KK
Uploaded byKrittika Kuhar
PPTX, PDF6,809 views

Luting cements

The document discusses different types of luting cements used to cement indirect dental restorations. It describes the ideal requirements of luting cements and provides classifications based on ingredients and application. Specific cements are discussed in detail, including their composition, setting reactions, indications, advantages and disadvantages. The key cements covered are zinc phosphate, polycarboxylate, zinc oxide eugenol, and glass ionomer.

Healthcare◦
Related topics:
Restorative Dentistry•
In this document
Powered by AI

Presentation introduces the topic of luting cements, mentioning author Krittika Kuhar and outlining contents including definitions, requirements, classification, applications, and conclusion.

Examines the necessity of luting cements in dental treatments, their adhesive properties, and ideal requirements like adhesion, strength, and biocompatibility.

Presents the ISO classification of dental cements based on ingredients and applications, detailing water-based, oil-based, and resin-based cements.

Discusses bonding mechanisms between cements and tooth surfaces, detailing non-adhesive, micromechanical, and molecular adhesion types.Highlights zinc phosphate cement's applications, setting reactions, advantages and disadvantages, and clinical manipulation working with it.

Details types of modified zinc phosphate cements such as fluoride cement and zinc silicophosphate, discussing their properties and uses.

Introduction to polycarboxylate cements, their applications, composition, mechanisms of adhesion, advantages, and disadvantages.

Overview of zinc oxide eugenol's types, manipulations, advantages, and disadvantages as a provisional luting cement.

Introduces glass ionomer cements, their classifications, composition, setting reactions, and applications in dental procedures.

Presents hybrid ionomer cement’s composition, setting reaction, retention mechanism, advantages and disadvantages, and applications. Introduces resin cements, discussing their properties, manipulation methods, strengths, and relevance in dental applications.Concludes that no single luting agent is ideal, emphasizing the importance of understanding each cement's properties for clinical success.

Lists scholarly sources and references cited in the presentation for further understanding of luting cements.

