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

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. 
 

INVESTING
Mixing investment with distilled water is done according to the manufacturers ratio in a clean dry bowl without entrapment of the air into the mix.

Mixing methods:
a.    Hand mixing and the use of the vibrator to remove air bubbles.
b.    Vacuum mixing- This is the better method because it removes air bubbles as well as gases that are produced and thus produces a smoother mix.

Methods of investing:
a.    Hand investing
b.    Vacuum investing

Hand investing:

First the mixed investment is applied on all the surfaces of the pattern with a soft brush. Blow off any excess investment gently, thus leaving a thin film of investment over the pattern, then apply again.
Then the coated pattern can be invested by two methods;
1. Placing the pattern in the ring first and then filling the ring full with investment.
2. Filling the ring with the investment first and then force the pattern through into it.

Vacuum investing :

Vacuum investing unit: This consists of the chamber of small cubic capacity from which air can be evacuated quickly and in which casting ring can be placed.
Evacuation of air can be done by electrically or water driven vacuum pump.

Procedure:

The ring filled with investment is placed in the vacuum chamber. Air entry tube is closed. Then the vacuum is applied. The investment will rise with froth vigorously for about 10-15 sec and then settles back. This indicates that air has been extracted from the ring. The pressure is now restored to atmospheric by opening the air entry tap gradually at first and then more rapidly as the investment settles back around the pattern. Then the ring is removed from the chamber and the investment is allowed to set. Modern investing unit does both mixing and investing under vacuum and is considered better than hand mixing and pouring.
Then there are two alternatives to be followed depending upon what type of expansion is to be achieved in order to compensate for metal shrinkage. They are:

1. If hygroscopic expansion of the investment is to be achieved then immediately immerse the filled ring in water at the temperature of 37C.
Or “under controlled water adding technique”. A soft flexible rubber ring is used instead of usual lined metal ring. Pattern is invested as usual. Then specified amount of water is added on top of the investment in the rubber ring and the investment is allowed to set at room temperature. In this way only enough water is added to the investment to provide the desired expansion.

2. If thermal expansion of the investment is to be achieved, then investment is allowed to set by placing the ring on the bench for 1 hour or as recommended by the manufacturer.

Dental Solders

Applications-bridges and orthodontic appliances

Terms

Soldering -joining operation using filler metal that melts below 500° C

Brazing -joining operation using filler metal that melts above 500°C

Welding-melting and alloying of pieces to be joined

Fluxing
 -Oxidative cleaning of area to be soldered
 - Oxygen scavenging to prevent oxidation of alloy being soldered
16- 650 -- 650 fineness solder to be used with 16-karat alloys; fineness refers to the gold content

Classification

a. Gold solders-bridges
b. Silver solders-gold-substitute bridges and orthodontic alloys

Structure of gold solders

Composition-lower gold content than of alloys being soldered

Manipulation-solder must melt below melting temperature of alloy

Properties

1. Physical-similar to alloys being joined
2. Chemical-more prone to chemical and electrochemical corrosion
3. Mechanical-similar to alloy  being joined
4. Biologic-similar to alloys being joined
 

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. 
 

Manipulation

1. Selection-based on strength for models, casts, or dies

2. Mixing
(1)Proportion the water and powder 
(2) Sift powder into water in rubber mixing bowl
(3) Use stiff blade spatula to mix mass on side of bowl
(4) Complete mixing in 60 seconds

3. Placement

(1) Use vibration to remove air bubbles acquired through mixing
(2) Use vibration during placement to help mixture wet and flow into the impression