Luting agents in prosthodontics and their effects

Luting in prosthodontics

1. LUTING CEMENTS IN PROSTHODONTICS Presented BY: Dr P Balaswamy 1 st MDS, Department of prosthodontics, Sibar institute of dental sciences

2. Previous Questions Discuss recent developments in luting agents (10M) Scope and limitations of luting agents used in fixed partial dentures 20M (RGUHS 2005) Critically evaluate different luting agents ( 20M) Give a brief account of luting agents used in dentistry 20M (June 2004) Current status of luting cements 100M (Dec 2004) 5/22/2023 Luting Cements Prosthodontics-103 2

3. Contents Introduction Key terms Ideal properties of dental cements Mechanism of retention Classification of Dental Cements Temporary luting agents Permanent luting agents Luting agents for Dental Implants Cementation Procedure Cementation Failures Recent Advances Conclusion References 5/22/2023 Luting Cements Prosthodontics-103 3

4. Introduction 5/22/2023 Luting Cements Prosthodontics-103 4

5. Key terms 5/22/2023 Luting Cements Prosthodontics-103 5

6. 5/22/2023 Luting Cements Prosthodontics-103 6

7. Ideal Properties of Dental cements Biologic Esthetic Mechanical 5/22/2023 Luting Cements Prosthodontics-103 7

8. Biocompatibility : should be least interactive with body tissues, non toxic , non pulp irritant . Caries and plaque inhibition : desirably they should possess antimicrobial properties, should prevent caries and plaque 5/22/2023 Luting Cements Prosthodontics-103 8 Ideal Biologic Properties

9. Compressive strength : According to ADA specification water based luting cements should have minimum strength of 70 Mpa at 24 hrs. Other properties like diametral tensile strength, flexural strength, fracture toughness, hardness testing should be as high as possible Modulus of elasticity should be as much as dentine i.e 13.7 Gpa . 5/22/2023 Luting Cements Prosthodontics-103 9 Ideal Mechanical Properties

10. Solubility : should be as low as possible, according to ANSI /ADA specification it should be maximum of 0.2 % of weight in water. Adhesion to tooth structure and restorative materials is desired. 5/22/2023 Luting Cements Prosthodontics-103 10

11. Ideal Working Properties Film thickness : According to ANSI /ADA specification it is should be maximum of 25 micron . More film thickness may lead to clinical problems in attaining complete restoration seating ,tilting of castings, decrease in retention. Working time: should be long to allow easy manipulation. Setting time: should be short 5/22/2023 Luting Cements Prosthodontics-103 11

12. Esthetic Properties Color stability : more color stable materials are desired , to maintain esthetics. Translucent Radiopacity : Ideal cement should be radioopaque to enable practitioner to distinguish between cement line and recurrent caries as well as cement overhangs 5/22/2023 Luting Cements Prosthodontics-103 12

13. Described by McLean and Wilson Low viscosity and film thickness Long working time with rapid set at mouth temperature Good resistance to aqueous or acid attack High compressive and tensile strength Resistance to plastic deformation Adhesion to tooth structure and restoration Cariostatic Biologically compatible with pulp Translucency Radio opacity 5/22/2023 Luting Cements Prosthodontics-103 13

14. Mechanism of retention 5/22/2023 Luting Cements Prosthodontics-103 14 Non- adhesive luting Micromechanical Bonding Molecular Adhesion

15. Classification of Dental Cements 5/22/2023 Luting Cements Prosthodontics-103 15

16. Classification of Dental Cements 5/22/2023 Luting Cements Prosthodontics-103 16

17. Classification of Dental Cements 5/22/2023 Luting Cements Prosthodontics-103 17

18. 5/22/2023 Luting Cements Prosthodontics-103 18 Dental Cements - A Review to Proper Selection; John Paul, Int.J.Curr.Microbiol.App.Sci (2015) 4(2): 659-669

