DENTAL MATERIAL 302

CHAPTER EIGHT
DENTAL CEMENT
BY
DR: MOHAMED MESAED
MOBILE: 01007060099
YEAR: 2022
 Cement
- Definition: Ceramic material bonded by ionic bond consist of two components mainly (P/L) or hard and brittle materials set
intraorally and commonly used to join a tooth and indirect prosthesis
- Ideal requirement of cements:
- (I) Biological effect:
- None irritant, none toxic – biocompatible - bacteriostatic in cavity with residual caries - Obtunding - sedative - palliative
- Thermal insulation to protect pulp from thermal shock or from temperature change under large metallic restoration (amalgam)
or heat liberated by light activated composite resin.
- Chemical insulation or protection to protect pulp from harmful chemical compound e.g. residual monomer in composite resin.
- Electrical insulation or protection to protect pulp from galvanic effect under metallic restoration (Amalgam – gold)
- Fluoride to protect against caries (Anticariogenic) (Inhibit bacterial activity)
- (II) Solubility: - Low solubility in oral fluids or saliva because lead to marginal leakage – losing restoration – recurrent caries
- (III) Mechanical properties: - Sufficient or adequate strength to withstand stress
- (IV) Optical properties: - Depend on purpose for cement uses (Radio-opaque in x-ray – mimic tooth structure)
- (V) Bonding: - Ideally Chemically bond with tooth structure but not to dental instruments.
- Uses of dental cements:
1. Luting or cementing agents: - Requirement of luting materials:
A. The setting characteristics: - low viscosity to allow flow of cement - If high restoration incompletely seat.
B. Film thickness: - low film thickness 25µ
- The film thickness depends on: Particle size of powder - P/L ratio - Viscosity of liquid - Amount of force applied to a
restoration during cementation.
C. Retention or bonding:
- Enters microscopic roughness in tooth and restoration surfaces (mechanical retention).
- Retention may be chemically to tooth surface and restoration e.g. (zinc polycarboxylate cement - glass ionomer cement - ARC)
D. Solubility: - Low solubility rate because margins are often exposed to oral fluids
2- Cavity bases: Protect pulp from thermal, chemical and electrical irritation- applied in thick layer about 1-2mm.
3- Cavity liners: a thin layer (0.2-1mm) to seal dentin on floor of cavity from bacteria or irritants from restorative material.
E. Compatibility of bases and liners:
- Compatible with filling material and tooth structure - not have any effect on setting characteristics or properties of filling
4. Restorative materials: in non-stress bearing area e.g. class III & V.
5. Root canal sealer: - Biocompatible - Resist dissolution – Radiopaque - forced into warm moist root canal.
6. Pulp capping. 7. Periodontal dressing. 8. Gingival tissue pack. 9. Temporary restoration. 10. Temporary cementation.
11. Orthodontic cements: - low viscosity - low film thickness - Rapid setting to avoid change of bracket position - Good bond
with both enamel and materials of band and bracket

1
 - Classification of cements:
(I) - According to mean or mechanism of setting or reaction:
1. Acid – base reaction or conventional types:
A. Zinc oxide and eugenol cement (ZOE). B. Zinc phosphate cement (ZPC)
C. Zinc polycarboxylate cement or polycarboxylate cement (PCC) or (ZPCC). D. Glass ionomer cement (GIC)
E. Resin modified glass ionomer cement
2. Free radical addition polymerization: Resin cement – Self-adhesive resin - Compomer (Polyacid modified composite resin)
3. Dual cure: - Acid base reaction and free radical addition polymerization - Example: Resin modified glass ionomer cement
(II) - Dental cements are generally classified according to their main chemical ingredients into:
- I. Cements based on Zinc oxide - II. Cements Based on Aluminosilicate glasses (ion leachable glasses)
- III. Resin cements - IV. Others (Cavity liner like Ca(OH) 2 or varnish)
(III) – Cement based on zinc oxide powder:
- Zinc oxide powder is opaque (Chalky like appearance) – none esthetic – anti-inflammatory – bacteriostatic
1. Zinc oxide and eugenol cement (ZOE):
- Application or uses:
- Temporary filling – Temporary cementation – liner – sub base – endodontic sealer – surgical pack and periodontal pack
- Setting reaction
- Set cement (cored structure of unreacted Zno particles imbedded in cohesive amorphous matrix zinc eugenolate)
- Setting time: (Long setting time) water – humid – warm - heat accelerate reaction (Body temperature) (Glycerin delay
reaction)
Manipulation: Powder and liquid in glass slap with S.S spatula
- Properties of ZOE:
- Mechanical properties:
A- Compressive strength: - Low strength in all cements
B- Tensile strength: - It is a brittle material. (Low tensile strength)
C- Film thickness: - 40 microns (µm)
-Solubility: - High solubility
-Bonding: - Mechanical interlocking
- Biocompatibility:
- G.R: ZOE cement is biocompatible? - neutral pH and free eugenol have a sedative effect on pulp also bacteriostatic.
- Optical properties: - Opaque not used with all ceramic crowns
- Setting reaction: - Acid base reaction (Chelation reaction) (Crabs Claws) (One zinc in center attached to two claws of eugenol)
- N.B: Water is essential for setting reaction of zinc oxide and eugenol cement
- G.R. water is essential for setting reaction of zinc oxide and eugenol cement or impression? - Because water is essential
for ionization of zinc oxide powder - Zno + H2o Zn (OH) 2 Zn (OH) 2 + eugenol Zinc eugenolate
- Mode of presentation: - P/L form or ratio - Ready-made paste (Temporary filling) – Two paste when used as impression
- Type I: Temporary luting – Type II: Permanent cementation (Modification like EBA or RBC

