NEET MDS Lessons
Dental Materials
Pit-and-Fissure Dental Sealants
Applications/Use
Occlusal surfaces of newly erupted posterior teeth
Labial surfaces of anterior teeth with fissures
Occlusal surfaces of teeth in older patients with reduced saliva flow (because low saliva increases the susceptibility to caries)
Types
Polymerization method
Self-curing (amine accelerated)
Light curing (light accelerated)
Filler content
Unfilled-most systems are unfilled because filler tends to interfere with wear away from self-cleaning occlusal areas(sealants are designed to wear away, except where there is no self-cleaning action a common misconception is that sealants should be wear resistant)
Components
Monomer-BIS-GMA with TEGDM diluent to facilitate flow into pits and fissures prior to cure
Initiator-benzoyl peroxide (in self-cured) and diketone (in light cured)
Accelerator-amine (In light cured)
Opaque filler-I % titanium dioxide. or other colorant to make the material detectable on tooth surfaces
Reinforcing filler-generally not added because wear resistance is not required within pits and fissures
Reaction-free radical reaction
Manipulation
Preparation
Clean pits and fissures of organic debris. Do not apply fluoride before etching because it will tend to make enamel more acid resistant. Etch occlusal surfaces, pits, and fissures for 30 seconds (gel) or 60 seconds (liquid) with 37% phosphoric acid . Wash occlusal surfaces for 20 seconds. Dry etched area for 20 seconds with clean air spray. Apply sealant and polymerize
Mixing or dispensing
Self-cured-mix equal amounts of liquids in Dappen dish for 5 seconds with brush applicator. Light cured-dispense from syringe tips
Placement
-pits, fissures, and occlusal surfaces --> Allow 60 seconds for self-cured materials to set.
Finishing
Remove unpolymerized and excess material .Examine hardness of sealant. Make occlusal adjustments where necessary in sealant; some sealant materials are self-adjusting
Properties
Physical
Wetting-low-viscosity sealants wet acid etched tooth structure the best
Mechanical
Wear resistance should not be too great because sealant should be able to wear off of self-cleaning areas of tooth
Be careful to protect sealants during polishing procedures with air abrading units to prevent sealant loss
Clinical efficacy
Effectiveness is 100% if retained in pits and fissures .Requires routine clinical evaluation for resealing of areas of sealant loss attributable to poor retention .
Sealants resist effects of topical fluorides
Dental Porcelain and PFM Porcelains
Applications/Use
a. Porcelain inlays and jacket crowns
b. PFM crowns and bridges
c. Denture teeth
Terms
PFM-porcelain fused to metal
Fusing-adherence of porcelain particles into a single porcelain mass
Classification
Dental porcelain is manufactured as a powder. When it is heated to a very high temperature in a special oven, it fuses into a homogeneous mass. The heating process is called baking. Upon cooling, the mass is hard and dense. The material is made in a variety of shades to closely match most tooth colors. Baked porcelain has a translucency similar to that of dental enamel, so that porcelain crowns, pontics, and inlays of highly pleasing appearance can be made. Ingredients of porcelain include feldspar, kaolin, silica in the form of quartz, materials which act as fluxes to lower the fusion point, metallic oxide, and binders. Porcelains are classified into high-, medium-, and low-fusing groups, depending upon the temperature at which fusion takes place.
High-Fusing Porcelains. High-fusing porcelains fuse at 2,400o Fahrenheit or over. They are used for the fabrication of full porcelain crowns (jacket crowns).
Medium-Fusing Porcelains. Medium-fusing porcelains fuse between 2,000o and 2,400o Fahrenheit. They are used in the fabrication of inlays, crowns, facings, and pontics. A pontic is the portion of a fixed partial denture, which replaces a missing tooth.
Low-Fusing Porcelains. Low-fusing porcelains fuse between 1,600o and 2,000o Fahrenheit. They are used primarily to correct or modify the contours of previously baked high- or medium-fusing porcelain restorations. Eg for PFM restorations
Structure
Components
a. Large number of oxides but principally silicon oxide, aluminum oxide. and potassium oxide
b. Oxides are supplied by mixing clay, feldspar, and quartz.
Manipulation
Porcelain powders mixed with water and compacted into position for firing
Shrinkage is 30% on firing because of fusing and so must be made oversized and built up by several firing steps
Properties
1. Physical
a. Excellent electrical and thermal insulation
b. Low coefficient of thermal expansion and contraction
c. Good color and translucency; excellent aesthetics
2. Chemical
a. Not resistant to acids (and can be dissolved by contact with APF topical fluoride treatments)
b. Can be acid-etched with phosphoric acid or hydrofluoric acid for providing microll1echanical retention for cements
3. Mechanical
a. Harder than tooth structure and ,will cause opponent wear
b. Can be polished with aluminum oxide pastes
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
Introduction
The science of dental materials involves a study of the composition and properties of materials and the way in which they interact with the environment in which they are placed
Selection of Dental materials
The process of materials selection should ideally follow a logical sequence involving
(1) analysis of the problem,
(2) consideration of requirements,
(3) consideration of available materials and their properties, leading to
(4) choice of material.
Evaluation of the success or failure of a material may be used to influence future decisions on materials selection.
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
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
Root canal sealers
Applications
Cementation of silver cone gutta-percha point
Paste filling material
Types
Zinc oxide-eugenol cement types
Noneugenol cement types
Therapeutic cement types
properties
Physical-radiopacity
Chemical-insolubility
Mechanical-flow; tensile strength
Biologic-inertness
Gingival tissue packs
Application-provide temporary displacement of gingival tissues
Composition-slow setting zinc oxide-eugenol cement mixed with cotton twills for texture and strength
Surgical dressings
1.Application-gingival covering after periodontal surgery
2. Composition-modified zinc oxide-eugenol cement (containing tannic, acid. rosin, and various oils)
Orthodontic cements
Application-cementation of orthodontic bands
Composition-zinc phosphate cement
Manipulation
Zinc phosphate types are routinely mixed with cold or frozen mixing slab to extend the working time
Enamel bonding agent types use acid etching for improved bonding
Band, bracket, or cement removal requires special care