NEET MDS Lessons
Dental Materials
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
Applications/Use
- Load -bearing restorations for posterior teeth (class I, II)
- Pinned restorations
- Buildups or cores for cast restorations
- Retrograde canal filling material
(1) Alloy. An alloy is a solid mixture of two or more metals. It is possible to produce a material in which the desirable properties of each constituent are retained or even enhanced, while the less desirable properties are reduced or eliminated.
(2) Amalgam. When one of the metals in an alloy mixture is mercury, an amalgam is formed. A dental amalgam is a combination of mercury with a specially prepared silver alloy, which is used as a restorative material.
(3) Mercury. Mercury is a silver-white, poisonous, metallic element that is liquid at room temperature
Properties
I. Physical
a. Excellent thermal and electrical insulator
b. Very dense
c. Excellent dimensional stability
d. Good reproduction of fine detail of hard and soft tissues
2. Chemical
a. Heating will reverse the reaction (decompose the material into calcium sulfate hemihydrate, the original dry component)
b. Models, casts, and dies should be wet during grinding or cutting operations to prevent heating
3. Mechanical
a. Better powder packing and lower water contents at mixing lead to higher compressive strengths (plaster < stone < diestone)
b. Poor resistance to abrasion
4. Biologic
a. Materials are safe for contact with external - epithelial tissues
b. Masks should be worn during grinding or polishing operations that are likely to produce gypsum dust
Solution Liners (Varnishes)
Applications
o Enamel and dentin lining for amalgam restorations
o Enamel and dentin lining for cast restorations that are used with non adhesive cements
o Coating over materials that are moisture sensitive during setting
Components of copal resin varnish
o 90% solvent mixture (e.g., chloroform, acetone, and alcohol)
o 10% dissolved copal resin
Reaction
Varnish sets physically by drying Solvent loss occurs in 5 to 15 seconds (a film forms the same way as drying fingernail polish)
Manipulation
Apply thin coat over dentin. enamel. And margins of the cavity preparation Dry lightly with air for 5 seconds Apply a second thin coat Final thickness is 1 to 5 µ.m
Properties
o Physical
Electrically insulating barrier that prevents shocks. Too thin to be thermally insulating. Decreases degree of percolation attributable to thermal expansion
o Chemical
Forms temporary barrier that prevents microleakage into dentinal tubules until secondary dentin formation occurs. Decreases initial tendency for electrochemical corrosion
o Mechanical
Very weak and brittle film that has limited lifetime
Film adheres to smear layer
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.
I . Procedure for single casting :
A 2.5 mm sprue former is recommended
for molar crowns 2.0 mm for premolars & partial coverage crowns .
II . Procedure for multiple casting :
Each unit is joined to a runner bar .
A single sprue feeds the runner bar
4 . SPRUE FORMER DIRECTION
Sprue Should be directed away from the delicate parts of the pattern
It should not be at right angles to a flat surface .(leads to turbulance porosity .)
Ideal angulation is 45 degrees .
5 . SPRUE FORMER LENGTH
Depends on the length of casting ring .. Length of the Sprue former should be such that it keeps the wax pattern about 6 to 8 mm away from the casting ring. Sprue former should be no longer than 2 cm. The pattern should be placed as close to the centre of the ring as possible.
Significance
Short Sprue Length:
The gases cannot be adequately vented to permit the molten alloy to fill the ring completelyleading to Back Pressure Porosity.
Long Sprue Length:
Fracture of investment, as mold will not withstand the impact force of the entering molten alloy.
Top of wax should be adjusted for :
6 mm for gypsum bonded investments .
3 -4 mm for phosphate bonded investments .
TYPES OF SPRUES
I . - Wax . II . Solid
- Plastic . Hollow
- Metal .
COMPOSITE RESINS
Types
- Amount of filler-25% to 65% volume, 45% to 85% weight
- Filler particle size (diameter in microns)
- Macrofill 10 to 100 µm (traditional composites)
- Midi fill- 1 to 10 µm(small particle composites)
- Minifill— 0.l to 1 µm
- Microfill-: 0.01 to 0.1 µm (fine particle composites)
- Hybrid--blend (usually or microfill and midifill or minifill and microfill)
- Polymerization method
- Auto-cured (self-cured)
- Visible light cured
- Dual cured
- Staged cure
- Matrix chemistry
- BIS-GMA type
- Urethane dimethacrylate (UDM or UDMA) type
- TEGDMA-diluent monomer to reduce viscosity