DENTAL MATERIALS - MIDTERMS

CEMENTS

Liners

● Material applied to the inside of the walls of a cavity, for protection and insulation
of the surface.
○ Liners for Depth C and Depth D, Depth A
○ For protection – protects the pulp
■ Cavity Varnish
■ Calcium Hydroxide
■ GIC

Bases

● A cavity lining agent used beneath permanent restoration to enhance recovery

of injured pulp or to protect it from thermal shock, galvanic shock, mechanical
trauma, microleakage, & toxic substances in some restorations
● Zinc Oxide Eugenol (rapid setting)
● Zinc Phosphate
● Polycarboxylate
● Zinc Silicophosphate
● Glass Ionomer Cement
○ Are usually placed prior to placement of final impression
○ Depth B, Depth C, and Depth D
○ Restore the prepared cavity into its original depth
● 1.5 to cap service margin (external surface that outlines the prepared cavity) – to
pulpal floor

Cements

● A substance that serves to produce solid union between two surfaces

○ ❏ ZOE
○ ❏ Zinc Phosphate
○ ❏ Zinc Polycarboxylate
○ ❏ GIC
○ ❏ Zinc Silicophosphate
● Materials of two surfaces
● Materials of multiple

Dental Cements
 ● A substance that serves to produce solid union between two surfaces
● Materials of multiple uses including restorations, luting, and therapeutic
○ They are generally materials of comparatively low strength, but have
extensive use in dentistry

CLASSIFICATION OF CEMENTS

● According to setting reaction

○ Acid base reactions
■ Formulated as powder (base) and liquid (acid)
■ On mixing the two an acid-base reaction takes place resulting a
viscous paste, which hardens to a solid mass
○ Polymerizing cements
■ Set by polymerizing reaction which may be light activated or
chemical activated
■ Ex: resin cement
○ Dual cure cements
■ Set by acid base and any one of the polymerization (light activated
or chemically activates ) mechanism
○ Tricure cements
■ Utilize all the forms of hardening of cement..
● Based on application
○ TYPE 1 Luting Agents
■ Type I fine grain for cementation
■ Type II medium grain for base, orthodontic purpose
○ TYPE 2 I Restorative Applications
○ TYPE 3 Liner or Base Application
● According to ISO standards
○ ISO 9917-1:2003
■ ➔water based cement- Part 1: powder/ liquid acid-base cements
○ ISO 9917-2: 1998
■ ➔ Water Based Cements Part 2: Light-activated cements
○ ISO 3107: 2004
■ ➔ Zinc Oxide/ Eugenol and Non Eugenol cements
○ ISO 4049: 2000
■ ➔ Polymer-based filling, restorative and luting materials
Uses of cements

FUNCTION CEMENT USED

Final cementation Zinc phosphate

zinc silicophosphate
EBA cement
Zinc polycarboxylate
glass ionomer
resin cement

Temporary cementation Zinc Oxide-Eugenol

Non-eugenol zinc oxide

bases Zinc Phosphate

Reinforced zinc oxide-eugenol
Zinc polycarboxylate
Glass Ionomer
Zinc Oxide-Eugenol
Calcium hydroxide

Long term restorations Glass Ionomer

Compomer
Metal Modified GIC

Temporary and intermediate Zinc oxide-eugenol

restorations Reinforced Zinc oxide- eugenol
Zinc polycarboxylate
Glass ionomer

Pulp therapy Calcium Hydroxide

Obtundant (pulp therapy) Zinc Oxide Eugenol

liners Calcium Hydroxide

Root canal sealers Zinc oxide- eugenol

Zinc polycarboxylate

Core build up Resin modified GIC

Metal modified GIC
Composites
● Final Cementation – adheres to the tooth surface
● Compomer = GIC + composite
● Pulp therapy – to heal the pulp (lining material beneath the pulp)
● ZOE – sedative effect on the pulp
● Core Build Up – in the absence of remaining tooth structure of the crown
● Final cementation
○ Material cannot be withdrawn from the surfaces of the tooth,
○ ex: fixed bridges, jacket crown, veneers
● Temporary cementation
○ For covering unfinished procedures
○ Ex: ZOE and non eugenol zinc oxide
● Bases
○ Cavity lined agent you place before the final lining? material
● Long term restorations
○ Filling materials
● Temporary and intermediate restorations
● Pulp therapy
● Obutandant (pulp therapy)
● Liners
● Root canal sealers
● Core build up
Requirements of good cement
● easy to manipulate
● biocompatible
● durable
● should have a low coefficient of thermal expansion
● should be dimensionally stable
● aesthetic suitability
● should have sufficient strength to adhere to the tooth (adhesive strength)

