Investment Techniques 

Single step investing technique:
The investing procedure is carried out in one step either by brush technique or by vacuum technique.

a). Brush technique:
The accurate water-powder ratio is mixed under vacuum. A brush is then used to paint the wax pattern with mix then the casting ring is applied over the crucible former and the ring is filled under vibration until it is completely filled.

b). vacuum technique:
• The mix in first hand spatulated, and then with the crucible former and pattern is place, then ring is attached to the mixing bowl.
• The vacuum hose is then attached to the assembly. The bowel is inverted and the ring is filled under vacuum and vibration

Two-step investing technique:

The investing procedure is carried out in two steps:

• First, the wax pattern is painted with a thick mix andis left till complete setting, the set investment block(first cost) is immersed in water for about tenminutes . the casting ring is then applied over the crucible former and filled with the properly mixedinvestment (second coat) till the ring is completely filled and the mix is left to set.The two-step investing technique is recommendedwhenever greater amount of expansion is required. Thistechnique also minimizes the distortion of the waxpattern and provides castings with smoother surfaces.

• The investment is allowed to set for the recommendedtime (usually one-hour) then the crucible former is removed. If a metal sprue former is used, it is removedby heating over a flame to loosen it from the wax pattern. Any loose particles of investment should beblown off with compressed air should be placed in a humidor if stored overnight.
 

Mouth Protectors

Use - to protect against effects of blows to chin, top of the head, the face, or grinding of the teeth

Types

o    Stock protectors-least desirable because of poor fit
o    Mouth-formed protectors-improved fit compared with stock type
o    Custom-made protectors-preferred because of durability. low  speech impairment, and comfort

I. Components

a. Stock protectors-thermoplastic copolymer of PYA-PE (polyvinyl acetate-polyethylene copolymer)
b. Mouth-formed protectors-thermoplastic copolymer
c. Custom-made protectors- thermoplastic copolymer, rubber. or polyurethane
2. Reaction-physical reaction of hardening during cooling
3. Fabrication

Alginate impression made of maxillary arch. High-strength stone cast poured immediately. Thermoplastic material is heated in hot water and vacuum-molded to cast .

Mouth protector trimmed to within ½ inch of labial fold, clearance provided at the buccal and labial frena, and edges smoothed by flaming. Gagging, taste, irritation. and impairment of speech are minimized with properly fabricated appliances

4. Instructions for use

a. Rinse before and after use with cold water
b. Clean protector occasionally with soap and cool water
c. Store the protector  in a rigid container
d. Protect from heat and pressure during storage
e. Evaluate protector routinely for evidence of deterioration

Properties

1. Physical-thermal insulators
2. Chemical-absorbs after during use
3. Mechanical-tensile strength, modulus, and hardness decrease after  water absorption, but elongation, tear strength, and resilience increase
4. Biologic-nontoxic as long as no bacterial, fungal, or viral growth occurs on surfaces between uses
 

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
 

METALLURGICAL TERMS

a. Cold Working. This is the process of changing the shape of a metal by rolling, pounding, bending, or twisting at normal room temperature.

b. Strain Hardening. This occurs when a metal becomes stiffer and harder because of continued or repeated application of a load or force. At this point, no further slippage of the atoms of the metal can occur without fracture.

c. Heat Softening Treatment (Annealing). This treatment is necessary in order to continue manipulating a metal after strain hardening to prevent it from fracturing. The process of annealing consists of heating the metal to the proper temperature (as indicated by the manufacturer's instructions) and cooling it rapidly by immersing in cold water. Annealing relieves stresses and strains caused by cold working and restores slipped atoms within the metal to their regular arrangement.

d. Heat Hardening Treatment (Tempering). This treatment is necessary to restore to metals properties that are decreased by annealing and cold working. Metals to be heat hardened should first be heat softened (annealed) so that all strain hardening is relieved and the hardening process can be properly controlled. Heat hardening is accomplished in dental gold alloy by heating to 840^o Fahrenheit, allowing it to cool slowly over a 15-minute period to 480^o Fahrenheit, and then immersing it in water.

