Dental Cements

DENTAL CEMENTS
Dr. Dyuti Sikdar

MDS 1ST Year
Deptt of Conservative dentistry and Endodontics
DENTAL CEMENTS - DYUTI SIKDAR

CONTENTS
• Introduction • Phenolate Based Cements

• History • Zinc oxide Eugenol cement
• Classification • Reinforced Zinc oxide eugenol cement
• Ideal requirements of Dental Cements • EBA modified phosphate cement
• Phosphate Based Cements • Calcium Hydroxide Cement
• Zinc Phosphate Cement • Polycarboxylate Based Cements
• Modified Zinc Phosphate Cement • Zinc Polycarboxylate
• Silicophosphate Cement • Glass Ionomer cements

• Polymer Based Cements
• Acrylic resin cement
• Adhesive resin cement
• Dimethacrylate cement
• Agents for pulp protection

• Cavity varnish
• Cavity liner
• Cavity base
• Conclusion
• References

INTRODUCTIO
N
• Dental cements have been in use in dentistry for a very long time.
• They serve several purposes such as retaining restorations and prosthesis in the mouth.
• Also restorative, endodontic, orthodontic, periodontic as well as surgical procedures.
• Last 2 decades have seen a variety of changes in the dental cement composition and also
introduction of newer advanced biocompatible materials.

• Definition:
• A substance that hardens from a viscous state to a solid state to join 2 surfaces.
• In dentistry, A cement acts as a base, liner, filling material or adhesive to bind

devices and prosthesis to tooth surfaces or to each other.

HISTORY
• First used dental cement- silicate cement
• 1871- Silicate cements (Fletcher)
• 1879- Zinc phosphate cements (Otto Hoffman)
• 1920- Calcium hydroxide (Hermann)
• 1942- Zinc oxide eugenol (Chrisholm)
• 1947- Methyl methacrylate resins
• 1960- Composites
• 1972- Glass Ionomers (Wilson & Kent)

CLASSIFICATI
ON
• Based on the INGREDIENTS
WATER BASED
Glass & Resin Modified Glass Ionomer
Zinc Polycarboxylate
Zinc Phosphate
OIL BASED
Zinc oxide eugenol
Non-eugenol Zinc oxide
RESIN BASED
Composite and Adhesive Resins
Compomer

• According to O’Brien (by Matrix type):
PHOSPHATE RESIN
Zinc Phosphate Polymethy Methacrylate
Zinc Silico phosphate Dimethyl Methacrylate
Adhesive
PHENOLATE
Zinc oxide eugenol RESIN MODIFIED GLASS IONOMER
Calcium Hydroxide Salicylate Hybrid Ionomer
POLYCARBOXYLATE
Zinc Polycarboxylate
Glass Ionomer

• According to Phillip’s:
Cement Primary Use Secondary Use

ZnPO4 • Luting agent for restoration • Intermediate restorations
and orthodontic bands • Thermal insulating bases
• Root canal restorations
ZnPO4 With Silver & Copper • Intermediate restorations
Salts
Copper Phosphate • Temporary and intermediate

restorations
ZOE • Temporary and intermediate • Root canal restorations

restorations • Periodontic bandage
• Luting agent
• Thermal insulating bases
• Pulp capping agents
Poly Carboxylate • Luting agent • Luting agent for orthodontic

• Thermal insulating bases bands
• Intermediate restorations

Cement Primary Use Secondary Use
Silicate • Anterior fillings
Silicophosphates • Luting agent for restoration • Intermediate restorations

• Luting agent for orthodontic
appliances
GIC • Coating for eroded areas • Pit &fissure sealants
• Luting agent for restoration • Anterior restorations
• Thermal insulating bases
Resin • Luting agent • Temporary restorations
Ca(OH) 2 • Thermal insulating bases

• Pulp capping agents

• According to Craig:
Functions Cements
Final cementation of completed restorations ZnPO4, zinc silicophosphates

Reinforced ZOE,Zinc poly carboxylate ,GIC
Temporary cementation of completed ZOE,Non eugenol zinc oxide
restorations/cementation of temporary restorations
High strength bases ZnPO4, Reinforced ZOE, Zinc poly
carboxylate, GIC
Temporary fillings ZOE, Reinforced ZOE, Zinc poly carboxylate
Low strength bases ZOE, Ca(OH) 2
Liners Ca(OH) 2 in a suspension
Varnishes Resin in a solvent

• According to Coombe:
• Acid base reaction cements

• Polymerising materials
Cyano acrylates
Dimethacrylate polymers
Polymer ceramic composites
• According to ADA Specification:
Type I - Fine grain for cementation, luting
Type II - Medium grain for bases, orthodontic purpose

• According to Donovan:
Conventional Cements
Zinc Phosphate
Zinc oxide eugenol
Zinc polycarboxylate
Glass Ionomers
Contemporary Cements
Resin Modified GIC
Resin Cements

IDEAL
REQUIREMENTS
• Non-toxic, Non-irritant to pulp and tissues
• Insoluble
• Mechanical properties
• Adhesion to enamel and dentin
• Bacteriostatic
• Obtundant effect on pulp
• Thermal, chemical and electrical insulation
• Optical properties

