3 1

Vitremer™
Luting Cement
Technical Product Profile
2
 3

Table of Background .............................................................................. 5

Contents
Description of Vitremer Luting Cement .................................. 6

Components .............................................................................. 7

Indications ................................................................................ 7

Properties ............................................................................... 10
Solubility ............................................................................................... 11
Fracture Toughness .............................................................................. 11
Radiopacity .......................................................................................... 12
Fluoride Release ................................................................................... 13
Adhesion .............................................................................................. 14
pH ......................................................................................................... 16
Ease of use ........................................................................................... 17
Strength ................................................................................................ 19

Questions & Answers ............................................................. 20

Instructions ............................................................................ 21

Competitive Product Comparison .......................................... 24

4
Background The primary purpose of a luting cement is to aid in retaining and sealing fixed
5
prosthetic devices to prepared teeth. The better the crown prep (long axial
walls and about a 6° taper) and the better the crown fit (<30 micron marginal
gap), the less a clinician has to rely on the retentive properties of a cement.
With the introduction of 3M™ Vitremer™ Luting Cement, there are now five
types of permanent cements available in the marketplace today. They are zinc
phosphate, polycarboxylate, glass ionomers, resins and now, hybrid glass
ionomers. Many doctors have more than one permanent cement in their
offices, one for routine crown and bridge procedures (usually zinc phosphates,
polycarboxylates or glass ionomers) and one or more for special circumstances.
Resin cements are frequently a secondary cement used for special cases.
Zinc phosphate Zinc phosphate (which, when mixed, combines orthophosphoric acid and zinc
oxide powder) is one of the oldest cement types. The reasons this system has
maintained popularity include a long history of clinical success and its
adjustable working time. It is also reported to have high impact resistance and
high rigidity which is needed for long span bridges. However, mixing of this
cement is technique sensitive and time consuming. A typical mix requires 1
minute, 20 seconds with the powder incorporated in 6 parts. The cement also
causes a relatively high incidence of postoperative sensitivity (presumably due
to the acid content of the liquid), has a long set time and is soluble in the oral
environment. This cement provides some mechanical but no chemical reten-
tion. Clean up is accomplished by chipping the cement away from the margins
once it is set.
Polycarboxylate Polycarboxylate cements also enjoy a long clinical success history. Polycarbox-
Cements ylate cements are based on polyacrylic acid (like glass ionomers) and zinc
oxide. Some of these materials also release low levels of fluoride. Their
popularity stems from a lack of postoperative sensitivity and the fact that they
are tolerant of some mild contamination. Polycarboxylate cements also
achieve chemical adhesion to tooth structure. An additional feature of this
product type is the change in appearance, from shiny to dull, when the
working time is over. Clean up of this cement is more difficult than zinc
phosphate. Timing is critical. If the cement is removed while it is in a rubbery
stage, the marginal integrity of the cement may be compromised. Once com-
pletely set, the adhesion to the tooth structure increases the difficulty of excess
removal. Users of polycarboxylate cements have reported failures after several
years in service probably due to the cement’s solubility in the oral environment.
Resin Cements Resin cements are a new entrant on the cement market. These cements rely on
the acid etch technique and dentin conditioning, similar to composite restora-
tions, to achieve high bond strengths. They have high compressive strengths,
tensile strengths and fracture toughness. Resins are not soluble in the oral
environment. They are especially useful for cases where the preparation is
short or extremely tapered. Resin cements do suffer some drawbacks. They
are technique sensitive and the techniques are complicated, involving several
steps. As with composite restorations, moisture control is critical. If instruc-
tions are not closely followed, clean up is extremely difficult, if not impos-
sible to accomplish without use of a bur (as most margins of porcelain-fused-
to-metal crowns are subgingival, this is not a preferred procedure). Fre-
quently, crown removal is only accomplished by grinding off the crown. In
market research, resins were most often cited as the secondary cement used in
offices. They are not typically used for routine crown and bridge procedures.
 Glass Ionomers Glass ionomers, the last category of permanent cement used in dental offices
6
today, are growing in popularity. Glass ionomers do exhibit some adhesion to
enamel and dentin and release fluoride. These materials have higher compres-
sive strengths and lower solubility than either zinc phosphate or polycarboxylate
cements. As with other glass-ionomer products, they suffer from a history of
high incidence of postoperative sensitivity and moisture intolerance during
the setting reaction. The most often cited reasons for postoperative sensi-
tivity are:
• Desiccation of the tooth—glass ionomers require water for their
setting reaction and may have a tendency to draw moisture out of a
desiccated tooth by pulling liquid up through the dentinal tubules.
• The thin viscosity of glass-ionomer cement mixtures—the cement
may be forced down the dentinal tubules during seating of the pros-
thesis.
• The initial pH of the material (although it increases rapidly) may
irritate the pulp.
• Moisture contamination during setting could result in compromised
margins (enabling leakage).
Improved techniques for use and better understanding of the setting mecha-
nism have diminished these drawbacks.