2
– Type III: Temporary filling and thermal insulating base – Type IV: Intermediate fillings
G.R: ZOE is contraindicated to be used as base under composite? - Because eugenol will inhibit polymerization reaction of -
composite also produce discoloration
G.R: ZOE is contraindicated to be used as base under amalgam? - Because it has low mechanical properties or strength and -
low E (Elastic modulus) will not withstand condensation force of amalgam
:Modification of zinc oxide and eugenol cement (ZOE) or method of reinforced of (ZOE) -
:We have two types -
Resin modified ZOE (RBC) or polymer reinforce ZOE: - Resin (PMMA 20% or 30%) added to powder (Increase strength) .1
Ethoxy benzoic acid (EBA): - Weak part from eugenol so replaced by more strength acid (EBA) (Make the matrix .2
semicrystaline) with 20% alumnia with powder (Increase strength)
Uses of both: - Base under amalgam – Permanent cementation – temporary filling -
zinc eugenol free cement (None eugenol cement): Eugenol replaced with carboxylic acids to react with zinc oxide particles .3
:Zinc phosphate cement (ZPC) .2
- Application or uses:
1- Cementation of cast restoration. 2- Cement base under metallic restoration (Specially amalgam)
3- Temporary filling materials for six month
- Composition:
A- Powder: 1- Zinc oxide (90%). B. Liquid: 1. Phosphoric acids 40%
2-Water 33%: - Controls rate of ionization of acid which control rate of reaction.
- Increase water ratio –rapid reaction and short setting time - Decrease water ratio –slow reaction and long setting time
- Setting reaction:
- Exothermic reaction
- Set cement (cored structure of unreacted Zno particles imbedded in cohesive amorphous matrix zinc alumino-phosphate)
- Setting time: (Short setting time)
Manipulation:
- Increment by increment should be incorporated into liquid - Slowly on a cooled glass slab
- Mixed should be done by long S.S spatula over large area to dissipate heat evolved from setting reaction.
- Factors affecting working & setting time:
1-Powder / liquid ratio: Decrease P / L ratio leads to increase working and setting time while this will lead to:
- Decrease in compressive strength - Lowering initial pH of cement.
2- Rate of powder incorporation:
- Introduction of small quantity of powder into liquid increases working and setting times by reducing amount of heat generated
3-Temperature of mixing slab: - Cooling glass slab retard setting reaction.
- While cooling glass slab below or at dew point may increase water into mix then reduce mixing time.
- Mixing over large area help to dissipate heat of reaction therefore increase setting time.
4-Water content of the liquid: - Increases water content accelerates setting reaction then decrease setting time.
5-Particle size: Fine particle size the faster the reaction then decreases setting time.

