Mercury bioactivity

• Metallic mercury is the least toxic from and is absorbed primarily through the lungs rather than the GI tract or skin
• Mercury in the body may come from air, water, food. dental (a low amount). Or medical sources
•  Half life for mercury elimination from body is 55 days .-
• mercury toxicity is <50 µm / m³ on average per 40-hour work week.
• Mercury hypersensitivity is estimated as less than 1 per 100,000,000 persons
• Indium-containing amalgams can have lower Hg vapor pressures than conventional dental amalgam

Model. Cast. and Die Materials

Applications
- Gold casting, porcelain and porcelain-fused–to metal fabrication procedures
- Orthodontic and pedodontic appliance construction
- Study models for occlusal records

Terms
a. Models-replicas of hard and soft tissues for study of dental symmetry
b. Casts-working replicas of hard and soft tissues for use in the fabrication of appliances or restorations
c. Dies :-  working replicas of one tooth (or a few teeth) used for the fabrication of a restoration
d. Duplicates-second casts prepared from original  casts

Classification by materials

a Models :- (model plaster or orthodontic stone; gypsum product)
b. Stone casts (regular stone; gypsum product)
c. Stone dies (diestone; gypsum product)-may electroplated
d. Epoxy dies (epoxy polymer)-abrasion-resistant dies

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

Chromium Alloys for Partial Dentures

Applications - Casting partial denture metal frameworks

Classification

a. Cobalt-chromium
b. Nickel-chromium
c. Cobalt-chromium-nickel

Composition

a. Chromium-produces a passivating oxide film for corrosion resistance
b. Cobalt-increase~ the rigidity of the alloy
c. Nickel-increases the ductility of the alloy
d. Other elements-increase strength and castability

Manipulation

a. Requires higher temperature investment materials
b. More difficult to cast because less dense than gold alloys usually requires special casting equipment
c. Much more difficult to finish and polish because of higher strength and hardness

Properties

a. Physical-less dense_than gold alloys
b. Chemical-passivating corrosion behavior
c. Mechanical-stronger. stiffer. and harder than gold alloys
d. Biologic

-Nickel may cause sensitivity in some individuals (I % of men and 11 % of women)
-Beryllium in some alloys forms oxide that  is toxic to lab technicians

Structure of gypsum products

Components
 
a. Powder (calcium sulfate hemihydrate = CaSO4½H2O)
b. Water (for reaction with powder and dispersing powder)

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