Cements

Professor Dr.Tahir Ali khan

BDS, MDSc, MHR, FICD, Ph.D (Scolar)
Vice Principal /HOD: Science of Dental
Materials

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Objectives of the lectures
What is cement
History of cements
Classification of cements
Applications of various cements
Order of placement
Chemistry of cements
Powder /Liquid ratios and systems of cements

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What is cement
Materials used for construction
A binder, glue or adhesive

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 A substance that hardens to act as an adhesive, glue

Bonding substances available in the two components,


Before use, mixed immediately, sets to a hard mass
In dentistry
Any material that fills a space

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 Histroy
Discovered __________ early 20th century
Zinc phosphate, Zinc oxide Eugenol & Silicates
Widely used until the 1970s
Improved biocompatibility and bonding to the
tooth
Lead to the introduction of new types of
cements
For development of Poly-acrylic acid based
cements

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First the Zinc Poly-acrylate followed by GIC then
Polymethacrylate Resin cements and Hybrid Ionomer
cements

The advent of the acrylic resins led to the development of

poly(methyl methacrylate) in the mid-1950s

Lack of adhesion, leakage, and toxicity terminated the use

of unfilled resin for routine cementation

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In the last 20-25 years
Polymerizable bis-GMA and other
dimethacrylate monomer as luting cements

Two-paste Calcium hydroxide cement

originated 30 years ago

Lining of deep cavities

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Classification
According to the matrix-forming species
1. Phosphate bonded
2. Phenolate bonded
3. Polycarboxylate bonded
4. Dimethylacrylate bonded
5. Polycarboxylate and dimethylacrylate combinations

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 Classification of dental cements
Type (matrix bond) Class of cement Formulations

Phosphate Zinc phosphate Zinc phosphate
 Zinc phosphate fluoride
 Zinc phosphate copper oxide/salts
 Zinc phosphate silver salts
 Zinc silicophosphate Zinc silicophosphate
 Zinc silicophosphate mercury salts

Phenolate Zinc oxide-eugenol Zinc oxide-eugenol
 Zinc oxide-eugenol polymer
 Zinc oxide-eugenol EBA/alumina
 Calcium hydroxide Calcium hydroxide salicylate
 salicylate

Polycarboxylate Zinc polycarboxylate Zinc polycarboxylate
 Zinc polycarboxylate fluoride
 Glass ionomer Calcium aluminum polyalkenoate
 Calcium aluminum polyalkenoate-
 polymethacrylate

Resin Acrylic Poly(methyl methacrylate)
 Dimethacrylate Dimethacrylate unfilled
 Dimethacrylate filled
 Adhesive 4-META

Resin-modified glass Hybrid ionomers Self cured Light cured

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Classification of dental cements according to bonding
mechanism
1. Phosphate
a. Zinc phosphate b. Zinc silicophosphate
2. Phenolate
a. Zinc oxide b. Calcium hyroxide
3. Poly-carboxylate
a. Zinc-Poly-carboxylate b. Glass ionomer
4. Resin
a. Poly-methy-methacrylate b. Dia-methyl-methacrylate
(Unfilled & filled)

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The ADA and ISO classification
According to their properties and their intended uses
in dentistry
 
Type I: Luting purposes (permanent and temporary
cements)
Type II: Restorative applications
Type III: Liner or base applications

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 Selection of dental cements
Application Cement type

Luting inlays, crown posts, multiretainers, fixed Glass-ionomer cement, hybrid
partial denture in or on: ionomers, resin

Nonvital teeth or teeth with advanced pulpal Zinc phosphate
recession and average retention

Vital teeth with average retention, average pulpal Zinc polycarboxylate
recession, thin dentin, especially for single
units and small-span fixed partial dentures

Multiretainer splints on vital teeth with above- Zinc oxide-eugenol polymer
average retention, minimal dentin thickness;
hypersensitive patients

Provisional cementation Zinc oxide-eugenol polymer
 Zinc polycarboxylate (thin mix)

Provisional cementation and stabilization of old, Dimethacrylate resin composite
loose restorations; fixation of facings and acid-
etched cast restorations

Base/liner in:

Cavity with remaining dentin greater than about Glass-ionomer cement, resin ionomer
0.5 mm Zinc polycarboxylate
 Zinc phosphate (low-acid type)

Cavity with minimal dentin or exposure Calcium hydroxide salicylate
 Zinc oxide-eugenol polymer

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Use of Dental Cements
A. Luting Agent
B. Pulp Protection
1. Liners
2. Bases
C. Temporary and
permanent Restoration
1. Temporary and permanent
Restorative Materials
2. Temporary Material as a
Base
3. Caries Control
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D. Other Formulations of
Dental Cements
As endodontic sealers
Surgical/periodontal packs
Impression materials
Bite-registration materials
E. Cavity Sealers
1. Varnish
2. Dentinal Bonding Agents
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 Order of Placement
If more than one base, liner, varnish, or dentinal bonding
system is used,
The properties of the materials determine their order of
placement
Adhesive materials are placed first
 Irritating materials are placed last
For example, when a calcium hydroxide liner is used, it is
first covered with the varnish, and then the composite or
amalgam is condensed

