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Dr. Lanja Abubakir Ali
M.Sc. in Conservative Dentistry
Cavity Liners & Cement Bases, their
Manipulation & Insertion into the
Cavity
Liners & Bases:
Are materials placed between dentin & the
restoration must provide pulpal protection .
* Protective needs for a restoration depend upon:
1-The extent & location of the preparation.(depth of
cavity)
2-The type of restorative material to
be used.(type of restoration)
Purposes of Liners & Bases:
protection the pulp from:
1-thermal changes
2-chemicals
(irritants within the materials)
3-leakage
(bacterial by product)
4-electric shock (galvanic reaction)
5-michanical (traumatic occlusion).
Properties of ideal lining restorative
material(liner and base)
1-it should be easy to supply.
2-the strength should be enough to
withstand condensation force.
3-it should be not irritate or interfere with the
setting reaction of the restoration(compatible
with restorative materials).
4- radiopaque (to facilitate subsequent
interpretation of X rays in diagnosis of
recurrent caries).
5-it should be
bacteriostatic effect.
6-well adapted to the
cavity walls(good
sealing ability).
7-reduce thermal
conductivity of the
restoration.
8-it should prevent
chemical exchange
between the tooth
and restoration.
Guidelines for Basing, Lining, & Sealing:
1-Do not remove sound tooth structure to provide
space for a base. Maintaining sound dentin will
enhance restoration support & provide maximum
pulpal protection.
2-Use minimum thickness of base & liner (avoid
unnecessary cavity extension & allow for adequate
thickness of overlying restoration).
Cavity Sealers, Liners, Base:
Cavity sealers: Materials are a thin film liner provide
a protective coating to the walls of the prepared
cavity & a barrier to leakage at the interface of the
restorative material & the walls. Usually sealers coat
all the walls of a cavity preparation commonly used
sealers fall into two categories:
A: Varnish.
B:Resin bonding system.



1-Cavity sealers:
A- Cavity varnish:
Provide a barrier against the passage
of irritants from cements or other
restorative materials.
Reduce penetration of oral fluids
at the restoration- tooth interface into
the underlying dentine.
Reduce sensitivity of newly cut
dentin
•
•
A- Cavity varnish:
composition:
Is a natural gum (copal resin) or synthetic resin
dissolved in solution of ether, chloroform or
acetone.
Volatile solvents evaporate quickly, thus leaving a
thin resin film.
•
•
•
•
A-Cavity varnish :
Manipulation :
Applied with either a small disposable applicator or a small
cotton pellet.
Apply thin layers of varnish 2-5 micrometer on walls , floor,
and margin of the cavity preparation .
Two thin layers found more protective than one heavy layer.
Tightly cap varnish solutions immediately after use to
minimize loss of solvent.
A-Cavity varnish :
•
•
•
•
•
Properties:
Reduce but not prevent the passage of constitutes of
the phosphoric acid cement into underlying dentin.
Thin film significantly reduce leakage around the
margins & wall of metallic restorations.
The integrity of resin film is destroyed when
composite materials are placed in contact with them.
Neither posses mechanical strength nor provide
thermal insulation.
■
■
■
■
Applications:
Cavity varnishes indicated for:
Frequently used under amalgam restoration.
On dentinal surfaces to minimize penetration of acid from
zinc phosphate cements.
On enamel & dentinal walls to reduce penetration of oral
fluids around metallic restorations.
Varnish retard penetration of discolored corrosion products
form dental amalgam into dentin.
Varnishes are not used :
Contraindications
Composite – free monomer layer dissolves the varnish
Ca (OH) 2 & ZOE – beneficial effects are lost
Polycarboxylates – interferes with adhesion
GIC –blocks fluoride production
•
•
B- Adhesive sealers:
These materials is suspension liner
20-25 micrometer have a bonding
ability allowing the restoration to
adhere to the tooth structure.
Adhesive bonding system used to
attach the composite resin or
bonded amalgam restorations to
the tooth structure.
•
•
b. Adhesive sealers :
Uses:
Usually used to reduce the microleakage
& post operative sensitivity in the following
cases:
1-Under slower corroding high copper
amalgam restoration.
2-Attach the composite resin or bonded
amalgam restorations to the tooth structure.
Advantages :
1. Provide prolonged seal compared to the
varnish.
2. Provide superior seal of the dentinal
tubules & tooth restoration interface.
3. Reduce post operative sensitivity.
2. Cavity liners: Cement coating of minimal thickness
(usually less than 0.5 mm) to achieve a physical
barrier to bacteria & their products and/or to provide a
therapeutic effect, such as an antibacterial effect or
pulpal medication effect. Liners are usually applied
only to dentin cavity walls that are near the pulp.
Commonly used liners are
1- Calcium hydroxide liner
2-(ZOE)cement in low strength
•
•
•
2. Cavity Liner:
Provide a barrier against passage of irritants from
cements or other restorative materials.
Reduce the sensitivity of freshly cut dentin.
Must be placed in the deepest area of the cavity on
the pulp should not applied at the margins of restorations.
Cavity liner Neither have mechanical strength nor any
significant thermal insulation.
•Cavity liner are fluid consistency & easily flowed or
painted over dentinal surfaces .Solvents evaporate to
leave a thin film residue.
