NEET MDS Lessons
Dental Materials
ACID ETCH TECHNIQUE
Cavities requiring added retention (to hold firmly) are treated with an acid etching technique. This technique improves the seal of the composite resin to the cavity wall. The enamel adjacent to the margins of the preparation is slightly decalcified with a 40 to 50 percent phosphoric acid solution. This etched enamel enhances the mechanical retention of the composite resin. In addition, the acid etch technique is used to splint unstable teeth to adjacent teeth. The acid is left on the cut tooth structure only 15 seconds, in accordance with the directions for one common commercial brand. The area is then flushed with water for a minimum of 30 seconds to remove the decalcified material. Etched tooth structure will have a chalky appearance.
Classification
Rigid impression materials
(1) Plaster
(2) Compound
(3) Zinc oxide-eugenol
Flexible hydrocolloid impression materials
(I) Agar-agar (reversible hydrocolloid)
(2) Alginate (irreversible hydrocolloid)
Flexible, elastomeric, or rubber impression materials
(1) Polysulfide rubber (mercaptan rubber)
(2) Silicone rubber (condensation silicone)
(3) Polyether rubber
(4) Polyvinyl siloxane (addition silicone)
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)
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
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
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
POLISHING MATERIALS
1 Tin Oxide. Tin oxide is used in polishing teeth and metal restorations. Tin oxide is a fine, white powder that is made into a paste by adding water or glycerin.
2. Pumice. Pumice is used as an abrasive and polishing agent for acrylic resins, amalgams, and gold. It consists mainly of complex silicates of aluminum, potassium, and sodium. Two grades--flour of pumice and coarse pumice--are listed in the Federal Supply Catalog.
3. Chalk (Whiting). Chalk is used for polishing acrylic resins and metals. It is composed primarily of calcium carbonate.
4.Tripoli. Tripoli is usually used for polishing gold and other metals. It is made from certain porous rocks.
5. Rouge (Jeweler's). Rouge is used for polishing gold and is composed of iron oxide. It is usually in cake or stick form.
6. Zirconium Silicate. Zirconium silicate is used for cleaning and polishing teeth. It may be mixed with water or with fluoride solution for caries prevention treatment. For full effectiveness, instructions must be followed exactly to obtain the proper proportions of powder to liquid.