3. Cement-Substance that hardens to act as a base, liner, filling malerial,
or adhesive to bind devices and prostheses to tooth structure or to
each other.
ANUSAVICE 11th EDITION
Cement : a binding element or agent used as a substance to make
objects adhere to each other, or something serving to firmly unite.
THE GLOSSARY OF PROSTHODONTIC TERMS
Traditional dental cements are based on reactions between acidic
liquids and basic powders to produce reaction product salts that form a
solid matrix surrounding residual powder particles.
STURDEVANT‘S
5TH EDITION
DEFINITION:
Dental cements are hard, brittle materials formed by mixing powder
and liquid together. They are either resin cements or acid-base
cements. In the latter the powder is a basic metal oxide or silicate and
the liquid is acidic.
ENCYCLOPEDIA
4. Classification
Classification of dental cements, Based on their chief chemical
ingredients And application: CRAIG 11TH
EDITION
1. GLASS AND HYBRID IONOMERS
2. ZINC POLYACRYLATE
3. ZINC PHOSPHATE
4.CALCIUM HYDROXIDE
Class 5 restorations
Retention of alloy restorations
High-strength bases
Retention of alloy restorations
Retention of orthodontic bands
High-strength bases
Retention of alloy restorations
Retention of orthodontic bands
High-strength bases
Provisional restorations
Low-strength bases
5. 5. ZINC OXIDE-EUGENOL
6. NON-EUGENOL-ZINC OXIDE
7. COMPOMERS
Low- and high-strength bases
Provisional restorations
Temporary and permanent retention of
restorations
Temporary retention of restorations
Root canal sealers
Gingival tissue packs
Surgical dressings
Bonded conventional crowns and bridges
Retention of orthodontic brackets
High-strength bases
8. COMPOSITES AND ADHESIVE RESINS
Bonded conventional crowns and bridges
Bonded ceramic veneers, inlays, and onlays
Bonded laboratory composites
Bonded posts and cores
Bonded Maryland bridges
Retention of provisional restorations
6. Classification of dental cements according to reaction
type: ANUSAVICE 11th
EDITION
Acid-base reaction
Zinc phosphate
Zinc oxide-eugenol
Zinc oxide-eugenol (EBA modefied)
Zinc polycarboxylate
Glass ionomer
Acid-base reaction
Acid-base reaction
Acid-base reaction
Acid-base reaction
Resin modified Powder glass ionomer
Compomer (one paste) Light-activated polymerization
Compomer (powder-liquid)
Light or chemically and acid base reaction
Resin cement (one paste)
Resin cement (two paste)
Resin cement (powder-liquid)
Light-activated polymerization
Light or chemically and acid base reaction
Chemical-activated polymerization
Light or chemically and acid base reaction
Materials Reaction type
9. Classification of dental cements according to
bonding mechanism:
1.Phosphate: a) zinc phosphate;
b)zinc silicophosphate
2.Phenolate: a) calcium hydroxide silicylate;
b) ZnO eugenol: -polymer;
-EBA;
-alumina;
3.Polycarboxylate: a) zinc polycarboxylate;
b) glass ionomer;
4.Resin: a) polymetelmetacrylate
b) dimethylacrylate: -filled;
-unfilled
.
O’Brien 4th edition
10. Type I: Luting agents that include
permanent and temporary cements.
Type II: Restorative applications.
Type III: Liner or base applications
Classification of cements according to the use:
O’Brien 4th edition
11.
12. Ideal Properties of a Dental Cement
1. Low viscosity and film thickness
2. Long working time
3. Low solubility
4. High compressive and tensile strengths
5. High proportional limit
6. Adhesion to tooth structure and restorative materials
7. Anticariogenic properties
8. Biocompatibility
9. Translucency
10. Radiopacity
13. Cement base
• A thick layer of cement (>0.75mm)
• The base should be strong enough to resist the
condensation force during the placement of restoration.
