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Classify dental cements. Add a note on the composition, types, chemistry of setting reaction and uses of glass
2.
ionomer cements.
Classify denture base resins. Discuss their properties, manipulation, advantages and disadvantages
SHORT ESSAYS
3.
4.
5.
6.
7.
8.
9.
10.
SHORT ANSWERS
11.
12.
13.
14.
15.
Separating media
Delayed expansion
Sandwich technique
Gold foil
Galvanism
ANSWERS
LONG ESSAYS
1.
Classify dental cements. Add a note on the composition, types, chemistry of setting reaction and uses of glass
ionomer cements.
CLASSIFICATION OF DENTAL CEMENTS
According to the Reaction
I.
GLASSIONOMER CEMENT
Composition
Powder
Silica (SiO2)
- Does not take part in the reaction but increases hardness & translucency
Alumina (Al2O3)
- Reacts with Polyacrylic acid to give aluminium polyacrylate matrix
Liquid
Types
Classification I
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Classification II (Phillip's)
1.
2.
3.
4.
Setting Reaction
Acid Base Reaction
When the powder & liquid are mixed, Surface of glass particles are attacked by acid. Then Ca, Al, Na, &
2.
During early stages of mixing Ca 2+ ions released more rapidly & cross-links the polyacrylic acid chains to
form calcium polyacrylate (initial set) & are being carvable like amalgam & are highly susceptible to
3.
polyacrylate ) is formed
Hardening
Can take as long as 7 days. Aluminum ions provide the final strength to the matrix.
Na & Fluorine ions do not participate in the cross linking of the cement
Uses
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
2.
Classify denture base resins. Discuss their properties, manipulation, advantages and disadvantages
CLASSIFICATION OF DENTURE BASE RESINS
A. According to the Materials used
1. Metallic materials
2.
Non-metallic materials
Earlier: Vulcanite, Bakelite, Polycarbonates, Nylon, Cellulose nitrite, PVC, Polystyrene & Epoxy resin
Present: PMMA unmodified, PMMA modified with carbon fibres, nylon & butadiene styrene rubber
B.
C.
PROPERTIES
Methyl Methacrylate monomer
Polymethylmethacrylate
1.
2.
Esthetics
It is a clear transparent resin, which can be pigmented easily to duplicate oral tissues.
3.
Density
4.
However they have adequate compressive and tensile strength for complete or partial denture application
5.
Transverse strength
Under clinical conditions, heat cure polymethyl methacrylate is stiff enough not to flex unduly during function
and recovers well from this degree of bending
6.
Impact strength
The impact strength of polyvinyl acrylic is about twice that of poly (methyl methacrylate)
7.
Cross-linked poly (methyl methacrylate) is only slightly harder than regular poly (methyl methacrylate). The
incorporation of fillers may alter resistance to abrasion but the hardness of plastic matrix remains unchanged.
8.
9.
Otherwise a small crack may be produced which will later propagate through the material.
Similarly surface of a denture must be smoothly polished.
In an upper denture stress accumulation during chewing may occur at a point between central incisors.
Here a notch to accommodate labial frenum frequently weakens the facial flange.
Fatigue or midline fracture may occur if the masticatory forces are relatively large.
Fatigue strength increases with a higher molecular weight and an increase in the plasticizer content.
Modulus of elasticity
Acrylic resins have sufficient stiffness (modulus of elasticity 2400 MPa) for use in complete and partial dentures.
When methyl methacrylate monomer is polymerized to form polymethyl methacrylate the density of the mass
MANIPULATION
Proportioning: P/L ratio 3:1 by volume or 2.5:1 by weight:
Mixing: Done with a stainless steel spatula. Allow the monomer to react physically with polymer in a sealed jar to
avoid monomer evaporation.
The mixture goes through the following physical stages:
1. Wet sandy stage
Polymer beads remain unaltered & the consistency of the mixture is coarse or grainy
2.
Material becomes tacky (sticky) as the monomer attacks surface of individual polymer & absorbed into the
3.
beads.
Polymer chain starts to uncoil, thereby increasing the viscosity.
Dough stage
An increased number of polymer chains enter the solution. Thus monomer dissolves polymer, forming
4.
Monomer will dissipated by evaporation & penetrate into remaining polymer bead.
5.
Stiff stage
If the mix is left too long it becomes too rubbery & stiff.
ADVANTAGES
DISADVANTAGES
SHORT ESSAYS
3.
The temperature lag between the gelation temperature and the liquefaction temperature of the gel makes it possible to
use agar as a dental impression material
Once in the mouth, the Material is cooled below mouth temperature to ensure gelation
The first step in material preparation is to liquefy the hydrocolloid gel in boiling water
At high altitudes, the boiling point of water is too low to liquefy the gel. Propylene glycol can be added to the water to
obtain a liquefaction temperature of 100C
After the agar hydrocolloid material has been liquefied, it may be stored in the sol condition at 65C until it is needed
for injection into the cavity preparation or for filling a tray.
