Department of Prosthodontics Including Crown & Bridge, Maxillofacial

Prosthodontics & Oral Implantology

RESIN CEMENTS
 contents
◦ Introduction
◦ Dental Cements
- Classification
◦ Resin Cements
- Classification
- What’s Different
- Composition
- Benefits
- Properties
◦ Clinical application
◦ Adhesion
- Role of etching
◦ Cementation
◦ Chemically activated resin cement
◦ Light activated
◦ Dual cure
◦ Conclusion
◦ References
 INTRODUCTION
CEMENTS

◦ 1. a binding agent used to firmly unite two approximating

objects;

◦ 2. a material that, on hardening, will fill a space or bind

adjacent objects

- GPT 9
CLASSIFICATION
American National Standards
Institute/American Dental
Association Specification No.
30 For Dental Cements

◦ —Type I. For temporary

cementing purposes.

◦ —Type II. For permanent

cementing purposes.

◦ —Type III. For filling materials

and bases.

◦ —Type IV. For cavity liners.

New American Dental Association Specification No. 30 for

Dental Zinc Oxide-Eugenol Type Restorative Materials
Council on Dental Materials and Devices
JADA, Vol. 95, November 1977
 PHILLIP’S CLASSIFICATION
Cements Primary uses Secondary uses
Cements Principal
Luting agent uses Secondary uses
 Intermediate
Zinc phosphate
restoration
 Base
Zinc oxide eugenol  Temporary &  Sealer for root
intermediate canals
restorations  Periodontal
 Temporary luting dressings
 Liners, bases
Poly carboxylate  Luting  Intermediate
 Base restorations
 For orthodontic
appliances
Silicate  Anterior -
restorations
Glass ionomer  Restoration  Bases
cement  Luting  Pit & fissure
 Liner sealants

Resin cements  Luting  Temporary

restorations

Calcium hydroxide  Pulp capping base

cement
 01 02 03
WATER BASED RESIN BASED OIL BASED
• Zinc phosphate • Compomers
cement • Composite and • Zinc oxide
• Polycarboxylate Adhesive Resin eugenol
cement cements • Non Eugenol
• Glass ionomer Zinc Oxide
cement
• Resin modified GIC

Based on the INGREDIENTS

CRAIG 12TH EDITION
◦Resin Methyl methacrylate-based resin cement has
been available since 1952 for cementation of
indirect restorations
◦Reformulations and improvements over the last
20 years, driven by a demand for all-ceramic and
bonded restorations, have increased resin’s
popularity

Phillips 12th Edition

 CLASSIFICATION
According to ISO Specification 4049 (2009)

CLASS 1 • Self Cure

CLASS 2 • Light Cure
CLASS 3 • Dual Cure
Compendium January 2013 Volume 34, Issue 1
Cementation of Indirect Restorations: An Overview of Resin Cements
Catherine Stamatacos, DDS; and James F. Simon, DDS, Med
Compendium January 2013 Volume 34, Issue 1
Cementation of Indirect Restorations: An Overview of Resin Cements
Catherine Stamatacos, DDS; and James F. Simon, DDS, Med
 What’s different
◦ Compressive and tensile strength, toughness, and
resilience of resin cement equal or exceed those of other
luting agents; solubility is exceptionally low; and esthetic
qualities are good, with color choices available.

◦ Used for cementation of resin-bonded fixed partial

dentures.
 Resin matrix with silane
treated inorganic fillers

Fillers
Silica or glass particles (20-
COMPOSITION 80%)

Adhesive monomer
HEMA
4-META
& an organophosphate (MDP)
ROLE OF EACH CONSITUENT
Resin matrix Fillers Silanes
(organic phase) (inorganic phase) (coupling agent)

Protects fillers
Cushion (transfers Strength Holds matrix and
load to strong fillers) Hardness fillers together
Holds fillers together

Responsible for bond

Responsible for Responsible for
between matrix and
physical properties mechanical properties
filler
These are the cross-linked
matrix of dimethacrylate
monomers.

Commonly used monomers ORGANIC

are aromatic dimethacrylayes POLYMER
[Bis-GMA and Urethane
dimethacrylate (UDMA)]. MATRIX

Both contain reactive carbon

double bonds at each end
that can undergo addition
polymerization by free
radical initiators.
 Resin matrix is initially a fluid monomer, but is
converted into a rigid polymer as a result of addition
polymerisation reaction between dimethacrylate resin
monomer that produces a heavily cross linked
polymer network surrounding the inert filler particles.
 Adhesive resin cements have been
formulated by adding an adhesion
promoter, 4-methacryloyloxy ethyl
trimellitate anhydride (4-META), to the
methyl methacrylate monomer as well as
an additional polymerization initiator,
tributyl boron, which is also believed to
aid chemical bonding to dentin.