• Good insulation
• Good sealing
Uses of cements
16. Luting cements
• Desirable features:
– Good wettability
– Good flow
– Thin film thickness: 25 µm or less
• If the luting agents layer is too thick:
– It will prevent proper seating of restoration
– Excess cement may wash out and cause irritation
and caries
17. • Permanent:
cements are rarely used as restorations due to:
– Low strength
– Low wear resistance
– High solubility
• The exception is GIC, used for class V cavities and primary teeth.
• Temporary and intermediate restorations:
– Uses:
• In symptomatic teeth, a sedative provisional restoration can be placed
• Between visits in cases of Endodontic treatment, crowns, inlays
Restorations
18. Surgical dressing
• Purpose
– Protection and support of surgery site
– Help to control bleeding
– Provide comfort for patient
• Material used: non eugenol
dressing, mixed to soft putty
like consistency.
19. 1. Reaction of acid and alkali (base) components – setting via
acid-base reaction (neutralization in water based cements)
2. Free radical polymerization (the same as that of acrylics
and also composites) or
3. Via combination of the free-radical polymerization and the
acid-base reaction
HOW ARE CEMENTS FORMED
21. CEMENT FORMING REACTION
• In general, cements are usually formed by an acid-base reaction in
which an acidic liquid and basic powder are mixed to produce a
final set material which is composed of
: a core: of unreacted powder, surrounded by
:a matrix: formed by reaction products of powder and liquid.
22. Water-based cements
Setting reaction
Water is needed:
-dissolves acids
-enables dissociation of acidic groups
- hydrates particles of cements and releases alkaline ions from their surface
23. Phosphate-Based Cements
• Applications
1. Cementation (luting) of fixed cast alloy and porcelain
restorations and orthodontic bands .
2. As a cavity liner or base.
Zinc phosphate:
Oldest of the luting cements, thus it has the longest clinical
"track record" and serves as standard with which newer
systems can be compared.
25. Setting reaction:
The amorphous zinc phosphate formed binds together the
unreacted zinc oxide and other components of the cement.
26. Manipulation
•The mixing slab must be thoroughly dried before use.
• The powder is added to the liquid in small portions to achieve the
desired consistency.
•The cement must be undisturbed until the end of the setting time.
•Use of a chilled (5°C) thick glass slab slows the initial reaction and
allows incorporation of more powder, giving superior properties in
the set cement. Frozen Slab Method
Powder/liquid ratio- 3.5 : 1
27. Effects of manipulation on some properties.
Manipulative
variables
Properties
Copressive
strength
Film
thickness
Solubility Initial
acidity
Setting
time
Decreased
powder/liquid ratio
Increase rate of
powder incorporation
Increase mixing
temperature
Water contamination
28. Properties of zinc phosphate cement
Working time 3 to 6 minutes
Setting time 5 to 14 minutes
Film thicknesses 25 um
Compressive strength 80 to 110 MPa
Tensile strength 5 to 7 MPa
Modulus of elasticity 13 GPa
Solubility 0.04% to 3.3%
29. • Mixed easily
• Relatively strong
• Manipulation is less critical
Advantages
Disadvantages
• Pulpal irritation
• Lack of antibacterial action
• Brittleness
• Lack of adhesion
• Solubility in oral fluids.
30. Modified zinc phosphate cements
• Black copper cements contain cupric oxide (CuO); red copper cements
contain cuprous oxide (Cu2O). Others may contain cuprous iodide or silicate.
•The mix is highly acidic, resulting in much greater pulpal irritation.
• Their solubility is higher and their strength is lower than zinc phosphate
cements.
• Their bacteriostatic or anticariogenic properties seem to be slight.
Silver cements
•Contain a small percentage of a salt such as silver phosphate.
•Their advantages over zinc phosphate cement have not been substantiated.
Copper cements
31. Silicophosphate cements
• The very first translucent ”aesthetic“ anterior restorative material (1900-
1950)
•Combination of zinc phosphate and silicate cements.
• The presence of the silicate glass provides a degree of translucency,
improved strength, and fluoride release.
