DENTAL CEMENTS

Presented by-Aisha Samreen

JR1
Under the guidance of-Prof. Shaista Afroz
CONTENTS

1. Introduction
2. Characteristics of ideal cement
3. Silicate cement
4. Zinc phosphate cement
5. Zinc polycarboxylate
6. Zinc oxide eugenol
7. Glass inomer cement
8. Resin cement
9. Mineral trioxide cement
10. Luting agent for cement retained implant prosthesis
 INTRODUCTION

CEMENT –A binding agent used to firmly unite two approximating

objects –
GPT9

A dental cement used to attach indirect restorations to prepared teeth is called a

luting agent.

Luting agents may be definitive or provisional, depending on their physical

properties and the planned longevity of the restoration.
CEMENTATION : The process of attaching parts by means of cement;
attaching a restoration to natural teeth by means of a cement -
GPT-9

Cementation is one of the final steps for indirect restorations.

There are two objectives for the cementation procedure:

To help retain the restoration To maintain the integrity of the

in place remaining tooth structure.
CHARACTERISTICS OF AN IDEAL CEMENT
Development of luting agents
CLASSIFICATION

According to Craig (12th edition)

Water based
Zn-phosphate
Zn-silicophosphate
Zn-polyacrylate
GIC
Oil based
Zinc oxide eugenol
Non eugenol based cements
Resin based
Composite
Compomer
According to O’Brien (Based on matrix type) :
1. Phosphate based
2. Phenolate based
3. Polycarboxylate based
4. Resin
5. Resin modified GIC

Practical clinical considerations of luting cements: A review J Int Oral Health. 2014 Feb; 6(1): 116–120
According to Donovan (Based on knowledge and experience of
use):
 Conventional (zinc phosphate, polycarboxylate, glass- ionomer)
 Contemporary (resin-modified glass-ionomers, resin)

According to WILSON (Based on the setting reaction):

 Acid-base cements
 Polymerization cements

Practical clinical considerations of luting cements: A review J Int Oral Health. 2014 Feb; 6(1): 116–120
Components and Reactions of Dental
Cements
SILICATE CEMENTS

o Introduced as anterior
esthetic filling material.
o They were-translucent
resembled porcelain
o They were the first tooth
colored filling materials.
o It also forms the basis for
the glass ionomer system
• Over time-silicates degraded and stained.
• Leakage around the margins-dark margins.
• The average life-four years
• The incidence of secondary caries and contact caries is
markedly less.
• Anticariogenic property-15% fluoride.
• severe irritant-low pH (acidic).
Zinc phosphate(Crown and Bridge and Zinc
Oxyphosphate)
• Oldest and serves as a standard.
APPLICATIONS
1. Luting of restorations (inlays, crowns, fixed dental
prostheses, etc.)
2. High strength bases.
3. Temporary restorations
4. Luting of orthodontic bands and brackets.
CLASSIFICATION
• ISO 9917-1:2007
a. Luting (Maximum film thickness—25 μm)
b. Bases and lining
COMPOSITION
SETTING REACTION
P/L ratio 1.4 g/0.5 Ml
Control of setting time-
Manufacturing process
1. Sintering temperature
2. Particle size.
3. Water content of liquid.
4. Buffering agents When added
slow down the reaction.
Factors under control of operator
1. Temperature
2. P/L 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
 Primary retentive mechanism is micromechanical
• pH is high(approx. 2) at the time of insertion due to phosphoric acid. By
the end of 24 hours the pH is 5.5
• Pulpal response -moderate.
• Pulp protection –
1. Avoid thin mixes.
2. Pulp protection should be carried out in deep cavities through the
use of an intervening liner or base – Zinc oxide eugenol – Calcium
hydroxide – Cavity varnish
ADVANTAGES AND DISADVANTAGES OF ZINC
PHOSPHATE

Advantages
1. Long track record with proven reliability.
2. Good compressive strength.
Disadvantages
1. No chemical adhesion.
2. No anticariogenic property.
3. Pulp irritation.
4. Poor esthetics; cannot be used with translucent (all
ceramic) restorations.
ZINC POLYCARBOXYLATE CEMENT
• Canadian biochemist Smith developed the first
polycarboxylate cement in 1968 by substituting the
phosphoric acid of zinc phosphate cement with polyacrylic
acid.
• Potential for adhesion to tooth structure.
• APPLICATIONS
1. Primarily for luting permanent restorations.
2. As bases and liners.
3. Used in orthodontics for cementation of bands.
4. Also used as root canal fillings in endodontics.
SETTING REACTION
• Released zinc, magnesium and tin ions bind to the polymer chain via the
carboxyl groups.
• carboxyl groups also react with adjacent polyacid chains to form cross-
linked salts.
STRUCTURE OF SET CEMENT
• Amorphous gel matrix of zinc polyacrylate in which unreacted powder
particles are dispersed.
MANIPULATION