CHARACTERISTIC PROPERTIES OF
DENTAL CEMENTS
FILM THICKNESS & CONSISTENCY
Height of space between two surfaces separated by cement

 Eg:distance between tooth surface and cemented crown
• Determines the adaptability and retention of restoration
• Consistency of the cement should be thick and plastic enough for ease of handling and
placement into the cavity
• Heavier the consistency
 Greater the film thickness
 Less complete seating of restoration
• Maximum allowable film thickness
• For luting application : 20-25 µm
• For restorative application -temporary/final cementation : 40 µm
• Ultimate film thickness depends up on the

• Particle size of the powder
• Concentration of the powder in liquid
• Viscosity of liquid
• Consistency of cement
• Amount of force

VISCOSIT
Y
Resistance of a liquid to flow
• It is a measure of consistency
• Factors affecting viscosity

• Increase in temperature and time - increase the viscosity of certain cements

SETTING TIME
The elapsed time from the start of mixing to the point at which the mixture reaches a
desired hardness or consistency
Net setting time:

Time elapsed between the end of the mixing and the time of setting
Working time:
Elapsed time from the start of mixing to the point at which the consistency of the
material is no longer suitable for its intended use

STRENGT
H
• ANSI /ADA specification recomends that the standard luting consistency of dental
cement must exhibit a minimum 24 hr compressive strength of 70 Mpa
SOLUBILITY
• Solubility in oral fluids & water
• Water based cements are more soluble than resin or oil-based cements
• Decrease in P:L ratio : higher solubility and disintegration rate
• ADA - 0.2Wt%
• Maximum permissible rates of dissolution

• GIC : 0.1 wt%
• Zinc Phosphate : 0.2 wt%
• Zinc Polycarboxylate : 0.3 wt%
REMAINING DENTIN THICKNESS
• Type of material to be used depends upon the minimum thickness

of the dentin left between the pulp floor and the dental pulp –
Remaining Dentin Thickness (RDT)
• RDT ≥ 2mm :
• Cavity Liner only to be given on
all internal surfaces (for metallic
restorations)
• No liners or base for GIC or Composite

• RDT < 2mm :
• Base must be given on the pulpal and axial floor
(0.5 – 0.75mm)
• RDT < 1mm :

• Cavity Liner is given on all internal surfaces, over which
a Base is given.

LUTING
MECHANISM
• By Schillinburg
• Non-Adhesive:
• Cement fills the restoration-tooth gap and holds by engaging in small surface
irregularities
• Micromechanical Bonding:
• Surface irregularities are enhanced by air abrasion or acid etching
• Improves the frictional retention
• Molecular Bonding:
• Chemical bond formation between cement and the tooth structure

ZINC PHOSPHATE
CEMENT
Aspect Information
- Introduced by Dr. Otto Hoffman during the 1800s.
Introduction - One of the oldest cements, considered a gold
standard for comparison with newer materials.
- Luting of restorations.
Applications - Luting of orthodontic bands.
- High strength bases.
Type I – Fine Grained:
- Luting permanent metallic restorations.
Types - Cementation of orthodontic bands.
Type II – Medium Grained:
- High strength thermal insulating base.
- Phosphoric acid attacks particle surfaces.
- Releases zinc ions into the liquid.
- Aluminum reacts with zinc to form zinc
aluminophosphate gel.
Setting Reaction - Exothermic reaction.
- Final set cement consists of unreacted zinc oxide
particles embedded in a cohesive amorphous zinc
aluminophosphate matrix

COMPOSITIO
N
POWDER % Function
ZnO 90.2% Principle ingredient
MgO 8.2% Reduce temperature of calcination process
SiO2 1.4% Improves the working characteristics
Bi2O3 0.1% Smoothness of mix &lengthen working time
Misc- BaO, Ba2SO4 & CaO 0.1%
LIQUID
H3 PO4 38.2% Reacts with ZnO
Al 2.5% Essential for cement forming reaction
Zn 7.1% Moderator for reaction between powder& liquid, allows
adequate working time
H20 36% Controls the rate of reation

Aspect Information
- Powder-to-liquid (P:L) ratio of 1.4g : 0.5ml.

- Powder incrementally added to liquid on a glass
slab.
- Spatulated to dissipate heat and control setting
reaction.
Manipulation - Slow neutralization of liquid, better reaction
control.
- Larger portions added during middle of mixing.
- Smaller increments added for desired consistency.
- Each increment spatulated for 15-20 seconds.
- Total mixing time is 60 – 90 seconds.
- Glass slab cooled to 6°C or -10°C.
- Allows 50 – 75% more powder incorporation.
Frozen Glass Slab Technique - Increases working time by 4 – 11 minutes.
- Shortens setting time by 20 – 40%.
- Mixing time: 1.5 – 2 minutes (Phillips).
- Working time: 5 minutes (Phillips).
Timings and Film Thickness - Setting time: 5 – 9 minutes (Craig), 5 – 14
minutes (O’Brien).
- Film thickness: 20µm.