Description Vitremer luting cement consists of two components, a powder and a liquid
of Vitremer like the other products in the 3M glass-ionomer line. The powder is mixed
Luting Cement with the liquid in a 1:1 drop:scoop ratio within 30 seconds. The resulting mix
is mousse-like and is easily scooped off the pad for placement in the crown or
bridge retainers. Working time is 2.5 minutes. After placement of the crown or
bridge, excess cement may be removed from the margins after a minimum of
3 minutes.
This product passes all ISO 9917:1991 (E) requirements for glass-ionomer
luting cements. These requirements include a maximum film thickness of 25
microns, setting time between 2.5 and 8 minutes, minimum compressive
strength of 70 MPa, and acid erosion of less than 0.05 mm/hour.
This system is based on the chemistry of Vitremer Core Buildup/Restorative
product. However, Vitremer luting cement is not light curable. Two setting
reactions do take place in this system, an acid-base reaction between the
fluoroaluminosilicate glass and the polycarboxylic acid (i.e., a true glass
ionomer setting reaction) and a free radical polymerization of the pendant
methacrylate groups of the polymer and HEMA (2-hydroxyethylmethacrylate).
The free radical polymerization reaction takes place without the need for light
activation (a methacrylate dark cure) via the same patented water-activated
redox catalyst system (US Patent 5,154,762) found in 3M Vitremer Core
Buildup/Restorative. FTIR (Fourier Transform Infrared) spectroscopy con-
firms the presence of both a glass ionomer and a methacrylate cure during
setting. Because of this chemistry, Vitremer luting cement can, therefore, be
classified as a hybrid glass-ionomer cement.
Components The Vitremer luting cement powder is composed of a radiopaque, fluoroalum-
7
inosilicate glass. It contains a microencapsulated potassium persulfate and
ascorbic acid catalyst system providing the methacrylate cure without the
need for light (i.e., methacrylate dark cure). The powder also contains small
amounts of an opacifying agent to aid in distinguishing the cement from tooth
structure.
The glass-ionomer liquid is an aqueous solution of polycarboxylic acid
modified with pendant methacrylate groups, i.e., the copolymer used in
Vitrebond liner/base and Vitremer Core Buildup/Restorative. It also contains
HEMA and water and small amounts of tartaric acid (which initially slows the
glass ionomer reaction, affording a snap set). This can be considered a type
of hydrous glass ionomer cement because the polycarboxylic acid moiety is
contained in the aqueous liquid.
The powder and liquid are mixed in a 1.6:1 (w/w) ratio (1 scoop:1 drop).
While the composition of both the powder and the liquid is similar to
Vitremer Core Buildup/Restorative, the actual concentration of each compo-
nent differs. As such, combining these systems is not recommended. Final
properties of the cement, e.g., low film thickness, strength, solubility, etc.,
have been optimized in this cement formulation. These properties, and many
more, may be adversely effected if the two systems are combined.

Indications Vitremer luting cement is indicated for:

• permanent cementation of porcelain fused-to-metal crowns and
bridges to tooth structure, amalgam, composite or glass ionomer core
buildups.
• luting metal inlays, onlays or crowns.
• pre-fabricated and cast post cementation.
• luting orthodontic appliances.
Vitremer luting cement is not indicated for composite or porcelain inlays or
onlays, composite or all porcelain crowns. However, it may be used for luting
porcelain jacket crowns.
The following guides illustrate the simple technique required to use Vitremer
luting cement.
 Crown Cementation
8 3
VitremerTM Luting Cement CROWN CEMENTATION

Indications: Tooth Preparation:

• Luting porcelain-fused-to-metal crowns and bridges to • Remove provisional restoration.
tooth structure, amalgam, composite or glass ionomer
core buildups. • Remove all temporary cement.

• Metal inlays, onlays or crowns • Clean tooth with oil-free pumice paste, rinse and dry.

• Pre-fabricated and cast posts. • Do not desiccate the tooth.

• Orthodontic appliances.

Dispense the powder:

• Fluff the powder.
• Dispense 3 level scoops.

Dispense the liquid:

• Keep the vial tip clean.
• Hold vial vertically and dispense 3 drops.

Mixing:
Liquid Powder • Mix all of the powder aggressively into the liquid.
• Continue mixing until all of the powder is incorpo-
rated into the liquid, about 30 seconds.

