NEET MDS Lessons
Dental Materials
Suspension liners
Applications
o Dentin lining under amalgam restorations
o Stimulation of reparative dentin formation
Components
-Calcium hydroxide powder
-Water
-Modifiers
Manipulation
Used as W/P or pastes Paint thin film on dentin → Use forced air for 15 to 30 seconds to dry → Film is thicker (15 µm) than varnishes → Do not use on enamel or cavosurface margins
Properties
Physical
-Electrically insulating barrier
-Too thin to be thermally insulating
Chemical
-High basicity for calcium hydroxide (pH is II)
-Dissolves readily in water and should not be used at exposed cavosurface margins or gaps may form
Mechanical - weak film
Biologic - calcium hydroxide dissolves, diffuses, and stimulates odontoblasts to occlude dentin tubules below cavity preparation
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
Properties of Acrylic Resins.
- They have a low thermal conductivity. These resins are not easily washed out by the acids of the oral cavity (low solubility). Acrylic resins are also resilient, which allows them to be used in stress-bearing areas.
- Acrylic resins exhibit a moderate shrinkage of from 3 to 8 percent. This shrinkage and low marginal strength can lead to marginal leakage. Acrylic resins have a low resistance to wear. Acrylic resins cannot be used over a zinc oxide and eugenol-type base because eugenol interferes with the acrylic curing process.
- Mixing. Insufficient mixing will cause an uneven color or streaks in the mixture. Overmixing will cause the material to harden before it can be placed
- Poor distortion resistance at higher temperatures, therefore dentures should not be cleaned in hot water
- Good resistance to color change
- Absorbs water and must be kept hydrated (stored in water when not in mouth) to prevent dehydration cycling and changes in dimensions
- Not resistant to strong oxidizing agents
- Low strength; however, flexible, with good fatigue resistance
- Poor scratch resistance; clean tissue-bearing surfaces of denture with soft brush and do not use abrasive cleaners
Spruing Technique:
Direct Spruing:
The flow of the molten metal is straight(direct) from the casting crucible to pattern area in the ring. Even with the ball reservoir, the Spruing method is still direct. A basic weakness of direct Spruing is the potential for suck-back porosity at the junction of restoration and the Sprue.
Indirect Spruing:
Molten alloy does not flow directly from the casting crucible into the pattern area, instead the alloy takes a circuitous (indirect) route. The connector (or runner) bar is often used to which the wax pattern Sprue formers area attached. Indirect Spruing offers advantages such as greater reliability & predictability in casting plus enhanced control of solidification shrinkage .The Connector bar is often referred to as a “reservoir .
Armamentarium :
1 . Sprue
2 . Sticky wax
3 . Rubber crucible former
4 . Casting ring
5 . Pattern cleaner
6 . Scalpel blade & Forceps
7 . Bunsen burner
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
Tooth Polishing and Cleansing Agents
1. Cleansing-removal of exogenous stains, pellicle, materia alba, and other oral debris without causing undue abrasion to tooth structure
2. Polishing-smoothening surfaces of amalgam, composite, glass ionomers, porcelain, and other restorative materials
Factors influencing cleaning and polishing
- Hardness of abrasive particles versus substrate
- Particle size of abrasive particles
- Pressure applied during procedure
- Temperature of abrasive materials
Structure
Composition
-contain abrasives, such as kaolinite, silicon dioxide, calcined magnesium silicate, diatomaceous silicon dioxide, pumice. Sodium-potassium
-aluminum silicate, or zirconium silicate; some pastes also may contain sodium fluoride or stannous fluoride, but they have never been shown to produce positive effects
Reactions-abrasion for cleansing and polishing
Properties - Mechanical
- Products with pumice and quartz produce more efficient cleansing but also generate greater abrasion of enamel and dentin
-Coarse pumice is the most abrasive
-The abrasion rate of dentin is 5 to 6 times faster than the abrasion rate of enamel, regardless of the product
-Polymeric restorative materials, such as denture bases, denture teeth, composites, PMMA veneers, and composite veneers, can be easily scratched during polishing
-Do not polish cast porcelain restorations (e.g., Dicor) that are externally characterized or the color will be lost
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