•
Type of Cavity Liner:
A-Calcium Hydroxide liner (Dycal):
Has long been used as a liner under restorative material ,
Ca (OH)2 is supplied either in the form of (Calcium
hydroxide pawder) is pawder of calcium hydroxide that
mixed with distilled water .or two paste system, one paste
contains (catalyst) while the other contains (base) , or
in single paste like light cured ca (OH)2
Properties of ca (OH)2:
1-it can stimulate the reparative dentin
formation with direct pulp
contact(because it stimulate odontoblast
cell.
2-serve as a protective barrier between
tooth tissues and acid containing cement
and restorative material because it has
high ph. so neutralizes the acidity of the
cement.
3-it has antibacterial action that reduces
inflammatory effect of bacteria.
4-conventional calcium hydroxide liner
(chemical cured type) base catalyst
demonstrated poor physical properties(high
solubility, low value of tensile and compressive
strength).visible light cured calcium hydroxide
overcomes most of these deficiency
•
•
•
•
b. Zinc Oxide- Eugenol Bases (low strength)
Used in deep cavities to retard penetration of acids &
reduce possible discomfort to the pulp (sedative).
ZOE. weaker & less rigid than Ca (OH)2.
Often used with a high strength base.
Should not used with composite restoration, because
eugenol inhibit polymerization of the bonding agent &
composite.
•
•
•
Manipulation:
ZOE & Ca (OH)2 are supplied as two paste
systems.
Equal lengths of the different –colored pastes are
dispensed on a paper pad & then mixed to a
uniform color with a ball point instrument .setting
time 2-3 minuets /mixing time 10 second at room
temperature
3. Cavity bases: Cement coating of 1-2 mm thickness in
deep cavities used to replace missing dentin, to provide
thermal protection for the pulp & to supply mechanical
support for the restoration by distributing local stresses
from the restoration across the underlying dentin
surface.
1-zinc phosphate cement.
2-reinforced zinc oxide eugenol cement.
3-zinc polycarboxylate cement.
4-glass ionomer cement.
5-resin modified glass ionomer
6-resin cement.
•
•
3. Bases (High strength bases):
Used to provide thermal protection for the pulp.
Used to provide mechanical support for a restoration.
* Cavity Sealers, Liners, Base:
•
•
•
•
3- Bases:
Is material with two or more different phases which
react together to form a set mass.
In general primary purpose of bases:
Insulation
Bulk build up
Blocking undercuts
1.
•
•
•
•
Zinc Phosphate cements:
Composition:
It supplied as a powder & liquid react one another to develop
a mass of cement.
Powder: Zinc oxide, Magnesium oxide, Silicon dioxide,
Bismuth trioxide & other minor ingredient.
Liquid: Produced by adding aluminum & sometimes zinc to a
solution of phosphoric acid.
Alkaline powder dissolved acid liquid Exothermic
reaction
•
•
•
•
•
•
•
•
•
•
Manipulation:
Incorporate proper amount of powder into liquid slowly on
cool slab (about 21˚C).
Mixing slab: A properly cooled, thick glass slab (dissipate the
heat of reaction) & free of moisture.
Powder/liquid ratio: Determines the properties of mixed mass.
Care of the liquid: keep the bottle tightly closed.
Mixing procedure: initially small portion P/L ratio.
Use long, narrow- bladed spatula to spread cement over large
area.
Middle large portion P/L ratio.
Final small portion P/L ratio.
Mixing time for 60-90 second.
Zinc Phosphate cements:
Zinc Phosphate cements:
Control of setting time
Manufacturing process
1. Sintering temperature The higher the temperature, the more
slowly the cement sets.
2. Particle size Finer particles react more quickly as a greater
surface area is exposed to the liquid.
3. Water content of liquid Presence of excess water accelerates,
whereas insufficient water retards the reaction.
4. Buffering agents When added slow down the reaction.


The setting time of cements in general vary widely. The
setting time varies between different manufacturers.
Warm humid climatic conditions accelerate the setting.
The portion of the material placed in the mouth sets faster
than that on the table. This is because of the warm and moist
conditions in the mouth. S.T about 2.5-8 min
Zinc Phosphate cements:
Factors under control of operator
1. Temperature Higher temperatures accelerate the
reaction. Cooling the mixing slab is an effective way of
slowing the reaction and prolonging the working time.
2. Powder-liquid ratio More the liquid, slower the reaction.
3. Rate of addition of powder to liquid The reaction is slower if
the powder is incorporated slowly.
4. Mixing time The longer the mixing time (within practical
limits), the slower is the rate of reaction.
-Biological properties
pH of the cement
The acidity is high at the time of insertion due to phosphoric
acid. At the time of cementation, the pH is 2 (approx.). After 5
hours 3.4 As time passes the acidity reduces. By the end of 24
hours the pH is 5.5, which is still in the acidic range (neutral
value is 7).
Pulp protection
A thickness of dentin as great as 1.5 mm can be penetrated by
the acid of the cement. If dentin is not protected against
infiltration of this acid, pulpal injury may occur, especially during
the first few hours.
1. Avoid thin mixes.
2. Pulp protection should be carried out in deep cavities through
the use of an intervening liner or base
Zinc Phosphate cements:(( properties))
–– Zinc oxide eugenol
–– Calcium hydroxide
–– Cavity varnish
-Optical properties
The set cement is opaque.