Properties of cement

(1) Silicate cements

● Don’t use anymore

● Anticariogenic because of fluoride
● Most soluble among the tooth colored restorative materials so that the fluoride
ion will be released and serve its purpose
● Very acidic: 2.8 pH at the time of insertion
● Use as final resto material for surfaces that don’t receive direct masticatory force
such as class 3, 5 and lingual occlusal pit
● Never use on the occlusal surface
● For ideal depth cavities: paint varnish into the prepared cavity before silicate
● For deep seated cavities: apply liner to prevent chemical irritation
● Never use silicate when the cavity touches the gum because it is very soluble to
the oral fluid

Liquid (like Zn PO4)/ silicate component

● H3PO4 - ortho phosphoric acid – can pass through dentinal tubules

● AlPO4
● ZnPO4
● MgPO4
● H2O

Manipulation of silicate

● Apparatus: plastic spatula and glass slab/ oil impervious pad

● Divide the powder into 6 equal parts
● Incorporate increment of powder at a time into the liquid
● Mix it in rotary motion to dissolve the powder and fold it to check if there’s any
unreacted powder. Apply pressure to dissolve it easily
 ● To check if the mixture is in correct consistency, taps and raises the spatula
slowly
● There should be no string like projection that goes with the spatula and the
surface of the mix should be moist
● The mixture should be shiny in appearance
● Consistency is heavy putty
● USE PLASTIC SPATULA

Considerations

● Work on a narrow working area to prevent air trapped bubbles (weaken the set)
and to get a correct consistency of the mix.
● Never use a stainless spatula. Once incorporated to the mix, it will remove sulfide
ions and it will lead to discoloration of the restoration.
● Silicate cements don't have adhesive property/ chemical bonding therefore
mechanical undercuts are needed.
● Lining angles – joining of two surfaces
● Outline form of molar – butterfly
● 5 walls for typical Class 1 preparation
● Mechanical undercuts – placed in a line angle
● It takes 24 to 48 hours before polishing the tooth using a bur
● Setting times is 3-8 minute

Factors that Control the Setting Time

● P:L ratio
● Temperature of the mixing apparatus
● Humidity of the room
● Rate of mixing the powder – particle size of the powder

Properties of Silicate Cements

● Solubility rate: 0.7%

● Compressive strength: 26,000 psi
● Tensile strength: 500 psi
● Hardness: 70 KHN

(2) ZINC PHOSPHATE CEMENT

● Crown and Bridge cement

● Oldest of the luting cements
● Other name is Zinc oxyphosphate
● Available as powder and liquid
● Supplied in shades of yellow, grey, golden brown pink and white

Application/ Uses are:

● Luting of restorations (inlays, crowns, fixed dental prostheses)

● High strength bases
● Temporary restorations
● Luting of orthodontic bands and brackets

Classification:

● Type 1: fine grained for luting

■ o Consistency is thick and creamy
● Type II: medium grained for base and temporary restoration
■ o Consistency is thick and doughy

Composition

● Powder
○ Zinc oxide - 90.2% as principal constituent
○ Magnesium oxide - 8.2% aids in sintering
○ Other oxides (like bismuth trioxide, calcium oxide) - 0.2% improves
smoothness of mix
○ Silica - 1.4% filler, aids in sintering
● Liquid
○ Phosphoric acid - 38.2% reacts with zinc oxide
○ Water - 36% controls rate of reaction
○ Aluminum phosphate - 16.2% buffers, to reduce rate of reaction
○ Aluminum - 2.5%
○ Zinc - 7.1%

Manipulation

● Spatula used: stainless steel

● Mixing Time: 1 min, 15 sec.
● Powder to Liquid ratio: 1.4gm/0.5 mL
○ Dispense the powder in a glass slab and place 2 drops of liquid
near the powder.
○ Divide the powder into 6 small parts. Bring the 1st part of the
powder into the liquid and mix it using brisk circular motion.
 ○ Each increment is mixed for 15 to 20 seconds and used large area
to dissipate exothermic heat.
○ To check for the correct consistency, a 1 inch string will form
between the spatula and the glass slab.

