Denture Cleansers

Use -  for removal of soft debris by light brushing and then rinsing of denture; hard deposits require professional repolishing

a. Alkaline perborates-do not remove bad stains; may harm liners .
b. Alkaline peroxides-harmful to denture liners
c. Alkaline hypochlorites-may cause bleaching, corrode base-metal alloys, and leave residual taste on appliance
d. Dilute acids-may corrode base-metal alloys
e. Abrasive powders and creams-can abrade denture surfaces

Denture cleaning Method

a. Full dentures without soft liners-immerse denture in solution of one part 5% sodium hypochlorite in three parts of water
b. Full or partial dentures without soft-liners immerse denture in solution of  1 teaspoon of hypochlorite with 2 teaspoons of  glassy phosphate  in a half of a glass of water
c. Lined dentures -- clean any soft liner with a cotton swab and cold water while cleaning the denture with a soft brush

Properties

1. Chemical-can swell plastic surfaces or corrode metal frameworks
2. Mechanical-can scratch the surfaces of denture bases or denture teeth
 

Dental Implants

Applications/Use
 
Single-tooth implants
Abutments for bridges (freestanding, attached to natural teeth)
Abutments for over dentures

Terms

Subperiosteal- below the periosteum -but above the bone (second most frequently used types)
Intramucosal-within the mucosa
Endosseous into the bone  (80%of all current types)
Endodontics-through the root canal space and into the periapical bone
Transosteal-through the bone
Bone substitutes -replace. Long bone

Classification by geometric form

Blades
Root forms
Screws
Cylinders
Staples
Circumferential
Others

Classification by materials type

Metallic-titanium, stainless steel, and .chromium cobalt
Polymeric-PMMA
Ceramic hydroxyapatite, carbon, and sapphire

Classification by attachment design

Bioactive surface retention by osseointegration
Nonative porous surfaces for micromechanical retention by osseointegration
Nonactive, nonporous surface for ankylosis. By osseointegration 
Gross mechanical retention designs (e.g.. threads, screws, channels, or transverse holes)
Fibrointegration by formation of fibrous tissue capsule
Combinations of the above

Components

a. Root (for. osseointegration)
b. Neck (for epithelial attachment and percutancaus sealing)
c. Intramobile elements (for shock absorption)
d. Prosthesis (for dental form and function)

Manipulation

a. Selection-based on remaining bone architecture and dimensions
b. Sterilization-radiofrequency glow discharge leaves biomaterial surface uncontaminated and sterile; autoclaving or chemical sterilization is contraindicated for some designs

Properties

1. Physical-should have low thermal and electrical conductivity

2. Chemical

a. Should be resistant to electrochemical corrosion
b. Do not expose surfaces to acids (e.g.. APF fluorides).
c. Keep in mind the effects of adjunctive therapies (e.g., Peridex)

3. Mechanical
a. Should be abrasion resistant and have a high modulus
b. Do not abrade during scaling operations (e.g.with metal scalers or air-power abrasion systems like  Prophy iet)

4. Biologic-depend on osseointegration and epithelial attachment

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.

Introduction

The science of dental materials involves a study of the composition and properties of materials and the way in which they interact with the environment in which they are placed

Selection of Dental materials

The process of materials selection should ideally follow a logical sequence involving

(1) analysis of the problem,

(2) consideration of requirements,

(3) consideration of available materials and their properties, leading to

(4) choice of material.

Evaluation of the success or failure of a material may be used to influence future decisions on materials selection.

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
 

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.