Dental Cements

Chapter 45

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 Learning Objectives
Lesson 45.1: Dental Cements
1. Pronounce, define, and spell the key terms.
2. Discuss the classification of dental cements,
including the following:
• Describe the three types of luting cements.
• Differentiate between permanent and temporary
cements.
3. Discuss the variables that influence final
cementation.
4. List the five cements discussed in this chapter
and identify their similarities and differences.
5. Discuss the steps in cement removal.
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 Classification of Dental Cements

 Dental materials that are routinely used when

working with indirect restorations
 May be classified into three types according
to properties and intended use:
 Type I: Luting agents, which include permanent
and temporary cements
 Type II: Restorative materials, such as glass
ionomers
 Type III: Liners or bases placed within the cavity
preparation

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 Permanent Cements

 Permanent cement is used for the long-term

cementation of cast restorations such as
inlays, crowns, bridges, laminate veneers,
and orthodontic fixed appliances
 Once prepared in the laboratory, cast
restorations are delivered to the dentist for
the cementation appointment
 A luting agent must have qualities that do not
interfere with a proper fit

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Casting Ready to Be Cemented

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 Temporary Cements

 The temporary cementation of an indirect

restoration may be considered if:
 The dentist needs to remove the restoration at a
later date
 The tooth is sensitive or is exhibiting other
symptoms that might require removal of the cast
restoration
 Temporary cementation of provisional coverage is
required while the patient waits until the laboratory
technician completes the cast restoration

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Variables Affecting Final Cementation

 A number of factors can influence the actual

cementation of a luting cement
 Cementing errors can be the result of:
 Improper mixing technique and time
 Humidity
 Incorrect temperature of the glass slab

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 Mixing Time

 Follow the manufacturer’s directions

regarding a material’s exact mixing time,
working time, and delivery time
 Any delay between completion of the mix and
seating of the cast restoration will result in the
initial setting process, which could cause the
casting not to seat properly

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Guidelines for Mixing Dental Cements

 Before mixing, follow the manufacturer’s

directions
 Determine the use of the cement; then
measure out the powder and liquid according
to the manufacturer’s instructions
 Place the powder and liquid on the glass slab
 Divide the powder into increments
 Incorporate each powder increment into the
liquid; then mix thoroughly
 The mixing time per increment will vary according
to the type of material and its use
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 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
 Always dispense the powder first, then the
liquid, to minimize the loss of water from
evaporation
 Wait until it is time to mix the material before
placing it on the pad
 Do not set it out at the beginning of the
procedure

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 Powder-to-Liquid Ratio

 Incorporating too much or too little powder

will alter the consistency of the cement
 Fluff the powder in the bottle before
dispensing the powder in the measuring
scoop
 Always hold the bottle or vial upright to
ensure drops of consistent size when
dispensing the liquid

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 Temperature

 Specific types of material will have a chemical

reaction during the setting stage
 Zinc phosphate cement generates heat (an
exothermic reaction)
 It may be beneficial to cool a glass slab in the
refrigerator before mixing the cement
 Make sure to thoroughly wipe the slab dry
before dispensing the material so as not to
incorporate any moisture condensation into
the material

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 Types of Cement

 Selection of cement for a specific procedure

requires knowledge of the chemical and
physical properties of each particular type of
cement
 Glass ionomer cement
 Composite resin cement
 Zinc oxide–eugenol cement
 Polycarboxylate cement
 Zinc phosphate cement

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 Glass Ionomer Cement

 One of the most versatile types of cement

used in dentistry
 A hybrid of silicate and polycarboxylate cements
 Adheres to enamel, dentin, and metallic materials

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 Glass Ionomer Cement (Cont.)

 Supplied in special formulations according to

their use
 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 a liner and dentin bonding agent

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 Advantages of Glass Ionomer

 The slow release of fluoride from this powder

aids in inhibiting recurrent decay
 Causes less trauma or shock to the pulp than
is caused by many other types of cements
 Has a low solubility in the mouth
 Adheres to a slightly moist tooth surface
 Has a very thin film thickness, which is
excellent for ease of seating a casting
 Can be formulated for use as a dentin
substitute or base material

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 Chemical Makeup of Glass
Ionomer Cement
 Liquid: Polyacrylic acid copolymer and water
 Powder: Calcium fluoroaluminosilicate glass
with barium glass

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 Application of Glass Ionomer

 Available as a self-curing or light-cured

formula
 Supplied in bottles of powder and liquid,
which can be mixed manually on a paper pad
or a cool, dry glass slab
 Also supplied in premeasured capsules that
are triturated and expressed through a
dispenser

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 Premeasured Capsules

From Hatrick CD, Eakle WS: Dental materials: clinical applications for dental assistants and dental hygienists, ed 3, St Louis, 2016, Elsevier.

