Certain types of zinc oxide, when mixed with eugenol, set to a hard cement that is

compatible with the hard and soft tissues of the mouth. These cements have been
used extensively in dentistry since 1980s. for example: Lining cavities, cementing
restorations, as bases, root canal sealants, periodontal dressings, and temporary
and intermediate restorations. Depending on their use, they vary widely in their
properties. In general, they are cements of low strength. Also they are the least
irritating of all dental cements, and are known to have an obtundant effect on
exposed dentin. To improve the strength, many modified zinc oxide-eugenol
cements have been introduced; e.g. EBA alumins modified and polymer reinforced
zinc oxide-eugenol cements. Recently noncugenol zinc oxide cements have become
available. They are suitable for patients sensitive to eugenol. Experimental vanillate
and syringe cements without eugenol are presently under investigation.
Chemistry and setting
ZOE cement is formulated as a powder liquid or two paste system. The powder
contains zinc oxide particles and the liquid is eugenol. For the two paste system, the
base paste contains zinc oxide powder and the eugenol is contained in the
accelerator. The setting reaction starts with water in the eugenol solution that
hydrolyzes and eugenol chelate and solidify. The setting reaction is slow but
proceeds more rapidly in a warm, humid environment. A wide variety of ZOE
cements are available, with compressive strengths ranging from 3 to 55 MPa, which
makes ZOE formulations best suited for provisional applications. Finer powders
increase the strength of resulting cement. Residual free eugenol interferes with the
proper setting of resin based composites or resins cements; therefore various types
of carboxylic acids have been used to replace eugenol and produce a ZOE like
material. These products are called zinc oxide noneugenol cements.
Other modifications have been made to improve the strength and abrasion
resistance of ZOE cement for longterm luting. One system substitutes
orthoethoxybenzoic acid for part of the eugenol liquid, and includes alumina in the
powder. Another system consists of eugenol liquid and a special powder containing
of 20% to 40% by weight of fine polymer particles and zinc oxide particles that have
been surfaced treated with carboxylic acid. The compressive strength of these
improved ZOE cements is acceptable but their strength values are inferior to those
of zinc phosphate, glass ionomer and resin cements.
Classification
ADA specification No. 30 has listed 4 types of Zinc oxide-eugenol restorative
materials.
Type I ZOE

Type II ZOE -

For temporary cementation

Permanent cementation

TYPE III ZOE -

Temporary filling material and thermal insulation

Type IV ZOE -

Cavity Liners.

It is dispensed in two forms:

a) Powder and liquid
b) Two-paste system

Commercial names
1. Unmodified

Tempac
Cavitic
Tempbond Type
2. EBA Alumina modified
Optow
Alumnina
EBA
Type
3. Polymer modified Fynal
Type
IRM
Type
4. Noneugenol
Neogenol
Type
Freegenol
Type

Type III
Type IV
I
II
II
III
I
I

Composition
Powder
Zinc oxide
White rosin

69.0%
29.3%

Zinc stearate
Zinc acetate

1.0%
0.7%

Magnesium oxide

Liquid
Eugenol
Olive oil
Setting

85.0
15.0

Principal ingredient
To reduce brittleness of
set cement
Accelerator, plasticizer
Accelerator improves
strength
Its added in some powders
It acts with eugenol in
similar manner as zinc
oxide
Reacts with zinc oxide
Plasticizer

As the basic components of the cement are zinc oxide and eugenol, the setting
reaction and microstructure are the same as that of the impression pastes. In the
first reaction hydrolysis of zinc oxide to its hydroxide takes place. Water is essential
for the reaction to proceed
1. ZnO
+
H 2O
Zn (OH)2 Hydrolysis
2. The reaction proceeds as a typical acid base reaction to form a chelate.
Zn(OH)2
+
2HE
ZnE2 + 2H2O
Base
Acid
Salt

The chelate forms an amorphous gel that tends to crystallize imparting strength to
the set mass.

