NEET MDS Lessons
Dental Materials
Principles of cutting, polishing, and surface cleaning
- Surface mechanics for materials
Cutting-requires highest possible hardness materials to produce cutting
Finishing-requires highest possible hardness materials to produce finishing, except at margins of restorations where tooth structure may be inadvertently affected
Polishing- requires materials with Mohs ./ hardness that is 1 to 2 units above that of substrate
Debriding-requires materials with Mohs hardness that is less than or equal to that of substrate to prevent scratching
- Factors affecting cutting, polishing. and surface cleaning
- Applied pressure
- Particle size of abrasive
- Hardness of abrasive
- Hardness of substrate
- Precautions
- During cutting heat will build up and change the mechanical behavior of the substrate from brittle to ductile and encourage smearing
- Instruments may transfer debris onto the cut surface from their own surfaces during cutting, polishing, or cleaning operations (this is important for cleaning implant surfaces)
COMPOSITE RESINS
Applications / Use
- Anterior restorations for aesthetics (class III, IV, V, cervical erosion abrasion lesions)
- Low-stress posterior restorations (small class I, II)
- Veneers
- Cores for cast restorations
- Cements for porcelain restorations
- Cements for acid-etched Maryland bridges
- Repair systems for composites or porcelains
Polymerization--reaction of small molecules (monomers) into very large molecules (polymers)
Cross-linking-tying together of polymer molecules by chemical reaction between the molecules to produce a continuous three-dimensional network
Effects of Amalgam.
(1) The combined effects of the properties of its ingredients should provide the most satisfactory restorative material.
(2) Quantity of mercury. Too little mercury in the mix results in a grainy, weak, readily tarnished, and corroded amalgam. Too much mercury will cause excessive expansion and weakened amalgam.
(3) Composition of the alloy. Composition of the alloy must include a minimum of 65 percent silver, a maximum of 29 percent tin, a maximum of 6 to 13 percent copper, and a maximum of two percent zinc by weight
(4) Correct proportion important. Before use, the silver alloy is mixed with pure and uncontaminated mercury. There are some alloys that are completely zinc free. They can therefore be used more successfully in a moisture-contaminated environment.
(5) Properties of the finished product.
Silver imparts strength, durability, and color, gives the alloy desirable setting expansion, decreases flow, and accelerates (decreases) the setting time.
Tin makes the amalgam easier to work, controls excessive setting expansion, and increases both flow and setting time.
Copper increases hardness, contributes to setting expansion, reduces flow, and decreases setting time.
Zinc increases workability, and unites with oxygen and other "impurities" to produce a clean amalgam.
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
Structure of gypsum products
Components
a. Powder (calcium sulfate hemihydrate = CaSO4½H2O)
b. Water (for reaction with powder and dispersing powder)
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
COMPOSITE RESINS
Types
- Amount of filler-25% to 65% volume, 45% to 85% weight
- Filler particle size (diameter in microns)
- Macrofill 10 to 100 µm (traditional composites)
- Midi fill- 1 to 10 µm(small particle composites)
- Minifill— 0.l to 1 µm
- Microfill-: 0.01 to 0.1 µm (fine particle composites)
- Hybrid--blend (usually or microfill and midifill or minifill and microfill)
- Polymerization method
- Auto-cured (self-cured)
- Visible light cured
- Dual cured
- Staged cure
- Matrix chemistry
- BIS-GMA type
- Urethane dimethacrylate (UDM or UDMA) type
- TEGDMA-diluent monomer to reduce viscosity