Types
Type I-cementation of fixed restorations and orthodontic bands
Type II-provisional posterior restorative material
Type III-dual-purpose material
32. Composition and setting
10% to 20% zinc oxide (zinc phosphate cement powder) and silicate
glass (silicate cement powder) mechanically mixed or fused and
reground.
powder
liquid orthophosphoric acid solution containing about 45% water and
2% to 5% aluminum and zinc salts.
zinc oxide / aluminosilicate glass + phosphoric acid zinc aluminos
The set cement consists of unreacted glass and zinc oxide particles
bonded together by the aluminosilico-phosphate gel matrix.
33. Properties of Silicophosphate cement
Working time 4 minutes
Setting time 5 to 7minutes
Film thicknesses 25 um
Compressive strength 140 to 170MPa
Tensile strength 7 MPa
Solubility 1% in 7 days
34. Advantages
Disadvantages
• Better strength, toughness & abrasion resistance properties
• Fluoride release
• Translucency
• Lower solubility and better bonding.
• Pulpal sensitivity may be of longer duration, and pulpal
protection is essential.
• Manipulation is more critical than with zinc phosphate cements.
35. ZINC OXIDE EUGENOL CEMENT (ZOE)
These cements have been used extensively in
dentistry since 1890's.
Their pH is approximately 7 at the time of
placement, which potentially makes them the
least irritating of all dental materials and are
known to have an obtundant (sedative) effects.
Applications
Provisional cementation of crowns and fixed
partial dentures
Provisional restoration
Cavity liner in deep cavitys.
36. Classification:
4 Types
• Type I ZOE- Temporary luting cement
• Type II ZOE- Long term luting cement
• Type III ZOE- Temporary restorations
• Type IV ZOE- lntermediate restorations
37. Composition
Powder
Zinc oxide 69% Principle Ingredient
White rosin 29.3% reduce brittleness of set cement
Zinc stearate 1.0% Accelerator, plasticizer
Zinc acetate 0.7% Accelerator, improve strength
Liquid
Eugenol 85% Reacts with zinc oxide
Olive oil 15% Plasticizer
39. Manipulation
The zinc oxide is slowly wetted by the eugenol; therefore, prolonged
and vigorous spatulation is required, especially for a thick mix.
A powder/liquid ratio of 3:1 or 4:1 must be used for maximum
strength.
40. Properties of zinc oxide-eugenol cement
Working time longer
Setting time 2 to 10 minutes
Film thicknesses 40 um
Compressive strength 7 to 40 MPa
Tensile strength low
Solubility 1.5% in 24 hrs
41. Advantages
Disadvantages
Anodyne and Obtundent effect on the pulpal tissues
Good sealing ability
Resistance to marginal penetration.
Low strength and abrasion resistance
Solubility and disintegration in oral fluids
Little anticariogenic action.
42. Modified Zinc-Oxide Eugenol Cements
These were introduced to improve the mechanical
properties of zinc-oxide eugenol cement.
The modified ZOE cements are:
EBA- Alumina modified
cements
Polymer reinforced
43. Reinforced zinc oxide-eugenol cements
Applications
Cementing agents for crowns and fixed partial dentures
Cavity liners and base materials
Provisional restorative materials.
Used as the intermediate restorative materials (IRMTM)
Add 10-40% resin polymer in the powder for strengthening the set
cement
44. Composition
Powder Liquid
• Zinc oxide- 80% Eugenol 85%
• Polymethyl methacrylate 20% Olive oil 15%
Powder/liquid ratio -
4:1
•The setting reaction is similar to zinc oxide-eugenol cements.
Setting reaction
(acrylic glass)
45. Properties of Reinforced zinc oxide-eugenol ce
Working time
longer
Setting time
7 to 9 minutes
Film thicknesses 35 to 75 um
Compressive strength 35 to 55 MPa
Tensile strength
Solubility Lower than ZOE
5 to 8 MPa
Modulus of elasticity 2 to 3 GPa
46. Advantages
Disadvantages
Minimal biologic effects
Good initial sealing properties
Adequate strength for final cementation of restorations.
Higher solubility and disintegration
Hydrolytic instability
Softening and discoloration of some resin restorative materials.