ADHESIVE
MONOMER Such materials have been developed as
cements for base metal FPD’s and for
bonding amalgam to dentin and
composites.
REACTION
◦ Due to the very high molecular
weight (512 g/mol),the Bis-GMA
provides
lower polymerization shrinkage
than other monomers and superior
mechanical qualities.

◦ Consequently, due to its very high ROLE OF

viscosity, the amount of fillers Bis-GMA
added into the monomer decreases.

◦ Therefore, diluent monomers

(TEGDMA) have to be used, or
other monomers have to substitute
the Bis-GMA, to make the resin
more fluid in nature.
 PROPERTIES
◦ High adhesive quality
◦ ⇧ Retention due to micromechanical
bonding

◦ High Tensile strength -- hence less brittle

◦ Low solubility

- Dissolution contributes to marginal leakage around

restorations and bacterial penetration.
◦ Since these materials have only low (10%) filler
content, the physical properties are typical of acrylic
resins, that is, moderate strength with high deformation
under load.

◦ The incidence of postoperative hypersensitivity after

cementation of full-crown restorations with a
conventional glass-ionomer cement and a adhesive
resin cement was similar.

(Int J Prosthodont. 2007 Jan-Feb;20(1):73-8.

Clinical comparison of postoperative sensitivity for an adhesive resin cement containing 4-
META and a conventional glass-lonomer cement. Denner N1, Heydecke G, Gerds T, Strub JR.)
MECHANICAL PROPERTIES
COMPRESSIVE TENSILE ELASTIC
STRENGTH STRENGTH MODULUS
RESIN (MPa) (MPa) (Gpa)
CEMENTS

90-140 25-40 4-6

COMPRESSIVE TENSILE ELASTIC

STRENGTH STRENGTH MODULUS
GIC (MPa) (MPa) (Gpa)

70-200 6-7 7-8

 Resin-
bonded fixed
partial
dentures

Metal Cast
restoration ceramic

USES

Orthodontic Porcelain
bracket
veneers

Resin
composite
restorations
 METALLIC PROSTHESIS

ROCHETTE TYPE
MARYLAND BRIDGES
OF BRIDGES
ORTHODONTIC
BRACKETS
CROWNS
BONDING OF VENEERS
INLAYS,
ONLYS
ENDODONTIC FIBRE POSTS
ADHESION
 For good adhesion

The interface should be

REQUIREMENTS microscopically intimate.
OF GOOD
ADHESION
(BONDING) They should have good
wetting, which leads to good
interaction of materials.

The surfaces being joined

should be clean.

Resin cements are used in
conjunction with enamel and
dentin bonding agents.
This bonding is usually
micro-mechanical in nature
and bond to appropriately
treated fitted surfaces of
restorations .i.e. ceramic,
resin composite or metallic
has been micro etched.
Unlike resin cements,
non-polymeric cements,
such as zinc phosphate
cement, generally cannot
bond to either the tooth
structure or the fitted
surface of the restoration.
One exception is glass
ionomer cement, which
can bond chemically to
both dentin and enamel;
however, the strength of
the bond is far less than
what can be achieved
with resin cements.
 Non-adhesive (zinc
phosphate)

ADHESIVE Micromechanical
bonding (resin
QUALITY cement)

Molecular adhesion
(polycarboxylate, GI,
RMGI)
ADHESION

◦ Dentin/enamel (micromechanical bond)

◦ Porcelain (hydrofluoric acid)+ silane.

◦ Metal (sandblasting- 30-30ûm alumina

particles at 0.4-0.7Mpa or electrochemical
etching)
 RESIN BONDING

DENTIN
ENAMEL
(more complex)
 • Micromechanical interlocking into
ENAMEL an acid etched surface

• It requires removal of smear

layer, surface demineralization
DENTIN • Then application of unfilled
resin bonding agent or primer
to which resin chemically bonds.
It dissolves the smear
layer and produces
microscopic relief 37% of phosphoric
with undercuts on acid is usually used
the surface to create for etching.
an opportunity for
mechanical bonding.
 ENAMEL BONDING AGENT
◦ Made by combination of :

• High viscosity therefore can not wet

bis-GMA the etched surface properly

• Having low viscosity is added to bis-

TEGDMA GMA to increase the wettability

• These agents are hydrophobic in nature, therefore

are useful in case of enamel because it can be dried
ENAMEL BONDING

• It is by RESIN TAGS which are interlocked into the

surface roughness created by etching.