Downloaded 80 times
Presented By :- Krittika Kuhar 1st year MDS LUTING CEMENTS
CONTENTS • INTRODUCTION • IDEAL REQUIREMENTS OF LUTING CEMENTS • CLASSIFICATION • CEMENTS USED FOR LUTING -- Zinc Phosphate Cement -- Zinc Polycarboxylate Cement -- Zinc Oxide Eugenol -- Glass Ionomer Cement -- Resin Luting Agent • CONCLUSION • REFERENCES
INTRODUCTION • Numerous dental treatments necessiate attachment of indirect restoration and appliances to the teeth by means of a cement. • The long- term clinical outcome of fixed prosthodontic treatment depends on the use of adhesives that can provide an impervious seal between the restoration and the tooth.
DEFINITIONS • Cement  Substance that hardens to act as base , liner , filling material , or adhesive to bind devices or prosthesis to tooth structure or to each other. (Anusavice 11th Edition) • Cementation  Attaching a restoration to natural teeth by means of a cement . (GPT-9) • Luting Agent  any material used to attach or cement indirect restorations to prepared teeth. (GPT-9)
REQUIREMENTS OF LUTING CEMENT  Adhesion to restorative material  Adequate strength to resist functional forces  Lack of solubility in oral tissues  Low film thickness  Biocompatibility with oral tissues  Radio-opaque  Anti-cariogenic properties  Relative ease of manipulation  Esthetic / color stability An ideal luting cement should have physicomechanical properties resembling those of dentine.
CLASSIFICATION • ISO classification ( BASED ON INGREDIENTS) Water-based cements Zinc phosphate, glass ionomer, etc. Oil-based cements ZOE and noneugenol cements Resin or polymer-based cements Resin cements, compomer, etc.
• Classification of cements based on application (ISO 9917-1:2007)* a. Luting b. Bases or lining c. Restoration
BONDING MECHANISM • According to Schillinburg , the cement , tooth surface and prostheses interface bonding mechanism can be divided into 3 types :-  Non Adhesive ( mechanical )  Micromechanical  Molecular
NON ADHESIVE (MECHANICAL) • The luting agent served primarily to fill the gap and prevent entrance of fluids. • It holds the restoration in place by engaging small irregularities on the surfaces of both tooth and restoration • Exhibits no adhesion on the molecular level. • For eg Zinc Phosphate • The nearly parallel opposing walls of a correctly prepared tooth make it impossible to remove the restoration without shearing or crushing the minute projections of cement extending into recesses in the surfaces.
The crown can be removed only along the path (large arrow) determined by the axial walls of the preparation. Cement extending into small irregularities of the adjoining surfaces {shown magnified in the two large circles) prevents removal along any path more vertical than the sides of the irregularities (small arrows).
MICROMECHANICAL BONDING The deep irregularities necessary for micromechanical bonding can be produced on enamel surfaces by etching with a phosphoric acid solution or gel21, on ceramics by etching with hydrofluoric acicF; and on metals by electrolytic etching, chemical etching, sandblasting, or by incorporating salt crystals into the preliminary resin pattern. Resin cements have tensile strengths in the range of 30 to 40 MPa, which is approximately five times that of zinc phosphate cement. When used on pitted surfaces, they can provide effective micromechanical bonding
Composite resin cements hold the restoration to the tooth by penetrating into deep and small surface pits.
MOLECULAR ADHESION • Molecular adhesion involves physical forces (bipolar, Van der Waals and chemical bonds (ionic, covalent) between the molecules of two different substances. • Newer cements, such as polycarboxylates and glass ionomers, possess some adhesive capabilities, although this is limited by their relatively low cohesive strength. They still depend primarily on nearly parallel walls in the preparation to retain restorations.
True adhesion is the molecular attraction exerted between the surface of bodies in contact.
ZINC PHOSPHATE CEMENT One of the oldest cements Introduced by Dr Otto Hoffman in 1877
• APPLICATIONS 1. Luting of restorations (inlays, crowns, fixed dental prostheses, etc.) 2. High strength bases. 3. Temporary restorations. 4. Luting of orthodontic bands and brackets. • CLASSIFICATION ISO 9917-1:2007 designates them as a. Luting (Maximum film thickness—25 μm) b. Bases and lining • AVAILABLE AS • •. Powder and liquid system. • •. Capsules of preproportioned powder and liquid.
SETTING REACTION When the powder is mixed with liquid, phosphoric acid attacks the surface of the particles and releases zinc ions. The aluminum in the liquid is essential for cement formation. The aluminum complexes with the phosphoric acid and the zinc ions to form a zinc aluminophosphate gel. The reaction is exothermic.
CLINICAL MANIPULATION
MIXING TIME 1.5-2 min (Philips) WORKING TIME 5 min (Philips) SETTING TIME 5-9 min (CRAIG) 5-14 min (O’BREIN) FILM THICKNESS TYPE 1 <25µm TYPE 2 <40µm FROZEN GLASS TECHNIQUE :- • To prolong working time and shorten setting time • Glass slab is cooled at 6 to -10 degree C • 50-75% more powder incorporation • Working time increased by 4-11 min • Setting time shortened by 20-40% • Due to increased P:L ratio , decreased solubility in oral fluids.  SLAKING THE FLUID
• No chemical adhesion • Low tensile strength • Post cementation sensitivity ( Resin based sealer / liner decreases casting retentive stress by 42% - Johnson et al , 2004) • High solubility in oral fluids 0.2% in 24 h  Marginal leakage. • Over 100 years of clinical experience • Longetivity. (27 fixed prosthesis that were in clinical service from 2 to 43 years) * • High initial strength • Adequate compressive strength • Low cost • Can be used in regions of high masticatory stress or long span prosthesis ADVANTAGES DISADVANTAGES *Margerit J, Cluzel B, Leloup JM, Nurit J, Pauvert B, Terol A (1996) Chemical characterization of in vivo aged zinc phosphate dental cements. J Mater Sci Mater Med 7:623–628
• Ceramic inlay • Veneer resin bonded FPD • Low retentive preparations • •Metallic inlay/onlay • •Metal–ceramic feldspathic full crowns • •Metal prefabricated or customized post • •Partial fixed prosthesis • MOST PREFERRED FOR Implant supported crowns Multiple unit implant supported prostheses INDICATIONS CONTRAINDICATIONS Ladha K, Verma M. Conventional and contemporary luting cements: an overview. The Journal of Indian Prosthodontic Society. 2010 Jun 1;10(2):79-88.
MODIFIED ZINC PHOSPHATE CEMENT • FLUORIDE CEMENT Add stannous fluoride Higher solubility , lower strength • ZINC SILICOPHOSPHATE Zinc Phosphate + Silicate Higher strength , lower solubility Fluoride released , high film thickness 88µm Transluency
• COPPER Containing Zinc Phosphate CEMENTS (not widely used) Copper (2-97%) was added to Zinc Phosphate cement , historically Pure Copper Phosphate cement  Teeth discoloration and toxic Not used  High acidity , High solubility and Low strength Indicated : deciduous teeth where it was not possible to remove all caries In cementation of cast silver cap splints-in facial fractures Silver cements contained small percentage of silver phosphate.
POLYCARBOXYL ATE CEMENT • DENNIS SMITH in 1968 • FIRST CEMENT WITH ADHESIVE BOND TO TOOTH STRUCTURE • ALSO KNOWN AS POLYACRYLATE CEMENT
APPLICATIONS • Primarily for luting permanent restorations. • As bases and liners. • Used in orthodontics for cementation of bands. • Also used as root canal fillings in endodontics. • Cementing SS crown in Peadiatric Dentistry. • AVAILABLE AS •. Powder and liquid in bottles •. Water settable cements As precapsulated powder/liquid system
INGREDIENT FUNCTION Zinc Oxide Basic ingredient Magnesium Oxide Principal modifier , aids in sintering Oxides of Bismuth and Aluminum Small amounts Stannous Fluoride adjust the setting time, increase the strength, and enhance the manipulative properties COMPOSITION OF POWDER Liquid - water solution of polyacrylic acid or a copolymer of acrylic acid with other carboxylic acids, such as itaconic Acid. Molecular weight ranges from 30,000 to 50,000 Acid concentration 32-42%
SETTING REACTION • When the powder and liquid are mixed, the surface of powder particles are attacked by the acid, releasing zinc, magnesium and tin ions. These ions bind to the polymer chain via the carboxyl groups. They also react with carboxyl groups of adjacent polyacid chains to form cross-linked salts. • Structure of set cement The hardened cement consists of an amorphous gel matrix of zinc polyacrylate in which unreacted powder particles are dispersed.
MECHANISM OF ADHESION • Chemical bond to tooth structure. • The polyacrylic acid bonds to calcium ions on the surface of enamel or dentin via Carboxyl group on the surface of enamel and dentin • Bond with Enamel (3.4–13.1 Mpa) > Dentin (2.07 MPa) • Weak bond with gold • No perceptible bond with porcelain • MIXING OF CEMENT P/L ratio is 1.5 by weight Non absorbent mixing surface eg glass slab Liquid dispensed just before the mixing (evaporates quickly) Cement must be used before it loses its glossy appearance indicating free carboxylic acid. No gloss - Cobweb
INDICATIONS CONTRADICTIONS • Cast Crown • PFM crown • Patient with previous history of sensitivity. • Pressed ceramic crown , ceramic inlay , ceramic veneer • Resin bonded FPD • Cast post and core • Crown or FPD
• Relatively lower compressive strength • Need for clean surface for adhesion • Short working time • Low Irritation • Chemical bond to tooth structure and alloys • Easy manipulation • Adequate strength • Low solubility • Adequate film thickness • Anticariogenic Advantages Disadvantages
ZINC OXIDE EUGENOL Provisional luting cement
TYPES Type I zinc oxide eugenol for temporary cementation. Type II zinc oxide eugenol cement for temporary restorations Type III zinc oxide eugenol— cavity liner (was previously Type IV).
INGREDIENT WEIGHT % FUNCTION EUGENOL 85 Reacts with Zinc Oxide OLIVE OIL 15 Plasticizer LIQUID
MANIPULATION POWDER: LIQUID- 4:1 TO 6:1 by weight. • Measured quantity of powder and liquid is dispensed onto a cool glass slab. • Powder is incorporated in liquid • Spatulated in circular motion.. • It exhibits pseudo-thickening. • For temporary restorations a thick putty-like consistency is recommended. • TWO PASTE SYSTEM • Equal length of each paste are dispersed and mixed until the uniform colour is observed.
Advantages Disadvantages • ideal pulp compatibility ( obtudent and sedative effect on pulp) • good initial adaptation to cavity walls • lower solubility in most acids • low compressive strength • poor resistance to abrasion and disintegration • continued loss of eugenol by fluid extraction. As such, pure ZOE is not suitable as a permanent luting agent. Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17.