CONDITIONING-clean tooth surface, with 10% polyacrylic acid

solution followed by rinsing with water, or 1 to 3% hydrogen
peroxide may be used.
Then dry and isolate the tooth.
PROPORTIONING-1.5 parts of powder to 1 part of liquid by
weight.
MIXING TIME 30 to 40 seconds
SETTING TIMES-7 to 9 minutes
Points to note
• The cement should be used while the surface is still glossy.
• Excess cement is not removed in rubbery stage.
• The powder may be cooled, but the liquid should not be cooled since
the viscosity of the liquid increases.
• Polycarboxylate cement adheres to instruments
• Use alcohol as release agent for mixing spatula.
• Any remaining material is removed by boiling in sodium hydroxide
solution.
• Excellent biocompatibility
ZINC OXIDE EUGENOL CEMENT

• These cements have been used extensively in dentistry

since the 1850s(low strength,least irritating,have an
obtundant effect)
• pH is 6.6 to 8.0
• Material interactions Eugenol interferes with the
hardening/and or cause softening of resin based
restorations and are therefore contraindicated as a base
under these restorations
CLASSIFICATION

• ANSI/ADA SPECIFICATION NO. 30

• TYPE I-TEMPORARY CEMENTATION
• TYPE II-LONG TERM CEMENTATION OF FDP
• TYPE III-TEMPORARY FILLING AND THERMAL INSULATING
BASE
• TYPE IV-INTERMEDIATE FILLING
• Also used as root canal sealers and periodontal dressings
COMPOSITION
SETTING REACTION

First hydrolysis of zinc oxide

takes place.
Water is essential for the
reaction (dehydrated zinc
oxide will not react with
dehydrated eugenol).
ZnO + H2 O → Zn(OH)2

The chelate formed is an

amorphous gel that tends to
crystallize imparting
strength to the set mass.
MANIPULATION

• Two paste system-Equal lengths of each paste are dispersed

• ZOE exhibits pseudothickening
• Oil of orange is used to clean eugenol cement from instruments
• Setting time 4–10 minutes.
• ZOE cements set quicker in the mouth due to moisture and heat
• Accelerators-Alcohol, glacial acetic acid and water.
• Retarders-glycol and glycerine
MODIFIED ZINC OXIDE EUGENOL
CEMENTS

1.EBA-Alumina modified cements

2.Polymer reinforced

EBA-ALUMINA MODIFIED CEMENTS

PROPERTIES
Their properties are better than that of unmodified
ZOE.
They are more easier to handle and have improved
carvability.
POLYMER REINFORCED ZINC OXIDE EUGENOL CEMENT
strongest of the zinc oxide eugenol based cements.
High strength and low wear and solubility

USES 1. Luting agent 2. As base 3. As temporary filling material

Available as 1. Powder and liquid. 2. Capsule for mechanical mixing.

PROPERTIES-Improved mechanical properties

Glass ionomer cement

The first usable glass ionomer system was formulated in 1972 by Wilson
and Kent and was known as ASPA.
Known as a biomimetic material, as similar mechanical properties to
dentine.
• Synonyms-Poly (alkenoate) cement
GIC (glass ionomer cement)
ASPA (alumino silicate polyacrylic acid)
• Esthetics-inferior to silicates and composites.lack translucency and have
a rough surface texture.
• Anticariogenic properties
CLASSIFICATION
• AVAILABLE AS
1. Powder/liquid
2. Preproportioned powder/liquid
in capsules
3. Light cure system
4. Powder/distilled water (water
settable type)
Composition
Powder

Liquid
Originally the liquid was a 50% aqueous solution of polyacrylic acid
SETTING REACTION

Sodium and fluorine ions-do not take part in the

cross-linking form sodium fluoride.
Hydration-very important role.
Initially it serves as the medium
Later-hydrates the matrix, adds to the
strength(maturation)
MANIPULATION

• TOOTH SURFACE- should be clean

• Rub with a cotton pellet and pumice slurry
• Conditioning-10% polyacrylic acid or 37%
phosphoric acid for 10-20 sec.Rinse with water
for 20 seconds
• Powder/liquid ratio
• Mixing-swiping and folding technique-30–40
sec.
• Setting time Luting type — 7 min
Restorative type — 4-5 min
METAL-REINFORCED GLASS IONOMER
CEMENTS
• First introduced in 1977 to improve the strength, fracture toughness
and resistance to wear and yet maintain the potential for adhesion
and anticariogenic property.

