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BDS3 DMS > Dental luting agents > Flashcards

Dental luting agents Flashcards

1
Q

What is luting agent another word for?

A
  • Dental cement
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2
Q

What is the ideal film thickness of luting agent?

A
  • 25um or less
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3
Q

What is the ideal viscosity for luting agent?

A
  • Must be low to allow seating of restoration without interference
  • Viscosity increases as material sets therefore must seat restoration quickly and maintain pressure
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4
Q

What ease of use properties should luting agents have?

A
  • Easy to mix i.e via clicker system in encapsulated ones
  • Working time long to allow for seating of restoration
  • Setting time short
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5
Q

Why must luting agents be radiopaque?

A
  • Some ceramic crowns are radiolucent
  • Makes it easier to see marginal breakdown
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6
Q

Ideally how should a luting agent bond to tooth and indirect restoration?

A
  • Bond chemically to tooth and indirect rest with a permanent and impenetrable bond
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7
Q

What is the ideal aesthetics of luting agents?

A
  • Tooth coloured with variation in shades and translucency
  • Non staining
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8
Q

What is the ideal solubility of luting agent?

A
  • Low
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9
Q

What is the ideal cariostatic properties of luting agents?

A
  • Fluoride releasing
  • Antibacterial
  • Important in preventing secondary caries around crown margins
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10
Q

What is the ideal biocompatibility of luting agents?

A
  • Non toxic
  • Not damaging to the pulp (inappropriate pH and heat on setting)
  • Low thermal conductivity
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11
Q

What are the ideal mechanical properties of luting agents?

A
  • High compressive strength (dentine 275MPa)
  • High tensile strength (dentine 50MPa)
  • High hardness value (dentine 70K and enamel 400k)
  • Young modulus similar to tooth (dentine 15GPa)
  • No luting agent gets close to tooth values for more than one or two physical properties*
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12
Q

What are the types of dental cement?

A
  • Zinc phosphate
  • Zinc polycarboxylate
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13
Q

What are the types of glass ionomer cement?

A
  • Conventional
  • Resin modified
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14
Q

What are the types of composite resin luting agents?

A
  • Total etch for use with DBA
  • Self etch
  • Requires etch but has own bonding agent incorporated
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15
Q

What is zinc phosphate?

A
  • In use for 100+years
  • Acid base reaction
  • Powder and liquid
  • Excellent clinical service
  • Easy to use
  • Cheap
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16
Q

What is the constituents of zinc phosphate powder?

A
  • Zinc oxide >90% (main reactive ingredient)
  • Magnesium dioxide <10%
  • Other oxides (alumina and silica)
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17
Q

What is magnesium dioxide used for in zinc phosphate powder?

A
  • Gives white colour
  • Increases compressive strength
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18
Q

What are alumina and silica used for in the powder of zinc phosphate cement?

A
  • Improves physical properties
  • Alter shade of set material
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19
Q

What are the constituents of zinc phosphate liquid?

A
  • Aqueous sol of phosphoric acid (approx 50%)
  • Aluminium oxide that ensures even consistency of set material
  • Zinc oxide slows the reaction giving better working time
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20
Q

What are the reactions of the zinc phosphate cement?

A
  • Initial acid base reaction
  • Followed by hydration reaction
  • Results in formation of crystallised phosphate matrix
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21
Q

What does the aluminium oxide prevent in Zinc phosphate?

A
  • Prevent crystallisation leading to amorphous glassy matrix of acid salt surrounding unreacted ZnO powder
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22
Q

What happens when zinc phosphate cement matures?

A
  • Matrix originally insoluble but it is porous and contains free water from setting reaction
  • When it matures it binds the water
  • Leads to stronger, less porous material
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23
Q

What are the disadvantages of zinc phosphate cement?

A
  • Low initial pH approx 2
  • Exothermic setting reaction (release heat)
  • Not adhesive to tooth or restoration
  • Not cariostatic
  • Final set takes 24hrs
  • Brittle
  • Opaque
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24
Q

What can a low pH lead to?

