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
 

POLISHING MATERIALS

1 Tin Oxide. Tin oxide is used in polishing teeth and metal restorations. Tin oxide is a fine, white powder that is made into a paste by adding water or glycerin.

2. Pumice. Pumice is used as an abrasive and polishing agent for acrylic resins, amalgams, and gold. It consists mainly of complex silicates of aluminum, potassium, and sodium. Two grades--flour of pumice and coarse pumice--are listed in the Federal Supply Catalog.

3. Chalk (Whiting). Chalk is used for polishing acrylic resins and metals. It is composed primarily of calcium carbonate.

4.Tripoli. Tripoli is usually used for polishing gold and other metals. It is made from certain porous rocks.

5. Rouge (Jeweler's). Rouge is used for polishing gold and is composed of iron oxide. It is usually in cake or stick form.

6. Zirconium Silicate. Zirconium silicate is used for cleaning and polishing teeth. It may be mixed with water or with fluoride solution for caries prevention treatment. For full effectiveness, instructions must be followed exactly to obtain the proper proportions of powder to liquid.

INVESTING
Mixing investment with distilled water is done according to the manufacturers ratio in a clean dry bowl without entrapment of the air into the mix.

Mixing methods:
a.    Hand mixing and the use of the vibrator to remove air bubbles.
b.    Vacuum mixing- This is the better method because it removes air bubbles as well as gases that are produced and thus produces a smoother mix.

Methods of investing:
a.    Hand investing
b.    Vacuum investing

Hand investing:

First the mixed investment is applied on all the surfaces of the pattern with a soft brush. Blow off any excess investment gently, thus leaving a thin film of investment over the pattern, then apply again.
Then the coated pattern can be invested by two methods;
1. Placing the pattern in the ring first and then filling the ring full with investment.
2. Filling the ring with the investment first and then force the pattern through into it.

Vacuum investing :

Vacuum investing unit: This consists of the chamber of small cubic capacity from which air can be evacuated quickly and in which casting ring can be placed.
Evacuation of air can be done by electrically or water driven vacuum pump.

Procedure:

The ring filled with investment is placed in the vacuum chamber. Air entry tube is closed. Then the vacuum is applied. The investment will rise with froth vigorously for about 10-15 sec and then settles back. This indicates that air has been extracted from the ring. The pressure is now restored to atmospheric by opening the air entry tap gradually at first and then more rapidly as the investment settles back around the pattern. Then the ring is removed from the chamber and the investment is allowed to set. Modern investing unit does both mixing and investing under vacuum and is considered better than hand mixing and pouring.
Then there are two alternatives to be followed depending upon what type of expansion is to be achieved in order to compensate for metal shrinkage. They are:

1. If hygroscopic expansion of the investment is to be achieved then immediately immerse the filled ring in water at the temperature of 37C.
Or “under controlled water adding technique”. A soft flexible rubber ring is used instead of usual lined metal ring. Pattern is invested as usual. Then specified amount of water is added on top of the investment in the rubber ring and the investment is allowed to set at room temperature. In this way only enough water is added to the investment to provide the desired expansion.

2. If thermal expansion of the investment is to be achieved, then investment is allowed to set by placing the ring on the bench for 1 hour or as recommended by the manufacturer.

ACID ETCH TECHNIQUE

Cavities requiring added retention (to hold firmly) are treated with an acid etching technique. This technique improves the seal of the composite resin to the cavity wall. The enamel adjacent to the margins of the preparation is slightly decalcified with a 40 to 50 percent phosphoric acid solution. This etched enamel enhances the mechanical retention of the composite resin. In addition, the acid etch technique is used to splint unstable teeth to adjacent teeth. The acid is left on the cut tooth structure only 15 seconds, in accordance with the directions for one common commercial brand. The area is then flushed with water for a minimum of 30 seconds to remove the decalcified material. Etched tooth structure will have a chalky appearance.

Reaction

a. Calcium sulfate hemihydrate(one-half water) crystals dissolve and react with water
b. Calcium sulfate dihydrate(two waters) form and precipitate new crystals
c. Unreacted (excess) water is left between crystals in solid

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.