NEET MDS Lessons
Dental Materials
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
Properties
I. Physical
a. Excellent thermal and electrical insulator
b. Very dense
c. Excellent dimensional stability
d. Good reproduction of fine detail of hard and soft tissues
2. Chemical
a. Heating will reverse the reaction (decompose the material into calcium sulfate hemihydrate, the original dry component)
b. Models, casts, and dies should be wet during grinding or cutting operations to prevent heating
3. Mechanical
a. Better powder packing and lower water contents at mixing lead to higher compressive strengths (plaster < stone < diestone)
b. Poor resistance to abrasion
4. Biologic
a. Materials are safe for contact with external - epithelial tissues
b. Masks should be worn during grinding or polishing operations that are likely to produce gypsum dust
CLEANING AND PICKLING ALLOYS
The surface oxidation or other contamination of dental alloys is a troublesome occurrence. The oxidation of base metals in most alloys can be kept to a minimum or avoided by using a properly adjusted method of heating the alloy and a suitable amount of flux when melting the alloy . Despite these precautions, as the hot metal enters the mold, certain alloys tend to become contaminated on the surface by combining with the hot mold gases, reacting with investment ingredients, or physically including mold particles in the metal surface. The surface of most cast, soldered, or otherwise heated metal dental appliances is cleaned by warming the structure in suitable solutions, mechanical polishing, or other treatment of the alloy to restore the normal surface condition.
Surface tarnish or oxidation can be removed by the process of pickling. Castings of noble or high-noble metal may be cleaned in this manner by warming them in a 50% sulfuric acid and water solution . . After casting, the alloy (with sprue attached) is placed into the warmed pickling solution for a few seconds. The pickling solution will reduce oxides that have formed during casting. However, pickling will not eliminate a dark color caused by carbon deposition
The effect of the solution can be seen by comparing the submerged surfaces to those that have still not contacted the solution. the ordinary inorganic acid solutions and do not release poisonous gases on boiling (as sulfuric acid does). In either case, the casting to be cleaned is placed in a suitable porcelain beaker with the pickling solution and warmed gently, but short of the boiling point. After a few moments of heating, the alloy surface normally becomes bright as the oxides are reduced. When the heating is completed, the acid may be poured from the beaker into the original storage container and the casting is thoroughly rinsed with water. Periodically, the pickling solution should be replaced with fresh solution to avoid excessive contamination.
Precautions to be taken while pickling
With the diversity of compositions of casting alloys available today, it is prudent to follow the manufacturer's instructions for pickling precisely, as all pickling solutions may not be compatible with all alloys. Furthermore, the practice of dropping a red-hot casting into the pickling solution should beavoided. This practice may alter the phase structure of the alloy or warp thin castings, and splashing acid may be dangerous to the operator. Finally, steel or stainless steel tweezers should not be used to remove castings from the pickling solutions. The pickling solution may dissolve the tweezers and plate the component metals onto the casting. Rubber-coated or Teflon tweezers are recommended for this purpose.
PFM Alloys
Applications-substructures for porcelain-fused-to-metal crowns and bridges
Classification
o High-gold alloys
o Palladium-silver alloys
o Nickel-chromium alloys
Structure
Composition
o High-gold alloys are 98% gold. platinum. And palladium
o Palladium-silver alloys are 50% to 60% palladium and 30 to 40% silver
o Nickel-chromium alloys are 70% to 80% nickel and 15% chromium with other metals
Manipulation
o Must have melting temperatures above that of porcelains to be bonded to their surface
o More difficult to cast (see section on chromium alloys)
Properties - Physical
Except for high-gold alloys, others are less dense alloys
Alloys are designed to have low thermal expansion coefficients that must be matched to the overlying porcelain
Chemical-high-gold alloys are immune, but others passivate
Mechanical-high modulus and hardness
RINGLESS INVESTMENT TECHNIQUE
Used for phosphate bonded investments .
This method uses paper or plastic casting ring .
It is designed to allow urestricted expansion .
Useful for high melting alloys .
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 .
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 .