MECHANICAL
PROPERTIES
Compressive Strength 104 Mpa

Tensile Strength 5.5 Mpa
Elastic Modulus 13.5 Gpa
Solubility in water 0.06 wt%
Thermal conductivity 0.0028°C/cm

Aspect Information
- Not suitable for direct pulp capping or as a base beneath

Contraindications
direct restorations
- Allergic reactions to components
- Inadequate strength for high-stress areas
Advantages - Long track record of clinical use
- High compressive strength
- Good thermal insulation properties
- Low solubility in oral fluids
- Biocompatible
Disadvantages - High acidity during mixing can lead to pulp irritation
- Brittle and subject to fracture
- Technique-sensitive mixing process
- Potential for microleakage over time
- Limited bonding to tooth structure

Fluoride Cements:
Type of Cement Fluoride Type Fluoride Concentration Characteristics
Fluoride uptake,
Silver Cements Silver salts Small percentage
anticariogenic
Higher solubility, lower
Stannous Fluoride Stannous fluoride 1-3%
strength
Copper & Silver Cements:
Type of Cement Copper Type Copper Concentration Characteristics
Highly acidic, lower

Black Copper Cupric oxide 2% - 97%
strength
Lower P:L ratio,

Red Copper Cuprous oxide Varies
higher solubility

SILICOPHOSPHATE CEMENTS (ADA Sp. No. 96)
• Presence of silicate glass: translucency, improved strength, fluoride release.
Aspect Information
- Type I: Cementation of fixed restorations
Applications - Type II: Provisional restorative material.
- Type III: Dual purpose material.
- ZnO (10 - 20%).
- Silicate glass
Composition (Powder) - Fluoride (12 – 25%).
- Mercury / Silver Compounds (Germicidal).
- Orthophosphoric acid (Reacts with ZnO).
Composition (Liquid) - Al salts (2 – 5%).
- Water (45%).
- Working time: 4 mins.
- Setting time: 5 – 7 mins.
- Compressive Strength: 140 - 170 Mpa.
Properties - Tensile Strength: 7 Mpa.
- Solubility: 1 wt%.
- Toughness/Abrasion resistance: Higher than phosphate cements.
- Prolonged low pH (4-5).
- Pulpal protection necessary.
Biologic A - Anticariogenic
- Fluoride release.
- Better strength, toughness, abrasion resistance, fluoride release, translucency.

Advantages - Better bonding than zinc phosphate.
- Total acidity greater than zinc phosphate.

Disadvantages - High solubility.

ZINC OXIDE EUGENOL (ADA SP.
NO. 30)
Introduction
Aspect
Introduced by Chisholm in 1873
Details
Common Uses - Used for luting and intermediate restorations

- Exhibits an obtundant property on exposed dentin
Application - Long-term and short-term luting agents
- Temporary and intermediate restorations
- Used as root canal sealers
- Utilized in surgical packs
Clinical Properties - Provides sealing due to its obtundant effect on exposed dentin
- Temporary cementing due to its solubility in oral fluids

- Acts as a soothing material for inflamed pulps
Drawbacks - Limited strength and durability
- Solubility in oral fluids, leading to disintegration over time
- Not suitable for long-term restorations due to its low mechanical properties
Notes - Frequently used in dental practices for various applications
- Important choice for provisional restorations and root canal sealers

Type Description
Type I - Intended for temporary restorations
- Used for provisional or temporary purposes
Type II - Designed for permanent cementation of restorations
- Used to permanently bond restorations in place
- Used for both temporary restorations and thermal
Type III
insulating bases
- Offers thermal insulation beneath restorative
materials
Type IV - Intended as a cavity liner
- Applied to protect pulp and promote dentin formation

Dispensed As:
• Two pastes
• Powder and liquid
COMPOSITION
POWDER % Function
ZnO 69 Principal component
White rosin 29.3 Reduce brittleness of the cement
Zinc stearate 1 Accelerator, plasticizer
Zinc acetate 0.7 Improves strength of the cement
Silica Filler
LIQUID
Eugenol / oil of cloves 85
Olive oil 15 Plasticizer
SETTING
REACTION
Reaction Description
- Zinc Oxide (ZnO) reacts with water (H2O) to form Zinc

ZnO + H2O → Zn(OH)2
Hydroxide (Zn(OH)2)
- Zinc Hydroxide (Zn(OH)2) reacts with acid Eugenol (HE)

Zn(OH)2 + 2HE → ZnE2 + 2H2O
to produce Zinc Eugenolate (ZnE2) and water (H2O)
- This reaction results in the formation of a crystalline

structure of Zinc Eugenolate which strengthens the cement
- The set cement includes unreacted Zinc Oxide (ZnO) that

Set cement contains free zinc oxide
is dispersed within a matrix of Zinc Eugenolate
Reaction is reversible - The reaction involving Zinc Eugenolate is reversible
- The moisture present in the oral cavity can hydrolyze Zinc

Eugenolate back into Eugenol and Zinc Hydroxide

Manipulation of ZOE Cement Description
- Recommended ratio of Powder (P) to Liquid (L) is 3:1
Powder-Liquid Ratio
or 4:1 (for maximum strength)
- Both Powder and Liquid are dispensed onto a glass
Dispensing onto Glass Slab
slab
Incorporation of Zinc Oxide - Zinc Oxide is incorporated into the Liquid
Spatulation Technique - Prolonged and vigorous spatulation is required
- Spatulation is done in a circular motion
- A stiff-bladed stainless steel spatula is used for
spatulation
Incorporation of Increments - Larger increments of powder are incorporated first
- Smaller increments are added subsequently
- Manipulation continues until the desired consistency
Desired Consistency
is achieved
Effect of More Powder Addition - Adding more powder results in:
- Stronger cement
- More viscous mixed cement