47. EBA- Alumina modified cements
Amongst various liquid chelating agents, the only system that
has received extensive commercial exploitation for luting and
lining is that containing ortho-ethoxybenzoic acid.
Applications
Cementation of inlays, crowns, and fixed partial dentures,
Provisional restorations
Base or lining materials.
48. Composition:
Setting reaction:
Powder Liquid
Zinc oxide- 70% EBA- 62.5%
Alumina- 30% Eugenol- 37.5%
The setting mechanism has not been fully known.
May involve formation of chelate salt by reaction between
the EBA,eugenol, and zinc oxide.
Powder/liquid ratio -
3.5 : 1 for cementation
5 : 1 for liners or bases.
49. Properties
Working time longer
Setting time 7 to 13 minutes
Film thicknesses 40 to 70 um
Compressive strength 55 to 70 MPa
Tensile strength
Solubility Lower than ZOE
3 to 6 MPa
Modulus of elasticity 5 GPa
50. Advantages
Disadvantages
Easy mixing
Long working time
Good flow characteristics
Low irritation to pulp
Critical proportioning
Hydrolytic breakdown in oral fluids
Liability to plastic deformation
Poorer retention than zinc phosphate cements
51. Super-EBA and IRM as root-end fillings in periapical surgery
with ultrasonic preparation: a prospective randomized clinical
study of 206 consecutive teeth
Oral Surg Oral Med Oral Pathol Oral Radiol Endod; 2011 Aug;112(2):258-63
Wälivaara DÅ et al
OBJECTIVE:
This study evaluated the treatment outcome after periapical surgery with
the use of 2 different retrograde root-filling materials on the periapical
healing.
CONCLUSIONS:
Both retrograde materials tested in this study can serve as a root-end seal
in periapical infected teeth, according to the results of the healing outcome
after 12 months' follow-up.
52. Classification of liners and bases
Liners: film thickness- 1 to 50 µm
Suspension liners- 2 to 5 µm
Solution liners- 20 to 25 µm
Thicker liners- 0.2 to 1 µm
Cement bases- 1 to 2 µm
53. The first adhesive cement
More biocompatible than zinc phosphate cement
Polycarboxylate (Carboxylate)- Based Cements
Invented by Smith in 1968
Zinc polycarboxylate cements
Also called Zinc polyacrylate cement
Applications
Cementation of cast alloy and porcelain restorations and
orthodontic bands
As cavity liners or base materials
As provisional restorative materials.
55. Setting reaction
The zinc oxide reacts with the polyacrylic acid, forming a cross-
linked structure of zinc polyacrylate.
Zinc oxide Polyacrylic acid Zinc polyacrylate
Powder/liquid ratio
– 1.5 : 1
56. Mixed rapidly for 30 to 40 seconds.
The mix should be used while it is still
glossy .
Prolonged or cold storage may cause the
liquid to gel; to reverse this, it must be
warmed to 50°C.
Loss of moisture from the liquid will lead
to thickening.
Manipulation
57. Properties
Working time
Setting time
6 to 9 minutes
Film thicknesses 25 to 35 um
Compressive strength 55 to 85 MPa
Tensile strength
Solubility 0.1% to 0.6 %
8 to 12 MPa
Modulus of elasticity 6 GPa
2.5 to 3.5 minutes
59. Increased antibacterial activity of zinc polycarboxylate cement by
the addition of chlorhexidine gluconate in fixed prosthodontics.
Int J Prosthodont 2005;18(5)
Orug BO et al
CONCLUSION:
This study demonstrated that the addition of 0.12% chlorhexidine
gluconate may enhance the antimicrobial action of polycarboxylate
cements .
60. Polymer-Based Cements
The majority of the materials in this group are polymethacrylates
of two types:
(1) based on methyl methacrylate
(2) based on aromatic dimethacrylates of bis-GMA
Commercially available polymer cements
Total-etch systems are calibra, cement-it, duolink, ultra-bond plus and
variolink ii.
Self-etch systems are panavia f 2.0.
The self-adhesive systems are maxcem and relyx unicem.
