In restorative dentistry, suitable dental cement can make all the difference in establishing a successful, long-term restoration for your patient. With the many different types of dental cements available today, it can be challenging to determine which one to use that is best for your tooth. Materials compatibility, strength, bonding properties, aesthetics, and cost have to be thought about when arriving at a proper decision. This informative blog is filled with tips and guidelines on how to select appropriate dental cement for your patients.
Look For Different Types Of Dental Cement
There are many types of dental cements, each with specific properties and applications. Read on to learn more about dental cement.
- Zinc Phosphate: Of these, zinc phosphate cement has the highest compressive strength and the best history of longevity; thus, it is often used for the permanent cementation of crowns and bridges.
- Polycarboxylate: This cement has excellent biocompatibility with dental structures and adhesive properties to enamel and dentin, hence finding application in permanent cementation of crowns and orthodontic brackets.
- GIC: Popular for its fluoride release and chemical bonding to tooth structure, it is used for luting crowns, bridges, and orthodontic bands. Resin-modified glass ionomer cement (RMGIC): This combines the desirable features of both GIC and resin cement to provide adhesion and reduce sensitivity.
- Resin cement: The best aesthetics and strength make it useful in all ceramic and composite restorations. Temporary cement: This type is used for provisional restorations and provides enough retention while being easily removable.
Consider The Properties As Well
The properties of dental cement play a significant role in choosing the appropriate cement for a particular clinical situation. Critical properties include:
- Strength: Compressive, Tensile, and Shear Strength: One of the most critical factors governing the longevity of restorations.
- Bonding Capability: The capability of the cement to bond to tooth structure and restorative materials.
- Aesthetics: This is a critical consideration for restorations visible when the colour and clarity of the cement alter the final appearance dramatically.
- Ease of Use: working time, setting time, and handling characteristics.
- Biocompatibility: The cement does not produce any unwanted responses in the nearby tissues.
- Solubility: The degree of resistance to dissolution should be high to minimise marginal leakage and possible secondary caries.
Assessment of Clinical Needs
Type of Restoration
The requirement of the cement varies according to the type of restoration needs. For Example:
- Crowns and Bridges – Resin or RMGIC are needed as they have excellent mechanical strength and durability.
- Veneers – Resin cement should be used as these types of restoration need aesthetic cement with a good colour match.
- Inlays and Onlays – Resin cement desirably have the additional properties of strength and bonding.
- In Orthodontic Appliances -Generally, it uses cements like polycarboxylate or GIC which has good adhesion and can be removed easily.
Location of Restoration
The location in the mouth can dictate the choice of cement. For example:
- Anterior Teeth: Aesthetics prevails and hence, resin cements have a priority.
- Posterior Teeth: Resistance and durability become more critical; therefore, resin or RMGIC is used.
Patient-Related Factors
Patient factors to be taken into account are as follows:
- Allergies or Sensitivities: One should avoid cements that include elements to which the patient is allergic.
- Oral Hygiene: Cement with fluoride release, such as GIC or RMGIC, may be helpful in patients with poor oral hygiene.
- Occlusal forces: Strong cements, in patients with high occlusal forces, for example, due to bruxism, should be resin.
How To Apply Correctly?
Preparation Is Important
Proper preparation of tooth and restoration is necessary. It involves the steps mentioned below for successful cementation.
- Preparing The Tooth: The tooth should be clean, dry, and free from any kind of contamination.
- Restoration preparation: according to the manufacturer’s guidelines, cleaning and conditioning of restoration is to be performed.
Cement Mixing and Application
Mix cement as per the manufacturer’s instructions. It involves:
- Proportioning: Mix the right proportion of powder and liquid for proper attainment of properties.
- Mixing Time: The mixing time, as per the recommendation, shall yield a mix with the right consistency.
- Application: Cement should be applied uniformly to eliminate air bubbles and to ensure wettability.
Placement and Setting
Place the restoration, allowing the cement to set:
- Proper Positioning: The restoration should be properly positioned before the setting of the cement.
- Initial Set: The cement should be allowed to have its initial set before the excess is removed.
- Final Set: The cement should be on its final set before the restoration is allowed to experience occlusal forces.
Post-Cementation Care
Immediate Care
After the cementation of the restoration, the patient should be informed about the immediate care:
- Avoid Chewing – Instruct the patient not to chew with the restoration for a certain period.
- Oral Hygiene – Educate the patient about the oral hygiene measures and their importance in preventing marginal leakage and secondary caries
In Closure
The proper selection of dental cement is critically important to successful restorative dentistry. Tips to consider in the selection process include types of dental cement, properties including bonding mechanism and retention, solubility and washout resistance and assessment of clinical need are important. It is also essential to know the types of dental cement and how to use each class in the clinic before choosing the proper adhesive cement for each restoration. Technique while applying cement in the right way is also essential for the durability and stability of dental restorations. So Keep in mind these tips whenever you think about getting dental restoration.