PROPERTIES
Base / Filling Temporar Permanent Cavity liner

material y cement
cement
Film Thickness (µm) 40 25
Setting Time (mins) 2 – 10 4 – 10 4 – 10 4 – 10
Solubility (wt%) 2.5 1.5
Compressive strength (Mpa) 25 35 35 5.5
Tensile strength (Mpa) 1–2 1–2 1–2 1–2
Thermal diffusivity 0.38 mm2/s
Linear COTE 35 x 10-6/°C

Biologic Effects of ZOE Cement Advantages Disadvantages
- Low strength and low abrasion
Bacteriostatic - Obtundant effect on pulpal tissues
resistance
Obtundant Property - Good sealing ability - Microleakage
pH (6.6 – 8) - Resistance to marginal penetration - Disintegration in oral fluids
Volumetric Shrinkage (0.9%) - Good thermal insulation - Less anticariogenic
- Solubility is highest among all
Irritant to Connective Tissues
cements
Variable Reparative Dentin
Formation in Exposed Pulp

REINFORCED ZINC OXIDE
EUGENOL CEMENT
Shortcomings of Zinc Oxide Cements Ways to Overcome Shortcomings
Low strength and abrasion resistance - Use alternative cement types with higher strength
- Incorporate adhesive systems for better marginal
Microleakage
sealing
Disintegration in oral fluids - Choose more durable and resistant materials
- Apply fluoride treatments or incorporate
Less anticariogenic
Applications of Improved Dental Materials antimicrobials
Cementing crowns and FPD
Solubility - Explore resin-modified glass ionomer cements
Cavity liner
Base materials
Provisional restoration

COMPOSITIO
N
Powder Composition:
Components Function
ZnO Main filler, contributes to the cement's structure
Finely divided natural/synthetic resin Filler material, possibly adds strength and structure
Accelerators Speeds up the setting reaction
Liquid Composition:
Components Function
Eugenol Liquid component, provides obtundant effect
Dissolved resins Enhances liquid properties and contributes to setting
Accelerators (Acetic Acid) Initiates and accelerates the setting reaction
Antimicrobial agents Adds antimicrobial properties to the cement

Aspect Details
Similar to ZnO eugenol cement with the possibility of an

Setting Reaction
acidic resin like colophony strengthening the matrix.
Method similar to ZnO eugenol cement. More powder

Advantages
Manipulation Disadvantages
needed for cementing mix. Follow correct P:L ratio.
Mixing surface should be dry.
Minimal biologic effects
Properties Low strength
Setting Time 7 - 9 minutes

Good initial sealing ability Higher disintegration
Film Thickness 35 – 75 µm
Adequate strength
Compressive Strengthfor final cementation of 35 - 55 MPa
Softening and discoloration
restoration
Tensile Strength 5 - 8 MPa
Modulus of Elasticity 2 – 3 GPa
Solubility 1 wt%

EBA MODIFIED ZINC OXIDE EUGENOL
CEMENT
Application
Cementation of inlays, crowns, FPD’s, provisional
restoration<br>Base / lining material
Powder (%)
ZnO: 60 – 75%
Aluminium oxide: 20 – 35%
Composition PMMA: 6%
Liquid (%)
Eugenol: 37%
EBA: 63%
- Not fully known

Setting Reaction - Appears to form chelate salt between EBA, eugenol, and zinc oxide
- Similar to ZnO eugenol cement
- Cement mixes readily to very fluid consistency even at a high P:L
ratio
Manipulation - For optimal properties, use high P:L ratio as possible
- Use 3.5 g/ml for cementation, 5 – 6 g/ml for liners and bases
- Vigorous spatulation required for about 2 mins to incorporate all
powder
- Setting time: 7 - 13 mins
- Film Thickness: 40 - 60 µm
- Compressive Strength: 55 - 70 Mpa
Properties - Tensile Strength: 3 - 6 Mpa
- Modulus of Elasticity: 5 Gpa
- Solubility: 1 wt%
- Plastic Deformation: 0.1 mm/min at 37°C
Biologic Effects Similar to ZnO eugenol cement

CALCIUM
HYDROXIDE
Aspect Details
Introduction - Introduced by Hermann in 1920
- Water-setting cement with osteoconductive and

osteoinductive properties
- Used as a pulp capping agent to facilitate reparative dentin

formation
- Alkaline pH, antibacterial, and protein-lysing properties

Types - Non-setting (pH: 11 – 13) – intracanal medicament
- Setting (pH: 9 – 10) – cavity liner
Application - Liners in deep cavity preparations
- Intracanal medicaments
- Direct and indirect pulp capping
- Apexification procedures

