Gypsum Products

Manipulation

Selection

o    Microfilled composites or hybrids for anterior class III, IV, V
o    Hybrids or midifills for posterior class I, II, III, V

Conditioning of enamel and / or dentin

Do not apply fluorides before etching.-->Acid-etch --> Rinse for 20 seconds with water --> Air-dry etched area for 20 seconds but do not desiccate or dehydrate --> Apply bonding agent and polymerize

Mixing (if required)--> mix two pastes for 20 to 30 seconds

o    Self-cured composite-working time is 60 to 120 seconds after mixing
o    Light-cured composite-working time is unlimited (used for most anterior and some posterior composite restorations)
o    Dual-cured composite-working time is > 10 minutes
o    Two-stage cured composite-working time is >5 minutes

Placement

use plastic instrument or syringe --> Light curing --> Cure incrementally in <2 mm thick layers. Use matrix strip where possible to produce smooth surface and contour composite .Postcure to improve hardness
 

PHYSICAL PROPERTIES OF MATERIALS

Definite and precise terms are used to describe the physical properties of dental materials.

a. Hardness. Hardness is the measure of the resistance of a metal to indentation or scratching. It is an indication of the strength and wearability of an alloy or metal.

b. Ductility. Ductility is the measure of the capacity of a metal to be stretched or drawn by a pulling or tensile force without fracturing. This property permits a metal to be drawn into a thin wire.

c. Malleability. Malleability is the measure of the capacity of a metal to be extended in all directions by a compressive force, such as rolling or hammering. This property permits a metal to be shaped into a thin sheet or plate.

d. Flexibility and Elasticity. These terms differ in their technical definition but they are very closely related. Flexibility is the characteristic of a metal, which allows it to deform temporarily. The elasticity of a metal is used when it returns to its original shape when the load or force is removed.

e. Fatigue. Fatigue is the property of a metal to tire and to fracture after repeated stressing at loads below its proportional limit.

f. Structure (Crystalline or Grain Structure). Metals are crystalline and many of their physical properties depend largely upon the size and arrangement of their minute crystals called grains.

(1) Grain size. The size of the grains in a solidified metal depends upon the number of nuclei of crystallization present and the rate of crystal growth. In the practical sense, the faster a molten is cooled to solidification, the greater will be the number of nuclei and the smaller will be the grain size. Generally speaking, small grains arranged in an orderly fashion give the most desirable properties.

(2) Grain shape. The shape of the grains is also formed at the time of crystallization. If the metal is poured or forced into a mold before cooling, the grains will be in a flattened state. Metal formed by this method is known as cast metal. If the metal is shaped by rolling, bending, or twisting, the grains are elongated and the metal becomes a wrought wire.

g. Crushing Strength. Crushing strength is the amount of resistance of a material to fracture under compression.

h. Thermal Conductivity. Thermal conductivity is defined as the ability of a material to transmit heat or cold. A low thermal conductivity is desired in restorative materials used on the tooth whereas a high thermal conductivity is desirable where the material covers soft tissue.

Tooth Polishing and Cleansing Agents

1. Cleansing-removal of exogenous stains, pellicle, materia alba, and other oral debris without causing undue abrasion to tooth structure
2. Polishing-smoothening surfaces of amalgam, composite, glass ionomers, porcelain, and other restorative materials

Factors influencing cleaning and polishing

-    Hardness of abrasive particles versus substrate
-    Particle size of abrasive particles
-    Pressure applied during procedure
-  Temperature of abrasive materials

Structure

 Composition

-contain abrasives, such as kaolinite, silicon dioxide, calcined magnesium silicate, diatomaceous silicon dioxide, pumice. Sodium-potassium
-aluminum silicate, or zirconium silicate; some pastes also may contain sodium fluoride or stannous fluoride, but they have never been shown to produce positive effects
 

Reactions-abrasion for cleansing and polishing

Properties -  Mechanical
 
- Products with pumice and quartz produce more efficient cleansing but also generate greater abrasion of enamel and dentin
-Coarse pumice is the most abrasive
-The abrasion rate of dentin is 5 to 6 times faster than the abrasion rate of enamel, regardless of the product
-Polymeric restorative materials, such as denture bases, denture teeth, composites, PMMA veneers, and composite veneers, can be easily scratched during polishing
-Do not polish cast porcelain restorations (e.g., Dicor) that are  externally characterized or the color will be lost
 

Temporary Filling Materials

Applications / Use

While waiting for lab fabrication of cast restoration
While observing reaction of pulp tissues

Objectives

Provide pulpal protection
Provide medication to reduce pulpal inflammation
Maintain the tooth position with an aesthetic restoration

Classification

Temporary filling cements
Temporary filling resins

Components

Temporary filling cements

1. Zinc oxide-eugenol cement with cotton fibers added
2. Polyme r powder-reinforced zinc oxide eugenol cement

Temporary filling resins

•    MMA / PMMA filling materials
•    Polyamide filling materials
•    BIS-GMA filling materials
 

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.)