Dental luting cements / oral surgery courses

INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY
Leader in continuing Dental EducationLeader in continuing Dental Education
 The fear of detachment has beenThe fear of detachment has been
bothering mankind since ages and so withbothering mankind since ages and so with
the dentists but here the fear of debondingthe dentists but here the fear of debonding
or detachment of FPD’s, crowns andor detachment of FPD’s, crowns and
restorations.restorations.
 So it is very essential that the bonding orSo it is very essential that the bonding or
the luting agent used is reliable andthe luting agent used is reliable and
retentive for long period of time.retentive for long period of time.
www.indiandentalacademy.com

www.indiandentalacademy.comwww.indiandentalacademy.com

Restoration failuresRestoration failures
CausesCauses
ImproperImproper
biomechanical toothbiomechanical tooth
preperationpreperation
Improper cementationImproper cementation
techniquetechnique
Improper luting agentImproper luting agent

INTRODUCTIONINTRODUCTION
THE PRACTICE OF FIXEDTHE PRACTICE OF FIXED
PROSTHODONTICS HAS CHANGEDPROSTHODONTICS HAS CHANGED
DRAMATICALLY WITH THE INTRODUCTIONDRAMATICALLY WITH THE INTRODUCTION
OF INNOVATIVE TECHNIQUES ANDOF INNOVATIVE TECHNIQUES AND
MATERIALS. TODAYS DENTIST HAS A WIDEMATERIALS. TODAYS DENTIST HAS A WIDE
RANGE OF OPTIONS OF WATER BASEDRANGE OF OPTIONS OF WATER BASED
LUTING AGENTS TO LATEST RESIN ADHESIVELUTING AGENTS TO LATEST RESIN ADHESIVE
SYSTEMS AND RESIN MODIFIED GLASS IONOMERS.SYSTEMS AND RESIN MODIFIED GLASS IONOMERS.

HISTORY
 Luting is derived from a
greek word LUTUM –
meaning mud. Primarily
cements were used to fill the
gap between restoration and
tooth structure. There was
no bonding.

Ideal biologic propertiesIdeal biologic properties
Biocompatibility : should be leastBiocompatibility : should be least
interactive with body tissues, non toxic ,interactive with body tissues, non toxic ,
non pulp irritant .non pulp irritant .
Caries and plaque inhibition : desirablyCaries and plaque inhibition : desirably
they should possess antimicrobialthey should possess antimicrobial
properties, should prevent caries andproperties, should prevent caries and
plaque .plaque .

Ideal mechanical properties
 Compressive strength : according to
ADA specification water based luting
cements should have minimum strength
of 70 Mpa at 24 hrs.
 Other properties like diametral tensile
strength flexural strength, fracture
toughness, hardness testing should be
as high as possible
 Modulus of elasticity should be as much
as dentine ie 13.7 Gpa.

 Solubility : should be as low as possible
according to ANSI /ADA specification it
should be maximum of .2 % of weight in
water.
 Adhesion to tooth structure and
restorative materials is desired.

Ideal working propertiesIdeal working properties
Film thickness : according to ANSI /ADAFilm thickness : according to ANSI /ADA
specification it is should be maximum ofspecification it is should be maximum of
25 micron . More film thickness may lead25 micron . More film thickness may lead
to clinical problems in attaining completeto clinical problems in attaining complete
restoration seating ,tilting of castings,restoration seating ,tilting of castings,
decrease in retention.decrease in retention.
Working time : should be long to allowWorking time : should be long to allow
easy manipulation.easy manipulation.
Setting time : should be shortSetting time : should be short

Esthetic propertiesEsthetic properties
Color stability : more color stable materialsColor stability : more color stable materials
are desired , to maintain esthetics.are desired , to maintain esthetics.
TranslucentTranslucent
Radiopacity : ideal cement should beRadiopacity : ideal cement should be
radioopaque to enable practitioner toradioopaque to enable practitioner to
distinguish between cement line anddistinguish between cement line and
recurrent caries as well as cementrecurrent caries as well as cement
overhangs .overhangs .

