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By Dr. Aadil Thimwala
M.D.S (1st Year)
Dept. Of Conservative Dentistry & Endodontics
 Introduction
 Classification
 Uses
 Properties
 Silicate Cements
 Zinc Phosphate Cement
 Zinc Polycarboxylate Cement
 Zinc Oxide Eugenol Cement
 Calcium Hydroxide
 Resin Cements
 Glass Ionomer Cement
 Metal Modified Glass ionomer cement
 Resin Modified Glass Ionomer Cement
Outline
 Copper cements
 Calcium sulphate cements
 MTA (Tri silicate based cements)
 Biodentine
Dental Cement-
“The substances that hardens to act as a base, liner, filling
material, or adhesive to bind devices and prosthesis to
tooth structure or to each other.” (GPT)
 First dental cement was introduced in 1785 by
Sorel.
 Created ‘Zink-oxide-chloric-cement’.
 Rostain and then Flak developed and introduced
Zinc Phosphate Cement.
Dental Cements-
 Consist of powder and liquid when mixed produce a plastic
mass.
Most Dental Cements are supplied as TWO components
Powder
Liquid
 With the exception of resin cements , the liquids are usually
acidic solutions or proton donors.
 The powder are basic in nature, consisting typically of either
glass or metallic oxide particles
 The reaction between the powder and liquid is
essentially an acid-base reaction.
 Upon setting , these cements gain sufficient strength
for use as a base, as a restorative material for
temporary or permanent restorations, or as a luting
agent.
 Cements of low viscosity have the ability to flow
between the tissue surface and prosthesis, and hold
the prosthesis in its place.
 Such agents known as luting agents.
 Before placement of the restoration, the pulp may
get irriratated.
 In order to prevent pulp from irritation and provide
thermal insulation some cements are applied as
bases.
 Some of the cements can be placed on the exposed
pulp as means of direct pulp capping agent.
Classification
Based on their core constituent
Ceramic based cements
Polymer based cements.
Based on the ISO standerds
ISO 9917-1:2003 Water-based cements part 1
ISO 9917-21998 Water-based cements part 2
ISO 3107:2004 Zonc oxide/eugenol and non eugenol
cements
ISO 4049:2000 Polymer based filling, restorative and
luting materials
Accoding to setting reaction
Acid-base reaction
Polymerizing cements
Dual cure cements
Tricure cements
According to their use
Type 1 : Luting agents
Type 2 : Restorative appplications
Type 3 : Liner or base applications
Craig’s Classification
A) Water based cements: They rely on acid-base setting
reaction
-GIC
-RMGIC
-Zinc phophate
-Zinc polycarboxylate
B) Oil-based cements: Depends on the presence or
absence of eugenol
- ZOE
- Non eugenol cements
C) Resin-based cements: Setting reaction based on
composite resin.
Uses
1) Strength
 The strength required for the cement
generally depend on the application of
the cement.
 Cements to be used under amalgam
should have higher strength to withstand
high condensation forces.
 Many dental cements as well as
restorative materials continue to gain
strength after placement.
 That is why it is always advisable to wait
for 2 hours for food after placement of
cement.
 Dental cements must exhibit minimum
24 hour compressive strength of 70 Mpa.
General Properties of Cements
2) Modulous of elasticity
 Measure of the stiffness of the cement.
 Cements under ceramic crowns should have
sufficient to withstand masticatory loads.
 A low MOE can result in flexing of the
restoration results in fracture.
3) Soubility and disintegration
 It is important as it determine the long term
survivability of restorations.
 Solubility and disintegration of the cements can
lead to problems like inflammation, caries,
sensitivity etc.
 It can be reduced by proper manipulation,
minimizing the exposure of the cement to the
oral environment.
4) Film Thickness
 Important for luting cements, as thinner film is
more advantageous for luting.
 It improves the sitting of the restoration
 Helps in greater flow, wetting of the tooth, thus
improves bonding.
 Minimizes the air spaces and structural defects
present in the bulk of the cement.
 Measured in μm.
 According to the ADA specification no.96
Type 1 ) 25 μm
Type 2) 40 μm
Working Time
 Time elapsed from the start of mixing to the
point at which the consistency of material is no
longer suitable for itended use.
 Cement should have adequate working time in
order to achieve a proper, uniform mix and an
even consistency and be manipulable for the
required period of time.
 Cements generally require about 2-5 minutes
Setting Time
 Defined as the time lapse from the start of the
mixing to the point the mixture reaches a
desired hardness or consistency.
 Sufficient time must be available to place and
adapt the material.
 It is generally 2.5 and 8 minutes at a temp. Of 37 ֯
C
Biologic Properties
 It must not be irritant or toxic to the pulp.
1) pH of the cement:
 Most cements are acidic
 Exceptions are zinc oxide eugenol, calcium hydroxide,
and resin cements,
2) Pulpal response:
 Classified as mild, moderate, or severe.
 Originally silicate cements used to compare other
cements because of its high acidity.
3) Pulp protection:
 In case of deep cavities pulp protection becomes
necessary.
 Luting- Placing a viscous material at the interface of
prosthesis and tooth surface in order to retain the
prosthesis.
 Numerous dental treatments include
attachment of prosthesis to the tooth.
 These include ceramics, metal, metal-
ceramic , composite restorations.
Prosthesis
Cement
Cement-tooth interface
CAVITY VARNISHES
 Varnish- A solution of a natural
gums, synthetic resins or resin
dissolved in the volatile solvants such
as acetone, ether or chloroform.
 Agents that reduces pulpal irritation.
 They are natural gums such as Copals
or rosins, or synthetic resins
dissolved in the organic solvents such
as acetone, chloroform, and ether.
 Literature generally suggests that
varnishes reduces pulpal irritation.
 This conclusion drown from the in vitro studies
showing reduction of infiltration of fluids through
marginal areas.
 It prevents penetration of corrosion products of
Amalgam through dentinal tubules.
 Thus it reduces the tooth discoloration.
 To attain a uniform and continuous coating on all
surfaces of the prepared cavity, the clinician should
apply at least two thin layers of varnish.
 When the first layer dries, small pinholes usually
develop. A second or third application fills in most of
these voids.
 A varnish is not indicated while adhesive materials, such
as GIC and resin-based composite, are used.
CAVITY LINERS
 Cavity liner- Thin layer of cement,
such as a calcium hydroxide
suspension in an aqueous or resin
carrier.
 Formulated by dispersing Calcium
hydroxide cement resin carrier
solutions.
 The carrier evaporates and leaves
very thin coating of a liner.
 Because calcium hydroxide is soluble
in oral fluid, it is mandatory not to
apply it on the cavity margins.
Liners Varnishes
Thicker than
varnishes
Carry therapeutic
agents
Greater film thickness
(25 μm)
Applied on dentin only.
Thinner than liners.
Doesn’t Carry
therapeutic agents
Less film thickness (5-
10 μm)
Applied on dentin and
frequently on enamel.
Operative dentistry- Modern theory and practice, M. A. Marzuck
CAVITY BASES
 Base- Layer of insulating,
sometimes medicated,
cement, placed in the
deep portion of the
preparation to protect
pulpal tissue from thermal
and chemical injury.
 In contrast to liners the
bases are applied in much
thicker layers(>0.75 mm)
 They protects pulp from
thermal insults, galvanic
shock, material should be
strong enough to
withstand condensation
forces.
Gladwin Clinical Aspects of Dental Materials
 ADA specification – 96 (old 9)
 Introduced by Fletscher in 1873.
 Steenbock introduced the improved version in 1904.
 Schoenback developed the silicate cements that
contain flouride in 1908.
 It was developed as the anterior aesthetic materials.
 Average life of silicate cements is four years may last
upto 25 years.
 Incidence of secondary caries are less with silicate
cements
 Incidence of contact caries also as compared to
amalgam.
