Acrylic Denture Bases

Use - used to support artificial teeth

Classification
a. PMMA/MMA dough systems
b. PMMA/MMA pour resin systems

1. Components

a. Powder-PMMA polymer, peroxide initiator, and pigments
b. Liquid-MMA monomer, hydroquinone inhibitor, and cross-linking agents

2. Reaction
a. Heat (or chemicals) is used as an accelerator to decompose peroxide into free radicals
b. Free radicals initiate polymerization of MMA into PMMA
c. New PMMA is formed as a matrix around residual PMMA powder particles
d. Linear shrinkage is 5% to 7% of monomer on polymerization

3. Manipulation
a. P/L mixed to form dough or fluid resin to fill mold
b. Mold heated to start and control reaction

Wax elimination (burnout):

Wax elimination or burnout consists of heating the investment in a thermostatically controlled furnace until all traces of the wax are vaporized in order to obtain an empty mold ready to receive the molten alloy during procedure.

• The ring is placed in the furnace with the sprue hole facing down to allow for the escape of the molten wax out freely by the effect of gravity .
• The temperature reached by the investment determines thethermal expansion. The burnout temperature is slowly increased in order to eliminate the wax and water without cracking the investment.
•For gypsum bonded investment, the mold is heated to650 -6870 c )to cast precious and semiprecious
precious alloys.
• Whereas for phosphate-bonded investment, the mold is heated up to 8340 c to cast nonprecious alloys at high fusing temperature.
The ring should be maintained long enough at the maximum temperature (“heat soak”) to minimize a sudden drop in temperature upon removal from the oven. Such a drop could result in an incomplete casting because of excessively rapid solidification of thealloy as it enters the mold.
• When transferring the casting ring to casting, a quick visual check of the sprue in shaded light is helpful to see whether it is properly heated. It should be a cherry-red color .

WAX BURNOUT AND HEATING THE RING

After the investment has set hard, the crucible former and the metal sprue former is removed carefully, and any loose particles at the opening of the sprue hole are removed with small brush.
The purpose of the wax burnout is to make room for the liquid metal. The ring is placed in the oven at 250C with the sprue end down, thus allowing the melted wax to flow, out for 30min or even up to 60min may be a good procedure to ensure complete elimination of the wax and the carbon.

Heating the ring: The object is to create a mold of such dimension, condition and temperature so that it is best suited to receive the metal.

Hygroscopic Low-Heat Technique. 

After the wax elimination the temperature of the same furnace can be set to a higher temperature for heating or else, the ring can be transferred to another furnace, which has already set to the higher temperature. In any case accurate temperature control is essential and therefore these furnaces have pyrometer and thermocouple arrangement. The ring is placed in the furnace with the sprue hole down and heated to 500C and kept at this temperature for 1 hour. In this low heat technique the thermal expansion obtained is less but together with the previously obtained hygroscopic expansion the total expansion amounts to 2.2 percent, which is slightly higher than what is required for gold alloys.

So this technique obtains its compensation expansion from three sources:
(1)   The 37º C water bath expands the wax pattern
(2)   The warm water entering the investment mold from the top adds some hygroscopic expansion
(3)   The thermal expansion at 500' C provides the needed thermal expansion.

High-Heat Thermal Expansion Technique. 

After the wax elimination, the ring should be placed in the furnace which is at room temperature and then the temperature is gradually raised, until it comes to 700C in 1 hour. Then the ring is heat soaked at this temperature for ½ hour. This slow rise in temperature is necessary to prevent 
This approach depends almost entirely on high-heat burnout to obtain the required expansion, while at the same time eliminating the wax pattern.  Additional expansion results from the slight heating of gypsum investments on setting, thus expanding the wax pattern, and the water entering the investment from the wet liner, which adds a small amount of hygroscopic expansion to the normal setting expansion.

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
 

Bonding Agents

Applications-composites, resin-modified gIass ionomers, ceramic bonded to enamel restorations, veneers, orthodontic brackets, and desensitizing dentin by covering exposed tubules (Maryland bridges, composite and ceramic repair systems, amalgams and amalgam repair, and pinned amalgams)

Definitions;-

Smear layer - Layer of compacted debris on enamel and/or dentin from the cavity preparation process  that is weakly held to the surface (6 to 7 MPa) , and that limits bonding agent strength if not removed

Etching (or, conditioning)- smear layer removal and production of microspaces for micromechanical bonding by dissolving –minor amounts of surface hydroxyapatite crystals

Priming..- micromechanical (and chemical) bonding to the microspaces created by conditioning step.

