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Dental Cements Chapter 45 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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Presentation on theme: "Dental Cements Chapter 45 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved."— Presentation transcript:

1 Dental Cements Chapter 45 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

2 Chapter 45 Lesson 45.1 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

3 Learning Objectives  Pronounce, define, and spell the Key Terms.  Describe luting cements and differentiate between permanent and temporary cements.  Discuss the factors that influence luting cements. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

4 Introduction Dental cements are a classification of dental materials that are routinely used in the placement of indirect restorations. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

5 Classification of Cements  Type I  Luting agents, which include permanent and temporary cements  Type II  Restorative materials, such as glass ionomers  Type III  Liners or bases placed with the cavity preparation Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

6 Luting Agent  Type I dental cements act as adhesives to hold together the casting and the tooth structure.  Luting agents are designed to be either permanent or temporary. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

7 Fig Casting ready to be cemented. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

8 Permanent Cement Permanent cement is used in the long ‑ term cementation of gold and ceramic restorations such as inlays/onlays, crowns, bridges, veneers, and orthodontic fixed appliances. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

9 Temporary Cement Temporary cements are used if a restoration would have to be removed as a result of sensitivity or other symptoms, as well as for the temporary cementation of provisional coverage. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

10 Variables Affecting Cements  Mixing time  Before mixing, follow the manufacturer's directions.  Measure the powder and liquid according to the intended use.  Separate the powder and liquid to make space for mixing.  Divide the powder into increments.  When increment sizes vary, smaller increments are incorporated first.  Incorporate each powder increment into the liquid and then mix thoroughly. (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

11 Variables Affecting Cements (Cont’d) (Cont’d)  Humidity  Premature exposure to warm temperatures or humidity can result in 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 undergo an exothermic reaction. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

12 Chapter 45 Lesson 45.2 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

13 Learning Objectives  List the five cements discussed in this chapter and identify their similarities and differences.  Mix and prepare glass ionomer for cementation.  Mix and prepare composite resin for cementation.  Mix and prepare zinc oxide-eugenol for cementation.  Mix and prepare two-paste zinc oxide–eugenol (Tempbond) for temporary cementation. (Cont’d) (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

14 Learning Objectives (Cont’d) (Cont’d)  Mix and prepare polycarboxylate for cementation.  Mix and prepare zinc phosphate for cementation.  Remove cement from permanent and temporary cementations. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

15 Types of Cements Glass ionomer Composite resin Zinc oxide–eugenol Polycarboxylate Zinc phosphate Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

16 Glass Ionomer  Chemical makeup  Liquid: itaconic acid, tartaric acid, maleic acid, and water  Powder: zinc oxide, aluminum oxide, and calcium Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

17 Types of Glass Ionomer  Type I  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 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

18 Benefits of Glass Ionomer  Powder is an acid ‑ soluble calcium. The slow release of fluoride from this powder helps inhibit recurrent decay.  Glass ionomer causes less trauma or shock to the pulp than do many other types of cements.  Glass ionomer has a low solubility in the mouth.  It adheres to a slightly moist tooth surface.  It has a very thin film thickness, which is excellent for seating ease. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

19 Supply of Glass Ionomer  Type I (powder/liquid)  Mixed manually on a paper pad or a cool, dry glass slab (slab increases the working time of the cement)  Type I (premeasured capsules)  Triturated and expressed through a dispenser. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

20 Fig Premeasured capsules of glass ionomer permanent cement. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

21 Composite Resin  Chemical makeup  Physical properties comparable to those of composite resins  Low film thickness (thinner in consistency than composite resins)  Insoluble in the mouth Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

22 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. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

23 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 the use of a spatula. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

24 Fig Examples of composite resin cements supplied in variable systems. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

25 ZOE  Chemical makeup  Liquid: eugenol, H 2 O, acetic acid, zinc acetate, and calcium chloride  Powder: zinc oxide, magnesium oxide, and silica Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

26 Types of ZOE  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 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

27 Fig ZOE type I cement for temporary cementation. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

28 Fig ZOE type II cement for permanent cementation. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

29 Supply of ZOE  Type I (paste)  Supplied as a two ‑ paste system as temporary cement  Pastes dispensed in equal lengths on a paper pad and mixed  Type II (liquid/powder)  Mixed on an oil ‑ resistant paper pad  Mixing time of 30 to 60 seconds  Setting time in the mouth of 3 to 5 minutes Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

30 Polycarboxylate Cements  Chemical makeup  Liquid: polyacrylic acid, itaconic acid, maleic acid, tartaric acid, and water  Powder: zinc oxide Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

31 Use of Polycarboxylate  Permanent cement for cast restorations, stainless-steel crowns, and orthodontic bands  As a nonirritating base under both composite and amalgam restorations  As an intermediate restoration Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

32 Supply of Polycarboxylate  Powder/liquid  Liquid may be measured with the use of either a plastic squeeze bottle or a calibrated syringe ‑ type liquid dispenser.  The liquid has a limited shelf life because it thickens as its water evaporates.  Mixing is carried out on a nonabsorbent paper pad. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

33 Fig Powder and calibrated syringe of polycarboxylate cement. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

34 Zinc Phosphate  Chemical makeup  Liquid: phosphoric acid, aluminum phosphate, and water  Powder: zinc oxide, magnesium oxide, and silica Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

35 Types of Zinc Phosphate  Type I (fine grain)  This type is used for the permanent cementation of cast restorations such as crowns, inlays, onlays, and bridges. It provides the very thin film layer necessary for accurate seating of castings.  Type II (medium grain)  This type is recommended for use as an insulating base for deep cavity preparations. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

36 Supply of Zinc Phosphate  Type I (powder/liquid)  Powder is divided into increments of varying sizes.  It is critical that the powder be added to the liquid in very small increments.  The cement must be spatulated slowly over a wide area of a cool, dry, thick glass slab to dissipate the heat. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

37 Fig Zinc phosphate type I cement for permanent cementation. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

38 Cement Removal  Operator preparedness and knowledge  The procedure requires certain instruments: Explorer, mouth mirror, excavator Explorer, mouth mirror, excavator  Use a fulcrum.  Use dental floss in and around the embrasure areas. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

39 Fig Excess cement must be removed after the setting process. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.


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