Dental Cements Flashcards

1
Q

WHY DENTAL CEMENTS?
(4)

A

caries
fractures
misalignment
prolong the life of the pulp in the war against oral bacteria- using protective coatings

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2
Q

prolong the life of the pulp in the war against oral bacteria- using protective coatings
(4)

A

varnish
base
liner
pits and fissure sealants

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3
Q

DENTAL CEMENT

A

substance that hardens to act as a base, liner, restorative material or luting agent (adhesive) to bind devices and prostheses to tooth structure or to each other

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4
Q

WHAT DO WE WANT A DENTAL
CEMENT TO BE?
(10)

A

biocompatible
non corrosive and inert
immune to acid attack
dimensionally stable
sets during the dental procedure
low surface tension; handles and palces easily
adapts and adheres to anatomy
insensitive to moisture during procedure
anti microbial/ F release
radiopaque
cost effective

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5
Q

immune to acid attack

A

insoluble

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6
Q

dimensionally stable
(2)

A

no cracking of tooth or device by expansion
no leaking because of shrinkage

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7
Q

WHAT MECHANICAL PROPERTIES FOR
THE CEMENT ARE NEEDED?
high values needed for:
(3)

A

cyclic fatigue
thermal cycling
strength

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8
Q

strength
(4)

A

tensile
compressive
flexural strength
shear

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9
Q

luting cements
(3)

A

permanent and provisional indirect restorations
ortho brackets
post and cores

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10
Q

restorative materials

A

permanent and provisional direct restorations

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11
Q

cavity liners and bases

A

pulp protection

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12
Q

multiple applications

A

no one cement can fulfill all requirements

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13
Q

LUTING CEMENT/AGENT

A

viscous material that fills the microscopic space between the abutment-prosthesis interface; upon setting, it forms a solid that seals the space and retains the prosthesis

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14
Q

Ideal properties of a permanent
luting agent
(8)

A

deal properties of a permanent
luting agent
1. *Low film thickness (25 m)
2. *Adequate strength (minimum 70 MPa)
3. *Low solubility (0.2% max. @ 24h)
4. *Reasonable setting time (2.5-8.0 min)
5. Adequate working time
6. Biocompatible, does not irritate pulp
7. Cariostatic
8. Adhesion to tooth structure and restorative materials
*ADA and ISO specification requirements

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15
Q

physical bonding

A

very weak interaction, secondary bonds
-van der waals forces, hydrogen bonds

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16
Q

chemical bonding

A

strongest bond, primary bonds
-limited occurrence, dissimilar materials
-ex, composite bond to adhesive bond agent

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17
Q

mechanical bonding

A

interlock undercuts, surface irregularities
-micromechanical retention
-ex: luting agent/tooth/crown, adhesive bond agent/tooth

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18
Q

MICROMECHANICAL RETENTION:
LUTING CEMENT VS ADHESIVE BOND
AGENT

LUTING CEMENT

A

cement locking into microscopic irregularities in prepared tooth surface and the internal surface of the crown
-non resin cements
-very low bond strength, 1-5 mpa

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19
Q

MICROMECHANICAL RETENTION:
LUTING CEMENT VS ADHESIVE BOND
AGENT

ADHESIVE BOND
AGENT

A

enamel: resin tags into etched enamel
dentin: hybrid layer
-interdiffusion or micromechanical interlocking of resin with demineralized collagen of intertubular dentin
-20-30 mpa bond strength

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20
Q

Cement
Setting mechanism

CaOH

A

Acid-base reaction

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21
Q

Cement
Setting mechanism

Zinc oxide (ZO) eugenol
Modified ZO eugenol
ZO non-eugenol

A

Acid-base

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22
Q

Cement
Setting mechanism

Zinc polycarboxylate Acid-base

A

Acid-base

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23
Q

Cement
Setting mechanism

Zinc phosphate

A

Acid-base

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24
Q

Cement
Setting mechanism

Glass Ionomer (GI)

A

Acid-base

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25
Q

Cement
Setting mechanism

Resin-modified GI

A

Acid-base AND
polymerization

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26
Q

Cement
Setting mechanism

Resin cement (RC)
Unfilled or Filled

A

polymerization

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27
Q

LIQUID: ACIDIC COMPONENT
(3)