Conditioning/priming agent-agent that accomplishes both actions

Bonding- formation of resin layer that connect  the primed surface to the overlying restoration (e.g., composite) .. –

Enamel bonding System-for bonding to enamel (although dentin bonding may be a Second step)

Dentin bonding system  for bonding  to dentin (although  enamel bonding  may have been a first step)

•        First-generation dentin bonding system for bonding to smear layer

•        New-generation dentin bonding system- for removing smear layer and etching intertubular dentin to allow  primer and/or bonding agent to diffuse into spaces between collagen and form hybrid zone

Enamel and dentin bonding system-for bonding to enamel and dentin surfaces with the same procedures

Amalgam bonding  system for bonding to enamel, dentin, and amalgam, dentin and amalgam during an amalgam placement procedure or for amalgam repair

Universal bonding system-for bonding to enamel, dentin, amalgam, porcelain , or any other substrate intraorally that may be necessary for a restorative procedure  using the  same set of procedures and materials

Types

Enamel bonding systems

Dentin bonding systems

Amalgam bonding systems

Universal bonding systems

Structure

o        Components of bonding systems

o        Conditioning agent-mineral or organic acid

Enamel only   37% phosphoric acid

Dentin only or enamel and .dentin---37% phosphoric acid, citric acid, maleic acid, or nitric acid

o        Priming agent

Hydrophobic-solvent-soluble, light cured monomer system

Hydrophilic-water-soluble, light-cured monomer system

Bonding agent

BIS-GMA-type monomer system

UDMA-type monomer system

Reaction

Bonding occurs primarily by intimate micromechanical retention with the relief created by the conditioning step

Chemical bonding is possible but is not recognized as contributing significantly to the overall bond strength

Manipulation-follow manufacturer's directions

Properties

Physical-thermal expansion and contraction may create fatigue stresses that debond the interface and permit micro leakage

Chemical-water absorption into the bonding agent may chemically alter the bonding

Mechanical-mechanical stresses may produce fatigue that debonds the interface and permits microleakage

Enamel bonding-adhesion occurs by macrotags (between enamel prisms) and microtags (into enamel prisms) to produce micromechanical retention

Dentin bonding-adhesion occurs by penetration of smear layer and formation of microtags into intertubular dentin to produce a hybrid zone (interpenetration zone or diffusion zone) that microscopically intertwines collagen bundles and bonding agent polymer

Biologic

Conditioning agents may be locally irritating if they come into contact with soft tissue

Priming agents (uncured), particularly those based on HEMA, may be skin sensitizers after several contacts with dental personnel

Protect skin on hands and face from inadvertent contact with unset materials and/ or their vapors

HEMA and other priming monomers may penetrate through rubber gloves in relatively short times (60 to 90 seconds)

Investment Materials

Investment is mold-making material

Applications

a. Mold-making materials for casting alloys
b. Mold-making materials for denture production

Classification

a. Gypsum-bonded investments (based on gypsum products for matrix)

b. Phosphate-bonded investments

c. Silicate-bonded investments

Components

a. Liquid-water or other reactant starts formation of matrix binder by reacting with reactant powder
b. Powder-reactant powder, filler, or modifiers

Manipulation

a. P/L mixed and placed in container around wax pattern
b. After setting, the investment is heated to eliminate the wax pattern in preparation for casting
 

Dental Porcelain and PFM Porcelains

Applications/Use

a. Porcelain inlays and jacket crowns
b. PFM crowns and bridges
c. Denture teeth

Terms

PFM-porcelain fused to metal
Fusing-adherence of porcelain particles into a single porcelain mass

Classification

 Dental porcelain is manufactured as a powder. When it is heated to a very high temperature in a special oven, it fuses into a homogeneous mass. The heating process is called baking. Upon cooling, the mass is hard and dense. The material is made in a variety of shades to closely match most tooth colors. Baked porcelain has a translucency similar to that of dental enamel, so that porcelain crowns, pontics, and inlays of highly pleasing appearance can be made. Ingredients of porcelain include feldspar, kaolin, silica in the form of quartz, materials which act as fluxes to lower the fusion point, metallic oxide, and binders. Porcelains are classified into high-, medium-, and low-fusing groups, depending upon the temperature at which fusion takes place. 
 
High-Fusing Porcelains. High-fusing porcelains fuse at 2,400o Fahrenheit or over. They are used for the fabrication of full porcelain crowns (jacket crowns). 

Medium-Fusing Porcelains. Medium-fusing porcelains fuse between 2,000o and 2,400o Fahrenheit. They are used in the fabrication of inlays, crowns, facings, and pontics. A pontic is the portion of a fixed partial denture, which replaces a missing tooth. 

Low-Fusing Porcelains. Low-fusing porcelains fuse between 1,600o and 2,000o Fahrenheit. They are used primarily to correct or modify the contours of previously baked high- or medium-fusing porcelain restorations. Eg  for PFM restorations

Structure

Components

a. Large number of oxides but principally silicon oxide, aluminum oxide. and potassium oxide    
b. Oxides are supplied by mixing clay, feldspar, and quartz.

Manipulation

Porcelain powders mixed with water and compacted into position for firing
Shrinkage is 30% on firing because of fusing and so must be made oversized and built up by several firing steps

Properties

1. Physical

a. Excellent electrical and thermal insulation
b. Low coefficient of thermal expansion and contraction
c. Good color and translucency; excellent aesthetics

2. Chemical

a. Not resistant to acids (and can be dissolved by  contact with APF topical fluoride treatments)
b. Can be acid-etched with phosphoric acid or  hydrofluoric acid for providing microll1echanical retention for cements

3. Mechanical

a. Harder than tooth structure and ,will cause opponent wear
b. Can be polished with aluminum oxide pastes