3
- N.B: - Care of liquid:
- Bottle should be closed after each use (To avoid loss or take of water).
- Evaporation of water from remaining liquid around neck of bottle results in crystallization
- These crystals may contaminate remaining.
- Properties of ZPC:
1-Viscosity:
A-Thin consistency: - It can be used for cementation of crowns and bridges. (One-inch test by follow spatula 2-3 cm up)
B-Thick consistency: - It can be used as thermal and chemical insulator (cement base) and temporary restoration.
- Mechanical properties:
A- Compressive strength: - (High strength) (The highest compressive strength in all cements)
B- Tensile strength: - It is a brittle material. (Low tensile strength)
C- Modulus of elasticity: - The Highest E so the least thickness – rigid or stiff cement) - 25 microns (µm)
-Solubility: - Solubility is depends on the P/L ratio, thick mix show little solubility than thin mix. (Low solubility)
-Bonding: Mechanical interlocking
- Thermal and electrical conductivity: Good insulator
- Biocompatibility or biological effect:
- It may produce pulp irritation and it is depending on:
- Freshly mixed cement = 2 - 1 hour = 6 - 48 hours = 7 (Severe pulp irritation)
- Therefore, in case of deep cavity pulp should protected by a layer of calcium hydroxide cement.
- Optical properties: - Opaque not used with all ceramic crowns
- Setting reaction: - Acid base reaction (transient pain with cementation subside by few minutes)
- Mode of presentation: - Powder/Liquid form or ratio
3. Zinc polycarboxylate cement (ZPCC or PCC):
- Application or uses:
1- Cementation of crowns and inlays (luting permanent restoration for metal).
2- Bases under restorations. 3- Cementation of orthodontic brackets.
- The first dental cement to exhibit chemical bonding to teeth.
- Mode of presentation: A - Powder/Liquid form or ratio B - Pre-proportioned capsules (P/L) mixed by mechanical mixer
C - Water settable or anhydrous: - Freeze dried powder and liquid mixed by distilled water
- Liquid having a molecular weight – viscous like honey
- Setting reaction
- Set cement (cored structure of unreacted Zno particles imbedded in cohesive amorphous matrix gel of polycarboxylate)
- Setting time: (Short setting time)
Manipulation:
- The mixed cement should not be used if it lost the glossy surface because loss of surface gloss indicates:
- initial setting of the cement and absence of free carboxylic groups necessary for adhesion.

4
- In addition the film thickness becomes too great to seat a restoration completely
- Properties of PCC:
1-Viscosity:
- 1:1 is a thin mix used for cementation
- 2:1 is a thick mix used as a base.
- The mixed cement is pseudoplastic i.e. viscosity decreases (flow increases) as shear rate increases, or in other terms, flow
increases as spatulation increases or as force is placed on the material.
- Mechanical properties:
A- Compressive strength: - (High but less than ZPC)
B- Tensile strength: - It is a brittle material. (Low tensile strength) (The highest tensile strength in all cements)
C- Film thickness: - 25 – 45 microns or 35 (µm)
-Solubility: - Low solubility than ZPC
-Bonding: Chemical bonding by free carboxylic group with calcium of tooth (More enamel than dentin)
- Thermal and electrical conductivity: Good insulator
- Biocompatibility:
- The polycarboxylate cements are acidic but not as irritant as zinc phosphate:
- weaker acid than phosphoric acid - molecules too large - limits acid penetration into dentinal tubules
- Rapid rise of pH of mixed cement on setting to approach 5.5-6.
- Optical properties: - Opaque not used with all ceramic crowns
- Setting reaction: - Acid base reaction
(V) – Cement based on fluoro – alumino – silicate galss powder particles:
- F: anticariogenic – Al: gives final strength (Responsible for cross linking) – Si: glass esthetics – tooth color translucent
1 - Fluoro – alumino – silicate glass powder + Phosphoric acid produce silicate cement (History) (Discussed in composite)
2 - Fluoro – alumino – silicate glass powder + Polycarboxylic acid produce glass ionomer cement (ASPA) (Polyalkynoate)
4. Glass ionomer cement (GIC)
- Advantages:
- Translucent esthetics (luting for all crowns)
- Chemical bond.
- Releases fluoride (anticariogenic) and act as a bacteriostatic agent.
- Fluoride release makes material first choice for cementation of orthodontic bands and restoration for childs
- Uses: - Base – liner – restoration (Filling) – luting for all crowns – pits and fissure sealant
- N.B: Used in class V or III restoration
- Bonding to tooth structure: - Chemical (Less than PCC because water sensitivity also both bond to enamel more than dentine)
- Optical properties: - Translucent (Esthetics)
- Film thickness: - 24 - 25 microns (µm)
- Solubility: High solubility if contaminated with water
- Mechanical properties: - Brittle (high compressive and have low tensile) equal or less ZPC