-Interfacial properties:
Zinc phosphate cement shows no chemical bonding
either to tooth structure or restoration surface
(mechanical retention and physical adhesion)
ZINC PHOSPHATE CEMENT
•
•
•
•
•
Applications:
Luting permanent metal restoration.
Used as a base.
Cementation of orthodontic bands.
Used as a provisional restoration.


-Chemical properties:
Cement shows some degree of solubility
and is dependent in L/P ratio
(thin mix solubility)
-thermal conductivity:
Has low thermal diffusivity used under
metallic restoration.
Michanical properties: zinc phosphate
cement is strong so it can be used as
final cementation and as cavity base.
•
•
•
•
Composition:
Powder: Mainly Zn O, add white rosin, zinc stearate & zinc
acetate.
Liquid: Euogenol with olive oil.
2 compositional changes used to increase the strength of
cement for luting purpose,
Zinc Oxide Eugenol cement
:
Zinc Oxide- Eugenol
•
•
•
•
•
•
•
•
Manipulation:
Dispensing:
Un modified ZOE are typically 2 paste are dispensed & mixed
to a uniform color.
For some cements, powder is often incorporated into a liquid
until a suitable consistency is achieved.
Mixing procedure:
A cooled mixing slab is not required because the setting
reaction is not significantly exothermic.
Usually the bulk of powder is incorporate in the initial step, the
mix is thoroughly spatulated & a series of smaller amounts is
then added until the mix is complete.
Setting time: is between 4-10 m.
•
•
•
•
•
•
•
Properties of ZOE:
Its neutral in Ph=7, it can be used safely in deep
cavities without dangering the pulp.
It has a sedative effect on the pulp.
Good sealing ability to cavity wall.
Bactericidal effects.
Radio-opaque (detectable by radiograph).
Impairs the setting reaction of composite restoration.
Zinc Oxide- Eugenol &
Non- Eugenol cements
•
•
•
•
•
•
Applications:
Used as a cement base.
Temporary & Permanent Cementation.
Used as a provisional restoration.
Endodontic sealers.
Tissue management.
•
•
•
•
•
•
Zinc Polycarboxylate (polyacrylate) cements:
Composition:
Supplied as a powder & liquid or as a powder that mixed with
water.
Liquid: Is a water solution of poly acrylic acid.
Powder: Is essentially Zn O & magnesium oxide.
Setting reaction:
Can retard by a cool environment or accelerated by a warm
environment.
•
•
•
•
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■
Manipulation:
The tooth structure should be clean for proper bonding,
Then dry and isolate the tooth.
1.5 parts of powder to 1 part of liquid by weight.
The liquid is dispensed just prior to the mixing, otherwise its
viscosity increases..
MIXING TIME AND SETTING TIMES
Mixing time ranges from 30 to 40 seconds. Setting time can be
from 7 to 9 minutes (The setting time can be increased by
cooling the glass slab. It also depends on method of
manufacture of powder and liquid).
Zinc Polycarboxylate (polyacrylate) cements:
•
1.
■
■
•
Main advantages: :
Reactivity between poly acrylic acid & calcium of enamel &
dentin producing chemical bonding to tooth.
Adherence to some metal.
Comparatively less irritating to the pulp.
Disadvantages:
Limited fluoride release when compared to GIC.
Zinc Polycarboxylate (polyacrylate) cements:
Zinc Polycarboxylate (polyacrylate) cements:
■
■
■
Biocompatibility
Pulpal response is classified as mild. Despite the initial
acidic nature of polycarboxylate cement, the pH of the
liquid is 1.0–1.7 and that of freshly mixed cement is
3.0–4.0,After 24 hours pH of the cement is 5.0-6.0.
They are less irritant than zinc phosphate cement
because:
1- The liquid is rapidly neutralized by the powder. The pH of
polycarboxylate cement rises more rapidly than that of zinc
phosphate.
2- Penetration of polyacrylic acid into the dentinal tubules is
less because of its higher molecular weight and larger size
■
■
Adhesion
An outstanding characteristic of zinc
polycarboxylate cement is that the cement
bonds chemically with the tooth structure.
The carboxyl group in the polymer molecules
chelates with calcium in the tooth structure.
Bond strength to enamel is 3.4–13.1 MPa
and to dentine 2.07 MPa.
•
•
•
•
Applications:
Used as a cement base.
Luting permanent alloy restorations.
Used in orthodontics for cementation of bands.
Zinc Polycarboxylat (polyacrylate) cements:
•
•
•
•
Glass ionomer cements:
Composition:
Supplied as a powder & liquid in botle ,or as a powder that mixed
with water. Or preproportioned in capsule
Liquid: is a solution of poly acrylic acid or copolymer .
Powder: is calcium fluoroalumino silicate glass.
In some products the poly acrylic
acid is coated on the powder. The
liquid of these products may be water
or a dilute solution of tartaric acid in
water.
•
•
•
•
•
•
•
Setting reaction:
SR. is an acid base reaction between acidic polyelectrolyte &
aluminosilicate glass.
The polyacid attacks the glass to release cataions & fluoride.
It bond chemically to enamel & dentin during setting process.
Mechanism of bonding involve ionic interaction with calcium
&/or phosphate ions from the surface of enamel or dentin.