Advantages

● Long track record with reliability

● Good compressive strength

Disadvantages

● No chemical adhesion
● No anticariogenic property
● Pulp irritation
○ Poor esthetics

Factors that Alter The Setting Time

● PL Ratio
○ Increase liquid, weaker set, longer setting time;
○ Increase powder, faster setting time
● Speed of Manipulation
○ slower rate of adding powder to the mix, longer setting time
● Temperature of Mixing Apparatus:
■ Ways to cool the slab: wash it in a running water
■ Pre-cool in a ref
■ Pat the glass slab dry before mixing

(3) ZINC OXIDE EUGENOL

● These cement have been used extensively in dentistry since 1890

● They are cement of low strength
● Least irritating of all dental cements and are known to have an obtundant effect
on the exposed dentin
● A dental cements used chiefly in temporary fillings, thermal insulating bases,
and root canal fillings
● Some formulations are used as luting agents for the permanent cementations of
gold inlays and crowns,

Uses
 ● Temporary and permanent cementing medium
● Liners
● Luting agent
● Base
● Root canal sealer
● Dispensing form: powder (Zinc Oxide) and liquid (Eugenol)

Classification According to Usage *cannot use with composite

● Type I Conventional ZOE

○ Used as temporary cementing medium
○ Dispensing form: 2 paste form
● Type II EBA (ethyl benzoic acid) Alumina ZOE
○ EBA - 60%, Aluminum - 34%, ZOE- 60.5%
○ Used as permanent cementing medium
○ Dispensing for: powder and liquid
● Type III Polymer Modified ZOE
○ 20% polymer methacrylate added to ZnO
○ Used for temporary restoration and base to permanent
restoration
○ Dispensing form: powder and liquid
● Type IV ZOE liner
○ Inhibits polymerization of resin, never use this with composite resin
○ Dispensing form: paste form

Manipulation as Base Materials

● On a glass slab, place a scoop of powder on one corner, and then one
drop of liquid is dispensed near the powder. Be sure to hold the dropper
perpendicular to the slab. The liquid should not touch the powder
● The powder is divided into 2 big parts, one of which is divided again into 2
smaller parts. The biggest part is now brought to the liquid.
● Spatulate the powder and liquid in a rotary motion until all the powder is
incorporated with the liquid. Then a folding motion is used
● Continue to incorporate a small portion of the powder deliberately
“pressing” the powder into the mix with the spatula. Use firm pressure with
the flat surface of the spatula when incorporating powder.
● The mix should be completed in 1 - 1.5 minute at the end of which the mix
should be doughy or putty consistency, smooth and free of lumps
● Enough powder has been incorporated for a base consistency when the
mix “flakes” from the spatula pressing on the cement.
 ● Gather the cement into one mass on the slab (rope like structure without
adhering). To check correct consistency for a base, the cement may be
rolled to a rope like structure without adhering to either the slab or the
cement spatula.
● Woodson’s plastic instrument used to carry the cement to the cavity
preparation. Using the club end of the spatula, cut a portion of the mix and
place in the cavity. To press or condense the mix into the cavity use the
smooth end of the plugger.

Properties

Type i Type ii Type iii Type iv

Compressive 800 - 1200 psi 9320 psi 7308 psi 798 psi
strength

Tensile 200 1030 600 62.3

strength

pH - & neutral
(neutral) 7

(4) Glass Ionomer Cement

● Are adhesive tooth colored anticariogenic restorative material which were

originally used for restorations of eroded areas
● The first usable glass ionomer system was formulated in 1972 by Wilson and
Kent was known as ASPA (alumino silicate polyacrylic acid)
● The powder is a type of glass and the setting reaction and adhesive bonding to
tooth structure is due to ionic bond
● Often known as biomimetic material, because of its similar mechanical properties
to dentin

