Non

adhesive
cements
Athira U R
  Definition
 Requirements of luting cements
 Classification
 Silicate cements
 Zinc phosphate cement
Contents  Zinc silicophosphate cement
 Zinc oxide eugenol
 Conclusion
 References
 Cement
 Substance that hardens to act as base
, liner , filling material , or adhesive
to bind devices or prosthesis to tooth
structure or to each other.
Definitions (Anusavice 11th Edition)
• Cementation : Attaching a
restoration to natural teeth by means
of a cement . (GPT-9)
• Luting Agent : Any material used to
attach or cement indirect restorations
to prepared teeth. (GPT-9)
 1. It should be or must be bio compatible to
the underlying tooth, it should not irritate
the underlying tooth in any manner.

REQUIREMEN
TS 2. It should not irritate the soft tissue around
OF LUTING the prepared tooth, it must be bio
CEMENT compatible to the soft tissue.

3. It should have sufficient working time.

4. Should have adequate flow.

5. Should have adequate compressive

strength.

6. Should have no or minimal micro leakage

around the margins of the given fixed dental
prosthesis.
 7. Should posses the characteristic property
of low solubility in to the oral fluids.

REQUIREMEN
TS 8. Should be adhesive in nature.
OF LUTING
CEMENT 9. Should posses the basic characteristic of
esthetics.
10. Should be easily available in the market.

11. Should be cost friendly.

12. Should posses the characteristic property

of ease of removal of the excess material.
  BASED ON INGREDIENTS
 Water-based cements- Zinc
phosphate, glass ionomer, zin
silicophosphate
 Oil-based cements - ZOE and non
Classificatio eugenol cements
n  Resin or polymer-based cements
Resin cements, compomer, self
adhesive cement

Craig’s Restorative Dentistry 12 th edition

Heboyan, A.; Vardanyan, A.; Karobari, M.I.; Marya, A.; Avagyan, T.; Tebyaniyan, H.; Mustafa,
M.; Rokaya, D.; Avetisyan, A. Dental Luting Cements: An Updated Comprehensive
Review. Molecules 2023, 28, 1619. [Link]
  Based on application (ISO 9917-
1:2007)*
 a. Luting
Classificatio  b. Bases or lining
n  c. Restoration
 According to Shillingburg, the
cement, tooth surface and
prostheses interface bonding
mechanism can be divided into
Classification 3 types :-
.
Non Adhesive ( mechanical )

Micromechanical

Molecular
Classification

Dental Materials and Their

Selection 3rd Ed - William J.
O'Brien
Mahalaxmi: Materials used in Dentistry
Classification

Skinners Science of Dental

materials 8th edition
AMERICAN NATIONAL STANDARD
INSTITUTE /AMERICAN DEN TAL
ASSOCIATION SPECIFICATION NO. 96 FOR
DENTAL WATER-BASED CEMENTS

ANSI/ADA Specification No. 8 for

Dental Zinc Phosphate Cement

ANSI/ADA Specification No. 9 for

Dental Silicate Cement

ANSI/ADA Specification No. 21 for

Dental Silico-Phosphate Cement
Heboyan A, Vardanyan A, Karobari MI, Marya A, Avagyan T, Tebyaniyan H, Mustafa M, Rokaya D, Avetisyan
A. Dental Luting Cements: An Updated Comprehensive Review. Molecules. 2023 Feb 8;28(4):1619. doi:
10.3390/molecules28041619. PMID: 36838607; PMCID: PMC9961919.
  The luting agent served primarily to fill
the gap and prevent entrance of fluids.

