The Effect of Temporary Cement Cleaning Methods

on the Retention of Crowns

Mi-Young Song, DDS, MSD,1 Hongseok An, DDS, MSD,2 & Eun-Jin Park, DDS, PhD3
1
Department of Dentistry, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, Korea
2
Department of General Dental Sciences, School of Dentistry, Marquette University, Milwaukee, WI
3
Department of Dentistry, School of Medicine, Ewha Womans University, Seoul, Korea

Keywords
Cleaning method; crown retention; temporary
cement.
Correspondence
Eun-Jin Park, Professor, Department of
Dentistry, School of Medicine, Ewha
Womans University, 1071, Anyangcheon-ro,
Yangcheon-gu, Seoul 07985, Korea.
E-mail: prosth@ewha.ac.kr
The authors deny any conflicts of interest.
Accepted March 10, 2017
doi: 10.1111/jopr.12646
Abstract
Purpose: To evaluate the effect of temporary cement cleaning methods on the re-
tention of cemented crowns using zinc phosphate cement and resin-modified glass
ionomer cement.
Materials and Methods: Forty titanium specimens were fabricated to simulate pre-
pared molars with minimally retentive taper. The Ni-Cr cast crowns were fabricated,
temporarily cemented, and separated. The specimens were divided into four groups
according to the temporary cement cleaning method (n = 10) as follows: control
group (no temporary cementation), orange solvent group, ultrasonic cleaning group,
and air-abrasion group. After the cleaning procedures, the specimens were cemented
with definitive cements (zinc phosphate cement and resin-modified glass ionomer,
RMGI, cement) and subjected to thermocycling (5000 cycles, 5-55C, dwell time,
10 seconds). The tensile bond strength of each specimen was measured using a uni-
versal testing machine, and the results were analyzed using the Kruskal-Wallis and
Mann-Whitney U test ( = 0.05).
Results: When cemented with zinc phosphate cement, the statistical analysis showed
that the value of the air-abrasion group was significantly higher than those of the
other groups (p < 0.01). There was no statistically significant difference among the
other groups. When cemented with RMGI cement, the air-abrasion group showed
the lowest value, and the control group showed the highest value (p < 0.01). The
difference between the ultrasonic cleaning group and the orange solvent group was
not statistically significant.
Conclusion: The use of temporary cement did not have a significant influence on
retention of permanently cemented crowns when zinc phosphate cement was used for
permanent cementation. Airborne-particle abrasion after provisional cementation im-
proved retention of crowns cemented with zinc phosphate cement; however, the use of
temporary cement significantly decreased retention of permanently cemented crowns
when RMGI cement was used regardless of the temporary cement cleaning method.

Cementing a restoration on an interim basis is occasionally
advised so that the patient and the dentist can assess its appear-
ance and function over a period longer than a single visit.1,2
Zinc oxide-eugenol (ZOE) cements are commonly used for
temporary cementation because of their sedative effect, ease
of removal, low cost, and excellent sealing property.3 After
provisional cementation with ZOE cement, the cast restora-
tion has to be carefully cleaned and luted with more definitive
cement.4 The remnant debris of the ZOE cement on the in-
taglio surface of cast restorations may have a negative effect
on the performance of definitive cement.5,6 The mechanical
removal of temporary cement using an excavator or a scalpel
blade has been found to be not completely effective, and the
remnants of the cement have been observed microscopically
on surfaces that appeared macroscopically clean.7,8 Therefore,
methods such as airborne-particle abrasion, ultrasonic clean-
ing, or the use of organic solvents may be needed for improved
cleaning.9-12
Traditionally, zinc phosphate cement (ZPC) has been a very
popular material despite its well-documented disadvantages,
including its solubility and lack of adhesion.1,13 The retention
of cast restorations cemented with ZPC is mainly influenced by
the configuration of the tooth preparation that limits the paths of
displacement of the cast restoration.14 The luting ability of ZPC
is derived from mechanical retention.15 However, conventional
glass ionomer, resin-modified glass ionomer (RMGI), and resin