TYPES OF LUTING CEMENTSTYPES OF LUTING CEMENTS
ZINC PHOSPHATE CEMENTZINC PHOSPHATE CEMENT
ZINC POLYCARBOXYLATEZINC POLYCARBOXYLATE
ZINC OXIDE EUGENOLZINC OXIDE EUGENOL
GLASS IONOMER CEMENTGLASS IONOMER CEMENT
RESIN IONOMER CEMENTRESIN IONOMER CEMENT
COMPOSITE RESIN CEMENTCOMPOSITE RESIN CEMENT
ADHESIVE RESINADHESIVE RESIN

ZINC PHOSPHATE CEMENTZINC PHOSPHATE CEMENT
THIS FIRSTTHIS FIRST
INTRODUCED IN 1878INTRODUCED IN 1878
AND IS STILL WIDELYAND IS STILL WIDELY
USED.DOESNTUSED.DOESNT
PROVIDE ADHESION ATPROVIDE ADHESION AT
MOLECULAR LEVELMOLECULAR LEVEL
BUT IT HOLDS THEBUT IT HOLDS THE
RESTORATION INRESTORATION IN
PLACE BY ENGAGINGPLACE BY ENGAGING
THE SMALLTHE SMALL
IRREGULARITIES ONIRREGULARITIES ON
TOOTH ANDTOOTH AND
RESTORATIONRESTORATION
SURFACE.SURFACE.
COMPOSITIONCOMPOSITION
POWDER-POWDER-
Zinc oxideZinc oxide
(Mg oxide, Al phosphate)(Mg oxide, Al phosphate)
LIQUID-LIQUID-
Orthophosphoric acidOrthophosphoric acid

Biological propertiesBiological properties
Biocompatibility – due to phosphoric acidBiocompatibility – due to phosphoric acid
the ph of cement is low ,may cause pulpthe ph of cement is low ,may cause pulp
damage.damage.
Solubility - Zn po4 shows relatively lowSolubility - Zn po4 shows relatively low
solubility in water but in oral cavity it issolubility in water but in oral cavity it is
more and that in dilute organic acids it ismore and that in dilute organic acids it is
appreciably greater.appreciably greater.

PropertiesProperties
MicroleakageMicroleakage is very high due to highis very high due to high
solubility of the cement in oral cavity.solubility of the cement in oral cavity.
Compressive strength-Compressive strength- this cement whenthis cement when
properly manipulated exhibit strength ofproperly manipulated exhibit strength of
104 mpa . This is quite good for a cement104 mpa . This is quite good for a cement
to withstand masticatory load.to withstand masticatory load.
Diametral Tensile bond strength - 5.5Diametral Tensile bond strength - 5.5
mpa provides moderate retention.mpa provides moderate retention.

COMMENTSCOMMENTS
ADVANTAGESADVANTAGES
History of useHistory of use
EconomicEconomic
Easy manipulationEasy manipulation
Easy crown removalEasy crown removal
DIS ADVANTAGEDIS ADVANTAGE
Pulp irritationPulp irritation
High solubilityHigh solubility
Micro leakageMicro leakage
Caries susceptibilityCaries susceptibility

Commercially availableCommercially available
Zinc phosphateZinc phosphate
FLECK’S : by MizzyFLECK’S : by Mizzy
HY-BOND – ZP : by ShofuHY-BOND – ZP : by Shofu
TENACIN : by DentsplyTENACIN : by Dentsply
DE TREY ZINC : byDe treyDE TREY ZINC : byDe trey
LEE SMITH ZINC :by TeledyneLEE SMITH ZINC :by Teledyne

ZINC POLYCARBOXYLATEZINC POLYCARBOXYLATE
CEMENTCEMENT
This cement was theThis cement was the
first cement system tofirst cement system to
be developed as toothbe developed as tooth
structure bondingstructure bonding
adhesive luting agent.adhesive luting agent.
It is the mostIt is the most
biocompatible,withbiocompatible,with
least irritation to pulp.least irritation to pulp.
POWDER-
Zinc oxide,Tin oxide,Zinc oxide,Tin oxide,
Al oxide,Mg oxide,Al oxide,Mg oxide,
Stanous flourideStanous flouride
LIQUID-
Polyacrylic acidPolyacrylic acid

