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Dental Materials - NEETMDS- courses
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Dental Materials

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
 

Suspension liners

Applications

o    Dentin lining under amalgam restorations
o    Stimulation of reparative dentin formation

Components

-Calcium hydroxide powder
-Water
-Modifiers

Manipulation

Used as W/P or pastes Paint thin film on dentin → Use forced air for 15 to 30 seconds to dry → Film is thicker (15 µm) than varnishes → Do not use on enamel or cavosurface margins

Properties

Physical

-Electrically insulating barrier
-Too thin to be thermally insulating

Chemical

-High basicity for calcium hydroxide (pH is II)
-Dissolves readily in water and should not be used at exposed cavosurface margins or gaps may form

Mechanical - weak film

Biologic - calcium hydroxide dissolves, diffuses, and stimulates odontoblasts to occlude dentin tubules below cavity preparation
 

CASTING DEFECTS

Classification :

1) Distortion.
2) Surface roughness .
3) Porosity .
4)Incomplete casting .
5) Oxidation .
6) Sulfur contamination .

Distortion
It is usually due to the distortion of wax pattern.

To avoid this :
Manipulation of the wax at its softening temp
Invest the pattern at the earliest .
If storage is necessary store it in a refrigerator .
Surface roughness

May be due to :
Air bubbles on the wax pattern .
Cracks due to rapid heating of the investment .
High W/P ratio .
Prolonged heating of the mold cavity .
Overheating of the gold alloy .
Too high or too low casting pressure .
Composition of the investment .
Foreign body inclusion.

POROSITY
May be internal or external .
External porosity causes discolouration .
Internal porosity weakens the restoration .

Classification of porosity .
I .Those caused by solidification shrinkage :
a) Localised shrinkage porosity .
b) Suck back porosity .
c) Microporosity .

They are usually irregular in shape .

II ) Those caused by gas :

a) Pin hole porosity .
b) Gas inclusions .
c) Subsurface porosity .

Usually they are spherical in shape .

III ) Those caused by air trapped in the mold :

Back pressure porosity .

Localised shrinkage porosity

Large irregular voids found near sprue casting junction.
Occurs when cooling sequence is incorrect .
If the sprue solidifies before the rest of the casting , no more molten metal is supplied from the sprue which can cause voids or pits (shrink pot porosity )


This can be avoided by -
- using asprue of correct thickness .
- Attach the sprue to the thickest portion of the pattern .
-Flaring of the sprue at the point of atttachment .
-Placing a reservoir close to the pattern .

Suck back porosity

It is an external void seen in the inside of a crown opposite the sprue .
Hot spot is created which freezes last .
It is avoided by :
Reducing the temp difference between the mold & molten alloy .

Microporosity :

Fine irregular voids within the casting .
Occurs when casting freezes rapidly .
Also when mold or casting temp is too low .

Pin hole porosity :
Upon solidification the dissolved gases are expelled from the metal causing tiny voids .
Pt & Pd absorb Hydrogen .
Cu & Ag absorb oxygen .

Gas inclusion porosities

Larger than pin hole porosities .
May be due to dissolved gases or due to gases Carried in or trapped by molten metal .
Apoorly adjusted blow torech can also occlude gases .

Back pressure porosity

This is caused by inadequate venting of the mold .The sprue pattern length should be adjusted so that there is not more than ¼” thickness of the investmentbetween the bottom of the casting .
This can be prevented by :
- using adequate casting force .
-use investment of adequate porosity .
-place the pattern not more than 6-8 mm away from tne end of the casting .
Casting with gas blow holes
This is due to any wax residue in the mold .
To eliminate this the burnout should be done with the sprue hol facing downwards for the wax pattern to run down.

Incomplete casting

This is due to :
- insufficient alloy .
-Alloy not able to enter thin parts of the mold .
-When the mold is not heated to the casting temp .
-Premature solidification of the alloy .
-sprues blocked with foreign bodies .
-Back pressure of gases .
-low casting pressure .
-Alloy not sufficiently molten .

Too bright & shiny casting with short & rounded margins :
occurs when wax is eliminated completely ,it combines with oxygen or air to form carbon monoxide .

Small casting :

occurs when proper expansion is not obtained & due to the shrinkage of the impression .

Contamination of the casting
1) Due to overheating there is oxidation of metal .
2) Use of oxidising zone of the flame .
3) Failure to use a flux .
4) Due to formation sulfur compounds .

Black casting

It is due to :
1) Overheating of the investment .
2) Incomplete elimination of the wax .
 

Manipulation

Mixing

o    P/L types mixed in bowl (plaster and alginate)
o    Thermoplastic materials not mixed (compound and agar-agar)
o    Paste/paste types hand mixed on pad (zinc oxide-eugenol, polysulfide rubber, silicone rubber, polyether rubber. and poly-vinylsiloxane)
o    Paste/paste mixed through a nozzle on an auto-mixing gun (poly-vinylsiloxane)

Placement

o    Mixed material carried in tray to mouth (full arch tray, quadrant tray. or triple tray)
o    Materials set in mouth more quickly because of higher temperature

Removal - rapid removal of impression encourages deformation to take place elastically rather than permanently (elastic deformation requires about 20 minutes)

Cleaning and disinfection of impressions 

Chromium Alloys for Partial Dentures

Applications - Casting partial denture metal frameworks

Classification

a. Cobalt-chromium
b. Nickel-chromium
c. Cobalt-chromium-nickel

Composition

a. Chromium-produces a passivating oxide film for corrosion resistance
b. Cobalt-increase~ the rigidity of the alloy
c. Nickel-increases the ductility of the alloy
d. Other elements-increase strength and castability

Manipulation

a. Requires higher temperature investment materials
b. More difficult to cast because less dense than gold alloys usually requires special casting equipment
c. Much more difficult to finish and polish because of higher strength and hardness

Properties

a. Physical-less dense_than gold alloys
b. Chemical-passivating corrosion behavior
c. Mechanical-stronger. stiffer. and harder than gold alloys
d. Biologic

-Nickel may cause sensitivity in some individuals (I % of men and 11 % of women)
-Beryllium in some alloys forms oxide that  is toxic to lab technicians

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
 

SELECTION OF SPRUE 

1 . DIAMETER :
It should be approximately the same size of the thickest portion of the wax pattern .
Too small sprue diameter suck back porosity results .

2 . SPRUE FORMER ATTACHMENT :
Sprue should be attached to the thickest portion of the wax pattern .
It should be Flared for high density alloys & Restricted for low density alloys .

3 . SPRUE FORMER POSITION

Based on the
1. Individual judgement .
2. Shape & form of the wax pattern .

Patterns may be sprued directly or indirectly .
Indirect method is commonly used

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