Uses

● Anterior esthetic restorative material for class 3 cavities

● Restorative material for eroded areas and class 5 restoration
● As a luting agent for restoration and orthodontic brackets
● As liners and bases
● For core build up
● To a limited extent as pit and fissure sealants
● Intermediate restorative material

Composition
 ● Powder
○ Fluoro - Silica Alumina - anticariogenic and makes cement
translucent
● Liquid
○ Aqueous solution of polyacrylic acid and copolymer-chemical
bonding
○ Tartaric acid - improves the handling characteristics by increasing
the working time and shortening the setting time
○ Itaconic acid - decreases the viscosity and reduces the setting
time
○ Water with citric/maleic acid - removes smear layer for better
adhesion

Classification According to Usage *don’t use glass slab and metal spatula

● GIC has silicate “GLASS” in it’s powder and so while mixing on glass slab
the polyacrylic acid attack the glass content of glass slab.
● This may even alter the properties of GIC
● Using metal spatula to GIC, it will discolor the material (mangingitim)
● Type I: cementing/luting agent
○ GIC as a luting agent
■ Powder particles should be smaller/ it should measures less
than 20 um for thin mix of the cement
■ Mixing pad and plastic spatula
■ Thinner mix better cementing action
■ Increments: 3
■ Mixing technique: add powder to liquid in one portion (mixing
pad)
■ Mixing time: 30 -45 seconds
■ Characteristics of a proper mix: mix while glossy
■ Setting time: 7 minutes
■ Put small amount in the crown (if full, hard time pressing the
crown will happen)
● Type II: restoration for class 3,5 and 1 (buccal and lingual pit)
○ GIC as a restorative material
■ Powder particle is 20 -50 um
■ Thicker consistency
■ The consistency for esthetic restoration is somewhat doughy
■ Mixing time: 45 seconds to 1 minute
■ Setting time: 4-5 minutes
■ Indications: class 3 and 5 cavities, microcavities under
direct masticatory forces and core build up

● Type III: liner, pit and fissure sealant

○ Base - under composite restoration and its called intermediary
base (when uses with composite filling material)
○ Increments: 3
○ Mixing technique: add powder to liquid in one portion (using mixing
pad)
○ Mixing time: 30-45 seconds
○ Characteristics of a proper mix: use while glossy
○ Setting time: 2-3 minutes
 ○ GIC as a liner
■ For class B cavities
■ Stronger bind to the pulp
■ With composite, acid etch the enamel to make the enamel
porous = resin tags are formed for the retention of composite
○ GIC as a sealant
■ Weaker, resin sealants are stronger than GIC
■ Use when there is a tiny opening

(most expensive)

● Type IV: pit and fissure sealant

● Type V: luting for orthodontic purpose (cementing the molar bands and
bracket)
● Type VI: core build up material (for good adhesion, for ex. Jacket crown)
● Type VII: high fluoride releasing command set GIC
● Type VIII: GIC for ART - using spoon shape excavator
● Type IX: Geriatric and pediatric GIC

(4) CALCIUM HYDROXIDE - CA(OH)2

● Relatively weak cement commonly employed as direct or indirect pulp capping

agents.
● Due to their alkaline nature they also serve as a protective barrier against irritants
from certain restorations
● A white powder with a slightly bitter alkaline taste, produced by the action of
calcium oxide with water
● Ball tip end applicator is used to place the cement on the prepared tooth
● pH: 11.5 - 13, most alkaline
● Does not prevent marginal leakage when used as a liner.
● Is an effective barrier to the passage of acid
● Partially prevents thermal shock. The thicker the layer, the more effective it is
against thermal shock.
● Compatible with all restorative materials
● Non-irritating to the pulp when separated from the pulp by dentin
● Possesses adequate strength to resist forces used in placing permanent
restorations.
● Bactericidal
● Can remineralized tissue
● Can form tertiary dentin (in class C)

USES

● Liner
● Root canal sealer
● Pulp capping agent

Dispensing form:

● Powder form (mix with distilled water) - to make paste

● Two paste form - catalyst and base
● Single paste form - (using light cure machine

Applications

● For direct and indirect pulp capping

● As low strength bases beneath restorations for pulp protection
● Apexification procedure in young permanent teeth where root formation is
incomplete

Available as:

