Zinc Phoshate Cement

Uses. Zinc phosphate cement is used both as an intermediate base and as a cementing medium. 

(1) Intermediate base. A thick mix  is used under permanent metallic restoration. This layer of cement protects the pulp from sudden temperature changes that may be transmitted by the metallic restoration. 

(2) Cementing medium. Zinc phosphate cement is used to permanently cement crowns, inlays, and fixed partial dentures upon the remaining tooth structure. A creamy mix of cement is used to seat the restoration or appliance completely into place. The cementing medium does not cement two objects together. Instead, the cement holds the objects together by mechanical interlocking, filling the space between the irregularities of the tooth preparation and the cemented restoration

c. Chemical Composition. 

(1) Powder. primary ingredients - zinc oxide and magnesium oxide. 
(2) Liquid. Phosphoric acid and water in the ratio of two parts acid to one part water. The solution may also contain aluminum phosphate and zinc phosphate Liquids exposed in open bottles will absorb moisture from the air in high humidity. The liquids will lose moisture if humidity is low. Water gain hastens setting; water loss lengthens setting time.
 
PROPERTIES OF ZINC PHOSPHATE CEMENT

a. Advantages. Some advantages of zinc phosphate cement as a cementing medium are:

o    Inconspicuous appearance. 
o    Speed and ease of usage. 
o    Sufficient flow to form a thin layer for the cementing of closely adapted crowns, fixed partial dentures, and inlays. 
o    Low thermal conductivity beneath a metallic restoration.

b. Disadvantages. Some disadvantages of zinc phosphate cement as a cementing medium are:

o    Low crushing strength that varies between 12,000 and 19,000 psi. 
o    Slight solubility in mouth fluids. 
o    Opaque material not suitable for visible surfaces. 

c. Strength. The ratio of powder to liquid increases the strength of phosphate cements to a certain point. For this reason, the dental specialist must use as thick a mix as practical for the work being performed. 

SETTING REACTIONS OF ZINC PHOSPHATE CEMENT 

a. Chemical Reaction. The chemical reaction that takes place between the powder and liquid of setting phosphate cement produces heat. The amount of heat produced depends upon the rate of reaction, the size of the mix, and the amount of heat extracted by the mixing slab. 

b. Powder to Liquid Ratio. The less powder used in ratio to the liquid, the longer the cement will take to harden. Good technique minimizes the rise in temperature and acidity of the setting cement that can injure the pulp. Generally, for increased strength, decreased shrinkage, and resistance to solubility, it is advisable to blend as much powder as possible to reach the desired consistencies. 

c. Setting Time. The setting time of zinc phosphate cement is normally between 5 and 9 minutes. 
 Lower the temperature of the glass mixing slab to between 65° and 75° F (18° to 24° C), if the glass mixing slab is not already cooled below the temperature at which moisture will condense on it. → Blend the powder slowly. →  Mix the powder over a large area of the cool slab. →  Use a longer mixing time, within optimum limits. 
 
Precautions. The following precautions should be observed. 

o    Prevent loss or gain of moisture in liquid cement by keeping bottles tightly stoppered. 
o    Dispense drops only when ready to mix. 
o    Use a cool, dry glass slab (65° to 75° F). 
o    Use the same brand of powder and liquid. 
o    Add increments of powder slowly. 
o    Use the maximum amount of powder to obtain the desired consistency. 

(To incorporate the most powder, the material should be mixed with a moderate circular motion over a large area of the slab, turning the spatula often.) 

COMPOSITE RESINS

Reaction

• Free radical polymerization

Monomers + initiator. + accelerators-+ polymer molecules

• Initiators-start polymerization by decomposing and reacting with monomer
• Accelerators-speed up initiator decomposition

• Amines used  for accelerating self –curing  systems
•  Light  used for accelerating light-curing systems

Retarders or inhibitors-prevent premature polymerization

Classification

Rigid impression materials

(1) Plaster
(2) Compound
(3) Zinc oxide-eugenol

Flexible hydrocolloid impression materials

(I) Agar-agar (reversible hydrocolloid)
(2) Alginate (irreversible hydrocolloid)

Flexible, elastomeric, or rubber impression materials

(1) Polysulfide rubber (mercaptan rubber)
(2) Silicone rubber (condensation silicone)
(3) Polyether rubber
(4) Polyvinyl siloxane (addition silicone)
 

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]

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

Properties-improve with filler content

Physical

Radiopacity depends on ions in silicate glass or the addition of barium sulfate (many systems radiolucent)
Coefficient of thermal expansion is 35 to 45 ppm/C and decreases with increasing filler content
Thermal and electrical insulators

Chemical

Water absorption is 0.5 % to 2.5% and increases with polymer level)
Acidulated topical fluorides (e.g., APF) tend to dissolve glass particles, and thus composites should be protected with petroleum jelly (Vaseline) during those procedures
Color changes occur in resin matrix with time because of oxidation, which produces colored by-products

Mechanical

Compressive strength is 45,000 to 60,000 lb/ in2, which is adequate
Wear resistance-improves with higher filler content, higher percentage of conversion in curing, and use of microfiller, but it is not adequate for some posterior applications
Surfaces rough from wear retain plaque and stain more readily

Biologic

Components may be cytotoxic, but cured composite is biocompatible as restorative filling material