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 Composite Resin Cement

 A newer classification of cement material

designed for:
 Cementation of ceramic or porcelain inlays,
onlays, crowns, and bridges
 Cementation of ceramic veneers
 Direct bonding of orthodontic brackets
 Cementation of metal-based crowns and bridges

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 Chemical Makeup of Composite
Resin Cement
 These cements have physical properties
comparable with those of composite resins,
including:
 Thin film thickness
 Virtual insolubility in the mouth
 The tooth must be free of all plaque and
debris and must be prepared by etching or by
treatment with a bonding system before
cementation

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Application of Composite Resin Cement

 Supplied:
 As a powder and liquid mix
 In a syringe-type applicator as a base and catalyst
 In a versatile light-cured/dual-cured system
 Recommended portions of either application
are dispensed onto a paper pad and mixed
rapidly with a spatula

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Examples of Composite Resin Cements

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 Zinc Oxide–Eugenol Cement

 Eugenol has a soothing effect on the pulp

and is often used on patients when
postoperative sensitivity may be a concern
 Type I
 Lacks strength and long-term durability and is
used for temporary cementation or provisional
coverage
 Type II
 Has reinforcing agents added for the permanent
cementation of cast restorations or appliances

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Zinc Oxide–Eugenol Cement (Cont.)

 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

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Temp-Bond NE

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ZOE Type II Cement

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 Chemical Makeup of Zinc
Oxide–Eugenol Cement
 Liquid: Eugenol, water, acetic acid, zinc
acetate, and calcium chloride
 Powder: Zinc oxide, magnesium oxide, and
silica
 ZOE is one of the least irritating of all dental
cements
 The eugenol can have a strong odor and may be
offensive to some patients

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 Application of Zinc
Oxide–Eugenol Cement
 ZOE is mixed on an oil-resistant paper pad
that will not absorb any of the liquid
 Take care when using a eugenol product because
of its irritating qualities to the oral mucosa
 Try not to allow the liquid to come into direct
contact with tissue
 When a slower set is required, a glass slab
can be used
 The thickness of the mix is determined by the
powder-to-liquid ratio, as recommended by the
manufacturer

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 Polycarboxylate Cement

 This cement generally has been used as a

permanent cement for cast restorations,
stainless steel crowns, and orthodontic bands
 It also maintains its versatility as a nonirritating
base under composite and amalgam restorations
and as an intermediate restoration

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 Chemical Makeup
of Polycarboxylate Cement
 Liquid: Polyacrylic acid, itaconic acid, maleic
acid, tartaric acid, and water
 Powder: Zinc oxide, magnesium oxide,
aluminum oxide, and other reinforcing fillers
 Polycarboxylate cement is less irritating to the
pulp than zinc phosphate cement is, and the
pulpal reaction is similar to that of ZOE
cement

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Application of Polycarboxylate Cement

 Available in a powder and liquid form

 Liquid may be measured using the plastic
squeeze bottle or the calibrated syringe-type liquid
dispenser supplied by the manufacturer
 The liquid has a limited shelf life because it will
thicken as the water evaporates.
 Mixing is carried out on a nonabsorbent paper pad
 If it is necessary to increase the working time, a
cool, dry glass slab can be used

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Polycarboxylate Cement (Cont.)

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 Zinc Phosphate Cement

 Classified as two types

 Type I (fine grain)
 Used for the permanent cementation of cast
restorations such as crowns, inlays, onlays, and
bridges
• Creates a very thin film layer, which is necessary for an
accurate cementing of castings
 Type II (medium grain)
 Recommended for use as an insulating base for
deep cavity preparations

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Zinc Phosphate Type I Cement

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 Chemical Makeup of Zinc
Phosphate Cement
 Chemical makeup
 Liquid: 50% phosphoric acid in water, buffered
with aluminum phosphate and zinc salts to control
the pH
 Powder: 90% zinc oxide and 10% magnesium
oxide
 The phosphoric acid can be irritating to the pulp
 A liner, sealer, or desensitizer should be placed
first to reduce sensitivity to the phosphoric acid

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 Application of Zinc Phosphate

 The powder is divided into increments of

varying size, with each increment spatulated
before the next increment is added
 It is critical that the powder be added to the
liquid in very small increments
 This method dissipates the heat of the
chemical action and retards the setting of the
cement

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 Cement Removal

 Once the dentist has completed the cementation

procedure of an indirect restoration, the patient
is asked to bite down for a few minutes on a
cotton roll for the initial setting process
 Excess cement is removed from around the margins,
interproximal spaces, and adjacent areas covered
with excess cement
 If excess cement is not removed from in and around
the gingival margin and sulcus of the tooth, the
cement could irritate the area and cause
inflammation and discomfort

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Excess Cement

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Questions?

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