Journal of Prosthodontics 00 (2017) 16 

C 2017 by the American College of Prosthodontists 1
Influence of Temporary Cementation on Crown Retention
Figure 1 Simulated die specimen used in this study: (A) 5 mm,
(B) 4 mm, (C) 11 mm, (D) 10 mm, (E) 1 mm, = 27.
cement have adhesive properties that enhance the retention of
the fixed prostheses.16
RMGI was introduced in the 1990s in an attempt to com-
bine the low solubility of resin cement and glass ionomer
cements desirable properties, such as fluoride release and
stronger adhesion.16 RMGI cement is less sensitive to early
moisture exposure than conventional glass ionomer is,17 and the
tensile strength of RMGI cement is remarkably higher than that
of conventional glass ionomer cement. RMGI is now among the
most popular luting agents in general practice.1
Several factors influence the retention of restoration, includ-
ing the accuracy of fit, the taper of preparation, the ratio of the
axial to the lateral dimensions, the auxiliary retention forms,
the area of the bond, the surface texture, and factors related
to the cement such as its adhesion, luting material type, and
film thickness.4,12,18-23 When an ideal retentive configuration is
achieved, a dentist may not be concerned with the dislodgment
of the restorations even if they have remnants of the temporary
cement on their intaglio surface; however, studies have shown
that dental students, general dentists, and even prosthodontists
have not been very successful in routinely creating an ideal
taper, such as 2 to 5.24-26 Particularly when the prepared
tooth has a minimally retentive design, the retention must be
maximized by cleaning the debris or the contaminants. The
purpose of this study was to evaluate the effect of temporary
cement cleaning methods on the tensile strength of permanently
cemented crowns using ZPC and RMGI cement. The null hy-
pothesis of this study was that the temporary cement cleaning
method does not affect the tensile strength of crowns perma-
nently cemented with ZPC and RMGI cement.
Materials and methods
Specimen preparation
Forty specimens were used for this study. The specimens were
composed of dies milled from titanium and counter cast crowns.
The design of the milled die was similar to that of prepared
teeth that have forms in the molars (Fig 1). Each die had an
11 mm base and 4 mm height, approximating the dimensions
of a molar preparation. The dies had 1 mm shoulder margins
2 Journal of Prosthodontics 00 (2017) 16 
Song et al
Figure 2 Schematic diagram of acrylic crown forming jig: (A) Simu-
lated milled die, (B) Acrylic resin crown, and (C) Aluminum tube with an
11 mm internal diameter.
and 27 tapers, which are the clinically acceptable maximum
axial tapers in molars.18 The opposite part of the die was milled
to a 5 mm diameter, which made it possible for the dies to
be held by a universal testing machine (Instron 4465; Instron,
Norwood, MA).
An aluminum tube with an 11 mm internal diameter was
used to fabricate acrylic patterns for counter-cast crowns.
(Fig 2). The dies were placed in the aluminum tube, and an
acrylic resin mixture (GC Pattern Resin; GC Corp., Tokyo,
Japan) was poured into the tube of the die-aluminum tube com-
plex. The loop of wax-pattern was connected to the occlusal
surface of the crown to create a handle, and the acrylic resin
crowns were sprued, invested using a phosphate bonded invest-
ment (UNIVEST NON-PRECIOUS; Shofu Dental Corp., San
Marcos, CA), and cast with Ni-Cr alloys (Bellabond Plus; Bego,
Bremen, Germany). The crowns were carefully adjusted using
an indicator (Occlude; Pascal International, Bellevue, WA), and
the intaglio surfaces of the crowns were drilled to make a 1 mm
hole. The holes of the crowns functioned as vents for exces-
sive cement and enabled the provision of complete seating. The
intaglio surface of the crowns and the external surface of dies
were air-abraded using 110 m aluminum oxide powder (Cobra
white; Renfert, Hilzingen, Germany) at 0.48 MPa. Each die and
crown part were steam-cleaned and dried before cementation.
Provisional cementation and cleaning
procedures
The 40 die-crown specimens were randomly divided into 4
groups of 10 specimens. The specimens excluding the control
group were cemented with temporary cement (Temp-Bond;
Kerr, Orange, CA). After the provisional cementation and sep-
aration of the specimens, the cleaning procedure for the cast
crowns was performed according to the protocol for each group
as follows.
The specimens in the control group (C) were cemented with
definitive cement without provisional cementation. For the or-
ange solvent group (OS), the remnant of temporary cement
C 2017 by the American College of Prosthodontists
Song et al Influence of Temporary Cementation on Crown Retention

Table 1 Descriptive statistics for the tensile bond strength of specimens

Definitive cement Group n Mean (N) SD Median IQR (Interquartile range)

