NEET MDS Lessons
Dental Materials
Properties of Amalgam.
The most important physical properties of amalgam are
- Coefficient of thermal expansion = 25-1 >ppm/ C (thus amalgams allow percolation during temperature changes)
- Thermal conductivity-high (therefore, amalgams need insulating liner or base in deep restorations)
- Flow and creep. Flow and creep are characteristics that deal with an amalgam undergoing deformation when stressed. The lower the creep value of an amalgam, the better the marginal integrity of the restoration. Alloys with high copper content usually have lower creep values than the conventional silver-tin alloys.
Dimensional change. An amalgam can expand or contract depending upon its usage. Dimensional change can be minimized by proper usage of alloy and mercury. Dimensional change on setting, less than ± 20 (excessive expansion can produce post operative pain)
- Compression strength. Sufficient strength to resist fracture is an important requirement for any restorative material. At a 50 percent mercury content, the compression strength is approximately 52,000 psi. In comparison, the compressive strength of dentin and enamel is 30,000 psi and 100,000 psi, respectively. The strength of an amalgam is determined primarily by the composition of the alloy, the amount of residual mercury remaining after condensation, and the degree of porosity in the amalgam restoration.
- Electrochemical corrosion produces penetrating corrosion of low-copper amalgams but only produces superficial corrosion of high copper amalgams, so they last longer
- Because of low tensile strength, enamel support is needed at margins
- Spherical high-copper alloys develop high tensile strength faster and can be polished sooner
- Excessive creep is associated with silver mercury phase of low-copper amalgams and contributes to early marginal fracture
- Marginal fracture correlated with creep and electrochemical corrosion in low-copper amalgams
- Bulk fracture (isthmus fracture) occurs across thinnest portions of amalgam restorations because of high stresses during traumatic occlusion and/or the accumulated effects of fatigue
- Dental amalgam is very resistant to abrasion
CASTING DEFECTS
Classification :
1) Distortion.
2) Surface roughness .
3) Porosity .
4)Incomplete casting .
5) Oxidation .
6) Sulfur contamination .
Distortion
It is usually due to the distortion of wax pattern.
To avoid this :
Manipulation of the wax at its softening temp
Invest the pattern at the earliest .
If storage is necessary store it in a refrigerator .
Surface roughness
May be due to :
Air bubbles on the wax pattern .
Cracks due to rapid heating of the investment .
High W/P ratio .
Prolonged heating of the mold cavity .
Overheating of the gold alloy .
Too high or too low casting pressure .
Composition of the investment .
Foreign body inclusion.
POROSITY
May be internal or external .
External porosity causes discolouration .
Internal porosity weakens the restoration .
Classification of porosity .
I .Those caused by solidification shrinkage :
a) Localised shrinkage porosity .
b) Suck back porosity .
c) Microporosity .
They are usually irregular in shape .
II ) Those caused by gas :
a) Pin hole porosity .
b) Gas inclusions .
c) Subsurface porosity .
Usually they are spherical in shape .
III ) Those caused by air trapped in the mold :
Back pressure porosity .
Localised shrinkage porosity
Large irregular voids found near sprue casting junction.
Occurs when cooling sequence is incorrect .
If the sprue solidifies before the rest of the casting , no more molten metal is supplied from the sprue which can cause voids or pits (shrink pot porosity )
This can be avoided by -
- using asprue of correct thickness .
- Attach the sprue to the thickest portion of the pattern .
-Flaring of the sprue at the point of atttachment .
-Placing a reservoir close to the pattern .
Suck back porosity
It is an external void seen in the inside of a crown opposite the sprue .
Hot spot is created which freezes last .
It is avoided by :
Reducing the temp difference between the mold & molten alloy .
Microporosity :
Fine irregular voids within the casting .
Occurs when casting freezes rapidly .
Also when mold or casting temp is too low .
Pin hole porosity :
Upon solidification the dissolved gases are expelled from the metal causing tiny voids .
Pt & Pd absorb Hydrogen .
Cu & Ag absorb oxygen .
Gas inclusion porosities
Larger than pin hole porosities .
May be due to dissolved gases or due to gases Carried in or trapped by molten metal .
Apoorly adjusted blow torech can also occlude gases .
Back pressure porosity
This is caused by inadequate venting of the mold .The sprue pattern length should be adjusted so that there is not more than ¼” thickness of the investmentbetween the bottom of the casting .
This can be prevented by :
- using adequate casting force .
-use investment of adequate porosity .
-place the pattern not more than 6-8 mm away from tne end of the casting .
Casting with gas blow holes
This is due to any wax residue in the mold .
To eliminate this the burnout should be done with the sprue hol facing downwards for the wax pattern to run down.
Incomplete casting
This is due to :
- insufficient alloy .
-Alloy not able to enter thin parts of the mold .
-When the mold is not heated to the casting temp .
