NEET MDS Lessons
Dental Materials
Structure of gypsum products
Components
a. Powder (calcium sulfate hemihydrate = CaSO4½H2O)
b. Water (for reaction with powder and dispersing powder)
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.
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
Denture Liners
Use - patients with soft tissue irritation
Types
Long-term liners (soft liners)-used over a period of months for patients with severe undercuts or continually sore residual ridges
Short-term liners (tissue conditioners)-used to facilitate tissue healing over several days
Structure
Soft liners-plasticized acrylic copolymers or silicone rubber
Tissue conditioners-PEMA plasticized with ethanol and aromatic esters
Properties
Liners flow under low pressure, allowing adaptation to soft tissues, but are elastic during chewing forces.
Low initial hardness, but liner becomes harder as plasticizers are leached out during intraoral use
Some silicone rubber liners support growth of yeasts
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