Some of the material we talked about in the summer course is zinc oxide eugenol material its an impression material

some variation of this material can be used as a temporary filling material we call it zinc oxide

eugenol filling material

Now the presence of eugenol in term of composite , Its prevent the complete sitting of composite, If the sitting is incomplete the material will be weak so if u have a deep cavity and u want to place al liner or a base to protect the pulp u cant place zinc oxide euginol base or liner underneath composite

Light-curing:
Light curing it should be as close as possible to composite The curing time is from 20 40 sec usually the bonding agent is 20 sec and the composite it self 40 sec not less than that because it will not set properly The Dr. said if you are not sure that the light is going to reach the whole thickness of the layer it said in the slide use more time but the dr. said the better option is to use thinner layers rather than increase the curing time

Finishing and polishing: sandpaper discs,fine, ultra-fine diamonds.

Abrasive strips and needle-shaped diamond burs are used. Polishing pasts can also be used. If u want to make sure that the upper layer of composite has no holes at all ,,good smooth surface ,, a layer of flowable composite or some time a layer of bonding agent on top , it will give u smother surface which mean good polashiablite and good esthetic appearance .

Different type of light curing machine are available It depend on the light source Halogen light bulbs Some of these light produce higher intensity,, high intensity mean shorter curing time Ex : Plasma arc curing units (PAC), Argon laser units

Some of them are cordless so you handle it without having a cord attached to the device Some of them corded

Precautions for light curing

These device should be checked regularly to make sure that the intensity of light doesnt decrease over time .

When we use composite you need always to cover it keep it away from any light source a.e light from the dental chair , natural light it can initiate the reaction so we have to keep the composite in a dark area to prevent pre mature sitting of the material . Eye protection The light that come out from the curing unit can cause damage to the patient eye or your eyes as a dentist it can cause

Premature set of composites

cataract so we

need to protect the patient eye using special glasses some time a certain shield could be placed so that when you are placing the light cure unit and you are curing your composite you dont actually directly look at the blue light .

Heat generation not all the unit produce heat but if you are very close to the pulp and you might think that if I use the light as close as possible to tooth it can generate heat and cause damage to the pulp , I can place a liner or a base in deep cavity

Light curing unit, protective glasses and shield

Modification on composite to give them a better quality, more attractive Are called Compomers Polyacid modified resin meaning the incorporate acid inside them manily arclic acid now this material , they clam that it can release fluoride . now in comber to another fluoride releasing material such as glass ionomer cement , the amount of fluoride it releases is very small . Because the fluoride within the composite material is actually captured by the resin and the risen doesnt allow it to release as much as we wanted to

The mane material that is able to release fluoride to prevent the caries is glass ionomer cement So in compomers they try to modified composite to get advantages both from composite and glass ionomer cement in one material . These material set by two mechanism I. II. One of them is light curing mechanism main one acid base reaction why { because it have the acrlic acid incorporated into it]

And they can shrank so you need to apply them in layers and require a bonding agent so similar to composite material

Indirect esthetic materials can be use

Either to restore labial surface of the tooth Missing cusp of the tooth or destroyed cusp we call it onlays In cavities in the proximal surface we call it inlay Can be used as a crown general speak for esthetic material except the composite we cant make crowns Indirect composite Manly it can be used in this cases Veneers remove part of the enamel in the labial surface .5mm then u take an impression and then to lab will prepare a veneer for u to

replace the missing structure in composite u can do this directly without take an impression if u got

for example staining in tooth surface , shape of tooth is abnormal u remove [part of the enamel and then applied composite, shape it and we are done we can use regular composite or modified composite reinforced

So they can be used directly or indirectly after taking an impression So if u use directly method u use a regular composite if u want to use it indirectly by taken an impression we can use the modified composite or any enforced composite that are made stronger Now one advantage of using this technique because the lab technician is curing the composite in the lab shrinkage occur out side the cavity so , once you cement it inside the patient mouth there are no more shrinkage because the material is already set we simply attaching it to the cavity Restorative materials used: Conventional composite Fiber reinforced composite. Fiber source is carbon Kevlar, glass fiber, polyethylene ( to improve strength). Particle-reinforced composite: heavily filled (70-80% by weight) with ceramic particles to improve wear resistance. These types are mainly used of indirect restorations that require impression and lab work

When we talked about rubber impression material addition silicon .. we said that they can be used for bite registration and for indirect restoration how dose this happen once you drill a cavity in the tooth you take impression using alginate now you want to pour your impression you are not going to pour it in gypsum ,, you actually pour it in rubber material in addition silicon rubber material to have a cast So this cast will not be made of gypsum it will be made out of rubber On this model u can add composite to make a restoration cure it and then take it out, and place it in the patient mouth if you dont remember this type of rubber material go back to the impression material slide So one way of using rubber material to make models out of them for this sort of filling material

Now in term of taking the shade of the composite to the teeth of the patient three things to consider What is the basic color of the patient toothhue how intense is the shade chroma and how dark or light the shade of the tooth is value The process of selecting the shade is group effort you the patient and the assistant are involved to select the shade

This is the shade guide it have what we calls taps made of crowns of central incisors and it dived to A,B,C. so you select one or two from them bring it close to the patient tooth put water on it because

normally your teeth are covered with saliva the shade of your tooth is different when its dehydrated using normal day light You always need to select the shade before cavity preparation , The tooth should be cleaned no stain no debris U can use natural day light some time u can use more tha one light sources and select something in between shade that look good underneath both light sources because usually most of us they are not always under natural day light usually we are in the offices, lecture hall , libratory were is artificial light so we can use two light sources select prober shade for both light sources Teeth may have different shade under different light sources metamerzime Female patients should be asked to remove lipstick, and colorful clothes should be covered A neutral background should be used (e.g. blue apron) to cover the cloth of the patient Several tabs are held close to patients teeth and select the prober one

Some people have certain stains on there teeth and they tell you I want the stain to be back I dont like my tooth to be absolutely white or same color from gingival third to insicial third I need some staining in the gingival third I need it to look a little bit yellowish just to match the against teeth { enamel is thin in the cervical third ] so some time

we need to use two shades for the same tooth especially if am doing a vianeer ,, same as enamel We have Graduation in shade from inscial to gingival ends

Some time a photograph can be taken before but we dont do that usually in the clinics

Some types of composite are called body composite or dentine composite ,, it is shaded more yellowish than other type of composite so you can use enamel composite, composite that have similar shade to enamel so layering procedure can be done to produce best esthetic result