- Working time: 3 – 5 mins (depends on moisture availability), 1 –
Properties
2 mins (rapid)
- Compressive Strength:
- At 7 mins: 6 Mpa
- At 1 hr: 10 Mpa
- At 24 hrs: 14 - 20 MPa
- Tensile Strength:
- At 7 mins: 1.5 Mpa
- At 1 hr: 1.5 Mpa
- At 24 hrs: 1.7 - 2 MPa
- Significant solubility in 50% phosphoric acid during etching
procedures
- Subject to hydrolytic breakdown: marginal leakage and
complete dissolution of lining
Biologic Effects - Strong antibacterial action
- Ionic dissociation of calcium hydroxide into calcium ions and
hydroxyl ions
- Hydroxyl ions induce chemical injury on bacteria's cytoplasmic
membrane, causing destruction of phospholipids or unsaturated
fatty acids

Base Paste
- Calcium tungstate / Barium sulphate (radio-opacifier)
- Tribasic calcium phosphate
- Zinc oxide
- Glycol salicylate
Composition
Catalyst Paste
- Calcium hydroxide
- ZnO
- Zn Stearate
- Ethylene Toluene
- Calcium hydroxide reacts with the salicylate, forming a chelate,

Setting Reaction
amorphous calcium disalicylate
- Hydroxyl ions from the cement neutralize acids produced from

clast cells, optimizing pH for pyrophosphatase activity
Manipulation - Equal lengths of the two pastes are mixed to a uniform color

Aspect Details
- Activates enzymes such as alkaline phosphatase,
Dentin Bridge Formation (Pulp Capping)
responsible for mineralization
- Free calcium hydroxide aids in remineralization of
carious dentin
Advantages - Easy manipulation
- Rapid hardening in thin layers
- Good sealing ability
- Beneficial effects on carious dentin and exposed pulp
Disadvantages - Low strength even when fully set
- Exhibit plastic deformation
- Dissolve under acidic conditions

LIGHT ACTIVATED CALCIUM
HYDROXIDE
• Recently introduced cement
COMPOSITION
Calcium Hydroxide
Barium sulphate Radio-opacifier
Urethane dimethacrylate
HEMA
Activators – camphorquinone
• They have longer working time

ADVANTAGES
Less brittle than conventional 2 paste
system
Improved strength
No solubility in acids
Minimal solubility in water
Longer working time

DYCAL
• Introduced in 1979
• As a liner/pulp capping agent in deep cavities
• Radio-opaque calcium hydroxide which is self setting
ADVANTAGES
High early strength
Lower water solubility
Excellent handling characteristics

CALYXL
• Calcium hydroxide containing sodium and potassium salts
• Allows maintenance of normal dentinogenesis by protecting the pulp against irritation from
operative procedures

SILICATE CEMENTS (ADA SP.
NO.
• Fletcher 96)
in 1871
• Oldest direct tooth colored materials
• Steenbock later introduced an improved version of the cement
COMPOSITION POWDER LIQUID

Silicon Dioxide 35 – 50% Phosphoric acid
Sodium fluoride Sodium & Aluminium phosphate
Calcium fluoride
Aluminium fluoride
Aluminium trioxide
Sodium fluoride
Setting Reaction Properties
Acid-Base Reaction Anticariogenic: Contains large amounts of fluoride.
Solubility: Soluble in saliva and highly in acidic

Powder particles attacked by acid, releasing Ca, Al, F ions
conditions.
Ions precipitate as phosphates, forming continuous Coefficient of Thermal Expansion: Close to tooth
cement matrix withADVANTAGES
silica gel DISADVANTAGES
structure, minimal microleakage.
Translucency
Fluoride ions remain as free ions High Properties:
Optical pulpal irritant
Good optical properties for natural
appearance.
Anticariogenic Highly soluble
pH: Initially low (around 3) for a few days, causing pulpal
Most powder particles' surfaces dissolve
irritation.
Set cement: phosphate matrix with unreacted powder pH remains below 7 even after a month, severe pulpal
particles irritant.
surrounded by acid gel and fluoride ions Adhesion: Mechanical bonding to tooth structure.

POLYCARBOXYLATE CEMENT (ADA
SP. NO. 96)
Dennis Smith Cement (Polyacrylate Cement)
Introduction
Introduced by Dennis Smith in 1968
First cement system with adhesive bond to tooth structure
Also known as polyacrylate cement
Application
Luting alloy restorations
Thermal insulating bases
Cementing orthodontic bands
Cementing stainless steel crowns in pediatric dentistry
Composition
POWDER (%)
ZnO
SnO / MgO (1 – 5)
Aluminium oxide (10 – 40)
Stannous Fluoride: Modified setting time
40% Aqueous solution of Polyacrylic Acid
LIQUID

Setting Reaction
Powder particles are attacked by the acid
Releasing Zn, Mg, Sn ions
Ions bind to the polymer chain via carboxyl groups
Ions react with carboxyl group of adjacent polyacid chains
To form cross linked salts
Bonding to tooth
Polyacrylic acid reacts with Calcium ions Via carboxyl groups on the surface of enamel and dentin
Manipulation
P:L = 1.5g : 1ml
Mixing on a non-absorbent surface
Incorporate most powder into liquid in one large increment
Mix over a small area with a stiff spatula
Add more powder to obtain required consistency
Use mix while still glossy
Mixed rapidly in 30 – 40 seconds
Working time: 2.5 – 3.5 minutes
Setting time: 6-9 minutes (at 37°C)
Methods to Increase Working
Time
Cooling glass slab
Thickening of the liquid
Difficulty in mixing
Powder refrigerated before mixing
Reaction occurs on a cool surface
Cool temperature retards the reaction
Without thickening of the liquid
Properties
Film Thickness 25 µm
Compressive Strength 55 - 85 MPa
Tensile Strength 8 - 12 MPa
Modulus of Elasticity 6 GPa
Bond Strength to Enamel 3.4 – 4.7 MPa
Bond Strength to Dentin 2.1 MPa
Thermal Diffusivity 0.223 mm²/sec
Solubility in Water Low
In Organic Acid (pH < 4.5) Increased Solubility
Reduced P:L Ratio Increases Solubility