Since 55C is the maximum tolerable temperature, a storage temperature of 65C would be too hot for the oral tissues,
especially for the bulk of the tray material. Therefore, the material used to fill the tray must be tempered.
The tempering time is short (3 to 10 min), just sufficient to ensure that all the material has reached a lower
temperature (55C).
In any case, the loaded tray should never be left in this bath for more than 10 minutes, because gelation may have
proceeded too far, thereby malting the material unusable.
Tempering of tray material also increases the viscosity so that it will not flow out of the tray.
The syringe material is never tempered, since it must be maintained in a fluid state to enhance adaptation to the
tissues.
4.
Dental gypsum products when mixed with water and allowed to set in air exhibit an expansion of their peripheral
boundaries that are known as "normal setting expansion."
Under ordinary conditions, plasters have 0.2% to 0.3% setting expansion, low- to moderate-strength dental stone
about 0.15% to 0.25%, and high-strength dental stone only 0.08% to 0.10%. The setting expansion of highstrength/high-expansion dental stone ranges from 0.10% to 0.20%. (AP-05)
A vacuum-mixed high-strength stone expands less at 2 hours than when mixed by hand.
Power mixing appears to cause a greater initial volumetric contraction than is observed for hand mixing.
The W/P ratio of the mix also has an effect, with an increase in the ratio reducing the setting expansion.
The addition by the manufacturer of sodium chloride (NaCl) in a small concentration increases the setting expansion
of the mass and shortens the setting time. The addition of 1% potassium sulfate, on the other hand, decreases the
setting time but has no effect on the setting expansion.
When additional water is brought into contact with the setting material, an increased expansion is observed. This
latter expansion has been termed "hygroscopic expansion."
If during the setting process the mass is immersed in water, it expands about 0.10%.
5.
6.
The austenitic steel mainly contains 18% of chromium; provides corrosion resistance, 8% of nickel;
stabilizes the austenitic structure, 80 percent iron and 0.05%-0.15% of Carbon.
Cobalt-Chromium Molybdenum Alloys
Advantages
1. These alloys possess an outstanding resistance to corrosion and they have high modulus.
2. Low cost and long - term clinical success.
Limitation: The cobalt alloys are least ductile and bending must be avoided.
iii. Titanium and titanium Alloys
Commercially pure titanium (Cp) is a very highly reactive metal. It oxidizes (passivate) on contact with
ii.
air or normal tissue fluids. This reactivity is favorable to the implant devices because it minimizes
biocorrosion.
Cp titanium is available in four different grades such as Cp grade 1,Cp grade 2,Cp grade 3 and Cp
grade 4.C
p titanium contains oxygen and minor amounts of impurities such as nitrogen, carbon, hydrogen, etc.
iv. Titanium-aluminum-vanadium (Ti AI V alloys)
Ceramics
This is used as an implant material for augmenting alveolar ridges & filling bony defects
ii. Bioglass
A dense ceramic material made from calcium oxide, sodium oxide, phosphorous pentoxide &
silicon dioxide
3.
Polymers
Have been fabricated in porous & solid forms for tissue attachment & replacement augmentation & as coating for
force transfer to soft & hard tissues
7.
Phosphate-bonded investments are much stronger and withstand much higher temperatures than do gypsum bonded
investments
Used for casting high fusing alloys, e.g. high fussing noble metal alloys metal ceramic alloys, and base metal alloys like
nickel chromium and cobalt-chromium.
Composition
1.
Refractory material (80%) Cristobalite or Quartz or mixture of both withstand high temperature & gives large
2.
3.
setting expansion
Binder Magnesium ammonium phosphate (NH4MgPO4) increases strength, setting & thermal expansion
Carbon Act as reducing agent
Setting Reaction
NH4 H2 PO4 + MgO + 5H2O NH4MgPO4.H2O
The final product is mono ammonium diacid phosphate or magnesium ammonium phosphate
Advantages
1.
2.
3.
4.
High setting and thermal expansion to compensate for thermal shrinkage of cast metal prosthesis or porcelain veneers
during cooling
Disadvantages
1.
2.
Using casting temperature greater than 1375C ,results in mold breakdown & rougher surface of the casting
Because of high strength of phosphate bonded investment, it is very difficult to remove the casting from the
investment
8.
Varnish is an organic gums or rosin suspended in organic solution like ether or chloroform.
When applied on the tooth surface the organic solvent evaporates leaving behind a thin protective film.
Provides a barrier against passage of irritants from the restorative material & reduces micro leakage.