• It holds the restoration in place by

NON engaging small irregularities on the
ADHESIVE surfaces of both tooth and restoration
(MECHANI
CAL) • • Exhibits no adhesion on the molecular
level

• For eg Zinc Phosphate

The crown can be removed only along the path (large arrow) determined by
the axial walls of the preparation. Cement extending into small irregularities
of the adjoining surfaces {shown magnified in the two large circles) prevents
removal along any path more vertical than the sides of the irregularities
(small arrows).
  The deep irregularities necessary for
micromechanical bonding can be produced
 on enamel surfaces by etching with a
Micromecha phosphoric acid solution or gel.
 on ceramics by etching with hydrofluoric
nical acid
bonding  on metals by electrolytic etching, chemical
etching, sandblasting, or by incorporating
salt crystals into the preliminary resin
pattern.
Composite resin cements hold the restoration to
the tooth by penetrating into deep and small
surface pits
 Resin cements have tensile strengths in the
range of 30 to 40 MPa, which is
approximately five times that of zinc
phosphate cement.
 When used on pitted surfaces, they can
provide effective micromechanical bonding
.
 Molecular adhesion involves physical
forces (bipolar, Van der Waals and
chemical bonds (ionic, covalent)
between the molecules of two different
substances.
Molecular
adhesion • Newer cements, such as
polycarboxylates and glass ionomers,
possess some adhesive capabilities,
although this is limited by their
relatively low cohesive strength.
True adhesion is the molecular attraction exerted
between the surface of bodies in contact.

They still depend primarily on nearly

parallel walls in the preparation to
retain restorations.
Pameijer CH. A review of luting agents. Int J Dent. 2012;2012:752861. doi: 10.1155/2012/752861. Epub 2012 Feb 22. PMID:
22505909; PMCID: PMC3296365.
  Introduced in 1903 by Fletcher as anterior
filling materials.
 Silicates are attacked by oral fluids and in
time degrade,
Silicates
 They may not be considered permanent
restoration.
 The uses of silicate cements diminished with
the advent of composite resins and
development of GIC.
  Powder mixed with liquid
 The H+ ions attack the glass powder
displacing Al, Ca, F, and Na+ ions.
Setting  Form a hydrated silicious gel around the
powder particles.
reaction  The ions liberated from the surface of the
glass particles combine with H2PO3 ions
and subsequently precipitate as phosphates
and fluorides.
  Good esthetic qualities .
 Anticariogenic property.
Advantages  Analogues to topical applied fluoride
solution
  It lacks stability in oral fluids with loss of
Disadvanta esthetic qualities
ges  Rubber dam is essential for successful
silicate.
 Irritant to pulp.
Zinc phosphate
cement
  Oldest cements

Zinc  by Dr Otto Hoffman in 1877

phosphate
cement It was the “gold standard” for fixing
indirect restorations for many years,
and it is still used for the same
purpose.
 1. Luting of restorations (inlays, crowns, fixed
dental prostheses, etc.)
2. High strength bases.
3. Temporary restorations.
Applications
4. Luting of orthodontic bands and brackets.
5. Nonvital teeth or teeth with advanced pulpal
recession and average retention
6. Cavity with remaining dentin greater than
about 0.5 mm (O’brien)
 ISO 9917-1:2007
designates them as
a. Luting (Maximum film thickness—
25 μm)
b. Bases and lining

Classificatio • ADA specification No.8.

n
Designates them as.
• Type I – Fine grained for luting
Film thickness should be 25 or less.

• Type II - Medium grain for luting

and filling
Film thickness should not be more
than 40 μm
 AVAILABLE AS
•. Powder and liquid system.
•. Capsules of preproportioned powder and liquid.

Compositio
n

McCabe and Walls Applied Dental Materials

9th edition
Compositio
n
 When the powder is mixed with liquid,
phosphoric acid attacks the surface of the
particles and releases zinc ions.
The aluminum complexes with the
phosphoric acid and the zinc ions to form a
Setting zinc aluminophosphate gel.
reaction The reaction is
exothermic.
The set cement is
porous
Manipulatio
n
 1/ 1/
1/4 1/4 1/4 1/8 1 1
6 6
  Mixing time 1.5-2 min (Philips)
 WORKING TIME 5 min (Philips)
 SETTING TIME 5-9 min (CRAIG) 5-14 min
Properties (O’BREIN)
 FILM THICKNESS :TYPE 1 <25µm
 TYPE 2 <40µm
 Solubility 0.2 %
 • To prolong working time and shorten
setting time
• Glass slab is cooled at 6 to -10 degree C
• 50-75% more powder incorporation
Frozen glass • Working time increased by 4-11 min
technique • Setting time shortened by 20-40%
• Due to increased P:L ratio , decreased
solubility in oral fluids.
Properties
 1) Strength
Compressive Strength – 104 MPa:
Tensile Strength – 5.5 MPa
:Modulus Of Elasticity – 13.7 GPa
Properties
2) Solubility: relatively low
Greater in organic acids like lactic acid etc

