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1
CEMENTS IN
ORTHODONTICS

By
Sonal Sahasrabudhe
1st year PG

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CONTENTS
Introduction
History
Classification Of Cements
Ideal Requirements Of Cements
Zinc Phosphate Cement
Zinc Polycarboxylate Cement
Zinc Silicate Cement
Zinc Silico-phosphate Cement
Glass Ionomer Cements
Recent Advances
Conclusion
Bibliography

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INTRODUCTION
Cement: substance that hardens to act as a base, liner,
filling material, or adhesive to bond devices and prostheses
to tooth structure or to each other (Phillips)

Cementation of band and brackets routine process in


orthodontics.

Much of preventive, interceptive, and corrective


orthodontics use for appliances retained by bands

For no matter how skillful an orthodontic band maybe


constructed it will not remain on the tooth throughout its
functional use without the aid of cement.

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For this reason physical characteristics of dental cement and
their manipulation are of particular interest to orthodontists

Retention, seal, and survival of the orthodontic bracket and


band depend so much upon this relatively weak thin film of
cement.
HISTORY
(1850s) First dental cements to be used- zinc oxychloride

Other cements like magnesium oxychloride and zinc


oxysulfate cement introduced
All found to be highly irritating to pulp tissues, unsatisfactory as
cementing media
High degree of solubility in oral fluids and generally did not withstand the
oral environment
(1878) Zinc phosphate cement was introduced.
This cement proved to be much more acceptable then the earlier forms.

(1880) Silicate cement was introduced

6
(1968) Smith introduced zinc polycarboxylate cement

(1972) GIC are introduced by A.D. Wilson & B.E. Kent

(1988) Light cure glass ionomer was introduced by


Antonucci and his co workers

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Classification
Cements

Phosphates Phenolates PolycarboxylatesAcrylates

Zinc GIC
Zinc Zinc sillico
Polycarboxylate
Phosphate Phosphate

Zinc oxide Ca(OH) Polymeth- Dimeth


Eugenol Salicylate acrylates acrylates

Filled Unfilled

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4 Principal types of cements of
acid-base reaction

Zinc Zinc
Phosphate Polycorboxylate

Zinc Oxide

Aq. Polyacrylic
Phosphoric acid
acid Fluorine
containing
alumino
-silicate
glass
Glass
Silicate Ionomer

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USES OF DENTAL CEMENTS
CEMENT PRINCIPAL USES SECONDARY USES

1) Zinc Phosphate Luting agent for restoration and Intermediate restoration


orthodontic appliances. thermal insulting bases

2) Polycarboxylate Luting agent for restorations; thermal Luting cement for


Insulating bases; orthodontic appliances;
Intermediate
restorations.

3)Silicophosphate Luting agent for restorations. Intermediate restorations


luting cement for
orthodontic appliances

4) Glass ionomer Anterior restorations, luting Pit & fissure sealant


cements for restorations and thermal insulating bases.
orthodontic appliances; cavity
liners.
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IDEAL REQUIREMENTS OF
LUTING CEMENTS
Adequate working and setting time
High tensile, compressive, and shear strength
Resistant to dissolution
Clinically acceptable bond strength
Anti-cariogenic
Adhesion to tooth structure
Non-irritant and non toxic
Ideally be of low initial viscosity or be pseudo
plastic to allow flow of the cement so that proper
banding can occur
should not stick to the dental instruments
Optimum handling properties

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ZINC PHOSPHATE

Oldest of the cements

1870- Pierce introduced zinc oxide-phosphoric acid cement

1878- Ames and Fleck established modern day cement

Serves as Gold Standard for all dental cements

Adopted by A.D.A. (1935), specification no. 8

Two types on the basis of intended use.


Type I: for cementation of precision castings (25m)
Type II: for luting orthodontic bands and as bases (40 m)

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COMPOSITION
Powder % Use
Zinc oxide 90 Principle ingredient
Mg oxide 8.2 Improvement in
mech proprties,
colour stability
Silicon dioxide 1.4 Inactive filler,
provides colour
Bismuth trioxide 0.1 Smoothness to
freshly mixed
cement, increses
setting time
Oxides of Ca Ba, 0.1 Radio-opacity
sulfate of Ba
Copper oxide, Traces Colour Pigments
manganese dioxide,
platinum, bismuth
oxide, Iron oxide or
titanium
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LIQUID
Liquid % Use
Phosphoric acid 55
Free 38.2 Reacts with zinc
Combined (Al, Zn) 16.2 oxide
Buffer, reduces
rate of reaction
Water 36 Controls rate of acid-
base reaction

Pre-reacted zinc 16.2 Reduce rate of


phosphate reaction

Manufacturing:
The ingredients of the powder are sintered at temperatures between
1000oc to 1400oc into a cake that is ground into fine powders.

