A laboratory and clinical evaluation of three dental luting cements

Investigation of zinc polycarboxylate cement used in dental treatments in terms of retrospective dosimeter

Zinc polycarboxylate cement is one of the few dental materials that demonstrate true adhesion to tooth structure. It is suitable for use in living organisms without causing harm. Its strong adhesion to teeth and low level of irritancy are two important parameters for the dental applications. In this study, the dosimetry properties of zinc polycarboxylate cement using thermoluminescence (TL) method were investigated and determined the effectiveness of its use as a good dosimeter. According to the results of this study, the sample shows a good TL properties with three main peaks found around 140°C, 220°C and 330°C. It has a wide linear dose response between 72 Gy and 2.3 kGy and good reusability of the TL peak found at 330°C. Unfortunately, the TL peak intensity values are rapidly faded within a short waiting time interval. Zinc polycarboxylate cement, which is frequently used in dental crowns, can be used as a retrospective dosimeter for measuring the amount of radiation in space studies and nuclear accidents due to its wide linear dose-response curve in the high dose region.

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (α=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.

Post cementation sensitivity evaluation of glass Ionomer, zinc phosphate and resin modified glass Ionomer luting cements under class II inlays: An in vivo comparative study

Objective:

This study aims to compare the patient-perceived post-cementation sensitivity of class II metal restorations preoperatively, immediately after cementation, one week after cementation and one month after cementation with (1) Glass Ionomer luting cement (2) Zinc Phosphate cement and (3) Resin-modified Glass Ionomer luting cement.

Materials and Methods:

A total of 60 patients, irrespective of sex, in the age group of 15-50 years were selected and the teeth were randomly divided into three groups of 20 each. Twenty inlay cast restorations were cemented with three different luting cements. The criteria adapted to measure tooth sensitivity in the present study were objective examination for sensitivity. (1) Cold water test (2) Compressed air test and (3) Biting pressure test.

Results:

The patients with restorations cemented with Resin-modified Glass ionomer demonstrated the least postoperative sensitivity when compared with Glass Ionomer and zinc phosphate cement at all different intervals of time evaluated by different tests.

Conclusion:

The patients with restorations cemented with resin-modified Glass ionomer demonstrated the least postoperative sensitivity.

Effect of early water contact on solubility of glass ionomer luting cements

STATEMENT OF PROBLEM

Glass ionomer cements are susceptible to attack by moisture during the initial setting period that can result in an increased solubility.

PURPOSE

This study was to evaluate the solubility of glass ionomer luting cements immersed in distilled water at early stages after mixing.

MATERIAL AND METHODS

Four commercial glass ionomer cements were used (Ketac-Cem, Fuji Ionomer I; AquaCem; AquaMeron). For each material, 5 resin cement holders were made with 2 circular cavities (diameter = 5 mm; depth = 2 mm). One minute after start of mixing, the specimens were placed in a humidifier at 37 degrees C and 100% relative humidity. After 2, 5, and 8 minutes storage time, they were immersed in 50 mL of distilled water in a glass weighing bottle where they were stored for 3 hours at 37 degrees C. Next, the specimens were removed and the water was evaporated from the weighing bottle at 130 degrees C for 2 hours. The difference between the final and initial weights of the bottle was taken as amount of solubility. Data were analyzed by analysis of variance and Duncan's test.

RESULTS

Solubility was greatest at 3 minutes immersion time and least at 9 minutes. The lowest cement loss was for AquaCem at 9 minutes immersion time (1.68 mg/cm2). The greatest loss was for Fuji Ionomer I after 3 minutes immersion time (14.98 mg/cm2). Solubility of cements decreased by 39% for Ketac-Cem, 61% for Fuji Ionomer I, 38% for AquaCem, and 37% for AquaMeron when the specimens were immersed in water 6 minutes after mixing. Comparison of all 4 cements revealed a relatively large difference between loss of substance from AquaCem and AquaMeron, and the 2 other conventional glass ionomer cements, Keta-cCem and Fuji Ionomer I.

CONCLUSIONS

Increasing the time from start of mixing until immersion in water from 3 to 9 minutes resulted in a marked decrease in loss of substance from the surface of all 4 cements. Water-hardening glass ionomer cements (AquaCem and AquaMeron) were less sensitive to early water contamination.

Dental luting agents: A review of the current literature

STATEMENT OF PROBLEM

The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice.

PURPOSE

This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material.

MATERIAL

The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale.

Ten years' clinical evaluation of three luting cements

OBJECTIVE

The aim of the present clinical longitudinal study was to observe, over 10 years, the prognosis of abutment teeth restored with fixed prostheses retained by glass ionomer luting cements and one conventional zinc phosphate cement.

METHODS

Three dentists prepared 135 abutment teeth in 61 patients to retain 81 fixed prostheses. The prostheses were retained by two glass ionomer luting cements (Ketac-Cem, Fuji Ionomer), or a conventional zinc phosphate cement (De Trey Zinc Zement Improved). The patients were examined yearly for 10 years.

RESULTS

Post-operative hypersensitivity occurred in five teeth restored with glass ionomer luting cement. The prevailing reason for abutment tooth failure was secondary caries (n = 21) and pulp necrosis (n = 5). Non-parametric survival estimates indicated that 80-85% of the abutment teeth remained intact after 5 years and 71-81% after 10 years.

CONCLUSIONS

The 10-year results indicate that the prognosis of abutment teeth restored with fixed prostheses is good, regardless of whether a glass ionomer or a zinc phosphate luting cement is used.

Short-term contamination of luting cements by water and saliva

OBJECTIVES

The aim of this study was to determine the effect of water, artificial saliva and natural saliva on the hardening process of three dental luting cements.

METHODS

Cement samples, 1 mm thick and 5 mm in diameter, were subjected to various storage conditions in an oven maintained at 37 degrees C. Some samples were aged in 100% humidity or water for up to 1 wk. The other samples were covered with water, artificial saliva or natural saliva at various times after mixing. The Knoop hardness values of the cement surfaces were measured. Differences between groups were evaluated with an ANOVA followed by a Tukey multiple comparison at the 5% level of significance. The hardness ratio of the contaminated samples was calculated using the 30 min mean KHN of the samples aged in 100% humidity as the divisor.

RESULTS

The glass ionomer samples were significantly harder (48.3 +/- 3.8) than the zinc phosphate (38.9 +/- 7.5) or composite cements (35.4 +/- 10.2) after 1 wk in 100% humidity storage condition. When immersed in water, the hardness of both the glass ionomer and the zinc phosphate decreased to almost half that of the specimens stored in 100% humidity (26.2 +/- 2.7 and 16.9 +/- 2.5, respectively). Contamination decreased the hardness of zinc phosphate and glass ionomer (hardness ratio, water contamination at 5 min: 0.39 +/- 0.10 and 0.52 +/- 0.12, respectively) but had very little effect on the composite. Overall, water had a greater softening effect than artificial or natural saliva on the cements.

SIGNIFICANCE

In light of these results, glass ionomer cement should be protected from water and saliva for the first 15 min after mixing.

Evaluation and control of post-cementation pulpal sensitivity: zinc phosphate and glass ionomer luting cements

Many studies have documented pulpal sensitivity after crown cementation, but none have determined its cause. By controlling technique variables in a large-scale clinical trial, the authors evaluated the contribution of zinc phosphate and glass ionomer luting cements in causing pulpal sensitivity or necrosis.