Dental cements manipulation technique & instruments

Drg. Hesti Witasari JE, SpKG

20 different experienced dental assistants mixing the same cement

Success / Failure Factors:
(1) (2) Operator Design Factors

CEMENT MANIPULATION

Frequency (n)

(3) (4) (5)

Materials Factors Intraoral Location Factors Patient Factors

4 3 2 1

Compressive Strength (MPa)

40 50 60 70 80 90

CROWN 100 90

CEMENT THICKNESS (100 m)

80 70 60 50 40 30 20 10 0 TOOTH

CROWN

???

TOOTH STRUCTURE

Powder CRACK LARGE ParticleCEMENT THICKNESS: PORE Erosion 110 m is average and 50-350 is typical. 100 m is generally considered ideal. RETENTION? Precipitation SEALING?

100

RELATIVE STRENGTH (%)

80

60 y = 100e-0.0598x 40 R2 = 0.9101

20

0 0 20 40 60 80 100 POROSITY (%)

Ryskewitsch. J Am Ceram Soc 1953;36:65. (Empirical suggestion =oexp(-nP) where n=4-7 and P=volume fraction porosity.)

The instruments

Zinc Oxide Eugenol

The

zinc oxide is slowly wetted by the eugenol Prolonged and vigorous spatulation is required, especially for a thick mix A powder/liquid ratio of 3:1 or 4:1 must be used for maximum strength

Zinc Oxide Eugenol

Zinc Phosphate
Powder

portions Liquid is dispensed according to manufacturer Mixing is gradual at 15 seconds intervals for 60-120seconds Large strokes over a large area

is dispensed and divided into 4-6

Mixing Procedure and Precautions

Zinc Phosphate Cement Chilled glass slab and dispensing P.
Flecks Mizzy ZP Cement

Dividing P portions and dispensing L.

Incremental additions and stropping.

Zinc Polycarboxylate
The

material should be carefully proportioned and the freshly dispensed components mixed rapidly in 30 to 40 seconds Mix should be used while it is still glossy The interior of restorations and tooth surfaces should be clean and free of saliva

 Powder

and liquid should be store under cool conditions and kept sealed with a stopper At luting consistency, the recommended powder/liquid ratio is about 1.5:1 Working time: 2,5-3,5 min Setting time: 6-9 min(37C)

Mixing Procedure and Precautions

Polycarboxylate Cement Dispensing P and L.
B A C D

Folding P into L.

Stropping.

Glass Ionomer Cement

The

material should be carefully proportioned and the freshly dispensed components mixed rapidly in 30 40 sec. Some brands are encapsulated, mechanically mixed, and injected The powder/liquid ratio for luting is about 1,3 : 1 for the conventional types of glassionomers cement

 The

correct cementing mix is fluid, similar with zinc phosphate Lining mix is more viscous The restorative mix should have putty-like consistency and a glossy surface Tooth surfaces should be clean and free from saliva but not dehydrated Restoration surfaces should be free from debris and contamination

 The

cement hardens slowly and should be protected from loss or gain of moisture when set clinically Restoration margins or filling surfaces should be protected with varnish or lightcuring sealant Setting time for luting : 6-9min Lining : 4-5 min Restorative materials : 3-4 min

Gambar varnish

Thankyou