● 2 paste system containing base and catalyst paste

● Single paste in syringe form light cured system
● Powder form (mixed with distilled water)

Manipulation

● Equal lengths of the two pastes are dispensed on a paper and mixed to a
uniform color
● The material is carried and applied using a Ca(OH)2 carrier or applicator
(a ball ended instrument)

Setting time

● Ranges from 2.5 to 5.5 secs (usually sa cavity na minimix)

CAVITY VARNISH

● Is a solution of one or more resins which when applied onto the cavity walls
(never on pulpal floor), evaporates leaving a thin resin film, that serves as a
barrier between the restorations and dentinal tubules
● Liquid material
● Natural gum such as copal, rosin, synthetic resin, dissolved in an organic solvent
like acetone, ether or chloroform
● Dispensing form: liquid (like colorless nail polish)

USES

● Prevents chemical irritation from acidic cement

● Prevents galvanic action
● Prevents discoloration under amalgam (in the absence of base) - Class A
● Prevents marginal leakage
● For better adaptation of amalgam

Application

● A small piece of cotton wool held in a pair of tweezers is moistened with

varnish which is then painted on the surface of the cavity
● The thin film of varnish is dried with a gentle jet of air and the process is
repeated
 Precaution

● Varnish solution should be tightly capped immediate after use to prevent

loss of solvent by evaporation
● It should be applied in a thin consistency
● Excess varnish should not be left on the margins of restorations (CSM
(cabu surface margin?-external outline) as it prevents proper finishing of
the margins of restorations

Contraindications

● Composite resin: the solvent in the varnish may react with the resin
● Glass ionomer: varnish eliminates the potential for adhesion, if applied
between GIC and the cavity
● When therapeutic action is expected from the overlying, e.g, oxide
eugenol and calcium hydroxide

Oct 4
 DENTAL WAX
Boxing wax
● Soft pliable wax with a smooth and shiny appearance
● Supplied in long narrow strips measuring 1 to 1 ½ inches wide and 12 to 18
inches long
● Used to form a wall or box around a preliminary impression when pouring it up.

Sticky wax
● Supplied in sticks or blocks
● Main ingredient are beeswax and rosin
● Very brittle wax, but when heated, it becomes very tacky
● Useful when creating a wax pattern or joining acrylic resin together

Utility wax
● Tacky at room temperature
● Once applied, it will adhere without heat
● Ideal for build-up of impression trays

Casting wax
● Makeup of paraffin, ceresin, beeswax, and resins
● Supplied in sheets of various thickness
 ● Used for single-tooth indirect restorations, fixed bridges, and casting metal
portions of a partial denture
● Used as pattern for indirect restoration or fixed bridges

Baseplate wax
● Made from paraffin or ceresin with beeswax and carnauba wax
● Hard and brittle at room temperature
● Supplied in sheets
● Three types:
○ Type I, which is a softer wax used for denture construction
○ Type II, a medium-hardness wax used in moderate climates
○ Type III, a harder wax for use in tropical climates

Bite registration wax

● Soft and very similar to casting waxes
● Softened under warm water
● Patient is instructed to bite down, and the wax will form an imprint of the teeth
Inlay casting wax
● Hard brittle wax made from paraffin wax, carnauba wax, resin, and beeswax
● Used to create a pattern of the indirect restoration on a model
● Poor thermal conductor and dark in color
● Classified according to how they flow:
○ Type I : medium wax - direct technique
○ Type II: soft wax - indirect technique

Composition of inlay wax

● Paraffin wax
○ Main ingredient
○ Usually in concentration of 40-60 wt%
● Gum dammar/ dammar resin
○ Improves smoothness and toughness render it more resistant to cracking
and flaking
● Carnauba wax
○ Quite hard and has a relatively high melting point, it decrease the flow and
contribute to the glossiness
● Candelilla wax
○ Replace the carnauba wax, same qualities but melting point is lower
● Coloring pigments

Methods in manipulating the inlay wax

● Dry heat
 ○ For small amount
○ Heat (torch)
● Moist heat
○ For big amount
○ Water bath
■ Soften the wax, knead it until homogenous inside and out
■ Form the wax into a cone and press it into the prepared cavity
■ Hold the wax until it solidifies
■ Carve the wax pattern to stimulate normal anatomy and contact
areas