A

eugenol/noneugenol oils
polycarboxylic acid
phosphoric acid

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28
Q

POWDER: BASIC COMPONENT

A

zinc oxide (ZO)
fluroaluminasilicate (FAS) glass

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29
Q

types of luting cements
(4)

A
  • ZINC-OXIDE EUGENOL AND NON-EUGENOL CEMENTS (ZO)
  • POLYCARBOXYLIC ACID CEMENTS
  • ZINC PHOSPHATE CEMENT
  • RESIN-BASED CEMENTS
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30
Q
  • POLYCARBOXYLIC ACID CEMENTS
    (3)
A

zinc polycarboxylate cement
glass ionomer cement
resin modified glass ionomer

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31
Q
  • RESIN-BASED CEMENTS
    (3)
A

resin modified glass ionomer
unfilled resin cements
filled resin: composite resin cements

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32
Q

ZNO-EUGENOL CEMENTS
types (3)
indications (1)

A

regular ZEO
reinforced ZEO
ZEO-EBA

temporary/intermediate cementation

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33
Q

INC OXIDE EUGENOL CEMENTS
(ACID-BASE)

composition

A

powder: zn oxide
liquid: eugenol

modifications
- polymer-reinforced: IRM
- EBA, alumina

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34
Q

INC OXIDE EUGENOL CEMENTS
(ACID-BASE)

low strength

A

ZOE
-compressive: 2-15
-tensile: 1-2

ZOE (modified)
-compressive: 40-50
-tensile: 3-5

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35
Q

INC OXIDE EUGENOL CEMENTS
(ACID-BASE)

uses

A

temp or provisional cement and restorations

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36
Q

ZINC OXIDE – EUGENOL
powder

A

99% ZnO and radiopaque fillers

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37
Q

ZINC OXIDE – EUGENOL
liquid

A

oil of cloves
85% eugenol

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38
Q

ZINC OXIDE – EUGENOL
rxn products

A

zinc oxide, zinc eugenolate
needs h2o to set

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39
Q

ZINC OXIDE – EUGENOL
no pulpal irritation

A

eugenol acts as sedative, obtundent

40
Q

ZINC OXIDE – EUGENOL
ZEO unmodified, tempbond

A

temp cement

41
Q

ZINC OXIDE – EUGENOL
ZOE polymer reinforced

A

IRM
-temp cement: decrease retention or increase time
-provisional/intermediate restoration

42
Q

ZINC OXIDE – EUGENOL
not used prior to resin based permanent cement, why?

A
43
Q

ZNO-EUGENOL
(6)

A

+ obtundent
+ slow setting
excess eugenol is irritant
shrinkage
low strength
solubility

44
Q

excess eugenol is irritant
(2)

A

cytotoxic
potential allergen

45
Q

ZINC OXIDE NON-EUGENOL CEMENTS
(4)

A

temp cement
eugenol replaced with other oils
used prior to permanent resin based cement
tempbond NE

46
Q

tempbond NE (2)

A

slow set
low retention

47
Q

ZINC POLYCARBOXYLATE CEMENT
(ACID-BASE)
reaciton

A

zn oxide + polyacrylic acid = zn polyacrylate (powder)

48
Q

ZINC POLYCARBOXYLATE CEMENT
(ACID-BASE)
low strength
(2)

A

compressive, 55-67 mpa
tensile, 6-8 mpa

49
Q

ZINC POLYCARBOXYLATE CEMENT
(ACID-BASE)
biological considerations
(2)

A

initial pH ~3, similar or lower than Zp PO4
minimal pulp rxn, large molecule not enter tubules

50
Q

ZINC POLYCARBOXYLATE CEMENT
(ACID-BASE)
dentin bond strength
chelation interaction:
physical bond:

A

~2 mpa
cement carboxylate and Ca on tooth surface
interaction between - and + charges

51
Q

ZINC POLYCARBOXYLATE CEMENT
advantages
(2)

A

-low pulpal irritation
-adhesion to tooth structure (more with enamel than dentin)

