Dental luting cements/ colleges for dentistry

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Dental luting cements/ colleges for dentistry

  1. 1.  The fear of detachment has beenThe fear of detachment has been bothering mankind since ages and so withbothering mankind since ages and so with the dentists but here the fear of debondingthe dentists but here the fear of debonding or detachment of FPD’s, crowns andor detachment of FPD’s, crowns and restorations.restorations.  So it is very essential that the bonding orSo it is very essential that the bonding or the luting agent used is reliable andthe luting agent used is reliable and retentive for long period of time.retentive for long period of time. www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. Restoration failuresRestoration failures CausesCauses ImproperImproper biomechanical toothbiomechanical tooth preperationpreperation Improper cementationImproper cementation techniquetechnique Improper luting agentImproper luting agent www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. INTRODUCTIONINTRODUCTION THE PRACTICE OF FIXEDTHE PRACTICE OF FIXED PROSTHODONTICS HAS CHANGEDPROSTHODONTICS HAS CHANGED DRAMATICALLY WITH THE INTRODUCTIONDRAMATICALLY WITH THE INTRODUCTION OF INNOVATIVE TECHNIQUES ANDOF INNOVATIVE TECHNIQUES AND MATERIALS. TODAYS DENTIST HAS A WIDEMATERIALS. TODAYS DENTIST HAS A WIDE RANGE OF OPTIONS OF WATER BASEDRANGE OF OPTIONS OF WATER BASED LUTING AGENTS TO LATEST RESIN ADHESIVELUTING AGENTS TO LATEST RESIN ADHESIVE SYSTEMS AND RESIN MODIFIED GLASS IONOMERS.SYSTEMS AND RESIN MODIFIED GLASS IONOMERS. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. HISTORY  Luting is derived from a greek word LUTUM – meaning mud. Primarily cements were used to fill the gap between restoration and tooth structure. There was no bonding. www.indiandentalacademy.com
  7. 7. Ideal biologic propertiesIdeal biologic properties Biocompatibility : should be leastBiocompatibility : should be least interactive with body tissues, non toxic ,interactive with body tissues, non toxic , non pulp irritant .non pulp irritant . Caries and plaque inhibition : desirablyCaries and plaque inhibition : desirably they should possess antimicrobialthey should possess antimicrobial properties, should prevent caries andproperties, should prevent caries and plaque .plaque . www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. Ideal mechanical properties  Compressive strength : according to ADA specification water based luting cements should have minimum strength of 70 Mpa at 24 hrs.  Other properties like diametral tensile strength flexural strength, fracture toughness, hardness testing should be as high as possible  Modulus of elasticity should be as much as dentine ie 13.7 Gpa. www.indiandentalacademy.com
  9. 9.  Solubility : should be as low as possible according to ANSI /ADA specification it should be maximum of .2 % of weight in water.  Adhesion to tooth structure and restorative materials is desired. www.indiandentalacademy.com
  10. 10. Ideal working propertiesIdeal working properties Film thickness : according to ANSI /ADAFilm thickness : according to ANSI /ADA specification it is should be maximum ofspecification it is should be maximum of 25 micron . More film thickness may lead25 micron . More film thickness may lead to clinical problems in attaining completeto clinical problems in attaining complete restoration seating ,tilting of castings,restoration seating ,tilting of castings, decrease in retention.decrease in retention. Working time : should be long to allowWorking time : should be long to allow easy manipulation.easy manipulation. Setting time : should be shortSetting time : should be short www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. Esthetic propertiesEsthetic properties Color stability : more color stable materialsColor stability : more color stable materials are desired , to maintain esthetics.are desired , to maintain esthetics. TranslucentTranslucent Radiopacity : ideal cement should beRadiopacity : ideal cement should be radioopaque to enable practitioner toradioopaque to enable practitioner to distinguish between cement line anddistinguish between cement line and recurrent caries as well as cementrecurrent caries as well as cement overhangs .overhangs . www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. TYPES OF LUTING CEMENTSTYPES OF LUTING CEMENTS ZINC PHOSPHATE CEMENTZINC PHOSPHATE CEMENT ZINC POLYCARBOXYLATEZINC POLYCARBOXYLATE ZINC OXIDE EUGENOLZINC OXIDE EUGENOL GLASS IONOMER CEMENTGLASS IONOMER CEMENT RESIN IONOMER CEMENTRESIN IONOMER CEMENT COMPOSITE RESIN CEMENTCOMPOSITE RESIN CEMENT ADHESIVE RESINADHESIVE RESIN www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. ZINC PHOSPHATE CEMENTZINC PHOSPHATE CEMENT THIS FIRSTTHIS FIRST INTRODUCED IN 1878INTRODUCED IN 1878 AND IS STILL WIDELYAND IS STILL WIDELY USED.DOESNTUSED.DOESNT PROVIDE ADHESION ATPROVIDE ADHESION AT MOLECULAR LEVELMOLECULAR LEVEL BUT IT HOLDS THEBUT IT HOLDS THE RESTORATION INRESTORATION IN PLACE BY ENGAGINGPLACE BY ENGAGING THE SMALLTHE SMALL IRREGULARITIES ONIRREGULARITIES ON TOOTH ANDTOOTH AND RESTORATIONRESTORATION SURFACE.SURFACE. COMPOSITIONCOMPOSITION POWDER-POWDER- Zinc oxideZinc oxide (Mg oxide, Al phosphate)(Mg oxide, Al phosphate) LIQUID-LIQUID- Orthophosphoric acidOrthophosphoric acid www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. Biological propertiesBiological properties Biocompatibility – due to phosphoric acidBiocompatibility – due to phosphoric acid the ph of cement is low ,may cause pulpthe ph of cement is low ,may cause pulp damage.damage. Solubility - Zn po4 shows relatively lowSolubility - Zn po4 shows relatively low solubility in water but in oral cavity it issolubility in water but in oral cavity it is more and that in dilute organic acids it ismore and that in dilute organic acids it is appreciably greater.appreciably greater. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. PropertiesProperties MicroleakageMicroleakage is very high due to highis very high due to high solubility of the cement in oral cavity.solubility of the cement in oral cavity. Compressive strength-Compressive strength- this cement whenthis cement when properly manipulated exhibit strength ofproperly manipulated exhibit strength of 104 mpa . This is quite good for a cement104 mpa . This is quite good for a cement to withstand masticatory load.to withstand masticatory load. Diametral Tensile bond strength - 5.5Diametral Tensile bond strength - 5.5 mpa provides moderate retention.mpa provides moderate retention. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. COMMENTSCOMMENTS ADVANTAGESADVANTAGES History of useHistory of use EconomicEconomic Easy manipulationEasy manipulation Easy crown removalEasy crown removal DIS ADVANTAGEDIS ADVANTAGE Pulp irritationPulp irritation High solubilityHigh solubility Micro leakageMicro leakage Caries susceptibilityCaries susceptibility www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. Commercially availableCommercially available Zinc phosphateZinc phosphate FLECK’S : by MizzyFLECK’S : by Mizzy HY-BOND – ZP : by ShofuHY-BOND – ZP : by Shofu TENACIN : by DentsplyTENACIN : by Dentsply DE TREY ZINC : byDe treyDE TREY ZINC : byDe trey LEE SMITH ZINC :by TeledyneLEE SMITH ZINC :by Teledyne www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. ZINC POLYCARBOXYLATEZINC POLYCARBOXYLATE CEMENTCEMENT This cement was theThis cement was the first cement system tofirst cement system to be developed as toothbe developed as tooth structure bondingstructure bonding adhesive luting agent.adhesive luting agent. It is the mostIt is the most biocompatible,withbiocompatible,with least irritation to pulp.least irritation to pulp. COMPOSITIONCOMPOSITION POWDER- Zinc oxide,Tin oxide,Zinc oxide,Tin oxide, Al oxide,Mg oxide,Al oxide,Mg oxide, Stanous flourideStanous flouride LIQUID- Polyacrylic acidPolyacrylic acid www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. PROPERTIESPROPERTIES BIOCOMPATIBILITYBIOCOMPATIBILITY- ph of liquid is approximately 1.7- ph of liquid is approximately 1.7 but it gets quickly neutralized by powder. Polyacrylic acidbut it gets quickly neutralized by powder. Polyacrylic acid has larger molecular size which are the reason for nonhas larger molecular size which are the reason for non irritation of pulp.irritation of pulp. SOLUBILITYSOLUBILITY- Highly soluble in oral fluids with ph < 4.5- Highly soluble in oral fluids with ph < 4.5 so leads to disintegration of material.so leads to disintegration of material. MICROLEAKAGE-MICROLEAKAGE- very high due to high