Chapter 45

Dental Cements
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Introduction
Dental cements are a classification of dental
materials that are continually used in
dentistry. The American Dental Association
and the International Standards
Organization (ISO) have teamed up to
classify dental cements according to their
properties and their intended uses in
dentistry.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Classification of Cements
Type I: Luting agents that include

permanent and temporary cements.

Type II: Restorative applications.
Type III: Liner or base applications.

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Luting Agent
A material that acts as an adhesive to
hold together the casting to the tooth
structure. Luting agents are designed to
be either permanent or temporary.

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Permanent Cement
For the longterm cementation of cast
restorations such as inlays, crowns,
bridges, laminate veneers, and
orthodontic fixed appliances.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Temporary Cement
Temporary cements are used when the
restoration will have to be removed.
Most commonly, temporary cement is
selected for the placement of
provisional coverage.

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Variables Affecting Cements

Mixing time

Make sure to follow the manufactures

directions for the mixing time, working
time, and delivery time.
Humidity
If the clinical area is warm or humid,
premature exposure of the cement to
these environments can create a loss of
water from the liquid or an addition of
moisture to the powder.

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Variables Affecting Cementscontd

Powder to liquid ratio

Incorporating too much or too little

powder will alter the consistency.
Temperature
Some types of cements put off an
exothermic reaction.

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Mixing Dental Cements

Before mixing, read and carefully follow the

manufacturer's directions for the brand

being mixed.
Determine the use and then measure the
powder and liquid according to the
manufacturer's instructions.
Place the powder toward one end of the
glass slab or paper pad and the liquid
toward the opposite end (the space between
allows room for mixing).

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Mixing Dental Cementscontd

Divide the powder into increments.
When increment sizes vary, the smaller

increments are used first.

Incorporate each powder increment into
the liquid and then mix thoroughly.

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Types of Cements

Zinc-oxide eugenol
Zinc phosphate
Polycarboxylate
Glass ionomer
Composite resin

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Zinc Oxide Eugenol

Chemical Makeup
Liquid: Eugenol, H2O, acetic acid,
zinc acetate, and calcium chloride.
Powder: Zinc oxide, magnesium
oxide, and silica.

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Types of Zinc-Oxide Eugenol

Type I

Lacks strength and longterm

durability and is used for temporary
cementation of provisional coverage.
Type II
Has reinforcing agents added and is
used for the permanent cementation
of cast restorations or appliances.

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Supply of Zinc-Oxide Eugenol

Liquid/Powder
Mixed on an oilresistant paper pad.
Mixing time ranges from 30 to 60 seconds.
Setting time in the mouth ranges from 3 to
5 minutes.
Paste
Supplied as a twopaste system as
temporary cement.
Pastes are dispensed in equal lengths on a
paper pad and mixed.

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Zinc Phosphate
Chemical Makeup
Liquid: Phosphoric acid, aluminum
phosphate, and water.
Powder: Zinc oxide, magnesium
oxide, and silica.

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Types of Zinc Phosphate

Type I (fine grain)
Used for the permanent cementation of
cast restorations such as crowns, inlays,
onlays, and bridges. This material
creates the very thin film layer that is
necessary for accurate seating of
castings.
Type II (medium grain)
Recommended for use as an insulating
base for deep cavity preparations.

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Supply of Zinc Phosphate

Powder/liquid
Powder is divided into increments that
vary in size.
It is critical that the powder be added
to the liquid in very small increments.
Cement must be spatulated slowly
over a wide area of a cool, dry, thick
glass slab to dissipate the heat.

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Polycarboxylate Cements
Chemical Makeup
Liquid: Polyacrylic acid, itaconic acid,
maleic acid, tartaric acid, and water
Powder: Zinc oxide

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Use of Polycarboxylate
Used as a permanent cement for cast

restorations, stainless steel crowns, and

orthodontic bands.
Used as a nonirritating base under both
composite or amalgam restorations.
Used as an intermediate restoration.

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Supply of Polycarboxylate
Powder/liquid
Liquid may be measured by using
either the plastic squeeze bottle or
the calibrated syringetype liquid
dispenser.
Liquid has a limited shelf life because
it thickens as its water evaporates.
Mixed on a nonabsorbent paper pad.

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Glass Ionomer
Chemical Makeup
Liquid: Itaconic acid, tartaric acid,
maleic acid, and water.
Powder: Zinc oxide, aluminum oxide,
and calcium.

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Types of Glass Ionomer

Type I
For the cementation of metal restorations
and directbonded orthodontic brackets.
Type II
Designed for restoring areas of erosion
near the gingiva.
Type III
Used as liners and dentin bonding
agents.

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Benefits of Glass Ionomer

Powder is an acidsoluble calcium. The

slow release of fluoride from this powder

aids in inhibiting recurrent decay.
Causes less trauma or shock to the pulp
than many other types of cements.
Low solubility in the mouth.
Adheres to a slightly moist tooth surface.
Has a very thin film thickness, which is
excellent for seating ease.

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Supply of Glass Ionomer

Powder/liquid

Mixed manually on a paper pad or a

cool, dry glass slab.
Glass slab increases the working time
of the cement.
Premeasured capsules
Triturated and expressed through a
dispenser.

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Composite Resin
Chemical Makeup
Physical properties are comparable to
those of composite resins.
Low film thickness.
Insoluble in the mouth.

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Uses of Composite Resin

Cementation of ceramic or resin inlays

and onlays.
Cementation of ceramic veneers.
Cementation of orthodontic bands.
Direct bonding of orthodontic brackets.
Cementation of all metal castings.

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Supply of Composite Resin

Powder and liquid mix

Syringe-type applicator
Base and catalyst
Light cure/dual cure system
Recommended portions of either
application are dispensed onto a
paper pad and mixed rapidly with a
spatula.

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Cement Removal
Operator preparedness and
knowledge
Instruments selected for the procedure:
Explorer, mouth mirror, black spoon.
Use of a fulcrum.
Use of dental floss in and around the
embrasure areas.

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