 Silicon dioxide
 Aluminimum
trioxide
 Sodium phosphate
 Flouride form of
sodium
 Calcium flouride
Aluminium flouride
• 35%-50% Phospheric acid
Sodium
• Aluminium Phosphate
Powder Liquid
S. Mahalaxmi- Textbook of Dental Materials
Properties
Biological properties
 Flouride release is low but occur throughout the life.
 The pH of cement remain as low as 3 for few days, hence
a source of pulpal irritation
Esthetics
 The optical properties are good because the are
transparent when compared to GIC.
Microleakage
 It has CTE closely matching the tooth structure hence it
minimizes the tooth structure.
Commercially available silicate
cement
 pH of the cement is low, hence it is severe irritant to
the pulp
Advantages
Flouride release throughout life
Tranclucent in nature
Disadvantages
Pulpal irritant
Over time they get degraded and stained
Leakage around the margin occur
Get easily attacked by oral fluids and in time degrade
 Zinc phosphate cement is the oldest of the luting
cements. It has the longest ‘track record’ and serves as
a standard with which newer systems can be
compared.
 Introduced bt Dr. Otto Hoffman in 1800s.
 It consist of powder and liquid in two separate
bottles.
 ADA specification – 96 (old 21)
Uses Of the cement
 Luting of restorations for inlays, crowns, fixed dental
prostheses, etc.
 High strength bases
 Temporary restorations
 Luting of orthodontic bands and brackets.
Composition
Powder % Function
Zinc oxide 90.2% Main Ingredient
Magnasium oxide 8.2% Aids in sintering
Other oxides(Bismuth
trioxide,barium
oxide,calcium oxide)
0.2% Improves
smoothness
Silica 1.4% Filler,
Liquid % Function
Phospheric acid 38.2% Reacts with ZnO
Aluminium 36% Controls rate of
reaction
Water 16.2% Buffer, to reduce rate
of reaction
Alumina 2.5%
Zinc 7.1%
 Some commercially available cements are –
 Confit, Harvard, Zinc cement(DPI), Modern
Tenacin, Poscal(VOCO), De Trey Zinc(Dentsply),
Hy Bond etc.
Physical Properties Of ZnPo4 Cement
 Two Relevant properties to the retention of fixed prosthesis
are the mechanical properties and solubilities.
 Dislodment of prosthesis if the underlying cement is
stressed beyond its strength.
 High solubility can induce loss of the cement needed for
retentionand may create plaque retetion.
 Compressive strength- 104 Mpa
 A Dimetral Tensile Strength- 5.5 Mpa
 Modulous Of Elasticity- 13.7 Gpa.
(Prevent deformation when employed as the luting agent
in restorations under high masticatory stress)
The compressive strength and
tensile strength vary with the P/L Ratio.
The Recommended P/L ratio is 1.4 g
Powder to 0.5 mL liquid.
Reduction in the P/L ratio of the mix produces a weaker
cement.
Retention of the cement-
 By mechanical interlocking at interfaces, not by
chemical interactions.
 Any coating applied on the tooth surface for pulp
protection reduces retention.
Biological Properties-
 Acidity of the material bacuase of the presence of
Phospheric acid.
Two min after the start of mixing – pH is 2
After 24 hr. Of placement – pH is 5.5
Working and Setting time-
 Working time for cement is
 Setting time for zinc phosphate cement is between 2.5 to 8
min, as Specified in ANSI/ADA specification No. 96
 It is desirable to extend the setting time of the cement to
proviode sufficient working time for manuplation.
Extending setting time (chair side)
1. Reducing P/L ratio producing thinner mixture. However,
this change will adversely Affect the physical properties and
result in a lower initial pH and also decreases the compresive
strength of the cement.
2. Mixing cements in incrememntAnd Introducing smaller
quantities of powder into the liquid for the first few
increments.
3. Prolonging the spatulation of the last increment, the
matrix will be destroyed as it is forming, extra time
will be neded to build the bulk of matrix.
4. Most effective method is to regulate the temperature
of the mixing slab
 Cooling the slab retards the reaction b/w powder
and liquid thereby retards the formation of liquid.
 This permits the optimum amount of powder to get
incorporated in the liquid before it develops high
viscosity.
 Mixing at room temprature will result in the mix of
high viscosity.
Temperature at 18 ֯ C
Temperature at 27 ֯ C
Manipultion-
 Five points
1. Maximum amount of powder possible for the particular
application should be used to ensure minimum solubility
and maximum strength.
2. A cool mixing slab should be employed.(note- The liquid
should not be dispensed until the start of mixing to
prevent evaporation of water.)
3. The powder should be divided in the increments, mixing is
initiated by addition of small amount of powder with brisk
spatulation
4. The prosthesis should be seated immediately before the
formation of matrix.
5. Excessive cement can be removed after it get set.
 ADA specification – 96 (old
61)
 Canadian biochemist Smith
Developed first
polycarboxylate cement by
substituting the phospheric
acid of zinc phosphate
cement with polyacrylic acid.
 It is the first system
developed with the potential
of adhesion to the tooth
structure.
Adhesion to the tooth structure
 React with the calcium ions of the enamel or dentin thrrough
carboxyl ions.
 Reaction involves particle dissolution by the acid that releases zinc,
magnesium, and tin ions.
 These ions react with carboxyl group of adjacent polyacid chains so
that a cross-linked salt is formed as the cement sets.
Composition
Powder
Zinc
Oxide
- Basic
ingredient
Magnasi
um
Oxide
-Principal
modifier and
also aids in
sintering
Oxide of
bismuth
and
aluminiu
m
-Small
amounts
Stannous
flouride
-Increases
strength, -
modifies
setting time,
-anticariogenic
property
Liquid
Aqueous solution of
polyacrylic acid or
copolymer of acrylic acid
with other unsaturated
carboxylic acids,
i.e. Iticonic,maleic or
tricaboxylic acid.
Mechanical properties :-
1) Compressive strength- 55 to 67 Mpa
2) Tensile strength- 2.4 to 4.4 Gpa or 6.2 Mpa
(Less than half that of zinc phosphate cement)
 Not as brittle as zinc phosphate
 Plastic deformation potential is high that’s why more difficult
to remove excess cement after setting.
Film Thickness :-
 25 μm or less.
Solubility :-
 Solubility of this cement is low, but when exposed to organic
acids such as Lactic acid of less than pH 4.5 the solubility
markedly increases.
 Reduction in the P/L ratio results in higher solubility and
disintegration rate in the oral cavity.
Working time :-
 Shorter than the zinc phosphate cement.
 Approximately 2.5 min.
 Lowering the temperature of the slab can increase the
working time.
 But lowering the temp. Of glass slab can result the acid to be
get thicken and increases the viscosity.
 It is advised to refrigerate only powder before mixing.
Setting time :-
 Ranges from 6 to 9 min.
 Acceptable for luting cement.
Biological Properties :-
 pH of the cement is 1.7
 pH rises rapidly as the setting reaction proceeds.
 pH of Zinc polycarboxylate cement rises more rapidly than the
pH of Zinc Phosphate cement.
 Larger size of the molecules of zinc polycarboxylate cement
limits its diffusion through the dentinal tubules.
 Thus imparts excellent biocompatibility equivalent to ZOE
cement.
Manipulation
 Powder to liquid ratio range from 1.5 parts of powder to 1
part of liquid by weight.
 Mixing should be done on the surface that doesn’t absorb
the liquid.
 Glass slab is advantageous over paper pads supplied by
manufacturer.
 Because once the glass slab is cooled, it maintains temp. for
longer time.
• The liquid should not be dispensed before
the time when the mix is to be made
It loses water to the atmosphere very rapidly.
• The loss of water from the liquid results in
a very marked increase in its viscosity.