Load the crown:

• Spread the cement over all of the interior surface of
the crown.
• Working time is 2.5 minutes.

Placement:
• Seat the crown.
• Wait at least 3 minutes after placement.

• Remove excess with an appropriate instrument.

Please refer to instructions for more detailed information as well as, precautionary and warranty information.
3M Technical Hotline 1-800-634-2249 © 1994 3M
 Bridge Cementation
3 9
VitremerTM Luting Cement
Indications: Tooth Preparation:
• Luting porcelain-fused-to-metal crowns and bridges to • Remove provisional restoration.
tooth structure, amalgam, composite or glass ionomer
core buildups. • Remove all temporary cement.

• Metal inlays, onlays or crowns • Clean tooth with oil-free pumice paste, rinse and dry.
• Do not desiccate the tooth.
• Pre-fabricated and cast posts.
• Orthodontic appliances.

Dispense the powder:

• Fluff the powder.
• Dispense 6 level scoops.
Dispense the liquid:
• Keep the vial tip clean.
• Hold vial vertically and dispense 6 drops.
Mixing:
Liquid Powder
• Mix all of the powder aggressively into the liquid.
• Continue mixing until all of the powder is incorpo-
6 drops 6 scoops rated into the liquid, about 30 seconds.

Load the bridge:

• Spread the cement over all the interior surface of the
retainers.
• Working time is 2.5 minutes.

Placement:
• Seat the bridge.
• Wait at least 3 minutes after placement.
• Remove excess with an appropriate instrument.

Please refer to instructions for more detailed information as well as, precautionary and warranty information.
3M Technical Hotline 1-800-634-2249 © 1994 3M
10 Properties Vitremer luting cement was designed to be the cement of choice for routine
crown and bridge procedures. As such, comparisons will be made with the
major competitive products that are used for routine cementations. These are:
Conventionally setting glass ionomer luting cements
KETAC-CEM® RADIOPAQUE (ESPE)
Fuji I (GC International)
GlasIonomer Cement, Type I (Shofu, Inc.)
AquaCem (Dentsply)
Zinc phosphate
Fleck’s® (Mizzy)
Polycarboxylate cement
DURELON® (ESPE)
Poly-F Plus (Dentsply)
The fourth class of cements, resins (e.g., Panavia®, Kuraray Co., LTD. and C
& B Metabond™, Parkell), are more frequently used as a secondary cement in
the office. Resin cements are not typically used for routine cementation
procedures, however comparisons, where appropriate, are given.
For the purposes of this profile, the following abbreviations are used:

Name Abbreviation

KETAC-CEM RADIOPAQUE KETAC-CEM

Fuji I (old formulation) Fuji I

Fuji I (new formulation) Fuji I (new)

GlasIonomer Cement, Type I GlasIonomer

C&B Metabond C&B

3M Vitremer Luting Cement Vitremer LC

Solubility 11
It is common knowledge that all cements, excluding resins, erode over time
in the oral environment. This wash out can lead to leakage at the margins
providing an avenue for bacterial entry resulting in secondary caries,
sensitivity or even loosening of the prosthetic device. One of the key
features of resin cements is their lack of erosion. Lactic acid erosion was
measured in accordance with ISO 9917:1991 (E). In this test, a jet of an
aqueous solution of lactic acid impinges on the test specimen. Conventional
glass ionomers, polycarboxylates and zinc phosphate are soluble. Resin
cements and
Vitremer luting actual values: 501 538
100
cement did not
90
exhibit any
80
measurable
70
solubility
60
(Figure 1).

µm/hour
50

40

30

20
Figure 1.
10
Lactic Acid
Erosion 0
) B

EM

EX
em

N
er
:1

s
)

w
:1

k'
O
ji
.4 &

om
ne
Fu

-C

aC

ec
EL
a
.6

(1 C

vi
I(

on
C

Fl
(1

qu

R
na
A
ji

U
sI
ET

A
Fu

Pa

D
la
Vitremer Luting

G
Fracture Toughness
Fracture toughness is defined as the ability of a material to resist propaga-
tion of an initiated crack. As shown in Figure 2, the conventional glass-
ionomer products and polycarboxylate cements and are very brittle, i.e.,
have a low fracture toughness. The zinc phosphate specimens all broke
during sample preparation, as such, the fracture toughness could only be
estimated. The
fracture tough- 1.4
ness of Vitremer
luting cement is 1.2

more than double

the values of these 1

products. In fact, it
K1c (MN/m^1.5)

is more similar to 0.8

typical resin
0.6
systems such as
Panavia EX or 3M
0.4
Restorative Z100.
Figure 2. 0.2