• Two methods are employed

1. Admixed Spherical amalgam alloy powder+ restorative type GIC
powder
2. Cermet Silver particles are bonded to glass particles by sintering
• USES
1. Restoration of small Class I
2. For core-build up of grossly destructed teeth
• PROPERTIES
Compressive strength,tensile strength,fracture toughness and wear
rates of metal modified GIC is similar to conventional GIC.

Anticariogenic property-less fluoride is released from cermet cement

admixed cement releases more fluoride
Esthetics-gray in color
 RESIN-MODIFIED GLASS IONOMER(Hybrid Inomer)

CLASSIFICATION
Depending on which is the predominant component.
1. Resin-modified glass ionomer cement (RMGI)
2. Compomers or polyacid-modified composites

• Developed to overcome some of the drawbacks of conventional

GIC
1. Moisture sensitivity
2. Low initial strength
3. Fixed working times.
Uses
1. Restoration of Class I, III or V cavities.
2. Bases and liners.
3. As adhesives for orthodontic brackets.
4. Cementation of crowns and FDPs.
5. Repair of damaged amalgam cores or cusps
6. Retrograde root filling.

SUPPLIED AS
powder and liquid as
Chemical cure
Dual cure
Tricure
 COMPOSITION.

SETTING REACTION
• Initial setting-polymerization of the methacrylate groups
giving it a high early strength.
• Subsequently the acid-base reaction sets it thereby
completing the setting reaction and giving the cement its
final strength.
PROPERTIES
• Compressive strength is slightly lower (105 MPa)
• Tensile strength (20 MPa),fracture toughness is greater
• Hardness-40 KHN is comparable to that of conventional
GIC.
• Adhesion-similar to conventional GIC. Micromechanical
retention also plays a role in the bonding process.
• Microleakage- greater
• Pulpal response-mild
• Esthetics-more translucent,more esthetic
COMPOMER (POLYACID-MODIFIED
COMPOSITE RESINS)
 Shortly after the introduction of RM GICs, ‘compomers’ were
introduced to the market.
 These materials had the fluoride release features of GIC with the
durability of composite.
APPLICATIONS
1. Restorative materials in pedodontics.
2. Restorative material in nonstress bearing areas.
3. Class V lesions.
4. Bases
5. Luting
SUPPLIED AS
These materials are sensitive to moisture.
 Supplied as Light cured single paste in moisture proof packets
 Powder/liquid
 Two paste static mixing system
COMPOSITION
Single component system - Silicate glass, sodium fluoride, and polyacid modified
monomer, photoinitiator,no water is present
Double component system
Powder- Glass fillers, accelerators, initiator, TiO2
Liquid - Acrylic monomers, photoinitiator, water, carboxylic acid
dimethacrylate

SETTING REACTION
Initial set is-free radical polymerization-activated by light.
Subsequently water from saliva-acid-base reaction
USES
Restorative compomer
• Low stress- bearing areas such as Class III and V cavity
• The tooth structure should be etched prior to application of the dentin bonding
agent and the compomer.

Luting system
• Indicated for cementing prostheses with a metallic substrate.
• Margin should be light-cured immediately to stabilize the prosthesis.
PROPERTIES

• They are inferior to composites

• Lower flexural strength, modulus of elasticity, compressive
strength, flexural strength fracture toughness and hardness, along
with significantly higher wear rates
• Lower levels of fluoride release than GICs

ADVANTAGES-fluoride release anticariogenic potential.

DISADVANTAGES-They lack adhesion. Thus bonding agents are

required
RECENT MODIFICATIONS OF GIC
• Fiber Reinforced GIC: The flexural strength of GIC was improved
by the incorporation of alumina fibres.
• Giomer: pre reacted glass ionomer technology-GIC and
composites were hybridised into Giomers.
2 types: F- PRG = reaction of Full / entire glass S- PRG = Surface
of glass.
• Amalgomers: Amalgomers are restorative material that are
based on glass ionomer but possess the strength of amalgam
• Hainomers: hydroxyapatite within glass ionomer powder. They
find their main applications in oral and maxillofacial surgery
where they are used as bone cements.
• Chlorhexidine impregnated GIC

• Proline Containing GIC: better surface hardness properties

than commercially available GIC.

