NEET MDS Lessons
Dental Materials
Classification of Dental amalgam
1. By powder particle shape .
- Irregular (comminuted, filing, or lathecut)
- Spherical (spherodized)
- Blends (e.g., irregular-irregular, irregularspherical, or spherical-spherical)
2. By total amount of copper
- Low-copper alloys (e.g., conventional, traditional); <5% copper
- High-copper alloys (e,g. corrosion resistant); 12% to 28% copper
3.By presence of zinc
Examples
- Low-copper, irregular-particle alloy-silver (70%)-tin (26%)-copper (4%)
- High-copper, blended-particles alloy-irregular particles, silver (70%) –tin (26%) -Copper (4%); spherical particles, silver (72%)-copper (28%)
- High-copper, spherical-particles alloy-silver (60%) - tin (27%)-copper (13%)
WETTABILITY
To minimise the irregularities on the investment & the casting a wetting agent can be used .
FUNCTIONS OF A WETTING AGENT
1 . Reduce contact angle between liquid & wax surface .
2 .Remove any oily film left on wax pattern .
COMPOSITE RESINS
Types
- Amount of filler-25% to 65% volume, 45% to 85% weight
- Filler particle size (diameter in microns)
- Macrofill 10 to 100 µm (traditional composites)
- Midi fill- 1 to 10 µm(small particle composites)
- Minifill— 0.l to 1 µm
- Microfill-: 0.01 to 0.1 µm (fine particle composites)
- Hybrid--blend (usually or microfill and midifill or minifill and microfill)
- Polymerization method
- Auto-cured (self-cured)
- Visible light cured
- Dual cured
- Staged cure
- Matrix chemistry
- BIS-GMA type
- Urethane dimethacrylate (UDM or UDMA) type
- TEGDMA-diluent monomer to reduce viscosity
Physical reaction-cooling causes reversible hardening
Chemical reaction-irreversible reaction during setting
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
Casting Alloys
Applications-inlay, onlay, crowns, and bridges
Terms
a. Precious-based on valuable elements
b. Noble or immune-corrosion-resistant element or alloy
c. Base or active-corrosion-prone alloy
d. Passive -corrosion resistant because of surface oxide film
e. Karat (24 karat is 100% gold; 18 karat is 75% gold)
f. Fineness (1000 fineness is I00% gold; 500 fineness is 50% gold)
Classification
High-gold alloys are > 75% gold or other noble metals
Type 1- 83% noble metals (e.g., in simple inlays)
Type II-≥78% noble metals (e.g.,in inlays and onlays)
Type IlI-≥75% noble metals (e.g., in crowns and bridges)
Type IV-≥75% noble metals (e.g., in partial dentures)
Medium-gold alloys are 25% to 75% gold or other noble metals
Low-gold alloys are <25% gold or other noble metals
Gold-substitute alloys arc alloys not containing gold
(1) Palladium-silver alloys-passive .because of mixed oxide film
(2) Cobalt-chromium alloys-passive because of Cr203 oxide film
(3) Iron-chromium alloys-passive because of Cr203 oxide film
Titanium alloys are based on 90% to 100% titanium ; passive because of TiO2 oxide film
Components of gold alloys
- Gold contributes to corrosion resistance
- Copper contributes to hardness and strength
- Silver counteracts orange color of copper
- Palladium increases melting point and hardness
- Platinum increases melting point
- Zinc acts as oxygen scavenger during casting
Manipulation
- Heated to just beyond melting temperature for casting
o Cooling shrinkage causes substantial contraction
Properties
Physical
- Electrical and thermal conductors
- Relatively low coefficient of thermal expansion
Chemical
- Silver content affects susceptibility to tarnish
- Corrosion resistance is attributable to nobility or passivation
Mechanical
- High tensile and compressive strengths but relatively weak in thin sections, such as margins, and can be deformed relatively easily
- Good wear resistance except in contact with Porcelain
CAD/CAM Restorations
Applications-inlays, onlays, veneers, crowns, bridges, implants, and implant prostheses
Stages of fabrication
CSD-computerized surface digitization
CAD-computer-aided (assisted) design
CAM-computer-aided (assisted) machining
CAE-computer-aided esthetics (currently theoretic)
CAF-computer-aided finishing or polishing (which are currently theoretic steps)
Classification
Chairside or in-office systems
(1) Cerec (Siemens system)-inlays, onlays, veneers
(2) Sopha (Duret system)-inlays, onlays (and Crowns)
Laboratory systems
(1) DentiCAD (Rekow system)-inlay, onlays, veneers, crowns
(2) Cicero (Elephant system)-porcelain fused-to-metal crowns
Materials
a. Feldspathic oorcelains (Vita)
b. Machinable ceramics (Dicor MGC)
c. Metal alloys limited use)
Cementing
- Etching enamel and/or dentin for micromechanical retention
- Bonding agent for retention to etched surface
- Composite as a luting cement for reacting chemically with bonding agent and with silanated surface of restoration
- Silane for bonding to etched ceramic (or metal) restorations and to provide chemical reaction
- Hydrofluoric acid etching to create spaces for micromechanical retention on surface or restoration
Properties
1. Physical properties
a. Thermal expansion coefficient well matched to tooth structure
b. Good resistance to plaque adsorption or retention
2. Chemical properties-not resistant to acids and should be protected from APF
3. Mechanical properties
a. Excellent wear resistance (but may abrade opponent teeth)
b. Some wear of luting cements but self-limiting
c. Excellent toothbrush abrasion
4. Biologic properties-excellent properties