LINERS

AND
BASES
 CONTENTS
Introduction
 Pulp-dentin organ irritants
 Dentin permeability to irritants
 Classification
 Objectives for protecting pulp dentin organ
 Ideal requirements of materials for pulp dentin protection
 Factors determining protective needs of restoration
 LINERS
• Classification
• Function
• Cavity Varnish
 Suspension Liners
 Bases
• Principles of intermediary basing
• Determination of effective depth
• Materials used for liners , Bases Sub Bases
• Zinc Oxide Eugenol
• Calcium hydroxide
• Glass Ionomer
• Zinc Phosphate
• Zinc Poly Carboxylate
• Mechanical Properties of Bases
• Flowable Composites
• Summary of clinical consideration
• Mineral trioxide aggregate
• Biodentin
• Resin modified calcium silicate
Conclusion
INTRODUCTION
• Most preparations involve dentin, majority of which is either irritated by disease process or
mechanical cavity preparation

• Since, the very presence of natural dentin minimises pulpal response to restorative treatment. It
would act as a barrier between restorative material and pulp

• However, the restorative material used might provide excellent properties of bulk, but not protect
the pulp during cyclic thermal and mechanical stressing

• Hence to prevent further irritation to pulp dentin organ and replace lost dentin - Liners , bases
are used
 PULP DENTIN IRRITANTS
TYPES OF STIMULUS EXAMPLES OF STIMULUS

Thermal Temp cycling in oral cavity

Thermal conductivity of restorative material
Frictional heat during tooth preparation

Mechanical Premature occlusal contact,

Condensation forces during restoration,
Pressure and vibrations during cavity preparation.

Chemical Acids

Electric Galvanic shock

 Factors influencing pulpal response to
dental restorative material :--
*Dentin Permiablility:-

 Location

 Smear layer

 Type and Nature of penetrants

 Intratubular material

 Reperative Dentin

 Remaining Dentin thickness (RDT)

• Reference :Marzouk))

6
 Dentin Permeability To Irritants
 Deficient resistance and retention form
 Micro leakage space
 Cracks and micro cracks in enamel and Dentin
 Type of Intermediary base / rest. material
 Desiccation of Dentin—(heat/air)

• (Reference: Marzouk)
CLASSIFICATION

 Agents that protect pulp dentin organ can be broadly classified into :

Varnishes Liners Bases

These are materials placed between dentin and restorative material to

provide pulpal protection .

8
 Objectives For Protecting Pulp Dentin Organ

 Thermal protection

 Mechanical protection

 Chemical protection

 Electrical protection

 Pulpal medication

9
 IDEAL REQUIREMENTS OF MATERIALS FOR PULP
DENTIN PROTECTION

 Should be capable of creating an impervious layer on cut vital dentin in

a thickness which neither impinges on the bulk of the restorative
material nor compromises the mechanical properties of the restorative
material

 Be biologically compatible with the pulp dentin organ.

 Be chemically compatible with the restorative material.

 Provide good seal & prevent penetration and growth of bacteria at the
tooth restoration interface

10
 IDEAL REQUIREMENTS OF MATERIALS FOR PULP
DENTIN PROTECTION

 Provide good chemical and thermal insulation

 Should provide galvanic insulation

 Adequate working time

 Be insoluble in the oral fluids

 Sufficient physical strength during insertion of the

restoration and during functioning in the oral environment

11
 Factors Determining Protective Needs Of
Restoration
 Depth of the cavity

 Type of restorative material (Composite - GIC, Ca(OH)2 base

; Amalgam -Ca(OH)2, ZOE base ; Gold -ZPC, Polycarboxylate
base used)

 Remaining Dentin Thickness(RDT)

12
LINERS
DEFINIITION:
1. Liners are relatively thin layers of material, used to provide a barrier
to protect dentin from residual reactants diffusing out of restoration
or from oral fluids that may penetrate leaky tooth-restoration
interfaces.
(Sturdevant)
2. Liners as a thin layer of “cement” used for protection of the pulp.
(Philips)

13
 CLASSIFICATION OF LINERS
Based on the film thickness liners can be further classified
as flows

LINERS

Thin liners Thick liners

(1-50μm) (200-1000μm)

Solution liner Suspension liner

(2-5μm) (20-25μm)

Aqueous Varnish
SOLUTION LINERS(Varnish)
 Thin film solution liners 2 to 5 µm
(Thickness does not exceed leakage space at tooth- restorative interface)

Film formed by : Resinous materials

• Natural gums or resins. e.g., copal or rosin

• Synthetic resins e g., nitrated cellulose or polystyrene.

