Dental cement

Ilmu Material

Topic

General requirements for dental

cements
Classification of dental cements
Component and properties
Setting reaction
Mixing process
The uses of dental cements

Definition
Dental cements : materials made from
two components, powder and liquid,
mixed together.

Powder + Liquid
Pastelike or flowable material
Hardens to a rigid solid

Uses of dental cements

Luting agent

Temporary cement
Permanent cement

Pulp protection or cavity sealer

Cavity varnish
Liner
Base

Uses of dental cement

Filling

Temporary filling
Permanent filling

Others

Root canal sealer

Calciumhydroxide cement
Bite registration material

Luting agent
Luting : the use of moldable
substance to seal a space between
two component.
Most dental treatment necessitate
attachment of prostheses to the
teeth by means of luting agent.

General requirements for

luting agents

Biocompatibility
Retention
High tensile strength, fracture
toughness, fatique strength
Good marginal seal

General requirements for

luting agents

Low film thickness

Ease of use
Radiopacity
Aesthetics

Film thickness

The thickness of film between two

flat surface
The maximum allowable thickness
is 25 m (ADA specification No. 96)
Low film thickness value is
preferred

Cement base

A thick layer of cement (>0.75mm)

is applied under restoration to
protect pulp against injuries.
The base should be strong enough
to resist the condensation force
during the placement of restoration.
Well insulation ability
Good sealing

Classification of dental
cements

Conventional cement

Zinc phosphate cement

Zinc oxide-eugenol cement
Polycarboxylate cement
Glass ionomer cement

Resin-base cement

Resin cement
Resin modified glass ionomer cement

Conventional cement

Typically powder/liquid system

Liquid is an acid
Powder is a base ; insoluble in oral
fluid

When mixed together Acid-base

reaction

Zinc Phosphate cement

Zinc phosphate cement

Powder

Liquid

Zinc oxide

Phosphoric acid

Magnesium
oxide

Water

Alumenium
phosphate

ZnO
ZnO

Zn+
ZnO

Zn+

Zinc
aluminophosphate
gel

Unreacted
ZnO

Unreacted
ZnO

Unreacted
ZnO

Zinc aluminophosphate matrix

Unreacted
ZnO

Setting reaction

Exothermic reaction
Adding of water can accerlate the
reaction.
Loss of water can lengthen the
setting reaction.

Working time and setting

time

Working time commonly is 3-6

minute
Setting time is 2.5-8 minute(ADA
specification No.96)

Depending on the manufacturer

instruction

How to extend the setting

time ?

Reducing powder/ liquid ratio

{not

recommended}

Mixing on the cool glass slap

{no

moisture}

Mixing over a large area.

Mixing cements in increments.

Mixing procedure
There are three steps:

First : add the small amount of

powder into the liquid

To achieve the slow neutralization of the

liquid.
To control the reaction.

Mixing procedure

Second : Larger amount of powder

is added to liquid

For further saturation of liquid to newly

form zinc phosphate.
This steps may not effect by heat
released from the reaction.

{because of the less amount of unreacted

acid}

Mixing procedure

Finally: the small amount of

powder is added again

To control the optimum consistency

4
2
1

5
3

7
8

4
2
1

5
3

7
8

Characteristic properties
Setting time at 37O
Minimum
compressive
strength

5 9 minutes
75 MPa

Maximum film
thickness
Maximum Solubility

25 m (for luting
the prostheses)
0.2% by weight

ADA specification NO.8 for Zinc phosphate cement

Effects of manipulation on
some properties.
Manipulative
variables
Decreased
powder/liquid ratio
Increase rate of
powder
incorporation
Increase mixing
temperature
Water
contamination

Properties
Copressiv Film
e
thicknes
strength s

Solubilit Initial
y
acidity

Setting
time

Biocompatibility

Acid can penetrate into the

dentinal tubule irritate pulp
pH of cement

Liquid = 2.0
3 minutes after mixing = 4.2
1 hour = 6
48 hours = 7

Modified zinc phosphate

cement

Fluoride cement

Add Stannous fluoride

Higher solubility/ Lower strength

Zinc silicophosphate

Zinc phosphate + Silicate

Higher strength/ lower solubility
Fluoride released
Translucency

Clinical applications

Zinc phosphate cement

Luting agent
Base and temporary filling

Modified zinc phosphate

Luting prostheses
Luting the orthodontics band

Zinc oxide-eugenol
cements

Lower strength than Zinc

phosphate cement.
Sedative effect
Usually used as temporary filling

Zinc oxide-eugenol
cement

Simple ZOE
Reinforced ZOE
EBA cement

Compositions of simple
ZOE

Powder

Zinc oxide
Rosin : reduce the brittleness of the
set cement
Zinc stearate : plastcizer
Zinc acetate : improve strength