Fracture
Toughness 0
I
00
t)
d)
EM

us
LC

er

EX
em

ji
's
w

en
O

Z1
te
k

Fu
om
ne

Pl
-C

aC

ec
EL
er

a
ar
en

vi
I(

F
on
C
em

Fl

sp
qu

na
A

ly
ji

U
sI

ig

an
ET

A
tr

Fu

Po

Pa
D
la
Vi

(p

(tr
K

B
&

&
C

C
12 Radiopacity
Radiopacity was determined in accordance with ISO specification 4049. In
this specification, the radiographic density of the test material is compared
and normalized to that of a 2 mm thickness of aluminum. A value greater
than or equal to one indicates the material is radiopaque. A value less
than one indicates the material is radiolucent. Radiopacity is important during
crown and bridge procedures for two reasons, it allows the doctor to discover
any residual excess material subgingivally and allows the doctor to discover any
marginal discrepancies. As shown in Figure 3, Vitremer luting cement is
radiopaque, whereas several other cements (i.e., AquaCem, GlasIonomer and
C&B Metabond) are not. In the field evaluation, 98% of the respondents
stated Vitremer luting cement was distinguishable from tooth structure under
X-ray.

3.5

2.5
radiopacity

1.5

0.5
Figure 3.
Radiopacity 0
) ) ) B

EM
um

er
us
N

em
:1 :1 :1

s
)

I
50
:1

k'
O

ji
.2 .4 .8 &

om
Pl

Fu
P-

aC

-C

ec
in

EL
.6

(1 (1 (1 C
um

on
C

Fl
(1

qu
R

ly
U

sI
al

ET

Po
D

la
——Vitremer Luting——
m

G
m
2
Fluoride Release 13
One of the key features of true glass-ionomer cements is their sustained
fluoride release. It is generally believed that this release of fluoride aids in the
prevention of secondary caries which may be difficult to detect under a crown
or bridge. Fluoride release was measured in-vitro in a buffer solution using a
fluoride-ion-specific electrode. As evidenced by Figures 4 and 5, the fluoride
release of Vitremer Luting Cement is typical of true glass-ionomer cements.
Figure 4 is a composite of two separate fluoride release studies. As the
fluoride release of Ketac-Cem in both of these studies was similar, the data
was combined to produce this summary graph. Figure 5 demonstrates the
fluoride release of Vitremer luting cement is not effected by differing powder
liquid ratios.
Vitremer Luting 1.6:1
KETAC-CEM
GlasIonomer

4000 DURELON
Fuji I

3500

3000
µg F / g Sample

2500

2000

1500

Figure 4. 1000

Cumulative
Fluoride 500

Release
0

0 40 80 120 160 200

Days

3000

2500
µg F- / g Sample

2000

1500

Vitremer Luting (1.2:1)

Figure 5. 1000 Vitremer Luting (1.4:1)
Cumulative AquaCem
Fluoride
500
Release:
Different P/L
Ratios 0
0 50 100 150

Days
14 Adhesion
Another advantage of glass-ionomer cements is their inherent ability to bond
to tooth structure without utilizing acid etch or dentin conditioning tech-
niques. While this adhesion is lower than that of properly placed resin sys-
tems, clinical experience has proven it to be adequate for retention of most
fixed prostheses. The shear adhesion was measured by cementing a sand-
blasted, 5 mm Rexillium III (a common non-precious alloy, Jeneric Pentron)
button to an appropriate substrate. Bovine dentin and enamel substrates were
prepared by potting teeth in methylmethacrylate, then grinding and polishing
these to expose dentin or enamel. Cements were mixed, according to manu-
facturers’ instructions, and sandwiched between the Rexillium III and the
substrate with a moderate amount of pressure. The samples were placed in a
37° C/95%RH environmental chamber for 2-3 minutes prior to clean-up of the
excess. After the excess was removed, the samples were replaced in the
environmental chamber for an additional 15 minutes. They were then stored in
distilled water at 37° C for 24 hours and shear adhesion values were measured.
Figure 6 demonstrates that different powder liquid ratios do not effect adhe-
sion. Additionally, the adhesion of Vitremer luting cement was found to be
similar to that of other glass
ionomer and polycarboxylate
cements and higher than
12
zinc phosphate. Properly
Enamel
placed resin cements 10
Dentin

exhibit the highest shear 8

adhesion values (Figure 7).

