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

ACRYLIC RESINS

Use. Acrylic (unfilled) resins are used as temporary crown material. Temporary crowns are placed to protect the crown preparation and provide patient comfort during the time the permanent crown is being constructed

Investment Techniques 

Single step investing technique:
The investing procedure is carried out in one step either by brush technique or by vacuum technique.

a). Brush technique:
The accurate water-powder ratio is mixed under vacuum. A brush is then used to paint the wax pattern with mix then the casting ring is applied over the crucible former and the ring is filled under vibration until it is completely filled.

b). vacuum technique:
• The mix in first hand spatulated, and then with the crucible former and pattern is place, then ring is attached to the mixing bowl.
• The vacuum hose is then attached to the assembly. The bowel is inverted and the ring is filled under vacuum and vibration

Two-step investing technique:

The investing procedure is carried out in two steps:

• First, the wax pattern is painted with a thick mix andis left till complete setting, the set investment block(first cost) is immersed in water for about tenminutes . the casting ring is then applied over the crucible former and filled with the properly mixedinvestment (second coat) till the ring is completely filled and the mix is left to set.The two-step investing technique is recommendedwhenever greater amount of expansion is required. Thistechnique also minimizes the distortion of the waxpattern and provides castings with smoother surfaces.

• The investment is allowed to set for the recommendedtime (usually one-hour) then the crucible former is removed. If a metal sprue former is used, it is removedby heating over a flame to loosen it from the wax pattern. Any loose particles of investment should beblown off with compressed air should be placed in a humidor if stored overnight.
 

CAD/CAM Restorations

Applications-inlays, onlays, veneers, crowns, bridges, implants, and implant prostheses    

Stages of fabrication
 
CSD-computerized surface digitization
CAD-computer-aided (assisted) design
CAM-computer-aided (assisted) machining
CAE-computer-aided esthetics (currently theoretic)
CAF-computer-aided finishing or polishing (which are currently theoretic steps)

Classification

Chairside or in-office systems

(1) Cerec (Siemens system)-inlays, onlays, veneers
(2) Sopha (Duret system)-inlays, onlays  (and Crowns)

Laboratory systems

(1) DentiCAD (Rekow system)-inlay, onlays, veneers, crowns
(2) Cicero (Elephant system)-porcelain fused-to-metal crowns

 
Materials

a. Feldspathic oorcelains (Vita)
b. Machinable ceramics (Dicor MGC)
c. Metal alloys limited use)

Cementing

- Etching enamel and/or dentin for micromechanical retention
- Bonding agent for retention to etched surface
- Composite as a luting cement for reacting chemically with bonding agent and with silanated surface of restoration
- Silane for bonding to etched ceramic (or metal) restorations and to provide chemical reaction
- Hydrofluoric acid etching to create spaces for micromechanical retention on surface or restoration

Properties

1. Physical properties

a. Thermal expansion coefficient well matched to tooth structure
b. Good resistance to plaque adsorption or retention

2. Chemical properties-not resistant to acids and should be protected from APF

3. Mechanical properties

a. Excellent wear resistance (but may abrade opponent teeth)
b. Some wear of luting cements but self-limiting
c. Excellent toothbrush abrasion

4. Biologic properties-excellent properties
 

Lost Wax Process

The lost wax casting process is widely used as it offers asymmetrical casting withnvery fine details to be manufactured relatively inexpensively. The process involves producing a metal casting using a refractory mould made from a wax replica pattern.
The steps involved in the process or the lost wax casting are:

1 . Create a wax pattern of the missing tooth / rim
2 . Sprue the wax pattern
3 . Invest the wax pattern
4 . Eliminate the wax pattern by burning it (inside the furnace or in hot water). This will create a mould.
5 . Force molten metal into the mould - casting.
6 . Clean the cast.
7 . Remove sprue from the cast
8 . Finish and polish the casting on the die .

The lost-wax technique is so named because a wax pattern of a restoration is invested in a ceramic material, then the pattern is burned out ("lost") to create a space into which molten metal is placed or cast. The entire lost-wax casting process . 

Wax pattern removal:

Sprue former can be used to remove the pattern. If not the pattern is removed with a sharp probe. Then the sprue former is attached to it. The pattern should be removed directly in line with the principle axis of the tooth or the prepared cavity. Any rotation of the pattern will distort it. Hollow sprue pin is advisable because of its greater retention to the pattern.