Zinc oxide eugenol

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Zinc oxide eugenol (ZOE) is a material created by the combination of zinc oxide and eugenol contained in clove oil. An acid-base reaction takes place with the formation of zinc eugenolate chelate. The reaction is catalysed by water and is accelerated by the presence of metal salts. ZOE can be used as a dental filling material or dental cement in dentistry. [1] [2] It is often used in dentistry when the decay is very deep or very close to the nerve or pulp chamber. Because the tissue inside the tooth, i.e. the pulp, reacts badly to the drilling stimulus (heat and vibration), it frequently becomes severely inflamed and precipitates a condition called acute or chronic pulpitis. This condition usually leads to severe chronic tooth sensitivity or actual toothache and can then only be treated with the removal of the nerve (pulp) called root canal therapy. For persons with a dry socket as a complication of tooth extraction, packing the dry socket with a eugenol-zinc oxide paste on iodoform gauze is effective for reducing acute pain. [3] The placement of a ZOE "temporary" for a few to several days prior to the placement of the final filling can help to sedate the pulp. But, ZOE had in vitro cytotoxicity majorly due to release of Zn ions, not eugenol. [4] In spite of severe in vitro cytotoxicity, ZOE showed relatively good biocompatibility in animal study when ZOE was applied on dentin. [5] When ZOE was used as dentin-protective based materials, use of dental composite resin on ZOE was strongly prevented due to its inhibition of resin polymerization through radical scavenging effect. [6] It is classified as an intermediate restorative material and has anaesthetic and antibacterial properties. The exact mechanism of anesthetic effect from ZOE was not revealed perfectly, but possibly through anti-inflammatory effect, modulating immune-cells to less inflamed status. [7]

Contents

It is sometimes used in the management of dental caries as a "temporary filling". ZOE cements were introduced in the 1890s.

Zinc oxide eugenol is also used as an impression material during construction of complete dentures and is used in the mucostatic technique of taking impressions, usually in a special tray, (acrylic) produced after primary alginate impressions. However, ZOE is not usually used if the patient has large undercuts or tuberosities, whereby silicone impression materials would be better suited.

Zinc oxide eugenol is also used as an antimicrobial additive in paint.

Types

According to ANSI/ADA Specification no:30 (ISO 3107) and depending on intended use and individual formulation designed for each specific purpose.

Composition

The chemical composition of ZOE is typically: [8]

ZOE impression pastes are sold in two separate tubes. The first tube contains zinc oxide and vegetable or mineral oil, while the second tube contains eugenol and rosin. The vegetable or mineral oil acts as a plasticizer and helps to counteract the irritant action of eugenol.

Clove oil, which contains 70% to 85% eugenol, is sometimes used instead of eugenol because it causes less burning sensation in patients when it comes into contact with soft tissues. Rosin added to the paste in the second tube speeds up the reaction and produces a smoother, more homogeneous product.

Canada balsam and Balsam of Peru are often used to increase flow and improve mixing properties. If the mixed paste is too thin or lacks body before it sets, a filler (such as a wax) or an inert powder (such as kaolin, talc, or diatomaceous earth) may be added to one or both of the original pastes.

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<span class="mw-page-title-main">Eugenol</span> Chemical compound

Eugenol is an allyl chain-substituted guaiacol, a member of the allylbenzene class of chemical compounds. It is a colorless to pale yellow, aromatic oily liquid extracted from certain essential oils especially from clove, nutmeg, cinnamon, basil and bay leaf. It is present in concentrations of 80–90% in clove bud oil and at 82–88% in clove leaf oil. Eugenol has a pleasant, spicy, clove-like scent. The name is derived from Eugenia caryophyllata, the former Linnean nomenclature term for cloves. The currently accepted name is Syzygium aromaticum.

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<span class="mw-page-title-main">Luting agent</span>

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<span class="mw-page-title-main">Pulpotomy</span>

Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. During the caries removal, this results in a carious or mechanical pulp exposure (bleeding) from the cavity. During pulpotomy, the inflamed/diseased pulp tissue is removed from the coronal pulp chamber of the tooth leaving healthy pulp tissue which is dressed with a long-term clinically successful medicament that maintains the survival of the pulp and promotes repair. There are various types of medicament placed above the vital pulp such as Buckley's Solution of formocresol, ferric sulfate, calcium hydroxide or mineral trioxide aggregate (MTA). MTA is a more recent material used for pulpotomies with a high rate of success, better than formocresol or ferric sulfate. It is also recommended to be the preferred pulpotomy agent in the future. After the coronal pulp chamber is filled, the tooth is restored with a filling material that seals the tooth from microleakage, such as a stainless steel crown which is the most effective long-term restoration. However, if there is sufficient remaining supporting tooth structure, other filling materials such as amalgam or composite resin can provide a functional alternative when the primary tooth has a life span of two years or less. The medium- to long-term treatment outcomes of pulpotomy in symptomatic permanent teeth with caries, especially in young people, indicate that pulpotomy can be a potential alternative to root canal therapy (RCT).

<span class="mw-page-title-main">Pulp capping</span>

Pulp capping is a technique used in dental restorations to prevent the dental pulp from necrosis, after being exposed, or nearly exposed during a cavity preparation, from a traumatic injury, or by a deep cavity that reaches the center of the tooth causing the pulp to die. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis (inflammation). Pulpitis, in turn, can become irreversible, leading to pain and pulp necrosis, and necessitating either root canal treatment or extraction. The ultimate goal of pulp capping or stepwise caries removal is to protect a healthy dental pulp and avoid the need for root canal therapy.

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References

  1. Jack L. Ferracane, Materials in Dentistry: Principles and Applications, 2001, 2d Edition, Lippincott Williams & Wilkins, ISBN   0-7817-2733-2
  2. Richard van Noort, 2002, Introduction to Dental Materials, 2d Edition, Elsevier Health Sciences, ISBN   0-7234-3215-5
  3. Tarakji B, Saleh LA, Umair A, Azzeghaiby SN, Hanouneh S (April 2015). "Systemic review of dry socket: aetiology, treatment, and prevention". J Clin Diagn Res. 9 (4): ZE10–3. doi:10.7860/JCDR/2015/12422.5840. PMC   4437177 . PMID   26023661.
  4. Lee, Jung-Hwan; Lee, Hae-Hyoung; Kim, Kyoung-Nam; Kim, Kwang-Mahn (2016-05-01). "Cytotoxicity and anti-inflammatory effects of zinc ions and eugenol during setting of ZOE in immortalized human oral keratinocytes grown as three-dimensional spheroids". Dental Materials. 32 (5): e93–e104. doi:10.1016/j.dental.2016.01.003. ISSN   0109-5641. PMID   26960744.
  5. Sabir, Ardo; Tabbu, Charles R.; Agustiono, Purwanto; Sosroseno, Wihaskoro (2005). "Histological analysis of rat dental pulp tissue capped with propolis". Journal of Oral Science. 47 (3): 135–138. doi: 10.2334/josnusd.47.135 . ISSN   1343-4934. PMID   16313091.
  6. Carvalho, Ceci Nunes; Bauer, José roberto De Oliveira; Loguercio, Alessandro Dourado; Reis, Alessandra (2007). "Effect of Zoe Temporary Restoration on Resin-Dentin Bond Strength Using Different Adhesive Strategies". Journal of Esthetic and Restorative Dentistry. 19 (3): 144–152. doi:10.1111/j.1708-8240.2007.00087.x. ISSN   1708-8240. PMID   17518904.
  7. Lee, Jung-Hwan; Lee, Hae-Hyoung; Kim, Hae-Won; Yu, Je-Wook; Kim, Kyoung-Nam; Kim, Kwang-Mahn (2017-01-01). "Immunomodulatory/anti-inflammatory effect of ZOE-based dental materials". Dental Materials. 33 (1): e1–e12. doi:10.1016/j.dental.2016.09.012. ISSN   0109-5641. PMID   27726970.
  8. Zinc Oxide Eugenol Impression Pastes -A Study of an impression material- Chung Suck Lee, D.D.S.

A D Wilson and J W Nicholson, Acid-Base Cements, 1993, ISBN   0-521-37222-4, Chapter 9