Glass Ionomer Cements

Applications

a. Class V restorations-resin-modified glass ionomers for geriatric dentistry
b. Class II restorations-resin-modified glass ionomers, metal-modified glass ionomers in pediatric dentistry
c. Class III restorations-resin-modified glass ionomers
d. permanent cementing of inlays, crowns, bridges, and/or orthodontic band/brackets. In addition, it can be used as a cavity liner and as a base.

Classification by composition

a. Glass ionomer-limited use
b. Metal-modified glass ionomer-limited use
c. Resin-modified glass ionomer-popular use

Components

a. Powder-aluminosilicate glass
b. Liquid-water solution of copolymers (or acrylic acid with maleic, tartaric, or itaconic acids) and water-soluble monomers (e.g., HEMA)

Reaction (may involve several reactions and stages of setting)

a. Glass ionomer reaction (acid-base reaction of polyacid and ions released from aluminosilicate glass particles)
- Calcium, aluminum, fluoride, and other ions released by outside of powder particle dissolving in acidic liquid
- Calcium ions initially cross-link acid functional copolymer molecules
- Calcium cross-links are replaced in 24 to 48 hours by aluminum ion cross-links, with increased hardening of system
- If there are no other reactants in the cement (e.g., resin modification), then protection from saliva is required during the first 24 hours

b. Polymerization reaction (polymerization of double bonds from water-soluble monomers and/or pendant groups on copolymer to form cross-linked matrix)
- Polymerization reaction can be initiated with chemical (self-curing) or light-curing steps
- Cross-linked polymer matrix ultimately interpenetrates glass ionomer matrix 

Manipulation

a. Mixing-powder and liquid components may be manually mixed or may be precapsulated for mechanical mixing
b. Placement-mixture is normally syringed into place
c. Finishing-can be immediate if system is resin-modified (but otherwise must be delayed 24 to 72 hours until aluminum ion replacement reaction is complete)
d. Sealing-sealer is applied to smoothen the surface (and to protect against moisture affecting the glass ionomer reaction)

Properties

1. Physical

-Good thermal and electrical insulation
-Better radiopacity than most composites
-Linear coefficient of thermal expansion and contraction is closer to tooth structure than for composites (but is less well matched for resin-modified systems)
-Aesthetics of resin-modified systems are competitive with composites

2. Chemical

-Reactive acid side groups of copolymer molecules may produce chemical bonding to tooth structure
-Fluoride ions are released
(1) Rapid release at first due to excess fluoride ions in matrix
(2) Slow release after 7  to 30 days because of slow diffusion of fluoride ions out of aluminosilicate particles

-Solubility resistance of resin-modified systems is close to that of composites

3. Mechanical properties

-Compressive strength of resin-modified systems is much better than that of traditional glass ionomers but not quite as strong as composites
- Glass ionomers are more brittle than composites

4. Biologic properties

- Ingredients are biologically kind to the pulp
- Fluoride ion release discourages secondary canes
 

Tooth Polishing and Cleansing Agents

1. Cleansing-removal of exogenous stains, pellicle, materia alba, and other oral debris without causing undue abrasion to tooth structure
2. Polishing-smoothening surfaces of amalgam, composite, glass ionomers, porcelain, and other restorative materials

Factors influencing cleaning and polishing

-    Hardness of abrasive particles versus substrate
-    Particle size of abrasive particles
-    Pressure applied during procedure
-  Temperature of abrasive materials

Structure

 Composition

-contain abrasives, such as kaolinite, silicon dioxide, calcined magnesium silicate, diatomaceous silicon dioxide, pumice. Sodium-potassium
-aluminum silicate, or zirconium silicate; some pastes also may contain sodium fluoride or stannous fluoride, but they have never been shown to produce positive effects
 

Reactions-abrasion for cleansing and polishing

Properties -  Mechanical
 
- Products with pumice and quartz produce more efficient cleansing but also generate greater abrasion of enamel and dentin
-Coarse pumice is the most abrasive
-The abrasion rate of dentin is 5 to 6 times faster than the abrasion rate of enamel, regardless of the product
-Polymeric restorative materials, such as denture bases, denture teeth, composites, PMMA veneers, and composite veneers, can be easily scratched during polishing
-Do not polish cast porcelain restorations (e.g., Dicor) that are  externally characterized or the color will be lost
 

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

Denture Teeth

Use-complete or partial dentures

Type

a. Porcelain teeth
b. Acrylic resin teeth
c. Abrasion-resistant teeth (microfilled composite)

Structure and properties

1. Porcelain teeth (high-fusing porcelain)
Only bonded into denture base mechanically. Harder than natural teeth or other restorations and abrades those surfaces. Good aesthetics.Used when patients have good ridge support and sufficient room between the arches

