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
 

POLYCARBOXYLATE CEMENT 

Use:. The primary use of polycarboxylate cement is as a cementing medium of cast alloy and porcelain restorations. In addition, it can be used as a cavity liner, as a base under metallic restorations, or as a temporary restorative material. 

Clinical Uses

Polycarboxylate cement is used in the same way as zinc phosphate cement, both as an intermediate base and as a cementing medium. 

c. Chemical Composition. 

(1) Powder:. It generally contains zinc oxide, 1 to 5 percent magnesium oxide, and 10 to 40 percent aluminum oxide or other reinforcing fillers. A small percentage of fluoride may be included. 
(2) Liquid. Polycarboxylate cement liquid is approximately a 40 percent aqueous solution of polyacrylic acid copolymer with other organic acids such as itaconic acid. Due to its high molecular weight, the solution is rather thick (viscous). 

d. Properties. 

The properties of polycarboxylate cement are identical to those of zinc phosphate cement with one exception. Polycarboxylate cement has lower compressive strength. 

e. Setting Reactions: 

The setting reaction of polycarboxylate cement produces little heat. This has made it a material of choice. Manipulation is simpler, and trauma due to thermal shock to the pulp is reduced. The rate of setting is affected by the powder-liquid ratio, the reactivity of the zinc oxide, the particle size, the presence of additives, and the molecular weight and concentration of the polyacrylic acid. The strength can be increased by additives such as alumina and fluoride. The zinc oxide reacts with the polyacrylic acid forming a cross-linked structure of zinc polyacrylate. The set cement consists of residual zinc oxide bonded together by a gel-like matrix. 

Precautions. 
The following precautions should be observed. 
o    The interior of restorations and tooth surfaces must be free of saliva. 
o    The mix should be used while it is still glossy, before the onset of cobwebbing. 
o    The powder and liquid should be stored in stoppered containers under cool conditions. Loss of moisture from the liquid will lead to thickening. 
 

Properties-improve with filler content

Physical

Radiopacity depends on ions in silicate glass or the addition of barium sulfate (many systems radiolucent)
Coefficient of thermal expansion is 35 to 45 ppm/C and decreases with increasing filler content
Thermal and electrical insulators

Chemical

Water absorption is 0.5 % to 2.5% and increases with polymer level)
Acidulated topical fluorides (e.g., APF) tend to dissolve glass particles, and thus composites should be protected with petroleum jelly (Vaseline) during those procedures
Color changes occur in resin matrix with time because of oxidation, which produces colored by-products

Mechanical

Compressive strength is 45,000 to 60,000 lb/ in2, which is adequate
Wear resistance-improves with higher filler content, higher percentage of conversion in curing, and use of microfiller, but it is not adequate for some posterior applications
Surfaces rough from wear retain plaque and stain more readily

Biologic

Components may be cytotoxic, but cured composite is biocompatible as restorative filling material

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
 

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 

Temporary Filling Materials

Applications / Use

While waiting for lab fabrication of cast restoration
While observing reaction of pulp tissues

Objectives

Provide pulpal protection
Provide medication to reduce pulpal inflammation
Maintain the tooth position with an aesthetic restoration

Classification

Temporary filling cements
Temporary filling resins

Components

Temporary filling cements

1. Zinc oxide-eugenol cement with cotton fibers added
2. Polyme r powder-reinforced zinc oxide eugenol cement

Temporary filling resins

•    MMA / PMMA filling materials
•    Polyamide filling materials
•    BIS-GMA filling materials