•The powder is rapidly
incorporated into the liquid in
large quantities
• Fig. A indicates the
consistency of the cement
immediately after the 30 sec
mix.
• Fig. B indicates the longer
mixing time or additional time
on the mixing slab
• If good bonding to tooth
structure is to be achieved,
the cement must be adapted
against the tooth surface before
it loses its glossy
Appearance.
• The glossy appearance
indicates a sufficient number
of free carboxylic acid groups
on the surface of the mixture
that are vital for bonding to
tooth structure.
 A dull-looking mixture means that an insufficient
number of unreacted carboxyl groups are available to
bond to the calcium In the tooth surface.
Retention of the Cement
 Despite of a property of tooth adhesion this cement
is not superior to Zinc Phosphate cement in the
means of retetion.
 Failure usually occurs at the cement-tooth interface
with zinc phosphate cement.
 In the case of the Zinc Polycarboxylate cements, the
failure occurs usually at the cement-metal
interface, rather than at the cement-tooth interface.
 The cement does not bond to the noble metal in
the chemically contaminated cast.
 Thus it is essential that this contaminated surface
in the cavity side of the casting be removed to
improve wettability and the mechanical bond at
the cement-metal interface
 The surface can he carefully abraded with a small
stone, or it can be sandblasted with high-pressure
air and alumina abrasive.
Removal of Excess Cement
 During setting, the zinc polycarboxylate cement
passes through a rubbery stage that makes removal
of the excess cement quite demanding.
 Excess cement should not be removed in this stage
because there are chances of cement gets pulled out
of the crown.
 It can removed only after it becomes hard.
 The outer surface of the prosthesis be coated
carefully with a thin layer of separated medium,
such as petrolium jelly, to prevent excess cement
from adhering its surfaces.
 care should be taken not to allow the medium to touch
the margin of the prosthesis
 Another approach is to start removing excess cement
as soon as setting of the cement.
 The goal of doing all is this is to prevent excess cement
duirng rubbery stage.
 Modified Zinc Phosphate cements
 Silver salts or copper oxide are the sometimes
added to the powders of the Zinc Phosphate
cement to increase their antibacterial
properties.
Composition
 Copper oxide-
 Zinc Oxide-
 Liquid is consist of clear Phospheric acid
Properties
Biological Properties :
 Ph is 5.3 and it is irritant to pulp.
 They are bactericidal or bacteriostatic in nature.
Manipulation
 Manipulated in same manner of Zinc Phosphate
cement.
Disadvantages
 Poor biological properties.
 Toxic to the cells
Uses
 Temporary fillings in the children
 Intermediate restorations
 For retention of silver cap splints in the oral surgery
 Indirect pulp capping
 As base beneath composite restorations
Commercial Examples
Ames Copper (Discontinued)
Doc’s Best Red and White copper kit
 ADA specification no. 34
 These cements used extensively in dentistry since
1890s.
 Cements of low strength
 Least irritating to the pulp and have obtundant effect
n dental pulp.
CLASSIFICATION: (ISO 3107:2004/COR.1:2006)
1. Type I ZOE – Temporary cementation
2. Type II ZOE – Permanent cementation
3. Type III ZOE – Bases
4. Type IV ZOE – Cavity liners and periodontal dressings
Type I Cements
 Meant for the short term luting .
 Used for the cementation of provisional restorations
 It has low strength which favours the easy removal of
temp. prosthesis.
 The presence of free eugenol from the temp. Cement is
thought to interfere with resin bonded composites.
 To prevent, various types of carboxylic acids have been
used to replace eugenol content, such cements known as
non-eugenol cements.
Type II Cements
 Meant for long term restorations
 Modified ZOE are used to substitute their lower strength
 There are two systems used in this way
 First system is that which substitutes the parts of the
eugenol with orthoethoxybanzoic acid and alumina
added to the powder.
Type III cements
 Used for the interim period when the tooth is
undergoing treatment or until it is ready for the
permanent restoration.
 Also used as bases under permanent restorations
Tyoe IV cements
 Used as liners
 Sufficient powder must be added to achieve its desired
properties.
Composition :-
 Available as powder and liquid systmes
Powder Wt% Finction
Zinc Oxide 69 % Principal ingrdient
White rosin 29.3 % Reduces brittleness of
set cement
Zinc stearate 1 % Acceleretaor
Zinc acetate 0.7 % Accelerator, improves
strength
Magnesium oxide Same as Zinc oxide
Powder
Liquid Wt % Function
Eugenol 85 % Reacts with ZnO2
Olive oil 15 % Plasticizer
Liquid
Setting reaction
• Reaction takes place between the Zinc oxide and Eugenol
• Hydrolysis of Zinc oxide takes place and reaction between Zinc
oxide and Eugenol result in the formation of chelates.
1) ZnO + H2 O Zn(OH)2
2) Zn(OH)2 + 2HE ZnE2 + 2H2O
• Water is needed to initiate the reaction and also a by product of this
reaction
• That is why the reaction occur moe rapidly in the humid environment or in
the presence of water
 Acetic acid is more active catalyst as it result in the more rapid formation of
zinc hydroxide
 High atmospheric temperature also accelerates the reaction
 The chelate formed is an amorphous gel that tend to crystallize imparting
strength to the set mass.
Commercial products
Availabe as powder liquid system and two paste system
A. Type I ZOE for temperory restorations
B. Type III ZOE for temperory restorations
Properties
Mechanical properties :
1) Compressive strength : Type I – 6 to 28 Mpa
Type 2 – 45 To 55 Mpa
Lowest with the cavity liners of 5 Mpa.
2) Tensile strength : Range from 0.32 to 5.3 Mpa
3) Modulous of elasticity : 0.22 to 5.4 Gpa
C. Type 4 ZOE for cavity liners
Thermal Properties
1) Thermal Conductivity : Excellent thermal insulating properties and
almost same as for the human dentin.
Solubility
 Highest among the cements
 They disintegrate in the oral fluids
 Disintegration is due to hydrolysis of the zinc eugenolate matrix
 Soubility is reduced by increasing the P/L ratio
Film Thickness
 25 μm
 Generally higher in cement and important for luting and bases application.
Adhesion
 They do not adhere to the tooth surface, hence can
not used for final cementation of the crown.
Biological Properties
 pH of the cement is 6.6 to 8
 Least irritating compare to other cements
 Mild irritant to the pulp
 Also bacteriostatic in nature and imparts soothing effect on the pulp of deep
cavities.
Manipulation
 Powder/Liquid ratio- 4:1 to 6:1
 Powder and liquid dispensed over the
glass slab
 The bulk of powder incorporated into
the liquid and spatulated thoroughly in
the circular motion with a stiff bladed
stainless steel spatula.
 Zinc oxide eugenol exhibits
pseudothickening.
 Further vigorous spatulation or
stroping loosen the mix.
 Putty like consistency is recommended
for temp. Restorations.
 Oil of orange is used to remove the
eugenol cement from the instruments.
Two paste systems
 Equal length of each paste are dispersed and mixed
until a uniform colour is observed.
Setting time
•4-10 minutes
•Sets quicky in mouth because of moisture and heat.
They are developed to improve the shortcomings of the
regular ZOE they are -
1. EBA – Alumina modified cements
2. Polymer reinforced ZOE cement.
Other forms of ZOE cements include
 Zoe based Endodontic sealers
 Available as White powder and a Pinkish liquid.
 A part of liquid is substituted by
orthoethoxybanzoic acid.
 Alumina is added to thr powder.
 These cements are increasing in its popularity for the
retrograde filling because the high cost of MTA.