How to prevent wax distortion

● Avoid thermal change
● Never allow relaxation (allowing the wax to cool down by itself)
● Soften it homogeneously
● Do not allow impurities
● No droplets of water incorporated in wax pattern
○ Spattering of wax upon flaming - ex frying with water
○ Smearing of the surface of the wax

Inlay
● Is an indirect restoration (filling) consisting of a solid substance fitted to a tooth
and cemented into place

*Direct inlay - wax pattern not the restoration (on patient mouth)
*Indirect inlay- done outside the mouth of the patient
*Inlay- there still the wall of the prepared cavity; restoration confided in the wall of
the tooth
*Onlay- missing cusp, no walls

Casting investments and procedures

● (1) Wax pattern construction
○ (A) Direct tooth technique - done inside the mouth into the tooth itself
 ■ Cavity preparation
■ Soften inlay wax until homogeneously soft (if not it will cause
distortion)
■ Insert wax to the cavity
■ Hold it firmly do wax pattern inside mouth
■ Follow outline of cavity
■ Advantage- less chances of distortion
■ Disadvantage - poor accessibility and visibility (like the tongue and
presence of saliva)

○ (b) Indirect technique

■ Done outside the mouth with a die stone
■ Take impression of mouth and construct with die stone
■ Apply separating medium (water)
■ Softens the inlay wax until homogeneously soft then insert to tooth
cavity until it hardens

● (2) Investing
○ To create a mold, use an investment compound because it can tolerate
high temperature
 ■ Withdraw the wax pattern from the prepared cavity with the use of a
sprue former (carbide burs)
■ Wrap this with moist cotton then heat the tip
■ Place it in the wax and allow it to pull down
■ Sprinkle cold water to facilitate faster cooling and hardening of the
wax
○ Investing technique
■ Single technique
● Creamy consistency
● Line the ring with asbestos sheet first before wetting it with
water
● Mix investing medium and pour it to the inlay ring
● Vibrate the set-up to release the entrapped air bubbles
● Spray water to facilitate fast cooling
■ Double technique
● Make a “cherry” or core to minimize the entrapment of air
bubbles
○ Coat first the wax pattern with investing medium - thin
mix to prolong the working and setting time
○ Need 2 camel hair brushes: 1 for the thin mix and the
other for the dry investing medium
○ Dip the 1st brush into the thin mix then paint the wax
pattern
○ Dip the 2nd brush into the dry investing medium then
sprinkle it to the wax pattern
○ Vibrate using a serrated hand instrument
○ Then do the investing like a single technique
■ *occluso proximal - where to stick the sprue

^ 6mm space from the wax pattern until the top end portion of the inlay ring
● (3) Wax elimination
 ○Remove the crucible former and sprue former
○Temperature: 700 degrees C to 1600 degrees C
○Continuous heating for 1 hour before 700 F should be reached
○Red hot color of inlay ring will assure that wax elimination is complete
○Sprue space or the ingate
■ Previously occupied by the sprue former
■ Passageway of the melted metal to the prepared mold space
● (4) Casting
○ Centrifugal casting machine is used
○ Before casting gold, melt it with casting torch
○ Once the metal melt, hold the arm of the centrifugal machine and do the
counterclockwise rotation (3-4 turns)
○ Then release it to go clockwise movement

● (5) Quenching
○ Bring the inlay ring into the running water to give an annealing (make
metal softer) effect to the metal
● (6) Pickling
○ Heating the metal in acid to remove the surface discoloration of the metal
○ Uses pickling solution: HCl acid
○ Wash in sodium bicarbonate and water to remove HCl acid then fit inside
the prepared cavity

● (7) polishing

Accessories for investing and casting

● Crucible former
 ○ Act as support for the sprue former as it cannot stand without a crucible
○ Made up of metal, resin, rubber, wax
● Sprue
○ Made up of metal, resin, and wax
○ No definite size
● Asbestos sheet
○ Act as shock absorber to prevent the sudden entrance or loss of heat
during wax elimination
○ Facilitate the easy removal of finished investing medium from inlay ring
○ Act as water reservoirs during wax elimination
● Inlay ring
○ Metallic tube open on both ends
● Investment method

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