NEET MDS Lessons
Dental Materials
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
POLISHING MATERIALS
1 Tin Oxide. Tin oxide is used in polishing teeth and metal restorations. Tin oxide is a fine, white powder that is made into a paste by adding water or glycerin.
2. Pumice. Pumice is used as an abrasive and polishing agent for acrylic resins, amalgams, and gold. It consists mainly of complex silicates of aluminum, potassium, and sodium. Two grades--flour of pumice and coarse pumice--are listed in the Federal Supply Catalog.
3. Chalk (Whiting). Chalk is used for polishing acrylic resins and metals. It is composed primarily of calcium carbonate.
4.Tripoli. Tripoli is usually used for polishing gold and other metals. It is made from certain porous rocks.
5. Rouge (Jeweler's). Rouge is used for polishing gold and is composed of iron oxide. It is usually in cake or stick form.
6. Zirconium Silicate. Zirconium silicate is used for cleaning and polishing teeth. It may be mixed with water or with fluoride solution for caries prevention treatment. For full effectiveness, instructions must be followed exactly to obtain the proper proportions of powder to liquid.
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
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
Dental Implants
Applications/Use
Single-tooth implants
Abutments for bridges (freestanding, attached to natural teeth)
Abutments for over dentures
Terms
Subperiosteal- below the periosteum -but above the bone (second most frequently used types)
Intramucosal-within the mucosa
Endosseous into the bone (80%of all current types)
Endodontics-through the root canal space and into the periapical bone
Transosteal-through the bone
Bone substitutes -replace. Long bone
Classification by geometric form
Blades
Root forms
Screws
Cylinders
Staples
Circumferential
Others
Classification by materials type
Metallic-titanium, stainless steel, and .chromium cobalt
Polymeric-PMMA
Ceramic hydroxyapatite, carbon, and sapphire
Classification by attachment design
Bioactive surface retention by osseointegration
Nonative porous surfaces for micromechanical retention by osseointegration
Nonactive, nonporous surface for ankylosis. By osseointegration
Gross mechanical retention designs (e.g.. threads, screws, channels, or transverse holes)
Fibrointegration by formation of fibrous tissue capsule
Combinations of the above
Components
a. Root (for. osseointegration)
b. Neck (for epithelial attachment and percutancaus sealing)
c. Intramobile elements (for shock absorption)
d. Prosthesis (for dental form and function)
Manipulation
a. Selection-based on remaining bone architecture and dimensions
b. Sterilization-radiofrequency glow discharge leaves biomaterial surface uncontaminated and sterile; autoclaving or chemical sterilization is contraindicated for some designs
Properties
1. Physical-should have low thermal and electrical conductivity
2. Chemical
a. Should be resistant to electrochemical corrosion
b. Do not expose surfaces to acids (e.g.. APF fluorides).
c. Keep in mind the effects of adjunctive therapies (e.g., Peridex)
3. Mechanical
a. Should be abrasion resistant and have a high modulus
b. Do not abrade during scaling operations (e.g.with metal scalers or air-power abrasion systems like Prophy iet)
4. Biologic-depend on osseointegration and epithelial attachment
Manipulation
Selection
o Microfilled composites or hybrids for anterior class III, IV, V
o Hybrids or midifills for posterior class I, II, III, V
Conditioning of enamel and / or dentin
Do not apply fluorides before etching.-->Acid-etch --> Rinse for 20 seconds with water --> Air-dry etched area for 20 seconds but do not desiccate or dehydrate --> Apply bonding agent and polymerize
Mixing (if required)--> mix two pastes for 20 to 30 seconds
o Self-cured composite-working time is 60 to 120 seconds after mixing
o Light-cured composite-working time is unlimited (used for most anterior and some posterior composite restorations)
o Dual-cured composite-working time is > 10 minutes
o Two-stage cured composite-working time is >5 minutes
Placement
use plastic instrument or syringe --> Light curing --> Cure incrementally in <2 mm thick layers. Use matrix strip where possible to produce smooth surface and contour composite .Postcure to improve hardness
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 .