cementos

1. RelyX™ Unicem Self-Adhesive
Universal Resin Cement
The FIRST self-adhesive universal resin cement for the
permanent cementation of all types of metallic, metal-
ceramic and all-ceramic/composite restorations*.
* Not indicated for veneers

2. Trends support the market for Unicem
• Growth in non-metal restorations
• Demand for ease of use and universal application
in cements
• Demand for products that provide for low patient
sensitivity
• Demand for easy handling
– Less technique sensitivity, reduced number of steps,
auto mix, direct delivery, easier mixing, etc…
… Unicem is faster, easier & better!

3. • Ion leachable filler
• Acid
• Water
• Monomers
• Initiators
RM-GIC
HYBRIDS
• Ion leachable filler
• Acid
• Water
Glassionomer
Cement
• Silanized Filler
• Methacrylates
• Initiators
Composites
Cements setting by
neutralization
Composites
Fuji I (GC) Fuji CEM (GC)
Fuji Plus (GC)
Fuji Luting / Cem (GC)
Protec Cem (Vivadent)
Dyract Cem Plus or
Principle (Dentsply)
Panavia (Kuraray)
Variolink II (Vivadent)
Calibra (Dentsply)
Nexus II (Kerr)
Ketac Cem
Durelon
Rely X Luting - - - - Rely X ARC / Veneer
Compolute
Sono Cem
The GIC-Composite „Continuum“
• Ion leachable filler
• Acid
• Monomers
• Initiators
PAMR-Compomer

4. Categories of Cement Materials
Conventional GI RMGI Resin/ Composite
Compomers
Increase strength
Ease of use/self-adhesion
Increase aesthetics
Increase fluoride release
Sensitivity potential

5. Composite
 easy handling/fast
 self adhesion
 fluoride release
low mechanical
properties
 poor aesthetics
Glass-Ionomer-Cement (GIC)
 mechanical properties
 abrasion resistance
 aesthetics
 no self adhesion
 no easy handling
low or no fluoride
release
Systems, that combine advantages of GIC and Composites and avoid their disadvantages
New Class of Cement
GIC - Composite Continuum

6. Future for Cements
Systems that combine advantages of
GI-based and composite resin-based
cements and avoid their disadvantages
RelyX Unicem

7. Glass-Ionomer-Cement
(GIC)
• Basic Filler
• Acid
• Water
Resin Modified
Glass-Ionomer-Cement
(RMGIC)
• Basic Filler
• Acid
• Water
• (Meth)acrylates
• Initiators
• Silanized Filler
• Acid
• (Meth)acrylates
• Initiators
Compomer
• Silanized Filler
• (Meth)acrylates
• Initiators
Composite
Hybrids
• Basic Filler / Silanized Basic Filler
• (Meth)acrylates
• Initiators
• Acidic (Meth)acrylates
Classes of materials:
New Cement Class
Combines Aspects from all Categories

8. • mechanical properties
• adhesive strength
• esthetics
like a resin
• easy handling
• moisture tolerance
• no pre-treatment of tooth
like glass ionomers
It is a true self-adhesive universal resin cement for luting all materials:
metal ceramic composite
RelyX Unicem combines the advantages of
both glass ionomer-based and resin cements!

9. Profile of RelyX Unicem
• Broad Indications for use:
– Metal based (full metal or PFM)
– Metal-free, All-ceramic/composite restorations
– Strengthened core restorations (i.e. Procera)
• Fast application time
• Self-adhesive – no conditioner or bonding agent required
– Significant reduction in sensitivity potential
– May not require use of anesthesia
– Reduced concern for film thickness build-up
• Reliable adhesion to dentin and enamel and sealing of
the tooth.
• Less concern for moisture sensitivity

10. Profile of RelyX Unicem
• Dual-curing chemistry ensures both light-curing
and self-curing of the cement
• Higher strength and mechanics compared to zinc
phosphate, GI’s, Compomers, and RMGI’s.
• Esthetics comparable to composite resin cements
• Low swelling and high dimensional stability
• Fluoride release higher than composites, but lower
than GI’s
• Excess removal easier than with other resins
• Easy handling with capsule delivery

