NEET MDS Lessons
Dental Materials
Effects of Amalgam.
(1) The combined effects of the properties of its ingredients should provide the most satisfactory restorative material.
(2) Quantity of mercury. Too little mercury in the mix results in a grainy, weak, readily tarnished, and corroded amalgam. Too much mercury will cause excessive expansion and weakened amalgam.
(3) Composition of the alloy. Composition of the alloy must include a minimum of 65 percent silver, a maximum of 29 percent tin, a maximum of 6 to 13 percent copper, and a maximum of two percent zinc by weight
(4) Correct proportion important. Before use, the silver alloy is mixed with pure and uncontaminated mercury. There are some alloys that are completely zinc free. They can therefore be used more successfully in a moisture-contaminated environment.
(5) Properties of the finished product.
Silver imparts strength, durability, and color, gives the alloy desirable setting expansion, decreases flow, and accelerates (decreases) the setting time.
Tin makes the amalgam easier to work, controls excessive setting expansion, and increases both flow and setting time.
Copper increases hardness, contributes to setting expansion, reduces flow, and decreases setting time.
Zinc increases workability, and unites with oxygen and other "impurities" to produce a clean amalgam.
Model. Cast. and Die Materials
Applications
- Gold casting, porcelain and porcelain-fused–to metal fabrication procedures
- Orthodontic and pedodontic appliance construction
- Study models for occlusal records
Terms
a. Models-replicas of hard and soft tissues for study of dental symmetry
b. Casts-working replicas of hard and soft tissues for use in the fabrication of appliances or restorations
c. Dies :- working replicas of one tooth (or a few teeth) used for the fabrication of a restoration
d. Duplicates-second casts prepared from original casts
Classification by materials
a Models :- (model plaster or orthodontic stone; gypsum product)
b. Stone casts (regular stone; gypsum product)
c. Stone dies (diestone; gypsum product)-may electroplated
d. Epoxy dies (epoxy polymer)-abrasion-resistant dies
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.
Waxes
Many different waxes are used in dentistry. The composition, form, and color of each wax are designed to facilitate its use and to produce the best possible results.
Applications
o Making impressions
o Registering of tooth or soft tissue positions
o Creating restorative patterns for lab fabrication
o Aiding in laboratory procedures
Classification
a. Pattern waxes-inlay, casting, and baseplate waxes
b. Impression waxes-corrective and biteplate waxes
c. Processing waxes-boxing, utility, and sticky waxes
Types
1) Inlay wax-used to create a pattern for inlay, onlay or crown for subsequent investing and casting in a metal alloy.
2) Casting wax-used to create a pattern for metallic framework for a removable partial denture
3) Baseplate wax-used to establish the vertical dimension. plane of occlusion. and initial arch form of a complete denture
4) Corrective impression wax-used to form a registry pattern of soft tissues on an impression
5) Bite registration wax-used to form a registry pattern for the occlusion of opposing models or casts
6) Boxing wax-used to form a box around an impression before pouring a model or cast
7) Utility wax -soft pliable adhesive wax for modifying appliances, such as alginate impression trays
8) Sticky wax-sticky when melted and used to temporarily adhere pieces of metal or resin in laboratory procedures
Components
a. Base waxes-hydrocarbon (paraffin) ester waxes
b. Modifier waxes-carnauba, ceresin, bees wax, rosin, gum dammar, or microcrystalline waxes
c. Additives-colorants
Reaction-waxes are thermoplastic
Properties
Physical
a. High coefficients of thermal expansion and contraction
b. Insulators and so, cool unevenly; should be waxed in increments to allow heat dissipation
Chemical
a. Degrade prematurely if overheated
b. Designed to degrade into CO2and H2Oduring burnout
Mechanical-stiffness, hardness, and strength depend on modifier waxes used
Casting of glass or ceramic
A castable ceramic is prepared in a similar manner as metal cast preparation .
Glass is heated to 1360 degrees & then cast.
Phosphate bonded investments are used for this purpose .
Cement Bases
Applications
• Thermal insulation below a restoration
• Mechanical protection where there is inadequate dentin to support amalgam condensation pressures
Types
• Zinc phosphate cement bases
• Polycarboxylate cement bases
• Glass ionomer cement bases (self-curing and light-curing)
Components
o Reactive powder (chemically basic)
o Reactive liquid (chemically acidic)
Reaction
o Acid-base reaction that forms salts or cross linked matrix
o Reaction may be exothermic
Manipulation-consistency for basing includes more powders, which improves all of the cement properties
Properties
Physical-excellent thermal and electrical insulation
Chemical-much more resistant to dissolution than cement liners
Polycarboxylate and glass ionomer cements are mechanically and chemically adhesive to tooth structure
Solubility of all cement bases is lower than cement liners if they are mixed at higher powder- to-liquid ratios
Mechanical- much higher compressive strengths (12,000 to 30,000 psi)
Light-cured hybrid glass ionomer cements are the strongest
Zinc oxide-eugenol cements are the weakest
Biologic (see section on luting cements for details)
Zinc oxide-eugenol cements are obtundent to the pulp
Polycarboxylate and glass ionomer cements are kind to the pulp
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)