MODIFIED ZINC OXIDE EUGENOL CEMENTS • EBA-ALUMINA MODIFIED CEMENTS A part of the liquid is substituted by orthoethoxy benzoic acid (EBA) . Alumina is added to the powder. • Rigidity of Alumina is more than that of fused quartz . • Reinforcing aluminium oxide by substitution of fused quartz :- Mixing properties and compressive strength improved Film thickness reduced. Tensile strength in same range as Zinc Phosphate ADVANTAGES DISADVANTAGES Palliative to pulp Good initial adaptation Exhibit compressive and tensile strengths in the same ranges as ZnP. Poor resistance to abrasion and disintegration Continual loss of eugenol by leaching Questionable long-range clinical performance.
GLASS IONOMER CEMENT Generic name of group of materials that use silicate glass powder and an aqueous solution of polyacrylic acid. Biomimetic Developed in 1970s by Wilson and Kent
• The GICs are classified below: Type I: Luting crowns, bridges, and orthodontic brackets Type IIa: Esthetic restorative cements Type IIb: Reinforced restorative cements Type III: Lining cements, base
COMPOSITION POWDER INGREDIENT WEIGHT % SILICA 41.9 ALUMINA 28.6 ALUMINIUM FLURIDE 1.6 CALCIUM FLUORIDE 15.7 SODIUM FLUORIDE 9.3 ALUMINIUM PHOSPHATE 3.8 The powder is an acid-soluble calcium fluoroaluminosilicate glass Lanthanum, strontium, barium or zinc oxide additions provide radiopacity
LIQUID COMPONENT FUNCTION Polyacrylic acid in the form of copolymer with itaconic acid, maleic acid and tricarballylic acid Copolymerizing with itaconic, maleic acid, etc. tends to increase reactivity of the liquid, decrease viscosity and reduce tendency for gelation Tartaric acid (5% by mass) Improves the handling characteristics, increases working time and shortens setting time. WATER Water is the most important constituent of the cement liquid, it is the medium of reaction and it hydrates the reaction products. The amount of water in the liquid is critical. Too much water results in a weak cement. Too little water impairs the reaction and subsequent hydration
SETTING REACTION
MECHANISM OF ADHESION
Mixing with a stiff spatula on non absorbant pad. 2 increments. First increment is mixed for 5-10 sec subequent increment. Total mixing time should not exceed 30-40 sec Glossy finish – residual polyacid for adhesion Dull mix : reduced adhesion. DISCARDED.
SETTING TIME- •Type 1 -4 to 5 mins •Type 2- 7 mins SURFACE PREPARATION- •The tooth should be cleaned for effective adhesion. • A pumice slurry is used to remove the smear layer. •Conditioning:- with 10% polyacrylic acid or 37% phosphoric acid for 10-20 seconds. •Rinse with water for 20 seconds. •After rinsing the preparation the surface should be dried but not dessicated and it should remain uncontaminated by saliva or blood.
• •Initial solubility (1.25% wt) • •Sensitivity to humidity • Post-op sensitivity (Woznaik 1984) esp with anhydrous freeze dried polyacid (Simmons 1986) • Friendly handling • •Fluidity • •Adhesion to tooth structure and metals • •Fluoride release and uptake • •Adequate translucency • •Adequate strength (85MPa for luting) • •Relative low cost ADVANTAGES DISADVANTAGES
• Intraradicular posts • •Partial fixed prosthesis in areas of high occlusal load • Class 2 and 6 cavities , lack fracture toughness. • Metallic crowns • •Metal–ceramic crowns • •High strength metal- free crowns (alumina and zirconia) INDICATIONS CONTRAINDICATIONS
HYBRID IONOMER CEMENT • Self cure or light cure ( or resin modified glass ionomers are present for cementation ) Composition The powder contains: • Radioopaque fluroaluminosilicate glass • Photo-initiators or Chemical initiators or both • Polymerizable resin • Micro encapsulated potassium persulphate • Ascorbic acid as catalyst The Liquid contains: • Aqueous solution of Polycarboxylic acid modified with pendant methacrylate group • Tartaric acid • 2 , hydroxyethyl methacrylate monomers (HEMA)
SETTING REACTION • Setting includes both polymerization and acid-base reaction. The initial setting occurs by polymerization of the methacrylate groups giving it a high early strength. • Polymerization may be light cured or chemical cured depending on the type of cement. • Subsequently the acid-base reaction sets it thereby completing the setting reaction and giving the cement its final strength. • Working time >2.5 min • Setting time about - 5 min from placement (depends on brand)
MECHANISM OF RETENTION • Several RMGI systems (e.g. RelyXTM Luting Cement and RelyXTM Luting Plus Cement, 3M ESPE) do not require any etching, priming or conditioning of the tooth and thus can be considered as self-adhesive cements. Others, such as AdvanceTM (Caulk/Dentsply) and FujiTM CEM or FujiTM Plus (GC Dental), suggest the use of additional conditioning agents. • Adhesion is a combination of 2 factors :- • the modification of the dentinal smear layer and interpenetration of the dentinal tubules by the fluid cement followed by polymerization and entanglement with collagen fibers; • • ionic reaction of the polycarboxylate with the calcium ions of hydroxyapatite
APPLICATION • Restoration of Class I, III or V cavities. • Bases and liners. • As adhesives for orthodontic brackets. • Cementation of crowns and FDPs. • Repair of damaged amalgam cores or cusps. • Retrograde root filling. (Uses vary according to brand.)
• Less biocompatible compared to GIC • Hygroscopic expansion (HEMA) • High solubility (4 times in lactic acid as GIC) CONTRAINDICATIONS • Metal-free ceramic restorations, susceptible to erosion • •Intraradicular post • Fluoride release similar to GIC • •Improved compressive and diametral strength INDICATIONS • Metallic restorations • •Metal–ceramic , FPD , GIC core build up , amalgam , composites ADVANTAGES DISADVANTAGES
• The term Compomer is derived from composite and GIC • Fluoride releasing ability of conventional GIC and durability of composite. COMPOMER
COMPOSITION • Compomers for luting purposes are available as a two component system, either powder/liquid or as two pastes • Powder: strontium aluminofluorosilicate, metallic oxides, chemical-activated and/or light-activated initiators. • Liquid: polymerizable methacrylate/carboxylic acid monomers, multifunctional acrylate monomers, water
PROPERTIES • Tensile strength , flexural strength and wear resistance of compomer is superior. • Glass ionomer cement but less effective than resin composites. • Cementation of metal prostheses • Hygroscopic expansion – all ceramic veneers(C/I)
RESIN CEMENTS • Low viscosity composite materials with filler distribution and initiator content adjusted to allow for a low film thickness and suitable working and setting time. • ISO specification 4049 (2009) classifies resin cement as :- CLASS 1 – Self Cured CLASS 2 – Light cured CLASS 3 – Dual Cured (most commercially used)
COMPOSITION • High molecular weight molecules like Bis-GMA , UDMA and Bis-EMA are combined with smaller molecules DEGDMA , TEGDMA  High conversion and low volumetric shrinkage. • Filler (30-66%) contains silanted radiopaque glasses such as barium , strontium , zirconia with silica particles . Avg filler size 0.5-8 micrometers. • Camphorquinone and tertiary amine – Initiate light activated reaction • Self cure activator – Benzoyl peroxide
MANIPULATION • use of dental bonding agents is essential to obtain adequate bond strength of the cement to the tooth structure. • the use of an etchant, e.g. 37% phosphoric acid gel • moisture control is critical. • surface of the prosthetic device also has to be prepared by sand-blasting or chemical treatments, e.g. with a silane primer. • Working time is 2–4 min while set time is 5–10 min • It is very important to clean up the cement within the window of time specified by the manufacturer, otherwise the cement sets very hard and the excess is extremely difficult to remove.
PROPERTIES • Compressive strength : 180 MPa (26000 Psi) • Tensile strength : 30 MPa (4000 Psi) • Film thickness : 10–25 μm • Biological properties : Irritating to the pulp. Pulp protection with calcium hydroxide or GIC liner is necessary for areas close to the pulp. • Solubility : Insoluble in oral fluids. • Polymerization shrinkage :Ishigh • Adhesion properties : They do not adhere to tooth structure, which may lead to microleakage if used without etching and bonding. • Bond strength to enamel : 7.4 MPa (1070 Psi). Bond strength to enamel is usually strong. • Failure most often occurs at the metal-resin interphase.
SELF ADHESIVE RESIN CEMENTS • Combining advantages of GIC ( adhesion and fluoride release) with mechanical properties of Resin cements. • Presented as 2 paste or powder and liquid.
INDICATIONS • Cementation of cast • Single alloy restoration and bridges • Ceramic metal crown and bridges • Ceramic (except veneers) • Indirect Composite restoration • Prefabricated posts • High Strength Ceramics
PROPERTIES • Higher cytotoxicity than resin cements and acid-base cements • Flexural strength – 50-100 Mpa • Compressive strength – 200-240Mpa • Film thickness – 15 and 20 micrometer • Bonding mechanism with tooth :- Micromechanical Interlocking and chemical Interaction between acidic groups and hydroxyapatite • Fluoride content is low (10%) and its beneficial effects have not been clinically proven.
CONCLUSION • No single luting agent is ideal in all the clinical situations. • Several new materials are available differing each other in content and physical attributions. Therefore it may be difficult to the dentist to make a choice amongst so many alternative products. Each luting agent has different physical, mechanical and biological characteristics resulting from its chemical structure. So, to achieve a clinical success, the clinician should be aware of the qualities, advantages and disadvantages of each type of cement.
REFERENCES • Anusavice KJ, Phillip’s Science of Dental Materials, WB Saunders Co., Philadelphia, 2003, 11th Edition, 443-493. • Sakaguchi RL, Powers JM, Craig’s Restorative Dental Materials, Elsevier, Mosby, Philadelphia, 2011, 12th Edition, 327-348. • Herbert T. Schillinberg – Fundamentals of Fixed Prosthodontics – 3rd Edition • Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17. • Ladha K, Verma M. Conventional and contemporary luting cements: an overview. The Journal of Indian Prosthodontic Society. 2010 Jun 1;10(2):79-88.
• Petrich A, VanDercreek CJ, Kenny CK. Dental luting cements. Clinical Update (National Naval Dental Center). 2004 Mar;26:31-2. • Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17 • Margerit J, Cluzel B, Leloup JM, Nurit J, Pauvert B, Terol A (1996) Chemical characterization of in vivo aged zinc phosphate dental cements. J Mater Sci Mater Med 7:623–628 • Mitra SB. Dental cements: formulations and handling techniques. InDental Biomaterials 2008 Jan 1 (pp. 162-193). Woodhead Publishing.
Luting cements