11. RelyX Unicem
Product Concept Introduction

12. RelyX Unicem Composition
• Powder
– Glass fillers
– Silica
– Calcium hydroxide
– Self-cure initiators
– Pigments
• Liquid
– Methacrylated phosphoric
esters
– Dimethacrylates
– Acetate
– Stabilizers
– Self-cure initiators
– Camphoroquinone

13. RelyX Unicem
Adhesion and Setting Mechanisms
• Methacrylated Phosphoric Esters
– Demineralizes tooth structure and allows for penetration into
tooth structure and achieving adhesion
– Radical polymerization reaction of methacrylate for primary
setting mechanism
• Subordinate cement reactions
– Aids in moisture tolerance
– Provides additional chemical adhesion to tooth structure
– Provides for fluoride release

14. RelyX Unicem Setting Reactions
• Radical polymerization reaction
• Subordinate cement reactions

15. CPQ
copper acetate
sodium toluene sulfinate
barbituric acid derivative
sodium toluene sulfinate
sodium peroxide sulfate
copper acetate
Polymerization reaction
Light Curing Redox Polymerisation
Curing by Means of Radical Polymerization
Dualcuring setting reaction

16. "methacrylated" calcium phosphate
phosphoric methacrylate + calcium hydroxide
H2O +
"methacrylated"
phosphates
+ "reactive" glass (Photac glass)
+ "residual" phosphoric methacrylate
Subordinate Cement Reactions
Fluoride release
Moisture tolerance
Adhesion

17. Tooth
structure
Ca
2+
Reactive
glas
Sr
Al
3+
Ca
2+
Ca
2+
Sr
2+
Al
F
Polymerization
F
P
O
O
O
P
O
O
O
O
O
O
O
O
H
Ca
Ca
O
H
H
H
Fluoride release
Complexation
Neutralization
Neutralization
Ca
2+
Chemistry of adhesive molecules

18. Increase of pH-value after mixing
0
2
4
6
0 5 10 15 20
time [min]
pH-value
pH - course

19. Unicem -Bonding Procedure
Preparation
-Remove temporary
-Clean tooth and leave moist
-Prep restoration surface
Activate Capsule
2 seconds
Mix Capsule
10 seconds
Rotomix
15 seconds
Regular High Speed
Load Restoration
-Insert capsule into Applier
-Apply cement to restoration
-Working time - 2:00 from start of mix

20. Unicem -Bonding Procedure
Seat Restoration
-Seat with gentle pressure
Clean Excess Cement
-Tack cure excess with light
-Self-cure to gel state
-Clean up in fluid state
-Allow to completely set and clean
Final Cure
20 seconds LC/surface
5 minutes SC from
Start of mix
Finish and Polish

21. Unicem - Timing
• Activation 2 seconds
• Mixing
– Rotary Mixer (Rotomix) 10 seconds
– High Speed Mixer 15 seconds
• Working Time
– From beginning of mixing 2 minutes
• Clean Up
– Tack cure with halogen light to gel stage 2-5 seconds
– Self cure to gel stage 3 minutes
• Set Time
– Light cure time per surface 20 seconds
– Self cure time from start of mix 5 minutes

22. Typical Adhesive Cementation

23. RelyX Unicem Procedure

26. RelyX Unicem
Initial Test Results

27. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivity
• Good marginal adaptation/integrity
• High values in mechanical properties
• Low risk potential with ceramics

28. Shear Bond Strength to Dentin
M. Irie, K. Suzuki, B. Windmüller, IADR meeting San Diego, 2002, Abstract # 3365.
0
2
4
6
8
10
12
14
16
18
shear bond
strength [MPa]
Unicem
Calibra
Panavia
F
one-day storage
Light-curing mode