Stages of manipulation

Definitions of intervals

• Mixing interval-length of time of the mixing stage.
• Working interval-length of time of the working stage
•  Setting interval-length of time of the setting stage

Definitions of times

• Mixing time-the elapsed time from the onset to the completion of mixing
• Working time-the elapsed time from the onset of mixing until the onset of the initial setting time
• Initial setting time-time at which sufficient reaction has occurred  to cause the materials to be resistant to  further manipulation
• Final setting time-time at which the material practically is set as defined by its resistance to indentation

[All water-based materials lose their gloss at the time of setting]

Dental Implants

Applications/Use
 
Single-tooth implants
Abutments for bridges (freestanding, attached to natural teeth)
Abutments for over dentures

Terms

Subperiosteal- below the periosteum -but above the bone (second most frequently used types)
Intramucosal-within the mucosa
Endosseous into the bone  (80%of all current types)
Endodontics-through the root canal space and into the periapical bone
Transosteal-through the bone
Bone substitutes -replace. Long bone

Classification by geometric form

Blades
Root forms
Screws
Cylinders
Staples
Circumferential
Others

Classification by materials type

Metallic-titanium, stainless steel, and .chromium cobalt
Polymeric-PMMA
Ceramic hydroxyapatite, carbon, and sapphire

Classification by attachment design

Bioactive surface retention by osseointegration
Nonative porous surfaces for micromechanical retention by osseointegration
Nonactive, nonporous surface for ankylosis. By osseointegration 
Gross mechanical retention designs (e.g.. threads, screws, channels, or transverse holes)
Fibrointegration by formation of fibrous tissue capsule
Combinations of the above

Components

a. Root (for. osseointegration)
b. Neck (for epithelial attachment and percutancaus sealing)
c. Intramobile elements (for shock absorption)
d. Prosthesis (for dental form and function)

Manipulation

a. Selection-based on remaining bone architecture and dimensions
b. Sterilization-radiofrequency glow discharge leaves biomaterial surface uncontaminated and sterile; autoclaving or chemical sterilization is contraindicated for some designs

Properties

1. Physical-should have low thermal and electrical conductivity

2. Chemical

a. Should be resistant to electrochemical corrosion
b. Do not expose surfaces to acids (e.g.. APF fluorides).
c. Keep in mind the effects of adjunctive therapies (e.g., Peridex)

3. Mechanical
a. Should be abrasion resistant and have a high modulus
b. Do not abrade during scaling operations (e.g.with metal scalers or air-power abrasion systems like  Prophy iet)

4. Biologic-depend on osseointegration and epithelial attachment

ZINC OXIDE AND EUGENOL 

This material is used for many dental purposes ranging from temporary restorative material to pulp capping. The material is composed of a powder that is basically zinc oxide and a liquid that is called eugenol.

Chemical Composition.

The powder must contain between 70 and 100 percent zinc oxide. The manufacturer may add hydrogenated resins to increase strength and zinc acetate to hasten the set. 

Eugenol is usually derived from oil of cloves. The oil of cloves contains more eugenol (82 percent) Eugenol is an obtundent (pain-relieving agent). It is a clear liquid that gradually changes to amber when exposed to light. 

Physical Properties. 
This material relieves pain, makes tissue less sensitive to pain, is slightly antiseptic, and is low in thermal conductivity. It provides a good marginal seal when placed in tooth cavities. The crushing strength (compression strength) of pure zinc oxide and eugenol is about 2,000 psi, which is low in comparison to other cements. The addition of hydrogenated resin increases the crushing strength to 5,000 psi. 

CLINICAL USES OF ZINC OXIDE AND EUGENOL 

Treatment Restoration. It helps prevent pulpal irritation in carious teeth, lost restorations, advanced caries, or pulpitis. This dental material also exerts a palliative effect on the pulp. 

Temporary Cementing Medium. Zinc oxide and eugenol is used as a temporary cementing medium for crowns, inlays, and fixed partial dentures. 

Intermediate Base. Zinc oxide and eugenol is used as an intermediate base. This material provides insulation between metallic restorations and vital tooth structure. Because of the low crushing strength, its use is sometimes contraindicated. 

Surgical Packing or Dressing. The surgical dressing applied and adapted over the gingival area after a gingivectomy. This dressing protects the area and makes the tissue less sensitive.