More Related Content

PPTX
Luting agents used in prosthodontics
byaruncs92
 
PPTX
Luting
byArunima Upendran
 
PPTX
luting cement
byVincy Bernice
 
PDF
Resin Luting Cements (2nd edition) pdf
byAhmed Mostafa Hussein Mohammed
 
PPT
Luting agents and cementation
byCing Sian Dal
 
PPTX
Luting
byAshitha Dominic
 
PPTX
Luting agents in prosthodontics and their effects
byVijayKumar997843
 
PPTX
composite Resins in prosthodontics
byDr.Richa Sahai
 
Luting agents used in prosthodontics
byaruncs92
 
Luting
byArunima Upendran
 
luting cement
byVincy Bernice
 
Resin Luting Cements (2nd edition) pdf
byAhmed Mostafa Hussein Mohammed
 
Luting agents and cementation
byCing Sian Dal
 
Luting
byAshitha Dominic
 
Luting agents in prosthodontics and their effects
byVijayKumar997843
 
composite Resins in prosthodontics
byDr.Richa Sahai
 

What's hot

PPTX
Dental ceramics
byNishu Priya
 
PPTX
Recent Advances in Dental Ceramics
byDr. Prathamesh Fulsundar
 
PPTX
Dental ceramics
byDr. KRITI TREHAN
 
PPTX
Die materials and die systems
bysmidsprostho
 
PPTX
Dental ceramics
byshari kurup
 
PPTX
Calcium hydroxide
byU1Yuvansai
 
PPT
8.working casts and dies
byLama K Banna
 
PPTX
Impression Techniques in Fixed partial denture
byDr.Richa Sahai
 
PPTX
Denture base materials
byNeerajaMenon4
 
PPTX
Investment materials
byPriyanka Makkar
 
PPTX
Inlay wax | Dentistry
byAbhiram A B
 
PDF
GIC
byIAU Dent
 
PPTX
Pressable ceramics
byDr.shifaya nasrin
 
PPS
dental cements (3) dental material
byDr-Faisal Al-Qahtani
 
PPT
Castable ceramics/ dentistry training
byIndian dental academy
 
PPT
recent advances in impression materials
byramkoti reddy
 
PDF
Mean Value Articulator
byAamir Godil
 
PPTX
Saliva in prosthodontics
byDr.Richa Sahai
 
PPT
Metal ceramic/prosthodontic courses
byIndian dental academy
 
PDF
Tissue-conditioners
byParth Thakkar
 
Dental ceramics
byNishu Priya
 
Recent Advances in Dental Ceramics
byDr. Prathamesh Fulsundar
 
Dental ceramics
byDr. KRITI TREHAN
 
Die materials and die systems
bysmidsprostho
 
Dental ceramics
byshari kurup
 
Calcium hydroxide
byU1Yuvansai
 
8.working casts and dies
byLama K Banna
 
Impression Techniques in Fixed partial denture
byDr.Richa Sahai
 
Denture base materials
byNeerajaMenon4
 
Investment materials
byPriyanka Makkar
 
Inlay wax | Dentistry
byAbhiram A B
 
GIC
byIAU Dent
 
Pressable ceramics
byDr.shifaya nasrin
 
dental cements (3) dental material
byDr-Faisal Al-Qahtani
 
Castable ceramics/ dentistry training
byIndian dental academy
 
recent advances in impression materials
byramkoti reddy
 
Mean Value Articulator
byAamir Godil
 
Saliva in prosthodontics
byDr.Richa Sahai
 
Metal ceramic/prosthodontic courses
byIndian dental academy
 
Tissue-conditioners
byParth Thakkar
 

Similar to Luting cements

PPTX
Dental cement 1
bypadmini rani
 
PPTX
LUTING CEMENTS in prosthodontics dentistry
byShreyaShastry
 
PPTX
Luting cements or dental cements
bymanipal college of dental sciences
 
PPTX
Dental cements
byPrajaktaGir
 
PPT
Cementation procedures in fpd
bysmidsprostho
 
PPT
traditional dental cements
bydr d y patil school of dentistry
 
PPT
Luting cements/prosthodontic courses
byIndian dental academy
 
PPTX
Dental Cements by Silas M. Toka
bySilas Toka
 
PPTX
cements.pptx
bymuktabansal8
 
PPTX
Dental cements part 2
byDr.Dhananjay Singh
 
PPTX
Dental Cements 2023.pptx
byMohammadAbdulsamad5
 
PPT
dental cements
bydr d y patil school of dentistry
 
PPTX
2. Recent advances in luting cements.pptx
byrakshasb
 
PPT
Luting cements/ dental courses/endodontic courses
byIndian dental academy
 
PPTX
Bonding and banding
byGayathri Menon
 
PDF
dentalcementsautosavedprajakta-220205182536-1.pdf
byDilu Davis
 
PPTX
lutingcements-201025110217.pptsdfgthujkmhngbdfdx
byvssanchi22
 
PPTX
LUTING CEMENTS - A PROSTHODONTIST'S POV
byDr . Karthikeyan G
 
PPTX
dental cements.pptxhyuiokkjnnnnnnnnmmmmmm
byKrantiKhadse
 
DOC
Luting agent/ orthodontic course by indian dental academy
byIndian dental academy
 