PROPERTIESPROPERTIES
BIOCOMPATIBILITYBIOCOMPATIBILITY- ph of liquid is approximately 1.7- ph of liquid is approximately 1.7
but it gets quickly neutralized by powder. Polyacrylic acidbut it gets quickly neutralized by powder. Polyacrylic acid
has larger molecular size which are the reason for nonhas larger molecular size which are the reason for non
irritation of pulp.irritation of pulp.
SOLUBILITYSOLUBILITY- Highly soluble in oral fluids with ph < 4.5- Highly soluble in oral fluids with ph < 4.5
so leads to disintegration of material.so leads to disintegration of material.
MICROLEAKAGE-MICROLEAKAGE- very high due to high solubilityvery high due to high solubility
WORKING TIMEWORKING TIME – (1.75-2.5 min) shorter than Zn po4– (1.75-2.5 min) shorter than Zn po4
,lowering the reaction temperature can increase working,lowering the reaction temperature can increase working
timetime
SETTING TIME-SETTING TIME- (6-9 min)(6-9 min)

Development of viscosity afterDevelopment of viscosity after
mixing of cementmixing of cement
0
1
2
3
4
5
6
7
1
min
2nd
min
3rd
min
4th
min
5 th
min
6 th
min
polycarb
Zn PO4
G I C

COMMENTSCOMMENTS
ADVANTAGESADVANTAGES
More biocompatibleMore biocompatible
Chemical adhesion toChemical adhesion to
tooth structuretooth structure
Fluoride releaseFluoride release
EconomicalEconomical
DISADVANTAGESDISADVANTAGES
High solubilityHigh solubility
High microleakageHigh microleakage
Low strengthLow strength
Less working timeLess working time

Commercially availableCommercially available
Polycarboxylate cementPolycarboxylate cement
DURELON : by ESPEDURELON : by ESPE
HY-BOND PC : by ShofuHY-BOND PC : by Shofu
TYLOC PLUS :by DentsplyTYLOC PLUS :by Dentsply
POLY CARB water set :by pulpdentPOLY CARB water set :by pulpdent
LIV CARBO : by G CLIV CARBO : by G C
CARBOXYLON : by 3MCARBOXYLON : by 3M

ZINC OXIDE EUGENOLZINC OXIDE EUGENOL
This cement is beenThis cement is been
in extensive use sincein extensive use since
1890 in dentistry.They1890 in dentistry.They
have sedative effecthave sedative effect
on exposed dentin,soon exposed dentin,so
they were used asthey were used as
temporary restorativetemporary restorative
materials.materials.
Now there is eugenolNow there is eugenol
free reinforcedfree reinforced
cement.cement.
POWDERPOWDER
Zinc oxide,whiteZinc oxide,white
rosin,zincrosin,zinc
stearate,zinc acetate.stearate,zinc acetate.
LIQUIDLIQUID
Eugenol,olive oilEugenol,olive oil

Biocompatibility – dentine sedative action,Biocompatibility – dentine sedative action,
it has ph of 7 biocompatible with pulp.it has ph of 7 biocompatible with pulp.
Microleakage – seals the margins wellMicroleakage – seals the margins well
against the ingress of oral fluids at leastagainst the ingress of oral fluids at least
for a brief period hence irritation causedfor a brief period hence irritation caused
by micrleakage is minimised.by micrleakage is minimised.
Solubility - highly soluble in oral fluids.Solubility - highly soluble in oral fluids.
Working time – (2 – 6) minWorking time – (2 – 6) min
Setting time - (4 – 10) minSetting time - (4 – 10) min

Advantage DisavdantageAdvantage Disavdantage
BiocompatibleBiocompatible
Easy manipulationEasy manipulation
Easy excess andEasy excess and
crown removalcrown removal
without any damagewithout any damage
to tooth structure.to tooth structure.
Ideal for temporaryIdeal for temporary
restorationrestoration
Low strengthLow strength
Poor retentionPoor retention
High solubility andHigh solubility and
microleakagemicroleakage
Some patients areSome patients are
eugenol sensitiveeugenol sensitive