• The unfilled liquid acrylic monomer flows into

interstices between and within enamel rods.
DENTIN BONDING AGENT

Due to its high fluid

Dentin is made up of
contents it requires a
dentinal tubules, through
material which act as a
which dentinal fluid may
coupling agent between
flow to surface and
the dentin and restorative
decrease adhesion.
materials.
◦ The dentine bonding agent should contain

• To interact moist
Hydrophilic dentin surface.

• To make bond
Hydrophobic restorative resin
DENTINE BONDING

• All adhesive systems include 3 fundamental steps

for achieving a bond of resin to dentin.
• The first step, phosphoric acid-etching, removes
the smear layer, opens the dentinal tubules and
decalcifies the intertubular and peritubular dentin
(intertubular bonding).
• After the etchant is rinsed off, a primer containing a
solvent such as acetone, ethanol and/or water and
one or more bifunctional resin monomers is applied.
• A bonding agent is applied and penetrates into the
primed dentin.
• The bonding agent copolymerizes with the primer
and forms an intermingled layer of collagen fibers
and resin called the “HYBRID LAYER”.
Open dentinal tubules

Resin tags infiltrated

demineralized dentin like
roots of a tree.
HYBRID LAYER -This area is created by the penetration
of liquid resin into the etched dentin
PRE-CEMENTATION PRE-CEMENTATION
PROCEDURE FOR PROCEDURE FOR
PREPARED TOOTH CROWN

Prepared tooth was Etchant was applied to

etched for 15 secs, the ceramic crown for
rinsed and dried 5 secs
Dentin primer applied
on preparation

Dentin primer applied

on the crown
 All-ceramic crown
Dual cure adhesive
cemented with dual-cure
painted on preparation
resin cement
Excess cement removed,
crown light cured for 30 The final restoration,
secs on facial surface, Highly esthetic and
30seconds on lingual translucent
surface
 BEFORE

AFTER
CHEMICALLY ACTIVATED SYSTEMS
AVAILABLE IN
POWDER-LIQUID SYSTEM TWO PASTE SYSTEMS

COMPONENTS

Peroxide
(initiator)
Amine (N-dimethyl-
(activator) p-toluidine)
LIGHT ACTIVATED SYSTEMS
SINGLE COMPONENT CONTAINING

PHOTOSENSITIZER AMINE
ACTIVATOR INITIATORS

dimethyl-
Camphorquinone aminoethyl-
methacrylate
FUNCTION : Act as proton
donor and considered an
accelerator of free radical CLINICAL
production RELEVANCE:

•Degrade over time,

altering the shade of the
cement.
•Becomes inactive when
in contact with acidic
adhesive systems
AMINE
 Time of exposure to light needed for
polymerization of the resin cement is
dependent on the light transmitted
through the ceramic restoration.

 It should never be less than 40 seconds.

 Used for luting light-transmitting

restorations that are thin enough (i.e.
1.5mm thick) to transmit light.
 Effect of Exposure Time on the
Polymerization of Resin Cement
Through Ceramic

◦ One light-curing resin cement (Variolink II, Ivoclar

Vivadent) was exposed for 20 s, 40 s, or 60 s with a
BluePhase G2 light (Ivoclar Vivadent) on the high power
setting through 1.0 mm of either ZirPress (ZR) or
Empress Esthetic (EST) ceramic (Ivoclar Vivadent)

Maan M. AlShaafia / Mohammed Q. AlQahtanib / Richard B. Pricec

J Adhes Dent 2014; 16: 129-135.
 DEGREE OF • was measured 100 s after
CONVERSION (DC) light exposure
KNOOP • was measured 5 min after
MICROHARDNESS
(KHN) light exposure