• CPP : CPP is an ACP containing GIC. Casein

phosphopeptide-amorphous calcium phosphate is
incorporated into a glass-ionomer cement. significantly
increased the microtensile bond strength by 33% and
compressive strength by 23% and significantly enhanced
the release of calcium, phosphate, and fluoride ions at
neutral and acidic pH.
• Zirconia Containing GIC

• NANO Bioceramic Modified GIC: This contains Nano

hydroxyapaptite / fluorapatite particles added to GIC.

• Calcium Aluminate GIC: This is a hybrid product with a

composition containing calcium aluminate and GIC,
designed for luting fixed prosthesis.
Resin cement (low-viscosity versions of restorative composites)

IS0 4049 for polymer-based filling, restorative, and luting materials

(ANSI/ADA No 27) three classes of composite cements:
• Class 1-self-cured materials
• Class 2-light-cured materials
• Class 3-dual-cured materials
According to the adhesive scheme
• Self-etching
• Total etching
• Self-adhesive
APPLICATIONS
1. For bonding of orthodontic brackets to acid-etched
2. Cementation of porcelain veneers and inlays.
3. Cementation of all-porcelain crowns and FDPs
4. Cementation of etched cast restorations
COMPOSITION
• Similar to that of modern composites
• The filler content has to be lowered and diluent monomers are added

• to adjust the viscosity.

• Some contain fluoride (e.g. Panavia F).
• For adhesion-organophosphates (MDP), HEMA and 4 META are used as
• bonding agent
PROPERTIES
 Biological properties : Irritating to the pulp. Pulp protection with
calcium hydroxide or GIC liner is necessary for areas close to the pulp.
 Solubility : Insoluble in oral fluids.
 Polymerization shrinkage : Is high
 Adhesion properties : They do not adhere to tooth structure, which may
lead to microleakage if used without etching and bonding.
 Bond strength-to enamel : 7.4 MPa (1070 Psi). Bond strength to enamel
is usually strong.
 Failure most often occurs at the metal-resin interphase.
MANIPULATION AND TECHNICAL CONSIDERATIONS
 Resin cements are technique sensitive.
The following processes are involved.
1. Etching the restoration
2. Etching the tooth surface
3. Bonding and curing
4. Removal of excess cement
ETCHING THE RESTORATION
• Etching metal-blasting with 30–50 µm alumina or
electrolytic bath containing an acid like sulfuric
(electrochemical etching)
• The non-bonding surface is protected with wax.
• Silica coating can also be used to improve bonding.
• Etching porcelain-Ceramic is a highly inert material-etched by hydrofluoric
acid.
• Orthodontic brackets-a fine mesh on the bonding side of the bracket helps
to improve its retention-mechanical retention.

ETCHING THE TOOTH SURFACE-etched with phosphoric acid -followed by an

application of bonding agent.
BONDING AND CURING
• Chemically activated systems-
Two paste system(Mixing time is 20–30 sec)
Single paste system with activator in bonding agent.
• Dual cure system
The two components are mixed and light cured(40 sec)
Light curing gives high initial strength.

REMOVAL OF EXCESS CEMENT-Removal of the excess cement

should be attempted soon after seating before the material
has fully hardened as it has high strength.
Recent advances in Resin Cement 

• Imparting anticariogenic capacity to resin cements by addition of

antimicrobial compounds,
such as silver nanoparticles, quaternary ammonium
polyethyleneimine nanoparticles, cetylpyridinium chloride modified
montmorillonite and chlorhexidine diacetate and ursolic acid

• Imparting “self-healing” capacities for the dental resin to resist

cracks and fractures.
This is achieved by embedding microcapsules with an external shell
and healing liquid into the composite material.
 Enhance the polymerization of the resin monomers
“touch curing” or “contact curing”.
In this system, a proprietary non-tertiary amine accelerator is present in the
primer, which accelerates the curing when it is in contact with the cement
Restorative Composite Resin as an Alternative Luting Material 
 Preheating and ultrasonic vibration techniques were tested to reduce the film
thickness and viscosity.