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CHEMISTRY
Powder+
Liquid= Acid
attacks surface
of powder
particles
Release of
zinc and Al
in liquid
Al first forms
complex with
phosphoric acid and
reacts with Zinc=
Zinc
aluminophosphate
gel
Set cement= core
structure primarily of
unreacted Zinc
embedded in cohesive
amorphous matrix of
zinc aluminophosphate
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MANIPULATION
Proportioning and consistency of the powder & liquid vary
to some degree with the clinical situation. The maximal
amount of powder be used to ensure minimum solubility
and maximum strength.

A cool mixing slab should be employed. The cool slab


prolongs the working and setting time and for incorporating
the maximum amount of powder before the matrix
formation.(FROZEN SLAB METHOD)

MIXING
Incorporate small quantity of powder with brisk spatulation.
A considerable area of the mixing slab should be used.
A good rule to follow is to spatulate each increment for 15
seconds before adding another increment.
Mixing time:-approximately 1 minute and 30 seconds. The
recommended P:L ratio -1.4g to 0.5 ml

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ZINC PHOSPHATE MIXING

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Precautions while banding
The band should be seated immediately, if possible before
matrix formation occurs
After placement hold under pressure until the cement sets
to minimize the air space
Dry field of operation
Removal of excessive cement
It is recommended that a layer of varnish or other non
permeable coating should be applied to the margins.
This allows the cement more time to mature & develop an
increased resistance to dissolution in oral fluid.
WORKING TIME AND SETTING TIME

Working Time: Approximately 4-5 min

Setting Time: 2.5-8 min(ADA Specification No. 96)

Defined as the elapsed time from the start of mixing until the
point of the needle no longest penetrates the cement as the
needle is lowered onto the surface.

Practically, it is the time at which the zinc phosphate cement


flash should be removed from the margin.
PHYSICAL AND BIOLOGIC PROPERTIES
Mechanical properties
4-7 min after mixing- initial rapid rise in strength upto 50%
Increases up to 24hours
The band can become dislodged if the underlying cement is
stressed beyond it strength.
The compressive strength varies with P:L ratio.
Increase in strength is attained by addition of more powder.
A reduction in the P:L ratio of the mix produces a
markedly weaker cement.
A loss or gain in water content of liquid reduces the
compressive and tensile strength of the cement
Solubility
High solubility can induce loss of the cement needed for
retention and may create plaque retention sites and a nidus
for decalcification.

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RETENTION
Setting of the zinc phosphate cement does not involve any
reaction with surrounding hard tissue or other restorative
materials. Therefore, primary bonding occurs by
mechanical interlocking at interfaces and not by chemical
interaction.

BIOLOGIC PROPERTIES
The presence of the phosphoric acid, the acidity of the
cement is quite high at the time when a band is placed on a
prepared tooth.
pH after 2 minutes of mixing, is approximately 2.
About 5.5 at 24 hours

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FACTORS GOVERNING THE RATE OF SET OF ZINC PHOSPHATE CEMENT

Controlled by manufacturer
A) Powder composition
B) Degree of powder calcination
C) Particle size of the powder
D) Water content of liquid
E) Neutralization of liquid

Controlled by operator
A) Powder/ liquid ratio
B) Rate of powder incorporation
C) Mixing temperature
D) Manner of spatulation
E) Water contamination or loss from fluid.

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Advantages and
Disadvantages
Can be mixed easily
Set sharply to a relatively strong mass from a fluid
consistency
Bond strength adequate for clinical service
Manipulation less critical compared to other cements

Pulpal irritation(acidic pH)


Lack of antibacterial action
Brittleness
Lack of adhesion
No protection against demineralization
Solubility in oral fluids

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ZINC POLYCARBOXLATE CEMENT

Dennis C. Smith (1963)

This was a major advance towards true adhesive


attachment by molecular bonding to tooth surface.