A
  • Pulpal irritation
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25
Q

How is zinc phosphate retained in tooth?

A
  • Works like grout on tiles and fills spaces
  • Retention slightly micromechanical due to surface irregularities on prep and restoration
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26
Q

What are the constituents of Zinc Polycarboxylate cement?

A
  • Aqueous sol of polyacrylic acid (approx 50%)
  • Aluminium oxide
  • Zinc oxide
  • Zinc oxide >90% (main reactive ingredient)
  • Magnesium dioxide <10%
  • Other oxides (alumina and silica)
27
Q

What are some negatives of Zinc Polycarboxylate cement?

A
  • Difficult to mix
  • Difficult to manipulate
  • Soluble in oral environment at lower pH
  • Opaque
  • Lower modulus and compressive strength than Zinc phosphate
28
Q

How does the glass ionomer cement bond to tooth surface?

A
  • Ion exchange with calcium in enamel and dentine
  • Hydrogen bonding with collagen in dentine
  • Results in fairly strong, durable bond to tooth
  • No chemical bond to restoration surface
29
Q

What are the advantages of glass ionomer cements?

A
  • Clinically easy to use and durable cement
  • Low shrinkage
  • Long term stability
  • Relatively insoluble once fully set
  • Aesthetically better than Zinc phosphate
  • Self adhesive to tooth substance
  • Fluoride release
  • Cheap
30
Q

What monomer does the RMGI cement liquid have in addition to conventional GIC powder?

A
  • Hydrophillic monomer
  • Must be hydrophilic as GIC is water based material
  • HEMA (Hydroxyethyl methacrylate)
31
Q

How is the RMGI set?

A
  • Light activation causes polymerisation of HEMA and any copolymers = rapid initial set
  • Acid base reaction continues for some time
  • Some materials have secondary cure via REDOX
  • Allows Dark curing
32
Q

What is Dark curing?

A
  • Material not exposed to light will cure
33
Q

What are some advantages of RMGI?

A
  • Shorter setting time
  • Longer working time
  • Higher compressive and tensile strengths
  • Higher bond strength to tooth
  • Decreased solubility
34
Q

What are some potential problems with RMGI?

A
  • HEMA is cytotoxic (can damage pulp if any remain)
  • HEMA swells (expands in wet environment so can’t use conventional porcelain crowns as may crack
  • No bond to indirect restoration
35
Q

What are the advantages and disadvantages of composite luting agents?

A
  • Can be light or dual cured
  • Better physical properties, lower solubility and better aesthetics
  • But technique sensitive
36
Q

What are the advantages and disadvantages to bonding to indirect composite?

A
  • Composite bonds to composite
  • Bond strength lower to inlay fitting than new composite
  • Bond is micromechanical to rough internal surface of inlay
  • Bond is chemical C=C bonds on fitting surface of inlay
  • Use dual curing cement as light penetration through inlay is poor
37
Q

Why does porcelain need to be treated with 10% HF in order to bond to tooth?

A
  • Porcelain is brittle and needs to be bonded to tooth to prevent fracture
  • Untreated porcelain is smooth and non retentive
  • Treated with HF to etch surface (toxic)
  • Leads to rough retentive surface
  • Allows silane bonded coupling agent to adhere
38
Q

What is a silane coupling agent and how does it bond?

A
  • Gamma-methacryoxypropyltrimothoxysilane
  • Applied to etched porcelain surface as monolayer
  • Strong bond between oxide groups on porcelain surface and silane
  • Other end of silane molecule has C=C bond which reacts with composite resin luting agent
  • Works same manner as dentine bonding agent
39
Q

When curing a composite luting agent to porcelain what should you do?

A
  • If porcelain restoration is thin use light cured
  • If thick use dual cure
  • Remove as much of the luting resin as poss before curing
40
Q

How does composite materials bond to metal?

A
  • Does not bond directly to metal
  • Metal surface to be roughened by etching
  • Usually done by sandblasting
41
Q

What does etching metal lead to?