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Chemistry of Dental Cements

Except Composite, cements are

Brittle, ceramic materials
Chemistry of cements is a simple acid-base
reaction
The resulting product is

Insoluble in water and oral fluids

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A. Formulation

Cements: Powder/Liquid system

The Liquid: acid
The Powder: base & must be insoluble in
oral fluids but reactive with the acid

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B. The Reaction

Acid + excess base → residual base + insoluble salt

In terms of the components of the dental cement,
the reaction is
Liquid + excess powder → residual powder +
matrix
The end product must be insoluble in oral fluids

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 Powders Used in Dental Cements

To make powders: Two materials are used

1. Zinc oxide 2. Glass
The manufacturing process grinds and
sieves the powders for proper particle size
The size of the particles determines the film
thickness

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 Zinc Oxide

The only insoluble, nontoxic, reactive

oxide or hydroxide to react with an acid
Common additives: Aluminum oxide
(alumina) Magnesium oxide
Zinc oxide has some antibacterial effects
Included in Diaper rash, Sunscreen, and
Foot powder products

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 Powdered Glass
Chemical formula: Silicon oxide, Un-
reactive
Addition of oxides of
Sodium, Calcium, and Potassium in
sufficient quantity ----reactive with a strong
acid
The powder is white of
Small, translucent glass particles
Also contains fluoride
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 Function of Fluoride

1. Reduces the melting temperature

2. Improves the flow of the molten glass
3. Anti-Cariogenic activity

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 Reactivity of Powders

The reactivity of the powder components

Controlled by the manufacturer
and
Is matched to the reactivity of the liquid
component

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 Liquids Used in Dental Cements

 The composition or strength of the acid

determines
 The reactivity of the cement liquid
 controlled by the manufacturer

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 Eugenol

Organic liquid, Weak acid

Major component of oil of cloves
Distinctive smell and taste (of cloves)
Antibacterial and Obtundent to the pulp
Inhibits free radical polymerization
Limits the use of eugenol-containing cements
Other organic liquids
Ethoxybenzoic acid(EBA)
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 Phosphoric Acid

Approximately two-thirds phosphoric

acid and one-third water by weight.
Very acidic formulation
Irritating to biologic tissues
Should be discarded if the liquid appears
cloudy (outlived its shelf-life)

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 Polyacrylic Acid

Aqueous solution of polyacrylic acid 30% to

50% by weight

Very viscous liquids

Maleic acid, Itacinic acid, Tartaric acid also

in use

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 Dispensing

Dispensing liquids requires more attention

Careful use of viscous liquid form independent drops

Instead, the drops can “run together,”

Aqueous solution of Phosphoric acid should be
dispensed immediately because water can evaporate
Changing the reactivity and the cement properties.
Cement liquids should not be stored in the refrigerator
because some will gel and become unusable

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 Bonding

The carboxyl groups of polyacrylic acid bond to

calcium in tooth structure
This bond is believed to be relatively stable in a wet
environment

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 Water Hardening Cements

“Water hardening” or “water setting” cements use

anhydrous, freeze-dried polyacrylic acid
The manufacturer mixes zinc oxide or glass powder
with the powdered anhydrous polyacrylic acid
Combined powder is mixed with a companion liquid
that is predominately water
 When mixed, the polyacrylic acid first dissolves in the
water and then reacts with the zinc oxide or powdered
glass

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 Powder/Liquid Ratios and Systems of Dental
Cements
A. Components Dictate Handling and Mixing

The ZOE cement and zinc phosphate cement

are mixed with a powder/liquid ratio that
depends on the intended use

A base or temporary restoration mix is thicker

than a luting mix

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Glass ionomer
Polycarboxylate cements have
powder/liquid ratios:
Determined by the manufacturer

Follow the manufacturer's directions

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If the mixing process is too slow

The carboxylic acid groups react with the

powder and are not available to react with
the tooth structure

Chemical adhesion is then reduced or even

eliminated

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Paper pads are available for mixing cements
Cement liquids may weaken the paper surface, causing it to
become abraded
The abraded paper particles are then incorporated into and
weaken the resulting cement
Some mixing pads use paper that has been coated with a
thin layer of plastic
Used with glass ionomer and polycarboxylate cements
Thick glass slab for mixing zinc phosphate cement;
typically, the slab is cooled to improve the resulting mix

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 Systems
Most cements come as powder/liquid systems,
But some are paste/paste systems.
Paste/paste systems are dispensed by equal lengths, as are
other paste/paste dental materials.
Each dental cement has its own advantages and
disadvantages

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 Thanks

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