1st cement with adhesive potential

The cement is formed by mixing zinc oxide powder with


polycarboxylic acid liquid.

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COMPOSITION AND CHEMISTRY
Powder % Use
Zinc oxide 90 Principle ingredient
Mg oxide/ Stannic Up to 10% Improvement in
oxide mech properties,
colour stability
Silicon dioxide 1.4 Inactive filler,
provides colour
Bismuth trioxide/ 0.1 Smoothness to
Aluminium oxide freshly mixed
cement, increases
setting time
Stannous fluoride 4-5%
Pigments
Liquid % Use
Polyacrylic acid 40
Copolymers of
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Itaconic and maleic
SETTING REACTION
Interaction of
Acid base reaction acid and
powder
particles

Release of zinc,
Mg and
ionization of
polycarboxylic
acid

The hardened cement carboxyl groups of


=an amorphous gel adjacent polyacid chains
matrix in which and metal ions react to
unreacted particles are form cross linked
dispersed polycarboxylate salts
(cement matrix)

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BONDING TO TOOTH STRUCTURE

Chemical adhesion to tooth structure.(Mechanism not


entirely understood)
The polyacrylic acid is believed to react via the
carboxyl groups with calcium of hydroxyapatite.
The inorganic component and the homogeneity of enamel
are greater than those of dentin. Thus, the bond strength
to enamel is greater than the to dentin.

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WORKING AND SETTING TIME

Mixing time: 30-40 sec


Cooling the glass slab can cause the polyacrylic
acid to thicken and which makes increased
viscosity making mixing procedure more difficult.
It is suggested that only powder be refrigerated
before mixing. The rationale for this procedure is
that reaction occurs on surface and the cool
temperature retards the reaction without
thickening the liquid.
Working time: 2 to 5 min at 23C
Setting time: and 6 to 9 min at 37C

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MIXING
P/L Ratio:- 1.5 parts of powder, to 1 part of liquid by
weight.
A glass slab /paper pad supplied by manufacturers
Dispense liquid just before mixing.
The power is rapidly incorporated into the liquid in large
quantities.
Mixing Time:- Usually with in 30 sec. (Increased by frozen
slab method)

Note
For good bonding the cement must be placed before it loses its
glossy appearance which indicates free carboxylic acid groups
on the surface of the mixture that are vital for bonding to tooth
structure.

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SURFACE PREPARATION
The surface of the metal is abraded with a small stone
or sand blasted with high pressure air to improve
wettability and mechanical bond at cement metal
interface.
Apply 10% Polyacrylic acid solution for 10 to 15 seconds
followed by rinsing with water, for removal of smear
layer before placement.
After cleansing, the tooth is isolated to prevent further
contamination by oral fluids. Blotting the surface before
cementation is considered sufficient drying procedure.

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REMOVAL OF EXCESS
POLYCARBOXLATE CEMENT
During setting the cement is rubbery and makes the
removal of the excess quite difficult.

If the excess is removed at this stage, there may be


possibility of pulling cement beneath the margin & creating
a void.

The excess in not removed until the cement becomes hard.

Another approach is to start removing excess cement as


soon as seating is completed.

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Factors influencing setting time

P/L ratio

Powder composition

Type of powder

Concentration and MW of polycarboxylic acid

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POLYCARBOXYLATE AFTER 30 SEC
AND 1 MINUTE

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GENERAL PROPERTIES

Film Thickness
More viscous than zinc phosphate cement.

However, shows pseudoplasticity and undergoes shear


thinning when pressure is applied during seating of
orthodontic bands

Clinically, action of spatulation with a vibratory action and


seating of the band reduce the viscosity of the cement, and
produce a film thickness of 20 micron

Also water settable cement variety has lower viscosity


immediately after mixing than conventional cement.

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MECHANICAL PROPERTIES
1) STRENGTH
Compressive strength is inferior to zinc phosphate
cement in this respect. However, the tensile strength is
slightly higher.
It is not as stiff as zinc phosphate cement. Its modulus
of elasticity is less than half that of zinc phosphate.
It is not brittle as zinc phosphate cement. So difficult to
remove after set.

2) SOLUBILITY
The solubility of cement in water is low, but when it is
exposed to organic acids with a pH 4.5 or less, the
solubility markedly increases.
Also, reduction in P:L ratio results in significantly higher
solubility and disintegration rate in oral cavity

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3) RETENETION
Despite the adhesion to tooth structure, polycarboxylate
cements are not superior to zinc phosphate cement in
the retention of band or bracket.