Commecially available ZnOECommecially available ZnOE
FYNAL :by DentsplyFYNAL :by Dentsply
TEMP BOND : by 3MTEMP BOND : by 3M
RELYX : ESPERELYX : ESPE
Zn Oxide Eugenol : by DentsplyZn Oxide Eugenol : by Dentsply

GLASS IONOMER CEMENTGLASS IONOMER CEMENT
It was first introducedIt was first introduced
in 1977,has manyin 1977,has many
properties of an idealproperties of an ideal
cement,and is one ofcement,and is one of
the most widely usedthe most widely used
luting cements.luting cements.
POWDERPOWDER
glassfillers,sodium,calciglassfillers,sodium,calci
um,aluminium,lanthanum,aluminium,lanthan
um,fluorosilicateum,fluorosilicate
LIQUIDLIQUID
Poly acrylic acid andPoly acrylic acid and
tartaric acidtartaric acid

BIOCOMPATIBILITY-they have low PH but polyacids weaker acids .PreBIOCOMPATIBILITY-they have low PH but polyacids weaker acids .Pre
existing pulpitis, excessive tooth cutting reduced dentin thickness , diffusionexisting pulpitis, excessive tooth cutting reduced dentin thickness , diffusion
of irritants to pulp will cause sensitivity. However P:L ratio influences the phof irritants to pulp will cause sensitivity. However P:L ratio influences the ph
It is known to produce bacteriostatic action due to fluoride release .It is known to produce bacteriostatic action due to fluoride release .
MICROLEAKAGE- less due to closing of marginal seal by bonding betweenMICROLEAKAGE- less due to closing of marginal seal by bonding between
restoration and tooth structure.restoration and tooth structure.
SOLUBILITY- During first 24 hrs is high, so it is important to protect fluidSOLUBILITY- During first 24 hrs is high, so it is important to protect fluid
contamination during this time. Later the solubility reduces significantly.contamination during this time. Later the solubility reduces significantly.
WORKING TIME- 2- 3.5 MIN can be extended by mixing on a cold slab .WORKING TIME- 2- 3.5 MIN can be extended by mixing on a cold slab .
SETTING TIME- 6 – 9 MIN ,if done by frozen slab technique settingSETTING TIME- 6 – 9 MIN ,if done by frozen slab technique setting
reaction can be slowed . But this has an adverse effect on the strength.reaction can be slowed . But this has an adverse effect on the strength.

MECHANICAL PROPERTIESMECHANICAL PROPERTIES
Compressive strength-Compressive strength- 122-162 Mpa122-162 Mpa
Tensile strength-Tensile strength- 12- 18 Mpa12- 18 Mpa
Film thickness-Film thickness- ( < 25 micron) proper P:L ratio has to be( < 25 micron) proper P:L ratio has to be
maintained , seating pressure should be adequate to getmaintained , seating pressure should be adequate to get
even film thickness.even film thickness.
RetentionRetention – very high retention ,bonds chemically to– very high retention ,bonds chemically to
tooth and restorationtooth and restoration
Removal of excess-Removal of excess- moderately easy.moderately easy.

Advantage DisadvantageAdvantage Disadvantage
Adequate highAdequate high
strengthstrength
Adhesion to toothAdhesion to tooth
structure, bondingstructure, bonding
and retention goodand retention good
Sustained FluorideSustained Fluoride
release,anticariogenicrelease,anticariogenic
Less solubility,andLess solubility,and
microleakagemicroleakage
post cementationpost cementation
sensitivity is common.sensitivity is common.

Commecially available GICCommecially available GIC
FUGI-I :by G CFUGI-I :by G C
KETAC –CEM : by ESPEKETAC –CEM : by ESPE
GLASS LUTE : byGLASS LUTE : by
pulpdentpulpdent
Viva glass cem : byViva glass cem : by
Ivoclar VivadentIvoclar Vivadent
Glass ionomer : by ShofuGlass ionomer : by Shofu

Resin ionomerResin ionomer
(fibre reinforced GIC)(fibre reinforced GIC)
Moisture sensitivity and low early strengthMoisture sensitivity and low early strength
of GIC s are the result of slow acid baseof GIC s are the result of slow acid base
setting reactions. Some polymerisablesetting reactions. Some polymerisable
functional groups have been added tofunctional groups have been added to
impart additional curing processes thatimpart additional curing processes that
can overcome these 2 drawbacks andcan overcome these 2 drawbacks and
allow the bulk of the material to matureallow the bulk of the material to mature
through the acid base reactions.through the acid base reactions.