MPa

Figure 6.
Shear Adhesion 4

to Bovine
2
Enamel
and Dentin 0
) ) I
EM

N
:1 :1
em

ji

s
)
:1

k'
O
.4 .8 Fu

ec
aC

-C

EL
.6

(1 (1
C

Fl
(1

qu

R
A

U
A

ET

——Vitremer Luting——
D
K

30

25

20
MPa

15

10
Figure 7.
Shear Adhesion 5

to Bovine
Enamel 0
Vitremer LC (1.6:1) C&B Panavia EX
Cements are also used to bond to other substrates, i.e., core buildup materials.
15
Figure 8 reveals the shear adhesion of Vitremer luting cement to a variety of
core buildup materials. These samples were prepared by substituting the core
buildup for the bovine teeth in the procedure detailed above.

P/L = 1.4:1

10 P/L = 1.6:1

9
P/L = 1.8:1
8

mPa
Figure 8. 5

Vitremer Luting 4

Cement/Rexillium 3
III Adhesion to 2
Various Core
1
Buildup
Substrates 0

re

re

er
y

00
llo

cu

cu

ilv

Z1
ra

-S
o

ht
pe

ut

ac
ig
is

)a

)l

et
D

K
B

B
(C

(C
er

er
em

em
tr

tr
Vi

Vi
16 pH
As stated earlier, one of the proposed causes of postoperative sensitivity is
low pH (acidic) when the cement contacts tooth structure. Vitremer luting
cement and KETAC-CEM were mixed at room temperature (23° C/50%RH).
The pH electrode was placed directly into the uncured cement. pH was
measured as a function of time. Figure 9 demonstrates the relatively constant,
less acidic pH (7 is considered a neutral pH) of Vitremer luting cement
compared to the highly acidic, slow rising pH of KETAC-CEM. In Figure 10,
the two cements were mixed and held for at 23° C/50%RH for 2 minutes.
Samples were placed in a test chamber (37° C/95%RH) where the surface pH
was measured as a function of time. Measurements were made by touching
the sample with the pH electrode with 100 microliters of distilled water (pH
6.0-7.5) interfacially. The curves show a rapid rise in pH of the KETAC-CEM
to a less acidic pH. Although the pH of Vitremer luting cement starts out
closer to neutral, it still gradually rises.

4 Vitremer Luting

KETAC-CEM

3.5
(surface electrode)

3
pH

2.5

Figure 9. 2

pH Rise at
Room Temperature 1.5
0 162.5 325 487.5 650
Time (sec.)
@23°C

4.5
(surface electrode)

Vitremer Luting
3.5 KETAC-CEM
pH

2.5

Figure 10.
2
pH Rise
During Setting 1.5
0 4 8 12 16 20
Time (min.)
@ 37°C & 95% RH)
 Ease of use 17
Glass-ionomer cements are easy to use. The products are simply mixed,
placed in the crown and excess cement is chipped away after set. No addi-
tional steps are required to prepare the tooth. In field evaluations, it has been
reported that Vitremer luting cement has advantages even over traditional
glass-ionomer cements. The powder and liquid are dispensed in an easy to
remember 1:1 ratio. The mixture size is adjustable for the variety of applica-
tions encountered in routine crown and bridge procedures (less waste).
Traditional glass ionomers may be stringy which may make the crown loading
procedure messy. This stringiness is often used as a measure of mix consis-
tency. The cement is considered properly mixed when it strings between the
pad and the spatula about 1 inch. The mousse-like consistency of Vitremer
luting cement makes placement in the crown easier as the cement is readily
scooped from the pad. However, in field evaluations, a few doctors have
reported this lack of flow as a negative because they feel they have to take
more time to coat the inner aspects of the crown. Clean up of Vitremer luting
cement is easily accomplished by removal of the excess in a waxy state,
during which time the cement is dislodged from the margins in large sections.
The ease of clean up and ease of mixing offers significant advantages over
polycarboxylate and zinc phosphate cements. As stated earlier, there is a
window of opportunity to clean up polycarboxylate cements. If excess cement
is removed too quickly, while the material is in a rubbery stage, marginal
integrity may be compromised by pulling some material away from the
margins. If excess is removed too late, sharper, more aggressive instruments
are required to scale the material away from the tooth structure because of the
adhesion to tooth structure. Zinc phosphate is not an easy cement to mix. In
typical mixes, powder is slowly incorporated into the liquid over a period of 1
minute, 20 seconds. Too rapid incorporation results in a limited working time. The
cement must also be mixed on a cold glass slab to maximize working time.
Field Evaluation In a field evaluation, doctors were asked to rate the performance of their
current cement and Vitremer luting cement for 6 parameters (ease of mix,
length of working time, length of time to set, flow, pressure to seat crown and
ease of clean up). Evaluators rated all 6 parameters as good to excellent for
Vitremer luting cement (Figure 11). Doctors did not report any advantage or
diadvantage for Vitremer luting cement when the ratings for set time, working
time or flow were compared. However, most doctors felt the ease of mix and
the pressure required to
seat a crown was slightly 30 Poor Fair Good Excellent

better with Vitremer luting

cement than with their 25

current cement. Most

Number of Responses

20
doctors also comfirmed
that the clean up of Vitremer 15
luting cement was easier
than their current product. 10