61. Acrylic resin cements
Applications
Acrylic resin cements are used for the cementation of restorations,
facings, and provisional crowns.
Composition
Powder Methyl methacrylate polymer or copolymer containing
benzoyl peroxide as the initiator
Liquid A methyl methacrylate monomer containing an amine
accelerator.
Manipulation
The liquid is added to the powder with minimal spatulation to avoid
an incorporation of air.
The mix must be used immediately because working time is short.
62. Properties comparable to those of the cold-curing acrylic resin filling
materials.
They are stronger and less soluble
Low rigidity and viscoelastic properties
No effective bond to tooth structure in the presence of moisture
Properties
Marked pulpal reaction may occur
Biologic effects
63. Advantages
Disadvantages
High strength and toughness
Low solubility
Short working time
Deleterious effects on pulp
Difficulty in removal of excess cement from margins.
64. Dimethacrylate cements
Dimethacrylate cements are usually based on the bis-GMA system
They are combinations of an aromatic dimethacrylate with other
monomers containing various amounts of ceramic filler
They are basically similar to composite restorative materials.
Used for bonding crowns (usually porcelain), fixed partial dentures,
inlays, veneers, and indirect resin restorations.
Applications
65. These cements are classified according to the following methods of
curing:
1. Chemically (or auto-) cured: These are usually paste-paste
systems and are used to cement metal and opaque ceramic core
restorations (eg, Panavia 21)
2. Dual cured: These cements start curing with light and continue
with chemical curing. These are used to cement translucent
restorations (eg, porcelain, indirect resin restorations). (Dual
Cement, Vivadent).
3. Light cured/dual cured: These can be used for light curing only
or can be dual cured when dual-cure catalysts are added to the
light-cure base. (Variolink II, Vivadent).
Classification
66. Composition:
Powder
Borosilicate or silica glass together with fine
polymer powder and an organic peroxide initiator.
Liquid
Mixture of bis-gma and/or other dimethacrylate
monomers containing an amine promoter for
polymerization.
Two-paste materials are of similar overall composition
Manipulation
Paste materials are usually proportioned 1:1 (equal lengths).
Rapid, thorough mixing, minimizing air inclusion, until uniform.
67. Advantages
Disadvantages
High strength
Low oral solubility
High micromechanical bonding
Meticulous and critical technique
More difficult sealing
Higher film thickness
Leakage
68. Comparative evaluation of effect of polymerizable and non-polymerizable
desensitizing agents on crown-retentive-strength of zinc-phosphate, glass-
ionomer and compomer cements.
Patil PG et al
Eur J Prosthodont Restor Dent; 2012;20(3)
Zinc phosphate was the least retentive.
Crown retentive values of Compomer cement were improved with
Prime & Bond NT and Gluma Desensitizer
Retentive values of zinc phosphate cement with Prime & Bond NT were
decreased and not affected with Gluma Desensitizer
Retentive values of Glass ionomer cement were not affected by any of
the desensitizers used in the study.
72. CONCLUSION
•Manipulation of the cement is very important;
variations in the powder and liquid ratio can influence
the working and setting time, the consistency and flow,
as well as the degree of solubility, erosion, strength
and film thickness
73. References
•Kenneth J. Anusavice ; Phillips’ science of dental materials; 11th edition
•Robert G. Craig; Restorative dental materials; 11th edition
•William J. O’Brien; Dental materials and their selection; 4th edition
•Bonding of Resin Materials to All-Ceramics: A Review; Liang Chen and Byoung I.
Suh; Current Research in Dentistry; 2012; 3(1)
•Comparative evaluation of effect of polymerizable and non-polymerizable
desensitizing agents on crown-retentive-strength of zinc-phosphate, glass-ionomer
and compomer cements;Patil PG, Parkhedkar RD, Patil SP, Bhowmik HS;
Eur J Prosthodont Restor Dent. 2012;20(3).
•Increased antibacterial activity of zinc polycarboxylate cement by the addition
of chlorhexidine gluconate in fixed prosthodontics; Int J Prosthodont 2005;18(5)