If force is applied to remove the bond with zinc phosphate


& polycarboxylate cement, the fracture surface shows that
failure usually occurs at the cement-tooth interface with
zinc phosphate cement.

In case of polycarboxylate cement, the failure occurs


usually at cement-metal interface rather then at cement
tooth interface.

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BIOLOGIC CONSIDERATION

The pH is 1.7. The liquid rapidly neutralizes the powder.

The pH is higher than that of a zinc phosphate cement at


various time intervals.

The pH of polycarboxylate cement rises more rapidly than


that of zinc phosphate cement.

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ZINC SILICATE CEMENT

This cement is a hybrid resulting from the combination of


zinc phosphate and silicate powders. Also termed as silicate
zinc.

Type I: Cementing media.


Type II: Temporary posterior filling material.
Type III: Used as dual purpose

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COMPOSITION

POWDER LIQUID
Silica Phosphoric acid 50%
Zinc oxide Zinc salts 4-9%
Magnesium oxide Aluminum salts
Fluoride 13.25%

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Mixing Time: 1 min

Setting Time: 3-5 min

Presence of fluoride- anticariogenic effect.

Semi-transulcency

pH is less than that of zinc phosphate

Solubility is 1% higher than the value allowed by ADA


specification which is 0.2%
ADVANTAGES
1) better strength and toughness than zinc phosphate.
2) considerable fluoride release.
3) translucency

DISADVANTAGES
1) Rheological property is poor of the cement leading to
higher film thickness.

2)Need for pulpal protection

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ZINC SILICOPHOSPHATE CEMENT

Also called as Zinc silicate, Silicate zinc cement


Hybrid of zinc phosphate cement and silicate powders.

Types of Zinc silicophosphate cements


According to ADA No. 28 (1969) there are 3 types:-
Type I as a cementing medium
Type II temporary posterior filling material
Type III Dual purpose

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Properties
Mixture of silicate glass, a small percentage of zinc oxide powder
and phosphoric acid.
Strength is somewhat superior to that of zinc phosphate
cement,
Appears somewhat translucent and releases fluoride by virtue of
silicate glass.
Less soluble in the mouth than zinc phosphate cement
The fluoride content should give some anticariogenic action.
Therefore it is recommended for patients with high caries rate.
Flow property of the mix is not as good as zinc phosphate
cement, leading to higher film thickness
Does not bond to tooth structure; hence retention is by
mechanical interlocking
Esthetically it is superior to zinc phosphate cement

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Advantages
Better bond strength and toughness than zinc phosphate
cement
Shows considerable fluoride release hence anticariogenic so less
incidence of decalcification under the bands
Translucent( better esthetics than zinc phosphate)
Under clinical conditions lower solubility

Disadvantages
Higher film thickness
Greater pulpal irritation
In both the laboratory and clinical studies it was found that it
remained attached to the enamel in higher percentages after a
band had become loose. It also was found that the remaining
cement was often quite difficult to remove from the enamel.

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GLASS IONOMER
CEMENT :
Generic name of a group of materials that use silicate
glass powder and as aqueous solution of polyacrylic acid
This materials acquires its name from its formulation of a
glass powder and an ionomeric acid that contains carboxyl
groups.
Polyalkenoate cement or ASPA
Water based cement
ADA specification No. 96

45
History
1965 A.D Wilson mixed dental silicate glass powder &
aqueous solutions of various organic acids including poly
acrylic acid. Set cement was sluggish. Not reported or
published.

The invention of glass ionomer cement was done in


1969.First reported by Wilson and Kent in 1971.( ASPA I)

First practical material: ASPA II in 1972 by Crisp and


Wilson, added tartaric acid.

ASPA III- Methyl alcohol was added.

First marketable material, ASPA IV in 1973


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Luting agent ASPA IVa in 1975 by Crisp and Abel

Metal reinforced cements in 1977 by Sced and Wilson

Water activated cements, ASPA V in 1982 by Prosser et al.

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Classification of GIC
Classification 1
Based on 3 types of GICs adopted by Wilson and Mclean
(1988)
Type I for luting cement (Orthodontic purpose)
Type II restorative material.
a) Aesthetic
b) Reinforced GIC
Type III use as liner or base.