Figure 11. 5

Field Evaluation
of Vitremer 0

Luting Cement Ease of Mix Working

Time
Set Time Flow Seating
Pressure
Cleanup
 Resin Technique A comparison of typical placement procedures of resin cements to Vitremer
18
Comparison luting cement is listed below. Use of resin cements requires more steps and
takes longer than use of the Vitremer luting cement. In addition moisture
control, via use of a rubber dam, is recommended with the resin cements.

3M™Vitremer™ C&B Metabond™ Panavia®

Luting Cement Adhesive Cement Dental Adhesive

2 chemical components 6 chemical components 5 chemical components (plus a

dentin/enamel bonding agent
should be used)

Prophylaxis Prophylaxis Prophylaxis

Etch Enamel (30 seconds). Etch enamel.

Rinse and dry. Rinse and dry.

Rubber dam is recommended. Rubber dam is required.

Apply dentin activator (10 Seal dentin with a dentin/enamel

seconds). Rinse and lightly dry. bonding agent.

Apply lubricant to adjacent teeth

and prosthesis.

Mix 3 drops of liquid and 3 Mix 4 drops of base and 1 drop Mix 1 scoop of powder to 1 drop
scoops of powder (30 of catalyst (less than 5 seconds). of liquid (60-90 seconds). After
seconds). Paint tooth. mix spread evenly over pad
surface.

Mix 4 drops of base and 1 drop

of catalyst (less than 5 seconds).
Add 2 level scoops of powder
and stir (5-10 seconds).

Line prosthesis with mix and Apply cement to restoration and Apply thin layer of cement on
seat (1 minute). seat (1 minute). casting. Apply thin layer of
cement to tooth structure. Seat
(1.5 minutes).

Remove excess with a cotton Remove excess cement.

pledget wet with base.

Hold casting on tooth until Hold casting on tooth until Apply Oxygard to margins. Wait
cement is set (3 minutes). cement is set (10 minutes). (3-4 minutes). Wash Oxygard
away from margins.

Clean excess cement from Clean any cured cement from Clean excess cured material
restoration and adjacent restoration and adjacent teeth with an explorer and or a disc.
teeth with an explorer or with a scaler.
scaler.

5 steps 11 steps 9 steps

Total Time 1=270 seconds Total Time 1=840 seconds Total Time 1= 500 seconds

1 Total Time is an approximation without including prophy or, in the cases of resin cements,
rubber dam placement.
Strength 19
In addition to fracture toughness, strength of a cement may be represented by
compressive and diametral tensile strengths. ISO 9917:1991 (E) lists a
minimum compressive strength needed for a cement as 70 MPa, no corre-
sponding requirements have been set for diametral tensile strengths. A
porcelain-fused-to-metal restoration gains much of its supporting strength
from the metal coping, not the cement used. The compressive and diametral
tensile strengths are depicted graphically (Figures 12 & 13). As expected, the
compressive and diametral tensile strengths of the resin cement category are
highest. Zinc phosphate and polycarboxylate cements have the lowest
strengths. Glass ionomers, including Vitremer luting cement exhibit moderate
strength.
40000

35000

30000

25000
Psi

20000

15000

10000
Figure 12.
5000
Compressive
Strength 0
1) 1)

EM

EX
er
N

em
s
)

I
2: 4:
:1

k'
O

ji

om
. .

Fu
ec

-C

aC
EL

a
.6

(1 (1

vi
on
C
Fl
(1

qu
R

na
A
U

sI
ET

A
Vitremer Luting

Pa
D

la
K

G
9000

8000

7000

6000

5000
Psi

4000

3000

Figure 13. 2000

Diametral
Tensile 1000
Strength 0
1) 1) I
EM

EX
er
N

em

ji
s
)

2: 4:
:1

k'
O

Fu
om

. .
ec

-C

aC
EL

a
.6

(1 (1
vi
on
C
Fl
(1

qu
R

na
A
U

sI
ET

Vitremer Luting
Pa
D

la
K

G
 Questions Q. Why isn’t Vitremer luting cement light curable like other
20
& Answers 3M glass ionomer products?

A. In early market research, doctors were asked to categorize various cement

attributes as Musts, Wants or Unnecessary with respect to porcelain-fused
to metal crowns. Ability to light cure was considered unnecessary, and,
because it created some difficulties in clean up, this path was abandoned.
Q. Does this product produce postoperative sensitivity?
A. Field evaluation reports have indicated very little postoperative sensitivity
while using this cement. As stated several times, the root cause(s) of
postoperative sensitivity haven’t been defined. However, as technique
may play a role in creating postoperative sensitivity (eg. desiccation of the
tooth), we cannot categorically make this claim.
Q. Since this cement contains a resin component, what will
be the effect of using a eugenol containing temporary
cement?

A. Generally speaking, it has long been reported that eugenol containing

materials will impede the crosslinking of resin based systems. Because a
methacrylate cure plays an important role in Vitremer luting cement, the
effect of eugenol contamination was tested. Adhesion to bovine dentin,
compressive strength and diametral tensile strengths were measured with
slight and heavy contamination from a eugenol containing cement. These
values were compared to noncontaminated samples. There was no signifi-
cant difference between the contaminated and noncontaminated values.
However, removal of all temporary cement is critical regardless of tempo-
rary or permanent cement used. Temporary cements are very weak
materials which reduce the overall strength of the restoration. As such,
prophylaxis of the tooth preparation is recommended prior to permanent
cementation.
Q. Can the working time be adjusted?
A. Yes. As shown in several earlier figures (Figures 1, 3, 5, 6, 7, 12, 13),
there is a very slight effect on the performance properties of Vitremer luting
cement when different powder:liquid ratios are used (ranging from 1.2:1
to 1.8:1). However, working time and the corresponding set time can be
adjusted by changing these ratios. A lower powder:liquid ratio, e.g. 1.4:1
will lengthen working and set time, while a higher ratio (1.8:1) will
shorten them.
Q. Can this cement be used for porcelain or composite crowns,
inlays or onlays?

A. Yes and no.

Porcelain veneer crowns, composite crowns, porcelain or composite
inlays and onlays rely on the tooth structure and the overall restoration for
much of their strength. Frequently, these restorations are translucent and
cement shade is an important characteristic of the total restoration. As
such, we cannot recommend the use of Vitremer luting cement for these
applications. There are more appropriate cements for these bonded
restorations. On the other hand, glass-ionomer cements have long been
 used for permanent cementation of porcelain jacket crowns. Porcelain
21
jacket crowns have thicker walls, use alumina reinforced core porcelain or
are specially fired to increase the strength of the prosthesis over other
porcelain restorations. These are typically anterior restorations. Vitremer
luting cement can be used in this application.

Instructions General Information

3M™ Vitremer™ Glass Cement is a glass-ionomer system comprised of two

parts: a powder and a liquid. The powder is a radiopaque, fluoroaluminosilicate
glass. The liquid is an aqueous solution of a modified polyalkenoic acid.
Vitremer luting cement provides the major benefits of glass-ionomer ce-
ments—adhesion to tooth structure and fluoride release, along with additional
benefits of low solubility, improved fracture toughness and a low viscosity,
non-stringy, slump-resistant mix.
Vitremer luting cement is a self-cure system using two dark-cure reactions to
provide the improved properties.

Indications

Vitremer luting cement is indicated for use when luting:

• porcelain-fused-to-metal crowns and bridges to tooth structure,
amalgam, composite or glass ionomer core build ups.
• metal inlays, onlays or crowns.
• pre-fabricated and cast post cementation.
• orthodontic appliances.
Vitremer luting cement is not indicated for composite or porcelain inlays or
onlays, composite or all porcelain crowns. However, it may be used for luting
porcelain jacket crowns.