Composition
Powder
Zince oxide - 60-75%
Alumina - 20-35%
Hydrogenated Rosin - 6%
Liquid
EBA – 62.5%
Eugenol – 37.5%
Properties
Mechanical Properties
Compressive strength – 55 to 60 Mpa
Tensile stength – 4.1 Mpa
Modulous of elasticity – 2.5 Mpa
Film thickness – 25 μm
Solubility
0.05% which is less
Effect on pulp
Mild irritant to pulp
Adhesion
Adhere well to tooth structure
Manipulation
 A glass slab is required
 Powder incorporated in the bulk kneaded for 30 sec
and again stropped for additional 60 sec with broad
strokes of spatula to obtain creamy consistency.
Setting time
 9.5 Minutes
Uses
 Long term cementation
 Temporary and intermediate restorations
 Root end filling material.
2 ) POLYMER REINFORCED ZOE CEMENT
 Modified form of ZOE whenresin added to the powder or
to the liquid.
 They can last as long as 1 year.
Commercial products
 IRM(Dentsply)
 Kalzinol(DPI)
Composition
Powder
Zinc oxide – 70%
Finely divided natural or synthetic resins
Liquid
Eugenol
Acetic acid
Thymol
Properties
Compressive strength – 48 Mpa
Tensile strength – 4.1 Mpa
Modulous of elasticity – 2.5 Gpa
Film thickness – 32 μm
Solubility – 0.03 %
Biocompatibility- Moderate
Working time – These cements have a long working time.
Setting time – 6 to 10 minutes.
Uses
1. Luting
2. As base
3. As temporary filling material
Two traditional formulations are very popular.
1. Rickert’s Formula
2. Grossman’s Formula
• Along with gutta percha these materials are used to seal
the canals in endodontic therapy.
• Some materials also can be used for the therapeutic
perpose by adding iodoform, paraformaldehyde.
Rickert’s Formula based sealers
•The earliest were made by dissolving gutta percha into
the solvants like chloroform and termed as Chloropercha.
•They had problem with shrinkage
•Rickets formula developed in 1931 to overcome this
Composition
Powder Liquid
Zinc oxide - 41.2 % Oil of clove - 78%
Precipitated silver - 30% Canada balsam - 22%
White rosin - 16%
Thymol iodide - 12.8%
 Silver is added because of its germicidal and edioopaque
properties.
 It also results in the discoloration of the tooth
 Pulp canal sealers are based on this formula
Grossman’s Formula based sealers
 To prevent staining Grossman developed this sealer as a
substitute of Rickert’s formula.
 It meets most of the Grossmans requirement of an ideal
sealer.
Composition
Powder Liquid
Zinc oxide - 42 % Eugenol
Staybetile resin - 27%
Bismuth subcarbonate - 15%
Bismuth sulphate - 15%
Sodium Borate - 1%
 Hardens in 2 hours at 37 ֯C and 100% humidity.
 Begins to set in canal within 10-30 minutes because of
the moisture present in dentin.
 Setting time can be influenced by quality of zinc oxide,
pH of resin used, care and technique of mixing.
 Tissue tolerance is good with little inflammation with
no inhibition of repair.
 Langeland and coworkers (1981) have stated that all
root canal sealers are irritating in their freshly mixed
state, but on setting becomes innert.
Commercially available sealers
1. Rickets sealer as Pulp canal Sealer
2. Tubli-seal(SybronEndo)
3. Roth’s cement
4. Proco-sol
5. Wachs Sealer(Balas Dental)
 Roth’s cement is manufactured by using Bismuth
Subnitrate in the place of Bismuth Subcarbonate.
 Single component temporary filling materials
 Available as putty in tubes, syringes or plastic
containers
 Commercial products are Cavit(ESPE),
Caviton(GC), Coltosol(Coltene).
Composition
Zinc oxide – 40-60%
Zinc sulphate-1-hydtrate - 1-20%
Calcium sulphate hemihydrate - 15-35%
Ethyylene diacetate - 0-20
Barium Sulphate
Poly vinylacetate
Diatomeceous earth
Properties
 It is radioopaque
 Expands on setting
 Low strength
 Slowly disintegrates there for not indicated for the longer
restorations
Setting reacion
 Sets by reating with water (Hydration)
Manipulation
 Dispensed and inserted into cavities using cement
carrier
 Condensed into cavity using plasric filling
instrument.
 Cavity should not be fully dried because it sets by
hydration
Setting time
20 to 30 minutes
Complete hardening takes place ain 2 to 3 hours.
 Commenly employed as the direct or indirect pulp
capping agent.
 Due to their alkaline nature they also serve as the
barrier against some irritant in certain restorations.
Commercially available as
1. Two paste systems containing base and catalyst
system.
2. Light cured system
3. Single paste in syringe form
4. Powder sytem
Composition
Base Paste % Function
1-methyl trimethylenedisalicylate 40
%
Reacts Ca(OH)2 and
ZnO
Calcium sulphate
Titanium Oxide Fillers and Pigments
Calcium tungstate or barium
ulphate
Radiopacity
Catalyst paste % Function
Calcium hydroxide 50% Principal reacting ingredient
Zinc oxide 10%
Zinc stearate 0.5% Accelerator
Ethylene toluene
Sulphonamide 39.5
%
Acts as a carrier.
Setting reaction
 Calcium hydroxide reacts with the 1-methyl trimethylene
disalicylate ester to form calcium disalicylate.
Properties
Mechanical Properties
Compressive strength : 10 to 27 Mpa after 24 hours
Tensile strength : 1 Mpa (Low).
Modulous of elasticity : Low elastic modulous.
Thermal properties
 Provide thermal insulation when applied in thick layers
Solubility and disintegration
 High water solubility
 Solubility is high in presence of phospheric acid and ether, so care
should be taken during acid etching and during application of varnish in
the presence of this cement.
Biological Properties
Effect on Pulp :
 Alkaline in nature due to the presence of Ca(OH)2
 pH is 9.2 to 11.7
Formation of secondary dentin :
 High Alkalinity, consequent antibacterial properties, and protein lysing
effect help in secondary dentin formation.
Adhesion
 Sensitive to moisture and does not adhere in the presence of water or
saliva
Manipulation
 Equal legths of two pastes are dispensed and mixed
until the uniform color of mix is obtained.
 Carried and applied in the deep cavities using carrier
or a ball ended instrument.
Setting time
 Ranges from 2.5 to 5.5
 Reaction is accelerated by the moisture.
Other formulations of calcium hydroxide
1) Light activated calcium hydroxide cement.
2) Calcium hydroxide based root canal sealers
Light Activated Calcium Hydroxide Cement
 Consist of calcium hydroxide and baium sulphate
dispersed in a urethane dimethacrylate resin.
 Also contains HEMA and polymerization activators
 Some contain flouride
 Have long working time and is less brittle than the
conventional two paste system.
 They are radiopaque.
 Supplied in a syringe form
 Examples – 1)Septacol LC(septodont),Calcimol
LC(VOCO)
Commercial products
Regular set – Dycal(Dentsply), Calcidor(Dorident), Recal(PSP),
Hydrox(Bosworth)
Light cured – Septocal (Septodont) and Cacimol LC(VOCO)
Calcium Hydroxide based sealers
 This are similar to the ones used for pulp
capping but having increased amount of
retarders to extend the working time.
 They are radiopaque
 Have effective anti bacterial property
without irritation.
 They simulate hard tissue repair in the apical
foramen.
1 ) Sealapex:
 It is noneugenol, calcium hydroxide polymeric resin
root canal sealer available as base catalyst system.
Composition
Base Catalyst
Zinc oxide Resin
Calcium hydroxide Isobutyl
salicylate
Butyl benzene Barium sulfate
Sulfonamide Titanium oxide
Zinc stearate Aerosol
Literature reviews of the sealer
1. Hovland and Dumsha (1985) reported that
approximatley the same amount of microleakage
of Sealapex, Procosol, and tubli-Seal, when these
materials used in fillling root canals.
2. Cox et al. (1989) reported healing at the root
apices of the monkeys6 months after sealing with
the Sealapex. It was more advanced when
compared with the AH26, Rickerts’s sealer.