Bonding is more effective to a clean surface.
Bonding strength improved by treating dentin with acidic
conditioner followed by application of a diluted aqueous
solution of ferric chloride.
Glass ionomer cements:
•
•
•
•
•
•
•
•
•
Manipulation:
P & L are dispensed onto a paper or glass slab.
P. divided into 2 equal portions, the 1st portion is incorporated
into liquid with a stiff spatula before the second portion added.
Mixing time is 30-60 s.
Encapsulated products mixed for 10s in mechanical mixer.
Must be used immediately because the working time after
mixing is about 2 m at room temperature.
GIC. Very sensitive to contact with water during setting.
Setting time:
Usually occurs within 6-8 m from the start of mixing.
Glass ionomer cements:
Glass ionomer cement:
•
•
•
•
•
•
Applications:
Used for permanent cementation or as a base.
Class V filling material.
As pit & fissure sealant.
As endodontic sealer
Used in orthodontics for cementation of bands.
,
Resin-modified glass ionomer
These are relatively new materials having various names like
compomer, resin-ionomers, RMGI (resin-modified glass
ionomer), light cured GIC, dual cure GIC, tricure GIC,
reinforced GIC, hybrid ionomers, etc.
These materials were developed to overcome some of the
drawbacks of conventional GIC like
1. Moisture sensitivity
2. Low initial strength
3. Fixed working times.



SUPPLIED AS:
Chemical cure (acid-base setting reaction of the glass
ionomer portion).
. Dual cure (combines acid-base setting reaction of the
GIC portion and light curing of the resin portion).
Tricure (combines acid-base setting reaction, chemical
and light cured polymerization of the resin portion).
All of them are usually supplied as powder and liquid. The
light cured type is supplied in dark shaded bottles (for light
protection).
■
■
■
■
■
■
■
COMPOSITION
Since these are combination materials, they contain
components of both resin and glass ionomer
Powder
Ion leachable glasses (silica, alumina)
Photoinitiators or chemical initiators or both
Polymerizable resin
Hydroxyethyl methacrylate monomers
Liquid
Polyacrylic acid , Water,Methacrylate monomer
■ Setting reaction
Setting includes both polymerization and acid-base reaction.
-The initial setting occurs by polymerization of the methacrylate
groups giving it a high early strength. Polymerization may be
light cured or chemical cured depending on the type of cement.
-Subsequently the acid-base reaction sets it thereby completing
the setting reaction and giving the cement its final strength.
Manipulation
RMGI is mixed and applied after conditioning the tooth, The
powder and liquid is mixed according to the manufacturer’s
instruction. Light cured RMGI is cured by exposure to blue light
(which is used for curing composite).
Properties:
Anticariogenicity
These materials have a significant anticariogenic effect
because of the fluoride release. Some tests indicate
fluoride release may be equivalent to that of conventional
GIC.
Pulpal response
The pulpal response to the cement is mild (similar to
conventional GIC).
Esthetics
They are more translucent and therefore more esthetic
than conventional GIC.
■
■
■
■
■
■
■
Uses
1. Restoration of Class I, III or V cavities.
2. Bases and liners.
3. As adhesives for orthodontic brackets.
4. Cementation of crowns .
5. Repair of damaged amalgam cores or
cusps.
6. Retrograde root filling.
Resin cements
Development of resin cements came naturally with the development of
composites resins. They are essentially low viscosity flowable composites.
These cements are known for their high esthetics and high bond strengths.
They were widely used for the cementation of orthodontic brackets and
resin-bonded restorations
APPLICATIONS
1. For bonding of orthodontic brackets to acid-etched enamel .
2. Cementation of porcelain veneers and inlays.
3. Cementation of all-porcelain crowns and.
4. Cementation of etched cast restorations
■
■
■
■
■
■
They are supplied in syringes
1. Chemical cured
–– Two paste system containing base and
accelerator
–– Single paste system with activator in the
bonding liquid
2. Light cured: Single paste system.
Most systems also include a bonding agent and
etchant.
■
■
■
■
■
■
■
■
■
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■
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COMPOSITION
The resin cements have a composition similar to that of
modern composites . Viscosity adjusted . Some contain
fluoride
POLYMERIZATION
1. Chemically by peroxide-amine system
2. Or by light activation
3. Or by both chemical and light activation (dual cure).
MANIPULATION AND TECHNICAL CONSIDERATIONS
Like composites, resin cements are technique sensitive. Improper
procedure can lead to poor bond strength and failure. The following
processes are involved.
1. Etching the restoration
2. Etching the tooth surface
3. Bonding and curing
4. Removal of excess cement
■
■
■
■
The majority of Non-metallic restorations can be
cemented only with resin cement.
Typically used in conjunction with enamel & dentin
bonding agents & as a result they are capable of
micromechanical attachment to both structure
through the bonding agents.
They can also bond to appropriately treated fitted
surface (micro etched).
The attachment of bonded crown with resin cement
was more 6 times higher than achieved with ZnPh
cement.
Amalgam Composite
- Shallow cavity
(RDT > 2 mm)
- Varnish or dentin
sealer or dentin
bonding system.
- Bonding system.
Moderately deep
cavity
(RDT 0.5 -2 mm)
- Cement base.