Dissolved in volatile organic solvent , e.g, acetone, alcohol ,

chloroform

• Upon drying it will produce a thin film layer.

15
LAYERS OF VARNISH:
• 2 coats applied
– Single coating covers only 55%
of the surface
– because the smear layer is moist
and the varnish is hydrophobic.
– SO A SECOND LAYER IS NEEDED-
80-85%

• Time between 2 successive

applications: 15-20 seconds, to
allow it to dry
• Air ,vacuum or increase in
temperature will accelerate
evaporation of solvent.

16
Composition Of Cavity Varnish
solid 10 % Copal resin
solvent 90% Acetone ,alcohol

Mechanism:

applied to
solvent evaporates leaving film of
prepared tooth
resinous material
surface

17
Functions of Varnish
 It acts as a barrier and prevents passage of irritants into
the dentinal tubules
 Incase of amalgam restorations,
 they prevent penetration of corrosion products into
the dentinal tubules
 It reduces micro leakage around the margins of
newly placed amalgam restorations
 There by reducing post-operative sensitivity

 Provides electric insulation (galvanic shock)

18
5) Prevents penetration of acids from Zinc phosphate cement (chemical
insulation)

19
• Varnish does not make impervious layer on cut dentin

• Hinders penetration of 70% of acids and irritating elements from

restorative material or oral environment

ADVANTAGE: Under Silver amalgam and Zn PO4

Base decrease micro leakage

Semi Film may Completely

permeable reduce or partially
membrane cavity occupy micro
irregularities leakage space

20
 COMPATIBILITY WITH RESTORATIVE
MATERIAL

• Varnishes do not interfere with setting of permanent restorative

material

• Can be dissolved by monomeric or polymeric restorative materials

dark line unaesthetic

• Not affected by manipulative forces of restorative materials

• Physically and chemically compatible with other intermediary bases

except GIC and polycarboxylate

21
CONTRA INDICATIONS:

a) Composite Resin: free monomer layer dissolves the

varnish

b) GIC – varnish eliminates the potential for adhesion

and biocompatibility of the cement

c) Poly carboxylate :varnish interferes with adhesion of

PCC

22
 SUSPENSION LINERS
Liners based on water and whose constituents are suspended and not
dissolved.
• Liners are volatile or aqueous suspension of zinc oxide Or calcium
hydroxide that can be applied to cavity surface in thin film.
• Neither posses strength nor provide thermal insulation.
• Hard setting ca(OH) 2
• ZOE
• GIC liners
• Placed in thickness of 0.5mm have adequate strength to withstand the
condensation
23
Calcium hydroxide liners:

• Is a chief ingredient of many cavity liners.

• It is antimicrobial- and has alkaline ph so it stimulates
formation of sec. Dentin over injured pulp to protect it.
• As a cavity liners- Ca(OH)2 powder is suspended in a
solvent carrying a thickening agents.
• When it is placed on pulpal floor solvent evaporate
leaving a thin film of Ca(OH)2
 CALCIUM HYDROXIDE LINERS
• The most common way of introducing calcium hydroxide into the cavity preparation is through
calcium hydroxide cements.
• They are supplied
 in a two paste system.
 Powder /distilled water
 Light cured single paste system

Depending on number of Components

• Single paste. system
• Two paste system

25
25
CALCIUM HYDROXIDE LINERS

The acidic paste :

• Isobutyl Salicylate - 40%- Reactive ingredent
• Titanium Dioxide - 12-14% - Inert fillers
• Barium Sulphate - 32-35% - Radiopacifier
• Calcium Tungstate or Calcium Sulphate

They are supplied in a two The basic paste

paste system. • Calcium hydroxide 50-60% - reactive
COMPOSITION ingredient
• Zinc oxide 10% - reactive ingredient
• Zinc stearate 0.5% - accelerator
• Sulfonamides/paraffin oil- carrier
26
26
Setting reaction of Calcium Hydroxide
• The ingredient responsible for setting reaction are calcium hydroxide
and alkyl salicylate.
• On mixing alkyl salicylate with paste containing Zinc oxide and
calcium hydroxide
Amorphous Calcium Disalicylate is formed

 The Set mass is hydrolytically unstable and contains a large

percentage of unreacted calcium hydroxide.
Calcium ions, hydroxyl ions and salicylate ions are released continuously
from the mass.

