Cement bases & Liners

Intended Learning Outcomes: ILO’ S

By the end of this chapter, the student should be able to:-

1- Recognize the ideal requirements for intermediary materials

2- Understand the principles of using intermediary materials.

3- Identify the types and classification of intermediary materials

 seals the dentinal tubules
and protect the dentin-
pulp organ

Enamel an effective thermal and

electrical insulator

is non-vital, non-porous
and non-permeable
 A good thermal insulator

is a viscoelastic substance that

provide safe transfer to stresses
Dentin

has protein rich dentinal fluid

dilute and neutralize
that act as an effective
the chemical irritant
buffering system

is a dynamic biological barrier that

can respond to biological insults
 Dentin
Thickness
Thermal, chemical,
biological and
mechanical
protective functions
of dentine
Type (1ry,
2ry, 3ry)
 Cavity preparation
Thermal irritation

Loss of enamel
Less thermal insulation

Deeper in dentin
More patent tubules, more permeability

Pulp approximation
High pulp irritation
 Electric

Thermal
Chemical
Dentin
substitute

Mechanical Biological
 Thermal

Restorative Chemical
material
Biological

Electric
Intermediary base material Resist degradation in the oral
environment

Should not affect the esthetics of

the RM

Easy to apply

Should not affect the setting

reaction of the RM
 Intermediary base material

Liners Cement bases

Liquid Thin
(Varnish) (Sub-base)
 Varnishes

e*Seal the dentinal tubules.

–Reduce leakage around a restoration.
–Act as a barrier to protect the tooth
from highly acidic cements such as zinc
phosphate.
Functions:
1- It seals dentinal tubules, so it reduces fluid flow
and hypersensitivity.
2- It reduces the irregularities of the prepared
surface this improving the adaptation of the
permanent restoration and decrease microleakage
space.
3- It prevents migration of metallic ions and
corrosion products into enamel and dentin thereby
reduces discoloration of teeth.
4- It does not prevent but rather reduce the
penetration of acid to the pulp.
Indications:-

Under amalgam restoration:

It prevents penetration corrosion products into
dentinal tubules, thus prevents amalgam blues, as well
as decreasing initial microleakage space

Under cast gold restoration:

When using Zinc phosphate cement in order to seal
tubules but it should be compatible with the luting
cement.
Contraindications:-

Under resin composite restorations:

• It will prevent mechanical interlocking of the resin
with the tooth structure
• The residual organic solvent in the varnish may
react with or soften the resin.

Under glass ionomer, resin modified glass ionomer

• Hinder the fluoride uptake from glass ionomer.
• Application process
–Applied with either a small disposable
microbrush or a cotton pellet.
–Thin coating of the varnish on the
walls, floor, and margin of the cavity
preparation.
–Apply a 2-3 coats.
 Dental Liners

• Dental liners provide a thin barrier that

protects the pulpal tissue from irritation
caused by electrical, chemical and biologic
element.
 Calcium Hydroxide
• Paste-paste
system for
hand
mixing.

• Syringe for
light curing.
 Calcium hydroxide Ca(OH)2

Increase
dentin
Stimulates thickness
odontoblast
High pH 11 to deposit
tertiary dentin
 Calcium hydroxide
Indications for use •
– Protects the pulp from chemical irritation
by its sealing ability.
– Stimulates the production of tertiary
dentin.
– Compatible with all types of restorative
materials.
• Application process
–Placed only on dentin.
–Placed directly over the deepest
portion of the preparation (indirect
pulp capping)
–Pinpoints exposure size (direct pulp
capping)
 Disadvantages