Sealer.
-
-
- Bonding system.
Extensive deep cavity
(RDT < 0.5 mm)
- Liner.
Cement base.
Sealer.
-
-
-
Liner.
Cement base.
Bonding agent.
-
-
-
* Cavity Liners & Bases:
Thank you
Thank U
Thank u

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Cement bases and types of cement and application of each of them

  • 1. Dr. Lanja Abubakir Ali M.Sc. in Conservative Dentistry Cavity Liners & Cement Bases, their Manipulation & Insertion into the Cavity
  • 2. Liners & Bases: Are materials placed between dentin & the restoration must provide pulpal protection . * Protective needs for a restoration depend upon: 1-The extent & location of the preparation.(depth of cavity) 2-The type of restorative material to be used.(type of restoration)
  • 3. Purposes of Liners & Bases: protection the pulp from: 1-thermal changes 2-chemicals (irritants within the materials) 3-leakage (bacterial by product) 4-electric shock (galvanic reaction) 5-michanical (traumatic occlusion).
  • 4. Properties of ideal lining restorative material(liner and base) 1-it should be easy to supply. 2-the strength should be enough to withstand condensation force. 3-it should be not irritate or interfere with the setting reaction of the restoration(compatible with restorative materials). 4- radiopaque (to facilitate subsequent interpretation of X rays in diagnosis of recurrent caries).
  • 5. 5-it should be bacteriostatic effect. 6-well adapted to the cavity walls(good sealing ability). 7-reduce thermal conductivity of the restoration. 8-it should prevent chemical exchange between the tooth and restoration.
  • 6. Guidelines for Basing, Lining, & Sealing: 1-Do not remove sound tooth structure to provide space for a base. Maintaining sound dentin will enhance restoration support & provide maximum pulpal protection. 2-Use minimum thickness of base & liner (avoid unnecessary cavity extension & allow for adequate thickness of overlying restoration).
  • 7. Cavity Sealers, Liners, Base: Cavity sealers: Materials are a thin film liner provide a protective coating to the walls of the prepared cavity & a barrier to leakage at the interface of the restorative material & the walls. Usually sealers coat all the walls of a cavity preparation commonly used sealers fall into two categories: A: Varnish. B:Resin bonding system.
  • 8.    1-Cavity sealers: A- Cavity varnish: Provide a barrier against the passage of irritants from cements or other restorative materials. Reduce penetration of oral fluids at the restoration- tooth interface into the underlying dentine. Reduce sensitivity of newly cut dentin
  • 9. • • A- Cavity varnish: composition: Is a natural gum (copal resin) or synthetic resin dissolved in solution of ether, chloroform or acetone. Volatile solvents evaporate quickly, thus leaving a thin resin film.
  • 10. • • • • A-Cavity varnish : Manipulation : Applied with either a small disposable applicator or a small cotton pellet. Apply thin layers of varnish 2-5 micrometer on walls , floor, and margin of the cavity preparation . Two thin layers found more protective than one heavy layer. Tightly cap varnish solutions immediately after use to minimize loss of solvent.
  • 11. A-Cavity varnish : • • • • • Properties: Reduce but not prevent the passage of constitutes of the phosphoric acid cement into underlying dentin. Thin film significantly reduce leakage around the margins & wall of metallic restorations. The integrity of resin film is destroyed when composite materials are placed in contact with them. Neither posses mechanical strength nor provide thermal insulation.
  • 12. ■ ■ ■ ■ Applications: Cavity varnishes indicated for: Frequently used under amalgam restoration. On dentinal surfaces to minimize penetration of acid from zinc phosphate cements. On enamel & dentinal walls to reduce penetration of oral fluids around metallic restorations. Varnish retard penetration of discolored corrosion products form dental amalgam into dentin. Varnishes are not used : Contraindications Composite – free monomer layer dissolves the varnish Ca (OH) 2 & ZOE – beneficial effects are lost Polycarboxylates – interferes with adhesion GIC –blocks fluoride production
  • 13. • • B- Adhesive sealers: These materials is suspension liner 20-25 micrometer have a bonding ability allowing the restoration to adhere to the tooth structure. Adhesive bonding system used to attach the composite resin or bonded amalgam restorations to the tooth structure.
  • 14. • • b. Adhesive sealers : Uses: Usually used to reduce the microleakage & post operative sensitivity in the following cases: 1-Under slower corroding high copper amalgam restoration. 2-Attach the composite resin or bonded amalgam restorations to the tooth structure. Advantages : 1. Provide prolonged seal compared to the varnish. 2. Provide superior seal of the dentinal tubules & tooth restoration interface. 3. Reduce post operative sensitivity.
  • 15. 2. Cavity liners: Cement coating of minimal thickness (usually less than 0.5 mm) to achieve a physical barrier to bacteria & their products and/or to provide a therapeutic effect, such as an antibacterial effect or pulpal medication effect. Liners are usually applied only to dentin cavity walls that are near the pulp. Commonly used liners are 1- Calcium hydroxide liner 2-(ZOE)cement in low strength
  • 16. • • • 2. Cavity Liner: Provide a barrier against passage of irritants from cements or other restorative materials. Reduce the sensitivity of freshly cut dentin. Must be placed in the deepest area of the cavity on the pulp should not applied at the margins of restorations. Cavity liner Neither have mechanical strength nor any significant thermal insulation.