19. temporary Luting agents 5/22/2023 Luting Cements Prosthodontics-103 19

20. Zinc Oxide Eugenol Commonly used intermediate restorative material. Chisolm (1873) introduced zinc oxide & clove oil. Developed by Dr. J. Foster Flagg in 1875 . Commercial Products: 5/22/2023 Luting Cements Prosthodontics-103 20

21. ZOE Composition Powder Liquid Zinc oxide (69%) Eugenol White rosin (29%) Clove oil Zinc stearate & acetate Alumina EBA 5/22/2023 Luting Cements Prosthodontics-103 21 Powder Liquid Zinc oxide Aromatic oils, Olive oil Alumina Petrolatum Jelly Oliec acid, bee wax Non- Eugenol Composition

22. Setting Reaction Acid- base Reaction – CHELATION ZnO+2 Eugenol Zinc eugenolate (amorphous form ) Properties: Film thickness: 16- 28µm Setting time: 2 mins Compressive strength: 35 MPa 5/22/2023 Luting Cements Prosthodontics-103 22 Water

23. Advantages Obtunding effect on pulp Can be used in cases where retrievability is important EBA & Al modified ZOE are clinically successful for long term cementation. Disadvantages Low CS Higher film thickness Softens the provisional crowns. High disintegration rate Contamination of preparation with eugenol can inhibit the polymerization of certain resin composites. 5/22/2023 Luting Cements Prosthodontics-103 23

24. Modifications: Use of vanillic acid Addition cured silicone based Zinc oxide cement with silane agent Eugenol free cement with calcium hydroxide, flourides , potassium nitrate, chlorhexidine etc 5/22/2023 Luting Cements Prosthodontics-103 24

25. Resin based temporary Used where greater bonding strength is needed- larger temporary unit span Not to be used for inlay/ onlays /trial cementation of final restorations. Silicone based Easy removal of intra- oral excess Superior adhesion Slight “rubbery” consistency No heat generation High degree of bio- compatability Short setting time 5/22/2023 Luting Cements Prosthodontics-103 25

26. PreVISION Eugenol -free Silicone-based Poor marginal integrity Difficult to remove excess Moisture sensitive → premature set 5/22/2023 Luting Cements Prosthodontics-103 26

27. Temposil Addition-cured silicone based zinc oxide temporary cement with a silane agent for optimal adhesion and superior marginal integrity. Working time- maximum 50 seconds Oral-setting time - 2 minutes Advantages: Removal of excess is easy intra-orally. Handling with the 5ml Automix Syringe Excellent marginal integrity Radiopaque 5/22/2023 Luting Cements Prosthodontics-103 27

28. 5/22/2023 Luting Cements Prosthodontics-103 28

29. Tempgrip Temporary crown & bridge, Zinc non- Eugenol   Advantages: Smooth seating  Easy removal Short setting time Low film thickness with high CS Does not influence the setting of resin based filling and luting materials 5/22/2023 Luting Cements Prosthodontics-103 29

30. Systemp.link (Ivoclar Vivadent) Temp-Bond Clear (Kerr) ImProv (Nobel Biocare) Premier Implant Cement (Premier Dental Products) SensiTemp Resin (Sultan Healthcare)   5/22/2023 Luting Cements Prosthodontics-103 30

31. The ADA Professional Product Review  (2011) Type of clinical application Appropriate working and setting time Degree of adhesion to dentin and enamel Ease of mixing and dispensing Ease of application and removal after setting Biocompatibility with other restoratives, pulp, and soft tissues Sensitivity to moisture during and after setting Viscosity for handling and application Solubility Erosion Strength Toughness Stiffness (elastic modulus) 5/22/2023 Luting Cements Prosthodontics-103 31 ADA Professional Product Review . Temporary Cements. 2011;6(1):13-16

32. Factors to be considered before provisional cement selection How long is the provisional to remain in place? How retentive is the preparation? Is an adhesive technique to be used for cementation of the permanent restoration? Is the clinician working in an aesthetic zone? 5/22/2023 Luting Cements Prosthodontics-103 32

