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
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
DISTORTION OF THE PATTERN
Distortion is dependant on temperature & time interval before investing .
To avoid any distortion ,
Invest the pattern as soon as possible .
Proper handling of the pattern .
PREREQUISITES
Wax pattern should be evaluated for smoothness , finish & contour .
Pattern is inspected under magnification & residual flash is removed .
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.
RINGLESS INVESTMENT TECHNIQUE
Used for phosphate bonded investments .
This method uses paper or plastic casting ring .
It is designed to allow urestricted expansion .
Useful for high melting alloys .
SELECTION OF SPRUE
1 . DIAMETER :
It should be approximately the same size of the thickest portion of the wax pattern .
Too small sprue diameter suck back porosity results .
2 . SPRUE FORMER ATTACHMENT :
Sprue should be attached to the thickest portion of the wax pattern .
It should be Flared for high density alloys & Restricted for low density alloys .
3 . SPRUE FORMER POSITION
Based on the
1. Individual judgement .
2. Shape & form of the wax pattern .
Patterns may be sprued directly or indirectly .
Indirect method is commonly used
Acrylic Denture Bases
Use - used to support artificial teeth
Classification
a. PMMA/MMA dough systems
b. PMMA/MMA pour resin systems
1. Components
a. Powder-PMMA polymer, peroxide initiator, and pigments
b. Liquid-MMA monomer, hydroquinone inhibitor, and cross-linking agents
2. Reaction
a. Heat (or chemicals) is used as an accelerator to decompose peroxide into free radicals
b. Free radicals initiate polymerization of MMA into PMMA
c. New PMMA is formed as a matrix around residual PMMA powder particles
d. Linear shrinkage is 5% to 7% of monomer on polymerization
3. Manipulation
a. P/L mixed to form dough or fluid resin to fill mold
b. Mold heated to start and control reaction