2. Acrylic resin teeth (PMMA  [polymethyl methacrylate])

Bonded pseudochemically into the denture base. Soft and easily worn by abrasive foods . Good initial aesthetics
Used with patients with poor ridges and in cases where they oppose natural teeth

3. Abrasion-resistant teeth (microfilled resins)
Bonded pseudochemically into the denture base.Better abrasion resistance then  acrylic resin teeth
 

CASTING
Melting & Casting Technique Melting & Casting requires Heat source to melt the alloy Casting force, to drive the alloy into the mould

Casting Torch Selection Two type of torch tips: Multi-orifice Single-orifice Multi-orifice tip is widely used for metal ceramic alloys. Main advantage is distribution of heat over wide area for uniform heating of the alloy. Single-orifice tip concentrate more heat in one area.Three fuel sources are used for Casting Torch; Acetylene ,Natural Gas ,Propane

CASTING CRUCIBLES
Four types are available ;
1) Clay .
2) Carbon .
3) Quartz .
4) Zirconia –Alumina .

Casting Machines

It is a device which uses heat source to melt the alloy casting force .

Heat sources can be :
1) Reducing flame of a torch .( conventional alloys & metal ceramic alloys )

2) Electricity .(Base metal alloys )

Advantages of electric heating :
-heating is evenly controlled .
-minimal undesirable changes in the alloy composition .
- Appropriate for large labs .

Disadvantage :
Expensive .
Casting machines use :
1) Air pressure .
2) Centrifugal force .
3) Evacuation technique .

Alloys can be melted by :
1) Alloy is melted in a separate crucible by a torch flame & is cast into the mold by centrifugal force .(centrifugal C M )
2) Alloy is melted by resistance heating or by induction furnace & then cast centrifugally by motor or spring action (springwound CM electrical resistance )
3) Alloy is melted by induction heating cast into mold centrifugally by motor or spring action .(Induction CM )
4) Alloy is vacum melted by an argon atmosphere

Torch melting / Centrifugal casting machine
Electrical resistance /Heated casting machine
Melting of the alloy should be done in a graphite or ceramic crucible .

Advantage :
-Oxidation of metal ceramic restorations on
overheating is prevented .
-Help in solidification from tip of the casting to the button surface .

Induction casting machine
Commonly used for melting base metal alloys.

Advantage :
- Highly efficient .
- Compact machine withlow power consumption
-No pre heating needed ,
- safe & reliable.

Direct current arc melting machine

A direct current arc is produced between two electrodes :
The alloy & the water cooled tungsten electrode .Temp used is 4000 degrees .

Disadvanage :
High risk of overheating the alloy .
Vacuum or pressure assisted casting machine
Molten alloy is drawn into the evacuated mold by gravity or vacuum & subjected to aditional pressure
For Titanium & its alloys vacuum heated argon pressure casting machines are used .

Accelerated casting method

This method reduces the time of both bench set of the investment & burnout .
Uses phosphate bonded investments which uses 15 mnts for bench set & 15mnts for burnout by placing in a pre – heated furnace to 815 degrees .

Effect of burnout on gypsum bonded investments
Rate of heating has influence on smoothness & on overall dimensions of the investment
Rapid heating causes cracking & flaking which can cause fins or spines .
Avoid heating gypsum bonded investment above 700 degrees .Complete the wax elimination below that temp .

Effect of burnout on phosphate bonded investments
Usual burnout temp is 750 -1030 degrees.
Although they are strong they are brittle too .
Since the entire process takes a long time two stage burnout & plastic ring can be used .

Solution Liners (Varnishes)

Applications 

o    Enamel and dentin lining for amalgam restorations
o    Enamel and dentin lining for cast restorations that are used with non adhesive cements
o    Coating over materials that are moisture sensitive during setting

Components of copal resin varnish

o    90% solvent mixture (e.g., chloroform, acetone, and alcohol)
o    10% dissolved copal resin

 Reaction
 
Varnish sets physically by drying Solvent loss occurs in 5 to 15 seconds (a film forms the same way as drying fingernail polish)

Manipulation

Apply thin coat over dentin. enamel. And margins of the cavity preparation  Dry lightly with air for 5 seconds Apply a second thin coat Final thickness is 1 to 5 µ.m

Properties

o    Physical 

Electrically insulating barrier that prevents shocks. Too thin to be thermally insulating. Decreases degree of percolation attributable to thermal expansion

o    Chemical

Forms temporary barrier that prevents microleakage into dentinal tubules until secondary dentin formation occurs. Decreases initial tendency for electrochemical corrosion

o     Mechanical

Very weak and brittle film that has limited lifetime 
Film adheres to smear layer