Dental cement 1
bypadmini rani
 
LUTING CEMENTS in prosthodontics dentistry
byShreyaShastry
 
Luting cements or dental cements
bymanipal college of dental sciences
 
Dental cements
byPrajaktaGir
 
Cementation procedures in fpd
bysmidsprostho
 
traditional dental cements
bydr d y patil school of dentistry
 
Luting cements/prosthodontic courses
byIndian dental academy
 
Dental Cements by Silas M. Toka
bySilas Toka
 
cements.pptx
bymuktabansal8
 
Dental cements part 2
byDr.Dhananjay Singh
 
Dental Cements 2023.pptx
byMohammadAbdulsamad5
 
dental cements
bydr d y patil school of dentistry
 
2. Recent advances in luting cements.pptx
byrakshasb
 
Luting cements/ dental courses/endodontic courses
byIndian dental academy
 
Bonding and banding
byGayathri Menon
 
dentalcementsautosavedprajakta-220205182536-1.pdf
byDilu Davis
 
lutingcements-201025110217.pptsdfgthujkmhngbdfdx
byvssanchi22
 
LUTING CEMENTS - A PROSTHODONTIST'S POV
byDr . Karthikeyan G
 
dental cements.pptxhyuiokkjnnnnnnnnmmmmmm
byKrantiKhadse
 
Luting agent/ orthodontic course by indian dental academy
byIndian dental academy
 

Recently uploaded

PPTX
ERRORS IN OBTURATION and ITS PREVENTION.pptx
byBogdan Dimitriu
 
PDF
Hospital Housekeeping Inspection Checklist with eAuditor Audits and inspections
byeAuditor Audits & Inspections
 
PPTX
Epistaxis.signs.symptoms.management.treatment
byhaniejaz902
 
PDF
20251022 Treasure Hunt - Deeping Participation.pdf
byInternational Society of Service Innovation Professionals
 
PDF
Monastic Academy - Focus On Societal Service
byMonastic Academy
 
PPTX
Risk of Bleeding Complications With Different Peri Operative Antithrombotic R...
byAmeliyaSecil
 
PPTX
CL 1--Sec 1-Pt. 3 Basic knowledge modi 1.pptx
byrecoverytechnyc
 
PPTX
Futuristic Nursing: Advanced Nursing Practice (ANP)
byKANCHAN PRIYA SOY
 
PPTX
Humanisation Antibody Therapy By Ilias Ahmed.pptx
byILIAS AHMED
 
PDF
How Many Ribs Does the Human Body Have.pdf
byThe Lifesciences Magazine
 
PPTX
Acute Abdominal Pain.pptxAcute Abdominal Pain.pptx
byAddis53
 
PPTX
Chapter 50 endocrine disorders general .pptx
byunique105
 
PDF
Presentation - Professional Skincare (1).pdf
byDrishti Barua
 
PPTX
November 4 NYS BRSS training-Peer Supervision Organizational Change ETHICS ...
byrecoverytechnyc
 
PPTX
bronchiolitis-power point presentation by
byUmmuNahyan
 
PPTX
CVD PPT Medical Terminology March 2022.pptx Chapter_05_Medical_Terminology (1...
byssuserd131ec
 
PPT
CONCEPT HEALTH- HEALTH LITERACY AND DISEASE –DECISION MAKING IN HEALTH- EVIDE...
byTauseef Jawaid
 
PPT
Chapter 19 Basic immunology ppts DZ 2010.ppt
byyoannesbuti25
 
PDF
Presentation - Gym Supplements A Professional Guide.pdf
byriyanshuseo
 
PDF
BEST LABS IN KOCHI/BEST HOME BLOOD COLLECTION/BEST LAB IN KOCHI
byhi.tech diagnostic centre
 
ERRORS IN OBTURATION and ITS PREVENTION.pptx
byBogdan Dimitriu
 
Hospital Housekeeping Inspection Checklist with eAuditor Audits and inspections
byeAuditor Audits & Inspections
 
Epistaxis.signs.symptoms.management.treatment
byhaniejaz902
 
20251022 Treasure Hunt - Deeping Participation.pdf
byInternational Society of Service Innovation Professionals
 
Monastic Academy - Focus On Societal Service
byMonastic Academy
 
Risk of Bleeding Complications With Different Peri Operative Antithrombotic R...
byAmeliyaSecil
 
CL 1--Sec 1-Pt. 3 Basic knowledge modi 1.pptx
byrecoverytechnyc
 
Futuristic Nursing: Advanced Nursing Practice (ANP)
byKANCHAN PRIYA SOY
 
Humanisation Antibody Therapy By Ilias Ahmed.pptx
byILIAS AHMED
 
How Many Ribs Does the Human Body Have.pdf
byThe Lifesciences Magazine
 
Acute Abdominal Pain.pptxAcute Abdominal Pain.pptx
byAddis53
 
Chapter 50 endocrine disorders general .pptx
byunique105
 
Presentation - Professional Skincare (1).pdf
byDrishti Barua
 
November 4 NYS BRSS training-Peer Supervision Organizational Change ETHICS ...
byrecoverytechnyc
 
bronchiolitis-power point presentation by
byUmmuNahyan
 
CVD PPT Medical Terminology March 2022.pptx Chapter_05_Medical_Terminology (1...
byssuserd131ec
 
CONCEPT HEALTH- HEALTH LITERACY AND DISEASE –DECISION MAKING IN HEALTH- EVIDE...
byTauseef Jawaid
 
Chapter 19 Basic immunology ppts DZ 2010.ppt
byyoannesbuti25
 
Presentation - Gym Supplements A Professional Guide.pdf
byriyanshuseo
 
BEST LABS IN KOCHI/BEST HOME BLOOD COLLECTION/BEST LAB IN KOCHI
byhi.tech diagnostic centre
 