solubilityvery high due to high solubility WORKING TIMEWORKING TIME – (1.75-2.5 min) shorter than Zn po4– (1.75-2.5 min) shorter than Zn po4 ,lowering the reaction temperature can increase working,lowering the reaction temperature can increase working timetime SETTING TIME-SETTING TIME- (6-9 min)(6-9 min) www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. Development of viscosity afterDevelopment of viscosity after mixing of cementmixing of cement 0 1 2 3 4 5 6 7 1 min 2nd min 3rd min 4th min 5 th min 6 th min polycarb Zn PO4 G I C www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. COMMENTSCOMMENTS ADVANTAGESADVANTAGES More biocompatibleMore biocompatible Chemical adhesion toChemical adhesion to tooth structuretooth structure Fluoride releaseFluoride release EconomicalEconomical DISADVANTAGESDISADVANTAGES High solubilityHigh solubility High microleakageHigh microleakage Low strengthLow strength Less working timeLess working time www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. Commercially availableCommercially available Polycarboxylate cementPolycarboxylate cement DURELON : by ESPEDURELON : by ESPE HY-BOND PC : by ShofuHY-BOND PC : by Shofu TYLOC PLUS :by DentsplyTYLOC PLUS :by Dentsply POLY CARB water set :by pulpdentPOLY CARB water set :by pulpdent LIV CARBO : by G CLIV CARBO : by G C CARBOXYLON : by 3MCARBOXYLON : by 3M www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. ZINC OXIDE EUGENOLZINC OXIDE EUGENOL This cement is beenThis cement is been in extensive use sincein extensive use since 1890 in dentistry.They1890 in dentistry.They have sedative effecthave sedative effect on exposed dentin,soon exposed dentin,so they were used asthey were used as temporary restorativetemporary restorative materials.materials. Now there is eugenolNow there is eugenol free reinforcedfree reinforced cement.cement. COMPOSITIONCOMPOSITION POWDERPOWDER Zinc oxide,whiteZinc oxide,white rosin,zincrosin,zinc stearate,zinc acetate.stearate,zinc acetate. LIQUIDLIQUID Eugenol,olive oilEugenol,olive oil www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. PROPERTIESPROPERTIES Biocompatibility – dentine sedative action,Biocompatibility – dentine sedative action, it has ph of 7 biocompatible with pulp.it has ph of 7 biocompatible with pulp. Microleakage – seals the margins wellMicroleakage – seals the margins well against the ingress of oral fluids at leastagainst the ingress of oral fluids at least for a brief period hence irritation causedfor a brief period hence irritation caused by micrleakage is minimised.by micrleakage is minimised. Solubility - highly soluble in oral fluids.Solubility - highly soluble in oral fluids. Working time – (2 – 6) minWorking time – (2 – 6) min Setting time - (4 – 10) minSetting time - (4 – 10) min www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. Advantage DisavdantageAdvantage Disavdantage BiocompatibleBiocompatible Easy manipulationEasy manipulation Easy excess andEasy excess and crown removalcrown removal without any damagewithout any damage to tooth structure.to tooth structure. Ideal for temporaryIdeal for temporary restorationrestoration Low strengthLow strength Poor retentionPoor retention High solubility andHigh solubility and microleakagemicroleakage Some patients areSome patients are eugenol sensitiveeugenol sensitive www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. Commecially available ZnOECommecially available ZnOE FYNAL :by DentsplyFYNAL :by Dentsply TEMP BOND : by 3MTEMP BOND : by 3M RELYX : ESPERELYX : ESPE Zn Oxide Eugenol : by DentsplyZn Oxide Eugenol : by Dentsply www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. GLASS IONOMER CEMENTGLASS IONOMER CEMENT It was first introducedIt was first introduced in 1977,has manyin 1977,has many properties of an idealproperties of an ideal cement,and is one ofcement,and is one of the most widely usedthe most widely used luting cements.luting cements. COMPOSITIONCOMPOSITION POWDERPOWDER glassfillers,sodium,calciglassfillers,sodium,calci um,aluminium,lanthanum,aluminium,lanthan um,fluorosilicateum,fluorosilicate LIQUIDLIQUID Poly acrylic acid andPoly acrylic acid and tartaric acidtartaric acid www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. PROPERTIESPROPERTIES BIOCOMPATIBILITY-they have low PH but polyacids weaker acids .PreBIOCOMPATIBILITY-they have low PH but polyacids weaker acids .Pre existing pulpitis, excessive tooth cutting reduced dentin thickness , diffusionexisting pulpitis, excessive tooth cutting reduced dentin thickness , diffusion of irritants to pulp will cause sensitivity. However P:L ratio influences the phof irritants to pulp will cause sensitivity. However P:L ratio influences the ph It is known to produce bacteriostatic action due to fluoride release .It is known to produce bacteriostatic action due to fluoride release . MICROLEAKAGE- less due to closing of marginal seal by bonding betweenMICROLEAKAGE- less due to closing of marginal seal by bonding between restoration and tooth structure.restoration and tooth structure. SOLUBILITY- During first 24 hrs is high, so it is important to protect fluidSOLUBILITY- During first 24 hrs is high, so it is important to protect fluid contamination during this time. Later the solubility reduces significantly.contamination during this time. Later the solubility reduces significantly. WORKING TIME- 2- 3.5 MIN can be extended by mixing on a cold slab .WORKING TIME- 2- 3.5 MIN can be extended by mixing on a cold slab . SETTING TIME- 6 – 9 MIN ,if done by frozen slab technique settingSETTING TIME- 6 – 9 MIN ,if done by frozen slab technique setting reaction can be slowed . But this has an adverse effect on the strength.reaction can be slowed . But this has an adverse effect on the strength. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. MECHANICAL PROPERTIESMECHANICAL PROPERTIES Compressive strength-Compressive strength- 122-162 Mpa122-162 Mpa Tensile strength-Tensile strength- 12- 18 Mpa12- 18 Mpa Film thickness-Film thickness- ( < 25 micron) proper P:L ratio has to be( < 25 micron) proper P:L ratio has to be maintained , seating pressure should be adequate to getmaintained , seating pressure should be adequate to get even film thickness.even film thickness. RetentionRetention – very high retention ,bonds chemically to– very high retention ,bonds chemically to tooth and restorationtooth and restoration Removal of excess-Removal of excess- moderately easy.moderately easy. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. Advantage DisadvantageAdvantage Disadvantage Adequate highAdequate high strengthstrength Adhesion to toothAdhesion to tooth structure, bondingstructure, bonding and retention goodand retention good Sustained FluorideSustained Fluoride release,anticariogenicrelease,anticariogenic Less solubility,andLess solubility,and microleakagemicroleakage post cementationpost cementation sensitivity is common.sensitivity is common. www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. Commecially available GICCommecially available GIC FUGI-I :by G CFUGI-I :by G C KETAC –CEM : by ESPEKETAC –CEM : by ESPE GLASS LUTE : byGLASS LUTE : by pulpdentpulpdent Viva glass cem : byViva glass cem : by Ivoclar VivadentIvoclar Vivadent Glass ionomer : by ShofuGlass ionomer : by Shofu www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. Resin ionomerResin ionomer (fibre reinforced GIC)(fibre reinforced GIC) Moisture sensitivity and low early strengthMoisture sensitivity and low early strength of GIC s are the result of slow acid baseof GIC s are the result of slow acid base setting reactions. Some polymerisablesetting reactions. Some polymerisable functional groups have been added tofunctional groups have been added to impart additional curing processes thatimpart additional curing processes that can overcome these 2 drawbacks andcan overcome these 2 drawbacks and allow the bulk of the material to matureallow the bulk of the material to mature through the acid base reactions.through the acid base reactions. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. Composition and chemistryComposition and chemistry PowderPowder – ion leachable glass particles– ion leachable glass particles and initiators for light or chemical cure.and initiators for light or chemical cure. LiquidLiquid - water , polyacrylic acid ,with- water , polyacrylic acid ,with some methacrylate and hydroxy ethylsome methacrylate and hydroxy ethyl methacrylate monomersmethacrylate monomers Variations of properties from ConventionalVariations of properties from Conventional GIC can be atributed the presence ofGIC can be atributed the presence of polymerisable resin and lesser amount ofpolymerisable resin and lesser amount of water and carboxylic acid in the liquid.water and carboxylic acid in the liquid. www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. Advantage DisadvantageAdvantage Disadvantage High strengthHigh strength Good retentionGood retention Low solubilityLow solubility Flouride releaseFlouride release Post cementationPost cementation sensitivitysensitivity www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. Commercially available resinCommercially available resin ionomersionomers Fuji CEM – by GCFuji CEM – by GC Advance – byAdvance – by DentsplyDentsply Vitremer – by 3MVitremer – by 3M Fuji plus – by GCFuji plus – by GC www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. RESIN LUTING CEMENTRESIN LUTING CEMENT Synthetic resins are available since 1952 forSynthetic resins are available since 1952 for cementation ,in1970 composite resin wascementation ,in1970 composite resin was introduced as crown and bridge material,sinceintroduced as crown and bridge material,since 1986 resin cements have gained popularity by1986 resin cements have gained popularity by usage in resin bonded bridges and aestheticusage in resin bonded bridges and aesthetic restoration.restoration. The term composite resins are defined as aThe term composite resins are defined as a compound of two or more distinctly differentcompound of two or more distinctly different materials with properties that are superior tomaterials with properties that are superior to individual constituents.individual constituents. www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. COMPOSITIONCOMPOSITION Available as powder /liquid or two paste formAvailable as powder /liquid or two paste form Resin matrix / binder – Bis GMA / urethaneResin matrix / binder – Bis GMA / urethane dimethacrylate, triethylene glycol dimethacrylatedimethacrylate, triethylene glycol dimethacrylate Fillers – quartz ,colloidal silica /metal oxidesFillers – quartz ,colloidal silica /metal oxides Coupling agents – organosilanesCoupling agents – organosilanes Also contains – Hydroquinone:preventsAlso contains – Hydroquinone:prevents premature polymerisation, u-v absorberpremature polymerisation, u-v absorber improves colour stability, Opacifiers: Ti dioxide Alimproves colour stability, Opacifiers: Ti dioxide Al oxide , colour pigments :to match the toothoxide , colour pigments :to match the tooth colourcolour www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. Metal composite bondingMetal composite bonding (Maryland and Rochett FPD)(Maryland and Rochett FPD) Earlier there was noEarlier there was no metal and compositemetal and composite bonding due to nonbonding due to non reactivity of metallicreactivity of metallic surface , neithersurface , neither micromechanical normicromechanical nor chemical bonding waschemical bonding was realistically attainable.realistically attainable. Now due to advent ofNow due to advent of specific metal bondingspecific metal bonding materials combined withmaterials combined with microetching technique.microetching technique. www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. Resin luting cementsResin luting cements Ultra Bond – Dent MatUltra Bond – Dent Mat Insure – CosmodentInsure – Cosmodent Choice – BiscoChoice – Bisco Dicor cement system – DentsplyDicor cement system – Dentsply Optec – Jeneric / PentronOptec – Jeneric / Pentron www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. All ceramic crown bondingAll ceramic crown bonding Composite lutingComposite luting cements are thecements are the choice . Here thechoice . Here the color shades playcolor shades play important role,thinimportant role,thin viscosity and haveviscosity and have dual curingdual curing mechanism are themechanism are the requirements.requirements. www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. PROPERTIESPROPERTIES Biocompatibility – pulp irritation due toBiocompatibility – pulp irritation due to diffusion of uncured composites ordiffusion of uncured composites or monomers into the dentinal tubules andmonomers into the dentinal tubules and cause long term pulp inflamation.cause long term pulp inflamation. Microleakage – microleakage due toMicroleakage – microleakage due to polymerisation shrinkage occuring