Composition and chemistryComposition and chemistry
PowderPowder – ion leachable glass particles– ion leachable glass particles
and initiators for light or chemical cure.and initiators for light or chemical cure.
LiquidLiquid - water , polyacrylic acid ,with- water , polyacrylic acid ,with
some methacrylate and hydroxy ethylsome methacrylate and hydroxy ethyl
methacrylate monomersmethacrylate monomers
Variations of properties from ConventionalVariations of properties from Conventional
GIC can be atributed the presence ofGIC can be atributed the presence of
polymerisable resin and lesser amount ofpolymerisable resin and lesser amount of
water and carboxylic acid in the liquid.water and carboxylic acid in the liquid.

High strengthHigh strength
Good retentionGood retention
Low solubilityLow solubility
Flouride releaseFlouride release
Post cementationPost cementation
sensitivitysensitivity

Commercially available resinCommercially available resin
ionomersionomers
Fuji CEM – by GCFuji CEM – by GC
Advance – byAdvance – by
DentsplyDentsply
Vitremer – by 3MVitremer – by 3M
Fuji plus – by GCFuji plus – by GC

RESIN LUTING CEMENTRESIN LUTING CEMENT
Synthetic resins are available since 1952 forSynthetic resins are available since 1952 for
cementation ,in1970 composite resin wascementation ,in1970 composite resin was
introduced as crown and bridge material,sinceintroduced as crown and bridge material,since
1986 resin cements have gained popularity by1986 resin cements have gained popularity by
usage in resin bonded bridges and aestheticusage in resin bonded bridges and aesthetic
restoration.restoration.
The term composite resins are defined as aThe term composite resins are defined as a
compound of two or more distinctly differentcompound of two or more distinctly different
materials with properties that are superior tomaterials with properties that are superior to
individual constituents.individual constituents.

Available as powder /liquid or two paste formAvailable as powder /liquid or two paste form
Resin matrix / binder – Bis GMA / urethaneResin matrix / binder – Bis GMA / urethane
dimethacrylate, triethylene glycol dimethacrylatedimethacrylate, triethylene glycol dimethacrylate
Fillers – quartz ,colloidal silica /metal oxidesFillers – quartz ,colloidal silica /metal oxides
Coupling agents – organosilanesCoupling agents – organosilanes
Also contains – Hydroquinone:preventsAlso contains – Hydroquinone:prevents
premature polymerisation, u-v absorberpremature polymerisation, u-v absorber
improves colour stability, Opacifiers: Ti dioxide Alimproves colour stability, Opacifiers: Ti dioxide Al
oxide , colour pigments :to match the toothoxide , colour pigments :to match the tooth
colourcolour

Metal composite bondingMetal composite bonding
(Maryland and Rochett FPD)(Maryland and Rochett FPD)
Earlier there was noEarlier there was no
metal and compositemetal and composite
bonding due to nonbonding due to non
reactivity of metallicreactivity of metallic
surface , neithersurface , neither
micromechanical normicromechanical nor
chemical bonding waschemical bonding was
realistically attainable.realistically attainable.
Now due to advent ofNow due to advent of
specific metal bondingspecific metal bonding
materials combined withmaterials combined with
microetching technique.microetching technique.

Resin luting cementsResin luting cements
Ultra Bond – Dent MatUltra Bond – Dent Mat
Insure – CosmodentInsure – Cosmodent
Choice – BiscoChoice – Bisco
Dicor cement system – DentsplyDicor cement system – Dentsply
Optec – Jeneric / PentronOptec – Jeneric / Pentron

All ceramic crown bondingAll ceramic crown bonding
Composite lutingComposite luting
cements are thecements are the
choice . Here thechoice . Here the
color shades playcolor shades play
important role,thinimportant role,thin
viscosity and haveviscosity and have
dual curingdual curing
mechanism are themechanism are the
requirements.requirements.