ADEQUATE DEGREE OF CONVERSION (DC) will

Reduce microleakage

Reduce the amount of leached monomers decrease pulpal

irritation & post-operative sensitivity

Increase the physical properties and color stability of the resin

Improve the bond strength between the tooth and the resin
 Ceramic Exposure DC Mean SD
Type Duration (%)
20s 59.4 0.8 The KHN and DC
EST 40s 62.4 0.3
results suggest that the
60s 63.9 0.7
resin did not approach its
maximum curing
20s 57.9 1.0
potential until after 40 s
ZR 40s 61.6 0.7
of light exposure
60s 63.9 1.0
because when the resin
Ceramic Exposure Immediate 24-h KHN specimens were exposed
Type duration KHN mean mean (SD) for 60s through either
(SD)
ceramic, there was no
20s 2.98 (0.23) 8.10 (0.43)
significant difference in
EST 40s 4.16 (0.20) 11.20 (0.71)
the immediate DC or
60s 4.68 (0.21) 12.66 (0.80)
KHN values
20s 2.51 (0.16) 7.03 (0.41)
ZR 40s 3.82 (0.21) 9.02 (0.72)
60s 4.75 (0.21) 11.63 (0.72)
◦ Morares et al reported that 58% to 73% light attenuation
through 1 mm of ceramic is important because light
curing resins must receive an adequate radiant exposure
for acceptable polymerization, and yet must not receive
too much radiant exposure that could cause thermal
damage to the pulp or other oral tissues.

Moraes RR, Correr-Sobrinho L, Sinhoreti MA, Puppin-Rontani RM, Ogliari FA, Piva E.
Light-activation of resin cement through ceramic: relationship between irradiance intensity
and bond strength to dentin. J Biomed Mater Res B Appl Biomater 2008;85:160-165.
DUAL CURE SYSTEMS
ADVANTAGES:
combination
of •Comfortable working time.
•Cure on command of light-
cured composites
•Gives security of high
Chemical Light degrees of conversion even in
activation activation areas not reached by light.
mechanism mechanism

Used for luting thin to moderately-thick (i.e., from

1.5mm to 2.5mm) where light penetration may be
limited.
Commercially
available products
include
◦ Comspan (Dentsply/Caulk),
◦ Variolink II (Ivoclar
Vivadent),
◦ Enforce (Dentsply/Caulk),
◦ Calibra (Dentsply/Caulk),
◦ Ultra-Bond (Den-Mat),
◦ Mirage FLC (Chameleon),
◦ Insure (Cosmedent),
◦ Panavia F2
 RESIN MODIFIED GIC

Conventi Resins &

onal Photo RMGIC
GIC initiators
• defined as a hybrid cement that sets via an acid base
reaction and partly via a photo- chemical polymerization
reaction.

◦ The use of copolymers of acrylic acid and methacrylate

monomers in the liquid leads to materials that undergo
the customary acid-base reaction on setting and can also
be light cured via the methacrylate groups.

Eg: Fuji II LC, Vitrebond, Photac –Fil, Vitremer, FujiV.

 PROPERTIES
COMPRESSIVE TENSILE MODULUS SHRINKAGE
STRENGTH STRENGTH OF (%vol)
(MPa) (MPa) ELASTICITY
(Gpa)

GIC 180-200 22-25 8 3

RMGIC
170-200 35-40 4 3.5 expansion

Data from Burgess et al (1996). Used with permission from The Compendium of
Continuing Education in Dentistry.
◦ Hybrid ionomers have been found to expand on setting,
possibly due to the absorption of water, which is more
than for resin cements. Therefore, hybrid ionomers are not
recommended for luting all ceramic crowns, to avoid
possible expansion stresses and crown fracture.

◦ Flexibility with the hybrid ionomers being twice as

flexible, as indicated by lower modulus of elasticity
values.

◦ There is a definite improvement in translucency as the

monomer brings the refractive index of the liquid close to
that of the glass particle.
 ESTHETICS: According to the
Phillips’ science of dental materials
12th ed, there is a definite improvement
in translucency as the monomer brings
the refractive index of the liquid close
to that of the glass particle.

PROPER- FLUORIDE RELEASE: is same as

that of the conventional but the lining
TIES version shows higher F release

STRENGTH: The diametrical tensile

strength is much higher but
compressive strength and hardness is
lesser.
  A study was conducted to evaluate post-operative
sensitivity in full coverage restorations using
conventional glass ionomer cement or resin cement.

 50 crowns were cemented, 25 using GC glass ionomer

cement and 25 using SmartCem resin cement.
Sensititvity was checked pre and post cementation of the
crowns.

 A visual analog scale was used to check the sensitivity.

