The document discusses various dental cements and their properties and uses. It describes zinc oxide eugenol cement, which is used for temporary cementation and has sedative properties due to eugenol. Zinc phosphate cement sets through an acid-base reaction and is used for cementing metal cores, though it can cause sensitivity. Glass ionomer cement bonds chemically to tooth structure and releases fluoride over time, making it useful for luting bands and as a restorative material. Resin-based cements are modified composites used for cementing ceramic restorations.
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Anatomy and clinical significance of denture bearing areasOgundiran Temidayo
A presentation on the anatomy and clinical significance of the denture bearing areas by Ogundiran Temidayo who is a dental student at OBAFEMI AWOLOWO UNIVERSITY ILE-IFE
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Anatomy and clinical significance of denture bearing areasOgundiran Temidayo
A presentation on the anatomy and clinical significance of the denture bearing areas by Ogundiran Temidayo who is a dental student at OBAFEMI AWOLOWO UNIVERSITY ILE-IFE
All details about the dental cements
Introduction
Definitions
Ideal properties
Classification
Based on Ingredients & Application(craig)
Based on Bonding mechanism(william O’Brien)
Based on setting reaction (Anusavice)
Silicate cement
Zinc phosphate cement
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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2. Pulpal Protection
Cavity Varnish
Acts as a protective barrier between preparation and restoration
Varnish formulations are solutions of natural resins (copal) or synthetic resins
dissolved in a solvent, such as alcohol or chloroform.
Varnish is applied in two-three layers over the surface of the preparation
The solution is placed in a thin film, allowing evaporation of the solvent to
occur for 5-15 seconds before application of the second layer.
The remaining resin protects the pulp by sealing the tubules from
penetration of irritating chemicals found in some restorative materials and
luting cements.
Luting: primary consistency, used to cement two components together
3. Copal Varnish
Brand name: Copalite
Is thought to reduce the amount of microleakage and
staining at the restoration/tooth interface.
Interface: the space between the walls of the preparation and the
restoration
Not widely used today
They were extensively used under amalgam restorations
They have been replaced by dentin bonding agents, since they
seal enamel and dentinal tubules.
4. Low-Strength Base/Liner
Example: Calcium Hydroxide
Brand name: Dycal
Used when dentin no longer covers the pulp
When close or very small exposures of pulp are suspected, this
material is used as an indirect or direct pulp-capping agent
Alkaline pH of 9-11
Stimulates secondary dentin when in direct contact with the
pulp
Provides a barrier between pulp and restoration
5. Calcium Hydroxide
Has some antimicrobial and thermal
insulating properties
Provides minimal strength to support
Under amalgam restorations, Dycal
slowly leaches out over time.
6. Calcium Hydroxide-- Dycal
Mixing time: 10 seconds
Setting time: 2-2.5 minutes
Procedure:
Dispense equal portions of catalyst
and base paste onto mixing pad
Mix pastes together using small
spatula or cavity liner applicator
Mix until material is uniform in color
Gather material together and place
on clean portion of the pad
https://youtu.be/czrBP-qrbYc
7. Zinc Oxide Eugenol
ZOE
Powder/liquid or paste/paste systems
Used for:
Temporary/provisional cementation
Temporary and intermediate restorations
High- and low-strength bases
root canal sealer
Periodontal dressings
8. Zinc Oxide Eugenol
Principal Ingredient: zinc oxide
Eugenol: distinct smell of cloves
Derivative of oil of cloves
Eugenol is known for its sedative effect on the pulp, caused by its
antibacterial effects.
Eugenol can be irritating when in direct contact with the oral
mucosa or pulp
Contraindication: direct pulp capping
When properly mixed, ZOE has a pH of 7
Makes it very biocompatible with tooth structure
9. Zinc Oxide Eugenol
Advantages
Wide variety of uses
Sedative to the pulp
Easily manipulated
Disadvantages
Low strength
High solubility
Unable to be used under composite
restorations and indirect
restorations cemented with resin or
resin-modified glass ionomer
cements (RMGICs)
10. Contraindications for ZOE?
Sensitivity or allergy to eugenol
Direct pulp capping
Use under resin restorations
Luting: https://youtu.be/8ENwbk5Zcf8
Base: https://youtu.be/yTj6zZDGJYk
11. Zinc Phosphate
Flecks
Set through acid-base reaction
What does this mean?? What type of cure?
Oldest of the cements
Has been around for over 100 years
Not widely used because it more soluble than other cements
Also causes postoperative sensitivity
If used, they are applied as permanent luting agents under metal core indirect
restorations, and with the addition of fluoride, for cementation of orthodontic
bands.
Could also add more powder to provide thermal insulation for use as a high-strength
base/restoration (provisional)
12. Zinc Phosphate
Powder/liquid system
The powder is Zinc Oxide; fluoride is added by some
manufacturers to aid in the prevention of carries under
orthodonically banded teeth.
The liquid is made of phosphoric acid and water
The chemical reaction (which occurs when the cement
powder is incorporated into the liquid) results in an
exothermic reaction
Exothermic rxn: heat is produced
13. Zinc Phosphate
Proper mixing technique is required to minimize the exothermic
rxn.