3) Thermal properties: good insulator

 4) Retention: mechanical interlocking
Any coating like varnish decreases retention

Properties 5) Biological properties

pH→ 2 (2 min) → 5.5 (24 hrs) → 7 (48 hrs)
Therefore pulp protection if thin layer of
dentine remains
 • It has adequate compressive
strength and same modulus of
elasticity of dentin to resist
fracture and deformation/under
stress.

Advantages • Easy manipulation procedure, and

less critical technique.

• Sets sharply to relatively hard

mass from a fluid consistency.

• Lower solubility than silicate

cement
 • Pulpal irritation due to its high initial acidity.
Hence should not be placed directly on
exposed dentin.

• Lack of anticariogenic property.

Disadvanta • It is a brittle cement, poor tensile strength.

ges
• Lack of chemical adhesion to the tooth.

• Soluble in oral fluids.

• Not aesthetic
Review of
literature
 Apart from compromised mechanical
performance resulting from inappropriate
proportioning, incorporation of too much
powder into the luting cement may result in
a thick mix of cement which could make
complete seating an indirect restoration
difficult. This could result in open margins
and/or a high restoration. Routine
encapsulation of zinc phosphate cement
components, in the form of single-use
disposable capsules, is suggested as a
method of addressing variability in
proportioning powder-liquid cements
especially amongst inexperienced operators.
Review of
literature
 All cements showed microleakage. Minimum
microleakage was seen with zinc phosphate
cement than zinc oxide noneugenol cement
and zinc polycarboxylate cement.
 • FLUORIDE CEMENT

Modified  Add stannous fluoride

zinc
phosphate  Higher solubility , lower strength
cements
 Fluoride uptake by enamel : reduced enamel
solubility and anticariogenic
  Copper (2-97%) was added to Zinc
Phosphate cement , historically Pure Copper
Phosphate cement
 Teeth discoloration and toxic
Copper
 High acidity , High solubility and Low
containing strength
zinc  Indicated : deciduous teeth where it was not
phosphate possible to remove all caries ‘
cements  In cementation of cast silver cap splints-in
facial fractures
 Silver cements contained small percentage
of silver phosphate.
.Hydrophospha
te  This cement is supplied as single component
water settable powder system. The liquid used is distilled
zinc phosphate water.
cement  The acidity is the same as that of the
conventional zinc phosphate cement.
 Compressive strength, film thickness,
solubility, and disintegration are inferior to
that of conventional zinc phosphate cement .
 Mainly used as luting cement and thermal
insulting bases
Silicophosph
Combination of zinc phosphate & silicate
ate cement cement. Contains small amounts of mercury
compounds.
 Type I : Cementation of fixed restorations
Types Type II : Provisional restorative material
Type III : Dual purpose material
 • Hardness – similar to dentine 70 KHN
• Compressive strength – 180 MPa
• Tensile strength – weak – 3.5 MPa
• Solubility – 0.7 (High)
Properties • Aesthetics
• Adhesion
 Has severe pulp irritation as it has pH less
than 3 at insertion,
 pH as noted is below 7 after 1 month .
 Is anticariogenic.
  It requires a Dry field, mixing by agate or
plastic spatula.
Manipulation  P/L ratio is- 1.6 gm/ 4 ml.
 after placement Varnish is applied for
protection
 Working time 4 min
 Setting time 5 – 7 min
  Better & toughness than zinc phosphate.