NOTE
Luting cement for orthodontic appliances, bands, brackets is
similar to the standard luting cements, but the setting time has
been extended to allow a generous working time
Classification 2
The general use-based classification of GICs is as follows:

Type I: For luting cements

Type II: For restorations

Type III: Liners and bases

Type IV: Pit and Fissure sealants

Type V: Orthodontic Cements

Type VI: Core build up

Type VII: Fluoride releasing

Type VIII: ART (atraumatic restorative technique)

Type IX: For Paediatric and geriatric purpose


Classification 3

Based on chemical composition:

1) Conventional GIC

2) Resin modified GIC

3) Metal reinforced GIC


Presentation forms
1. Powder-liquid - To be mixed using plastic spatula over
paper pad

2. Water-settable powder - Dry powder of PAA


copolymer is blended with cement powder in the same
bottle. - The material is mixed with regular water

3. Capsules - Both cement powder and liquid are


contained in the same capsule and separated from each
other by a diaphragm

4. Two-paste system - Recently introduced as a luting


material- Equal lengths to be mixed over a paper pad
Manufacturing
The glass ionomer powder is an acid-soluble calcium
fluoroaluminosilicate glass.

The components are fused to a uniform glass by heating


them to a temperature of 1100 to 1300C for 40 to
150 min.

The melt is poured in a tray and quenched.

The glass so formed is ground into a powder having


particles in the range of 20 to 50um.

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Powder
Component Type Use
Al2O3 & SiO2 glass Main Matrix formation
component

CaF2 also cryolite Flux Reduces the temp at


(Na3AIF6) which the glass will
flow
Increases translucency
of set cement
Fluoride Lowers fusion temp,
acts as flux
Improves working
characteristics &
strength
Al3PO4 Improves translucency.
Apparently adds body
to the cement paste

53
COMPOSITIION OF TWO GLASS IONOMER
CEMENT POWDERS

SPECIES A weight % B weight %


Sio2 41.9 35.2
Al2 O3 28.6 20.1
AlF3 1.6 2.4
CaF2 15.7 20.1
NaF 9.3 3.6
AlPO4 3.8 12.0

54
LIQUID
Content % Use
Polyacrylic acid 45 % Main reacting acid
Increases viscosity
Water 50% Medium for
reaction
Hydration of matrix
Copolymers like Increase reactivity
Itaconic acid, of liquid
Maleic acid, Decrease viscosity
Tricarboxylic acid Reduce gelation
tendency
Increase shelf life
Tartaric acid Improves handling
5-10 characteristics,
Powder strength
To increase working time: Increases working
Glass powder
Anhydrous/ Water settable GIC timepolyacid powder
Freeze dried
Eg. Ketac-Cem, ESPE
Shortens setting
Liquid
time 55
Water OR water + tartaric acid
CHEMISTRY OF SETTING
Acid base reaction
Acid: Poly (alkenoic acid) Base: Fluoroaluminosilicate
glass with high F content

alcium, aluminum, sodium, and fluorine ions are leached in to the aqueous mediu

e polyacrylic acid chains are cross-linked by the calcium ions and form a solid ma
(Next 24 hours)

new phase forms in which aluminum ions become bound with in the cement mi
This leads to more rigid set cement

Some of the sodium ions may combine with fluorine ions forming
sodium fluoride uniformly dispersed within the set cement.

56
3 Phases of setting of GIC
1. Ion Leaching Phase( Immediately after mixing)- Placement of
band should be done before the end of this phase
Appearance- shiny/ glossy
2. Hydrogel Phase( initial set, 5-10 min after mixing)-cement
should be protected from moisture and desiccation
Appearance- Rigid, opaque
3. Polysalt gel phase( final set)- can continue for several months
Appearance- reduced opacity

57
The cement consists of an agglomeration of unreacted
powder particles surrounded by a silica gel in an
amorphous matrix of hydrated calcium and aluminum
polysalts.

58
ROLE OF WATER IN THE SETTING
PROCESS
1)Reaction medium initially
2)Hydration of cross-linked matrix, thereby increasing the
strength
During the initial reaction period, this water can readily be
removed by desiccation and is called loosely-bound water.
As setting continues, the same water hydrates the matrix
and cannot be removed by desiccation and is called
tightly-bound water.

