NEET MDS Lessons
Dental Materials
Waxes
Many different waxes are used in dentistry. The composition, form, and color of each wax are designed to facilitate its use and to produce the best possible results.
Applications
o Making impressions
o Registering of tooth or soft tissue positions
o Creating restorative patterns for lab fabrication
o Aiding in laboratory procedures
Classification
a. Pattern waxes-inlay, casting, and baseplate waxes
b. Impression waxes-corrective and biteplate waxes
c. Processing waxes-boxing, utility, and sticky waxes
Types
1) Inlay wax-used to create a pattern for inlay, onlay or crown for subsequent investing and casting in a metal alloy.
2) Casting wax-used to create a pattern for metallic framework for a removable partial denture
3) Baseplate wax-used to establish the vertical dimension. plane of occlusion. and initial arch form of a complete denture
4) Corrective impression wax-used to form a registry pattern of soft tissues on an impression
5) Bite registration wax-used to form a registry pattern for the occlusion of opposing models or casts
6) Boxing wax-used to form a box around an impression before pouring a model or cast
7) Utility wax -soft pliable adhesive wax for modifying appliances, such as alginate impression trays
8) Sticky wax-sticky when melted and used to temporarily adhere pieces of metal or resin in laboratory procedures
Components
a. Base waxes-hydrocarbon (paraffin) ester waxes
b. Modifier waxes-carnauba, ceresin, bees wax, rosin, gum dammar, or microcrystalline waxes
c. Additives-colorants
Reaction-waxes are thermoplastic
Properties
Physical
a. High coefficients of thermal expansion and contraction
b. Insulators and so, cool unevenly; should be waxed in increments to allow heat dissipation
Chemical
a. Degrade prematurely if overheated
b. Designed to degrade into CO2and H2Oduring burnout
Mechanical-stiffness, hardness, and strength depend on modifier waxes used
COMPOSITE RESINS
Reaction
- Free radical polymerization
Monomers + initiator. + accelerators-+ polymer molecules
- Initiators-start polymerization by decomposing and reacting with monomer
- Accelerators-speed up initiator decomposition
- Amines used for accelerating self –curing systems
- Light used for accelerating light-curing systems
Retarders or inhibitors-prevent premature polymerization
CASTING: casting is the process by which the wax pattern of a restoration is converted to a replicate in a dental alloy. The casting process is used to make dental restorations such as inlays, onlays, crowns, bridges and removable partial dentures.
Objectives of casting
1) To heat the alloy as quickly as possible to a completely molten condition.
2) To prevent oxidation by heating the metal with awell adjusted torch .
3) To produce a casting with sharp details by having adequate pressure to the well melted metal to force into the mold.
STEPS IN MAKING A CAST RESTORATION
1. TOOTH PREPARATION
2. IMPRESSION
3. DIE PREPARATION
4. WAX PATTERN FABRICATION
5. SPRUING
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
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
I . Procedure for single casting :
A 2.5 mm sprue former is recommended
for molar crowns 2.0 mm for premolars & partial coverage crowns .
II . Procedure for multiple casting :
Each unit is joined to a runner bar .
A single sprue feeds the runner bar
4 . SPRUE FORMER DIRECTION
Sprue Should be directed away from the delicate parts of the pattern
It should not be at right angles to a flat surface .(leads to turbulance porosity .)
Ideal angulation is 45 degrees .
5 . SPRUE FORMER LENGTH
Depends on the length of casting ring .. Length of the Sprue former should be such that it keeps the wax pattern about 6 to 8 mm away from the casting ring. Sprue former should be no longer than 2 cm. The pattern should be placed as close to the centre of the ring as possible.
Significance
Short Sprue Length:
The gases cannot be adequately vented to permit the molten alloy to fill the ring completelyleading to Back Pressure Porosity.
Long Sprue Length:
Fracture of investment, as mold will not withstand the impact force of the entering molten alloy.
Top of wax should be adjusted for :
6 mm for gypsum bonded investments .
3 -4 mm for phosphate bonded investments .
TYPES OF SPRUES
I . - Wax . II . Solid
- Plastic . Hollow
- Metal .
Cement liners
Applications (if remaining dentin thickness is <0.5 mm)
o Used for thermal insulation where cavity preparation is close to the pulp
o Used for delivering medicaments to the pulp
• Calcium hydroxide stimulates reparative dentin or
• Eugenol relieves pain by desensitizing nerves
• Used to deliver F ion to enamel and dentin
Components
o Paste of calcium hydroxide reactant powder, ethyl toluene sulfonamide dispersant, zinc oxide filler, and zinc stearate radiopacifier
o Paste of glycol salicylate reactant liquid, titanium dioxide filler powder, and calcium tungstenate radiopacifier
Reaction
Chemical reaction of calcium ions with salicylate to form methylsalicylate salts Moisture absorbed to allow calcium hydroxide to dissociate into ions to react with salicylate Mixture sets from outside surface to inside as water diffuses
Manipulation
Dentin should not be dehydrated or material will not setMix drop of each paste together for 5 secondsApply material to dentin and allow I to 2 minutes to set
Properties
o Physical-good thermal and electrical insulator
o Chemical-poor resistance to water solubility and may dissolve
o Mechanical-low compressive strength (100 to 500 psi)
o Biologic-releases calcium hydroxide constituents, which diffuse toward the pulp and stimulate
o reparative dentin formation