1. Dental Cements Chapter 45
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2. Introduction
Dental cements are a classification of dental materials that are routinely used when working with indirect restorations.
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3. Classification of Cements
Type I
Luting agents which include permanent and temporary cements
Type II
Restorative materials such as glass ionomers
Type III
Liner or bases placed with the cavity preparation
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4. Luting Agent
Type I dental cements that act as an adhesive to hold together the casting to the tooth structure
Luting agents are designed to be either permanent or temporary.
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5. Fig. 45-1 Casting ready to be cemented
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6. Permanent Cement
For the long‑term cementation of gold and ceramic restorations such as inlays/onlays, crowns, bridges, veneers, and orthodontic fixed appliances.
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7. Temporary Cement
Temporary cements are used if the restoration would have to be removed due to sensitivity or other symptoms, and for the temporary cementation of provisional coverage.
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8. Variables Affecting Cements
Mixing Time
Before mixing, follow the manufacturer's directions
Measure the powder and liquid according to the intended use
Separate powder and the liquid to allow space for mixing
Divide the powder into increments.
When increment sizes vary, the smaller increments are incorporated first
Incorporate each powder increment into the liquid and then mix thoroughly
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9. Variables Affecting Cements-cont’d
Humidity
If warm or humid, premature exposure to these environments can create a loss of water from the liquid or addition of moisture to the powder.
Powder to Liquid Ratio
Incorporating too much or too little powder will alter the consistency.
Temperature
Some cements will have an exothermic reaction.
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10. Types of Cements Zinc-Oxide Eugenol Zinc Phosphate Polycarboxylate
Glass Ionomer
Composite Resin
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11. Zinc Oxide Eugenol Chemical Makeup
Liquid: Eugenol, H2O, acetic acid, zinc acetate, and calcium chloride.
Powder: Zinc oxide, magnesium oxide, and silica.
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12. Types of Zinc-Oxide Eugenol
Type I
Lacks strength and long‑term durability and is used for temporary cementation of provisional coverage
Type II
Has reinforcing agents added for the permanent cementation of cast restorations or appliances
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13. Fig Type I ZOE cement
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14. Fig Type II ZOE cement
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15. Supply of Zinc-Oxide Eugenol
Type I (Paste)
Supplied as a two‑paste system as temporary cement.
Pastes are dispensed in equal lengths on a paper pad and mixed.
Type II (Liquid/Powder)
Mixed on an oil‑resistant paper pad.
Mixing time ranges from 30 to 60 seconds.
Setting time in the mouth ranges from 3 to 5 minutes.
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16. Zinc Phosphate Chemical Makeup
Liquid: Phosphoric acid, aluminum phosphate, and water
Powder: Zinc oxide, magnesium oxide, and silica
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17. Types of Zinc Phosphate
Type I (fine grain)
Used for the permanent cementation of cast restorations such as crowns, inlays, onlays, and bridges. This material creates the very thin film layer necessary for accurate seating of castings .
Type II (medium grain)
Recommended for use as an insulating base for deep cavity preparations.
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18. Supply of Zinc Phosphate
Type I (Powder/Liquid)
Powder is divided into increments varying in size.
It is critical that the powder be added to the liquid in very small increments.
Cement must be spatulated slowly over a wide area of a cool, dry, thick glass slab to dissipate the heat.
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19. Fig. 45-5 Zinc phosphate cement
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20. Polycarboxylate Cements
Chemical Makeup
Liquid: Polyacrylic acid, itaconic acid, maleic acid, tartaric acid, and water
Powder: Zinc oxide
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21. Use of Polycarboxylate
Permanent cement for cast restorations, stainless steel crowns, and orthodontic bands
As a nonirritating base under both composite or amalgam restorations
As an intermediate restoration
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22. Supply of Polycarboxylate
Powder/Liquid
Liquid may be measured by using either the plastic squeeze bottle or the calibrated syringe‑type liquid dispenser.
Liquid has a limited shelf life because it thickens as its water evaporates.
Mixed on a nonabsorbent paper pad.
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23. Fig. 45-6 Polycarboxylate cement
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24. Glass Ionomer Chemical Makeup
Liquid: Itaconic acid, tartaric acid, maleic acid, and water
Powder: Zinc oxide, aluminum oxide, and calcium
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25. Types of Glass Ionomer Type I Type II Type III
For the cementation of metal restorations and direct‑bonded orthodontic brackets
Type II
Designed for restoring areas of erosion near the gingiva
Type III
Used as liners and dentin bonding agents
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26. Benefits of Glass Ionomer
Powder is an acid‑soluble calcium. The slow release of fluoride from this powder aids in inhibiting recurrent decay.
Causes less trauma or shock to the pulp than many other types of cements.
Low solubility in the mouth.
Adheres to a slightly moist tooth surface.
Has a very thin film thickness, which is excellent for seating ease.
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27. Supply of Glass Ionomer
Type I (Powder/liquid)
Mixed manually on a paper pad or a cool, dry glass slab.
Glass slab increases the working time of the cement.
Type I (Premeasured capsules)
Triturated and expressed through a dispenser.
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28. Fig. 45-7 Premeasured capsules of glass ionomer cement
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29. Composite Resin Chemical Makeup
Physical properties comparable to composite resins
Low film thickness (thinner in consistency compared to composite resins)
Insoluble in the mouth
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30. Uses of Composite Resin
Cementation of ceramic or resin inlays and onlays
Cementation of ceramic veneers
Cementation of orthodontic bands
Direct bonding of orthodontic brackets
Cementation of all metal castings
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31. Supply of Composite Resin
Powder and liquid mix
Syringe-type applicator
Base and catalyst
Light cure/dual cure system
Recommended portions of either application are dispensed onto a paper pad and mixed rapidly with a spatula
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32. Fig. 45-8 Examples of composite resin
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33. Cement Removal Operator Preparedness and Knowledge
Instruments selected for the procedure:
Explorer, mouth mirror, excavator
Use a fulcrum.
Use dental floss in and around the embrasure areas.
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34. Fig. 45-9 Excess cement to be removed
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