If freshly mixed cement is isolated from the ambient air

Loosely held water converted to tightly bound water over


time, resulting in increased strength and decreased
susceptibility to moisture

Therefore, should protected against water changes in the


structure during placement and for a few weeks after
placement if possible

59
PROPERTIES OF GLASS IONOMER
CEMENT PHYSICAL PROPERTIES
The initial solubility is associated with leaching of
intermediate products or those not involved in
matrix formation.

In vivo, solubility is compared with that of other


cements. GICs are much inferior to composites in
fracture toughness when subjected to in vitro
tooth brush abrasion tests and simulated occlusal
wear tests.

However, GICs are attractive in that they are


biocompatible, they bond to enamel and dentin
and they provide an anticariogenic benefit due to
fluoride release.

60
Physical Properties
1. Low solubility
2. Coefficient of thermal expansion similar to dentin
3. Fluoride release and fluoride recharge
4. High compressive strengths
5. Bonds to tooth structure
6. Low shear strength
7. Dimensional change (shrinks on setting, expands with water
sorption)
8. Brittle
9. Lacks translucency
10.Rough surface texture

61
MECHANISM OF ADHESION
Bonding of glass ionomer is achieved in part by
mechanical retention and in part by chemical
reaction.

Good mechanical bonding is much more


important.
The potential of glass ionomers for adhesion with
tooth surface is only an advantage in situation in
which it is difficult or impossible to produce
effective micromechanical retention on inorganic
content of enamel.
The mechanism primarily involves surface
diffusion of Ca and phosphate and reaction of
carboxyl groups of the polyacids with the calcium62
in the apatite of enamel.
BIOLOGIC PROPERTIES
The glass ionomer cement bonds adhesively to tooth
structure and they inhibit infiltration of oral fluids at the
cement tooth interface.
The pH initially at 2 minutes of polyacid liquid is 2 and
water settable is 1
After 10 minutes- approximately same at around 3.5
After 24 hours- around 6

63
SURFACE PREPARATION
Clean surface is essential to promote adhesion.
A pumice wash to remove the smear layer.
Then apply 10% polyacrylic acid solution for 10 to 15 seconds,
followed by a 30 seconds water rinse. This procedure si called
conditioning
Then the surface is dried but not be desiccated and prevention by
saliva and blood is taken care of.

Mixing
The recommended P:L ratio is in range of 1.25 to 1.5g of powder per
1mL of liquid.
A cool, dry glass slab may be used to slow down the reaction and
extend working time. The glass slab is not used if it is cooled below
dew point as the moisture condensation on glass slab can alter the
acid water balance needed for proper reaction.
The powder and liquid is just dispensed before mixing.
64
Mixing Time:
The mixing time should not exceed 45 to 60 seconds.
At this time, the mix should have a glossy surface. The
shiny surface indicates the presence of polyacid that has
not participated in the setting reaction.
This residual acid ensures adhesive bonding to tooth
enamel.

Setting Time:
Type I 4-5 min
Type II 7 min

65
BAND CEMENTATION:
Depends on the most important of which is fit. The better
fit of the band, the less chance for failure most bands
Bands can be mechanically roughened or microetched on
the inside to increase adhesion between the cement and
the band material.
Once the cement is mixed the bands internal side is
covered with cement. The band is seated, and excess
adhesive is removed, the edges of band are protected by
varnish provided by manufacturers.
Three parameters that must be controlled to ensure
success
Conditioning of tooth surface.
Proper manipulation.
Protection of cement during setting.

66
Why GIC???
Major advantage- relatively easy to use and to remove

A resin will penetrate deep into enamel, difficult to remove

GIC will fail cohesively on removal and the reminder can


simply be polished off

Anticariogenic effect

67
Advantages
High compressive strength
Adhesive to enamel
Resistance to microleakage
Low exothermic reaction
Compatibility with the oral tissues.
Ability to leach fluoride ,fluoride recharge( Reservoir effect)
Dimensional stability

Disadvantages
Brittleness
Susceptibility to dehydration
Moisture sensitivity during placement
Low tensile strength
Esthetic problems due to insufficient translucency

68
RESIN-MODIFIED GLASS IONOMER CEMENT
Also known as glass-ionomer hybrid cements/hybrid
ionomer cements
Developed to overcome Moisture sensitivity and low early
strength of conventional GICs
Set through combination of acid-base reaction and
photo/chemical polymerization.
Addition of hydrophilic monomer e.g., HEMA to the liquid of
GIC
Can be grouped further as:
Self Cure RMGIC
Light cure RMGIC
Tricure RMGIC
Inclusion of resin monomer to form a protective matrix in
which the regular cement setting takes place

