NEET MDS Lessons
Dental Materials
COMPOSITE RESINS
Reaction
- Free radical polymerization
Monomers + initiator. + accelerators-+ polymer molecules
- Initiators-start polymerization by decomposing and reacting with monomer
- Accelerators-speed up initiator decomposition
- Amines used for accelerating self –curing systems
- Light used for accelerating light-curing systems
Retarders or inhibitors-prevent premature polymerization
Classification of Dental amalgam
1. By powder particle shape .
- Irregular (comminuted, filing, or lathecut)
- Spherical (spherodized)
- Blends (e.g., irregular-irregular, irregularspherical, or spherical-spherical)
2. By total amount of copper
- Low-copper alloys (e.g., conventional, traditional); <5% copper
- High-copper alloys (e,g. corrosion resistant); 12% to 28% copper
3.By presence of zinc
Examples
- Low-copper, irregular-particle alloy-silver (70%)-tin (26%)-copper (4%)
- High-copper, blended-particles alloy-irregular particles, silver (70%) –tin (26%) -Copper (4%); spherical particles, silver (72%)-copper (28%)
- High-copper, spherical-particles alloy-silver (60%) - tin (27%)-copper (13%)
Applications
a. Dentulous impressions for casts for prosthodontics
b. Dentulous impressions for pedodontic appliances
c. Dentulous impressions for study models for orthodontics
d. Edentulous impressions for casts for denture construction
Denture Cleansers
Use - for removal of soft debris by light brushing and then rinsing of denture; hard deposits require professional repolishing
a. Alkaline perborates-do not remove bad stains; may harm liners .
b. Alkaline peroxides-harmful to denture liners
c. Alkaline hypochlorites-may cause bleaching, corrode base-metal alloys, and leave residual taste on appliance
d. Dilute acids-may corrode base-metal alloys
e. Abrasive powders and creams-can abrade denture surfaces
Denture cleaning Method
a. Full dentures without soft liners-immerse denture in solution of one part 5% sodium hypochlorite in three parts of water
b. Full or partial dentures without soft-liners immerse denture in solution of 1 teaspoon of hypochlorite with 2 teaspoons of glassy phosphate in a half of a glass of water
c. Lined dentures -- clean any soft liner with a cotton swab and cold water while cleaning the denture with a soft brush
Properties
1. Chemical-can swell plastic surfaces or corrode metal frameworks
2. Mechanical-can scratch the surfaces of denture bases or denture teeth
Bonding Agents
Applications-composites, resin-modified gIass ionomers, ceramic bonded to enamel restorations, veneers, orthodontic brackets, and desensitizing dentin by covering exposed tubules (Maryland bridges, composite and ceramic repair systems, amalgams and amalgam repair, and pinned amalgams)
Definitions;-
Smear layer - Layer of compacted debris on enamel and/or dentin from the cavity preparation process that is weakly held to the surface (6 to 7 MPa) , and that limits bonding agent strength if not removed
Etching (or, conditioning)- smear layer removal and production of microspaces for micromechanical bonding by dissolving –minor amounts of surface hydroxyapatite crystals
Priming..- micromechanical (and chemical) bonding to the microspaces created by conditioning step.