Luting cements

  • 2.
    Presented By :- KrittikaKuhar 1st year MDS LUTING CEMENTS
  • 3.
    CONTENTS • INTRODUCTION • IDEALREQUIREMENTS OF LUTING CEMENTS • CLASSIFICATION • CEMENTS USED FOR LUTING -- Zinc Phosphate Cement -- Zinc Polycarboxylate Cement -- Zinc Oxide Eugenol -- Glass Ionomer Cement -- Resin Luting Agent • CONCLUSION • REFERENCES
  • 4.
    INTRODUCTION • Numerous dentaltreatments necessiate attachment of indirect restoration and appliances to the teeth by means of a cement. • The long- term clinical outcome of fixed prosthodontic treatment depends on the use of adhesives that can provide an impervious seal between the restoration and the tooth.
  • 5.
    DEFINITIONS • Cement Substance that hardens to act as base , liner , filling material , or adhesive to bind devices or prosthesis to tooth structure or to each other. (Anusavice 11th Edition) • Cementation  Attaching a restoration to natural teeth by means of a cement . (GPT-9) • Luting Agent  any material used to attach or cement indirect restorations to prepared teeth. (GPT-9)
  • 6.
    REQUIREMENTS OF LUTING CEMENT Adhesion to restorative material  Adequate strength to resist functional forces  Lack of solubility in oral tissues  Low film thickness  Biocompatibility with oral tissues  Radio-opaque  Anti-cariogenic properties  Relative ease of manipulation  Esthetic / color stability An ideal luting cement should have physicomechanical properties resembling those of dentine.
  • 7.
    CLASSIFICATION • ISO classification( BASED ON INGREDIENTS) Water-based cements Zinc phosphate, glass ionomer, etc. Oil-based cements ZOE and noneugenol cements Resin or polymer-based cements Resin cements, compomer, etc.
  • 10.
    • Classification ofcements based on application (ISO 9917-1:2007)* a. Luting b. Bases or lining c. Restoration
  • 11.
    BONDING MECHANISM • Accordingto Schillinburg , the cement , tooth surface and prostheses interface bonding mechanism can be divided into 3 types :-  Non Adhesive ( mechanical )  Micromechanical  Molecular
  • 12.
    NON ADHESIVE (MECHANICAL) •The luting agent served primarily to fill the gap and prevent entrance of fluids. • It holds the restoration in place by engaging small irregularities on the surfaces of both tooth and restoration • Exhibits no adhesion on the molecular level. • For eg Zinc Phosphate • The nearly parallel opposing walls of a correctly prepared tooth make it impossible to remove the restoration without shearing or crushing the minute projections of cement extending into recesses in the surfaces.
  • 13.
    The crown canbe removed only along the path (large arrow) determined by the axial walls of the preparation. Cement extending into small irregularities of the adjoining surfaces {shown magnified in the two large circles) prevents removal along any path more vertical than the sides of the irregularities (small arrows).
  • 14.
    MICROMECHANICAL BONDING The deepirregularities necessary for micromechanical bonding can be produced on enamel surfaces by etching with a phosphoric acid solution or gel21, on ceramics by etching with hydrofluoric acicF; and on metals by electrolytic etching, chemical etching, sandblasting, or by incorporating salt crystals into the preliminary resin pattern. Resin cements have tensile strengths in the range of 30 to 40 MPa, which is approximately five times that of zinc phosphate cement. When used on pitted surfaces, they can provide effective micromechanical bonding
  • 15.
    Composite resin cementshold the restoration to the tooth by penetrating into deep and small surface pits.
  • 16.
    MOLECULAR ADHESION • Molecularadhesion involves physical forces (bipolar, Van der Waals and chemical bonds (ionic, covalent) between the molecules of two different substances. • Newer cements, such as polycarboxylates and glass ionomers, possess some adhesive capabilities, although this is limited by their relatively low cohesive strength. They still depend primarily on nearly parallel walls in the preparation to retain restorations.
  • 17.
    True adhesion isthe molecular attraction exerted between the surface of bodies in contact.
  • 18.
    ZINC PHOSPHATE CEMENT One of theoldest cements Introduced by Dr Otto Hoffman in 1877
  • 19.
    • APPLICATIONS 1. Lutingof restorations (inlays, crowns, fixed dental prostheses, etc.) 2. High strength bases. 3. Temporary restorations. 4. Luting of orthodontic bands and brackets. • CLASSIFICATION ISO 9917-1:2007 designates them as a. Luting (Maximum film thickness—25 μm) b. Bases and lining • AVAILABLE AS • •. Powder and liquid system. • •. Capsules of preproportioned powder and liquid.
  • 21.
    SETTING REACTION When thepowder is mixed with liquid, phosphoric acid attacks the surface of the particles and releases zinc ions. The aluminum in the liquid is essential for cement formation. The aluminum complexes with the phosphoric acid and the zinc ions to form a zinc aluminophosphate gel. The reaction is exothermic.
  • 22.
  • 23.
    MIXING TIME 1.5-2min (Philips) WORKING TIME 5 min (Philips) SETTING TIME 5-9 min (CRAIG) 5-14 min (O’BREIN) FILM THICKNESS TYPE 1 <25µm TYPE 2 <40µm FROZEN GLASS TECHNIQUE :- • To prolong working time and shorten setting time • Glass slab is cooled at 6 to -10 degree C • 50-75% more powder incorporation • Working time increased by 4-11 min • Setting time shortened by 20-40% • Due to increased P:L ratio , decreased solubility in oral fluids.  SLAKING THE FLUID
  • 24.
    • No chemicaladhesion • Low tensile strength • Post cementation sensitivity ( Resin based sealer / liner decreases casting retentive stress by 42% - Johnson et al , 2004) • High solubility in oral fluids 0.2% in 24 h  Marginal leakage. • Over 100 years of clinical experience • Longetivity. (27 fixed prosthesis that were in clinical service from 2 to 43 years) * • High initial strength • Adequate compressive strength • Low cost • Can be used in regions of high masticatory stress or long span prosthesis ADVANTAGES DISADVANTAGES *Margerit J, Cluzel B, Leloup JM, Nurit J, Pauvert B, Terol A (1996) Chemical characterization of in vivo aged zinc phosphate dental cements. J Mater Sci Mater Med 7:623–628
  • 25.
    • Ceramic inlay •Veneer resin bonded FPD • Low retentive preparations • •Metallic inlay/onlay • •Metal–ceramic feldspathic full crowns • •Metal prefabricated or customized post • •Partial fixed prosthesis • MOST PREFERRED FOR Implant supported crowns Multiple unit implant supported prostheses INDICATIONS CONTRAINDICATIONS Ladha K, Verma M. Conventional and contemporary luting cements: an overview. The Journal of Indian Prosthodontic Society. 2010 Jun 1;10(2):79-88.
  • 26.
    MODIFIED ZINC PHOSPHATECEMENT • FLUORIDE CEMENT Add stannous fluoride Higher solubility , lower strength • ZINC SILICOPHOSPHATE Zinc Phosphate + Silicate Higher strength , lower solubility Fluoride released , high film thickness 88µm Transluency
  • 27.
    • COPPER ContainingZinc Phosphate CEMENTS (not widely used) Copper (2-97%) was added to Zinc Phosphate cement , historically Pure Copper Phosphate cement  Teeth discoloration and toxic Not used  High acidity , High solubility and Low strength Indicated : deciduous teeth where it was not possible to remove all caries In cementation of cast silver cap splints-in facial fractures Silver cements contained small percentage of silver phosphate.
  • 28.