CRCS
 Calicibiotic root canal sealer
 Contains 14% by weight of calcium hydroxide
Metapex
 It is the Calcium hydroxide
with the Idoform.
 Used for pulpotomy, direct
pulp capping, root canal
filling material, apexifcation.
 Excellent antibacterial effect
and radiopacity .
 Premixed paste in a
convenient syringe i available.
 Excellent accessibility to the
root canal and prevention of
cross-contamination

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3. dental cements i

  • 1.
  • 2. By Dr. Aadil Thimwala M.D.S (1st Year) Dept. Of Conservative Dentistry & Endodontics
  • 3.  Introduction  Classification  Uses  Properties  Silicate Cements  Zinc Phosphate Cement  Zinc Polycarboxylate Cement  Zinc Oxide Eugenol Cement  Calcium Hydroxide  Resin Cements  Glass Ionomer Cement  Metal Modified Glass ionomer cement  Resin Modified Glass Ionomer Cement Outline
  • 4.  Copper cements  Calcium sulphate cements  MTA (Tri silicate based cements)  Biodentine
  • 5. Dental Cement- “The substances that hardens to act as a base, liner, filling material, or adhesive to bind devices and prosthesis to tooth structure or to each other.” (GPT)  First dental cement was introduced in 1785 by Sorel.  Created ‘Zink-oxide-chloric-cement’.  Rostain and then Flak developed and introduced Zinc Phosphate Cement.
  • 6. Dental Cements-  Consist of powder and liquid when mixed produce a plastic mass. Most Dental Cements are supplied as TWO components Powder Liquid  With the exception of resin cements , the liquids are usually acidic solutions or proton donors.  The powder are basic in nature, consisting typically of either glass or metallic oxide particles
  • 7.  The reaction between the powder and liquid is essentially an acid-base reaction.  Upon setting , these cements gain sufficient strength for use as a base, as a restorative material for temporary or permanent restorations, or as a luting agent.  Cements of low viscosity have the ability to flow between the tissue surface and prosthesis, and hold the prosthesis in its place.
  • 8.  Such agents known as luting agents.  Before placement of the restoration, the pulp may get irriratated.  In order to prevent pulp from irritation and provide thermal insulation some cements are applied as bases.  Some of the cements can be placed on the exposed pulp as means of direct pulp capping agent.
  • 9. Classification Based on their core constituent Ceramic based cements Polymer based cements. Based on the ISO standerds ISO 9917-1:2003 Water-based cements part 1 ISO 9917-21998 Water-based cements part 2 ISO 3107:2004 Zonc oxide/eugenol and non eugenol cements ISO 4049:2000 Polymer based filling, restorative and luting materials
  • 10. Accoding to setting reaction Acid-base reaction Polymerizing cements Dual cure cements Tricure cements According to their use Type 1 : Luting agents Type 2 : Restorative appplications Type 3 : Liner or base applications
  • 11. Craig’s Classification A) Water based cements: They rely on acid-base setting reaction -GIC -RMGIC -Zinc phophate -Zinc polycarboxylate B) Oil-based cements: Depends on the presence or absence of eugenol - ZOE - Non eugenol cements C) Resin-based cements: Setting reaction based on composite resin.
  • 12. Uses
  • 13. 1) Strength  The strength required for the cement generally depend on the application of the cement.  Cements to be used under amalgam should have higher strength to withstand high condensation forces.  Many dental cements as well as restorative materials continue to gain strength after placement.  That is why it is always advisable to wait for 2 hours for food after placement of cement.  Dental cements must exhibit minimum 24 hour compressive strength of 70 Mpa. General Properties of Cements
  • 14. 2) Modulous of elasticity  Measure of the stiffness of the cement.  Cements under ceramic crowns should have sufficient to withstand masticatory loads.  A low MOE can result in flexing of the restoration results in fracture. 3) Soubility and disintegration  It is important as it determine the long term survivability of restorations.  Solubility and disintegration of the cements can lead to problems like inflammation, caries, sensitivity etc.  It can be reduced by proper manipulation, minimizing the exposure of the cement to the oral environment.
  • 15. 4) Film Thickness  Important for luting cements, as thinner film is more advantageous for luting.  It improves the sitting of the restoration  Helps in greater flow, wetting of the tooth, thus improves bonding.  Minimizes the air spaces and structural defects present in the bulk of the cement.  Measured in μm.  According to the ADA specification no.96 Type 1 ) 25 μm Type 2) 40 μm
  • 16. Working Time  Time elapsed from the start of mixing to the point at which the consistency of material is no longer suitable for itended use.  Cement should have adequate working time in order to achieve a proper, uniform mix and an even consistency and be manipulable for the required period of time.  Cements generally require about 2-5 minutes Setting Time  Defined as the time lapse from the start of the mixing to the point the mixture reaches a desired hardness or consistency.  Sufficient time must be available to place and adapt the material.  It is generally 2.5 and 8 minutes at a temp. Of 37 ֯ C
  • 17. Biologic Properties  It must not be irritant or toxic to the pulp. 1) pH of the cement:  Most cements are acidic  Exceptions are zinc oxide eugenol, calcium hydroxide, and resin cements, 2) Pulpal response:  Classified as mild, moderate, or severe.  Originally silicate cements used to compare other cements because of its high acidity. 3) Pulp protection:  In case of deep cavities pulp protection becomes necessary.
  • 18.  Luting- Placing a viscous material at the interface of prosthesis and tooth surface in order to retain the prosthesis.  Numerous dental treatments include attachment of prosthesis to the tooth.  These include ceramics, metal, metal- ceramic , composite restorations.
  • 20. CAVITY VARNISHES  Varnish- A solution of a natural gums, synthetic resins or resin dissolved in the volatile solvants such as acetone, ether or chloroform.  Agents that reduces pulpal irritation.  They are natural gums such as Copals or rosins, or synthetic resins dissolved in the organic solvents such as acetone, chloroform, and ether.  Literature generally suggests that varnishes reduces pulpal irritation.
  • 21.  This conclusion drown from the in vitro studies showing reduction of infiltration of fluids through marginal areas.  It prevents penetration of corrosion products of Amalgam through dentinal tubules.  Thus it reduces the tooth discoloration.  To attain a uniform and continuous coating on all surfaces of the prepared cavity, the clinician should apply at least two thin layers of varnish.  When the first layer dries, small pinholes usually develop. A second or third application fills in most of these voids.  A varnish is not indicated while adhesive materials, such as GIC and resin-based composite, are used.
  • 22. CAVITY LINERS  Cavity liner- Thin layer of cement, such as a calcium hydroxide suspension in an aqueous or resin carrier.  Formulated by dispersing Calcium hydroxide cement resin carrier solutions.  The carrier evaporates and leaves very thin coating of a liner.  Because calcium hydroxide is soluble in oral fluid, it is mandatory not to apply it on the cavity margins.
  • 23. Liners Varnishes Thicker than varnishes Carry therapeutic agents Greater film thickness (25 μm) Applied on dentin only. Thinner than liners. Doesn’t Carry therapeutic agents Less film thickness (5- 10 μm) Applied on dentin and frequently on enamel. Operative dentistry- Modern theory and practice, M. A. Marzuck
  • 24. CAVITY BASES  Base- Layer of insulating, sometimes medicated, cement, placed in the deep portion of the preparation to protect pulpal tissue from thermal and chemical injury.  In contrast to liners the bases are applied in much thicker layers(>0.75 mm)  They protects pulp from thermal insults, galvanic shock, material should be strong enough to withstand condensation forces.
