The document discusses dental cements and luting agents. It describes the ideal properties of luting agents, including long working time, good adhesion, sealing ability, biocompatibility, and adequate mechanical properties. It then discusses different types of cements like zinc phosphate, polycarboxylate, glass ionomer, resin-modified glass ionomer, and resin cements. It provides details on the composition, advantages, and disadvantages of each cement type. It emphasizes that the type of cement used depends on factors like the restoration being cemented and tooth morphology. The document also outlines best practices for surface preparation and cementation procedures.

1. By Dr EL Sayed ALI

2. Dr EL Sayed ALI

3. CEMENTATION
•Ideal Luting Agent Should be:
•Long working time.
•Adhere to both tooth structure and restoration.
•Provide a good seal.
•Non-irritating, non-toxic .
•Have adequate mechanical properties.
Dr EL Sayed ALI

4. CEMENTATION
•Ideal Luting Agent Should be:
•Have low viscosity; low solubility.
•Suitable setting time.
•Easily to be removed after setting.
•Fluoride release.
Dr EL Sayed ALI

5. CEMENTATION
Cement
Interim Definitive
ZnO Eugenol
Eugenol free ZnO.
Zinc phosphate
Zinc Polycarboxylate.
Glass Ionomer.
Resin modified G.I.
Adhesive resin cement
Reinforced ZnO Eugenol
Dr EL Sayed ALI

6. Dental Cement
• Zinc phosphate
• Polycarboxylate
• Glass ionomer
• RMGI cement
• MZOE
• Resin cement
Conventional
(Water based)
Adhesive
Dr EL Sayed ALI

7. Dr EL Sayed ALI

8. CHD 2005
Interim Cement
Resin-based Eugenol Non-Eugenol
- Interim cement can be mixed with a little petrolatum.
- Luting agent is applied only to the margins of the restoration to seal
them and yet allow subsequent removal without difficulty
Rely-X ARC TempBond TempBond NE
Variolink II Freegenol

9. Why temporary cementation:
• Decrease post operative pain.
• Reduce the incidence of pulpal involvement.
• The prosthesis can be further removed for adjustment &
modification.
• Decrease post cementation symptoms of hypersensitivity.
• Too see if the patient accepts the esthetic.
• Too see the oral hygiene of the patient (follow oral hygiene
instructions).
Dr EL Sayed ALI

10. Dr EL Sayed ALI

11. Reinforced Zinc oxide eugenol
Reinforced by (EBA) or aluminum oxide & PMA
- Used as definitive cement
- Extremely biocompatible & provides an excellent seal
- Physical properties are generally inferior to those of other cements
- Cement used only in restorations with good retention form in which
emphasis is on biocompatibility and pulpal protection
- Eugenol inhibit free radical of polymerized materials
- Relatively short working time, and excess material is difficult to
remove
Dr EL Sayed ALI

12. ➢Composition:
➢ZnO powder and phosphoric acid
➢Micromechanical interlocking
➢Used for cast restorations
➢Film thickness: 25 micron
➢Reasonable working time, could be increased by
incremental mixing and cooled slabs
Zinc phosphate cement
Dr EL Sayed ALI

13. •Advantages:
•Reasonable working time
•Low film thickness
•Excess material easily removed with sharp explorer.
•Disadvantages:
•Toxic effects of phosphoric acid
Dr EL Sayed ALI

14. •Composition:
•The powder is zinc oxide ,tin or magnesium oxide,
aluminum oxide or other reinforcing filler
•Liquid is (high MW) polyacrylic acid
•Film thickness: 25 micron
•Limited to restorations with good retention & resistance
form for which minimum pulp irritation is desired(i.e., in
children with large pulp chambers).
Polycarboxylate Cements
Dr EL Sayed ALI

15. • Advantages:
➢ Bonds to enamel and dentine(it chelates the calcium)
➢ No adverse effect on the pulp(polyacrylic acid molecule is large)
• Disadvantages:
➢ High viscosity (difficult to mix)
➢ Short working time(2.5min)
➢ Residual cement is more difficult to remove
Because of a chemical interaction between zinc polycarboxylate & titanium,
it is contraindicated when cementing implant crowns on titanium abutments
Dr EL Sayed ALI

16. •Glass ionomer cement
•Composition:
•Powder alumino-fluorosilicate glass
•Liquid polyacrylic acids
•Advantages:
•Chemical adhesion to enamel and dentin
•Exhibits good biocompatibility
•It releases fluoride
Dr EL Sayed ALI