5
- Setting reaction: - Acid base reaction
- Setting time: - Long setting reaction take 24 h after gelation stage by Ca ++ (Initial setting) to reach final strength need
aluminum (Al+++) so can loss from the cement and cannot complete the reaction (Aluminum responsible for hardening and final
strength – cross linking) so should cover by varnish – Second problem high water sensitivity (Disadvantage)
- Stages of setting: (Dissolution – Migration & gelation – Precipitation & hardening)
- Role of water: Reaction medium so increase strength (Produce stable gel) – water contamination produce dissolution –
dryness produce cracks and reaction not completed
- G.R: Any conventional glass ionomer or any resin glass ionomer modification should cover by varnish or coating agent
or Vaseline resin coat or petroleum gel? Or Glass ionomer restoration should be coated immediately by varnish after
placement? - To prevent water evaporation or gain
- Microstructure: undissolved glass particles surrounded by silica gel embedded in an amorphous cross linked matrix of
hydrated calcium and aluminum poly salts containing fluoride.
- Biological properties:
1- mild effect on pulp in case of deep cavities, calcium hydroxide lining
2. Anticariogenic effect: due to Fluoride release.
- Mode of presentation: A - P/L form or ratio B - Pre-proportioned capsules C - Water settable or anhydrous
- Types of glass ionomer: - Type I: For lutting - Type II: As restorative - Type III: As liner or base - Type IV: Light cure
- G.R: Zinc poly carboxylate and glass ionomer cement should be use when the mix shows glossy or shiny appearance? Or
zinc poly carboxylate and glass ionomer cement should be discarding when the mix shows dull appearance? - Because
glossy appearance means it contain free carboxylic group bond chemically with tooth structure (Ca ++)
C - Modification of glass ionomer cement (GIC) or method of reinforced of (GIC):
:Metal reinforced glass ionomer cement .1
A. Miracle: - They first add Ag3Sn (ɤ) (Amalgam powder) + Conventional glass ionomer cement
Disadvantages: High solubility – corrosion - all bad from tin - None esthetics (Opaque) (Metal) – lower F release - rough -
B. Cermet (Ketac silver): - add silver (Most common) – palladium – gold – platinum + Conventional glass ionomer cement
Advantages: - Higher abrasion resistance than conventional glass ionomer cement - adhesive -
Disadvantages: - None esthetics (Opaque) (Metal) – lower fluoride release – Short setting time – no improve in strength -
:Resin modified glass ionomer cement or hybrid resin GIC .2
.Add HEMA (Hydroxyethyl methacrylate) which is usually added to the liquid -
.The acid base reaction plays a significant part of the reaction over the curing (polymerization) reaction -
Dual cure: (Acid base – light cure polymerization) -
.Triple cure: acid-base reaction - Light-cure polymerization of resin - Chemical-cure polymerization of resin –
:Compomer (polyacid modified composite resin) .3
.made by incorporating glass particles of GIC in water-free polyacid liquid monomer with appropriate initiator -
intermediate restoratives between glass ionomer and composite resin materials -
.The light curing reaction plays a significant part of reaction over the acid-base reaction -
They are used as anterior restorative materials -

6
.N.B. Polyacid modified resin composite materials are more related to composite resin rather than glass ionomer materials -
:Light curing glass ionomers have the following advantages over conventional types -
.Better optical properties - Less sensitivity to moisture after setting - Superior mechanical properties -
:Nanoionomer .4
Latest advancement in resin-modified glass ionomers is nanoionomer -
.Addition of nanoparticles improves polishability and optical properties - very high surface area so fluoride release increased -
:III- Resin cement
Typical composite (Organic matrix + Inorganic fillers) -
.A. Conventional resin cement: - Unfilled resin cement (Matrix only)
B. Filled or composite resin cement: - Organic matrix + Inorganic fillers
.Classification of composite resin cement: according to bonding mechanism -
:A- Conventional composite resin Cement (micro mechanical bonding) also according to cure
.i- Self cured composite resin. ii- Light cured composite resin. iii- Dual cured composite resin
:B- Self-adhesive Resin Cements or Phosphonate Cement
META or phosphonated group make chemical bond 4 -
Effect on pulp: - Mild pulp irritation should be preceded by Ca(OH)2 or GIC -
Advantages: - Insoluble in oral fluids – translucent (Esthetics) -
Disadvantage: - Polymerization shrinkage + Water sorption + need oxiguard or gel -
Mode of presentation: - Base + catalyst (Two paste) – Light cured (One syringe or paste) – Dual cure capsules -
Uses: - Base + Sub base with esthetics restoration (None metallic restoration) - Core builds up –luting for all crowns -
.The best cement (Adhesive resin cement) -
:IV others
:A- Cavity liner or sub base
:Calcium hydroxide (CaOH)2 -
Chemical insulator -
Advantages: - Alkaline (11 – 12) - Bactericidal effect -
Disadvantages: - Low mechanical properties - High solubility in oral fluids -
Uses: - Liner or sub base in deep cavities on base or floor of cavity and not at walls or margins (Chemical insulator) -
G.R: Direct and indirect pulp capping? - To enhance secondary dentin formation because it highly alkaline and bactericidal -
Mode of presentation: Suspension – chemically cured (Two paste) - light cured on resin carrier (One paste) -
:B- Cavity varnish
Solution of natural gum copal rosin or synthetic resin dissolved in volatile an organic solvent (Acetone – chloroform – ether) -
Uses: - On floor of cavity (horizontal) and axial walls to seal the dentinal tubules - decrease marginal leakage around amalgam -
Improve marginal seal under amalgam restoration – Reduce pulp irritation – Protect pulp chemically – Prevents penetration of -
corrosion products of amalgam – Prevent discoloration - Used to cover or coat GIC (Above not under)
Application: - Two thin layer -