  • 17. •Cavity liner are fluid consistency & easily flowed or painted over dentinal surfaces .Solvents evaporate to leave a thin film residue.
  • 18. • Type of Cavity Liner: A-Calcium Hydroxide liner (Dycal): Has long been used as a liner under restorative material , Ca (OH)2 is supplied either in the form of (Calcium hydroxide pawder) is pawder of calcium hydroxide that mixed with distilled water .or two paste system, one paste contains (catalyst) while the other contains (base) , or in single paste like light cured ca (OH)2
  • 19. Properties of ca (OH)2: 1-it can stimulate the reparative dentin formation with direct pulp contact(because it stimulate odontoblast cell. 2-serve as a protective barrier between tooth tissues and acid containing cement and restorative material because it has high ph. so neutralizes the acidity of the cement. 3-it has antibacterial action that reduces inflammatory effect of bacteria.
  • 20. 4-conventional calcium hydroxide liner (chemical cured type) base catalyst demonstrated poor physical properties(high solubility, low value of tensile and compressive strength).visible light cured calcium hydroxide overcomes most of these deficiency
  • 21. • • • • b. Zinc Oxide- Eugenol Bases (low strength) Used in deep cavities to retard penetration of acids & reduce possible discomfort to the pulp (sedative). ZOE. weaker & less rigid than Ca (OH)2. Often used with a high strength base. Should not used with composite restoration, because eugenol inhibit polymerization of the bonding agent & composite.
  • 22.
  • 23. • • • Manipulation: ZOE & Ca (OH)2 are supplied as two paste systems. Equal lengths of the different –colored pastes are dispensed on a paper pad & then mixed to a uniform color with a ball point instrument .setting time 2-3 minuets /mixing time 10 second at room temperature
  • 24. 3. Cavity bases: Cement coating of 1-2 mm thickness in deep cavities used to replace missing dentin, to provide thermal protection for the pulp & to supply mechanical support for the restoration by distributing local stresses from the restoration across the underlying dentin surface. 1-zinc phosphate cement. 2-reinforced zinc oxide eugenol cement. 3-zinc polycarboxylate cement. 4-glass ionomer cement. 5-resin modified glass ionomer 6-resin cement.
  • 25. • • 3. Bases (High strength bases): Used to provide thermal protection for the pulp. Used to provide mechanical support for a restoration. * Cavity Sealers, Liners, Base:
  • 26. • • • • 3- Bases: Is material with two or more different phases which react together to form a set mass. In general primary purpose of bases: Insulation Bulk build up Blocking undercuts
  • 27. 1. • • • • Zinc Phosphate cements: Composition: It supplied as a powder & liquid react one another to develop a mass of cement. Powder: Zinc oxide, Magnesium oxide, Silicon dioxide, Bismuth trioxide & other minor ingredient. Liquid: Produced by adding aluminum & sometimes zinc to a solution of phosphoric acid. Alkaline powder dissolved acid liquid Exothermic reaction
  • 28. • • • • • • • • • • Manipulation: Incorporate proper amount of powder into liquid slowly on cool slab (about 21˚C). Mixing slab: A properly cooled, thick glass slab (dissipate the heat of reaction) & free of moisture. Powder/liquid ratio: Determines the properties of mixed mass. Care of the liquid: keep the bottle tightly closed. Mixing procedure: initially small portion P/L ratio. Use long, narrow- bladed spatula to spread cement over large area. Middle large portion P/L ratio. Final small portion P/L ratio. Mixing time for 60-90 second. Zinc Phosphate cements:
  • 29.
  • 30. Zinc Phosphate cements: Control of setting time Manufacturing process 1. Sintering temperature The higher the temperature, the more slowly the cement sets. 2. Particle size Finer particles react more quickly as a greater surface area is exposed to the liquid. 3. Water content of liquid Presence of excess water accelerates, whereas insufficient water retards the reaction. 4. Buffering agents When added slow down the reaction.   The setting time of cements in general vary widely. The setting time varies between different manufacturers. Warm humid climatic conditions accelerate the setting. The portion of the material placed in the mouth sets faster than that on the table. This is because of the warm and moist conditions in the mouth. S.T about 2.5-8 min
  • 31. Zinc Phosphate cements: Factors under control of operator 1. Temperature Higher temperatures accelerate the reaction. Cooling the mixing slab is an effective way of slowing the reaction and prolonging the working time. 2. Powder-liquid ratio More the liquid, slower the reaction. 3. Rate of addition of powder to liquid The reaction is slower if the powder is incorporated slowly. 4. Mixing time The longer the mixing time (within practical limits), the slower is the rate of reaction.
  • 32. -Biological properties pH of the cement The acidity is high at the time of insertion due to phosphoric acid. At the time of cementation, the pH is 2 (approx.). After 5 hours 3.4 As time passes the acidity reduces. By the end of 24 hours the pH is 5.5, which is still in the acidic range (neutral value is 7). Pulp protection A thickness of dentin as great as 1.5 mm can be penetrated by the acid of the cement. If dentin is not protected against infiltration of this acid, pulpal injury may occur, especially during the first few hours. 1. Avoid thin mixes. 2. Pulp protection should be carried out in deep cavities through the use of an intervening liner or base Zinc Phosphate cements:(( properties))
  • 33. –– Zinc oxide eugenol –– Calcium hydroxide –– Cavity varnish -Optical properties The set cement is opaque. -Interfacial properties: Zinc phosphate cement shows no chemical bonding either to tooth structure or restoration surface (mechanical retention and physical adhesion)
  • 34. ZINC PHOSPHATE CEMENT • • • • • Applications: Luting permanent metal restoration. Used as a base. Cementation of orthodontic bands. Used as a provisional restoration.