69
COMPOSITION
Powder:
Alumino-silicate glass particles
Polymerization initiator
Chemical initiator (Benzoyl peroxide) in case of chemically-
activated polymerization
Photo-initiator (Camphroquinon) in case of light- activated
polymerization
Both in case of tri-cured material

Liquid:
Aqueous solution of Poly-alkenoic acid
Poly-acrylic acid having some carboxylic groups modified with
HEMA monomer or hydrophilic monomer

70
Setting
The initial and rapid setting of the material is provided
through polymerization of resin monomer

Slow acid-base reaction also takes place within the cured


resin matrix. This reaction is responsible for maturing
process and the final strength.

The water content is too little to complicate the


polymerizaton, however its presence is essential for the
acid-base reaction.
Bonding mechanism is similar to that of conventional GIC,
shear bond strength tests are higher for resin-modified
materials.

71
Advantages over conventional GIC
The diametral tensile strength higher than those of
conventional GICs
Higher strength and fracture toughness than that of
conventional GIC
Lower solubility of the freshly-set material
Possibility for immediate finishing and polishing
No need for resin or varnish coating due to initial rapid set
and strength

Disadvantages
These materials release levels of fluoride comparable to
those of conventional GICs but slightly less.
Loss of translucency of GIC

72
RESIN MODIFIED GIC

73
COMPOMERS( Polyacid modified resins)
First Compomer- introduced in 1993- DYRACT (Dentsply)

Hydrophobic resins which contain polyacid side chains that


are attached to one or more methacrylate monomers

Rely primarily on light initiated polymerisation mechanism for


setting ( unlike RMGIC where acid-base reaction is primary)

Fluorides can be added

Fillers-reactive aluminosilicate glass (used in GIC)

Primary reaction due to light initiated polymerisation

Secondary reaction- Absorption of water by residual


monomer- free H- ions liberated- react with glass filler-
initiation of acid base reaction.
74
75
One paste system- Restorative purpose
Two paste system- Luting purpose

Powder ( paste A) Liquid (paste B)

Strontium aluminium Polymerizable


fluorosilicate methacrylate/carboxylic acid
monomers
Metallic oxides Multifunctional acrylate
monomers

Chemical/ light activated Water


initiators

76
Advantages
No mixing required
Ease of technique
Excellent handling
Less susceptible to dehydration
Higher bond strengths than RMGIC
Stronger than GIC
The newer compomers even bond chemically to band
material than zinc phosphate or GIC.
Non-tooth colored band cements in blue and pink color are
available for clean up process after the bands are removed.

Disadvantages
Bonding agent required
More leakage than RMGIC
Expansion due to water sorption
Limited fluoride uptake and release
77
Conclusion

An ideal cementing agent capable of withstanding oral


condition over the long terms has proven difficult to develop.
There is as yet no ideal dental cement.
Each material must be used on its merits with knowledge of
its limitations.
Although there has been much research and development on
cements in recent years and the factor affecting cements
and cementation are better understood by in-vitro studies,
factual evaluation of in-vivo performance of cements is still
difficult.
There are few clinical studies of the comparative behaviour
of cements despite their importance to successful practice.

78
Bibliography
Orthodontic Materials Scientific and Clinical Aspects.
William A. Brantley Theodore Eliades. Thieme
Phillips Science of Dental Materials. K J Anusavice. 12th
Edi. SAUNDERS An Imprint of Elsevier.
Dental Materials and Their Selection. William J
Obrien.2nd Edi. Quintessence Publishing Co, Inc.
Tooth Coloured Restoratives- Principles and
Techniques. Harry F. Albers. 9th Edi. BC Decker Inc
Restorative Dental Materials. R.G. Craig, J.M. Powers. 11th
Edi.Mosby
Three Cements Used for Orthodontic Banding of
Porcelain Molars. Tracy Heriona; Jack L. Ferracaneb; David
A. Covell Jrc. Angle Orthod,2007.77;(1) ,94-99.
An evaluation of silicophosphate as an orthodontic
cement.Clark RJ, Phillips RW, Norman RD. Am J Orthod.
1977 Feb;71(2):190-6.

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THANK YOU

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