Biologic Effects
Good Biocompatibility
Low Intrinsic Toxicity
Rapid pH Rise towards Neutrality
Fluoride Release
Advantages Disadvantages
Low Irritation Lower Compressive Strength
Chemical Bond to Tooth Structure and Alloys Greater Viscoelasticity
Easy Manipulation Need for Clean Surfaces for Adhesion
Adequate Strength Short Working Time
Low Solubility
Adequate Film Thickness
Anticariogenic

ACRYLIC RESIN CEMENT
Application
Cementation Restorations, Facings, Crowns
Composition
Powder Liquid
MMA Polymer or Copolymer MMA Monomer
Benzyl Peroxide Amine Accelerators
Mineral Filler
Pigments
Manipulation
Add Liquid to Powder with Minimal Spatulation Avoid Incorporation of Air
Short Working Time Use Mix Immediately
Remove Excess Material After Final Set Only When Cement is Hard
(Not When Rubbery)
Properties Stronger and Less Soluble
Low Rigidity and Visco-Elastic Properties
No Effective Bond to Tooth Structure in Presence of Moisture
Biologic Effects
Marked Pulpal Response
Advantages Disadvantages
High Strength Marked Pulpal Irritation
High Toughness Short Working Time
Low Solubility Difficulty in Excess Cement Removal
ADHESIVE RESIN
CEMENT
• Formulated by adding the following to MMA monomer:
• 4 methacryloxy ethyl trimellitate anhydride (4-META)
• Tributyl boron initiator (helps in adhesion)
APPLICATION
• Luting FPD and base metal
• Bonding amalgam to dentin and composite

PROPERTIES
• (similar to acrylic resin)
• Stronger and less soluble
• Low rigidity and visco-elastic properties
• No effective bond to the tooth structure in the presence of moisture
• Moderate strength and high deformation under a load.
PROPERTIES
• Marked pulpal response

DIMETHACRYLATE
CEMENTS
• Composition is similar to resin composites.
• Combinations of an aromatic dimethacrylate with other monomers containing

various amounts of ceramic filler.
APPLICATION
• Bonding crowns, FPD, inlays and veneers.

COMPOSITIO
N
POWDER
Borosilicate / silica glass
Polymer powder
Peroxide initiator
LIQUID
Bis-GMA / dimethacrylate monomer
Amine Accelerators

MANIPULATION
• Paste materials are mixed in the ratio 1:1 (equal lengths)
• P:L , thorough mixing to minimize air inclusion until uniform mix is obtained.
• On mixing, polymerization of monomers occurs leading to a highly cross-linked

resin composite structure
TYPES based on the method of curing

• Chemically cured : for cementing ceramic, metal and opaque metal ceramic restorations
• Dual cured : for cementing translucent restorations
• Light cured / dual cured : used for both light cure and dual cure applications

PROPERTIES
Film Thickness 20 - 60 µm
Setting Time 3 – 7 mins
Compressive Strength 70 - 200 Mpa
Tensile Strength 25 – 40 Mpa
Modulus of elasticity 4 – 6 Gpa
Solubility 0.05 wt%
BIOLOGIC EFFECTS
• Polymerization shrinkage
• Microleakage

ADVANTAGES DISADVANTAGES
High strength Higher film thickness
Low solubility Microleakage
High micromechanical bonding Pulpal sensitivity
Difficulty in removing excess cement

99
PURPOSE OF A CAVITY LINER / VARNISH
• Serve as a physical barrier to ingress of bacteria/ bacterial byproducts.
• To provide therapeutic effect such as antibacterial, anticariogenic or pulpal anodyne effect.
• Provide barrier for protection of pulp from residual reactants

diffusing out of a restoration.
• Prevent oral fluids that may penetrate leaky restorations from

reaching the pulp through the dentin

CAVITY VARNISH
• A solution of one or more resins which when applied to the cavity walls, evaporates,
leaving a thin resin film that serves as a barrier between the restoration and the dentinal
tubules.
APPLICATION
• Prevents post-op sensitivity from galvanic shock
• Minimize penetration of acid from zinc phosphate cements
• Prevent diffusion of corrosion products from dental amalgam into dentin
CONTRAINDICATION
• Not to be used with Glass Ionomer Cement or Resin composites
COMPOSITION
Solid Copal Resin, Rosin Or Synthetic Resin

Solvent 90% Ether, Acetone Or Alcohol
Medicinal Agent Chlorbutanol, Thymol, Eugenol
MANIPULATION
• Applied by means of small cotton pellets / brush / applicator
• 2 – 3 layers – sufficient protection
• Volatile solvents evaporate quickly after application, leaving a thin resin film

PROPERTIES
Film thickness 1 – 4 µm
Tensile strength < 1 Mpa
Low solubility in water

CAVITY
LINER
• Suspensions of calcium hydroxide in a volatile solvent.
• Used like a cavity varnish to provide barrier against the passage of irritants
from the cements and other restorative materials.
COMPOSITION
• Suspension of calcium hydroxide in an organic liquid such as methyl
ethyl ketone or ethyl alcohol.

