NEET MDS Lessons
Dental Materials
Manipulation
Selection
o Microfilled composites or hybrids for anterior class III, IV, V
o Hybrids or midifills for posterior class I, II, III, V
Conditioning of enamel and / or dentin
Do not apply fluorides before etching.-->Acid-etch --> Rinse for 20 seconds with water --> Air-dry etched area for 20 seconds but do not desiccate or dehydrate --> Apply bonding agent and polymerize
Mixing (if required)--> mix two pastes for 20 to 30 seconds
o Self-cured composite-working time is 60 to 120 seconds after mixing
o Light-cured composite-working time is unlimited (used for most anterior and some posterior composite restorations)
o Dual-cured composite-working time is > 10 minutes
o Two-stage cured composite-working time is >5 minutes
Placement
use plastic instrument or syringe --> Light curing --> Cure incrementally in <2 mm thick layers. Use matrix strip where possible to produce smooth surface and contour composite .Postcure to improve hardness
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
Mixture of powder and liquid is painted onto working cast to create shape for acrylic appliance à After curing of mixture, the shape and fit are adjusted by grinding with burrs and stones with a slow-speed handpiece .Acrylic dust is irritating to epithelial tissues of nasopharynx and skin and may produce allergic dermatitis or other reactions. Grinding may heat polymer to temperatures that depolymerize and release monomer vapor. which may be an irritant
Denture Teeth
Use-complete or partial dentures
Type
a. Porcelain teeth
b. Acrylic resin teeth
c. Abrasion-resistant teeth (microfilled composite)
Structure and properties
1. Porcelain teeth (high-fusing porcelain)
Only bonded into denture base mechanically. Harder than natural teeth or other restorations and abrades those surfaces. Good aesthetics.Used when patients have good ridge support and sufficient room between the arches
2. Acrylic resin teeth (PMMA [polymethyl methacrylate])
Bonded pseudochemically into the denture base. Soft and easily worn by abrasive foods . Good initial aesthetics
Used with patients with poor ridges and in cases where they oppose natural teeth
3. Abrasion-resistant teeth (microfilled resins)
Bonded pseudochemically into the denture base.Better abrasion resistance then acrylic resin teeth
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