Dental luting cement

Bond StrengthStrengthFlow (viscosity)

WettingFilm thickness (<25 microns)

SolubilityWorking,Setting timeEsthetic

*Complication

Dental luting Cement

Zinc phosphatePolycarboxylateGlass ionomerRMGI cementResin cement

Zinc phosphate

Over 100 yrs of clinical experienceRoutine applicationPost-op sensitivitiesLow hardnessHigh solubilitypHNo bond with tooth

Polycarboxylate

Molecular bonding to tooth substance (2MPa)

Cost

Low F¯ releaseLow post-op sensitivitiesLow hardnesssolubility

Glass ionomer

Molecular bonding to tooth substanceF¯ releaseCost-Eff.Minimal dimentional changeOcca. post-op sensitivitiesSensitive to waterLimited application (ceramics)

(High caries risk)

(3-5MPa)

RMGI

Molecular bonding to tooth substance

F¯ releaseLow solubilityFewer post-op sensitivitiesApplication ? (ceramics,composite)

(>10MPa)

Resin cement

High adhesive quality (18-20MPa)

⇧ RetentionHigh hardnessLow solubilityAll metal, ceramic,composite(indirect)

Occa. Post-op sensitivities

Adhesive quality

Non-adhesive (zinc phosphate)

Micromechanical bonding (resin cement)

Molecular adhesion (polycarboxylate,GI,RMGI)

Dental Cement

Zinc phosphatePolycarboxylateGlass ionomerRMGI cementResin cement

Conventional

Adhesive

Advantage conventional cement

Easy handlingMoisture toleranceNo pre-Tx stepsRoutine for metal base

Advantage resin cement

Excellent mechanical propertiesHigh bond strength with pre-Tx stepHigh aesthetics/translucencySuitable for Ceramic, Porcelain, Composite,Metal

Resin cement

MatrixPrimerFillerCoupling agent

Resin cement

Matrix - DimethacrylatePrimer- DicrylateFiller - Quartz, silica Coupling agent- Silane dimethacrylate

Resin cement

Total etch Rely X ARC,Variolink II ,Calibra ,C&B

Self-etch Panavia F

Self-Adhesive Rely X Unicem

Adhesion

Dentin/enamel (micromachanical bond)Porcelain (hydrofluoric acid,Ammoniumfluoride acid)+ silane

Metal (sandblasting)(metal bonding adhesive)

Fiber post

Adhesion

Dentin/enamel (micromachanical bond)Porcelain (hydrofluoric acid,Ammoniumfluoride acid)+ silane

Metal (sandblasting)(metal bonding adhesive)

Fiber post

Adhesion

Dentin/enamel (micromachanical bond)Porcelain (hydrofluoric acid,Ammoniumfluoride acid)+ silane

Metal (sandblasting)(metal bonding adhesive)

Fiber post

Adhesion

Dentin/enamel (micromachanical bond)Porcelain (hydrofluoric acid,Ammoniumfluoride acid)+ silane

Metal (sandblasting)(metal bonding adhesive)

Fiber post

Why are fiber post?

1. Clinical success rate: Less root fracture than with metal posts: Dentine-like flexural strenght avoids the “wedge” effect of stiff and hard metal posts.

root fracture!

no local peak forces, no root fracture

metalfiber post

2. Esthetics: the new post is translucent and does not shine through ceramic or composite restorations

3. Easy and conservative removal with drills if endodontic re-treatment is required

further advantages: no corrosion, easy cutting of over-length, light-translucent...

Resin cement

Bond strength > Zinc phosphate 10 times

↑ RetentionReinforced ceramic - base CrownAdhesive system (micromachanical bond-tooth)

(chemical bond-porcelain,metal)

Low solubility↓ leakage

Pre-treatment procedure

Pre-treatment procedure

Pre-treatment procedure

Polymerization

Light-cured/Dual cure (2 vials - Base,Catalyst)

Self cure/auto cureDual cure

Adhesion

Dentin/enamel (micromachanical bond)Porcelain (hydrofluoric acid,Ammoniumfluoride acid)+ silane

Metal (sandblasting)(metal bonding adhesive)

Fiber post

Adhesive cement bonding to tooth ,alloy structure

Clinical Tips

AnestheticIsolate (pack cord)

Light cure 2-3 secInclude 3-5 shades,silaneRemove solvent-can inhibit setting of resin cement

Excess bonding –poor fit,low strength

Temp NE

Shade

Opaque –veneer + Tetracycline

Clear (translucent)Vita shade