  • 25. Gladwin Clinical Aspects of Dental Materials
  • 26.  ADA specification – 96 (old 9)  Introduced by Fletscher in 1873.  Steenbock introduced the improved version in 1904.  Schoenback developed the silicate cements that contain flouride in 1908.  It was developed as the anterior aesthetic materials.  Average life of silicate cements is four years may last upto 25 years.  Incidence of secondary caries are less with silicate cements  Incidence of contact caries also as compared to amalgam.
  • 27.  Silicon dioxide  Aluminimum trioxide  Sodium phosphate  Flouride form of sodium  Calcium flouride Aluminium flouride • 35%-50% Phospheric acid Sodium • Aluminium Phosphate Powder Liquid S. Mahalaxmi- Textbook of Dental Materials
  • 28. Properties Biological properties  Flouride release is low but occur throughout the life.  The pH of cement remain as low as 3 for few days, hence a source of pulpal irritation Esthetics  The optical properties are good because the are transparent when compared to GIC. Microleakage  It has CTE closely matching the tooth structure hence it minimizes the tooth structure.
  • 30.  pH of the cement is low, hence it is severe irritant to the pulp Advantages Flouride release throughout life Tranclucent in nature Disadvantages Pulpal irritant Over time they get degraded and stained Leakage around the margin occur Get easily attacked by oral fluids and in time degrade
  • 31.  Zinc phosphate cement is the oldest of the luting cements. It has the longest ‘track record’ and serves as a standard with which newer systems can be compared.  Introduced bt Dr. Otto Hoffman in 1800s.  It consist of powder and liquid in two separate bottles.  ADA specification – 96 (old 21) Uses Of the cement  Luting of restorations for inlays, crowns, fixed dental prostheses, etc.  High strength bases  Temporary restorations  Luting of orthodontic bands and brackets.
  • 32. Composition Powder % Function Zinc oxide 90.2% Main Ingredient Magnasium oxide 8.2% Aids in sintering Other oxides(Bismuth trioxide,barium oxide,calcium oxide) 0.2% Improves smoothness Silica 1.4% Filler, Liquid % Function Phospheric acid 38.2% Reacts with ZnO Aluminium 36% Controls rate of reaction Water 16.2% Buffer, to reduce rate of reaction Alumina 2.5% Zinc 7.1%
  • 33.  Some commercially available cements are –  Confit, Harvard, Zinc cement(DPI), Modern Tenacin, Poscal(VOCO), De Trey Zinc(Dentsply), Hy Bond etc.
  • 34. Physical Properties Of ZnPo4 Cement  Two Relevant properties to the retention of fixed prosthesis are the mechanical properties and solubilities.  Dislodment of prosthesis if the underlying cement is stressed beyond its strength.  High solubility can induce loss of the cement needed for retentionand may create plaque retetion.  Compressive strength- 104 Mpa  A Dimetral Tensile Strength- 5.5 Mpa  Modulous Of Elasticity- 13.7 Gpa.
  • 35. (Prevent deformation when employed as the luting agent in restorations under high masticatory stress) The compressive strength and tensile strength vary with the P/L Ratio. The Recommended P/L ratio is 1.4 g Powder to 0.5 mL liquid. Reduction in the P/L ratio of the mix produces a weaker cement.
  • 36. Retention of the cement-  By mechanical interlocking at interfaces, not by chemical interactions.  Any coating applied on the tooth surface for pulp protection reduces retention. Biological Properties-  Acidity of the material bacuase of the presence of Phospheric acid. Two min after the start of mixing – pH is 2 After 24 hr. Of placement – pH is 5.5
  • 37. Working and Setting time-  Working time for cement is  Setting time for zinc phosphate cement is between 2.5 to 8 min, as Specified in ANSI/ADA specification No. 96  It is desirable to extend the setting time of the cement to proviode sufficient working time for manuplation. Extending setting time (chair side) 1. Reducing P/L ratio producing thinner mixture. However, this change will adversely Affect the physical properties and result in a lower initial pH and also decreases the compresive strength of the cement. 2. Mixing cements in incrememntAnd Introducing smaller quantities of powder into the liquid for the first few increments.
  • 38. 3. Prolonging the spatulation of the last increment, the matrix will be destroyed as it is forming, extra time will be neded to build the bulk of matrix. 4. Most effective method is to regulate the temperature of the mixing slab  Cooling the slab retards the reaction b/w powder and liquid thereby retards the formation of liquid.  This permits the optimum amount of powder to get incorporated in the liquid before it develops high viscosity.  Mixing at room temprature will result in the mix of high viscosity.
  • 39. Temperature at 18 ֯ C Temperature at 27 ֯ C
  • 40. Manipultion-  Five points 1. Maximum amount of powder possible for the particular application should be used to ensure minimum solubility and maximum strength. 2. A cool mixing slab should be employed.(note- The liquid should not be dispensed until the start of mixing to prevent evaporation of water.) 3. The powder should be divided in the increments, mixing is initiated by addition of small amount of powder with brisk spatulation 4. The prosthesis should be seated immediately before the formation of matrix. 5. Excessive cement can be removed after it get set.
  • 41.
  • 42.  ADA specification – 96 (old 61)  Canadian biochemist Smith Developed first polycarboxylate cement by substituting the phospheric acid of zinc phosphate cement with polyacrylic acid.  It is the first system developed with the potential of adhesion to the tooth structure.
  • 43. Adhesion to the tooth structure  React with the calcium ions of the enamel or dentin thrrough carboxyl ions.  Reaction involves particle dissolution by the acid that releases zinc, magnesium, and tin ions.  These ions react with carboxyl group of adjacent polyacid chains so that a cross-linked salt is formed as the cement sets.
  • 44. Composition Powder Zinc Oxide - Basic ingredient Magnasi um Oxide -Principal modifier and also aids in sintering Oxide of bismuth and aluminiu m -Small amounts Stannous flouride -Increases strength, - modifies setting time, -anticariogenic property Liquid Aqueous solution of polyacrylic acid or copolymer of acrylic acid with other unsaturated carboxylic acids, i.e. Iticonic,maleic or tricaboxylic acid.
  • 45. Mechanical properties :- 1) Compressive strength- 55 to 67 Mpa 2) Tensile strength- 2.4 to 4.4 Gpa or 6.2 Mpa (Less than half that of zinc phosphate cement)  Not as brittle as zinc phosphate  Plastic deformation potential is high that’s why more difficult to remove excess cement after setting. Film Thickness :-  25 μm or less.
  • 46. Solubility :-  Solubility of this cement is low, but when exposed to organic acids such as Lactic acid of less than pH 4.5 the solubility markedly increases.  Reduction in the P/L ratio results in higher solubility and disintegration rate in the oral cavity. Working time :-  Shorter than the zinc phosphate cement.  Approximately 2.5 min.  Lowering the temperature of the slab can increase the working time.  But lowering the temp. Of glass slab can result the acid to be get thicken and increases the viscosity.  It is advised to refrigerate only powder before mixing.
  • 47. Setting time :-  Ranges from 6 to 9 min.  Acceptable for luting cement. Biological Properties :-  pH of the cement is 1.7  pH rises rapidly as the setting reaction proceeds.  pH of Zinc polycarboxylate cement rises more rapidly than the pH of Zinc Phosphate cement.  Larger size of the molecules of zinc polycarboxylate cement limits its diffusion through the dentinal tubules.  Thus imparts excellent biocompatibility equivalent to ZOE cement.
  • 48. Manipulation  Powder to liquid ratio range from 1.5 parts of powder to 1 part of liquid by weight.  Mixing should be done on the surface that doesn’t absorb the liquid.  Glass slab is advantageous over paper pads supplied by manufacturer.  Because once the glass slab is cooled, it maintains temp. for longer time.
  • 49. • The liquid should not be dispensed before the time when the mix is to be made It loses water to the atmosphere very rapidly. • The loss of water from the liquid results in a very marked increase in its viscosity.