causingpolymerisation shrinkage occuring causing marginal leakage ,so care should be takenmarginal leakage ,so care should be taken to reduce shrinkage.to reduce shrinkage. Solubility – very less soluble in oral fluidsSolubility – very less soluble in oral fluids www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. MECHANICAL PROPERTIESMECHANICAL PROPERTIES Compressive strength – 194 – 200 mpa veryCompressive strength – 194 – 200 mpa very high and is attributed to composite technique.high and is attributed to composite technique. Tensile strength – 15 mpaTensile strength – 15 mpa Film thickness - ( > 25 microns ) this is theFilm thickness - ( > 25 microns ) this is the mater of concern ,since it is high many attemptsmater of concern ,since it is high many attempts have been made to decrease but strength has tohave been made to decrease but strength has to be sacrificed.be sacrificed. Removal of excess – moderately easyRemoval of excess – moderately easy Retention – good,micromechanical bondingRetention – good,micromechanical bonding www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. COMMENTSCOMMENTS ADVANTAGES:ADVANTAGES: Low solubilityLow solubility Good retention andGood retention and strengthstrength Good aestheticsGood aesthetics usefull in ceramicusefull in ceramic veneers and inlayveneers and inlay DISADVANTAGEDISADVANTAGE More film thicknessMore film thickness microleakage due tomicroleakage due to polymerisationpolymerisation shrinkageshrinkage Pulp irritationPulp irritation Cost moreCost more www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. Adhesive (Bonding) ResinAdhesive (Bonding) Resin These are new generations of adhesiveThese are new generations of adhesive bonding agents which are been usedbonding agents which are been used extensively in dentistry now. Sinceextensively in dentistry now. Since composite resins were very viscous theycomposite resins were very viscous they were not flowing well into the dentinalwere not flowing well into the dentinal tubules of etched surface , these adhesivetubules of etched surface , these adhesive resins flowed well into the irregularitiesresins flowed well into the irregularities and bonded well to restoration and toothand bonded well to restoration and tooth surface.surface. www.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. PropertiesProperties Biocompatibility – pulp irritation is presentBiocompatibility – pulp irritation is present Microleakage - very lowMicroleakage - very low Solubility – very lowSolubility – very low Working time - .5 – 5 minWorking time - .5 – 5 min Setting time – 1 – 15 minSetting time – 1 – 15 min www.indiandentalacademy.comwww.indiandentalacademy.com
  46. 46. Mechanical propertiesMechanical properties Compressive strength – 179 – 255 mpaCompressive strength – 179 – 255 mpa Tensile strength – 30 – 45 mpaTensile strength – 30 – 45 mpa Film thickness – >25 micronsFilm thickness – >25 microns Removal of excess – difficultRemoval of excess – difficult Retention – very highRetention – very high www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. Advantage DisadvantageAdvantage Disadvantage Adhesive to toothAdhesive to tooth structure, very highstructure, very high retentionretention Low solubility in oralLow solubility in oral fluidsfluids AestheticAesthetic High strengthHigh strength Pulp irritation high,Pulp irritation high, post insertionpost insertion sensitivitysensitivity Cost highCost high Technique sensitiveTechnique sensitive www.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. Resin Metal bondingResin Metal bonding materialsmaterials C & B MetabondC & B Metabond All bond 2,All bond 2, Tenure ,Tenure , Geristore ,Geristore , InfinityInfinity PanaviaPanavia www.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. Commercially available adhesiveCommercially available adhesive resinsresins Flexi flow : by essntial dental systemFlexi flow : by essntial dental system Cement it : by Jenric/PentronCement it : by Jenric/Pentron Metabond : by ParkellMetabond : by Parkell www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. Mechanical Properties 0 50 100 150 200 250 300 Zinc phosphate Polycarboxylate Glass ionomer Resin ionomer Resin composite Adhesive resin Cements Values Compressive strength (Mpa) Tensile Strength (Mpa) Elastic Modulus www.