52
Q

ZINC POLYCARBOXYLATE CEMENT
disadvantages (3)

A

-low strength
-more viscoelastic
-prosthesis dislodgment over time

53
Q

ZINC POLYCARBOXYLATE CEMENT
marketed as a temp cement
(3)

A

-ultratemp
-can be used prior to resin cement (no poly inhibition)
-ultratemp rez: resin based

54
Q

ZINC POLYCARBOXYLATE CEMENT
characteristics
(6)

A

oldest, still in use
gold standard for new cements
easy to manipulate
working time: 3-6 min
setting time <14 min
indications: luting (non adhesive cementation), fixed pros

55
Q

ZINC PHOSPHATE (ZNPO4) CEMENT
(ACID-BASE)

reaction

A

zinc oxide (powder) + phosphoric acid (liquid) = zn phosphate

56
Q

ZINC PHOSPHATE (ZNPO4) CEMENT
(ACID-BASE)(1878)
micromechanical bond to preparation surface and crown internal surface micro-irregularities
(3)

A

no chelation interaction
bond strength: 0.5-1.5 mpa
preparation retention and resistance form critical

57
Q

ZINC PHOSPHATE (ZNPO4) CEMENT
(ACID-BASE)
no longer a major luting agent
(2)

A

possible current use: cement retained implant crowns
radiographic visibility, easier removal with less damage to implant surface

58
Q

ZN PHOSPHATE CEMENT
powder

A

?75% zinc oxide <13% magnesium oxide

59
Q

ZN PHOSPHATE CEMENT
liquid= aqueous solution of

A

38-59% H3PO4
2-3% AL phosphate
<9% zn phosphate

60
Q

ZN PHOSPHATE CEMENT
reaction products
(3)

A

amorphous Zn3(PO4)4H2O matrix
zinc aluminophosphate matrix
residual zno particles

61
Q

ZINC PHOSPHATE
exothermic
(3)

A

use chilled glass slab
mix over large area of slab
mix in increments

62
Q

ZINC PHOSPHATE
(3)

A

exothermic
create stringy consistency
remove excess after set

63
Q

ZN PHOSPHATE CEMENT
(4)

A

+ thermally protective
acidic
exothermic rxn
some solubility with acids

64
Q

GLASS IONOMER (GI) CEMENT
(ACID-BASE)
composition

A

powder: FAS
liquid: polycarboxylic acid/h2o

65
Q

GLASS IONOMER (GI) CEMENT
(ACID-BASE)
strength
compressive:
tensile:

A

90-140 mpa
6-7 mpa

66
Q

GLASS IONOMER (GI) CEMENT
(ACID-BASE)
— release

A

fluoride

67
Q

GLASS IONOMER (GI) CEMENT
(ACID-BASE)
bond strength

A

3-5 mpa
-chelation, cement carboxyl and ca in apatite

68
Q

GLASS IONOMER
(GI) CEMENT
(ACID-BASE)
posts cementation hypersensitivity
brands (2)

A

early protection (varnish to prevent dehydration of initially set cement

ketac-cem, glasslute

69
Q

ACID-BASE CEMENT COMPONENTS
liquid

A

acidic component
-eugenol/non eugenol oils
-polycarboxylic acid
-phosphoric acid

70
Q

ACID-BASE CEMENT COMPONENTS
powder

A

basic component
-xinc oxide
-FAS glass

71
Q

GLASS IONOMER CEMENT

A

combo of tech of silicate cememnt and polycarboxylate reaction

72
Q

GLASS IONOMER CEMENT
glass powder

A

Ca-F-Al-silicate
-optional Ba, Sr for radiopacity
-optional Ag, Zn
-powder size <25mm

73
Q

GLASS IONOMER CEMENT
liquid

A

water solution of
-50% polyacrylic-itaconic copolymer
-optional water-soluble polymer
-citric, maleic and tartaric acids

74
Q

GI CEMENT
(3)

A

-affixing devices )ortho bands)
-fluoride release
-requires protection from dilution or evaporation during setting

75
Q

GIC -CLINICAL
(7)