Conditioning/priming agent-agent that accomplishes both actions
Bonding- formation of resin layer that connect the primed surface to the overlying restoration (e.g., composite) .. –
Enamel bonding System-for bonding to enamel (although dentin bonding may be a Second step)
Dentin bonding system for bonding to dentin (although enamel bonding may have been a first step)
• First-generation dentin bonding system for bonding to smear layer
• New-generation dentin bonding system- for removing smear layer and etching intertubular dentin to allow primer and/or bonding agent to diffuse into spaces between collagen and form hybrid zone
Enamel and dentin bonding system-for bonding to enamel and dentin surfaces with the same procedures
Amalgam bonding system for bonding to enamel, dentin, and amalgam, dentin and amalgam during an amalgam placement procedure or for amalgam repair
Universal bonding system-for bonding to enamel, dentin, amalgam, porcelain , or any other substrate intraorally that may be necessary for a restorative procedure using the same set of procedures and materials
Types
Enamel bonding systems
Dentin bonding systems
Amalgam bonding systems
Universal bonding systems
Structure
o Components of bonding systems
o Conditioning agent-mineral or organic acid
Enamel only 37% phosphoric acid
Dentin only or enamel and .dentin---37% phosphoric acid, citric acid, maleic acid, or nitric acid
o Priming agent
Hydrophobic-solvent-soluble, light cured monomer system
Hydrophilic-water-soluble, light-cured monomer system
Bonding agent
BIS-GMA-type monomer system
UDMA-type monomer system
Reaction
Bonding occurs primarily by intimate micromechanical retention with the relief created by the conditioning step
Chemical bonding is possible but is not recognized as contributing significantly to the overall bond strength
Manipulation-follow manufacturer's directions
Properties
Physical-thermal expansion and contraction may create fatigue stresses that debond the interface and permit micro leakage
Chemical-water absorption into the bonding agent may chemically alter the bonding
Mechanical-mechanical stresses may produce fatigue that debonds the interface and permits microleakage
Enamel bonding-adhesion occurs by macrotags (between enamel prisms) and microtags (into enamel prisms) to produce micromechanical retention
Dentin bonding-adhesion occurs by penetration of smear layer and formation of microtags into intertubular dentin to produce a hybrid zone (interpenetration zone or diffusion zone) that microscopically intertwines collagen bundles and bonding agent polymer
Biologic
Conditioning agents may be locally irritating if they come into contact with soft tissue
Priming agents (uncured), particularly those based on HEMA, may be skin sensitizers after several contacts with dental personnel
Protect skin on hands and face from inadvertent contact with unset materials and/ or their vapors
HEMA and other priming monomers may penetrate through rubber gloves in relatively short times (60 to 90 seconds)
Acrylic Appliances
Use - space maintenance or tooth movement for orthodontics and pediatric dentistry
1. Components
a. Powder-PMMA powder. peroxide initiator, and pigments
b. Liquid-MMA monomer, hydroquinone inhibitor, cross-linking agents, and chemical accelerators (N, N-dimethyl-p-toluidine)
2. 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
Casting Alloys
Applications-inlay, onlay, crowns, and bridges
Terms
a. Precious-based on valuable elements
b. Noble or immune-corrosion-resistant element or alloy
c. Base or active-corrosion-prone alloy
d. Passive -corrosion resistant because of surface oxide film
e. Karat (24 karat is 100% gold; 18 karat is 75% gold)
f. Fineness (1000 fineness is I00% gold; 500 fineness is 50% gold)
Classification
High-gold alloys are > 75% gold or other noble metals
Type 1- 83% noble metals (e.g., in simple inlays)
Type II-≥78% noble metals (e.g.,in inlays and onlays)
Type IlI-≥75% noble metals (e.g., in crowns and bridges)
Type IV-≥75% noble metals (e.g., in partial dentures)
Medium-gold alloys are 25% to 75% gold or other noble metals
Low-gold alloys are <25% gold or other noble metals
Gold-substitute alloys arc alloys not containing gold
(1) Palladium-silver alloys-passive .because of mixed oxide film
(2) Cobalt-chromium alloys-passive because of Cr203 oxide film
(3) Iron-chromium alloys-passive because of Cr203 oxide film
Titanium alloys are based on 90% to 100% titanium ; passive because of TiO2 oxide film
Components of gold alloys
- Gold contributes to corrosion resistance
- Copper contributes to hardness and strength
- Silver counteracts orange color of copper
- Palladium increases melting point and hardness
- Platinum increases melting point
- Zinc acts as oxygen scavenger during casting
Manipulation
- Heated to just beyond melting temperature for casting
o Cooling shrinkage causes substantial contraction
Properties
Physical
- Electrical and thermal conductors
- Relatively low coefficient of thermal expansion
Chemical
- Silver content affects susceptibility to tarnish
- Corrosion resistance is attributable to nobility or passivation
Mechanical
- High tensile and compressive strengths but relatively weak in thin sections, such as margins, and can be deformed relatively easily
- Good wear resistance except in contact with Porcelain