A
  • Electrolytic etching removes diff phases of alloy at different rates
  • Gives very retentive surface
  • But technique sensitive
  • Beryllium alloy works best
  • Can’t etch precious metals at all
42
Q

What is required after sandblasting a metal?

A
  • Sandblasting roughen surface
  • Does not give undercut surface of etching
  • Chemical bonding required to strengthen bond
43
Q

How are non-precious metals bonded?

A
  • MDP and 4-META
  • Molecules have acidic end and C=C end
  • Acidic end of molecule reacts with metal oxide and surface is now hydrophobic
  • Use dual cure as light doesn’t penetrate metal
44
Q

How are precious metals bonded?

A
  • Change precious alloy composition to allow oxide formation
  • Increase copper content and heat 400oC in air
  • Tin plate
  • Sulphur based chemistry of bonding agent
  • Complicated and technique sensitive
45
Q

What are the advantages of self adhesive composites resins?

A
  • Good film thickness
  • Opaque
  • Moisture sensitive
  • Expensive
46
Q

What is a self adhesive composite resin?

A
  • Metal coupling agent incorporated into composite resin
  • Simplifies bonding process
47
Q

What are the advantages and disadvantages of Self etching composite resin cements (Rely X Unicem)?

A
  • Stick to everything
  • Easy to use
  • Requires good moisture control
  • Potential inadequate bond strength to enamel due to inadequate etching
  • pH of carboxylic monomer doesn’t stay low enough enough for good etch
48
Q

How do Self etching composite resin luting agents work?

A
  • Acidic group binds with calcium in hydroxyapatite
  • Forms stabilising attachment between tooth and resin
  • Ions from dissolution of filler neutralise remaining acidic groups
  • Forms chelate reinforced methacrylate network
  • Limited removal of smear layer or sig infiltration into tooth surface
  • Good bond strength to dentine
49
Q

What are the properties of Self etching composite resin luting agents?

A

Mechanical
- Compressive strength
- Tensile strength
- Hardness

  • Wear resistance
    *Slightly lower than conventional resin luting agent’s but better than cements
50
Q

When using a MCC what luting agent should you use?

A
  • Glass ionomer cement
  • RMGI
51
Q

When using metal post what luting agent should you use?

A
  • GIC
52
Q

When using a fibre post what luting agent should you use?

A
  • Dual cure composite and DBA
  • Self adhesive composite
53
Q

When using veneer what luting agent should you use?

A
  • Light cure composite and DBA
54
Q

When using adhesive bridge what luting agent should you use?

A
  • Anaerobic cure composite
55
Q

When using zirconia crown what luting agent should you use?

A
  • GIC
  • RMGIC
  • Dual cure composite and DBA
  • Anaerobic cure composite
  • Self adhesive composite
56
Q

When using composite inlay what luting agent should you use?

A
  • Dual cure composite and DBA
  • Self adhesive composite
57
Q

When using porcelain inlay what luting agent should you use?

A
  • Dual cure composite and DBA
  • Self adhesive composite
58
Q

When using gold restoration what luting agent should you use?

A
  • GIC
  • RMGIC
59
Q

What are temporary cements used for?

A
  • Cement temporary restorations in place whilst permanent restoration is fabricated
  • Soft for easy removal and some don’t even set
  • Prep must be physically retentive or doesn’t work
60
Q

What are temporary cements made of?

A
  • Two paste system (base and catalyst/accelerator)
  • Base = ZnO, Starch and mineral oil
  • Accelerator = resins, eugenol or ortho-EBA and carnauba wax
61
Q

What is the wax for in temporary cements?

A
  • Weakens structure of set cement
  • Makes it easier to remove
  • Can be made even weaker with petroleum jelly
62
Q

What are the two types of temporary cements?

A
  • With and without eugenol
63
Q

What can’t eugenol containing temporary cements be used for?

A
  • Not used to cement provisional restoration where permanent restoration will be cemented with resin cement
  • Any eugenol residue can interfere with setting of resin cement

BDS3 DMS (10 decks)

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