PROPERTIES
Film thickness 1 – 4 µm
Tensile strength < 1 Mpa
• No significant thermal insulation
• Soluble : should not be applied to margins of restorations
• Fluoride compounds are added to newer compounds to prevent secondary caries

MANIPULATION
• (Similar to varnishes)
• Applied by means of small cotton pellets / brush / applicator
• 2 – 3 layers – sufficient protection
• Volatile solvents evaporate quickly after application, leaving a thin resin film
Other Liners
• Type III Glass Ionomer Cement
• Type IV Zinc Oxide Eugenol

BASES
• Material that is used to protect the pulp in a prepared cavity by providing
thermal insulation
• Iethese are those cements commonly used in thicker dimensions beneath
permanent restorations to provide for mechanical, chemical and thermal protection to the
pulp.
• Eg:
• Zinc Phosphate
• Zinc Oxide Eugenol
• Calcium Hydroxide
• Zinc Polycarboxylate
• Glass Ionomer

INDICATIONS OF A CAVITY
BASE
• To protect the pulp against thermal injury, galvanic shock and chemical irritation. (Zinc
phosphate under amalgam restoration)
• To withstand the forces of condensation of the restorative material and act as

shock absorbers. (Zinc phosphate under amalgam restoration)
• To substitute dentin in deep cavities. (all high strength bases)
• To serve as intermediate bonding material between the tooth

and composite restoration. (GIC in sandwich technique)

CLASSIFICATIO
N
• Low strength bases

• Zinc oxide Eugenol, calcium hydroxides
• Calcium hydroxide as a sub-base
• High strength bases

• GIC, reinforced ZOE, Zinc phosphate, Zinc polycarboxylate
• Used under direct and indirect metallic restorations
• Only some bases are indicated under composite resins (GIC)

CLINICAL
CONSIDERATIONS
Clinician must observe certain general guidelines for placement of bases:
• Base should be 0.5 – 0.75mm thick.

• Very thick bases compromise the bulk of the restoration
• Increase the potential for fracture of the restoration
• It is not recommended to remove sound tooth structure inorder to provide space

for a base
• Bases are applied only on internal walls of the cavity preparation

to prevent dissolution by saliva

MTA
Aspect MTA Pulp Capping

MTA (Mineral Trioxide Aggregate) is used in dental
Introduction pulp capping to preserve pulp vitality when exposed or
irritated due to caries or trauma.
MTA is composed of fine hydrophilic particles,
Composition including tricalcium silicate, dicalcium silicate,
tricalcium aluminate, and bismuth oxide.

- Biocompatibility: Well-tolerated by pulp tissues and stimulates dentin
formation. - Sealing Ability: Excellent at preventing contamination and
Advantages irritation. - Tissue Regeneration: Can induce dentin bridge formation. -
Longevity: Stable over time, reducing the need for re-treatment. - Versatility:
Applicable in various clinical situations.
- Cost: Relatively expensive compared to some alternatives. - Technique

Sensitivity: Requires precise placement. Setting Time: Relatively long setting
Disadvantages
time. - Color: Grayish color may be unpleasing in anterior teeth. - Limited
Manipulation: Challenging handling and mixing process.
Apart from pulp capping, MTA is also used in: - Root Canal Treatment:
Sealing and filling root canals. - Perforation Repair: Repairing root or
Other Uses furcation perforations. - Apexification: Inducing apical closure in immature
teeth. - Pulpotomy: Partial removal of pulp in primary teeth. - Endodontic
Surgery: Retrograde fillings and repair of root resorption.
- Osteoinductive: Stimulates bone formation in endodontic surgery. - Hermetic

Seal: Provides effective sealing in various procedures. - Biomineralization:
Additional Advantages
Promotes tissue growth and repair. - Non-toxic: Safe for use in the oral
environment. - Radiopacity: Clearly visible on X-rays for monitoring.

Com Tensil elastic Film Settin Solubilit Bond Pulp C TC CTE
pre e modul thick g time y (Wt%) strengt respons (0C/cm)-1
ssive streng u s n ess (min) h to e
th (GPa) (mm) dentin
stre (MPa )
ngt
h
(MPa
)
ANSI 70 N/A N/A 25 5 0.20

/ADA 8
ZnPO4 104 5.5 13.5 20 5.5 0.06 0 Moderate 3.11 X 10-4 35X 10-6/0C
Zn 55 6.2 4.4 21 6 1.25 2.1 Mild

polycarbox
ylate
ZOE 25 1-2 0.22 25 4-10 0.04 0 Mild 3.98X 10-4
Silico 140 - 7 - 25 3.5-4 1 Moderate 4.38 X 10-4

Phosphate 170
GIC 93- 4.2-5.3 3.5-6.4 25 2.5-8 0.4-1.5 3-5 Mild -

226 moderat
e
111
Eugenol-Modified Zinc
Property Zinc Phosphate Cement Zinc Oxide-Eugenol Cement Glass Ionomer Cement Resin Cement
Oxide-Eugenol (EBA) Cement
- Powder: Zinc oxide, finely