Biocompatibility – pulp irritation due toBiocompatibility – pulp irritation due to
diffusion of uncured composites ordiffusion of uncured composites or
monomers into the dentinal tubules andmonomers into the dentinal tubules and
cause long term pulp inflamation.cause long term pulp inflamation.
Microleakage – microleakage due toMicroleakage – microleakage due to
polymerisation shrinkage occuring causingpolymerisation shrinkage occuring causing
marginal leakage ,so care should be takenmarginal leakage ,so care should be taken
to reduce shrinkage.to reduce shrinkage.
Solubility – very less soluble in oral fluidsSolubility – very less soluble in oral fluids

MECHANICAL PROPERTIESMECHANICAL PROPERTIES
Compressive strength – 194 – 200 mpa veryCompressive strength – 194 – 200 mpa very
high and is attributed to composite technique.high and is attributed to composite technique.
Tensile strength – 15 mpaTensile strength – 15 mpa
Film thickness - ( > 25 microns ) this is theFilm thickness - ( > 25 microns ) this is the
mater of concern ,since it is high many attemptsmater of concern ,since it is high many attempts
have been made to decrease but strength has tohave been made to decrease but strength has to
be sacrificed.be sacrificed.
Removal of excess – moderately easyRemoval of excess – moderately easy
Retention – good,micromechanical bondingRetention – good,micromechanical bonding

COMMENTSCOMMENTS
ADVANTAGES:ADVANTAGES:
Low solubilityLow solubility
Good retention andGood retention and
strengthstrength
Good aestheticsGood aesthetics
usefull in ceramicusefull in ceramic
veneers and inlayveneers and inlay
DISADVANTAGEDISADVANTAGE
More film thicknessMore film thickness
microleakage due tomicroleakage due to
polymerisationpolymerisation
shrinkageshrinkage
Pulp irritationPulp irritation
Cost moreCost more

Adhesive (Bonding) ResinAdhesive (Bonding) Resin
These are new generations of adhesiveThese are new generations of adhesive
bonding agents which are been usedbonding agents which are been used
extensively in dentistry now. Sinceextensively in dentistry now. Since
composite resins were very viscous theycomposite resins were very viscous they
were not flowing well into the dentinalwere not flowing well into the dentinal
tubules of etched surface , these adhesivetubules of etched surface , these adhesive
resins flowed well into the irregularitiesresins flowed well into the irregularities
and bonded well to restoration and toothand bonded well to restoration and tooth
surface.surface.

PropertiesProperties
Biocompatibility – pulp irritation is presentBiocompatibility – pulp irritation is present
Microleakage - very lowMicroleakage - very low
Solubility – very lowSolubility – very low
Working time - .5 – 5 minWorking time - .5 – 5 min
Setting time – 1 – 15 minSetting time – 1 – 15 min

Mechanical propertiesMechanical properties
Compressive strength – 179 – 255 mpaCompressive strength – 179 – 255 mpa
Tensile strength – 30 – 45 mpaTensile strength – 30 – 45 mpa
Film thickness – >25 micronsFilm thickness – >25 microns
Removal of excess – difficultRemoval of excess – difficult
Retention – very highRetention – very high

Adhesive to toothAdhesive to tooth
structure, very highstructure, very high
retentionretention
Low solubility in oralLow solubility in oral
fluidsfluids
AestheticAesthetic
High strengthHigh strength
Pulp irritation high,Pulp irritation high,
post insertionpost insertion
Cost highCost high
Technique sensitiveTechnique sensitive

Resin Metal bondingResin Metal bonding
materialsmaterials
C & B MetabondC & B Metabond
All bond 2,All bond 2,
Tenure ,Tenure ,
Geristore ,Geristore ,
InfinityInfinity
PanaviaPanavia

Commercially available adhesiveCommercially available adhesive
resinsresins
Flexi flow : by essntial dental systemFlexi flow : by essntial dental system
Cement it : by Jenric/PentronCement it : by Jenric/Pentron
Metabond : by ParkellMetabond : by Parkell

Mechanical Properties
0
50
100
150
200
250
300
Zinc phosphate Polycarboxylate Glass ionomer Resin ionomer Resin composite Adhesive resin
Cements
Values
Compressive strength (Mpa)
Tensile Strength (Mpa)
Elastic Modulus

0
5
10
15
20
25
Zn po4 G I C Z O E Resin
GIC
adesiv
resin
sensitivity
anticaries

0
20
40
60
80
100
120
140
160
Zn Po4 polyc G I C resinGIC adhesive
cost in $

Cast ,metal ceramic ,F P DCast ,metal ceramic ,F P D
Almost all cementsAlmost all cements
can be used.can be used.