17. • Translucent (used with the porcelain labial margin design)
• Disadvantages:
• Sensitive to moisture contamination during setting (protected with
resin coat, or a band of cement should be left undisturbed for 10
minutes)
• Residual cement is more difficult to remove
• Glass ionomers have been reported to cause sensitivity (actually be
result of desiccation or bacterial contamination)
• Desensitizing agent may prevent sensitivity, although it may also
reduce retention
Dr EL Sayed ALI

18. •Resin modified glass ionomer cement
- Combine some of the desirable properties of glass
ionomer (fluoride release and adhesion) with the
higher strength and low solubility of resins.
- Post cementation sensitivity resulting from their use
is minimal
Dr EL Sayed ALI

19. • Adhesive Resin cement
• Adhesive resin luting agents are indicated for all-ceramic and
laboratory-processed composite restorations.
• Used for resin-bonded prostheses
• Resin cements with adhesive properties (capable of bonding
chemically to dentin)
• Available in a wide range formulation(Chemical, photo- and dual-
cure), chemically polymerized system is appropriate with metal
restorations, whereas a light- or dual-polymerized system is
appropriate with ceramics
• Possible leakage and pulp sensitivity
• Polymerization shrinkage
Dr EL Sayed ALI

20. Dr EL Sayed ALI

21. Dr EL Sayed ALI

22. Cannot use only one type for everything . . .
• Type of FP to be cemented
• Preparation and morphology
• FPD span length
• Tooth position and function

23. Selection of Cement
•High caries index
•Deep preparations
•All ceramic
•Core structures (amalgam, comp, GI, metal, ceramic)
•Posts
•Resin bonded bridges
Dr EL Sayed ALI

24. Dr EL Sayed ALI

25. Dr EL Sayed ALI

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27. Dr EL Sayed ALI

28. Preparation of the Restoration and Tooth Surface for
Cementation
• Cast restorations are best prepared by airborne-particle abrasion
of the fitting surface with 50-μm alumina particles, steam
cleaning, the use of ultrasonic units & washed with alcohol
• Teeth cleaned & dried (pumice)
• Cotton rolls & saliva evacuator
• Excessively desiccated; overdrying the prepared tooth leads to
postoperative sensitivity.
• If a non adhesive is to be used, the tooth should be cleaned,
gently dried, and coated with cavity varnish or dentin bonding
resin.
Dr EL Sayed ALI

29. Dr EL Sayed ALI

30. Cementation procedures
• Cement application:
•Thin layer of cement is mix applied to fitting surface
of the casting
•For post(use lentulo spiral into holes or post holes)
•To extend working time, the cement should be
applied to a cool restoration rather than to a warm
tooth.
• Seating the restoration:
•Rocking force by orange wood stick
•Using a static load may cause binding of the
restoration and lead to incomplete seating.
Dr EL Sayed ALI

31. Cementation technique with self-adhesive resin
Dr EL Sayed ALI

32. Cementation procedures
• Check the margins to verify complete setting
• When it is fully set, remove excess cement with an
explorer, Dental floss with a small knot in it can be used to
remove any irritating residual interproximal cement
• Avoid early cement removal, some cements, such as
polycarboxylate or resin, tend to pull away from the
margins if excess cement is removed too early
• After the excess has been removed, the occlusion can be
checked once more.
Dr EL Sayed ALI

33. Dr EL Sayed ALI

34. Post-Cementation Instructions
•Cements take at least 24 hours to develop their
final strength. Therefore, the patient should be
cautioned to chew carefully for a day or two
Dr EL Sayed ALI

35. Cementation procedures for ceramic veneers and
inlays
•Bonding is achieved with the following steps:
➢1. Etching the fitting surface of the ceramic with
hydrofluoric acid
➢2. Applying a silane coupling agent to the ceramic material
➢3. Etching the enamel with phosphoric acid
➢4. Applying a resin-bonding agent to etched enamel and
silane
➢5. Seating the restoration with a composite resin luting
agent
Dr EL Sayed ALI

36. Cementation procedures for ceramic veneers and
inlays
•For veneers, a light-polymerized material can be used.
For inlays, a chemical-polymerized material is
preferred
•To facilitate shade selection, color matched try-in
pastes are available
Dr EL Sayed ALI

37. Dr EL Sayed ALI

38. Dr EL Sayed ALI

39. REFERENCES
• Contemporary fixed
prosthodontics, Fifth edition:
Luting Agents and Cementation
Procedures, 774
Dr EL Sayed ALI

40. Any question
Dr EL Sayed ALI