Liquid

Eugenol and olive oil

Setting reaction

First
ZnO + Eugenol --

water

Zn(OH)2

Second
Zn(OH)2+2HE ZnE2+H2O

Setting reaction

Water accelerates the reaction

Zinc eugenolate is easily
hydrolized by moisture

Manipulation

Paste/paste

Mix two equal pastes together until it

obtains the homogeneous color.

Powder/liquid

Usually 4/1 for maximum strength

Mix the large increment, firstly
Not require cool glass slap

Classification

Type I

Type II

Permanent cementation

Type III

Temporary luting cement

Temporary restoration [for a few days]

Type IV

Cavity liner

Specification requirements
Type

Settin Compressiv Solubilit Film

g time e strength y
thicknes
[min] [MPa]
s
[%]
[m]

Type I

4-10

35 maximum 2.5

25

Type II

4-10

35 maximum 1.5

25

Type III 4-10

35 maximum 1.5

Reinforced ZOE

Used as the intermediate

restorative materials (IRMTM)
Add 10-40% resin polymer in the
powder for strengthening the set
cement
Compressive strength 35-55 MPa

EBA cement

Powder

Liquid

Add 20-30% of aluminium oxide

Add 50-60% ethoxybenzoic acid in
eugenol

Compressive strength 55-75 MPa

Clinical applications

Base
Temporary cementation
Permanent cementation

If cement contains eugenol, it is not to

use with resin restorative material.

Zinc polycarboxylate
cement

Or called Zinc polyacrylate cement

The first adhesive cement

More biocompatibility than zinc

phosphate cement

Bond to tooth structure and metal

Polyacrylic acid have more molecular weigth

Moderate strength/ moderate

solubility

Composition

Powder [the same as zinc

phosphate cement ]

Zinc oxide
Magnesium oxide
Stannous fluoride

Liquid

Aqueous solution of polyacrylic acid

Other carboxylic acid

Manipulation

Mix first half of powder to liquid to

obtain the maximum length of
working time.
The reaction is thixotropic
The viscosity decreases when the shear
rate increases

Setting reaction

Like zinc phosphate cement

Retarded by cool environment

Bonding to tooth structure

The polyacrylic acid is believed to

react with calcium ion via the
carboxyl group.
The adhesion depends on the
unreacted carboxyl group.

Specification requirements

Setting time at 37OC: 9 minutes

Maximum film thickness: 25m
Minimum compressive strength: 50
MPa
Maximum solubility: 0.2%

Applications

Cement inlays or crowns

Used as base
Temporary filling
Lute the stainless steel crown

Glass ionomer cement

Or called Polyalkynoate cements

Conventional glass ionomercement
Resin-modified glass ionomer
cement [RMGICs]
Powder + Liquid/ Powder + water/
Encapsulated

Composition

Powder

Calcium aluminum fluorosilicate glass

Liquid

Polyacid

Copolymer of polyacrylic / itaconic acid

Copolymer of polyacrylic / maleic acid
Add tartaric: accelerator

Setting reaction
There are three stages:
Dissolution
Gelation
Hardening.
Water hardening or water setting

Polyacid liquid
Hydrogen
ions

Ca2+
Glass core

Al3+
F-

Silica gel

Polyacid liquid

Ca2+
Al3+
F-

-COOH
Cross-linked
polyacid

Gelation

Calcium ions have more reactivity

than aluminium ions.
This is critical phase of
contamination.

Polyacid liquid

Al3+

-COOH
Cross-linked
polyacid

Hardening

Last as long as 7 days.

The reaction of aluminium ions
provides the final strength of set
cement.

Glas
s
core

Cross-linked polyacid

Silica gel

Properties

Film thickness is similar or less

than zinc phosphate cement.
Setting time 6 to 8 minutes from
start of mixing.
Less pulpal irritation.
Bacteriocidal or bacteriostatic.
Prevent caries.