33. Permanent luting agents 5/22/2023 Luting Cements Prosthodontics-103 33

34. Zinc Phosphate Cement One of the oldest cementation agents. Has the longest track record. Serves as a standard by which newer systems can be compared. Composition: 5/22/2023 Luting Cements Prosthodontics-103 34 Powder Liquid Zinc oxide – 90.2% Phosphoric acid-38.2% Magnesium oxide- 8.2% Water-36% Other oxides – 0.2% Al/Zn phosphate- 16.2% Silica – 1.4% Aluminium-2.5% Zinc- 7.1%

35. ADA Spa. No. 96 . designates them as: Type I: Fine grained for luting . Film thickness should be 25micrometer. Type II: Medium grained for luting and filling . Film thickness should not more than 40micrometer. 5/22/2023 Luting Cements Prosthodontics-103 35

36. Setting Reaction Acid –base and Exothermic reaction. Crystals of hopeite Zn 3 (po 4 ) 2 or tertiary zinc phosphate, are found on the surface of the cement. 5/22/2023 Luting Cements Prosthodontics-103 36

37. Manipulation Supplied in powder and liquid form. P/L Ratio: 1.4gm/0.5ml Liquid should be dispensed just before mixing 5/22/2023 Luting Cements Prosthodontics-103 37

38. 5/22/2023 Luting Cements Prosthodontics-103 38

39. 5/22/2023 Luting Cements Prosthodontics-103 39 Mixing time: 60-90 seconds Working time : 2.5 to 8 minutes Frozen slab method: 4-11 minutes Setting time :5-9 min

40. Properties Film thickness : 25 μ ( luting ) Setting time : 5-9 mins Compressive strength : 96-110Mpa pH of newly mixed zinc phosphate is less than 2.0 but rises to 5.9 within 24 hours and is neutral (pH 7.0) by 48 hours . 5/22/2023 Luting Cements Prosthodontics-103 40

41. Commercial names: Advantages: Long record of clinical acceptability. High compressive strength. Acceptably thin film thickness. 5/22/2023 Luting Cements Prosthodontics-103 41

42. Drawbacks Does not bond to the tooth structure Increased clinical solubility No anticariogenic effect Hydraulic pressure of cementation can cause pulpal irritation Both thermal & chemical injury Post-cementation sensitivity 5/22/2023 Luting Cements Prosthodontics-103 42

43. Zinc Polycarboxylate Cement Also called as Zinc Polyacrylate cement/ Carboxylate cement Developed by Dennis Smith in 1968 First cement developed which achieved a chemical bond to tooth structure Mode of supply: Powder and liquid system Powder which is to be mixed with water Pre-capsulated P/L system 5/22/2023 Luting Cements Prosthodontics-103 43

44. Composition : Setting Reaction: Zinc oxide + Polyacrylic acid → Zinc Polyacrylate 5/22/2023 Luting Cements Prosthodontics-103 44 Powder Liquid Zinc oxide – 90% Aqueous solution of poly acrylic acid (OR) Co-polymer of acrylic acid w ith other carboxylic acids such as itaconic , malic acid.. Magnesium oxide- 10% Other oxides– small amounts Stannous flouride

45. Manipulation P/L ratio : 1.5: 1 Mix polyacrylate cement within 30 to 60 seconds The mixed cement is pseudoplastic Under no circumstances should the liquid be cooled in a refrigerator Working time :2.5 minutes Setting time :6 to 9 minutes 5/22/2023 Luting Cements Prosthodontics-103 45

46. Commercial Products 5/22/2023 Luting Cements Prosthodontics-103 46

47. Properties ANSI/ADA Specification No . 61 Film thickness : 25-48 μ m Compressive strength : 57 to 99 Mpa ( ZnP - 98 to 133 MPa ) Tensile strength : 40% higher than that of ZnP Bonds to tooth structure Bond strength to enamel : 3.4 – 13 Mpa , Dentine :2.1 Mpa Acidicity : slightly more acidic than ZnP but doesnot penetrate to pulp. Forms reparative dentin. Thixotropic 5/22/2023 Luting Cements Prosthodontics-103 47