  • 35.   -Chemical properties: Cement shows some degree of solubility and is dependent in L/P ratio (thin mix solubility) -thermal conductivity: Has low thermal diffusivity used under metallic restoration. Michanical properties: zinc phosphate cement is strong so it can be used as final cementation and as cavity base.
  • 36. • • • • Composition: Powder: Mainly Zn O, add white rosin, zinc stearate & zinc acetate. Liquid: Euogenol with olive oil. 2 compositional changes used to increase the strength of cement for luting purpose, Zinc Oxide Eugenol cement :
  • 37. Zinc Oxide- Eugenol • • • • • • • • Manipulation: Dispensing: Un modified ZOE are typically 2 paste are dispensed & mixed to a uniform color. For some cements, powder is often incorporated into a liquid until a suitable consistency is achieved. Mixing procedure: A cooled mixing slab is not required because the setting reaction is not significantly exothermic. Usually the bulk of powder is incorporate in the initial step, the mix is thoroughly spatulated & a series of smaller amounts is then added until the mix is complete. Setting time: is between 4-10 m.
  • 38. • • • • • • • Properties of ZOE: Its neutral in Ph=7, it can be used safely in deep cavities without dangering the pulp. It has a sedative effect on the pulp. Good sealing ability to cavity wall. Bactericidal effects. Radio-opaque (detectable by radiograph). Impairs the setting reaction of composite restoration.
  • 39. Zinc Oxide- Eugenol & Non- Eugenol cements • • • • • • Applications: Used as a cement base. Temporary & Permanent Cementation. Used as a provisional restoration. Endodontic sealers. Tissue management.
  • 40. • • • • • • Zinc Polycarboxylate (polyacrylate) cements: Composition: Supplied as a powder & liquid or as a powder that mixed with water. Liquid: Is a water solution of poly acrylic acid. Powder: Is essentially Zn O & magnesium oxide. Setting reaction: Can retard by a cool environment or accelerated by a warm environment.
  • 41. • • • • ■ ■ ■ Manipulation: The tooth structure should be clean for proper bonding, Then dry and isolate the tooth. 1.5 parts of powder to 1 part of liquid by weight. The liquid is dispensed just prior to the mixing, otherwise its viscosity increases.. MIXING TIME AND SETTING TIMES Mixing time ranges from 30 to 40 seconds. Setting time can be from 7 to 9 minutes (The setting time can be increased by cooling the glass slab. It also depends on method of manufacture of powder and liquid). Zinc Polycarboxylate (polyacrylate) cements:
  • 42. • 1. ■ ■ • Main advantages: : Reactivity between poly acrylic acid & calcium of enamel & dentin producing chemical bonding to tooth. Adherence to some metal. Comparatively less irritating to the pulp. Disadvantages: Limited fluoride release when compared to GIC. Zinc Polycarboxylate (polyacrylate) cements:
  • 43. Zinc Polycarboxylate (polyacrylate) cements: ■ ■ ■ Biocompatibility Pulpal response is classified as mild. Despite the initial acidic nature of polycarboxylate cement, the pH of the liquid is 1.0–1.7 and that of freshly mixed cement is 3.0–4.0,After 24 hours pH of the cement is 5.0-6.0. They are less irritant than zinc phosphate cement because: 1- The liquid is rapidly neutralized by the powder. The pH of polycarboxylate cement rises more rapidly than that of zinc phosphate. 2- Penetration of polyacrylic acid into the dentinal tubules is less because of its higher molecular weight and larger size
  • 44. ■ ■ Adhesion An outstanding characteristic of zinc polycarboxylate cement is that the cement bonds chemically with the tooth structure. The carboxyl group in the polymer molecules chelates with calcium in the tooth structure. Bond strength to enamel is 3.4–13.1 MPa and to dentine 2.07 MPa.
  • 45. • • • • Applications: Used as a cement base. Luting permanent alloy restorations. Used in orthodontics for cementation of bands. Zinc Polycarboxylat (polyacrylate) cements:
  • 46. • • • • Glass ionomer cements: Composition: Supplied as a powder & liquid in botle ,or as a powder that mixed with water. Or preproportioned in capsule Liquid: is a solution of poly acrylic acid or copolymer . Powder: is calcium fluoroalumino silicate glass. In some products the poly acrylic acid is coated on the powder. The liquid of these products may be water or a dilute solution of tartaric acid in water.
