Luting Cements

 Luting Materials
 Passive
• Fill the gap between the tooth and indirect
restoration
 Active
• Bonds to tooth structure and indirect
restoration
 Passive luting materials
 Zinc Phosphate cement
 Glass ionomer
 Resin modified glass ionomer
 Zinc Phosphate Cement

Good track record it has been the standard to which other luting cements are
compared

High compressive strength, mechanical properties depend on the powder/liquid ratio
(high early strength which makes it suitable for cementation of a prefabricated or for a
cast metal post-core)

Inclusion of fluoride may impart cariostatic properties and clinically little caries is seen
under inlays when the cement has washed out over time

Zinc phosphate does not adhere to tooth structure or restorative materials, the cement
forms tag on the micro irregularities (phosphoric acid thought to roughen surface of
the tooth)

Low solubility changes in water content of the liquid leads to weakening of the set
cement

Set cement will erode in an acid environment

Low pH when mixed and may be potential irritant to pulp, must be lined with CaOH2

Very opaque – may affect shade of final restoration in all ceramic crowns
 Glass ionomer Cement
•
Good compressive strength, similar to dentine
•
Compressive and flexural strength increase as cement matures
•
Adhesion (chemical bond) to tooth material (enamel, dentine, cementum)
•
Adhesion to passivating metals & alloys (eg stainless steel etc)
•
Fluoride release and anticariogenic characteristics

•
Solubility – susceptible to early water degradation which may initiate cracks and
crack propagation in the cement.
•
Set through acid base reactions and may exacerbate surface flaws in ceramic
owing to the acidity of the cement
Simple Glass Ionomer
AquaCem, Dentsply
Fuji I, GC Europe
Ketac Cem, 3M ESPE
Riva Luting, SDI Dental
 Resin Modified Glass ionomer Cements
 Developed to overcome the shortcomings of GIC – strength,
fracture toughness and wear resistance, while maintaining the
advantages of adhesion and fl release.
 Offers increased retention than conventional GIC
 Hydrophilic resins eg HEMA added to facilitate combining
hydrophilic Glass ionomer with hydrophobic resin and may result
in continued uptake of water after polymerisation
 Expansion under restoration in moist conditions can lead to
fracture of ceramic restorations
 Recommended for cast restorations and can be used in
situations where retention and resistance form not compromised
and bonding not required
 Also can be used for all-aluminia or all-zirconia strengthened core
ceramic systems
Resin-Modified Glass
Ionomer
Fuji Cem, GC Europe
Fuji Plus, GC Europe
Ketac Cem Plus, 3M ESPE
Rely X Luting, 3M ESPE
 Resin Based luting materials
 Active bonding to enamel and dentine and the fit
surface of the restorations
 Facilitates retention of indirect restorations lacking
retentive features e.g. veneers or RBB
 Suited to clinical situations with short clinical crown or
preparations lacking retentive features e.g. overly
tapered
 Adhesive cementation improves retention, marginal
adaptation and fracture resistance
 Allows for a more conservative preparation
 Excellent physical properties - Good
compressive and tensile strengths
 Low solubility in oral fluids
 Reduced micro leakage due to bonding
 Variety of shades
 But can be technique sensitive –
multiple steps!
 OPTIONS……!!
READ THE INSTRUCTIONS

 Three step bonding systems/Total etch cements (eg Rely X ARC, Variolink II,
Nexus 3)
 Etch, primer and adhesive and then resin cement
• Highest bond strength
• Technique sensitive leads to variable outcomes
• Increased post operative sensitivity?
 Two step bonding system
 etch and rinse (eg Rely X ARC, Variolink II, Nexus 3, Calibra)

or
 self etch primer (Variolink II)
 One step system (panavia, clearfil esthetic and Nexus 3)
 Self etching primer and adhesive
 Self adhesive Cements(RelyX Unicem, MaxCem Elite, speed cem)
 No etching, priming or placing of bonding agents
 Simplifies the procedure
PANAVIA EX
original
powder/liquid PANAVIA F
powder/liquid PANAVIA 21
fluoride releasing
paste/paste
(KURARAY) automatic dispensing
 PASTES
(automatic
dispensing)

OXYGEN BLOCKER ENAMEL / DENTINE

ACCELERATOR PRIMER
 DRY FIELD
ACID ETCHING ENAMEL
AIR ABRASION METAL SUBSTRATE (ULTRASONIC CLEANING?)
PRIMER FOR NOBLE METALS (or tin plating)
ANAEROBIC (“COMMAND”) SETTING
MIXING TO TAKE PLACE AT RT
SETTING TO TAKE PLACE AT 37degC
SHORT SETTING TIME

http://www.kuraray-dental.de/eng/overview.html
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 How to fix dental restorations

Esthetic,
RelyX ARC
Calibra
Variolink
adhesive ®
II
Nexus Variolink
luting ® Total-etch Adhesive
Clearfill Esthetic Cement composites
Veneer
Panavia
C&B Metabond Universal,® adhesive
Linkmax Multilink Automix Self-etch Adhesive
luting composites
RelyX Unicem
Maxcem Self-adhesive
Composite
G-Cem Self-adhesive
SpeedCEM
resin cements
Ketac Cem
Havard
Fuji

Conventional
Vivaglass® cements
CEM
 Pretreatment of restorations prior to adhesive cementation

silicate ceramics oxide ceramics* base metals noble metals

etch with HF air abrasion (grit-blasting)

silane primer thiol primer

Cementation
*Resin cements and primers containing the acidic monomer 10-MDP are recommended for zirconia ceramics as MDP
can chemically bond with zirconia
 Surface Treatment Methods
 Silica based ceramics
 Glassy matrix is selectively removed by HF (increases the
surface roughness and increases mechanical retention)
followed by application of a silane coupling agent which
bonds to the silicon dioxide (SiO2) and copolymerises with
the organic matrix of the resin cement
 Zirconia based ceramics
 Lack of glassy matrix and the absence of SiO2 make acid
etching plus silane application incapable of modifying and
treating the Zirconia surface
 Roughening of the internal surface of the restoration
increases the surface area for bonding to ensure a good
adhesion between the cement and internal surface of the
restoration.
 Depending on the restoration material, this procedure is done
through air abrasion, sandblasting, or etching with a
hydrofluoric acid