48. Advantages: Chemical bonding to tooth structure Pulp friendly Drawbacks: High solubility Shorter WT Tooth requires conditioning before cementation Not anticariogenic even powder contains SnF Plastic deformation makes it unsuitable for high stresses 5/22/2023 Luting Cements Prosthodontics-103 48

49. In a study conducted by Pooja Garg et al to compare the retentiveness of a luting agent designed for use with dental implants, following were compared. Resin-bonded zinc oxide– eugenol cement Zinc phosphate cement Zinc polycarboxylate cement, and Glass- ionomer cement Results showed that retention provided by polycarboxylate cement was significantly greater than that of all other luting agents. 5/22/2023 Luting Cements Prosthodontics-103 49 Pooja Garg et al, Retentiveness of Various Luting Agents Used with Implant-Supported Prostheses: A Preliminary In Vitro Study, Int J Prosthodont 2013;26:82–84.

50. Glass Ionomer Cement First developed by Wilson and Kent in 1972 Also called as the Polyalkenoate cement ASPA- Alumino Silicate Polyacrylic Acid cement Sometimes referred to as the “white knight of contemporary dental materials”. One of the most reliable cements of all time. Composition : Powder : Silica, Alumina, AlF3,CaF2, NaF , AlPO4 Liquid: Polyacrylic acid, Tartaric acid & Water 5/22/2023 Luting Cements Prosthodontics-103 50

51. Types of Glass ionomer cements Based on chemical composition 2 types of Glass ionomer : Glass- ionomer cement Glass polyalkenoates Glass polyphosphonates Glass- ionomer hybrid materials- Resin modified glass- ionomer Based on types of cure : Autocure : Chemical cure – acid-base reaction Dualcure : Light initiation followed by acid-base reaction Tricure : Autocure resin reaction in remaining uncured resin 5/22/2023 Luting Cements Prosthodontics-103 51

52. Setting Reaction 1. Dissolution 2.Gelation/ cross- linking 3.Maturation 4.Hardening 5/22/2023 Luting Cements Prosthodontics-103 52

53. Manipulation 5/22/2023 Luting Cements Prosthodontics-103 Mixing done with Plastic spatula Dispensing the P & L Glossy structure

54. Properties Mixing time : 30-60 secs Working time : 2 mins at room temp Setting time : 6-8 mins Very sensitive to contact with water Compressive Strength(24 hr): 90-230 Mpa Elastic modulus is lesser than that of ZnP 5/22/2023 Luting Cements Prosthodontics-103 54

55. Advantages: Adheres to tooth Flouride release Adequate strength and easy to mix Disadvantages: Moisture intolerance during setting History of post-operative sensitivity Difficult to clean up Low fracture toughness No adhesion to restorations 5/22/2023 Luting Cements Prosthodontics-103 55

56. Water settable GIC’s Polyacids have been dehydrated and added to their powders. This is done by the manufacturer to lengthen shelf life . The liquid of these cements is tartaric acid or distilled water. E.g., Ketac-Cem (3M ESPE) 5/22/2023 Luting Cements Prosthodontics-103 56

57. Hybrid/ Resin modified GIC’s Developed in the late 80s by adding resin into GIC. 80% GIC and 20% resin. The qualities of RMGIC are between conventional glass ionomer cements and composite resins which means RMGIC is a hybrid material . 5/22/2023 Luting Cements Prosthodontics-103 57

58. Self and light cure GIC’s Initially introduced as light-activated liners/bases & later as dual-activated restorative materials . Greater tensile strength and are less brittle Less soluble, & are less sensitive to moisture contamination & desiccation and lesser microleakage . 5/22/2023 Luting Cements Prosthodontics-103 58