The release is mostly controlled by the percentage to The continuous

phase and the type of plasticizer (sulphonamides allows more erosion
and ion release than paraffin oil

27
• Single paste /the light cured calcium hydroxide
composes of :
• Urethane dimethacrylate .Eg Bis
GMA(initiator) &

• Visible light (Accelerator)

• Hydroxy ethyl methacrylate (HEMA)

• Calcium hydroxide

• Barium sulphate

• all these ingredients are dispensed in

ethylene toulene sulfonamide of 39.5%

28 28
Action of Calcium Hydroxide
1. Alkaline PH (12)- neutralises acid released from bacteria
and cement.
2. helps in formation of reparative dentin.
3. Has antibacterial action.

29
 In a study on, Adaptation of two different calcium hydroxide bases
under a composite restoration.
o chemically cured calcium hydroxide –Dycal
o Light cured-Prisma VLC Dycal

• Prisma VLC Dycal base was found to be pulled away from the dentine
floor of the cavity as a result of an apparent adhesion to the
composite resin during polymerization contraction.
• Dycal was better adapted to the cavity floor

• Disorganization of the resin-bonded Prisma VLC Dycal was minimal

even after acid etching the enamel
• Dycal appeared to be more friable, and occasionally exhibited marked
disorganization
 Biological compatibility of calcium
hydroxide with the pulp-dentin organ
• Calcium hydroxide is an irritant to the pulp-dentin organ, if it comes in direct contact with it.

• Provided the pulp and the periapical tissues are healthy and devoid of any degeneration, the
following Pulpal reaction to calcium hydroxide can occur:
100 Microns or more Healthy reparative dentin
less than 100 microns unhealthy reparative reaction

. When calcium hydroxide comes in contact with the pulp or root canals the area of tissues in direct
contact would undergo chemical necrosis.

31
• Also calcium hydroxide can stimulate the formation barrier when in
direct contact thus decreasing the permeability of the dentin.

• Ca (OH)2 is porous but permeability reduced to some extent by its

neutralizing effect(on acids from restoration),that would penetrate
dentin.

• If used in sufficiently thick layers’ they provide some thermal insulation.

However, a thickness greater than 0.5mm in not recommended.
Thermal protection should be provided with a separate base.

• Calcium hydroxide in any form is not an electrical insulator at any

thickness.

32
33
Compatibility of calcium hydroxide with
restorative materials
• Indicated :base/sub base under the amalgam and direct tooth-colored
materials

• but when used under the direct filling gold and cast restorations calcium
hydroxide should be covered with zinc phosphate or polycarboxylate
cement.

• Calcium hydroxide in methylcellulose, reacts with the zinc oxide eugenol

and hence not used together

34
• No effect on the setting reaction or the properties of any permanent
restorative material.

• It does not discolor any permanent restorative material.

• With thin cross-sections tooth colored materials, calcium hydroxide will

show through as a chalky patch.

35
• Liner doesn't have any mechanical or thermal
properties
• But it can neutralize acid that migrates towards pulp
and in the process it induces formation of sec. Dentin.
• Ca(OH)2 is soluble in water so, must not be left on
margins of prepared cavity or margins will not properly
sealed.
DEFINIITION: BASES
1.Materials that provide thermal protection to the pulp, and mechanical
support to restoration by distributing local stresses from the restoration
across the underlying dentin surface (Sturdevant)

2. Bases are applied in thick layers and must be strong enough to

support a restorative material during its placement and function, and
should offer thermal and electrical protection (from galvanic activity)
to the pulp. (Ferracane)

 Used directly on certain areas of dentin of the preparation

 May be used indirectly as supporting, retaining modes for sub bases
37
CLASSIFICATION
Based on strength bases are classified as:

HIGH STRENGTH LOW STRENGTH

• Glass Ionomer • Calcium hydroxide
• Hybrid ionomer (light cured
• Polymer reinforced ZOE &a
(type III) mp;amp;amp;amp;amp;
amp;amp;amp;amp;am
• Zinc phosphate
p;amp;amp;amp; self
• Zincpolycarboxylate cured)
• Zinc oxide eugenol
(Type IV)