  • 50. •The powder is rapidly incorporated into the liquid in large quantities • Fig. A indicates the consistency of the cement immediately after the 30 sec mix. • Fig. B indicates the longer mixing time or additional time on the mixing slab • If good bonding to tooth structure is to be achieved, the cement must be adapted against the tooth surface before it loses its glossy Appearance. • The glossy appearance indicates a sufficient number of free carboxylic acid groups on the surface of the mixture that are vital for bonding to tooth structure.
  • 51.  A dull-looking mixture means that an insufficient number of unreacted carboxyl groups are available to bond to the calcium In the tooth surface. Retention of the Cement  Despite of a property of tooth adhesion this cement is not superior to Zinc Phosphate cement in the means of retetion.  Failure usually occurs at the cement-tooth interface with zinc phosphate cement.  In the case of the Zinc Polycarboxylate cements, the failure occurs usually at the cement-metal interface, rather than at the cement-tooth interface.
  • 52.  The cement does not bond to the noble metal in the chemically contaminated cast.  Thus it is essential that this contaminated surface in the cavity side of the casting be removed to improve wettability and the mechanical bond at the cement-metal interface  The surface can he carefully abraded with a small stone, or it can be sandblasted with high-pressure air and alumina abrasive.
  • 53. Removal of Excess Cement  During setting, the zinc polycarboxylate cement passes through a rubbery stage that makes removal of the excess cement quite demanding.  Excess cement should not be removed in this stage because there are chances of cement gets pulled out of the crown.  It can removed only after it becomes hard.  The outer surface of the prosthesis be coated carefully with a thin layer of separated medium, such as petrolium jelly, to prevent excess cement from adhering its surfaces.
  • 54.  care should be taken not to allow the medium to touch the margin of the prosthesis  Another approach is to start removing excess cement as soon as setting of the cement.  The goal of doing all is this is to prevent excess cement duirng rubbery stage.
  • 55.  Modified Zinc Phosphate cements  Silver salts or copper oxide are the sometimes added to the powders of the Zinc Phosphate cement to increase their antibacterial properties. Composition  Copper oxide-  Zinc Oxide-  Liquid is consist of clear Phospheric acid
  • 56. Properties Biological Properties :  Ph is 5.3 and it is irritant to pulp.  They are bactericidal or bacteriostatic in nature. Manipulation  Manipulated in same manner of Zinc Phosphate cement. Disadvantages  Poor biological properties.  Toxic to the cells
  • 57. Uses  Temporary fillings in the children  Intermediate restorations  For retention of silver cap splints in the oral surgery  Indirect pulp capping  As base beneath composite restorations Commercial Examples Ames Copper (Discontinued) Doc’s Best Red and White copper kit
  • 58.  ADA specification no. 34  These cements used extensively in dentistry since 1890s.  Cements of low strength  Least irritating to the pulp and have obtundant effect n dental pulp. CLASSIFICATION: (ISO 3107:2004/COR.1:2006) 1. Type I ZOE – Temporary cementation 2. Type II ZOE – Permanent cementation 3. Type III ZOE – Bases 4. Type IV ZOE – Cavity liners and periodontal dressings
  • 59. Type I Cements  Meant for the short term luting .  Used for the cementation of provisional restorations  It has low strength which favours the easy removal of temp. prosthesis.  The presence of free eugenol from the temp. Cement is thought to interfere with resin bonded composites.  To prevent, various types of carboxylic acids have been used to replace eugenol content, such cements known as non-eugenol cements. Type II Cements  Meant for long term restorations  Modified ZOE are used to substitute their lower strength
  • 60.  There are two systems used in this way  First system is that which substitutes the parts of the eugenol with orthoethoxybanzoic acid and alumina added to the powder. Type III cements  Used for the interim period when the tooth is undergoing treatment or until it is ready for the permanent restoration.  Also used as bases under permanent restorations Tyoe IV cements  Used as liners  Sufficient powder must be added to achieve its desired properties.
  • 61. Composition :-  Available as powder and liquid systmes Powder Wt% Finction Zinc Oxide 69 % Principal ingrdient White rosin 29.3 % Reduces brittleness of set cement Zinc stearate 1 % Acceleretaor Zinc acetate 0.7 % Accelerator, improves strength Magnesium oxide Same as Zinc oxide Powder
  • 62. Liquid Wt % Function Eugenol 85 % Reacts with ZnO2 Olive oil 15 % Plasticizer Liquid Setting reaction • Reaction takes place between the Zinc oxide and Eugenol • Hydrolysis of Zinc oxide takes place and reaction between Zinc oxide and Eugenol result in the formation of chelates. 1) ZnO + H2 O Zn(OH)2 2) Zn(OH)2 + 2HE ZnE2 + 2H2O • Water is needed to initiate the reaction and also a by product of this reaction • That is why the reaction occur moe rapidly in the humid environment or in the presence of water
  • 63.  Acetic acid is more active catalyst as it result in the more rapid formation of zinc hydroxide  High atmospheric temperature also accelerates the reaction  The chelate formed is an amorphous gel that tend to crystallize imparting strength to the set mass. Commercial products Availabe as powder liquid system and two paste system A. Type I ZOE for temperory restorations B. Type III ZOE for temperory restorations
  • 64. Properties Mechanical properties : 1) Compressive strength : Type I – 6 to 28 Mpa Type 2 – 45 To 55 Mpa Lowest with the cavity liners of 5 Mpa. 2) Tensile strength : Range from 0.32 to 5.3 Mpa 3) Modulous of elasticity : 0.22 to 5.4 Gpa C. Type 4 ZOE for cavity liners
  • 65. Thermal Properties 1) Thermal Conductivity : Excellent thermal insulating properties and almost same as for the human dentin. Solubility  Highest among the cements  They disintegrate in the oral fluids  Disintegration is due to hydrolysis of the zinc eugenolate matrix  Soubility is reduced by increasing the P/L ratio Film Thickness  25 μm  Generally higher in cement and important for luting and bases application.
  • 66. Adhesion  They do not adhere to the tooth surface, hence can not used for final cementation of the crown. Biological Properties  pH of the cement is 6.6 to 8  Least irritating compare to other cements  Mild irritant to the pulp  Also bacteriostatic in nature and imparts soothing effect on the pulp of deep cavities.
  • 67. Manipulation  Powder/Liquid ratio- 4:1 to 6:1  Powder and liquid dispensed over the glass slab  The bulk of powder incorporated into the liquid and spatulated thoroughly in the circular motion with a stiff bladed stainless steel spatula.  Zinc oxide eugenol exhibits pseudothickening.  Further vigorous spatulation or stroping loosen the mix.  Putty like consistency is recommended for temp. Restorations.  Oil of orange is used to remove the eugenol cement from the instruments.
  • 68. Two paste systems  Equal length of each paste are dispersed and mixed until a uniform colour is observed. Setting time •4-10 minutes •Sets quicky in mouth because of moisture and heat.
  • 69. They are developed to improve the shortcomings of the regular ZOE they are - 1. EBA – Alumina modified cements 2. Polymer reinforced ZOE cement. Other forms of ZOE cements include  Zoe based Endodontic sealers
  • 70.  Available as White powder and a Pinkish liquid.  A part of liquid is substituted by orthoethoxybanzoic acid.  Alumina is added to thr powder.  These cements are increasing in its popularity for the retrograde filling because the high cost of MTA. Composition Powder Zince oxide - 60-75% Alumina - 20-35% Hydrogenated Rosin - 6% Liquid EBA – 62.5% Eugenol – 37.5%
  • 71. Properties Mechanical Properties Compressive strength – 55 to 60 Mpa Tensile stength – 4.1 Mpa Modulous of elasticity – 2.5 Mpa Film thickness – 25 μm Solubility 0.05% which is less Effect on pulp Mild irritant to pulp Adhesion Adhere well to tooth structure
  • 72. Manipulation  A glass slab is required  Powder incorporated in the bulk kneaded for 30 sec and again stropped for additional 60 sec with broad strokes of spatula to obtain creamy consistency. Setting time  9.5 Minutes Uses  Long term cementation  Temporary and intermediate restorations  Root end filling material.