59. Self- cure Composition Powder Liquid Fluroaluminosilicate glass Aqueous solution of polycarboxylic acid modified with pendant methacrylate groups Potassium persulfate HEMA Ascorbic acid Tartaric Acid 5/22/2023 Luting Cements Prosthodontics-103 59 Powder Liquid Fluroaluminosilicate glass Copolymer of acrylic & maleic acids HEMA Water, camphoroquinone & activator Light- cure Composition

60. Compomers Structure & physical qualities COMPOSITES Flouride releasing capacity GIC No salt matrix and hydrogel are formed. Hence their fluoride release is restricted. Advantages : Greater compressive strength With their unique bonding agents, they bond to the hard tissue of tooth. 5/22/2023 Luting Cements Prosthodontics-103 60

61. Resin Cements Resin cements are one type of composites consisting of three phases that are structurally different; organic phase, inorganic phase and inter phase . Biological compatibility and physical qualities of resin cements depend on curing mechanism of resin. The ISO specification 4049 (2009) classified resin cements according to curing mode as class 1 (self-cured) class 2 (light-cured) class 3 (dual-cured) 5/22/2023 Luting Cements Prosthodontics-103 61

62. Composition 5/22/2023 Luting Cements Prosthodontics-103 62 Type of curing Mode of supply Initiator Accelerator Chemically activated 2 paste system Benzoyl peroxide Tertiary amine Light cure single paste system Camphorquinone Aliphatic amine Dual cure two paste or powder-liquid form Camphorquinone (polymerization starter) Peroxytamine (chemical activator)

63. Advantages Adhesion is created via micromechanical interlocking of resin to hybrid layer. High wear resistance, less solubility, esthetic . SO USED FOR ALL CERAMIC RESTORATIONS Disadvantages Greater film thickness Pulpal biocompatibility is doubtful in deep penetrations Technique sensitive High cost Flouride release not great 5/22/2023 Luting Cements Prosthodontics-103 63

64. Adhesive luting Agents Traditional adhesive systems: (‘Etch and rinse' adhesives) a. Three-bottle systems (3 step) 5/22/2023 Luting Cements Prosthodontics-103 64 Conditioning Primer Bonding Agent

65. Two bottle system/ 2 step/ one bottle adhesive: Composition conditioner (usually 30-40% phosphoric acid), which is rinsed away after 15-30 seconds; combined primer and adhesive (usually in solvent) 5/22/2023 Luting Cements Prosthodontics-103 65

66. Advantages: Basic features of the three-step systems Application procedure simpler with one less step Possibility of single dose packaging Relatively durable bond Disadvantages: Technique sensitive (multiple layers) Risk of too thin bonding layer, reducing bond durability Phase separation may compromise adhesion to dentine 5/22/2023 Luting Cements Prosthodontics-103 66

67. Self etching adhesives (SEAs) 2 bottle All in one adhesive system They can be mild, intermediary or strong depending on etching. Strong SEA’s - pH 1 or less Mild SEA’s - use acidic monomers of approximately pH 2 and form a thin hybrid layer of 0.5-1 µm. 5/22/2023 Luting Cements Prosthodontics-103 67

68. All-in-one Adhesive System 5/22/2023 Luting Cements Prosthodontics-103 68

69. All-in-one Adhesive System Intended to fulfil the three functions of the traditional three-bottle systems. Contain significant amounts of water and form incomplete layers, allowing the passage of fluids through the adhesive. Acidity is likely to inhibit the setting of resin luting cements. 5/22/2023 Luting Cements Prosthodontics-103 69

70. The acidity of the cement is strong enough to promote hybridization with the tooth structure. Need no conditioning Beneficial for luting posts Involve a single cementation stage Rarely associated with post cementation sensitivity 5/22/2023 Luting Cements Prosthodontics-103 70

71. Bonding of Self Adhesive Cements Micromechanical retention & chemical interaction between acidic groups and Ca ions of hydroxyapatite . Alternative to GIC for high strength restorations but not ideal for veneers, inlays, partial crowns. Self-adhesive cements have been reported to perform equally effective when compared with most conventional resin cements 5/22/2023 Luting Cements Prosthodontics-103 71

