ACRYLIC RESINS

Use. Acrylic (unfilled) resins are used as temporary crown material. Temporary crowns are placed to protect the crown preparation and provide patient comfort during the time the permanent crown is being constructed

Physical reaction-cooling causes reversible hardening

Chemical reaction-irreversible reaction during setting

Acrylic Appliances

Use - space maintenance  or tooth movement for orthodontics and pediatric dentistry

1. Components

a. Powder-PMMA powder. peroxide initiator, and pigments

b. Liquid-MMA monomer, hydroquinone inhibitor, cross-linking agents, and chemical accelerators (N, N-dimethyl-p-toluidine)

2. 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

Pit-and-Fissure Dental Sealants

Applications/Use

Occlusal surfaces of newly erupted posterior teeth
Labial surfaces of anterior teeth with fissures
Occlusal surfaces of teeth in older patients with reduced saliva flow (because low saliva increases the susceptibility to caries)

Types

Polymerization method

Self-curing (amine accelerated)
Light curing (light accelerated)

Filler content

Unfilled-most systems are unfilled because filler tends to interfere with wear away from self-cleaning occlusal areas(sealants are designed to wear away, except where there is no self-cleaning action a common misconception is that sealants should be wear resistant)

Components

Monomer-BIS-GMA with TEGDM diluent to facilitate flow into pits and fissures prior to cure
Initiator-benzoyl peroxide (in self-cured) and diketone (in light cured)
Accelerator-amine (In light cured)
Opaque filler-I % titanium dioxide. or other colorant to make the material detectable on tooth surfaces
Reinforcing filler-generally not added because wear resistance is not required within pits and fissures

Reaction-free radical reaction 

Manipulation

Preparation

Clean pits and fissures of organic debris. Do not apply fluoride before etching because it will tend to make enamel more acid resistant. Etch occlusal surfaces, pits, and fissures for 30 seconds (gel) or 60 seconds (liquid) with 37% phosphoric acid . Wash occlusal surfaces for 20 seconds. Dry etched area for 20 seconds with clean air spray. Apply sealant and polymerize

Mixing or dispensing

Self-cured-mix equal amounts of liquids in Dappen dish for 5 seconds with brush applicator. Light cured-dispense from syringe tips 
Placement

-pits, fissures, and occlusal surfaces  --> Allow 60 seconds for self-cured materials to set. 

Finishing

Remove unpolymerized and excess material .Examine hardness of sealant. Make occlusal adjustments where necessary in sealant; some sealant materials are self-adjusting

Properties

Physical

Wetting-low-viscosity sealants wet acid etched tooth structure the best

Mechanical

Wear resistance should not be too great because sealant should be able to wear off of  self-cleaning areas of tooth
Be careful to protect sealants during polishing procedures with air abrading units to prevent sealant loss

Clinical efficacy

Effectiveness is 100% if retained in pits and fissures .Requires routine clinical evaluation for resealing of areas of sealant loss attributable to poor retention .
Sealants resist effects of topical fluorides
 

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 setMix drop of each paste together for 5 secondsApply 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

METALLURGICAL TERMS

a. Cold Working. This is the process of changing the shape of a metal by rolling, pounding, bending, or twisting at normal room temperature.

b. Strain Hardening. This occurs when a metal becomes stiffer and harder because of continued or repeated application of a load or force. At this point, no further slippage of the atoms of the metal can occur without fracture.

c. Heat Softening Treatment (Annealing). This treatment is necessary in order to continue manipulating a metal after strain hardening to prevent it from fracturing. The process of annealing consists of heating the metal to the proper temperature (as indicated by the manufacturer's instructions) and cooling it rapidly by immersing in cold water. Annealing relieves stresses and strains caused by cold working and restores slipped atoms within the metal to their regular arrangement.

d. Heat Hardening Treatment (Tempering). This treatment is necessary to restore to metals properties that are decreased by annealing and cold working. Metals to be heat hardened should first be heat softened (annealed) so that all strain hardening is relieved and the hardening process can be properly controlled. Heat hardening is accomplished in dental gold alloy by heating to 840^o Fahrenheit, allowing it to cool slowly over a 15-minute period to 480^o Fahrenheit, and then immersing it in water.

Stages of manipulation

Definitions of intervals

• Mixing interval-length of time of the mixing stage.
• Working interval-length of time of the working stage
•  Setting interval-length of time of the setting stage

Definitions of times

• Mixing time-the elapsed time from the onset to the completion of mixing
• Working time-the elapsed time from the onset of mixing until the onset of the initial setting time
• Initial setting time-time at which sufficient reaction has occurred  to cause the materials to be resistant to  further manipulation
• Final setting time-time at which the material practically is set as defined by its resistance to indentation

[All water-based materials lose their gloss at the time of setting]