38
Mechanical Properties of bases

0.58
Determination of effective depth

Effective depth in radiograph = Actual effective depth

.
.
Enamel Thickness in radiograph Actual enamel thickness

Actual effective depth= Eff.depth in Rg X Actual enamel thickness

Enamel thickness in radiograph

Disadvantages:
Rg is taken after excavating all reparable margin
2Dimensional measure rather than 3 dimensional

41
Materials used as Liners and bases

42
ZINC OXIDE EUGENOL
Type III-Bases
Type IV- Cavity Liners

Powder and Liquid

2 paste system

Eugenol
solution
Setting Reaction:
 ZnO + H2O Zn (OH)2
Zn hydroxide
Zn (OH)2 + 2HE ZnE2 + 2H2O
Base Acid Zn – eugenolate salt
43
 Unmodified ZOE- therapeutic agent only
Modified ZOE: Used as Base

Modifications in basic composition

(strength improved)
1. EBA -Alumina modified cements are
added increases the strength of the
cement

2. RESIN REINFORCED

 POLYMER REINFORCED

polymer particles and ZnO surface treated with

carboxylic acid increases strength and abrasive
resistance 44
PROPERTIES :
• Setting time : 4-10mins
• Compressive strength (after 24hrs): • Least irritating of all dental
5 - 55 MPa materials.
• Thermal conductivity :excellent,
same as that of dentin • ZOE should not be placed in
• Coefficient of thermal direct contact with the pulp
expansion:35×10-6/°C (dehydrating effect-desiccation)
• Film thickness: 25um higher than Ca(OH) liner places before ZOE
other cements
• Excellent marginal seal
• Solubility and disintegration:
highest among all cement(0.04% by • ZOE has thermal insulating
weight) properties that are similar to
dentine I. e coefficient of
• pH of approximately 7 thermal expansion is high
• Pulp response: mild least irritating
 Setting time of ZOE and factors affecting it:

Acceleration of set achieved by 1. Incorporating chemical accelerators in mix

2. Increasing P/L ratio

3. Increasing percentage of rosin and fillers

4. Increasing temperature

5. Introducing greater energy in mixing

6. Reducing powder particle size

7. Adding water to original mix, after mixing is complete and

seated into preparation

46
Actions:
1. Insulate and seal pulp dentin organ

2. Reduce micro leakage

3. Exerts palliative effect on Pulp

4. Anti inflammatory effect

5. Anti bacterial action

6. Anti septic action

47
BIOLOGIC COMPATIBILITY WITH PULP
DENTIN ORGAN:
• Least irritating to the P-D organ of all the intermediary base materials

 Whenever there is any effective depth between the unmodified ZOE and the
pupal tissue will have healthy reparative reaction

• Can create a completely impervious layer to elements normally present in

the oral environment, if it is applied in 0.5mm thickness, provided it is not
disturbed either mechanically or by dissolution

• Does not increase penetrability of underlying dentin

• Excellent thermal insulator with a coefficient of thermal conductivity,

(1.67 W/m.K) slightly less than that of tooth structure, 0.25mm thickness is
sufficient to impart this property

48
 COMPATIBILITY WITH OTHER BASE MATERIALS AND
RESTORATIVE MATERIALS
• The eugenol of ZOE interferes with the setting reaction of any polymer and,
to some extent, can even depolymerize already set polymeric materials.

• If ZOE is the only pulp protecting agent to be used, it should be covered

with zinc phosphate cement to minimize the amount of eugenol seeping to
the resinous restorative material

• In amalgam, direct gold, and cast alloy restorations, unmodified ZOE is not
sufficiently rigid, tough, or durable so when used a as liner, it should be
covered with a modified ZOE or Zinc phosphate cement base

• Zinc oxide and eugenol can interfere with the setting of polycarboyxlate
cements, glass ionomer cements and methyl cellulose carried calcium
hydroxide if they polymerize in contact with it
 Dentin Substitute GLASS IONOMER
Man-made Dentin
Artificial dentin

• Also called ‘ Glass Polyalkeonate Cement’

(Calcium or Strontium Aluminoflurosilicate glass powder combined with a
water soluble polymer(acid))

CLASSIFICATION:
I. Based on their usage (Wilson and McLean) :
• TYPE 1: FOR LUTING
• TYPE 2: FOR RESTORATIVE PURPOSES
• TYPE 3: FOR LINER AND BASE APPLICATIONS