ZPC C 10 6.931 1.356 6.834 2.443

ZPC OS 7 5.027 1.089 5.384 2.236
ZPC U 8 5.533 0.999 5.44 1.757
ZPC AA 10 24.834 4.186 23.585 7.691
RMGI C 10 258.299 29.697 250.611 38.638
RMGI OS 10 26.808 5.528 24.208 10.618
RMGI U 10 27.011 4.305 25.969 5.262
RMGI AA 8 3.254 1.115 3.126 1.993

*Specimens debonded prior to testing were excluded.

was removed with cotton pellets saturated with the orange sol-
vent (Smart Cleaner; Florida Chemical, Winter Haven, FL)
until the intaglio surface of the crowns looked clean macro-
scopically. Then, an alcohol-saturated cotton pellet was used to
remove the Smart cleaner residue. For the third group (U),
the ultrasonic cleaning method was used. The cast crowns
were dipped into the temporary cement remover solution
(P&S cleaner II; Mediforce, Tampa, FL) and cleaned with
an ultrasonic cleaning device for 10 minutes. For the last
group (AA), the airborne-particle abrasion and steam-cleaning
method was used. Airborne-particle abrasion was applied to
remove the temporary cement using 110 m aluminum ox-
ide powder at 0.48 MPa, and the cast crowns and dies were
steam-cleaned.
Permanent cementation and tensile bond
strength test
The specimens were cemented with ZPC (Flecks zinc phos-
phate cement; Mizzy, Cherry Hill, NJ) and RMGI cement (GC
FujiCEM; GC Corp.). After the test for the ZPC, all the spec-
imens were cleaned using ultrasonic cleaning for 10 minutes,
followed by airborne-particle abrasion, and steam cleaning. The
same specimens in each group in the ZPC test were used again
for the RMGI cement.
The ZPC was mixed following the manufacturers instruc-
tions, and then applied to the crown using a syringe (E/Z Sy-
ringe; Centrix, Inc., Shelton, CT). A Centrix tip with marking
was used to provide equal amounts of cement. One investiga-
tor cemented all the specimens. The crowns were seated on
their counter dies after they were vibrated and twisted back and
forth, as Rosenstiel and Gegauff recommended.27 The 1-mm
vent hole improved the complete seating of the crown, and
5 kg constant load was applied to the crowns for 10 minutes.28,29
The RMGI cement was mixed according to the manufacturers
instructions, and then applied to the crown. The cartridge (GC
Corp.) was used to make equal amounts of cement, which pro-
duced uniform quantities of mixed cement for each squeeze.
After the permanent cementation, the specimens were sub-
jected to thermocycling (5000 cycles, 5-55C, dwell time,
10 seconds);30-33 10,000 thermocycles has been suggested to
correspond approximately to 1 year of in vivo functioning.34
The regimen of 5000 thermocycles in this study could be con-
sidered as 6 months usage.
Table 2 Comparative significance of statistical analysis for ZPC
Group C OS U AA
C
OS ns
U ns ns
AA
*p < 0.05. **p < 0.01. ***p < 0.001. ns; p 0.05.
Table 3 Comparative significance of statistical analysis for RMGI
cement
Group C OS U AA
C
OS
U ns
AA
*p < 0.05. **p < 0.01. ***p < 0.001. ns; p 0.05.
The crown-die specimens were mounted on a universal test-
ing machine, and the tensile bond strength values of the spec-
imens were measured on a universal testing machine at a
0.5 mm/min crosshead speed. The ultimate force required for
the separation was recorded from the digital screen of the test-
ing machine in kg. The tensile force values required for the
separation of the specimens were calculated in Newtons (N)
according to the following equation:
Tensile bond strength (N) = Force (kg) 9.8067 (m/s2 )
A statistical analysis was performed using the Kruskal-Wallis
and Mann-Whitney U test ( = 0.05) to evaluate the effect of the
cleaning methods depending on definitive cements (SPSS 12.0;
IBM, Armonk, NY). Nonparametric tests were used because
the data did not meet the assumption of normality.
Results
The mean tensile strengths of the two definitive cements for
each cleaning method are shown in Table 1. The results of
statistical analysis are given in Tables 2 and 3.
A few of the specimens in this low-retention design were
spontaneously separated after the thermocycling. The thermo-
cycling had a detrimental effect on the retention properties of