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. 0 5 10 15 20 25 Zn po4 G I C Z O E Resin GIC adesiv resin sensitivity anticaries www.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. 0 20 40 60 80 100 120 140 160 Zn Po4 polyc G I C resinGIC adhesive cost in $ www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. Cast ,metal ceramic ,F P DCast ,metal ceramic ,F P D Almost all cementsAlmost all cements can be used.can be used. www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. Crown or F P D with poorCrown or F P D with poor retentionretention (Resin cements)(Resin cements) Cases where inadequate retentionCases where inadequate retention resistance form exists after preparationresistance form exists after preparation (i.e., preparation is overtapered and(i.e., preparation is overtapered and short).short). www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. Casting on patient with historyCasting on patient with history of post cementation sensitivityof post cementation sensitivity Zn polycarboxylate is the choiceZn polycarboxylate is the choice Zn oxide Eugenol also can be usedZn oxide Eugenol also can be used www.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. Pressed high leucite ,ceramicPressed high leucite ,ceramic crowncrown Adhesive resin orAdhesive resin or composite resin arecomposite resin are the choice of cementsthe choice of cements since aesthetics andsince aesthetics and retentions areretentions are importantimportant www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. Resin retained FPDResin retained FPD (Maryland, Rochett)(Maryland, Rochett) Adhesive resin andAdhesive resin and composite resins arecomposite resins are the choice ofthe choice of cements.cements. www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59. Cast post and coreCast post and core Almost all cementsAlmost all cements can be used.can be used. www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60. Ceramic inlay,onlay, ceramicCeramic inlay,onlay, ceramic veneerveneer Adhesive resins are usedAdhesive resins are used www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. RestorationRestoration DrDr RosensteilRosensteil Dr LandDr Land Dr CrispinDr Crispin Cast metalCast metal & ceramic& ceramic FPD’s,FPD’s, crownscrowns Fleck’sFleck’s Zn Po4Zn Po4 Fuji IFuji I GlassGlass ionomerionomer Vitremer orVitremer or Fuji PlusFuji Plus ResinResin ionomerionomer FPD’s withFPD’s with poorpoor retentionretention Panavia 21Panavia 21 AdhesiveAdhesive resinresin Panavia 21Panavia 21 C&BC&B Metabond/Metabond/ Panavia 21Panavia 21 PostPost insertioninsertion sensitivitysensitivity casecase Fleck’sFleck’s Zn PO4Zn PO4 DurelonDurelon PolyPoly carboxylatecarboxylate Vitremer orVitremer or Fuji plusFuji plus www.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. RosenstielRosenstiel Dr LandDr Land Dr CrispinDr Crispin Pressed highPressed high Leucite ceramicLeucite ceramic crownscrowns EnforceEnforce (composite(composite DualDual cementcement (Resin )(Resin ) Dual cureDual cure compositecomposite Ceramic veneerCeramic veneer NexusNexus (light cure(light cure resin)resin) ChoiceChoice dualdual curecure resinresin Light cureLight cure compositecomposite Cast post &coreCast post &core Fleck’sFleck’s Znpo4Znpo4 PanaviaPanavia 2121 PanaviaPanavia 2121 www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. ConclusionConclusion Dental luting cements form a link between aDental luting cements form a link between a fixed restoration and the supporting toothfixed restoration and the supporting tooth structure.structure. Although no available luting cement satisfies allAlthough no available luting cement satisfies all the ideal requirements , the out standing clinicalthe ideal requirements , the out standing clinical performance of traditional materials should beperformance of traditional materials should be appreciated before practitioner is willing toappreciated before practitioner is willing to abandon them for latest formulations.abandon them for latest formulations. Also utilise the advanced adhesive technology toAlso utilise the advanced adhesive technology to the maximum for better prognosis.the maximum for better prognosis. www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com

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