Gypsum Products

Glass Ionomer Cements

Applications

a. Class V restorations-resin-modified glass ionomers for geriatric dentistry
b. Class II restorations-resin-modified glass ionomers, metal-modified glass ionomers in pediatric dentistry
c. Class III restorations-resin-modified glass ionomers
d. permanent cementing of inlays, crowns, bridges, and/or orthodontic band/brackets. In addition, it can be used as a cavity liner and as a base.

Classification by composition

a. Glass ionomer-limited use
b. Metal-modified glass ionomer-limited use
c. Resin-modified glass ionomer-popular use

Components

a. Powder-aluminosilicate glass
b. Liquid-water solution of copolymers (or acrylic acid with maleic, tartaric, or itaconic acids) and water-soluble monomers (e.g., HEMA)

Reaction (may involve several reactions and stages of setting)

a. Glass ionomer reaction (acid-base reaction of polyacid and ions released from aluminosilicate glass particles)
- Calcium, aluminum, fluoride, and other ions released by outside of powder particle dissolving in acidic liquid
- Calcium ions initially cross-link acid functional copolymer molecules
- Calcium cross-links are replaced in 24 to 48 hours by aluminum ion cross-links, with increased hardening of system
- If there are no other reactants in the cement (e.g., resin modification), then protection from saliva is required during the first 24 hours

b. Polymerization reaction (polymerization of double bonds from water-soluble monomers and/or pendant groups on copolymer to form cross-linked matrix)
- Polymerization reaction can be initiated with chemical (self-curing) or light-curing steps
- Cross-linked polymer matrix ultimately interpenetrates glass ionomer matrix 

Manipulation

a. Mixing-powder and liquid components may be manually mixed or may be precapsulated for mechanical mixing
b. Placement-mixture is normally syringed into place
c. Finishing-can be immediate if system is resin-modified (but otherwise must be delayed 24 to 72 hours until aluminum ion replacement reaction is complete)
d. Sealing-sealer is applied to smoothen the surface (and to protect against moisture affecting the glass ionomer reaction)

Properties

1. Physical

-Good thermal and electrical insulation
-Better radiopacity than most composites
-Linear coefficient of thermal expansion and contraction is closer to tooth structure than for composites (but is less well matched for resin-modified systems)
-Aesthetics of resin-modified systems are competitive with composites

2. Chemical

-Reactive acid side groups of copolymer molecules may produce chemical bonding to tooth structure
-Fluoride ions are released
(1) Rapid release at first due to excess fluoride ions in matrix
(2) Slow release after 7  to 30 days because of slow diffusion of fluoride ions out of aluminosilicate particles

-Solubility resistance of resin-modified systems is close to that of composites

3. Mechanical properties

-Compressive strength of resin-modified systems is much better than that of traditional glass ionomers but not quite as strong as composites
- Glass ionomers are more brittle than composites

4. Biologic properties

- Ingredients are biologically kind to the pulp
- Fluoride ion release discourages secondary canes
 

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 .

Classification of Dental amalgam

1. By powder particle shape .

• Irregular (comminuted, filing, or lathecut)
• Spherical (spherodized)
• Blends (e.g., irregular-irregular, irregularspherical, or spherical-spherical)

2. By total amount of copper

• Low-copper alloys (e.g., conventional, traditional); <5% copper
• High-copper alloys (e,g.  corrosion resistant); 12% to 28% copper

3.By presence of zinc

Examples

• Low-copper, irregular-particle alloy-silver (70%)-tin (26%)-copper (4%)
• High-copper, blended-particles alloy-irregular particles, silver (70%) –tin (26%) -Copper (4%); spherical particles, silver (72%)-copper (28%)
• High-copper, spherical-particles alloy-silver (60%) - tin (27%)-copper (13%)

INVESTING
Mixing investment with distilled water is done according to the manufacturers ratio in a clean dry bowl without entrapment of the air into the mix.

Mixing methods:
a.    Hand mixing and the use of the vibrator to remove air bubbles.
b.    Vacuum mixing- This is the better method because it removes air bubbles as well as gases that are produced and thus produces a smoother mix.

Methods of investing:
a.    Hand investing
b.    Vacuum investing

Hand investing:

First the mixed investment is applied on all the surfaces of the pattern with a soft brush. Blow off any excess investment gently, thus leaving a thin film of investment over the pattern, then apply again.
Then the coated pattern can be invested by two methods;
1. Placing the pattern in the ring first and then filling the ring full with investment.
2. Filling the ring with the investment first and then force the pattern through into it.

Vacuum investing :

Vacuum investing unit: This consists of the chamber of small cubic capacity from which air can be evacuated quickly and in which casting ring can be placed.
Evacuation of air can be done by electrically or water driven vacuum pump.

Procedure:

The ring filled with investment is placed in the vacuum chamber. Air entry tube is closed. Then the vacuum is applied. The investment will rise with froth vigorously for about 10-15 sec and then settles back. This indicates that air has been extracted from the ring. The pressure is now restored to atmospheric by opening the air entry tap gradually at first and then more rapidly as the investment settles back around the pattern. Then the ring is removed from the chamber and the investment is allowed to set. Modern investing unit does both mixing and investing under vacuum and is considered better than hand mixing and pouring.
Then there are two alternatives to be followed depending upon what type of expansion is to be achieved in order to compensate for metal shrinkage. They are:

1. If hygroscopic expansion of the investment is to be achieved then immediately immerse the filled ring in water at the temperature of 37C.
Or “under controlled water adding technique”. A soft flexible rubber ring is used instead of usual lined metal ring. Pattern is invested as usual. Then specified amount of water is added on top of the investment in the rubber ring and the investment is allowed to set at room temperature. In this way only enough water is added to the investment to provide the desired expansion.

2. If thermal expansion of the investment is to be achieved, then investment is allowed to set by placing the ring on the bench for 1 hour or as recommended by the manufacturer.

Root canal sealers

Applications

Cementation of silver cone gutta-percha point
Paste filling material

Types

Zinc oxide-eugenol cement types
Noneugenol cement types
Therapeutic cement types

properties

Physical-radiopacity
Chemical-insolubility
Mechanical-flow; tensile strength
Biologic-inertness

Gingival tissue packs

Application-provide temporary displacement of gingival tissues
Composition-slow setting zinc oxide-eugenol cement mixed with cotton twills for texture and strength

Surgical dressings
1.Application-gingival covering after periodontal surgery
2. Composition-modified zinc oxide-eugenol cement (containing tannic, acid. rosin, and various oils)

Orthodontic cements

Application-cementation of orthodontic bands
Composition-zinc phosphate cement 

Manipulation

Zinc phosphate types are routinely mixed with cold or frozen mixing slab to extend the working time
Enamel bonding agent types use acid etching for improved bonding
Band, bracket, or cement removal requires special care