  • 73. 2 ) POLYMER REINFORCED ZOE CEMENT  Modified form of ZOE whenresin added to the powder or to the liquid.  They can last as long as 1 year. Commercial products  IRM(Dentsply)  Kalzinol(DPI) Composition Powder Zinc oxide – 70% Finely divided natural or synthetic resins Liquid Eugenol Acetic acid Thymol
  • 74. Properties Compressive strength – 48 Mpa Tensile strength – 4.1 Mpa Modulous of elasticity – 2.5 Gpa Film thickness – 32 μm Solubility – 0.03 % Biocompatibility- Moderate Working time – These cements have a long working time. Setting time – 6 to 10 minutes. Uses 1. Luting 2. As base 3. As temporary filling material
  • 75. Two traditional formulations are very popular. 1. Rickert’s Formula 2. Grossman’s Formula • Along with gutta percha these materials are used to seal the canals in endodontic therapy. • Some materials also can be used for the therapeutic perpose by adding iodoform, paraformaldehyde. Rickert’s Formula based sealers •The earliest were made by dissolving gutta percha into the solvants like chloroform and termed as Chloropercha. •They had problem with shrinkage •Rickets formula developed in 1931 to overcome this
  • 76. Composition Powder Liquid Zinc oxide - 41.2 % Oil of clove - 78% Precipitated silver - 30% Canada balsam - 22% White rosin - 16% Thymol iodide - 12.8%  Silver is added because of its germicidal and edioopaque properties.  It also results in the discoloration of the tooth  Pulp canal sealers are based on this formula
  • 77. Grossman’s Formula based sealers  To prevent staining Grossman developed this sealer as a substitute of Rickert’s formula.  It meets most of the Grossmans requirement of an ideal sealer. Composition Powder Liquid Zinc oxide - 42 % Eugenol Staybetile resin - 27% Bismuth subcarbonate - 15% Bismuth sulphate - 15% Sodium Borate - 1%
  • 78.  Hardens in 2 hours at 37 ֯C and 100% humidity.  Begins to set in canal within 10-30 minutes because of the moisture present in dentin.  Setting time can be influenced by quality of zinc oxide, pH of resin used, care and technique of mixing.  Tissue tolerance is good with little inflammation with no inhibition of repair.  Langeland and coworkers (1981) have stated that all root canal sealers are irritating in their freshly mixed state, but on setting becomes innert.
  • 79. Commercially available sealers 1. Rickets sealer as Pulp canal Sealer 2. Tubli-seal(SybronEndo) 3. Roth’s cement 4. Proco-sol 5. Wachs Sealer(Balas Dental)  Roth’s cement is manufactured by using Bismuth Subnitrate in the place of Bismuth Subcarbonate.
  • 80.  Single component temporary filling materials  Available as putty in tubes, syringes or plastic containers  Commercial products are Cavit(ESPE), Caviton(GC), Coltosol(Coltene).
  • 81. Composition Zinc oxide – 40-60% Zinc sulphate-1-hydtrate - 1-20% Calcium sulphate hemihydrate - 15-35% Ethyylene diacetate - 0-20 Barium Sulphate Poly vinylacetate Diatomeceous earth Properties  It is radioopaque  Expands on setting  Low strength  Slowly disintegrates there for not indicated for the longer restorations
  • 82. Setting reacion  Sets by reating with water (Hydration) Manipulation  Dispensed and inserted into cavities using cement carrier  Condensed into cavity using plasric filling instrument.  Cavity should not be fully dried because it sets by hydration Setting time 20 to 30 minutes Complete hardening takes place ain 2 to 3 hours.
  • 83.
  • 84.  Commenly employed as the direct or indirect pulp capping agent.  Due to their alkaline nature they also serve as the barrier against some irritant in certain restorations. Commercially available as 1. Two paste systems containing base and catalyst system. 2. Light cured system 3. Single paste in syringe form 4. Powder sytem
  • 85. Composition Base Paste % Function 1-methyl trimethylenedisalicylate 40 % Reacts Ca(OH)2 and ZnO Calcium sulphate Titanium Oxide Fillers and Pigments Calcium tungstate or barium ulphate Radiopacity Catalyst paste % Function Calcium hydroxide 50% Principal reacting ingredient Zinc oxide 10% Zinc stearate 0.5% Accelerator Ethylene toluene Sulphonamide 39.5 % Acts as a carrier.
  • 86. Setting reaction  Calcium hydroxide reacts with the 1-methyl trimethylene disalicylate ester to form calcium disalicylate. Properties Mechanical Properties Compressive strength : 10 to 27 Mpa after 24 hours Tensile strength : 1 Mpa (Low). Modulous of elasticity : Low elastic modulous. Thermal properties  Provide thermal insulation when applied in thick layers Solubility and disintegration  High water solubility  Solubility is high in presence of phospheric acid and ether, so care should be taken during acid etching and during application of varnish in the presence of this cement.
  • 87. Biological Properties Effect on Pulp :  Alkaline in nature due to the presence of Ca(OH)2  pH is 9.2 to 11.7 Formation of secondary dentin :  High Alkalinity, consequent antibacterial properties, and protein lysing effect help in secondary dentin formation. Adhesion  Sensitive to moisture and does not adhere in the presence of water or saliva
  • 88. Manipulation  Equal legths of two pastes are dispensed and mixed until the uniform color of mix is obtained.  Carried and applied in the deep cavities using carrier or a ball ended instrument. Setting time  Ranges from 2.5 to 5.5  Reaction is accelerated by the moisture. Other formulations of calcium hydroxide 1) Light activated calcium hydroxide cement. 2) Calcium hydroxide based root canal sealers
  • 89. Light Activated Calcium Hydroxide Cement  Consist of calcium hydroxide and baium sulphate dispersed in a urethane dimethacrylate resin.  Also contains HEMA and polymerization activators  Some contain flouride  Have long working time and is less brittle than the conventional two paste system.  They are radiopaque.  Supplied in a syringe form  Examples – 1)Septacol LC(septodont),Calcimol LC(VOCO)
  • 90. Commercial products Regular set – Dycal(Dentsply), Calcidor(Dorident), Recal(PSP), Hydrox(Bosworth) Light cured – Septocal (Septodont) and Cacimol LC(VOCO)
  • 91. Calcium Hydroxide based sealers  This are similar to the ones used for pulp capping but having increased amount of retarders to extend the working time.  They are radiopaque  Have effective anti bacterial property without irritation.  They simulate hard tissue repair in the apical foramen.
  • 92. 1 ) Sealapex:  It is noneugenol, calcium hydroxide polymeric resin root canal sealer available as base catalyst system. Composition Base Catalyst Zinc oxide Resin Calcium hydroxide Isobutyl salicylate Butyl benzene Barium sulfate Sulfonamide Titanium oxide Zinc stearate Aerosol
  • 93. Literature reviews of the sealer 1. Hovland and Dumsha (1985) reported that approximatley the same amount of microleakage of Sealapex, Procosol, and tubli-Seal, when these materials used in fillling root canals. 2. Cox et al. (1989) reported healing at the root apices of the monkeys6 months after sealing with the Sealapex. It was more advanced when compared with the AH26, Rickerts’s sealer. CRCS  Calicibiotic root canal sealer  Contains 14% by weight of calcium hydroxide
  • 94. Metapex  It is the Calcium hydroxide with the Idoform.  Used for pulpotomy, direct pulp capping, root canal filling material, apexifcation.  Excellent antibacterial effect and radiopacity .  Premixed paste in a convenient syringe i available.  Excellent accessibility to the root canal and prevention of cross-contamination