Structure of set cement

The set cement consists of particles of zinc oxide embedded in a matrix of particles
of zinc eugenolate.
Setting time: 4-10 min.
Factors affecting setting time: The complete reaction between zinc oxide and
eugenol takes place in about 12 hrs. this is too slow for clinical convenience.
1. Manufacture: The most active zinc powders are those formed by
decomposing zinc salts like hydroxide and zinc carbonate by heating at
3000C.
2. Particle size: Cements from powders containing smaller zinc oxide particles
set faster.
3. Accelerator : Alcohol, glacial acetic acid, and small amounts of water
accelerate the reaction.
4. Heat : Higher temperature accelerate setting
Lower Temperature, e.g. cooling the glass slab, slows the reaction.
5. Retarders : The set can be retarded with glycol and glycerine.
6. Powder to liquid rate: The higher the ratio, the faster the set.
Properties

1. Mechanical properties
a. Compressive strength: They are relatively weak cements. The strength
depends on the intended use of the materials. For example, cements
intended for temporary purposes like temporary restorations and
cementation (type I) and cavity lining (type IV), will have a lower strength.
Cements intended for permanent cementation (type II) and intermediate
restorations will be stronger. The compressive strength ranges from a low
of 3 to 4 MPa up to 50-55 MPa. Particle size affects the strength. In
general, the smaller the particle size, the stronger the cement. The
strength can also be increased by reinforcing with alumina EBA or
polymers.
b. Tensile strength: It varies according to its intended use Ranges from 0.32
to 5.8 MPa.
c. Modulus of elasticity: This is an important property for those cements
intended for use as bases Ranges from 0.22 to 5.4 Gpa.
2. Thermal Properties
a. Thermal Conductivity : Their thermal insulating properties are excellent
and are approximately the same as for human dentin. The thermal
conductivity of zinc oxide eugenol is in the range of insulators like cork
and asbestos
b. Co-efficient of thermal expansion 35 x 10-6/0C.
3. Solubility and Disintegration: This property is important for cements used for
permanent cementation: 0.04% wt. the solubility of the set cement is high,
the highest among the dental cements. They disintegrate in oral fluids. This
breakdown is due to hydrolysis of the zinc eugenolate matrix to form zinc
hydroxides and eugenol. Solubility is reduced by increasing the powder/liquid
ratio.
4. Film thickness: This property is important for those cements used of
restorations. The film thickness of zinc oxide eugenol cements is higher than
other cements
5. Adhesion: These cements do not adhere to enamel or dentin. This is one of
the reasons why they are not often used for final cementation of dental
restoration.
6. Biological properties
a. pH and effect on pulp: They are the least irritating of all dental cements. In
terms of pulpal response they are classified as mild. pH is 6.6 to 8.0
clinical manipulation
the versatile uses of ZOE are reflected in ANSI/ADA specification No. 30 or ISO 3107;
Dentistry Zinc Oxide/eugenol cements and zinc oxide/non-eugenol cements, which
lists four types of ZOE cements by clinical application: (I) temporary cementation;
(II) temporary fillings and thermal cementation of fixed prostheses; (III) temporary
fillings and thermal insulating bases and (IV) intermediate fillings. ZOE cement is
also used as a root canal sealer and periodontal dressings. Its antimicrobial attribute
is a benefit compared with glass ionomer cements or resin based composites.

Temporary ZOE cements, including eugenol free cement, are excellent for luting
provisional acrylic crowns and fixed partial dentures. Temporary ZOE restorations
are expected to last a few weeks at most. They seal the dentinal tubules
surprisingly well against the ingress of oral fluids and have sedative effect on the
pulp. Hence irritation caused by microleakage is minimized and these cements are
suitable for temporary restorative treatment while the pulp heals or until al longer
lasting restoration can be fabricated and cemented. The ZOE cements can cause
pulp necrosis and should not be used directly on pulp. ZOE cements should never
be used for temporary cementation of final fixed prostheses since the cement can
be difficult to remove and removal can risk the integrity of the prepared teeth.
When ZOE cement is mixed to a stiff puttylike consistency, it serves effectively as
an intermediate restorative material for at least a year. Mixing on a cool glass slab
slows the setting to enable the formation of a thick consistency but the slab should
not be colder than the dew point; otherwise water will condense onto the cement
and accelerate the reaction.
ZOE luting cements used for long term applications are somewhat difficult to
manipulate because of their high film thickness. ZOE cement is one of the several
cements of choice for implant superstructure cementation. One of the
disadvantages of restoring dental implants with a cement-retained prostheses is the
lack of easy retrievability of the cemented superstructure. Retentive cement can
damage the supporting implant if the prosthesis is removed with aggressive
removal techniques; on the other hand less retentive cement causes frequent
loosening of the prostheses. As a result, practitioners who desire retrievability have
generally gravitated toward using cements with lower retentive properties. ZOE
cement is one of the several cements choice for implant superstructure
cementation. Mechanical factors such as resistance/retention form, height,
distribution, number of abutments, accuracy of superstructure fit, as well as
maxillary versus mandibular arch-strongly influence the degree of cement
retentiveness required for a given restoration. Knowledge of the relative
retentiveness of cements improves the clinicians success in choosing a cement.