    POLYCARBOXYL ATE CEMENT • DENNISSMITH in 1968 • FIRST CEMENT WITH ADHESIVE BOND TO TOOTH STRUCTURE • ALSO KNOWN AS POLYACRYLATE CEMENT
  • 29.
    APPLICATIONS • Primarily forluting permanent restorations. • As bases and liners. • Used in orthodontics for cementation of bands. • Also used as root canal fillings in endodontics. • Cementing SS crown in Peadiatric Dentistry. • AVAILABLE AS •. Powder and liquid in bottles •. Water settable cements As precapsulated powder/liquid system
  • 30.
    INGREDIENT FUNCTION Zinc OxideBasic ingredient Magnesium Oxide Principal modifier , aids in sintering Oxides of Bismuth and Aluminum Small amounts Stannous Fluoride adjust the setting time, increase the strength, and enhance the manipulative properties COMPOSITION OF POWDER Liquid - water solution of polyacrylic acid or a copolymer of acrylic acid with other carboxylic acids, such as itaconic Acid. Molecular weight ranges from 30,000 to 50,000 Acid concentration 32-42%
  • 31.
    SETTING REACTION • Whenthe powder and liquid are mixed, the surface of powder particles are attacked by the acid, releasing zinc, magnesium and tin ions. These ions bind to the polymer chain via the carboxyl groups. They also react with carboxyl groups of adjacent polyacid chains to form cross-linked salts. • Structure of set cement The hardened cement consists of an amorphous gel matrix of zinc polyacrylate in which unreacted powder particles are dispersed.
  • 33.
    MECHANISM OF ADHESION •Chemical bond to tooth structure. • The polyacrylic acid bonds to calcium ions on the surface of enamel or dentin via Carboxyl group on the surface of enamel and dentin • Bond with Enamel (3.4–13.1 Mpa) > Dentin (2.07 MPa) • Weak bond with gold • No perceptible bond with porcelain • MIXING OF CEMENT P/L ratio is 1.5 by weight Non absorbent mixing surface eg glass slab Liquid dispensed just before the mixing (evaporates quickly) Cement must be used before it loses its glossy appearance indicating free carboxylic acid. No gloss - Cobweb
  • 34.
    INDICATIONS CONTRADICTIONS • CastCrown • PFM crown • Patient with previous history of sensitivity. • Pressed ceramic crown , ceramic inlay , ceramic veneer • Resin bonded FPD • Cast post and core • Crown or FPD
  • 35.
    • Relatively lower compressivestrength • Need for clean surface for adhesion • Short working time • Low Irritation • Chemical bond to tooth structure and alloys • Easy manipulation • Adequate strength • Low solubility • Adequate film thickness • Anticariogenic Advantages Disadvantages
  • 36.
  • 37.
    TYPES Type I zincoxide eugenol for temporary cementation. Type II zinc oxide eugenol cement for temporary restorations Type III zinc oxide eugenol— cavity liner (was previously Type IV).
  • 38.
    INGREDIENT WEIGHT %FUNCTION EUGENOL 85 Reacts with Zinc Oxide OLIVE OIL 15 Plasticizer LIQUID
  • 39.
    MANIPULATION POWDER: LIQUID- 4:1TO 6:1 by weight. • Measured quantity of powder and liquid is dispensed onto a cool glass slab. • Powder is incorporated in liquid • Spatulated in circular motion.. • It exhibits pseudo-thickening. • For temporary restorations a thick putty-like consistency is recommended. • TWO PASTE SYSTEM • Equal length of each paste are dispersed and mixed until the uniform colour is observed.
  • 41.
    Advantages Disadvantages • idealpulp compatibility ( obtudent and sedative effect on pulp) • good initial adaptation to cavity walls • lower solubility in most acids • low compressive strength • poor resistance to abrasion and disintegration • continued loss of eugenol by fluid extraction. As such, pure ZOE is not suitable as a permanent luting agent. Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17.
  • 42.
    MODIFIED ZINC OXIDEEUGENOL CEMENTS • EBA-ALUMINA MODIFIED CEMENTS A part of the liquid is substituted by orthoethoxy benzoic acid (EBA) . Alumina is added to the powder. • Rigidity of Alumina is more than that of fused quartz . • Reinforcing aluminium oxide by substitution of fused quartz :- Mixing properties and compressive strength improved Film thickness reduced. Tensile strength in same range as Zinc Phosphate ADVANTAGES DISADVANTAGES Palliative to pulp Good initial adaptation Exhibit compressive and tensile strengths in the same ranges as ZnP. Poor resistance to abrasion and disintegration Continual loss of eugenol by leaching Questionable long-range clinical performance.
  • 43.
    GLASS IONOMER CEMENT Generic nameof group of materials that use silicate glass powder and an aqueous solution of polyacrylic acid. Biomimetic Developed in 1970s by Wilson and Kent
  • 44.
    • The GICsare classified below: Type I: Luting crowns, bridges, and orthodontic brackets Type IIa: Esthetic restorative cements Type IIb: Reinforced restorative cements Type III: Lining cements, base
  • 45.
    COMPOSITION POWDER INGREDIENT WEIGHT % SILICA41.9 ALUMINA 28.6 ALUMINIUM FLURIDE 1.6 CALCIUM FLUORIDE 15.7 SODIUM FLUORIDE 9.3 ALUMINIUM PHOSPHATE 3.8 The powder is an acid-soluble calcium fluoroaluminosilicate glass Lanthanum, strontium, barium or zinc oxide additions provide radiopacity
  • 46.
    LIQUID COMPONENT FUNCTION Polyacrylic acidin the form of copolymer with itaconic acid, maleic acid and tricarballylic acid Copolymerizing with itaconic, maleic acid, etc. tends to increase reactivity of the liquid, decrease viscosity and reduce tendency for gelation Tartaric acid (5% by mass) Improves the handling characteristics, increases working time and shortens setting time. WATER Water is the most important constituent of the cement liquid, it is the medium of reaction and it hydrates the reaction products. The amount of water in the liquid is critical. Too much water results in a weak cement. Too little water impairs the reaction and subsequent hydration
  • 47.
  • 48.
  • 49.
    Mixing with astiff spatula on non absorbant pad. 2 increments. First increment is mixed for 5-10 sec subequent increment. Total mixing time should not exceed 30-40 sec Glossy finish – residual polyacid for adhesion Dull mix : reduced adhesion. DISCARDED.
  • 50.
    SETTING TIME- •Type 1-4 to 5 mins •Type 2- 7 mins SURFACE PREPARATION- •The tooth should be cleaned for effective adhesion. • A pumice slurry is used to remove the smear layer. •Conditioning:- with 10% polyacrylic acid or 37% phosphoric acid for 10-20 seconds. •Rinse with water for 20 seconds. •After rinsing the preparation the surface should be dried but not dessicated and it should remain uncontaminated by saliva or blood.
  • 51.
    • •Initial solubility(1.25% wt) • •Sensitivity to humidity • Post-op sensitivity (Woznaik 1984) esp with anhydrous freeze dried polyacid (Simmons 1986) • Friendly handling • •Fluidity • •Adhesion to tooth structure and metals • •Fluoride release and uptake • •Adequate translucency • •Adequate strength (85MPa for luting) • •Relative low cost ADVANTAGES DISADVANTAGES
  • 52.
    • Intraradicular posts ••Partial fixed prosthesis in areas of high occlusal load • Class 2 and 6 cavities , lack fracture toughness. • Metallic crowns • •Metal–ceramic crowns • •High strength metal- free crowns (alumina and zirconia) INDICATIONS CONTRAINDICATIONS
  • 53.
    HYBRID IONOMER CEMENT •Self cure or light cure ( or resin modified glass ionomers are present for cementation ) Composition The powder contains: • Radioopaque fluroaluminosilicate glass • Photo-initiators or Chemical initiators or both • Polymerizable resin • Micro encapsulated potassium persulphate • Ascorbic acid as catalyst The Liquid contains: • Aqueous solution of Polycarboxylic acid modified with pendant methacrylate group • Tartaric acid • 2 , hydroxyethyl methacrylate monomers (HEMA)