Controlled by time and temperature
Incremental incorporation of the powder into the liquid allows for
controlled dissipation of heat
Mixing over cool glass slab also dissipates the heat
Make sure the slab does not have moisture on its surface
Dissipating the heat increases working time
14. Zinc Phosphate
Initially the pH is 4.2, but becomes neutral within 24-48
hours
The initially low pH may irritate the pulp in deep
restorations
Contraindication: Direct pulp capping
Must cover the pulp with low-strength base first (Dycal)
then place zinc phosphate
Ceramic restorations are not cemented with Zinc
Phosphate
15. Zinc Phospate
Advantages
Long clinical history
Low film thickness
Inexpensive
High rigidity
Disadvantages
Initial pulpal irritation and
postoperative sensitivity
Mechanical bond only
Technique-sensitive
proportioning and mixing
Relatively high solubility
https://youtu.be/rtUAS0Ml8Ms
16. Zinc Polycarboxylate
Durelon
Acid-base reaction
First cement developed with an adhesive bond to
tooth structures caused by the affinity of the
cement with the calcium of the tooth substrate
Used for:
Final cementation of indirect restorations
Base
Selected orthodontic cementation (bands)
Cementation of SS crowns
17. Polycarboxylate
Powder/liquid system
Some manufacturers supply predosed capsules for mixing in an
amalgamator
Powder: Zinc Oxide
Liquid: aqueous solution (in water) of polyacrylic acid
Polyacrylic acid produces minimal irritation to the pulp
18. Polycarboxylate
Liquid should not be dispensed before mixing time
Water loss by evaporation can adversely increase the viscosity
Lower compressive strength
Higher solubility
Retention by chemical and mechanical means
Chemical: bonds to calcium ions
Working time can be extended by using cool glass slab
What type of chemical reaction then??
19. Polycarboxylate
Advantages
Adheres to tooth structure
Nonirritating to the pulp
Inexpensive
Easy to use
Disadvantages
Higher solubility
Lower strength
Shorter working time
https://youtu.be/vYy6GyHv-3E
20. Glass Ionomer Cements
Introduced in 1969
Continually evolving
Most versatile
Chemically bond with tooth through calcium ions(like
Polycarboxylate)
Contain aluminum fluorosilicate glass
Gives ability to release and replenish fluoride
21. Glass Ionomer Cements
Used as:
Permanent luting agents
luting of ortho bands and brackets
Restorative materials
Low-and high-strength bases
Core buildups
CANNOT BOND TO GLAZED PORCELAIN
Contraindication
22. Glass Ionomer Cements
Powder/liquid
Powder: aluminum fluorosilicate glass with barium glass added for
radiopacity
Liquid: Polyacrylic acid copolymer and water
When powder and liquid are mixed, the polyacrylic acid attacks the
glass to release fluoride ions
When mixed properly, GICs are biologically compatible with the pulp
Can also be dispensed as encapsulated powder/liquid and a
paste/paste system (newest)
23. Glass Ionomer Cements
Mild to severe postoperative sensitivity have been reported
Over drying (Desiccating)
Moisture contamination during first 24 hours
Fluoride release for the life of the cement has an Anticariogenic
effect
Increased solubility has been linked to moisture contamination
within the first 24 hours
24. Glass Ionomer Cements
Type I: luting (cementation)
Type II: restorative materials
Type III: liners and bases for cavity preparations
Similar in chemical composition, but size of powder particles and ratios of
powder and liquid are different
25. Glass Ionomer Cements
Biocompatible
Bond to tooth structure
Fluoride release
Initially high level of fl2 for the first few days, then fall to low levels
Can absorb fl2 from in office tx
Acts as a fluoride reservoir
Solubility
Sensitivity to moisture in the first 24 hours is less desirable
thermal expansion and contraction
Similar to tooth structure
Thermal protection
26. Glass Ionomer Cements
Compressive and Tensile Strength
Moderately high compression strength
Weaker in tension and are relatively brittle in then sections
Wear resistance
Wear faster than composites
Surface gets rougher over time
Cannot be polished like composites
Radiopacity
More radiopaque than dentin
Color
More opaque than composites
Translucency and the shades available have improved over the years
27. Glass Ionomer Cements
Advantages:
Chemical adhesion to tooth
and metal
Fluoride release
Easy to mix
Moderate strength
Disadvantages:
History of postoperative
sensitivity
Moisture sensitive during setting
Does not bond to glazed
porcelain
Marginal solubility
https://youtu.be/7CYpB6jcjbs
https://youtu.be/kwm3XldbHjc
https://youtu.be/SCL-JMYzTxA
28. Hybrid Glass Ionomer Cements
AKA: Resin-Modified Glass Ionomer Cements (RMGIC)
Similar to traditional Gis, but resin is added to improve bond strength
and compressive and tensile strength, and decrease solubility
Virtually insoluble
Excellent film thickness
Fluoride release is the same as GIC
Expansion of the material as it absorbs moisture after setting is of
concern, making it less desirable for cementation of some all-ceramic
indirect restorations because of the risk of fracture.
34. 6th and 7th Generation System
Self-Adhesive resin cements
One-step system
Acidic primers that etch the tooth are combined with the adhesive resin
During the setting of the self-adhesive resin, the acidic primers undergo a change
from acidic (pH 2) to less acidic (pH 5-6)
The initial acidity allows the cement to be self-etching
The smear layer is incorporated into the cement, rather than being dissolved and
rinsed away like in other generations.
Cement must be COMPLETELY cured
Uncured resin will irritate the pulp
36. Resin-Based Cements
Advantages:
High strength
Insoluble
Low wear
Excellent adherence to tooth
structure
Can bond all-ceramic
restorations
Esthetic shades available
Low chance of postoperative
sensitivity
Disadvantages:
The introduction of water or oral
fluids at any points during the
bonding procedure can lead to
lowered bond strength
Self-adhesive resin cements should
not be applied on exposed pulp or
dentin that is close to the pulp
Requires additional steps in
preparation of internal restoration
surfaces
Removal of excess cement may be
difficult