50
Supplied as
 Powder –liquid system
 2 paste system
 Capsules
 Light cure system
51
Adhesion to tooth:

Setting reaction:
• POWDER

53
Setting Action:
When the powder & liquid are mixed, Surface of glass particles are
attacked by acid.
Ca, Al, sodium, & fluoride ions are leached into aqueous medium.
Calcium poly salts are formed first, then followed by aluminum poly
salts which cross link with poly anion chain.
54
 Set cement consist of unreacted powder particle
surrounded by silica gel in amorphous matrix of
hydrated calcium & aluminum poly salts.
 (Calcium alumino Fluoro silicate gel)

55
ADVANTAGES OF GIC
 Chemical bonding to the tooth surface.
 Good marginal seal.
 Anti cariogenic property.
 Biocompatibility
 Co-efficient of thermal expansion similar to dentin.(11 ppm/K)
help reduce microleakage and therefore postoperative sensitivity.
 Minimal cavity preparation required
 Low exothermic reaction on setting.
 Rechargeable fluoride component
(does not inhibit caries but rather causes the formation of
fluorohydroxyapatite in the adjacent tooth structure which makes it more
resistant to demineralization)
DISADVANTAGES
 Low fracture resistance.

 Low wear resistance

 Water sensitive during setting phase

 Less esthetic compared to composite.

RESIN MODIFIED GLASS IONOMER
CEMENT
POWDER: Acid –base
Ion leachable- reaction
fluoroaluminosilicateglass
particles initiators

Resin
Composition & Reaction Photo
cure
LIQUID:
Water+polyacrylicacid Resin self
+Resin(HEMA /BisGMA)
cure
58
RESIN MODIFIED GLASS IONOMER CEMENT
• Anticariogenic effect
• Easiest and most predictable method to manage microleakage
• Have a longer working time and
• Less moisture-sensitive
• Reduce probability of gap formation at gingival margins, and
compensate for polymerisation shrinkage
• it has been suggested that RRGI has a chemical bond to sclerotic
dentin that is stronger than the bond that results from etching dentin
followed by a Dentin Bonding agent
INDICATION:
Intermediate material(liners ,base) between teeth and composite restoration

CONTRAINDICATION:
Direct Pulp capping

Material 14 days (μG) 30 days(μG)

Fl release
Conventional Liner 1000 1300

Hybrid Liner 1200 1600

REACTIONS OF THE PULP TO GLASS IONOMER
CEMENT
• Reactions of the pulp dentin organ to glass ionomer cement are milder
than composites
effective dentin depth is reparative reaction is seen
1.5mm,

depth of 0.5-1mm unhealthy reaction

less than 0.5mm destructive reaction of the

pulp-dentin organ

• RMGICs are more cytotoxic to the pulp cells than conventional GICs due
to the presence of unpolymerized monomers, and should not be applied
directly to the pulp tissue.
ZINC PHOSPHATE CEMENT
COMPOSITION : POWDER LIQUID
Zinc Oxide 90.2%
Phosphoric acid 38.2%
Magnesium Oxide 8.2%
Water 36%
Other Oxides (Ca 0.2% Al phosphate/Zn 16.2%
oxide,bismuth phosphate
trioxide,barium oxide
Aluminium 2.5%
Silica 1.4%
Zinc 7.1%

63
 VLC Traditional LC Reinforced
DYCAL GIC ZOE
Elastic modulus 588 1820
Compressive 138MPa 128 71
strength,>24 hrs
Flexural strength 46
Dentin shear bind 5.8
Solubility 0.3-0.5% 0.8 Modest
INDICATION
• Base with or without under lying sub base

• It is indicated when significant forces are anticipated during the

subsequent stage of restorative sequence, e.g. direct gold and
cast restoration, amalgam restorations

• Used when other base materials are not compatible with the
subbases.

CONTRAINDICATION:
• It should not be used on effective depths of less than 2 mm
without an intervening subbase.

