Denture Teeth

Use-complete or partial dentures

Type

a. Porcelain teeth
b. Acrylic resin teeth
c. Abrasion-resistant teeth (microfilled composite)

Structure and properties

1. Porcelain teeth (high-fusing porcelain)
Only bonded into denture base mechanically. Harder than natural teeth or other restorations and abrades those surfaces. Good aesthetics.Used when patients have good ridge support and sufficient room between the arches

2. Acrylic resin teeth (PMMA  [polymethyl methacrylate])

Bonded pseudochemically into the denture base. Soft and easily worn by abrasive foods . Good initial aesthetics
Used with patients with poor ridges and in cases where they oppose natural teeth

3. Abrasion-resistant teeth (microfilled resins)
Bonded pseudochemically into the denture base.Better abrasion resistance then  acrylic resin teeth
 

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

POLYCARBOXYLATE CEMENT 

Use:. The primary use of polycarboxylate cement is as a cementing medium of cast alloy and porcelain restorations. In addition, it can be used as a cavity liner, as a base under metallic restorations, or as a temporary restorative material. 

Clinical Uses

Polycarboxylate cement is used in the same way as zinc phosphate cement, both as an intermediate base and as a cementing medium. 

c. Chemical Composition. 

(1) Powder:. It generally contains zinc oxide, 1 to 5 percent magnesium oxide, and 10 to 40 percent aluminum oxide or other reinforcing fillers. A small percentage of fluoride may be included. 
(2) Liquid. Polycarboxylate cement liquid is approximately a 40 percent aqueous solution of polyacrylic acid copolymer with other organic acids such as itaconic acid. Due to its high molecular weight, the solution is rather thick (viscous). 

d. Properties. 

The properties of polycarboxylate cement are identical to those of zinc phosphate cement with one exception. Polycarboxylate cement has lower compressive strength. 

e. Setting Reactions: 

The setting reaction of polycarboxylate cement produces little heat. This has made it a material of choice. Manipulation is simpler, and trauma due to thermal shock to the pulp is reduced. The rate of setting is affected by the powder-liquid ratio, the reactivity of the zinc oxide, the particle size, the presence of additives, and the molecular weight and concentration of the polyacrylic acid. The strength can be increased by additives such as alumina and fluoride. The zinc oxide reacts with the polyacrylic acid forming a cross-linked structure of zinc polyacrylate. The set cement consists of residual zinc oxide bonded together by a gel-like matrix. 

Precautions. 
The following precautions should be observed. 
o    The interior of restorations and tooth surfaces must be free of saliva. 
o    The mix should be used while it is still glossy, before the onset of cobwebbing. 
o    The powder and liquid should be stored in stoppered containers under cool conditions. Loss of moisture from the liquid will lead to thickening.