-Premature solidification of the alloy .
-sprues blocked with foreign bodies .
-Back pressure of gases .
-low casting pressure .
-Alloy not sufficiently molten .
Too bright & shiny casting with short & rounded margins :
occurs when wax is eliminated completely ,it combines with oxygen or air to form carbon monoxide .
Small casting :
occurs when proper expansion is not obtained & due to the shrinkage of the impression .
Contamination of the casting
1) Due to overheating there is oxidation of metal .
2) Use of oxidising zone of the flame .
3) Failure to use a flux .
4) Due to formation sulfur compounds .
Black casting
It is due to :
1) Overheating of the investment .
2) Incomplete elimination of the wax .
Manipulation
Mixing
o P/L types mixed in bowl (plaster and alginate)
o Thermoplastic materials not mixed (compound and agar-agar)
o Paste/paste types hand mixed on pad (zinc oxide-eugenol, polysulfide rubber, silicone rubber, polyether rubber. and poly-vinylsiloxane)
o Paste/paste mixed through a nozzle on an auto-mixing gun (poly-vinylsiloxane)
Placement
o Mixed material carried in tray to mouth (full arch tray, quadrant tray. or triple tray)
o Materials set in mouth more quickly because of higher temperature
Removal - rapid removal of impression encourages deformation to take place elastically rather than permanently (elastic deformation requires about 20 minutes)
Cleaning and disinfection of impressions
Root canal sealers
Applications
Cementation of silver cone gutta-percha point
Paste filling material
Types
Zinc oxide-eugenol cement types
Noneugenol cement types
Therapeutic cement types
properties
Physical-radiopacity
Chemical-insolubility
Mechanical-flow; tensile strength
Biologic-inertness
Gingival tissue packs
Application-provide temporary displacement of gingival tissues
Composition-slow setting zinc oxide-eugenol cement mixed with cotton twills for texture and strength
Surgical dressings
1.Application-gingival covering after periodontal surgery
2. Composition-modified zinc oxide-eugenol cement (containing tannic, acid. rosin, and various oils)
Orthodontic cements
Application-cementation of orthodontic bands
Composition-zinc phosphate cement
Manipulation
Zinc phosphate types are routinely mixed with cold or frozen mixing slab to extend the working time
Enamel bonding agent types use acid etching for improved bonding
Band, bracket, or cement removal requires special care
COMPOSITE RESINS
Reaction
- Free radical polymerization
Monomers + initiator. + accelerators-+ polymer molecules
- Initiators-start polymerization by decomposing and reacting with monomer
- Accelerators-speed up initiator decomposition
- Amines used for accelerating self –curing systems
- Light used for accelerating light-curing systems
Retarders or inhibitors-prevent premature polymerization
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PROPERTY |
INGREDIENT |
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Silver |
Tin |
Copper |
Zinc |
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Strength |
Increases |
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Durability |
Increases |
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Hardness |
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Increases |
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Expansion |
Increases |
Decreases |
Increases |
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Flow |
Decreases |
Increases |
Decreases |
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Color |
Imparts |
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Setting time |
Decreases |
Increases |
Decreases |
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Workability |
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Increases |
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Increases |
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CAD/CAM Restorations
Applications-inlays, onlays, veneers, crowns, bridges, implants, and implant prostheses
Stages of fabrication
CSD-computerized surface digitization
CAD-computer-aided (assisted) design
CAM-computer-aided (assisted) machining
CAE-computer-aided esthetics (currently theoretic)
CAF-computer-aided finishing or polishing (which are currently theoretic steps)
Classification
Chairside or in-office systems
(1) Cerec (Siemens system)-inlays, onlays, veneers
(2) Sopha (Duret system)-inlays, onlays (and Crowns)
Laboratory systems
(1) DentiCAD (Rekow system)-inlay, onlays, veneers, crowns
(2) Cicero (Elephant system)-porcelain fused-to-metal crowns
Materials
a. Feldspathic oorcelains (Vita)
b. Machinable ceramics (Dicor MGC)
c. Metal alloys limited use)
Cementing
- Etching enamel and/or dentin for micromechanical retention
- Bonding agent for retention to etched surface
- Composite as a luting cement for reacting chemically with bonding agent and with silanated surface of restoration
- Silane for bonding to etched ceramic (or metal) restorations and to provide chemical reaction
- Hydrofluoric acid etching to create spaces for micromechanical retention on surface or restoration
Properties
1. Physical properties
a. Thermal expansion coefficient well matched to tooth structure
b. Good resistance to plaque adsorption or retention
2. Chemical properties-not resistant to acids and should be protected from APF
3. Mechanical properties
a. Excellent wear resistance (but may abrade opponent teeth)
b. Some wear of luting cements but self-limiting
c. Excellent toothbrush abrasion
4. Biologic properties-excellent properties