 Fluoride release & degree of translucency.

Advantages  Lower solubility & better bonding.

• Markedly has less secondary caries

• Incidence of proximal caries

adjacent to silicate cement is also
less because of fluoride release
  Less satisfactory mixing & rheological
Disadvantag properties ;Leading to higher film thickness
es & greater potential for pulp irritation.

 Has high solubility rate which causes loss of

anatomic contour
Zinc oxide eugenol
cement
 According to ADA specification No. 30, they are
classified into 4 types according to their uses
• Type I: Temporary cementation ...... comp strength
<35 MPa

Types • Type II: Permanent cementation ...... comp

strength
>35 MPa
• Type III: Temporary restoration ...... comp strength
>25 MPa
• Type IV: Cavity lining ..................... comp strength
>5 MPa
ADA SPECIFICATION no 30
  Multiretainer splints on vital teeth with
above average retention, minimal dentin
thickness; hypersensitive patients
 Cement of choice for implant super
Applications structure cementation
 Provisional cementation
 Cavity with minimal dentin or exposure
Composition
Setting
1. ZnO + H2O → Zn (OH)2
reaction 2. Zn (OH)2 + 2HE → Zn eugenolate +
2H2O
 Powder / liquid ratio 4:1- 6:1 by weight.
• Measured quantity of powder and liquid is
dispensed onto a cool glass slab.
• Powder is incorporated in liquid

Manipulatio • Spatulated in circular motion.. •

n It exhibits pseudo-thickening.
• For temporary restorations a thick putty-
like consistency is recommended.
• TWO PASTE SYSTEM : Equal length of
each paste are dispersed and mixed until the
uniform colour is observed.
Mixing and
setting times  Mixing time is about 1–1.5 minutes
 Setting time is 4–10 minutes
Setting time is decreased by
• Sintering of powder at 300°C for a longer
time
• Smaller particle size
• Accelerators like calcium chloride, primary
alcohols,
glacial acetic acid
• Moisture
• Higher powder–liquid ratio
• Higher temperature, i.e. warm glass slab
and spatula
Setting time is increased by
• Larger particle size
• Retarders like glycol or glycerine
• Lower powder–liquid ratio
• Lower temperature without moisture
contact, i.e. by
cooling the glass slab and spatula, but not
below the
dew point. If cooled further, atmospheric-
moisture
condenses on the mix, which acts as
accelerator
 Zinc oxide eugenol cements are
contraindicated for
using in contact with:
Contraindicatio
n • Composite resins (eugenol can dissolve the
resin and
make it soft)

• GIC restorations (leaching eugenol can

diffuse and
cause discolouration).
 • Obtundent—suitable for use to relieve
postoperative
sensitivity, pulp protection from thermal,
chemical
Advantages and electrical insults.
• Good marginal sealing properties due to
low
dimensional changes during setting.
• Resist marginal leakage.
• Sufficient strength for cementation—only
for
modified ZnOE cement
  The low compressive strength of
conventional cement is inadequate for
permanent cementation
• Eugenol is a solvent for resins. Hence,
Disadvantag contraindicated to use as a base for
es composite resins.
• Eugenol leaches and may diffuse causing
discolouration if used as a base for glass
ionomer
cements.
• Does not chemically bond with dentin,
enamel or
metallic restorations and not anticariogenic
Recent 1. Noneugenol cements
modifications
Since direct contact of eugenol can cause
irritation to soft tissues, eugenol is
completely replaced with material like
vanillate esters (hexyl vanillate) and
orthoethoxybenzoic acid.
 Cementation of crowns, bridges and splints.
 Retention of temporary crowns, sealing
dressing in teeth during root canal therapy
procedures.
 Trial cementation of permanent
restorations prior to final insertion.
 Testing of interproximal contact prior to
final placement.
 Insoluble in mouth fluids and retains a tight
marginal seal to prevent seepage of these
fluids under the restorations.
 The cement will withstand functional
stresses and permit ease of removal.
 2. Resin-modified zinc oxide-
eugenol cements:

Polymer Natural or synthetic resins (methyl

methacrylate resin) are added into
reinforced the powder to increase the strength
ZnOE of the cement
 introduced in an effort to increase THE
STRENGTH AND REDUCE SOLUBILITY
Polymer Contains Zinc Oxide and finely divided
reinforced natural or synthetic resin like polystyrene
ZnOE good strength, improved abrasion
resistance and increased toughness
Luting agent, Base, temporary filling
material and as a cavity liner.
Film thickness - 25-75 um

Compressive strength - 3-55 MPa

Tensile Strength - 4 MPa

Modulus of elasticity - 2000-3000MPa

Mechanical retention of crowns of ZOE cement is less than Zinc phosphate cements.
An 83.5% success rate was noted for polymer reinforced cement after 7 years.

ST 6- 10 min
 Ethoxybenzoic acid (EBA)
alumina cement

Fused alumina is added to the
powder and orthoethoxy benzoic acid
into the liquid to enhance the
strength of the cement
 • COMPOSITION
• Powder
• ZnO – 70 %
• Aluminium oxide/other mineral fillers – 20-
30%
• Barium sulphate - radiopacity
EBA & • Liquid
ALUMINA MODIFIED • O- ethoxy benzoic acid 50- 60%
• Eugenol – Remaining part 37%
 • Easy manipulation

• Long working time

• Good flow and strength characteristics

Advantages • Compressive strength 55-70 MPa

• Minimal irritation to pulp

• Best suited to luting of restorations

with good fit retention where there is
no under stress and for cavity bases
 • More critical proportioning

• Hydrolytic break down in oral fluids

Disadvanta
ges • Liability to plastic deformation

• Less retention than zinc phosphate cements

  Easy mix rapid setting zinc oxide - eugenol
cement for thermal insulation and temporary
restoration.
Indications:

• Ideal temporary sealant and filling material

ZITEMP for cavities after removal of carious dentine
Quick Set before permanent restoration
ZnOE • Perfect cavity liner

• Temporary fixation of crowns and bridges

• Ideal cavity liner under most restorative

materials
 The prevalence of cement retained FDP loosening was
significantly lower than that of screw-retained FDPs.
Cementing FDPs on implants using a temporary
cement does not necessarily lead to a higher number
of loosened reconstructions. Permanent cementation
with ZEC appears to be justified.
  Philips Science of Dental Materials 12 th edition
• Applied Dental Materials 9 th edition
John F McCabe and Angus W G Walls
• Dental Materials and Their Selection 3rd edition
William J O’Brien
 Craigs Restorative Dental Materials 13 th edition
References  Contemporary fixed Prosthodontics Fifth edition
Stephen F. Rosenstiel,
 Fundamentals of fixed Prosthodontics 4th edition

Shillingburg
 Science of Dental Materials with Clinical
Applications 3rd edition
Shama bhatt
 Heboyan A, Vardanyan A, Karobari MI, Marya A,
Avagyan T, Tebyaniyan H, Mustafa M, Rokaya D,
Avetisyan A. Dental Luting Cements: An Updated
Comprehensive Review. Molecules. 2023 Feb
8;28(4):1619. doi: 10.3390/molecules28041619.
PMID: 36838607; PMCID: PMC9961919.
 Kumari S, Jadhav MS, Gupta V, Isaac TK,
Subramanium A, Kumar V. Microleakage at Implant
References Abutment and Prosthesis Interface in Cemented
Implant-Supported Prosthesis. J Pharm Bioallied Sci.
2021 Nov;13(Suppl 2):S1679-S1681. doi:
10.4103/jpbs.jpbs_405_21. Epub 2021 Nov 10. PMID:
35018054; PMCID: PMC8687004.
Korsch M, Walther W. Retrospective analysis of loosening
of cement-retained vs screw-retained fixed implant-
supported reconstructions. Quintessence Int. 2015 Jul-
Aug;46(7):583-9. doi: 10.3290/[Link].a34077. PMID:
25918762.
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