  • 47. • • • • • • • Setting reaction: SR. is an acid base reaction between acidic polyelectrolyte & aluminosilicate glass. The polyacid attacks the glass to release cataions & fluoride. It bond chemically to enamel & dentin during setting process. Mechanism of bonding involve ionic interaction with calcium &/or phosphate ions from the surface of enamel or dentin. Bonding is more effective to a clean surface. Bonding strength improved by treating dentin with acidic conditioner followed by application of a diluted aqueous solution of ferric chloride. Glass ionomer cements:
  • 48. • • • • • • • • • Manipulation: P & L are dispensed onto a paper or glass slab. P. divided into 2 equal portions, the 1st portion is incorporated into liquid with a stiff spatula before the second portion added. Mixing time is 30-60 s. Encapsulated products mixed for 10s in mechanical mixer. Must be used immediately because the working time after mixing is about 2 m at room temperature. GIC. Very sensitive to contact with water during setting. Setting time: Usually occurs within 6-8 m from the start of mixing. Glass ionomer cements:
  • 49. Glass ionomer cement: • • • • • • Applications: Used for permanent cementation or as a base. Class V filling material. As pit & fissure sealant. As endodontic sealer Used in orthodontics for cementation of bands. ,
  • 50. Resin-modified glass ionomer These are relatively new materials having various names like compomer, resin-ionomers, RMGI (resin-modified glass ionomer), light cured GIC, dual cure GIC, tricure GIC, reinforced GIC, hybrid ionomers, etc. These materials were developed to overcome some of the drawbacks of conventional GIC like 1. Moisture sensitivity 2. Low initial strength 3. Fixed working times.
  • 51.    SUPPLIED AS: Chemical cure (acid-base setting reaction of the glass ionomer portion). . Dual cure (combines acid-base setting reaction of the GIC portion and light curing of the resin portion). Tricure (combines acid-base setting reaction, chemical and light cured polymerization of the resin portion). All of them are usually supplied as powder and liquid. The light cured type is supplied in dark shaded bottles (for light protection).
  • 52. ■ ■ ■ ■ ■ ■ ■ COMPOSITION Since these are combination materials, they contain components of both resin and glass ionomer Powder Ion leachable glasses (silica, alumina) Photoinitiators or chemical initiators or both Polymerizable resin Hydroxyethyl methacrylate monomers Liquid Polyacrylic acid , Water,Methacrylate monomer
  • 53. ■ Setting reaction Setting includes both polymerization and acid-base reaction. -The initial setting occurs by polymerization of the methacrylate groups giving it a high early strength. Polymerization may be light cured or chemical cured depending on the type of cement. -Subsequently the acid-base reaction sets it thereby completing the setting reaction and giving the cement its final strength. Manipulation RMGI is mixed and applied after conditioning the tooth, The powder and liquid is mixed according to the manufacturer’s instruction. Light cured RMGI is cured by exposure to blue light (which is used for curing composite).
  • 54. Properties: Anticariogenicity These materials have a significant anticariogenic effect because of the fluoride release. Some tests indicate fluoride release may be equivalent to that of conventional GIC. Pulpal response The pulpal response to the cement is mild (similar to conventional GIC). Esthetics They are more translucent and therefore more esthetic than conventional GIC.
  • 55. ■ ■ ■ ■ ■ ■ ■ Uses 1. Restoration of Class I, III or V cavities. 2. Bases and liners. 3. As adhesives for orthodontic brackets. 4. Cementation of crowns . 5. Repair of damaged amalgam cores or cusps. 6. Retrograde root filling.
  • 56. Resin cements Development of resin cements came naturally with the development of composites resins. They are essentially low viscosity flowable composites. These cements are known for their high esthetics and high bond strengths. They were widely used for the cementation of orthodontic brackets and resin-bonded restorations APPLICATIONS 1. For bonding of orthodontic brackets to acid-etched enamel . 2. Cementation of porcelain veneers and inlays. 3. Cementation of all-porcelain crowns and. 4. Cementation of etched cast restorations
  • 57. ■ ■ ■ ■ ■ ■ They are supplied in syringes 1. Chemical cured –– Two paste system containing base and accelerator –– Single paste system with activator in the bonding liquid 2. Light cured: Single paste system. Most systems also include a bonding agent and etchant.
  • 58. ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ COMPOSITION The resin cements have a composition similar to that of modern composites . Viscosity adjusted . Some contain fluoride POLYMERIZATION 1. Chemically by peroxide-amine system 2. Or by light activation 3. Or by both chemical and light activation (dual cure). MANIPULATION AND TECHNICAL CONSIDERATIONS Like composites, resin cements are technique sensitive. Improper procedure can lead to poor bond strength and failure. The following processes are involved. 1. Etching the restoration 2. Etching the tooth surface 3. Bonding and curing 4. Removal of excess cement
  • 59. ■ ■ ■ ■ The majority of Non-metallic restorations can be cemented only with resin cement. Typically used in conjunction with enamel & dentin bonding agents & as a result they are capable of micromechanical attachment to both structure through the bonding agents. They can also bond to appropriately treated fitted surface (micro etched). The attachment of bonded crown with resin cement was more 6 times higher than achieved with ZnPh cement.
  • 60. Amalgam Composite - Shallow cavity (RDT > 2 mm) - Varnish or dentin sealer or dentin bonding system. - Bonding system. Moderately deep cavity (RDT 0.5 -2 mm) - Cement base. Sealer. - - - Bonding system. Extensive deep cavity (RDT < 0.5 mm) - Liner. Cement base. Sealer. - - - Liner. Cement base. Bonding agent. - - - * Cavity Liners & Bases: