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Dental Materials

Cement Bases

Applications

•    Thermal insulation below a restoration
•    Mechanical protection where there is inadequate dentin to support amalgam condensation pressures

Types

•    Zinc phosphate cement bases
•    Polycarboxylate cement bases
•    Glass ionomer cement bases (self-curing and light-curing)

Components

o    Reactive powder (chemically basic)
o    Reactive liquid (chemically acidic)

Reaction

o    Acid-base reaction that forms salts or cross linked matrix
o    Reaction may be exothermic

Manipulation-consistency for basing includes more powders, which improves all of the cement properties

Properties

Physical-excellent thermal and electrical insulation

Chemical-much more resistant to dissolution than cement liners

    Polycarboxylate and glass ionomer cements are mechanically and chemically adhesive to tooth structure

    Solubility of all cement bases is lower than cement liners if they are mixed at higher powder- to-liquid ratios

Mechanical- much higher compressive strengths (12,000 to 30,000 psi)
  
 Light-cured hybrid glass ionomer cements are the strongest
    Zinc oxide-eugenol cements are the weakest

Biologic (see section on luting cements for details)

    Zinc oxide-eugenol cements are obtundent to the pulp
    Polycarboxylate and glass ionomer cements are kind to the pulp
 

Acrylic Appliances

Use - space maintenance  or tooth movement for orthodontics and pediatric dentistry

1. Components

a. Powder-PMMA powder. peroxide initiator, and pigments

b. Liquid-MMA monomer, hydroquinone inhibitor, cross-linking agents, and chemical accelerators (N, N-dimethyl-p-toluidine)

2. Reaction

 PMMA powder makes mixture viscous for manipulation before curing . Chemical accelerators cause decomposition of benzoyl peroxide into free radicals that initiate polymerization of monomer .  New PMMA is formed into a matrix that surrounds PMMA powder. Linear shrinkage of 5% to 7% during setting. but dimensions of appliances are not critical

Applications

a. Dentulous impressions for casts for prosthodontics

b. Dentulous impressions for pedodontic appliances

c. Dentulous impressions for study models for orthodontics

d. Edentulous impressions for casts for denture construction

DISTORTION OF THE PATTERN

Distortion is dependant on temperature & time interval before investing .
To avoid any distortion ,
Invest the pattern as soon as possible .
Proper handling of the pattern .

PREREQUISITES
Wax pattern should be evaluated for smoothness , finish & contour .
Pattern is inspected under magnification & residual flash is removed .

SELECTION OF SPRUE 

1 . DIAMETER :
It should be approximately the same size of the thickest portion of the wax pattern .
Too small sprue diameter suck back porosity results .

2 . SPRUE FORMER ATTACHMENT :
Sprue should be attached to the thickest portion of the wax pattern .
It should be Flared for high density alloys & Restricted for low density alloys .

3 . SPRUE FORMER POSITION

Based on the
1. Individual judgement .
2. Shape & form of the wax pattern .

Patterns may be sprued directly or indirectly .
Indirect method is commonly used

Zinc Phoshate Cement

Uses. Zinc phosphate cement is used both as an intermediate base and as a cementing medium. 

(1) Intermediate base. A thick mix  is used under permanent metallic restoration. This layer of cement protects the pulp from sudden temperature changes that may be transmitted by the metallic restoration. 

(2) Cementing medium. Zinc phosphate cement is used to permanently cement crowns, inlays, and fixed partial dentures upon the remaining tooth structure. A creamy mix of cement is used to seat the restoration or appliance completely into place. The cementing medium does not cement two objects together. Instead, the cement holds the objects together by mechanical interlocking, filling the space between the irregularities of the tooth preparation and the cemented restoration

c. Chemical Composition. 

(1) Powder. primary ingredients - zinc oxide and magnesium oxide. 
(2) Liquid. Phosphoric acid and water in the ratio of two parts acid to one part water. The solution may also contain aluminum phosphate and zinc phosphate Liquids exposed in open bottles will absorb moisture from the air in high humidity. The liquids will lose moisture if humidity is low. Water gain hastens setting; water loss lengthens setting time.
 
PROPERTIES OF ZINC PHOSPHATE CEMENT

a. Advantages. Some advantages of zinc phosphate cement as a cementing medium are:

o    Inconspicuous appearance. 
o    Speed and ease of usage. 
o    Sufficient flow to form a thin layer for the cementing of closely adapted crowns, fixed partial dentures, and inlays. 
o    Low thermal conductivity beneath a metallic restoration.

b. Disadvantages. Some disadvantages of zinc phosphate cement as a cementing medium are:

o    Low crushing strength that varies between 12,000 and 19,000 psi. 
o    Slight solubility in mouth fluids. 
o    Opaque material not suitable for visible surfaces. 

c. Strength. The ratio of powder to liquid increases the strength of phosphate cements to a certain point. For this reason, the dental specialist must use as thick a mix as practical for the work being performed. 

SETTING REACTIONS OF ZINC PHOSPHATE CEMENT 

a. Chemical Reaction. The chemical reaction that takes place between the powder and liquid of setting phosphate cement produces heat. The amount of heat produced depends upon the rate of reaction, the size of the mix, and the amount of heat extracted by the mixing slab. 

b. Powder to Liquid Ratio. The less powder used in ratio to the liquid, the longer the cement will take to harden. Good technique minimizes the rise in temperature and acidity of the setting cement that can injure the pulp. Generally, for increased strength, decreased shrinkage, and resistance to solubility, it is advisable to blend as much powder as possible to reach the desired consistencies. 

c. Setting Time. The setting time of zinc phosphate cement is normally between 5 and 9 minutes. 
 Lower the temperature of the glass mixing slab to between 65° and 75° F (18° to 24° C), if the glass mixing slab is not already cooled below the temperature at which moisture will condense on it. → Blend the powder slowly. →  Mix the powder over a large area of the cool slab. →  Use a longer mixing time, within optimum limits. 
 
Precautions.
The following precautions should be observed. 

o    Prevent loss or gain of moisture in liquid cement by keeping bottles tightly stoppered. 
o    Dispense drops only when ready to mix. 
o    Use a cool, dry glass slab (65° to 75° F). 
o    Use the same brand of powder and liquid. 
o    Add increments of powder slowly. 
o    Use the maximum amount of powder to obtain the desired consistency. 

(To incorporate the most powder, the material should be mixed with a moderate circular motion over a large area of the slab, turning the spatula often.) 

Principles of cutting, polishing, and surface cleaning

  • Surface mechanics for materials

Cutting-requires highest possible hardness materials to produce cutting

Finishing-requires highest possible hardness materials to produce finishing, except at margins of restorations where tooth structure may be inadvertently affected

Polishing- requires materials with Mohs ./ hardness that is 1 to 2 units above that of substrate

 Debriding-requires materials with Mohs hardness that is less than or equal to that of substrate to prevent scratching

  •    Factors affecting cutting, polishing. and surface cleaning
    • Applied pressure
    • Particle size of abrasive
    •  Hardness of abrasive
    •  Hardness of substrate
  •      Precautions
    • During cutting heat will build up and change the mechanical behavior of the substrate from brittle to ductile and encourage smearing
    • Instruments may transfer debris onto the cut surface from their own surfaces during cutting, polishing, or cleaning operations (this is important for cleaning implant surfaces)

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