Crown or F P D with poorCrown or F P D with poor
retentionretention
(Resin cements)(Resin cements)
Cases where inadequate retentionCases where inadequate retention
resistance form exists after preparationresistance form exists after preparation
(i.e., preparation is overtapered and(i.e., preparation is overtapered and
short).short).

Casting on patient with historyCasting on patient with history
of post cementation sensitivityof post cementation sensitivity
Zn polycarboxylate is the choiceZn polycarboxylate is the choice
Zn oxide Eugenol also can be usedZn oxide Eugenol also can be used

Pressed high leucite ,ceramicPressed high leucite ,ceramic
crowncrown
Adhesive resin orAdhesive resin or
composite resin arecomposite resin are
the choice of cementsthe choice of cements
since aesthetics andsince aesthetics and
retentions areretentions are
importantimportant

Resin retained FPDResin retained FPD
(Maryland, Rochett)(Maryland, Rochett)
Adhesive resin andAdhesive resin and
composite resins arecomposite resins are
the choice ofthe choice of
cements.cements.

Cast post and coreCast post and core
Almost all cementsAlmost all cements
can be used.can be used.

Ceramic inlay,onlay, ceramicCeramic inlay,onlay, ceramic
veneerveneer
Adhesive resins are usedAdhesive resins are used

RestorationRestoration DrDr
RosensteilRosensteil
Dr LandDr Land Dr CrispinDr Crispin
Cast metalCast metal
& ceramic& ceramic
FPD’s,FPD’s,
crownscrowns
Fleck’sFleck’s
Zn Po4Zn Po4
Fuji IFuji I
GlassGlass
ionomerionomer
Vitremer orVitremer or
Fuji PlusFuji Plus
ResinResin
ionomerionomer
FPD’s withFPD’s with
poorpoor
retentionretention
Panavia 21Panavia 21
AdhesiveAdhesive
resinresin
Panavia 21Panavia 21 C&BC&B
Metabond/Metabond/
Panavia 21Panavia 21
PostPost
insertioninsertion
casecase
Fleck’sFleck’s
Zn PO4Zn PO4
DurelonDurelon
PolyPoly
carboxylatecarboxylate
Vitremer orVitremer or
Fuji plusFuji plus

RosenstielRosenstiel Dr LandDr Land Dr CrispinDr Crispin
Pressed highPressed high
Leucite ceramicLeucite ceramic
crownscrowns
EnforceEnforce
(composite(composite
DualDual
cementcement
(Resin )(Resin )
Dual cureDual cure
compositecomposite
Ceramic veneerCeramic veneer NexusNexus
(light cure(light cure
resin)resin)
ChoiceChoice
dualdual
curecure
resinresin
Light cureLight cure
compositecomposite
Cast post &coreCast post &core Fleck’sFleck’s
Znpo4Znpo4
PanaviaPanavia
2121
PanaviaPanavia
2121

ConclusionConclusion
Dental luting cements form a link between aDental luting cements form a link between a
fixed restoration and the supporting toothfixed restoration and the supporting tooth
structure.structure.
Although no available luting cement satisfies allAlthough no available luting cement satisfies all
the ideal requirements , the out standing clinicalthe ideal requirements , the out standing clinical
performance of traditional materials should beperformance of traditional materials should be
appreciated before practitioner is willing toappreciated before practitioner is willing to
abandon them for latest formulations.abandon them for latest formulations.
Also utilise the advanced adhesive technology toAlso utilise the advanced adhesive technology to
the maximum for better prognosis.the maximum for better prognosis.

Dental luting cements / oral surgery courses

Dental luting cements / oral surgery courses

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