CEMENTATION

Glossary of Prosthodontic Terms-8

Luting cement is defined as a binding
element or agent used as a substance to make
objects adhere to each other ,a material that
on hardening will fill a space or bind adjacent
objects.
 Ideal Luting Agent

• Adhere well to both tooth structure and cast alloy.

• Provide a good seal.

• Non-irritating, non-toxic to both pulp and surrounding

supporting structure.

• Have adequate strength

Ideal Luting Agent

• Have low viscosity; low solubility.

• Exhibit good working and setting characteristic.

• Easily to be removed after setting.

• Fluoride release.
 Cements bonding mechanisms

• Non-adhesive -
mechanical luting
• Micro-mechanical
bonding
• Molecular adhesive
Zinc phosphate cement
 Zinc phosphate cement (1878)
• Composition:
• ZnO powder and phosphoric acid

• Advantages:
• Show high chemical stability .
• Adequate strength (80-110 MPa c.s,5-7 MPa t.s).
• Reasonable working time (3-6min w.t, 5-14 s.t).
• Excess material can be easily removed.
Zinc phosphate cement (1878)

• Disadvantages:
• Water-sensitive during setting; microleakage; high
solubility
• Pulp irritation -Low initial pH
• Brittleness,
• Lack of adhesion.
Zinc Polycarboxylate Cement
 Zinc polycarboxylate cement

• Exhibits specific (low) adhesion to tooth structure because it

chelates with the calcium. Adhesion to some alloys.

• Higher tensile strength compared to zinc phosphate cement,

• Anticariogenic in nature but this property is less than that of

GIC.

• Biocompatible to the pulp , rapid rise of the cement PH toward

neutrality.

• Lack of post operative sensitivity. (excellent for sensitive teeth )

 Zinc polycarboxylate cement

• Disadvantages
• It is thixotropic in nature. Hence, it may be too thick and will not flow
adequately.
• Short (2.5min)working time - makes it difficult to lute long span bridges

• Residual cement is more difficult to remove.

• Shows plastic deformation,

Glass ionomer cement
 Glass Ionomer Cements 1970s

• Adhesive, and reports of reduced microleakage

• Early exposure to water significantly reduces ultimate strength
• It releases fluoride (anticariogenic effect).
• Low cement film thickness (25 to 35µm)
• Non-irritant to pulp
 Glass Ionomer Cement
• Disadvantages
• High susceptibility to moisture contamination.
during setting,
• Residual cement is more difficult to remove.
Adhesive resin agents
Adhesive resin agents
 Adhesive Resins

• The manipulative techniques may be very different with different brands

of resin cements.

• Shade of veneers can be modified by the shade of the luting agent

• Colour-match try-in pastes are available to facilitate selecting the best

cement shade.
Adhesive Resins
•Advantages:
•high strength,
•low oral solubility.
• high micromechanical bonding to
prepared enamel, dentin, alloys and
ceramic surfaces.
Adhesive Resins
• Disadvantages:
• The need for meticulous and critical technique,
• More difficult sealing and higher film thickness
than traditional cements,
• Pulp sensitivity,
• Difficulty in removal excess cement
Provisional Cements
 Provisional cementation
• Zinc oxide –eugenol: powder zinc oxide, the liquid is
purified eugenol.
• Low compressive and tensile strength(
• Film thickness of 40 µm
• High solubility about 1.5%, little anticariogenic action
• Abtudent effect on the pulp, good sealing ability and
resistance to marginal penetration.
• Reinforced zinc oxide-eugenol cements: by adding
EBA, alumium oxide and PMM.
Cementation procedure
Proximal Contacts Adjustment
 Checking for Proximal Contacts
(Cont’d)

• Excessive tightness can be corrected by:

Adjusting with a rubber wheel (all metal restoration)
Adjusting with a cylindrical mounted stone (porcelain
restoration)
• Deficient proximal contacts in a gold casting can be corrected by soldering
.
 Checking for Marginal Integrity

Margin adaptation with a gap around 30m is

clinically acceptable.
• Marginal integrity can be assessed by moving a
sharp explorer from the restoration to the tooth
and from the tooth to the restoration (open
margin= 50 µm the tip of sharp explorer can be
inserted between the restoration and the tooth).
• What is the most common cause of poorly
adapted margins?
 Checking for Marginal Integrity
(Cont’d)
• Testing whether the casting binds to the tooth surface,
is helpful to determine the marginal integrity. This can
be done using the following materials:
• Disclosing waxes
• Powdered sprays
• Water soluble marking agents
• Elastomeric detection paste (by far the most reliable-fit
checker)
Checking for Stability

• The restoration should not rock or rotate

• Instability produced by a small positive nodule on

the fitting surface can be corrected by trimming.

• If the instability is due to a distorted wax pattern,

the casting procedure should be repeated.
Checking for Occlusion
 Preparation of the Restoration and
Tooth Surface for Final Cementation
Cementation

Pdr1.2mg+Lq0.6m
l
Mixing and Isolation
Cementation with Zinc Phosphate
cement
Factors that influence the completeness of
seating after cementation

• Viscosity of the cement.

• Morphology of the restoration.
• Vibration.
• Seating force.
• Venting.
 Post-Cementation Instructions
Sudden impact forces should be avoided in the restored area, e.g.
biting on a nut or metallic object.
Maintenance:
• Oral hygiene procedures with special attention to use of
floss, inter-dental brushes in the concerned area.
• De-sensitizing tooth paste or mouth wash can be used if
there is sensitivity.
Thepatient is advised to report immediately if there is pain.
Regular recall visits for review.
Choice of a luting cement
 Cast crown, metal ceramic crown, fixed
partial denture and metal ceramic
restorations with porcelain margin
1) Adhesive resin
2) glass ionomer cement
3 reinforced ZOE
4) zinc phosphate
5) zinc polycarboxylate
Choice of a luting cement
 Patient with post treatment sensitivity
Zinc polycarboxylate
Reinforced ZOE
Contraindicated cement
Composite resin
Choice of a luting cement
 Ceramic veneer, ceramic inlay and resin
retained fixed partial denture
Adhesive resin

Contraindicated cements include

Glass ionomer cement
Reinforced ZOE
Zinc phosphate
Zinc polycarboxylate
Choice of a luting cement
 Cast post and core
Adhesive resin
Glass ionomer cement
Zinc phosphate
Contraindicated cements include
Reinforced ZOE
Zinc polycarboxylate