NEET MDS Lessons
Dental Materials
Acrylic Appliances
Use - space maintenance or tooth movement for orthodontics and pediatric dentistry
1. Components
a. Powder-PMMA powder. peroxide initiator, and pigments
b. Liquid-MMA monomer, hydroquinone inhibitor, cross-linking agents, and chemical accelerators (N, N-dimethyl-p-toluidine)
2. Reaction
PMMA powder makes mixture viscous for manipulation before curing . Chemical accelerators cause decomposition of benzoyl peroxide into free radicals that initiate polymerization of monomer . New PMMA is formed into a matrix that surrounds PMMA powder. Linear shrinkage of 5% to 7% during setting. but dimensions of appliances are not critical
RINGLESS INVESTMENT TECHNIQUE
Used for phosphate bonded investments .
This method uses paper or plastic casting ring .
It is designed to allow urestricted expansion .
Useful for high melting alloys .
CASTING: casting is the process by which the wax pattern of a restoration is converted to a replicate in a dental alloy. The casting process is used to make dental restorations such as inlays, onlays, crowns, bridges and removable partial dentures.
Objectives of casting
1) To heat the alloy as quickly as possible to a completely molten condition.
2) To prevent oxidation by heating the metal with awell adjusted torch .
3) To produce a casting with sharp details by having adequate pressure to the well melted metal to force into the mold.
STEPS IN MAKING A CAST RESTORATION
1. TOOTH PREPARATION
2. IMPRESSION
3. DIE PREPARATION
4. WAX PATTERN FABRICATION
5. SPRUING
I . Procedure for single casting :
A 2.5 mm sprue former is recommended
for molar crowns 2.0 mm for premolars & partial coverage crowns .
II . Procedure for multiple casting :
Each unit is joined to a runner bar .
A single sprue feeds the runner bar
4 . SPRUE FORMER DIRECTION
Sprue Should be directed away from the delicate parts of the pattern
It should not be at right angles to a flat surface .(leads to turbulance porosity .)
Ideal angulation is 45 degrees .
5 . SPRUE FORMER LENGTH
Depends on the length of casting ring .. Length of the Sprue former should be such that it keeps the wax pattern about 6 to 8 mm away from the casting ring. Sprue former should be no longer than 2 cm. The pattern should be placed as close to the centre of the ring as possible.
Significance
Short Sprue Length:
The gases cannot be adequately vented to permit the molten alloy to fill the ring completelyleading to Back Pressure Porosity.
Long Sprue Length:
Fracture of investment, as mold will not withstand the impact force of the entering molten alloy.
Top of wax should be adjusted for :
6 mm for gypsum bonded investments .
3 -4 mm for phosphate bonded investments .
TYPES OF SPRUES
I . - Wax . II . Solid
- Plastic . Hollow
- Metal .