A

fluidity like Zn PO4
chill the powder and slab
avoid liquid evaporation
remove smear layer created by preparation instruments
dont dehydrate tooth
protect cement from excess or frequency of H2O during set (apply copalite on exterior)
remove excess immediately (avoid adhesion in unwanted areas)

76
Q

RESIN-MODIFIED GLASS IONOMER (RMGI)
CEMENT (ACID-BASE + POLYMERIZATION)
composition
(3)

A

powder: FAS glass
liquid
photoactivator (light activated only)

77
Q

RESIN-MODIFIED GLASS IONOMER (RMGI)
CEMENT (ACID-BASE + POLYMERIZATION)
liquid

A

polycarboxylic acid/h2o
resin monomers, vary with products
-hema, bis-GMA
-replace some of the h2o of conventional GI

78
Q

RESIN-MODIFIED GLASS IONOMER (RMGI)
CEMENT (ACID-BASE + POLYMERIZATION)
setting reactions (2)

A

acid base rxn
monomer polymerization: light, chemical, dual activated

79
Q

RMGI CEMENT
strength

A

compressive: 150-200
tensile: 13-24

80
Q

RMGI CEMENT
fluoride release
from….

A
81
Q

RMGI CEMENT
bond strength

A

5-10 mpa

82
Q

RMGI CEMENT
powder/liquid system
potential for
brands (3)

A

dispending error
rely z, fuji plus, CX plus

83
Q

RMGI CEMENT
paste/paste systems
(6)

A

2 tube dispenser
mix on pad
quicker dispensing
less dispensing error
mix within 30 s
brands: rely x plus, fuji cem

84
Q

CEMENTATION WITH RMGI:
POWDER/LIQUID SYSTEM (RELY X)
(11)

A
  1. gently shake powder bottle to fluff powder
  2. dispense powder before liquid
  3. equal number powder scoops and liquid drops
    (3 scoops for crown, 6 for FPD, 2 abutments)
  4. hold bottle vertically to dispense liquid
  5. mix powder into liquid within 30 s
  6. load the crown with cement
    (spread cement onto all internal surfaces)
  7. working time is 2.5 minutes
  8. seat the crown
  9. wait at least 3 min after placement
  10. after cement is completely set, remove excess (scaler, explorer, knotted floss)
  11. gingival crevice, remaining cement (any cement that is not removed will be very irritating to the tissue)
85
Q
  1. seat the crown
    (2)
A

maintain pressure on restoration while cement is setting
maintain dry field: cotton rolls, suction

86
Q

RESTORATION CEMENTATION POTENTIAL
PROBLEMS
(5)

A

premature contacts
pulpitis
loosening of the restoration
recurrent caries
restoration incomplete seating, often linked to other problems

87
Q

incomplete seating factors
(4)

A

cement viscosity; pseudoplasticity
vibration
venting, preparation groove
seating force

88
Q

cement viscosity; pseudoplasticity

A

restoration morphology
-onlay vs crown, less force required

89
Q

seating force

A

excess force leads to dentin rebound and potential restoration. dislodgement

90
Q

RMGI INDICATIONS
(6)

A

cavity liners, base
pit and fissure sealants
core buildups
restorative
adhesive
retrograde root filling materials

91
Q

RMGI INDICATIONS
(6)

A

cavity liners, base
pit and fissure sealants
core buildups
restorative
adhesive
retrograde root filling materials

92
Q

adhesive
(2)

A

ortho brackets, crowns
repair amalgam

93
Q

resin cements
(5)

A

1950s, 1970s
based on methyl methacrylate
chemical (self) cure
light cure
dual cure

94
Q

RESIN CEMENTS
(12)

A

looks esthetic, transulcent, shades to match tooth
insoluble
fast curing or slow curing formulas
good for ceramic restorations
strong and insoluble
shrinkage: leakage
higher film thickness
more complex clinically
incomplete conversion of monomer
poorer strength, more irritation
odor, allergies
wear of resin

95
Q

RESIN CEMENT USES
(2)

A

protheses cementing
ortho brackets

96
Q

protheses cementing
(3)

A

metal
polymer
ceramic

97
Q

COMPOMERS
(3)

A

combo of resin cements with a dash of GIC
polyacid liquid monomers and resin monomers (water free)
usually light curing