Biomaterials Lecture 2

General Requirements for Cements (from lecture 1)

- Safe to use around pulpal tissues
- Insoluble in the oral environment
- Provide adhesion if possible
- Antibacterial effect
- Obtundent effect (alleviates/removes the pain; beraye7); most materials don’t have this quality,
but this is for ideal materials

As a cement: (3 main rules)

1. Low film thickness (thickness of cement between crown and tooth)
Measured in micrometers (depends on viscosity; a high viscosity material doesn’t allow low film
thickness; adequate viscosity needed)
Ideal requirement: 25 microns; 25/1000 millimeters or 0.025mm; maximum acceptable thickness
is 40microns
To preserve and perfect the bite
To avoid compromised bond strength (yaane besir fi majel ynkeser lsen)
“The best cement is no cement”

2. Optical Translucency or Opacity (in case of veneers)

Ability to manipulate the cement
For example to cover dark stains or to preserve aesthetics

3. Adequate mechanical properties

Bond strength mainly / Sheer bond test [transverse direction] (microtensile bond test) / tensile
bond test [tip-to-tip] values in MPa (value varies for different brands)
Bond strength of enamel is always higher than that of the dentin because it’s more mineralized,
has more porosities and less water content than dentin

Having a cement that is self-adhesive / self-etch is also a new preferred quality for cements to ease the
process for the practitioner. This is not always a realistic/good thing to use, you need to follow all
bonding steps in some cases.

As a Cavity Liner: [film thickness should still be thin in this case]

1. Thermal Insulation (If you put amalgam on a cavity, you need to isolate the tooth thermally )
2. Chemical Insulation (to avoid harming tissues of the tooth)
3. Electrical Insulation (long ago gold and metals placed next to each other caused some sort of
electric current; not very relevant nowadays)
While working with veneers, it’s recommended to work with photo-cured cements (need LCU to be
cured) in order for you to take your time while placing the increments)
Regular Liners around 25-50micrometers
Simple Liners <25micrometer, around 1-4micrometer; it’s no longer a liner it’s called a varnish
Bases are thick, around 0.5-2millimeters; for more thermal isolation

As a Filling Material:
- Bonding (desirable quality) and prevention of marginal leakage
(Mechanical bonding; needing to etch and bond is a terrible quality that amalgam has, it doesn’t
stick to the tooth, it only sits in the certain converging preparation of amalgam cavity)

- Adequate mechanical properties especially good abrasion resistance (relatively high hardness
[resistance to abrasion])

- Adequate aesthetics if used in anterior region ( certain requirements for translucency and opacity)

- Minimal dimensional changes on setting and upon exposure to temperature fluctuation

(for example if you drink something hot, your tooth expands depending on the coefficient of
thermal expansion, and your filling also expands to fill all gaps and maintain proper bonding;
ideally an equal coefficient of expansion is needed between the tooth and restorative material)
Enamel and dentin have different coefficients

Classification According to Nature:

1. Oil based (zinc oxide eugenol [mn zahret l 2renfol; cloves])
2. Water based (zinc phosphate, zinc polyacrylate, glass ionomer [could slightly be resin based])
3. Resin based (com pomer, resin cements)
Mainly used: glass ionomer and resin cements. Zinc phosphate is also used a lot due to its affordable
price.

Zinc Oxide Eugenol (ZOE) Cements

- Smells like a dental clinic
Types:
1. Unmodified (unmixed, you get the materials and combine them)
2. Resin modified (still an oil based cement, but resin is added to improve mechanical properties)
3. Ethoxybenzoic acid-alumina modified (EBA)
Unmodified ZOE
- Powder
1. Pure zinc oxide (69%): main reactant
2. Rosin (30%): increases toughness (natural polymer, decreases brittleness and solubility; glue-
like substance secreted by trees)
3. Zinc acetate (1%): accelerator

- Liquid
1. Purified eugenol oil (85%): main reactant
2. Olive oil (15%): improves handling [improves tackiness/application]
Ratios should be mixed using their own proportioning devices (scoops/droppers) because they each have
certain proportions.
ZOE is one of the most soluble cements, that’s why rosin is important.
ZOE is a temporary/interim cement, it’s never used as a permanent cement/restorative material.

Reaction
- Zinc oxide + water = zinc hydroxide
- Zinc hydroxide + eugenol = zinc eugenolate (setting cement)
Zinc doesn’t directly result in ZOE. Therefore water is necessary for the initiation of the reaction

Applications
1. Temporary cementation of crowns
2. Temporary filling
3. Cavity liner in deep cavity preparation (permanent but outdated; ZOE and resin composites don’t
mix well, inhibition of polymerization occurs by reacting with free radicals; resin doesn’t
solidify)
4. RCT sealer (permanent)
5. Periodontal and surgical dressing (obtudant); soothes pain
6. Gingival retraction; retraction paste

Initiation of polymerization starts when curing (LCU) begins