Development of Novel Luting Materials—Castor Oil Polyurethane Cement

 Castor oil polyurethane - great biocompatibility, and it is easy to handle,less
cost, osteo-inductive properties and antimicrobial abilities.
As luting material it has two-part system with calcium carbonate fillers
Flexural strength -25% of that of adhesive resin cement, it is comparable to
the conventional cements such as zinc phosphate and GIC.
MINERAL TRIOXIDE AGGREGATE CEMENT

Indications
Mineral trioxide aggregate materials are indicated for various restorative, endodontic,
and regenerative dental procedures.
1. Vital pulp therapy (pulp capping and pulpotomy)
2. Apexification
3. Perforation repair (lateral and furcation)
4. Root-end filling
5. Internal bleaching
6. Resorption repair
7. As sealer and as obturating material (partial or complete).
Manipulation
• P/L Ratio ranges from 4 to 1 to 2 to 1
• Chemistry and setting reaction-MTA sets through a hydration reaction
when mixed with water.
• MTA + water → calcium hydroxide + calcium silicate hydrate
• A setting expansion of 0.1% is seen which contributes to its sealing
ability.

Properties
1. Compressive strength -within 24 hours of mixing was about 40.0 MPa
and increases to 67.3 MPa after 21 days
2. Radiopacity- MTA is radio opaque
3. Solubility-set MTA shows no signs of solubility
4. Marginal adaptation and sealing
5. Reaction with other dental materials MTA does not react
or interfere with any other restorative material.
6. Good biocompatibility
7. Tissue regeneration-MTA is capable of activation of
cementoblasts and production of cementum
8. Mineralization-MTA, just like calcium hydroxide, induces
dentin bridge formation and is believed to be due to its
sealing property, biocompatibility, alkalinity and other
associated properties.
What is the Best Available Luting Agent
for Implant Prosthesis?

Cement-retained implant-supported prostheses (CRISP) have been

commonly used because of simplicity and cost effectiveness
SELECTION OF DENTAL CEMENTS

1. Esthetic Value
2. Retentiveness

Shade selection

Dede and colleagues tested the effect of 3 different shades of resin

cement (translucent, universal, and white opaque) on the visual
perception of the final prosthesis.
• Lithium disilicate (LS2) crown was used.

• Abutments tested-zirconium, gold-

palladium, and titanium.

• Of all the tested combinations, only the

combination of zirconia or gold-palladium
abutments with universal shade resin
cement were esthetically acceptable.
Retentiveness
• Tensile strength of a cement determines the degree of
retention.

Zirconia abutments
• Lithium disilicate-Sellers and colleagues found that- most
retentive cement after thermocycling was resin cement.

• Zirconia-Rinke and colleagues also stated that resin cement is

preferred if excess cement removal can be achieved.
Titanium abutments

Cobalt-chromium In 2013, Mehl,the highest retention was obtained with resin

cement. Polycarboxylate was the second followed by GI.

Zirconia Schiessl and colleagues. Retention was noticed to be similar when

ZnP, EF-ZnO, GI, or resin cements are used.

Porcelain fused to metal

• Worni Et.al. suggested that PCB and resin cement provided the highest
retention for PFM crowns supported by titanium abutments.
Techniques to cement prostheses supported
by implants
• The common goal is limiting excess cement extrusion during seating of the
prostheses.

• Incomplete Coating of the Intaglio of the Prosthesis

Coat only the coronal half of the intaglio of the prostheses
The apical half of the prostheses intaglio surface

• Extraoral Prosthetic Preseating Using Abutment Analog is advisable especially if the

prosthesis margins are 3 mm below the gingival crest

• Extraoral Cementation (Screwmentation)

• Creating a Vent Hole as a Cement Reservoir

References
• Pritam P Lad, Maya Kamath,Kavita Tarale,Preethi B Kusugal,Practical clinical
considerations of luting cements: A review, J Int Oral Health. 2014 Feb; 6(1): 116–
120
• P Deeksheetha [1], Dr Subash Sharma[2],Recent Advances in Dental Cements - A
Review International Journal of Research Publication and Reviews Vol (2) Issue (9)
(2021)
• Gary Kwun-Hong Leung, Amy Wai-Yee Wong, Chun-Hung Chu, and Ollie Yiru Yu.
Update on Dental Luting Materials, Dent J (Basel). 2022 Nov; 10(11): 208

• Nehal Almehmadi 1, Ahmad Kutkut 2, Mohanad Al-Sabbagh What is the Best Available

Luting Agent for Implant Prosthesis?dental clinics of North America 2019,jul

• John J Manappallil,Basic Dental Mterials,4th edition

• Anusavice,Shen,Rawls.Phillips science of Dental Materials,first south Asian edition

THANK YOU