Precautions for Dental Personnel and Patients

Liquid contains HEMA (2-hydroxyethylmethacrylate). HEMA is severely

irritating to the eye and is a known contact allergen. A small percentage of
the population is known to have an allergic response to acrylate resins. To
reduce the risk of allergic response, minimize exposure to these materials. In
particular, exposure to uncured resin should be avoided. Use of protective
gloves and a no-touch technique is recommended. If skin contacts liquid or
powder/liquid mix, wash skin immediately with soap and water. Acrylates
may penetrate commonly used gloves. If glove contacts liquid or powder/
liquid mix, remove and discard glove, wash hands immediately with soap and
water, and then reglove.
Liquid and powder/liquid mix may cause eye irritation upon contact and may
be mildly irritating to oral soft tissue upon contact. Avoid contact with eyes
and minimize contact with oral soft tissue. If accidental contact with eye
occurs, flush immediately with large amounts of water. If irritation persists,
consult a physician.
 Instructions for Use
22
1. Remove the provisional restoration and all residual temporary cement.
Thoroughly clean the preparation with an oil-free pumice paste. Rinse
with water and let dry.
Note: Do not desiccate the tooth. Desiccation of tooth structure is
believed to cause postoperative sensitivity in some individuals.
2. Pulp protection: Use a hard setting calcium hydroxide material with near
exposures.
3. Casting preparation: Thoroughly clean interior surfaces of cast crown,
inlay or onlay.
4. Dispense powder and liquid:
The standard powder/liquid ratio of 1.6:1 by weight can be obtained by
using an equal number of level scoops of powder and liquid drops.
Three scoops of powder and three drops of liquid will provide an ad-
equate amount of material to seat 1 typical crown.
Shake the jar to fluff the powder before dispensing. Insert the scoop into
the jar. Overfill it with loosely packed powder and withdraw it against the
plastic leveler to remove excess powder and obtain a level scoop. Dis-
pense the desired number of powder scoops onto the mixing pad.
Note: The glass-ionomer powders are sensitive to high humidity. Store
with jar caps securely tightened and away from high humidity.
To obtain a proper liquid drop size, hold the Vitremer luting cement liquid
vial vertically with the dropper tip down and without the tip contacting
the mixing pad. Squeeze the vial to dispense the desired number of liquid
drops onto the mixing pad.
5. Mixing: Using a cement spatula, mix the powder into the liquid. To
minimize water evaporation and maximize working time, confine
spatulation of the powder and liquid to a small area of the mixing pad. All
of the powder should be incorporated into the liquid within 30 seconds.
6. Working time of the standard powder/liquid ratio is at least 2.5 minutes
from the start of mix at a room temperature of 73° F (23° C). Higher
temperatures and vigorous spatulation will shorten working time. Lower
temperatures will lengthen working time.
Note: Working time can be lengthened by using refrigerated liquid or by
mixing on a cold slab.
7. Crown placement: Load the crown by spreading a layer of the cement
over all the interior surfaces of the crown. Seat crown. Maintain pressure
on crown to maintain position during setting process.
8. Clean up excess. Excess material can be removed when cement reaches a
waxy stage after a minimum of 3 minutes from placement in the mouth
(37° C or 98° F). Use a suitable instrument for this process.
Storage and Use
23
1. Shelf life at room temperature is 24 months. See outer package for expiry
date.
2. The glass ionomer system is designed to be used at room temperatures of
approximately 70-75° F (21-24° C).
3. Glass ionomer powders are sensitive to high humidity. Store with jar caps
securely tightened and away from high humidity.
4. Do not substitute 3M™Vitremer™ Core Buildup/Restorative System
powder or liquid for Vitremer luting cement powder or liquid.

Warranty

3M will replace such product that is proved to be defective. 3M does not

accept liability for any loss or damage, direct or consequential, arising out of
the use of or the inability to use these products. Before using, the user shall
determine the suitability of the product for its intended use and user assumes
all risk and liability whatsoever in connection therewith.
Competitive Permanent Cement Product Comparison

Polycar-
Hybrid boxylic Zinc
GI ———————Conventional Glass Ionomers—————— Acid Phosphate
Vitremer ESPE KETAC- GC Fuji I Shofu Dentsply ESPE
Luting Cement CEM GC Fuji I (new) GlasIonomer AquaCem DURELON Mizzy Fleck’s

Solubility (µ/hr) 0 6 2 3.2 9 3 501 538

Adhesion to 8.9 8.7 7.8 N/A N/A 11.9 9.3 1.6

Enamel (MPa)

Adhesion to Dentin 4.3 2.9 4.3 N/A N/A N/A 5.3 0.3
(MPa)

Diametral Tensile 3373 3264 3038 3014 2851 1940 2206 1690
Strength (Psi)

Compressive 19222 22406 24578 23409 21751 13377 10052 10005

Strength (Psi)

Fracture 0.78 0.34 0.33 0.35 0.35 0.27 0.38 ***

Toughness
(MN/m3/2)

Powder:liquid ratio 1.6:1 3.8:1 1.8:1 1.8:1 1.5:1 3.3:1 1.5:1 2.67:1

Mix Time 30 sec 1 min 20 sec 20 sec 20 - 30 sec 15 sec 30 sec 1 min 20 sec.

Working Time 2.5 min 3.5 min 2.25 min 2 min 3 min 2.75 min 2.5 min
23oC/50%RH

Set Time 3 min 5 min 5 min 4 min 5.5 min 5 min 4 min
@37oC/95%RH

Radiopacity 1.12 1.18 1.45 0.87 0.93 2.07 2.86

Fluoride Release High High High High High High Very low None
 25

3
Dental Products Laboratory

3M Center, Building 260-2B-13 Printed in U. S. A.

St. Paul, MN 55144-1000 ©1994 3M 70-2008-7655-8