65
SETTING TIME AND FACTORS AFFECTING IT:

Setting time: 2.5-8 min

• Factors:
1.Temperature-glass slab atmospheric dew point and

20°C(retard reaction)
2.Rate of addition of powder to liquid: reaction slower if liquid
slowly added
3.P/l ratio –more the liquid slower the ratio
4.Accelerate reaction: increase liquid,
decrease particle size
increase temp of mixing environment

66
Variables in Manipulation of Zinc Phosphate

67
BIOLOGIC COMPATIBILITY WITH PULP DENTIN
ORGAN:
1. The zinc phosphate cement is the most irritating of all the base
materials. The irritating ingredients and characteristics are
 Acidity during setting
 Exothermic reaction- heat
 Micro leakage
2. Effect at different effective depths
2.5 mm and more Usually healthy reparative
reaction
1.5-2.5mm Mostly Healthy ,destructive
sometimes
Less than 1.5mm Destruction of pulpal tissues
68
BIOLOGIC COMPATIBILITY WITH PULP DENTIN
ORGAN:
3. It can create a partially impervious layer on cut dentin in a thickness of
more than 1 mm thinner application will be completely previous

4. Effective on dentin permeability. It depletes the underlying dentin from part

of its calcium content, thereby increasing dentinal permeability to in coming
elements, especially the cements own phosphoric acid
5. It is an excellent thermal insulator, but in thickness of 1mm or more

69
COMPATIBILITY WITH OTHER BASE MATERIALS AND
RESTORATIVE MATERIALS
• Zinc phosphate does not interfere with the setting or physical properties of any permanent
restorative material

• Does not discolor any restorative material,

but if it is used in any other color than yellowish color will show through translucent or thin section of
tooth colored materials

• With stand manipulative forces

Compatible with other intermediary bases .Hence used as base over sub base

70
ZINC POLY CARBOXYLATE
• First cement developed to from a physico -chemical bond to the tooth substance
• Cement consists of a powder which is almost similar to that of zinc phosphate cement. The liquid is
mainly poly acrylic acid solution

71
SETTING REACTION
• When the zinc oxide and poly(acrylic acid) come into contact
, a salt (zinc polyacrylate) matrix is formed only on the surface of the
zinc oxide particles.
Poly(acrylic acid) chains crosslink through the zinc ions of the zinc oxide

The set material has cores of unreacted

zinc oxide within the zinc polyacrylate matrix binding
the unreacted zinc oxide cores together

Bonding to tooth structure

The polyacrylic acid is believed to react with
calcium ion via the carboxyl group.
The adhesion depends on the unreacted
carboxyl group. 72
Indications
• Used as a base with or without underlying subbases

• As base for preparations with effective depths as low as

0.5mm,varnish not required beneath

PROPERTIES:
• Only a mechanical diffusion barrier and thermal insulator.
• Advantage:
• the biological acceptance by the pulp;
this should be considered if poor pulpal response is likely

73
Biological Compatibility With Pulp Dentin Organ
• The cement is minimally irritating to the pulp-dentin organ

• Effective depth less than 1mm

1 mm or greater effect Healthy reparative reaction

depths-
Less than 1 mm unhealthy reaction occur

Material comes in contact with destructive reaction

the pulp tissue

• Good thermal insulator in thickness of 1.5mm,and at thickness

less than 0.5 mm not an effective thermal insulator

• The material is electronically conductive at any thickness,

74
 MINERAL TRIOXIDE AGGREGATE
MTA IS A CEMENT COMPOSED OF

Portland Cement Bismuth Oxide Gypsum

(75%) (20%) (Calcium Sulphate)
• Tricalcium silicate (5%)
• Dicalcium silicate
• Tricalcium aluminate
TYPES
• Tetracalcium aluminoferrite • Grey MTA
(Contains
aluminoferrite)
• White MTA

75
Types of MTA :-
Mixing of MTA :-
Setting reaction
 On hydration calcium silicates present in MTA undergoes hydrolysis and produce calcium silicate
hydrate (C-S-H) and calcium hydroxide.
• 2(3CaO.SiO2) + 6H2O  3CaO2.SiO2.3H2O + 3Ca(OH)2

• 2(2CaO.SiO2) + 4H2O  3CaO2.SiO2.3H2O + Ca(OH)2

 Tricalcium silicate engages in the formation of C-S-H to provide early strength.

 Dicalcium silicate reacts relatively slow and give later strength to the set material.