7
Contraindicated: - Under composite (Inhibition of polymerization reaction) - Under CaOH (Inhibition of Ca ++ release) - -
Under GIC (Inhibition of fluoride ions release and prevent chemical bonding with tooth structure)
?S.N: Compare between types of cement -
Point of ZPC PCC ZOE GIC Resin cement
comparison
Presentation or P/L - P/L - P/L - P/L - Self cured -
:made od supply Water settable - Ready-made paste - Water settable - Light cured -
Capsules - (TF) Capsules - Dual cured -
Composition ZnO ZnO ZnO Glass particles Polymer and
:Powder monomer
:Liquid Phosphoric acid Polycarboxylic acid Eugenol Polycarboxylic acid Matrix and filler -
:Manipulation On cooled glass slap - Cooling powder - Glass slap or oil - Glass slap or special - On paper pad -
by increment mixed on glass slap resistant special paper pad and coating Light cure -
technique or special paper pad paper pad by varnish Both -
:Setting reaction Acid base reaction Acid base reaction Acid base reaction Acid base reaction Free radical
(chelation reaction) addition
polymerization
:Film thickness )Least film thickness ( or 35 45 -25 microns 40 microns 25 - 24 microns 25
microns 25 microns
Solubility and lower solubility lower solubility higher solubility High solubility (so Insoluble
:Disintegration should coated by
varnish)
Strength Brittle (high Less in compressive Poor mechanical Brittle (highest Sufficient strength
mechanical( compressive and low but slightly higher properties low compressive and have
:)properties tensile) in tensile than ZPC compressive and low tensile)
)high strength( )good strength( tensile strength (low )low strength(
)high E( strength)
Bonding Mechanical Chemical Mechanical Chemical Chemical
Optical Opaque opaque Opaque Translucent Translucent
properties
Biological pH of freshly mixed.1 Acidic, but not as- pH of set cement=7 - Mild effect on pulp.1 Mild effect on.1
properties or Cement low irritant as ZPC due so it has )neutral( so in deep cavities pulp so in deep
:effects ,after 48hrs=neutral - :to obtunding effect on sub-base of Ca(OH)2 cavities sub-base of
irritant effect on the.2 1.polyacrylic acid is the is placed under GIC to Ca(OH)2 or glass
pulp due weaker than pulp and prevent pulp irritation ionomer placed
To its initial acidity phosphoric acid bacteriostatic Anticariogenic.2 under resin cement
So in deep cavities 2.polyacid chains effect: inhibiting
sub-base of ZOE or are large and cannot secondary caries due
Ca(OH)2 is placed penetrate dentinal to presence of fluoride
under Zn-phosphate tubules 3.rapid rise
to prevent pulpal of pH
.Irritation 4.higher molecular
weight
:Microstructure Cored structure of - Cored structure of - Cored structure of - Cored structure of - Matrix and filler
unreacted ZnO unreacted ZnO unreacted ZnO unreacted glass bonding by
powder embedded in powder embedded powder embedded in particles surrounded coupling agent like
matrix of zinc in matrix of zinc matrix of zinc by silica acid gel composite
phosphate polycarboxylate eugenolate embedded in matrix of
cross linked multi-
poly ions
:Uses Base under amalgam Base under TF – temporary Base – liner – luting - Best luting agent
– long lasting restorations – cementation – liner – restoration and cement for
restoration – cementation of sub-base – esthetics and all
cementation of crown and inlays endodontic sealer ceramics crowns
metallic restoration – (luting agent)
cementation of post

8
:Spatula Stainless steel Plastic Stainless steel Plastic Plastic