CROWN AND BRIDGE CEMENT

BY:SURBHI BHARDWAJ BDS II

Alternate name

Zinc Phosphate cement Zinc Oxyphosphate Cement Zinc Cement

HISTORY
The earliest formulation as reported by Rollins(1879),Gaylord(1889),Ames(1893 & Fleck(1902) were variously based on syrup of orthophosphoric acid or unstable mix of metaphosphoric acid & sodium metaphospate in solution. Later cements with 50% sol. of o-phosphoric acid was used but problem revolved around the control of setting reaction but by the time Flecks (1902) paper these problems had been solved.

The importance of densifying & deactivating the ZnO powder to moderate the reaction was recognized & it was also found that satisfactory cements could be produced only if aluminum was incorporated into the o-phosphoric acid solution The basic science underlying this empirical finding was elucidated only in 1970

Definition

According to Boucher zinc phosphate cement is defined as material used for cementation of inlays, crowns, bridges, and orthodontic appliances and occasionally as a temporary restoration. It is prepared by mixing zinc oxide and magnesium oxide powders with a liquid consisting principally of phosphoric acid, water, and buffers.

TYPES
Type I (fine grain) - Used for the permanent cementation of cast restorations such as crowns, inlays, onlays, and bridges. This material creates the very thin film layer that is necessary for accurate seating of castings. Type II (medium grain) -Recommended for use as an insulating base for deep cavity preparations

dispensing

As powder liquid system

As single component

NOTE-A capsulated system which is mechanically mixed has been marketed

Composition of powder
ZINC OXIDE90.2% (Reactive ingredient) MgO-8.2% (To reduce temp. of calcination) SILICA-1.4% (inactive filler)

BITHMUS OXIDE.1% (imparts strength to freshly mixed cement)

BaO/CaO- .1% (modifiers)

Colour pigments in trace amount

Composition of liquid
Phosphoric acid Aluminum phosphate & zinc phos. Zinc Water 38.2%

Reactive ingredient
16.2% buffer 7.1% Moderator

manipulation

cement forming reaction

ZnO

Aluminophosphoric acid complex

Zinc alumino phosphate gel

Heat

properties

1.BIOLOGICAL PROPERTY
It is recognized as pulpal irritant Probable cause is free phosphoric acid present at the time of placement of cement Pulp should be covered with pulp capping agents

RHEOLOGICAL PROPERTIES

1.WORKING AND SETTING TIME

MATERIAL ADA no. 96 Commercial product

TYPE I
TYPE II

2.5-8 mins
---

5.5 mins
3-4mins

FACTORS AFFECTING
# Powder liquid ratio # Rate of powder incorporation # Temperature of mixing slab # Spatulation time # Water content

2.CONSISTENCY
luting

standard

base

3.RETENTION
Non-adhesive to tooth structure or surface of casting MECHANICAL adhesion (factors affecting) #Rough surface on tooth & restoration #Film thicknes & consistency of material #Strength of luting cement

3.SOULBILITY & DISINTEGRATION

Measured by wt. loss when a disc of cement is suspended in distilled water for 24hr. ADA req. for type I is max. 0.2% FACTORS AFFECTING #P/L ratio #Initial wetting of cement mix #Solvent & its pH

Mechanical properties
PROPERTIES Compressive strength Tensile strength TYPE I 80-100 MPa (ADA>75MPa) 5.5MPa TYPE II 100-170MPa (ADA>103.5) 5-14MPa(brittle)

MOE
Film thickness

14,000MPa
25-30 mc mt.

22,000MPa
30-35 mc mt.

STRENGTH OF CEMENT IS INFLUENCED BY

#Initial powder & liquid composition #P/L ratio #Time #Handeling of the cement during placement

Thermal property
Have adequate thermal insulating property. Used as base under metallic restoration

Optical property
Set cement is opaque Hence,cant be used for ant. restoration

uses
Primarily used as permanent cementation material to fix performed restorations To fix orthodontic bands Thermal insulating base Temporary or intermediate restorative material

Advantages

disadvantages

Good compressive strength Easy manipulation process Sets sharply to relative hard mass Low cost production Long history of clinical success

Pulpal irritation Lack of anticariogenic & anti bacterial action Lack of chemical adhesion to tooth structure Soluble in oral fluids Non-aesthetic

modifications

HYDROPHOSPHATE CEMENT

The phosphoric acid is freeze dried & converted to solid form, these solid acid phosphates are blended with phosphate of Zn,Ca & other metals as well as the oxides of these metals with water Liquid used id distilled water Acidity is same as of conventional Zn-P cement Other properties inferior then that of conventional one Used as luting cement & thermal insulating bases

FLUORIDE CEMENYS
Some zinc phosphate cement contain 13% of stannous fluorides & they are particularly used for orthodontic cementation Have low strength & high solubility because of dissolution of fluoride containing material But ant cariogenic property is not so good as leaching of fluoride ions decrease in 1-2days

Copper cement/Silver cement/germicidal cement

Ag salts or Cu oxides are sometimes added to powder of zinc phosphate cement to impart antibacterial /antiseptic property Silver cement generally contain few % of salt such as silver phosphate. Silver salts darkens on exposure in the mouth Cement is black when cupric oxide is added,red if cuprous oxide is added white if cuprous iodide is added & green if cupric silicate is added Cement is used in rare cases such as rampant caries of deciduous teeth They are seldom used currently because there clinical behavior doesnt seem superior to any other temporary restorative material & their toxic reaction to the pulp is generally recognized

CONCLUSION

Zinc phosphate is oldest and most widely used dental material and is considered as gold standard cement because of its long clinical success.