 Set MTA can be described as calcium hydroxide contained within a silicate matrix.
Setting reaction of MTA :-

• By mixing 3parts of powder & 1part of water to obtain putty like

consistency (distilled water, LA, Normal saline)
• MTA has ph (10.2) immediately after mixing &after 3 hrs ph is 12.5 which is
similar to ca(OH)2.
• Mixing time = less than 4 mins.
• If mixing time is prolonged, it results in dehydration of mix.
• Setting time = Grey MTA - 2hrs 55mins
• White MTA - 2hrs 20 mind
• Extended setting time is main drawback of MTA.
• By incorporating accelerator like sodium phosphate dibasic (Na2HPO4) &
calcium chloride (cacl2) maymay reduce setting time.
• MTA is Hydrophillic so, it requires moisture to set.
• Absolute dryness is contraindicated.
• Presence of moisture during setting improves Flexural strength.
• Though moisture is needed for setting but excess moisture results in a
'soupy' mix. & difficult to use.
• Increase in condensation pressure might reduce surface hardness.
• Applied MTA should be covered by a damp pellet of cotton because for
correct setting moisture is required, then tooth should be capped with
hermatic dressing for 1 - 2 days.
Advantages
1. Alkaline pH, which may impart antibacterial effect

2. Can induce formation (regeneration) of dentin, cementum, bone & periodontal ligament.

3. Decreased Toxicity to filling materials

4. Excellent biocompatibility and appropriate mechanical properties.

5. Excellent sealing ability, and Resistance to the marginal leakage

6. More radiopaque than Ca(OH)2.

7. Negligible Solubility

8. Vasoconstrictive. This could be beneficial for hemostasis (most importantly in pulp capping)
DISADVANTAGES
• Long setting time.

• Poor handling properties. The loose sandy nature of the mixture causes
much difficulty for insertion & packing of MTA.

• Dissolves in acidic pH

• Low compressive strength

• High cost
Properties of MTA :-
1.Compressive strength :
Within 24hrs of mixing compressive strength is about 40MPa
& it increases to 67.3MPA after 21 days.

Grey MTA > White MTA

2.PH :
Inital ph is 10.2
3hrs after mixing it is 12.5
3.Radiopacity:
Less radiopaque than super EBA, amalgam, gutta purchased
Mean radiopacity of MTA = 7.17 mm of equivalent to aluminium
thickness
4.solubility :
Set MTA shows no signs of solubility
5. Marginal adaptation &sealing ability :
MTA expands during setting which may be the reason of its excellent
sealing ability.
MTA thickness of about 4 mm is sufficient to provide good seal.
6.Antibacterial & Antifungal property :
Because of its alkaline ph
7. Biocompatibility :
MTA causes no DNA damage
On direct contact it produces less inflammatory reaction with soft tissue &
capable of inducing tissue regeneration.
Shows good interaction with bone forming cells (cells remained viable &
released collagen even after 72hrs with good adherence).
8.Tissue regeneration :
MTA is capable of activation of cementoblast and production of cementum.
& also facilitates regeneration of PDL
9.Mineralization :
MTA reacts with tissue fluids to form ca(OH)2 resulting in hard tissue
formation. Same as that of calcium hydroxide.
But dentin bridge that is formed with MTA is faster with good structural
integrity & more complete than with ca(oh)2..
It is better at stimulating reperative dentin formation and maintaining the
integrity of pulp.
BIODENTINE
• Biodentine is new bioactive cement with dentin like mechanical
properties and can be used as biocompatible dentin substitute. It has a
positive effect on vital pulp cells and stimulates tertiary dentin
formation
SETTING REACTION:
 The calcium silicate has the ability to interact with water leading to the
setting and hardening of the cement.
 2(3CaO.SiO2) + 6H2O  3CaO.2SiO2.3H2O + 3Ca(OH)2
TricalciumSilicate Hydrated Calcium Silicate Gel
(CSH gel)

 The unreacted tricalcium silicate grains are surrounded by layers of

calcium silicate hydrated gel

 The C-S-H gel gradually fills in the spaces between the tricalcium silicate
grains.
CHARACTERISTICS MTA BIODENTINE
SETTING TIME Initial –70 Initial –06
(minutes) Final-175 Final- 10
DENSITY 1.882 g/cm3 2.260 g/cm3
POROSITY 22.6% 6.8%
COMPRESSIVE STRENGTH (
Mpa)
1) 24 HRS 1) 7.5 1) 241.1
2) 7 DAYS 2) 164.5 2) 253.2
Ph 10.2 rises to 12.5 after 3 12
hours
HANDLING difficult to handle Easier to manipulate

RADIOPACITY 7.17 mm of equivalent 3.5 mm of equivalent

thickness of aluminum, thicknes of aluminum
Thank you!