Strength

The 24-hour compressive strength

is greater than zinc phosphate
cement.
The compressive strength increase
to 280MPa between 24 hours to 1
year after initial setting.

Bonding

It can be chemically bonded to the

tooth structure.
The mechanism of bonding is the
same as polyacrylate cement.
The dentine bond strength may be
lower than polyacrylate because of
technique sensitivity.

Modified GI

Cermet

Combination of glass and metal

No significantly improve the strength
More wear resistance and short
setting time

Resin-modified GI

Resin-modified glass
ionomer cement

Add polymerizable function groups

Both chemical & light curing

Overcome moisture sensitive & low
early strength
Names: Ligth cured GICs, Dual-cured
GICs, Tri-cured GICs, Hybrid ionomer,
Compomers, Resin-ionomers

Setting reaction

Polymerization

Acid-base reaction

initial setting

maturing process & final strength

Heat released from the

polymerization reaction.

Properties

Higher strength than conventional

GI
Higher adhesion to resin material
Less water sensitivity

Can be polished after curing

Relative properties of a glass

ionomer and a resin-modified GI
cements
Property

GIC

RMGIC

Working time

2 min

3 min 45 sec

Setting time

4 min

20 sec

Compressive
strength

202 MPa

242 Mpa

Tensile strength 16 Mpa

37 Mpa

Applications

Type I : Luting agent

Type II : Filling material
Type III : Base and liner

Conventional GI for cementation

GI filling material

Adhesive resin cement

Occur later from the direct filling

resin
Become popular because of the
improved properties, high bond
strength.
Resin cement is flowable
composite resin.

Composite resin cement

Composite :
Resin matrix + inorganic filler

Silane
coated

Composition

Filler

Silica

Matrix

Bis-GMA (polymer)

The fillers binds with matrix by

silane coupling agent

Setting reaction

Polymerization

Chemical activation
Light activation
Dual activation [chemical and light]

Preparations

Powder / liquid
Chemical, light, or dual cure
2 paste system [base / catalyst]
Chemical, light, or dual cure
Single paste
Light cure

Bonding system

Bond with the tooth surface by

enamel an dentine bonding system.
Bond with metal by using metal
primer.
Bond with ceramic restoration by
treating the surface of porcelain
with silane coupling agent

Properties

Very good bond strength

High compressive strength
Water sensitive
Might irritate pulpal tissues

Applications

Tooth color filling materials

Luting cements

Calcium hydroxide cement

Used as base and

liner
High pH value
Good
biocompatibility

Composition
2 Pastes system
Base
Salicylate reaction
Calcium tungstate and barium sulfate
radiopacity

Catalyst

Calcium hydroxide

Properties

Lower compressive strength than

others
Resist to the condensation force of
amalgam filling
High pH 9.2-11.7 [Alkaline]
Bactericidal
High solubility

Properties

Stimulate the secondary dentine

formation in the area of thin
dentine [<0.5mm]
Stimulate the dentine formation in
the exposed-pulp lesion [Direct
pulp capping]

Comparable properties of
cements

Compressive strength
[MPa]

Zhen Chun Li and Shane N. White, 1999

Bond strength
Separation forces [MPa]

Sule Ergin and Deniz Gemalmaz, 2002

Film thickness [m]

Shane N. White, Zhaokun Yu, 1992

Others

Solubility

ZOE > Polycarboxylate > Zinc

phosphate~GIC > Resin cement

Irritation to pulp tissues

Resin~Zinc phosphate > GIC >

Polycarboxylate > ZOE~Calcium
hydroxide

References

Textbooks

Kenneth J. Anusavice
Phillips science of dental materials
11th edition
W.B. Saunders company 2003

References

Textbook

Robert G. Craig
Restorative dental materials
9th edition
Mosby company 1993

References

Textbook

Richard van Noort

Introduction to dental materials
2nd edition
Mosby company 2002

References

Journals

Li ZC, White SN. Mechanical properties of

dental luting cements. J Prosthet Dent
1999;81(5):597-609
White SN, Yu Z. Film thickness of new
adhesive luting agents. J Prosthet Dent
1992;67(6):782-90
Ergin S, Gemalmaz D. Retentive properties of
five luting cements on base and noble metal
copings. J Prosthet Dent 2002;885:491-97