NEET MDS Lessons
Dental Materials
CRUCIBLE FORMER
It serves as a base for the casting ring during investing .Usually convex in shape.
May be metal , plastic or rubber .
Shape depends on casting machine used .
Modern machines use tall crucible to enable the pattern to be positioned near the end of the casting machine .
Bonding Agents
Applications-composites, resin-modified gIass ionomers, ceramic bonded to enamel restorations, veneers, orthodontic brackets, and desensitizing dentin by covering exposed tubules (Maryland bridges, composite and ceramic repair systems, amalgams and amalgam repair, and pinned amalgams)
Definitions;-
Smear layer - Layer of compacted debris on enamel and/or dentin from the cavity preparation process that is weakly held to the surface (6 to 7 MPa) , and that limits bonding agent strength if not removed
Etching (or, conditioning)- smear layer removal and production of microspaces for micromechanical bonding by dissolving –minor amounts of surface hydroxyapatite crystals
Priming..- micromechanical (and chemical) bonding to the microspaces created by conditioning step.
Conditioning/priming agent-agent that accomplishes both actions
Bonding- formation of resin layer that connect the primed surface to the overlying restoration (e.g., composite) .. –
Enamel bonding System-for bonding to enamel (although dentin bonding may be a Second step)
Dentin bonding system for bonding to dentin (although enamel bonding may have been a first step)
• First-generation dentin bonding system for bonding to smear layer
• New-generation dentin bonding system- for removing smear layer and etching intertubular dentin to allow primer and/or bonding agent to diffuse into spaces between collagen and form hybrid zone
Enamel and dentin bonding system-for bonding to enamel and dentin surfaces with the same procedures
Amalgam bonding system for bonding to enamel, dentin, and amalgam, dentin and amalgam during an amalgam placement procedure or for amalgam repair
Universal bonding system-for bonding to enamel, dentin, amalgam, porcelain , or any other substrate intraorally that may be necessary for a restorative procedure using the same set of procedures and materials
Types
Enamel bonding systems
Dentin bonding systems
Amalgam bonding systems
Universal bonding systems
Structure
o Components of bonding systems
o Conditioning agent-mineral or organic acid
Enamel only 37% phosphoric acid
Dentin only or enamel and .dentin---37% phosphoric acid, citric acid, maleic acid, or nitric acid
o Priming agent
Hydrophobic-solvent-soluble, light cured monomer system
Hydrophilic-water-soluble, light-cured monomer system
Bonding agent
BIS-GMA-type monomer system
UDMA-type monomer system
Reaction
Bonding occurs primarily by intimate micromechanical retention with the relief created by the conditioning step
Chemical bonding is possible but is not recognized as contributing significantly to the overall bond strength
Manipulation-follow manufacturer's directions
Properties
Physical-thermal expansion and contraction may create fatigue stresses that debond the interface and permit micro leakage
Chemical-water absorption into the bonding agent may chemically alter the bonding
Mechanical-mechanical stresses may produce fatigue that debonds the interface and permits microleakage
Enamel bonding-adhesion occurs by macrotags (between enamel prisms) and microtags (into enamel prisms) to produce micromechanical retention
Dentin bonding-adhesion occurs by penetration of smear layer and formation of microtags into intertubular dentin to produce a hybrid zone (interpenetration zone or diffusion zone) that microscopically intertwines collagen bundles and bonding agent polymer
Biologic
Conditioning agents may be locally irritating if they come into contact with soft tissue
Priming agents (uncured), particularly those based on HEMA, may be skin sensitizers after several contacts with dental personnel
Protect skin on hands and face from inadvertent contact with unset materials and/ or their vapors
HEMA and other priming monomers may penetrate through rubber gloves in relatively short times (60 to 90 seconds)
FLUXING
To prevent oxidation of gold alloys during melting always use a reducing flux .
Boric acid & borax are used .
Casting of glass or ceramic
A castable ceramic is prepared in a similar manner as metal cast preparation .
Glass is heated to 1360 degrees & then cast.
Phosphate bonded investments are used for this purpose .
PFM Alloys
Applications-substructures for porcelain-fused-to-metal crowns and bridges
Classification
o High-gold alloys
o Palladium-silver alloys
o Nickel-chromium alloys
Structure
Composition
o High-gold alloys are 98% gold. platinum. And palladium
o Palladium-silver alloys are 50% to 60% palladium and 30 to 40% silver
o Nickel-chromium alloys are 70% to 80% nickel and 15% chromium with other metals
Manipulation
o Must have melting temperatures above that of porcelains to be bonded to their surface
o More difficult to cast (see section on chromium alloys)
Properties - Physical
Except for high-gold alloys, others are less dense alloys
Alloys are designed to have low thermal expansion coefficients that must be matched to the overlying porcelain
Chemical-high-gold alloys are immune, but others passivate
Mechanical-high modulus and hardness
Mercury hygiene
- Do not contact mercury with skin
- Clean up spills to minimize mercury vaporization
- Store mercury or precapsulated products in tight containers
- Only triturate amalgam components-in tightly- sealed capsules
- Use amalgam with covers
- Store spent amalgam under water or fixer in a tightly sealed jar
- Use high vacuum suction during amalgam alloy placement, setting, or removal when mercury may be vaporized
- Polishing amalgams generally causes localized melting of silver-mercury phase with release of mercury vapor, so water cooling and evacuation must be used
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