Introduction

Dental cements are a classification of dental materials that are continually used in dentistry. The American Dental Association (ADA) and the International Standards Organization (ISO) have teamed up to classify dental cements according to their properties and intended uses in dentistry.

Classification of Cements

Type I : Luting agents that include permanent and temporary cements. Type II : Restorative applications. Type III : Liner or base applications.

Component :-

Zinc Oxide Eugenol

Chemical content

Liquid : Eugenol, H2O,

Acetic acid,
Zinc acetate Calcium chloride.

Powder : Zinc oxide, Magnesium oxide, Silica.

Zinc Oxide Eugenol

Advantages:
Good biological properties (pH 7 after setting) Antibacterial properties Sedative effect Fast setting in the mouth (presence of water) Ease to dislodge

Disadvantages:
Low strength, not adhesive High solubility in water

Types of Zinc-Oxide Eugenol

Type I

Lacks strength and long-term durability and is used for temporary cementation of provisional coverage.
Type II

Has reinforcing agents added and is used for the permanent cementation of cast restorations or appliances.

Supply of Zinc-Oxide Eugenol

Liquid / Powder Mixed on an oil-resistant paper pad. Mixing time ranges from 30 to 60 seconds. Setting time in the mouth ranges from 3 to 5 minutes. Paste

Supplied as a two-paste system as temporary cement Pastes are dispensed in equal lengths on a paper pad and mixed.

Modified zinc oxide-eugenol Ethoxybenzoic acid (EBA) cements

Incorporation of ethoxybenzoic acid (EBA) increases strength of ZOE cements

Reinforced ZOE
IRM ( Intermediary Restorative Material ) Non-irritating to the pulp Low compressive strength 8,000 lbs/sq. in. Does not bond to tooth structure Stimulates reparative dentin formation

REVIEW OF LITERATURE

Few studies have reported that ZnOE sets into a harder cement that resists resorption when extruded beyond the apices. Investigation by Mani et al reported 67% of all overfilled canals showed over-retained ZnOE at 6 months follow-up. Flaitz et al 1964reported that 20% of the permanent teeth showed deflection in case of overfilling of canals with ZnOE. Eransqun & Munuzabul 1972 reported that ZnOE irritates the periapical tissue of rats and may produce necrosis of bone 13 and cementum.

Months/years to resorb Grossman, 1974

woods, 1984 Jevell & Ronk 1982 reported that premolar eruption was arrested due to toxic effects of ZnOE. According to Reddy et al 1985 lack of ZnOEs antibacterial properties may aggravate residual infection of root canal instead of promoting healing of infected tissue. Coll et al 1992 reported it has no significant effect on exfoliation of primary teeth in any of the case.
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Goerig et al in their study reported that ZnOE when mixed with other root canal filling materials like calcium hydroxide & iodoform has good antimicrobial activity and resorption capabilities as when used alone. In 1985 Coll reported that ZnOE could alter the path of eruption of succedneous teeth.

Wright KJ 1994 did a study on comparison and antimicrobial effects of ZnOE & KRI paste (ZnOE+Iodoform). Results suggested that ZnOE has better antimicrobial activity then KRI 15 paste. It had lower cytotoxicity.

Coll et al 1998in their study reported that gross own filling was related to failure of pulpectomy with ZnOE. According to Sadiuan et al 2000 tooth overfilled with ZnOE and those filled up to the apex did not show resorption as compared to those which were filled 1 mm or short of the apex.

Holan et al 2001 reported that 100% of the tooth filled to the apex with KRI paste and 85% of those filled with ZnOE were successful and not statistically different.

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No difference was observed when the teeth were under filled with ZnOE or KRI paste.
Overfilling of canals, however, resulted in a much higher success rate of KRI (75%) then ZnOE (41%), which was statistically significant difference.

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ADVANTAGES:

Easily available. Radiopaque material. Cheaper/ cost effective. Effective antimicrobial agent. Also less cytotoxic to cells in direct or indirect contact. Good plasticity Insoluble in tissue fluids
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DISADVANTAGES:

Excessive filling - it leads to mild foreign body reaction. Muruzabul found that ZnOE cement was highly irritating to the periradicular tissues and caused necrosis of bone and cementum. Rate of resorption does not coincide with rate of resorption of root ( a little slow).

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Coll and Sadrian reported that ZnOE retained material alter the path of eruption of succedeneous teeth in 20% of cases. (However it has been shown that optimally filled and overfilled canals showed a statistically higher success rate compared to underfilled root canals). It has been found that Eugenol is not only cytotoxic but is neurotoxic also.

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MANIPULATION
It

consists of powder containing ZnO and liquid containing Eugenol. contains finely ground ZnO which enhances flow of cement. has been shown that 1 mm of ZnO Eugenol cement has a radiopacity corresponding to 4.5 mm of Aluminum sheet, which is slightly lower than G.P.
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Powder

It

 Resin

acids (Monobasic carboxylic acids) when mixed with ZnOE it renders it less soluble than regular ZnOE cement.
of paste when used for filling should be 1 scoop powder : 1 drop liquid. for temporary filling ZnOE cement should be 2:1.

Consistency

Consistency

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EUGENOL ALLERGY