Journal of Prosthodontics 00 (2017) 16 

C 2017 by the American College of Prosthodontists 3
Influence of Temporary Cementation on Crown Retention
the cements,23 and the minimally retentive design of the prepa-
ration in this study resulted in a low tensile bond strength.
The tensile strength of the separated specimens could not be
measured and were excluded.
For ZPC groups, the value of group AA was significantly
higher than those of the other groups (p < 0.01). There was no
statistically significant difference among other groups.
For RMGI cement, group C showed the highest retention
(p < 0.001), and group AA showed least retention (p < 0.001).
Group AA did not have a high value for RMGI cement, un-
like the result of group AA for ZPC. The efficacy of the ul-
trasonic and orange solvent cleansing methods did not show
significant difference for both ZPC and the RMGI cement
(p > 0.05).
Discussion
The retention of fixed prostheses depends on many factors,
including the preparation taper,35 the preparation height,36
the method of cleaning the preparations,37 the type of core
material,38 the thickness of die-spacer,39,40 the surface area of
preparations,41 the surface roughness of the preparations,42 the
surface roughness of the internal surface of the cast crown,12
the auxiliary grooves,43 and the type of cement used.16 Be-
cause the design of the preparation in this study was inten-
tionally compromised, the effect of the remnant temporary ce-
ment on the crown definitely appeared. Among several ways
to remove temporary cements, airborne-particle abrasion with
alumina is a less sensitive technique in terms of producing a
rough alloy surface, is inexpensive, and can improve adhesive
and cement wetting because of the mechanical removal of the
debris.44
Kim et al45 reported that surface modification with airborne-
particle abrasion is an effective way to improve retention when
Temp-Bond is used, and Gurbuz et al46 noted that airborne-
particle abrasion had a positive effect on the retention of over-
tapered complete metal crowns. ZPC is commonly used in
clinical practice, and the surface roughness might be a main
factor for the tensile strength in cases of low retention. In
this study, the airborne-particle abrasion group had a higher
value than the control group, which was cemented with ZPC
without provisional cementation. The airborne-particle abra-
sion on the intaglio surface of the crowns gave a higher reten-
tion value than that of the control group, for which only a pre-
treatment procedure was performed; however, airborne-particle
abrasion should be applied with extreme caution because sig-
nificant marginal damage can occur during the procedure,47 and
marginal disintegrity or surface roughness can mediate exces-
sive plaque accumulation, which will eventually jeopardize gin-
gival health.48 The chemical organic solvents including alcohol,
soap, chloroform, and eucalyptus oil or an ultrasonic removal
solution dissolves and removes the temporary cement.1,2,49,50
In this study, the efficacy of the ultrasonic and orange solvent
cleaning method did not significantly differ for both ZPC and
the RMGI cement. Although the remnant of temporary cement
was cleaned very carefully with the orange solvent, the effi-
cacy of this method might be variable because the standard of
macroscopically clean can be subjective; however, the result of
4 Journal of Prosthodontics 00 (2017) 16 
Song et al
this study shows that the orange solvent method, if done with
caution, can be as effective as the ultrasonic cleaning method.
The tensile strengths of OS and U groups for ZPC were not
significantly lower than that of the control group. This means
that the cleaning methods using the orange solvent and ultra-
sonic cleaning can be used to remove temporary cement simply
and conveniently in clinics when ZPC is used as definitive ce-
ment; however, to obtain maximum retention, particularly with
compromised preparations, airborne-particle abrasion is rec-
ommended for cleaning temporary cement prior to permanent
cementation with ZPC.
RMGI cement has been recommended due to its hybrid
properties similar to glass-ionomer cement, with the addition
of a small quantity of resin such as hydroxyethyl methacry-
late or bis-GMA.51 The adhesive and fluoride-leaching prop-
erties of these materials have led to their widespread use as
restorative, lining, and luting materials.52 Because the speci-
mens did not have natural tooth structure, but were made of
metal, the RMGI cement was luted without bonding forming a
hybrid layer. Therefore, the conditions of this study differed
from those of the oral environment, and mechanical bond-
ing rather than chemical bonding of the RMGI cement was
measured.
The possible negative effect of eugenol-containing tempo-
rary cement on RMGI cement is the inhibition of the poly-
merization of the resin material or the smoothing of the mi-
croroughness of the intaglio surface of the cast crown and the
milled dies, which play the role of barriers. There is controversy