Mechanical properties
1. Resolution of forces
Uniaxial (one-dimensional) forces-compression, tension, and shear
Complex forces-torsion, flexion. And diametral
2. Normalization of forces and deformatations
Stress
Applied force (or material’s resistance to force) per unit area
Stress-force/area (MN/m2)
Strain
Change in length per unit of length because of force
Strain-(L- Lo)/(Lo); dimensionless units
3. Stress-strain diagrams
Plot of stress (vertical) versus strain (horizontal)
- Allows convenient comparison of materials
- Different curves for compression, tension, and shear
- Curves depend on rate of testing and temperature
4. Analysis of curves
- Elastic behavior
- Initial response to stress is elastic strain
- Elastic modulus-slope of first part of curve and represents stiffness of material or the resistance to deformation under force
- Elastic limit (proportional limit)- stress above which the material no longer behaves totally elastically
- Yield strength-stress that is an estimate of the elastic limit at 0.002 permanent strain
- Hardness-value on a relative scale that estimates the elastic limit in terms of a material’s resistance to indentation (Knoop hardness scale, Diamond pyramid, Brinnell, Rockwell hardness scale, Shore A hardness scale, Mohs hardness scale
- Resilience-area under the stress strain curve up to the elastic limit (and it estimates the total elastic energy that can be absorbed before the onset of plastic deformation)
- Elastic and plastic behavior
- Beyond the stress level of the elastic limit, there is a combination of elastic and plastic strain
- Ultimate strength-highest stress reached before fracture; the ultimate compressive strength is greater than the ultimate shear strength and the ultimate tensile strength
- Elongation (percent elongation)- percent change in length up to the point of fracture = strain x 100%
- Brittle materials-<5% elongation at fracture
- Ductile materials->5% elongation at fracture
- Toughness-area under the stress strain curve up to the point of fracture (it estimates the total energy absorbed up to fracture)
- Time-dependent behavior
the faster a stress is applied, the more likely a material is to store the energy elastically and not plastically
- Creep-strain relaxation
- Stress relaxation
Glass Ionomer Cements
Applications
a. Class V restorations-resin-modified glass ionomers for geriatric dentistry
b. Class II restorations-resin-modified glass ionomers, metal-modified glass ionomers in pediatric dentistry
c. Class III restorations-resin-modified glass ionomers
d. permanent cementing of inlays, crowns, bridges, and/or orthodontic band/brackets. In addition, it can be used as a cavity liner and as a base.
Classification by composition
a. Glass ionomer-limited use
b. Metal-modified glass ionomer-limited use
c. Resin-modified glass ionomer-popular use
Components
a. Powder-aluminosilicate glass
b. Liquid-water solution of copolymers (or acrylic acid with maleic, tartaric, or itaconic acids) and water-soluble monomers (e.g., HEMA)
Reaction (may involve several reactions and stages of setting)
a. Glass ionomer reaction (acid-base reaction of polyacid and ions released from aluminosilicate glass particles)
- Calcium, aluminum, fluoride, and other ions released by outside of powder particle dissolving in acidic liquid
- Calcium ions initially cross-link acid functional copolymer molecules
- Calcium cross-links are replaced in 24 to 48 hours by aluminum ion cross-links, with increased hardening of system
- If there are no other reactants in the cement (e.g., resin modification), then protection from saliva is required during the first 24 hours
b. Polymerization reaction (polymerization of double bonds from water-soluble monomers and/or pendant groups on copolymer to form cross-linked matrix)
- Polymerization reaction can be initiated with chemical (self-curing) or light-curing steps
- Cross-linked polymer matrix ultimately interpenetrates glass ionomer matrix
Manipulation
a. Mixing-powder and liquid components may be manually mixed or may be precapsulated for mechanical mixing
b. Placement-mixture is normally syringed into place
c. Finishing-can be immediate if system is resin-modified (but otherwise must be delayed 24 to 72 hours until aluminum ion replacement reaction is complete)
d. Sealing-sealer is applied to smoothen the surface (and to protect against moisture affecting the glass ionomer reaction)
Properties
1. Physical
-Good thermal and electrical insulation
-Better radiopacity than most composites
-Linear coefficient of thermal expansion and contraction is closer to tooth structure than for composites (but is less well matched for resin-modified systems)
-Aesthetics of resin-modified systems are competitive with composites
2. Chemical
-Reactive acid side groups of copolymer molecules may produce chemical bonding to tooth structure
-Fluoride ions are released
(1) Rapid release at first due to excess fluoride ions in matrix
(2) Slow release after 7 to 30 days because of slow diffusion of fluoride ions out of aluminosilicate particles
-Solubility resistance of resin-modified systems is close to that of composites
3. Mechanical properties
-Compressive strength of resin-modified systems is much better than that of traditional glass ionomers but not quite as strong as composites
- Glass ionomers are more brittle than composites
4. Biologic properties
- Ingredients are biologically kind to the pulp
- Fluoride ion release discourages secondary canes
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.