  • 54.
    SETTING REACTION • Settingincludes both polymerization and acid-base reaction. The initial setting occurs by polymerization of the methacrylate groups giving it a high early strength. • Polymerization may be light cured or chemical cured depending on the type of cement. • Subsequently the acid-base reaction sets it thereby completing the setting reaction and giving the cement its final strength. • Working time >2.5 min • Setting time about - 5 min from placement (depends on brand)
  • 55.
    MECHANISM OF RETENTION •Several RMGI systems (e.g. RelyXTM Luting Cement and RelyXTM Luting Plus Cement, 3M ESPE) do not require any etching, priming or conditioning of the tooth and thus can be considered as self-adhesive cements. Others, such as AdvanceTM (Caulk/Dentsply) and FujiTM CEM or FujiTM Plus (GC Dental), suggest the use of additional conditioning agents. • Adhesion is a combination of 2 factors :- • the modification of the dentinal smear layer and interpenetration of the dentinal tubules by the fluid cement followed by polymerization and entanglement with collagen fibers; • • ionic reaction of the polycarboxylate with the calcium ions of hydroxyapatite
  • 56.
    APPLICATION • Restoration ofClass I, III or V cavities. • Bases and liners. • As adhesives for orthodontic brackets. • Cementation of crowns and FDPs. • Repair of damaged amalgam cores or cusps. • Retrograde root filling. (Uses vary according to brand.)
  • 57.
    • Less biocompatible comparedto GIC • Hygroscopic expansion (HEMA) • High solubility (4 times in lactic acid as GIC) CONTRAINDICATIONS • Metal-free ceramic restorations, susceptible to erosion • •Intraradicular post • Fluoride release similar to GIC • •Improved compressive and diametral strength INDICATIONS • Metallic restorations • •Metal–ceramic , FPD , GIC core build up , amalgam , composites ADVANTAGES DISADVANTAGES
  • 58.
    • The termCompomer is derived from composite and GIC • Fluoride releasing ability of conventional GIC and durability of composite. COMPOMER
  • 59.
    COMPOSITION • Compomers forluting purposes are available as a two component system, either powder/liquid or as two pastes • Powder: strontium aluminofluorosilicate, metallic oxides, chemical-activated and/or light-activated initiators. • Liquid: polymerizable methacrylate/carboxylic acid monomers, multifunctional acrylate monomers, water
  • 60.
    PROPERTIES • Tensile strength, flexural strength and wear resistance of compomer is superior. • Glass ionomer cement but less effective than resin composites. • Cementation of metal prostheses • Hygroscopic expansion – all ceramic veneers(C/I)
  • 61.
    RESIN CEMENTS • Lowviscosity composite materials with filler distribution and initiator content adjusted to allow for a low film thickness and suitable working and setting time. • ISO specification 4049 (2009) classifies resin cement as :- CLASS 1 – Self Cured CLASS 2 – Light cured CLASS 3 – Dual Cured (most commercially used)
  • 62.
    COMPOSITION • High molecularweight molecules like Bis-GMA , UDMA and Bis-EMA are combined with smaller molecules DEGDMA , TEGDMA  High conversion and low volumetric shrinkage. • Filler (30-66%) contains silanted radiopaque glasses such as barium , strontium , zirconia with silica particles . Avg filler size 0.5-8 micrometers. • Camphorquinone and tertiary amine – Initiate light activated reaction • Self cure activator – Benzoyl peroxide
  • 63.
    MANIPULATION • use ofdental bonding agents is essential to obtain adequate bond strength of the cement to the tooth structure. • the use of an etchant, e.g. 37% phosphoric acid gel • moisture control is critical. • surface of the prosthetic device also has to be prepared by sand-blasting or chemical treatments, e.g. with a silane primer. • Working time is 2–4 min while set time is 5–10 min • It is very important to clean up the cement within the window of time specified by the manufacturer, otherwise the cement sets very hard and the excess is extremely difficult to remove.
  • 64.
    PROPERTIES • Compressive strength: 180 MPa (26000 Psi) • Tensile strength : 30 MPa (4000 Psi) • Film thickness : 10–25 μm • Biological properties : Irritating to the pulp. Pulp protection with calcium hydroxide or GIC liner is necessary for areas close to the pulp. • Solubility : Insoluble in oral fluids. • Polymerization shrinkage :Ishigh • Adhesion properties : They do not adhere to tooth structure, which may lead to microleakage if used without etching and bonding. • Bond strength to enamel : 7.4 MPa (1070 Psi). Bond strength to enamel is usually strong. • Failure most often occurs at the metal-resin interphase.
  • 65.
    SELF ADHESIVE RESINCEMENTS • Combining advantages of GIC ( adhesion and fluoride release) with mechanical properties of Resin cements. • Presented as 2 paste or powder and liquid.
  • 66.
    INDICATIONS • Cementation ofcast • Single alloy restoration and bridges • Ceramic metal crown and bridges • Ceramic (except veneers) • Indirect Composite restoration • Prefabricated posts • High Strength Ceramics
  • 67.
    PROPERTIES • Higher cytotoxicitythan resin cements and acid-base cements • Flexural strength – 50-100 Mpa • Compressive strength – 200-240Mpa • Film thickness – 15 and 20 micrometer • Bonding mechanism with tooth :- Micromechanical Interlocking and chemical Interaction between acidic groups and hydroxyapatite • Fluoride content is low (10%) and its beneficial effects have not been clinically proven.
  • 70.
    CONCLUSION • No singleluting agent is ideal in all the clinical situations. • Several new materials are available differing each other in content and physical attributions. Therefore it may be difficult to the dentist to make a choice amongst so many alternative products. Each luting agent has different physical, mechanical and biological characteristics resulting from its chemical structure. So, to achieve a clinical success, the clinician should be aware of the qualities, advantages and disadvantages of each type of cement.
  • 71.
    REFERENCES • Anusavice KJ,Phillip’s Science of Dental Materials, WB Saunders Co., Philadelphia, 2003, 11th Edition, 443-493. • Sakaguchi RL, Powers JM, Craig’s Restorative Dental Materials, Elsevier, Mosby, Philadelphia, 2011, 12th Edition, 327-348. • Herbert T. Schillinberg – Fundamentals of Fixed Prosthodontics – 3rd Edition • Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17. • Ladha K, Verma M. Conventional and contemporary luting cements: an overview. The Journal of Indian Prosthodontic Society. 2010 Jun 1;10(2):79-88.
  • 72.
    • Petrich A,VanDercreek CJ, Kenny CK. Dental luting cements. Clinical Update (National Naval Dental Center). 2004 Mar;26:31-2. • Going RE, Mitchem JC. Cements for permanent luting: a summarizing review. The Journal of the American Dental Association. 1975 Jul 1;91(1):107-17 • Margerit J, Cluzel B, Leloup JM, Nurit J, Pauvert B, Terol A (1996) Chemical characterization of in vivo aged zinc phosphate dental cements. J Mater Sci Mater Med 7:623–628 • Mitra SB. Dental cements: formulations and handling techniques. InDental Biomaterials 2008 Jan 1 (pp. 162-193). Woodhead Publishing.