in the literature regarding the interaction between resin-based
cement and eugenol-containing cement residues. Millstein and
Nathanson53 reported that the retention of crowns cemented
with resin cement was greatly reduced when pretreated with
eugenol-containing temporary cement. They also reported that
the reduced retention could be attributed to inhibition of poly-
merization of resin cement. Terata et al54 reported that the
remnant of temporary materials could reduce the wettability
and infiltration of the adhesive on the tooth structure, and that
the main reason for decreased bond strength was the prevention
of the infiltration of the adhesive into the tooth rather than the
inhibition of the polymerization of the resin.55 Abo-Hamar et
al56 and Peutzfeldt and Asmussen57 also reported that previ-
ous contact of dentin with ZOE cement did not decrease the
bond strength of composite resin on dentin. On the other hand,
Hume58 noted that eugenol was not only present in and released
from the remnants of cement, but had also been shown to pene-
trate the dentin to change its wettability and reactivity. Being a
radical scavenger, eugenol inhibits the polymerization of resin
materials,59 and this inhibited polymerization might lead to re-
duced microhardness and color stability of the composite resin
that was polymerized in contact with ZOE cement.3,60-62
The control group had a significantly higher value for
the RMGI cement than for the other groups, on which
provisional cementation and subsequent cleaning procedures
(p < 0.001) were performed. Especially, the airborne-particle
abrasion method for the RMGI cement showed the lowest ten-
sile strength, and its result was opposite to the result of ZPC.
Although the airborne-particle abrasion method could extend
the surface area and provide micromechanical retention, the
remnant of the eugenol-containing temporary cement was not
C 2017 by the American College of Prosthodontists
Song et al
chemically cleaned and had a detrimental effect on the tensile
strength of the RMGI cement. Moreover, the debris of the tem-
porary cement on the die could have contributed to the low
tensile strength of the specimens. The excessive remnants of
the cement on the dies were removed with only an excavator,
which could have a negative effect on the tensile strength of
the definitive cement as well. Therefore, for the RMGI cement
group, provisional cementation is not recommended, especially
using Temp-Bond. In this case, permanent cementation directly
would be recommended, otherwise noneugenol Temp-Bond
might be used if it needed. In that case, both the mechanical
and chemical cleaning methods for temporary cement should
be applied. This in vitro investigation evaluated the effect of
cleaning methods for temporary cement on the retention of cast
crowns using different definitive cements. Despite the simu-
lated in vivo environment such as thermocycling, the situation
could not be the same as the actual oral environment, and this
certainly is a limitation of this study. The preparation design
used in this study was simplified and fabricated from titanium
alloy. Also, an overtapered preparation design was used for this
study. This may not represent the average clinical situation. Al-
though tensile bond strength can be a useful predictor for the
performance of crowns as far as their retention is concerned,
it may not be an exact simulation of how crowns lose their
retention in an actual oral environment. Further clinical studies
or studies with more comprehensive in vitro simulations such
as cyclic loadings on the specimens made out of human teeth
are needed to confirm the findings of this study.
Conclusions
Within the limitations of this in vitro study, the following con-
clusions can be drawn:
1. The retention of cast crowns cemented with ZPC or
RMGI cement were influenced by the cleaning methods
of temporary cement, and the effects of cleaning meth-
ods were different between two kinds of the definitive
cements.
2. The efficacy of the ultrasonic and orange solvent clean-
ing method for both ZPC and the RMGI cement did not
significantly differ. The two methods had a lower re-
tention than the airborne-particle abrasion method when
ZPC was used, but they had a higher retention than the
airborne-particle abrasion method when the RMGI ce-
ment was used.
3. All the cleaning methods for ZPC were effective. The air-
borne particle abrasion method for ZPC had an especially
improved retention value. For the RMGI cement group,
provisional cementation is not recommended, especially
using Temp-Bond, but chemical cleaning methods such
as orange solvent or ultrasonic cleaning could be used
when needed.
Acknowledgments
The authors would like to thank Pf. Bum-Sun Lim, Pf.
Ji-Man Park, and CDT Seok-Yeon Choi for their contribution
and support to this study.
Journal of Prosthodontics 00 (2017) 16 
C 2017 by the American College of Prosthodontists
Influence of Temporary Cementation on Crown Retention
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