Weak No thermal Non

Soluble
mechanically insulation adhesive

Not to be
Needs a Easily Should be
placed
base for removed protected
directly
thermal during by a base
beneath
insulation placement or RM
amalgam
 Cement base
• A thick layer of cement (>0.75mm) is applied
under restoration to protect pulp against
injuries.
• The base should be strong enough to resist
the condensation force during the placement
of restoration.
• Well insulation ability
• Good sealing
 Cement bases
• Zinc Oxide\Eugenol
• Zinc Phosphate cement
• Zinc Polycarboxylate cement
• Glass ionomer
 Compositions of simple ZOE\Eugenol
• Powder
– Zinc oxide
– Rosin : reduce the brittleness of the set cement
– Zinc stearate : plastcizer
– Zinc acetate : improve strength
• Liquid
– Eugenol and olive oil
 Setting reaction
• Water accelerates the reaction
• Zinc eugenolate is easily hydrolized by
moisture
 Advantages
• Sedative to slightly inflamed pulp.
• Good initial sealing ability.
 Disadvantages
• Weak mechanical properties
• High solubility.
• Inhibit resin polymerization.

Therefore, contraindicated under

amalgam glass ionomer and resin
restorations.
 Zinc phosphate cement

PRESENTATION

White powder
zinc oxide with up to 10%
magnesium oxide (reduce
reactivity)

Clear Liquid
45-64% aqueous solution of
phosphoric acid
 Zinc phosphate cement
Setting reaction

3ZnO + 2H3PO4 + H2O ® Zn3(PO4)2 .4H2O

(hopeite)
 How to extend the setting time ?
• Reducing powder/ liquid ratio {not recommended}
• Mixing on the cool dry glass slap {no moisture}
• Mixing over a large area.
• Mixing cements in increments.
 Zinc phosphate cement
ADVANTAGES DISADVANTAGES
• They are easy to mix • They have a potential for
pulpal irritation due to low
• They have a sharp, well- pH
defined set. • They have no antibacterial
• They are a low cost action
product • They are brittle
• They have no adhesive
qualities.
• They are relatively soluble
in the oral environment
 Zinc polycarboxylate cement

PRESENTATION

White powder
zinc oxide with up to 10%
magnesium oxide

Clear Liquid
30-40% aqueous solution of
polyacrylic acid
Zinc polycarboxylate cement
SETTING REACTION
CROSSLINKING REACTION
 Zinc polycarboxylate cement
ADVANTAGES DISADVANTAGES
• Their properties are highly
• They bond to enamel and dependent upon handling
dentine as well as some of procedures
the metallic cast restorations • They have short working times
and long setting times
• They have a low irritancy.
• An exacting technique is required
• Strength, solubility and film to ensure bonding
thickness are comparable to • Clean up is difficult and timing is
that of zinc phosphate critical
cement
 Glass ionomer cement
• Conventional glass ionomer cement
• Resin-modified glass ionomer cement
[RMGICs]
• Metal reinforced
• Powder + Liquid
• Powder + water
• Encapsulated
 Composition
• Powder
– Calcium aluminum fluorosilicate glass
• Liquid
– Polyacid
• Copolymer of polyacrylic / itaconic acid
• Copolymer of polyacrylic / maleic acid
• Add tartaric: accelerator
 Properties
• Film thickness is similar or less than zinc
phosphate cement.
• Setting time 6 to 8 minutes from start of
mixing.
• Less pulpal irritation.
• Anticariogenic effect due to fluoride release.
• Good adhesion to tooth structure.
 Strength
• The 24-hour compressive strength is greater
than zinc phosphate cement.
 Bonding
• It can be chemically bonded to the tooth
structure.
 Modified GI
• Metal reinforced
– Combination of glass and metal
– No significantly improve the strength
– More wear resistance and short setting time
• Resin-modified GI
Resin-modified glass ionomer cement
• Add polymerizable function groups
– Both chemical & light curing
– Overcome moisture sensitive & low early strength
– Names: Ligth cured GICs, Dual-cured GICs, Tri-
cured GICs, Hybrid ionomer, Compomers, Resin-
ionomers
 Properties
• Higher strength than conventional GI
• Higher adhesion to resin material
• Less water sensitivity
– Can be polished after curing