 Higher post-operative sensitivity was seen in GIC as

compared to Resin cements.
Shetty et al, Comparative evaluation of post-cementation hypersensitivity with glass ionomer and resin
cements: An in vivo study, thejcdp,may-june, 13(3):327-31
 Various shades of resin
cements are available which
plays an important role in
aesthetic dentistry
High bonding strength to
tooth structure
PROS

It doesn't expand on setting

there by minimizing
fractured temporary or
fabricated restorations.
 It is technique sensitive.

If the total etch system is not

used impeccably and under
CONS controlled circumstances post-
operative sensitivity can occur.

It is sometimes difficult to remove

the excess cement after the
cement has set or while removing
the temporary prostheses.
RESIN CEMENTS ARE CONSIDERED THE BEST CHOICE FOR LUTING ALL-
CERAMIC RESTORATIONS, BASED ON MULTIPLE LABORATORY AND
CLINICAL STUDIES LOOKING AT FRACTURE RESISTANCE AND SEALING.
IT HAS BEEN POSTULATED THAT RESIN CEMENT BONDED TO
CONDITIONED TOOTH ON ONE SIDE AND ETCHED/SILANE COATED
PORCELAIN ON THE OTHER HELPS DIFFUSE STRESSES ACROSS THE
TOOTH .

RESIN SHRINKAGE DURING CURING PLACES BONDED CERAMIC UNDER

COMPRESSIVE STRESS THAT HELPS PROTECT THE CERAMIC FROM
TENSILE FORCES.
REFERENCES
◦ Anusavice J K. Phillip’s Science of Dental Materials 11th ed. St.
Louis: Mosby Elsevier, 2003.
◦ Craig’s Restorative Dental Materials, 13th ed. St. Louis: Mosby
Elsevier, 2002.
◦ New American Dental Association Specification No. 30 for
Dental Zinc Oxide-Eugenol Type Restorative Materials Council on
Dental Materials and Devices JADA, Vol. 95, November 1977
◦ Compendium January 2013 Volume 34, Issue 1 Cementation of
Indirect Restorations: An Overview of Resin Cements Catherine
Stamatacos, DDS; and James F. Simon, DDS
o (Int J Prosthodont. 2007 Jan-Feb;20(1):73-8.Clinical comparison
of postoperative sensitivity for an adhesive resin cement
containing 4-META and a conventional glass-lonomer cement.
Denner N1, Heydecke G, Gerds T, Strub JR.)
o Maan M. AlShaafia / Mohammed Q. AlQahtanib / Richard B.
Pricec J Adhes Dent 2014; 16: 129-135.
o Moraes RR, Correr-Sobrinho L, Sinhoreti MA, Puppin-Rontani
RM, Ogliari FA, Piva E. Light-activation of resin cement through
ceramic: relationship between irradiance intensity and bond
strength to dentin. J Biomed Mater Res B Appl Biomater
2008;85:160-165.
o Burgess et al (1996). Used with permission from The
Compendium of Continuing Education in Dentistry.
o Shetty et al, Comparative evaluation of post-cementation
hypersensitivity with glass ionomer and resin cements: An in
vivo study, thejcdp,may-june, 13(3):327-31
 CRAIG’S CLASSIFICATION
FUNCTIONS CEMENTS

FINAL CEMENTATION OF ZINC PHOSPHATE , ZINC

COMPLETED RESTORATION SILICOPHOSPHATE,GLASS IONOMER

TEMPORARY CEMENTATION OF ZINC OXIDE EUGENOL

COMPLETED RESTORATIONS
HIGH STRENGTH BASES ZINC PHOSPHATE, ZINC
POLYCARBOXYLATE, GLASS
IONOMER,ZINC OXIDE EUGENOL
TEMPORARY FILLINGS ZINC OXIDE EUGENOL, ZINC
POLYCARBOXYLATE
LOW STRENGTH BASES ZINC OXIDE EUGENOL, Ca(OH)2

LINERS Ca(OH)2 in suspension

 FUNCTIONS CEMENTS

VARNISHES RESIN in solvent

ROOT CANAL SEALER ZINC OXIDE EUGENOL, ZINC

POLYCARBOXYLATE

GINGIVAL TISSUE PACK ZINC OXIDE EUGENOL

CEMENTATION OF ORTHODONTIC ZINC PHOSPHATE, ZINC

BANDS POLYCARBOXYLATE

ORTHODONTIC BONDING ACRYLIC RESIN,COMPOSITE RESIN