- Powder: Zinc oxide, - Powder:
- Powder: Zinc oxide divided resin, accelerators - Mixture of polymerizable
magnesium oxide - Liquid: Eugenol, dissolved Fluoroaluminosilicate glass
Composition - Liquid: Phosphoric acid - Liquid: Eugenol resin matrix and inorganic
powder, polyacrylic acid
resins, accelerators, - Liquid: Water-based solution fillers
solution
antimicrobial agents
Acid-base reaction between Acid-base reaction between

Acid-base reaction between Acid-base reaction with Photopolymerization (light
Setting Reaction powder (ZnO) and liquid glass powder and polyacrylic
ZnO and eugenol modification using eugenol activation)
(phosphoric acid) acid
Requires thorough mixing for Vigorous spatulation, similar to Similar to ZOE cement with Mixing of powder and liquid Mixing of two components
Manipulation
adequate strength ZOE cement eugenol-modification components followed by light activation
Variable, controlled by light

Setting Time Short setting time Moderate setting time Moderate setting time Moderate setting time
exposure
High compressive and tensile

Strength Good compressive strength Moderate strength Moderate strength Lower compressive strength
strength
Solubility Low solubility High solubility Low solubility Low solubility Low solubility
Generally well-tolerated by oral Some biologic effects due to Improved biocompatibility with Generally well-tolerated by oral
Biocompatibility Biocompatible
tissues eugenol eugenol-modification tissues
Chemical adhesion to tooth

Adhesion to Tooth Structure Limited adhesion Limited adhesion Limited adhesion Limited adhesion
structure
Crown and bridge cementation,

Temporary restorations, luting Temporary restorations, luting Restorations, luting agents, Indirect restorations, veneers,
Uses inlays, onlays, orthodontic
agents, cavity liners agents, cavity liners liners bonding
bands
CONCLUSION
• No single type of cement satisfies all of the ideal requirements or is best suited for
all indications in dentistry
• Each situation must be evaluated based on the environmental, mechanical and

biological factors and finally decide on which material to be used in each case.

REFERENCES
• Phillip’s Science of Dental Materials : Anusavice ( 12th Edition )
• Craig’s Restorative Dental Materials ( 13th Edition )

Dental Cements - Dr. Nithin
DENTAL CEMENTS Mathew
- DYUTI SIKDAR

Dental Cements

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DENTAL CEMENTS

Dr. Dyuti Sikdar

DENTAL CEMENTS - DYUTI SIKDAR

• Introduction • Phenolate Based Cements

DENTAL CEMENTS - DYUTI SIKDAR

• Agents for pulp protection

DENTAL CEMENTS - DYUTI SIKDAR

• Also restorative, endodontic, orthodontic, periodontic as well as surgical procedures.

DENTAL CEMENTS - DYUTI SIKDAR

• In dentistry, A cement acts as a base, liner, filling material or adhesive to bind

DENTAL CEMENTS - DYUTI SIKDAR

• 1871- Silicate cements (Fletcher)

• 1879- Zinc phosphate cements (Otto Hoffman)

• 1920- Calcium hydroxide (Hermann)

• 1942- Zinc oxide eugenol (Chrisholm)

• 1947- Methyl methacrylate resins

• 1972- Glass Ionomers (Wilson & Kent)

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

Cement Primary Use Secondary Use

Copper Phosphate • Temporary and intermediate

ZOE • Temporary and intermediate • Root canal restorations

Poly Carboxylate • Luting agent • Luting agent for orthodontic

DENTAL CEMENTS - DYUTI SIKDAR

Silicate • Anterior fillings

Silicophosphates • Luting agent for restoration • Intermediate restorations

Ca(OH) 2 • Thermal insulating bases

DENTAL CEMENTS - DYUTI SIKDAR

Final cementation of completed restorations ZnPO4, zinc silicophosphates

DENTAL CEMENTS - DYUTI SIKDAR

• Acid base reaction cements

• According to ADA Specification:

Type I - Fine grain for cementation, luting

Type II - Medium grain for bases, orthodontic purpose

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

• Adhesion to enamel and dentin

• Obtundant effect on pulp

• Thermal, chemical and electrical insulation

DENTAL CEMENTS - DYUTI SIKDAR

Height of space between two surfaces separated by cement

• Determines the adaptability and retention of restoration

• Ultimate film thickness depends up on the

DENTAL CEMENTS - DYUTI SIKDAR

• Factors affecting viscosity

DENTAL CEMENTS - DYUTI SIKDAR

Net setting time:

DENTAL CEMENTS - DYUTI SIKDAR

• Maximum permissible rates of dissolution

• Type of material to be used depends upon the minimum thickness

• No liners or base for GIC or Composite

DENTAL CEMENTS - DYUTI SIKDAR

• RDT < 1mm :

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

DENTAL CEMENTS - DYUTI SIKDAR

- Powder-to-liquid (P:L) ratio of 1.4g : 0.5ml.

DENTAL CEMENTS - DYUTI SIKDAR

Compressive Strength 104 Mpa

DENTAL CEMENTS - DYUTI SIKDAR