72. Bonding of All ceramics 2 mechanisms 1. Micromechanical attachment to porosity originated from HF acid etching 2. Grit blasting associated with silane coupling agent 5/22/2023 Luting Cements Prosthodontics-103 72

73. Cement Rankings Compressive Strength (highest to lowest): resin; glass ionomer ; zinc phosphate; polycarboxylate ; ZOE Solubility (lowest to highest): resin; glass ionomer ; zinc phosphate; polycarboxylate ; ZOE 5/22/2023 Luting Cements Prosthodontics-103 73

74. Luting agents for Implant supported FPD 5/22/2023 Luting Cements Prosthodontics-103 74

75. Premier Implant Cement Designed specifically for implant-retained crowns and is suitable for temporary cementation of provisional  restorations where long-term or increased retention is desired. Made from a tough elastomeric resin. The radiopacity helps in detection of excess cement.   5/22/2023 Luting Cements Prosthodontics-103 75

76. Premier® Implant Cement 5/22/2023 Luting Cements Prosthodontics-103 76

77. Retrieve™ Implant Cement Provides long-term cementation of restoration to implant abutment. No bonding, priming or etching required. Fully cured cement exhibits slight elasticity. Convenient gel stage after two minutes for easy clean-up around the margins . 5/22/2023 Luting Cements Prosthodontics-103 77 Ref: http://www.parkell.com/products/390/Retrieve-Implant-Cement-Kit

78. Improv ® Temporary Implant Cement Urethane resin based cement Ideal temporary cement for both implants & natural teeth. Dual barrel delivery syringe eliminates inaccuracy & the mess of two tube mixing. Eugenol free.... Easily removed from both hard & soft tissues. 5/22/2023 Luting Cements Prosthodontics-103 78

79. Cementation Procedure The preparations are thoroughly cleaned; all interim luting agent should be removed 5/22/2023 Luting Cements Prosthodontics-103 79

80. Cementation Procedure 5/22/2023 Luting Cements Prosthodontics-103 80 The restorations are seated, and a readily accessible area of the margin is examined with an explorer. The restorations are thoroughly cleaned with airborne particle abrasion, steam cleaning/ ultrasonics .

81. Cementation Procedure 5/22/2023 Luting Cements Prosthodontics-103 81 The luting agent is mixed according to the manufacturer’s recommendations.

82. Cementation Procedure The restorations are seated to place with a firm rocking pressure 5/22/2023 Luting Cements Prosthodontics-103 82 The accessible margin area is quickly re-examined to ensure complete seating

83. Cementation Procedure Once the luting agent has completely set, all excess is removed 5/22/2023 Luting Cements Prosthodontics-103 83

84. Removal of excess cement Most popular being wiping with a cotton pellet directly after cementation and ‘‘flicking-off’’ with a hand instrument or scalpel after initial polymerization of the luting cement. Removal of excess cement can also be done with number 15 scalpel blade, superfine diamond points, extra-fine tungsten carbide 12- bladed burs, flexible abrasive disks, and 30-mm grit diamond finishing bur . 5/22/2023 Luting Cements Prosthodontics-103 84

85. Cementation Procedure For All Ceramic Crowns After being sandblasted with 50-μm Al2O3 particles, the internal surface of the crown is etched with 9.5% hydrofluoric acid for 20 s 5/22/2023 Luting Cements Prosthodontics-103 85 View of the internal surface of a crown after etching with 9.5% hydrofluoric acid. The crown is opaque white.

