Physical reaction-cooling causes reversible hardening

Chemical reaction-irreversible reaction during setting

CAD/CAM Restorations

Applications-inlays, onlays, veneers, crowns, bridges, implants, and implant prostheses    

Stages of fabrication
 
CSD-computerized surface digitization
CAD-computer-aided (assisted) design
CAM-computer-aided (assisted) machining
CAE-computer-aided esthetics (currently theoretic)
CAF-computer-aided finishing or polishing (which are currently theoretic steps)

Classification

Chairside or in-office systems

(1) Cerec (Siemens system)-inlays, onlays, veneers
(2) Sopha (Duret system)-inlays, onlays  (and Crowns)

Laboratory systems

(1) DentiCAD (Rekow system)-inlay, onlays, veneers, crowns
(2) Cicero (Elephant system)-porcelain fused-to-metal crowns

 
Materials

a. Feldspathic oorcelains (Vita)
b. Machinable ceramics (Dicor MGC)
c. Metal alloys limited use)

Cementing

- Etching enamel and/or dentin for micromechanical retention
- Bonding agent for retention to etched surface
- Composite as a luting cement for reacting chemically with bonding agent and with silanated surface of restoration
- Silane for bonding to etched ceramic (or metal) restorations and to provide chemical reaction
- Hydrofluoric acid etching to create spaces for micromechanical retention on surface or restoration

Properties

1. Physical properties

a. Thermal expansion coefficient well matched to tooth structure
b. Good resistance to plaque adsorption or retention

2. Chemical properties-not resistant to acids and should be protected from APF

3. Mechanical properties

a. Excellent wear resistance (but may abrade opponent teeth)
b. Some wear of luting cements but self-limiting
c. Excellent toothbrush abrasion

4. Biologic properties-excellent properties
 

Finishing and Polishing

Remove oxygen-inhibited layer .Use stones or carbide burs for gross reduction.Use highly fluted carbide burs or special diamonds for fine reduction.Use aluminum oxide strips or disks for finishing. Use fine aluminum oxide finishing pastes. Microfills develop smoothest finish because of small size of filler particles
 

CASTING DEFECTS

Classification :

1) Distortion.
2) Surface roughness .
3) Porosity .
4)Incomplete casting .
5) Oxidation .
6) Sulfur contamination .

Distortion
It is usually due to the distortion of wax pattern.

To avoid this :
Manipulation of the wax at its softening temp
Invest the pattern at the earliest .
If storage is necessary store it in a refrigerator .
Surface roughness

May be due to :
Air bubbles on the wax pattern .
Cracks due to rapid heating of the investment .
High W/P ratio .
Prolonged heating of the mold cavity .
Overheating of the gold alloy .
Too high or too low casting pressure .
Composition of the investment .
Foreign body inclusion.

POROSITY
May be internal or external .
External porosity causes discolouration .
Internal porosity weakens the restoration .

Classification of porosity .
I .Those caused by solidification shrinkage :
a) Localised shrinkage porosity .
b) Suck back porosity .
c) Microporosity .

They are usually irregular in shape .

II ) Those caused by gas :

a) Pin hole porosity .
b) Gas inclusions .
c) Subsurface porosity .

Usually they are spherical in shape .

III ) Those caused by air trapped in the mold :

Back pressure porosity .

Localised shrinkage porosity

Large irregular voids found near sprue casting junction.
Occurs when cooling sequence is incorrect .
If the sprue solidifies before the rest of the casting , no more molten metal is supplied from the sprue which can cause voids or pits (shrink pot porosity )

This can be avoided by -
- using asprue of correct thickness .
- Attach the sprue to the thickest portion of the pattern .
-Flaring of the sprue at the point of atttachment .
-Placing a reservoir close to the pattern .

Suck back porosity

It is an external void seen in the inside of a crown opposite the sprue .
Hot spot is created which freezes last .
It is avoided by :
Reducing the temp difference between the mold & molten alloy .

Microporosity :

Fine irregular voids within the casting .
Occurs when casting freezes rapidly .
Also when mold or casting temp is too low .

Pin hole porosity :
Upon solidification the dissolved gases are expelled from the metal causing tiny voids .
Pt & Pd absorb Hydrogen .
Cu & Ag absorb oxygen .

Gas inclusion porosities

Larger than pin hole porosities .
May be due to dissolved gases or due to gases Carried in or trapped by molten metal .
Apoorly adjusted blow torech can also occlude gases .

Back pressure porosity

This is caused by inadequate venting of the mold .The sprue pattern length should be adjusted so that there is not more than ¼” thickness of the investmentbetween the bottom of the casting .
This can be prevented by :
- using adequate casting force .
-use investment of adequate porosity .
-place the pattern not more than 6-8 mm away from tne end of the casting .
Casting with gas blow holes
This is due to any wax residue in the mold .
To eliminate this the burnout should be done with the sprue hol facing downwards for the wax pattern to run down.

Incomplete casting

This is due to :
- insufficient alloy .
-Alloy not able to enter thin parts of the mold .
-When the mold is not heated to the casting temp .
-Premature solidification of the alloy .
-sprues blocked with foreign bodies .
-Back pressure of gases .
-low casting pressure .
-Alloy not sufficiently molten .

Too bright & shiny casting with short & rounded margins :
occurs when wax is eliminated completely ,it combines with oxygen or air to form carbon monoxide .

Small casting :

occurs when proper expansion is not obtained & due to the shrinkage of the impression .

Contamination of the casting
1) Due to overheating there is oxidation of metal .
2) Use of oxidising zone of the flame .
3) Failure to use a flux .
4) Due to formation sulfur compounds .

Black casting

It is due to :
1) Overheating of the investment .
2) Incomplete elimination of the wax .
 

Impression Material

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