NE cements)
Luting cements
In dentistry cements are luting agents that are used to ‘cement’ a restoration to prepared teeth,
usually by mechanical retention.
Two categories exist: permanent luting agents and those for temporary (provisional) luting
and/or a protective action.
Traditionally dental luting cements were inorganic zinc oxide–based materials.
Inorganic and organic salt cements rely on mechanical interlocking into surface
discontinuities and roughness although, with organic salt cements, there is some chemical
bonding between the organic acid and calcium in hard tissue.
Resin cements rely more upon chemical interactions for their retentive action (adhesive
dentistry).
Thus, until the advent of resin-based cements, retention by dental cements was primarily
mechanical in nature.
Thermal properties
Cast restorations have higher thermal conductivities than enamel and dentin, and dental
cements must have low conductivity to provide a thermal barrier between restoration and
tooth.
Mechanical properties
Cements must possess sufficient strength to support the restoration and withstand transmitted
masticatory forces.
COMPONENT FUNCTION
Powder
Zinc oxide Primary reactive ingredient
Zinc acetate (1-5%) Accelerator
Liquid
Eugenol Primary reactive ingredient
Olive oil (5-15%) To control viscosity
Provisional luting agents commonly are based on zinc oxide‒eugenol (ZOE) and set by
initial hydrolysis of ZnO to Zn(OH)2 the latter reacting with eugenol to form zinc
eugenolate gel at the ZnO particle surface.
With time, the gel crystallizes, increasing the strength of the set mass, crystallite
formation being accelerated by zinc acetate.
Zinc eugenolate decomposes in water to form Zn(OH)2 with liberation of eugenol.
Eugenol release by hydrolysis of ZOE can leave residues that interfere with the setting
reaction (polymerization) of subsequently applied resin-based permanent luting agents.
Despite an anesthetic effect, eugenol is severely inflammatory.
ZOE sets in 4‒10 min with a film thickness of 25µm but the set material has low
compressive strength (27.6 MPa).
The P/L ratio determines the consistency and mechanical properties of ZOE cements
ZOE is hydrolytically unstable which, with its low strength, predicates its use as a
provisional luting agent.
EBA cement
This cement is a modified ZOE cement.
Modification with ortho-ethoxybenzoic acid (EBA) with a 1.66 : 1 EBA-to-eugenol ratio
markedly increases cement strength.
NE cements
Eugenol-free or non‒eugenol‒based provisional cements with carboxylic acids replacing
eugenol are increasingly available.
NE provisional cements are supplied as paste-paste systems or in automix syringes.
NE provisional cements are stronger, more retentive, and have longer working and setting
times than ZOE but may have slightly inferior flow properties and somewhat greater film
thicknesses.
These cements are less susceptible to hydrolytic breakdown and, consequently, are
considered to be more suitable for long-term provisional cements than ZOE.
POWDER LIQUID
Zinc oxide (90.3%) Phosphoric acid (38.2%)
Magnesium oxide (8.2%) Phosphoric acid buffered with Al and Zn
(16.2%)
Silica (1.4%)
Bismuth oxide (0.1%)
Barium oxide, barium sulfate and calcium
oxide (≤0.1%)
Setting occurs within 5–7 min, the low initial pH (about 2.1) increasing to pH 4 within 60
min.
Strength increases with time, achieving about 90% (100 MPa) of final strength in 24 h, while
solubility decreases.
After mixing and cement placement within the crown, the restoration should be seated
immediately to ensure low film thickness.
CATEGORY APPLICATION
Type I Luting agents
Type II Filling material
Type III Base/liner
Type IV Core build-up
Zinc polycarboxylate and GIC characteristics compared with those of zinc phosphate
(ZNP) cement
RMGI APPLICATIONS
Type I Luting agents of cast metal and porcelain
restorations, posts, and orthodontic appliances
Type II Filling material as provisional restorations
Type III Base/liner for amalgam restorations
Type IV Core build-up
RMGIs are available in self-, light-, or dual-cured forms and are supplied as powder–liquid
systems, as paste–paste systems, and in automix cartridges and syringes as well as pre-dosed
capsules.
COMPONENT FUNCTION
Methacrylate resin Permits setting by polymerization.
Polyacid Reacts with the glass causing setting by an
acid–base reaction.
HEMA (hydroxyethylmethacrylate) Facilitates coexistence of resin and acid in
aqueous solution and participation in
polymerization.
Water Essential for ionization of acid required for
acid–base reaction.
Setting reaction
RMGIs may have three setting mechanisms: acid–base reaction, ligh-tactivated
polymerization, and chemically activated polymerization.
Initial setting is polymerization of methacrylate groups in the liquid component whereas the
slower acid–base reaction provides final strength.
Some products use conditioning or bonding agents such as polyacrylic acid and aluminum
chloride or citric acid containing ferric chloride.
Water must be present, either by incorporation or inward diffusion following the initial set,
for the acid–base reaction to occur.
Properties
Compared with GICs, RMGIs have improved translucency, the same fluoride release, and
greater strength.
Bonding to dentin is comparable to that of GICs but RMGIs bond better to resin-based
restorations.
Initial pH is low (3.5) but increases over time.
Some RMGIs (and GICs), particularly the light-curing types, sorb water and will expand after
placement.
This hygroscopic expansion can cause fracture of sintered alumina copings of all-ceramic
crowns and zirconia crowns.
Resin cements
Resin cements are essentially low-viscosity composite filling materials having a resin matrix
containing silane-treated inorganic fillers (silica, glass, or ceramic particles and/or colloidal
silica).
The polymer systems of resin cements include acrylic resin (PMMA) or methacrylate
copolymers, bis-GMA resins, and urethane dimethacrylate resins with diluents such as
triethylene glycol dimethacrylate (TEGMA).
The fillers, approximately 75% by weight, 47% by volume, have a particle size of
approximately 1 micron and provide wear resistance, increased strength, and reduced
expansion and contraction.
Polymerization is by conventional chemical-cure or light activation.
Dual-cure systems, which utilize both curing mechanisms, are usually radiopaque whereas
light-cured systems are not radiopaque but are available in different shades.
Most resin cements require a bonding agent to promote adhesion to tooth structure.
Some cements are available with high- and low-viscosity catalyst pastes.
Properties
Resin cements have greater strength and lower solubilities than inorganic cements, GICs and
hybrid ionomers.
They form thinner films but set faster.
They adhere to hard tissue but bond strengths to tooth and metals are lower than for adhesive
resin cements.
The disadvantages of resin cements are technique sensitivity, radiolucency with some
materials, difficulty in removing excess material, and higher cost.
Types of resin cements and their applications