29. Shear Bond Strength to Cured Z250
J. Powers, UTHSC
0
5
10
15
20
25
Unicem LC Unicem SC VII-B-LC VII-B+C-LC

30. Shear Bond Strength to Dentin and Enamel
J. Powers, UTHSC
0
2
4
6
8
10
12
14
16
18
20
Enamel (LC Bulk) Dentin (SC Thin Film)

31. Tensile Bond Strength to Bovine Dentin
R. Hecht, M. Ludsteck, G. Raia, IADR meeting San Diego, 2002, # 398.
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
[MPa]
D
y
r
a
c
t
C
e
m
P
l
u
s
P
a
n
a
v
i
a
F
V
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k
I
I
F
u
j
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P
l
u
s
U
n
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m
sc
lc

32. Shear Bond Strength to Empress 2
A. Piwowaryzyk, H.X. Berge, H.-Ch. Lauer, J.A. Sorensen, IADR meeting San Diego, 2002, # 3241.
0
2
4
6
8
10
12
14
16
18
20
22
FujiPlus
FujiC
em
R
ely
X
Luting
R
ely
X
A
R
C
sc
R
ely
X
A
R
C
lc
Panavia
F
sc
Panavia
F
lc
V
ariolink
sc
V
ariolink
lc
C
om
polute
sc
C
om
polute
lc
U
nicem
sc
U
nicem
lc
(MPa)
30 min
14 d/TC

33. Shear Bond Strength to Lava
A. Piwowaryzyk, H.X. Berge, H.-Ch. Lauer, J.A. Sorensen, IADR meeting San Diego, 2002, # 3342.
0
2
4
6
8
10
12
14
F
l
e
c
k
s
c
e
m
e
n
t
F
u
j
i
I
K
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a
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C
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m
F
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P
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F
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C
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m
R
e
l
y
X
L
u
t
i
n
g
R
e
l
y
X
A
R
C
s
c
R
e
l
y
X
A
R
C
l
c
P
a
n
a
v
i
a
F
s
c
P
a
n
a
v
i
a
F
l
c
V
a
r
i
o
l
i
n
k
s
c
V
a
r
i
o
l
i
n
k
l
c
C
o
m
p
o
l
u
t
e
s
c
C
o
m
p
o
l
u
t
e
l
c
U
n
i
c
e
m
s
c
U
n
i
c
e
m
l
c
(MPa)
30 min
14 d/TC

34. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivities
• Good marginal adaptation/integrity
• High values in mechanical properties
• Low risk potential with ceramics


35. Postoperative Sensitivity
• No separate etching step
• No remove of smear layer
• No opening of dental tubules
• No low molecular acid involved
• Only one step!

36. Postoperative Sensitivity
European Clinical Evaluation
313
16
94
2
94
12
69
1 4
158
5
25 31
0
50
100
150
200
250
300
350
Metal/PFM
Crowns
All Ceramic
Crowns
Composite
Crowns
Metal Inlays All Ceramic
Inlays
Composite
Inlays
Pins and Posts Others
DC
LC
• 824 Restorations
• Only 3 comments on sensitivities

37. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivities
• Good marginal adaptation/integrity
• High values in mechanical properties
• Low risk potential with ceramics

()

38. Marginal adaptation/integrity of
ceramic inlays
M. Rosentritt, M. Behr, R. Lang, G. Handel, IADR meeting San Diego, 2002, Abstract # 53.
0
20
40
60
80
100
perfect margin
[%]
Variolink
II
Dyract Cem
Plus
Panavia F
Fuji Plus
Unicem
SEM surface analysis
Enamel before TC
Enamel after TC
Dentin before TC
Dentin after TC

39. Marginal adaptation analysis
M. Rosentritt, M. Behr, R. Lang, G. Handel, IADR meeting San Diego, 2002, Abstract # 53.
Dyract Cem Plus before
TCML
Dyract Cem Plus after
TCML
Fuji Plus before TCML
Fuji Plus after TCML
RelyXTM
Unicem before
TCML
RelyXTM
Unicem after
TCML

40. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivities
• Good marginal adaptation/integrity
• High values in mechanical properties
• Low risk potential with ceramics

()


41. Three-point Flexural and
Compressive Strength
A. Piwowarczyk, B. Windmüller, A. Mahler, H.-Ch. Lauer, IADR meeting, San Diego, 2002, # 3342.
0
20
40
60
80
100
120
[MPa]
Harvard
Cem
ent
Fuji I
Keta Cem
Fuji Plus
Rely
X
Luting
Panavia F
Variolink
II
Com
polute
Unicem
sc
lc
0
50
100
150
200
250
300
350
[MPa]
H
a
r
v
a
r
d
C
e
m
e
n
t
F
u
j
i
I
K
e
t
a
C
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F
u
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P
l
u
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R
e
l
y
X
L
u
t
i
n
g
P
a
n
a
v
i
a
F
V
a
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i
o
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i
n
k
I
I
C
o
m
p
o
l
u
t
e
U
n
i
c
e
m
sc
lc
Three point Flexural Strength Compressive Strength

42. Surface Hardness and
Film Thickness
0
50
100
150
200
250
300
350
[MPa]
Harvard
Cem
ent
Fuji I
Keta Cem
Fuji Plus
Rely
X
Luting
Panavia F
Variolink
II
Com
polute
Unicem
sc
lc
Surface Hardness Film Thickness
0
5
10
15
20
25
[MPa]
H
a
r
v
a
r
d
C
e
m
e
n
t
F
u
j
i
I
K
e
t
a
C
e
m
F
u
j
i
P
l
u
s
R
e
l
y
X
L
u
t
i
n
g
P
a
n
a
v
i
a
F
V
a
r
i
o
l
i
n
k
I
I
C
o
m
p
o
l
u
t
e
U
n
i
c
e
m
sc
A. Piwowarczyk, B. Windmüller, A. Mahler, H.-Ch. Lauer, IADR meeting, San Diego, 2002, # 3342.

43. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivities
• Good marginal adaptation/integrity
• High values in mechanical properties
• Low risk potential with ceramics

()



44. Criteria of Risk
• Dimensional stability
• Water uptake
• Acid erosion

45. Linear Expansion
0
0.5
1
1.5
2
[%]
F
u
j
i
P
l
u
s
D
y
r
a
c
t
C
e
m
P
l
u
s
U
n
i
c
e
m
C
o
m
p
o
l
u
t
e
R
e
l
y
X
A
R
C
V
a
r
i
o
l
i
n
k
I
I
P
a
n
a
v
i
a
2
1
1 month
sc
lc
3M ESPE internal data, unpublished results, 2001.

46. Linear Expansion
J. Burgess, LSU
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
Unicem Fuji Plus FujiCEM
1 Day
1 Week
1 Month
2 Month
3 Month

47. Water uptake
0
20
40
60
80
100
120
140
160
180
[µg/mm3]
Fuji Plus
Dyract Cem
Plus
Unicem
Com
polute
Rely
X
A
RC
Variolink
II
Panavia 21
1 month
sc
lc
3M ESPE internal data, unpublished results, 2001.

48. Acid Erosion (solubility)
-32
-96
14
6 2
-100
-80
-60
-40
-20
0
20
[µm]
K
e
t
a
c
C
e
m
F
u
j
i
I
R
e
l
y
X
L
u
t
i
n
g
U
n
i
c
e
m
sc
lc
3M ESPE internal data, unpublished results, 2001.

49. Most important criteria
• Strong adhesion
• Low risk of post operative sensitivities
• Good marginal adaptation
• High values in mechanical properties
• Low risk potential with ceramics

()




50. RelyX Unicem Review
• Fast and simple procedure
• Convenient and consistent capsule dispensing
• Self-adhesive with no conditioner or adhesive
required – may not require anesthesia
• Significant reduction in potential for patient
sensitivity
• Esthetics and strengths of resin cements
• Broad versatility of use