Supplied as liquid in dark colored bottles
Composition
Natural gums such as copal or rosins or synthetic resins dissolved in an organic solvent, such as acetone,
chloroform or ether
Functions
1. Reduces the marginal leakage around silver amalgam
2. Protection against various restorative irritant chemicals
3. Blocks the penetration of corrosion products of amalgam into the dentinal tubules
4. In case of amalgam restoration, varnish prevents the discoloration of tooth against migration of ions into the
dentin
Application
Dipping a small cotton pellet (ball) held in pliers, in to the varnish and then thoroughly painting all cavity walls.
Apply at least 2 thin layers of varnish. When first layer dries, small pinholes usually develop. A second or third
application fills in voids & produces a continuous coating
Precaution
9.
Varnish is not indicated for adhesive materials, such as GIC and resin based composite.
I.
II.
Trapped gases
1. Pin hole porosity
2. Gas inclusions
3. Subsurface porosity
III. Residual air
1.
During a correct cooling sequence, the sprue should freeze last. This allows more molten metal to flow into the
casting (pattern area), to compensate for the shrinkage of the casting as it solidifies.
If the sprue solidifies before the rest of the casting no more molten metal can be supplied from the sprue into the
pattern (casting). The subsequent shrinkage produces voids or pits known as porosity.
Prevention
o Using sprue of correct thickness
o Attach sprue to thickest portion of wax pattern
o Flaring the sprue at the point of attachment or placing a reservoir close to the wax pattern
2.
If the temperature of the liquid entering is very high, it raises the temperature of the mold opposite to the sprue
attachment
Due to this hot spot , liquid solidify last near it
Since the sprue has already solidified, no more molten material is available and the resulting solidification
shrinkage localize near the hot spot & causes a suck back porosity.
Prevention
o By reducing the temperature of liquid
o By reducing the thickness of the sprue
o By flaring the point of sprue attachment ( 90 angle)
3.
Microporosity
These are fine irregular voids formed throughout the internal portion of the casting.
Causes
o
o
o
Prevention
o By increasing the mold temperature
4.
Pinhole porosity
Many metals dissolve or occlude gases when molten. Upon solidification the dissolved gases are expelled causing
tiny voids
E.g. platinum and palladium absorb hydrogen. Copper and silver dissolve oxygen
Prevention
o Liquid should not be kept for longer time before casting & its temperature should not be low
5.
Are spherical voids & larger than the pin whole type.
Larger spherical porosity can be caused by occluded gas from a poorly adjusted torch flame or use of mixing or
oxidizing zones rather than reducing zone of the flame
Prevention
o Minimized by melting gold alloy on a graphite crucible & by correctly adjusting & positioning the torch
flame during melting
6.
Minimised by controlling the rate at which molten metal enters the mold
7.
As the liquid enters the mold through the sprue, air trapped in the mold is compressed at the extremities ,which
exert a back pressure preventing the alloy liquid to occupy this region
Causes
o
o
Prevention
o Using adequate casting force
o Use investment of adequate porosity
o Place pattern not more than 6 to 8 mm away from the end of the ring.
o Providing vents in large castings
SHORT ANSWERS
11. Separating media
Functions
1.
2.
3.
To prevent the diffusion of water molecules from the mold (gypsum) into the unpolymerized packed dough
To prevent the diffusion of the monomer from the unpolymerized packed dough in the mold material
To prevent direct contact between the denture base resin & the mold surface
One of the first widely used material was tin foil, which was found to be time consuming & inconvenient
All parts of the gypsum cast in the flask should be painted by sodium alginate (by camel hair brush) except the exposed
surface of the teeth
Synonym
Secondary Expansion
Definition
Clinical Significance
Remedy
Steps
This technique , involves the bonding between composite resin & GIC
GIC act as enamel or dentin bonding agent & composite resin as a restorative material
1.
2.
3.
4.
Conditioning of dentin: Acid etching using 37% phosphoric acid, makes the tooth surface rough
Application of bonding agent (GIC) & is polymerized by light activation
Insertion of composite resin into the cavity
Finally finishing of the restoration
Indication
15. Galvanism
The presence of metallic restorations in the mouth may cause a phenomenon called galvanic action, or galvanism.
This results from a difference in potential between dissimilar fillings in opposing or adjacent teeth. These fillings, in
conjunction with saliva or bone fluids such as electrolytes, make up an electric cell.
When two opposing fillings contact each other, the cell is short-circuited, and if the flow of current occurs through the
pulp, the patient experiences pain and the more anodic restoration may corrode.
A single filling plus the saliva and bone fluid may also constitute a cell of liquid junction type.
The galvanic currents developed from the contact of two metallic restorations depend on their composition and
surface area. An alloy of stainless steel develops a higher current density than either gold or cobalt-chromium alloys
when in contact with an amalgam restoration.
As the size of the cathode (such as a gold alloy) increases relative to that of the anode (such as an amalgam), the
current density may increase
The larger cathode likewise can enhance the corrosion of the smaller anode.
Remedy
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