86. 5/22/2023 Luting Cements Prosthodontics-103 86 Silane is applied to the crown Gingival retraction cord is placed The adjacent teeth are protected with Teflon tape

87. The gingival retraction cord is removed 5/22/2023 Luting Cements Prosthodontics-103 87 The tooth is etched with 37% phosphoric acid Resin cement is applied

88. Shade 5/22/2023 Luting Cements Prosthodontics-103 88

89. 5/22/2023 Luting Cements Prosthodontics-103 89 Self-adhesive Resin Cements: A Literature Review; Radovic et.al, J Adhes Dent 2008; 10: 251-258

90. 5/22/2023 Luting Cements Prosthodontics-103 90 Cementing all-ceramic restorations; Varghas et.al, JADA 2011;142(4 suppl ):20S-24S

91. Cementation failures Causes of cement failure: Cement selection Old cement Prolonged mixing time Thin mix or Thick mix 5/22/2023 Luting Cements Prosthodontics-103 91

92. Cement setting prior to seating Inadequate isolation Incomplete removal of temporary cement Inclusion of cotton fibres Insufficient finger pressure causing incomplete seating Inadequate removal of excess cement 5/22/2023 Luting Cements Prosthodontics-103 92

93. Basic modes of failures: Cohesive fracture of the cement Separation along the interfaces 5/22/2023 Luting Cements Prosthodontics-103 93

94. Factors that influence retention of FPD: First, the film thickness beneath the prosthesis should be thin. Second, the cement should have high strength values. Third, the dimensional changes occurring in the cement during setting should be minimized. Fourth, a cement with the potential of chemically bonding to the tooth and prosthetic surfaces or bond- enhancing intermediate layers may be used to reduce the potential of separation at the interface and maximize the effect of the inherent strength on the retention. 5/22/2023 Luting Cements Prosthodontics-103 94

95. Recent Advances Fluorescent sensors being added to luting agent. Detect any change in the matrix by color change . Microleakage and recurrent caries can be detected easily. Phosphophoryns are being tried out to aid in remineralization . They are dentin matrix proteins which aid in faster recovery of tooth from caries. 5/22/2023 Luting Cements Prosthodontics-103 95

96. Recent Advances Polyethylene glycol is also being used as a coating on HEMA in resin cements. Establishes a biocompatible layer between the luting agent and tooth. Alkaline phosphatase is added to HEMA to improve the remineralization of tooth. 5/22/2023 Luting Cements Prosthodontics-103 96

97. 5/22/2023 Luting Cements Prosthodontics-103 97

98. Conclusion 5/22/2023 Luting Cements Prosthodontics-103 98

99. CONCLUSION 5/22/2023 Luting Cements Prosthodontics-103 99

100. References Phillips RW. Skinner’s science of dental materials. 11 th ed. Philadelphia: W.B Saunders; 2005. p. 443-90. Craig RG. Restorative dental materials. 12thed. St. Louis: Mosby; 2003. Rosensteil FS, Land FM, Fujimoto J: Contemporary fixed prosthodontics , 4 th ed. St. Louis, Elsevier,2011 Shillingburg TH et al.,: Fundamentals of fixed prosthodontics , 3 rd ed. Carol Stream, Quintessence, 1997 5/22/2023 Luting Cements Prosthodontics-103 100

101. Cornelis H. Pameijer , A Review of Luting Agents IJD,2012 1-8. Pooja Garg et al, Retentiveness of Various Luting Agents Used with Implant-Supported Prostheses: A Preliminary In Vitro Study, Int J Prosthodont 2013;26:82–84. Stephen F. Rosenstiel et al, Dental luting agents: A review of the current literature, J Prosthet Dent 1998;80:280-301. Self-adhesive Resin Cements: A Literature Review; Radovic et.al, J Adhes Dent 2008; 10: 251-258 5/22/2023 Luting Cements Prosthodontics-103 97

102. Cementing all-ceramic restorations; Varghas et.al, JADA 2011;142(4 suppl ):20S-24S Jose C. de la Macorra , Conventional and adhesive luting cements, Clin Oral Invest (2002) 6:198–204. Conventional and Contemporary Luting Cements: An Overview; Komal Ladha , Mahesh Verma , J Indian Prosthodont Soc ( Apr - June 2010) 10(2):79–88 Dental Cements - A Review to Proper Selection; John Paul, Int.J.Curr.Microbiol.App.Sci (2015) 4(2): 659-669 5/22/2023 Luting Cements Prosthodontics-103 102