Cement Bases

Applications

•    Thermal insulation below a restoration
•    Mechanical protection where there is inadequate dentin to support amalgam condensation pressures

Types

•    Zinc phosphate cement bases
•    Polycarboxylate cement bases
•    Glass ionomer cement bases (self-curing and light-curing)

Components

o    Reactive powder (chemically basic)
o    Reactive liquid (chemically acidic)

Reaction

o    Acid-base reaction that forms salts or cross linked matrix
o    Reaction may be exothermic

Manipulation-consistency for basing includes more powders, which improves all of the cement properties

Properties

Physical-excellent thermal and electrical insulation

Chemical-much more resistant to dissolution than cement liners

    Polycarboxylate and glass ionomer cements are mechanically and chemically adhesive to tooth structure

    Solubility of all cement bases is lower than cement liners if they are mixed at higher powder- to-liquid ratios

Mechanical- much higher compressive strengths (12,000 to 30,000 psi)
    Light-cured hybrid glass ionomer cements are the strongest
    Zinc oxide-eugenol cements are the weakest

Biologic (see section on luting cements for details)

    Zinc oxide-eugenol cements are obtundent to the pulp
    Polycarboxylate and glass ionomer cements are kind to the pulp
 

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
 

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

Denture Liners

Use - patients with soft tissue irritation

Types

Long-term liners (soft liners)-used over a period of months for patients with severe undercuts or continually sore residual ridges

Short-term liners (tissue conditioners)-used to facilitate tissue healing over several days

Structure

Soft liners-plasticized acrylic copolymers or silicone rubber

Tissue conditioners-PEMA plasticized with ethanol and aromatic esters

Properties

Liners flow under low pressure, allowing adaptation to soft tissues, but are elastic during chewing forces. 
Low initial hardness, but liner becomes  harder as plasticizers are leached out during intraoral use 
Some silicone rubber liners support growth of yeasts
 

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)