1. DMS Flashcards
Stress calculation
Strain calculation
YM relates to material
Material failure mechanisms (8)
Blacks cavity classifications (6)
Stress (Pa/Nm2) = force/unit area
Strain = change in length/original length
Rigidity
Fracture, hardness, abrasion, abrasion resistance, fatigue, creep, deformation, de-bond, impact
Class I - pit and fissure carues Class II - posterior approximal caries Class III - anterior approximal caries Class IV - approximal caries involving incisal edge Class V - affecting cervical surface Class VI - affecting cusp tips
What type of bonding is enamel/restorative material
How is this bonding obtained
How does the acid-etch process work
Effect of increased surface energy
Mechanical
Acid-etch
Micromechanical interlocking of resin-filled material and increase surface energy
Better gettability and adaptation of resin to surface
Why is dentine bonding difficult (2)
Definition of smear layer
What is done to the smear layer (2)
DBA requirements (2)
Type of bonding in dentine/DBA (2)
Contact angle of a hydrophobic surface
Dentine has low surface energy and is hydrophilic
Adherent layer of organic debris that remains on the dentine surface after restoration preparation (0.5-5um)
Can be removed (acid-etch) or infiltrated and incorporated (DBA)
Low viscosity, adhesion to substrate
Chemical (electrostatic dipole interaction - strength depends on contact angle) and mechanical (interlocking)
<90
Definition of critical surface energy
Liquid/solid surface energy relationship
Wet dentine/composite surface energy relationship
Function of DBA in regards to surface energy
How can adhesion occur
Surface tension of a liquid that will just spread on the surface of a solid
A liquid must have a lower surface energy that the surface it is attaching to, to flow and stick
Dentine < composite
A DBA will increase the surface energy of dentine, allowing composite (liquid) to flow and stick
Through molecular entanglement
Types of DBAs (2)
Function of dentine conditioner
Definition of dentine primer
Function of dentine primer
Examples of dentine primer (3)
Components of dentine adhesive
Function of adhesive
Components of total etch
Toth-etch problems (3)
Action of self-etching primers
Advantage of self-etching primer
Disadvantage of self-etching primer
Why are MDP and 4-META better than HEMA
Bis-GMA, NPG-GMA
Remove smear layer, open tubules
Coupling agent - bifunctional molecule
To bond to dentine (hydrophilic head) and resin (hydrophobic head - methacrylate)
HEMA, 4-META, MDP
Mix of resins with filler particles (increase strength) and camphorquinone (photo-activator catalyst, initiates resin polymerisation when activated by blue light - 430-490nm)
Penetrates primed dentine and forms micro mechanical bond with tubules (molecular entanglement)
Conditioner, primer and adhesive
Over-etching –> collapse of exposed dentine fibres –> no resin penetration; too dry –> dentine surface collapses; too wet –> dilution –> reduces bond strength
Infiltrate and incorporate themselves into the smear layer
Less technique sensitive
Weaken bond integrity
Less acidic and absorb less water –> increased bond durability
What does bonding involve and how does this work (2)
What is the AD concept
How does it work (2)
Mineral exchange - minerals removed from dental hard tissues and replaced by resin, which mechanically interlocks the porosities (molecular entanglement)
Interaction of resins with hydroxyapatite based tissue
All acid monomers bond to calcium in HA. Monomers with a lower pKa do not form a stable bond but continue to dissolve HA.
Function of cavity liners (2)
Features of a cavity base
Thickness of a cavity liner
Function of a cavity liner (4)
Ideal liner properties (4)
Ideal thermal properties (3)
Definition of thermal conductivity
Definition of thermal expansion coefficient
Definition of thermal diffusivity
Ideal mechanical properties
Types of liners (8)
Prevent gaps and act as a protective layer
Thick, for metal restorations
<0.5mm
Protects pulp from chemical and thermal stimuli, bacteria and endotoxins
Easy to use, radiopaque, cariostatic, biocompatible
Low conductivity, expansion coefficient and diffusivity should be similar to/lower than dentine
How well heat energy is transferred through material
Change in length per unit length for a 1C rise
Similar to conductivity, different measurement
High compressive strength, YM similar to dentine
CaOH, ZnO-based (ZnPO4, Zn polycarboxylate, ZOE, RMZOE, EBAZOE), GI and RMGI
CaOH
Components of base (4)
Components of catalyst (4)
Setting reaction
Action (2)
Advantages (2)
Disadvantages (2)
CaOH, ZnO filler, Zn stearate filler, N-ethyl toluene sulphonamide plasticiser
Butylene glycol disalicylate reactive element, titanium dioxide filler, calcium tungsten filler
Chelation between zinc oxide and butylene glycol disalicylate
Bactericidal to cariogenic bacteria, irritation (leads to reparative tertiary dentine formation)
Quick setting time, radiopaque
Low compressive strength, soluble
ZnPO4
Type of reaction (2)
Powder components
Liquid components
Initial setting reaction
Final setting reaction
Function of AlO
Problems (5)
Acid/base - powder/liquid
Magnesium dioxide (white, increases compressive strength), other oxides (Al, silica - improve physical properties and alter shade)
Aqueous phosphoric acid, oxides (buffer solution - AlO2), ZnO slows reaction (better working time)
ZnO + 2H3PO4 –> Zn(H2PO4)2 + H2O
ZnO + Zn(H2PO4)2 + 2H2O –> Zn3(H2PO4).4H2O
Prevents crystallisation –> glassy matrix (insoluble but porous with water)
Low initial pH, exothermic setting, not adhesive/cariostatic, 24hr set, brittle, opaque
Zn polycarboxylate
Difference between this and ZnPO4
Action
Problems (3)
Polyacrylic acid, not phosphate
Bonds to tooth like GIC
Difficult to mix/manipulate, soluble in oral environment at low pH, lower YM/compressive strength than ZnPO4
ZOE
Uses (4)
Basic reaction
Setting reaction (3)
Properties (5)
Deep linings/bases, temporary restorations, root canal sealer, periodontal dressings
ZOE = ZnO + eugenol –> salt + water
Chelation reaction of ZnO and eugenol –> Zn eugenolate matrix, which bonds unreacted ZnO particles
Adequate working time, relatively rapid setting time, low thermal conductivity, low strength, high solubility
RMZOE
What does adding resin do
Advantages of RMZOE (2)
Strengthen backbone to set material - increases compressive strength (>40MPa)
Increased compressive strength, decreases solubility
EBA ZOE
Components of powder (2) Components of liquid (2) Setting reaction Feature of adding EBA Advantages of EBA ZOE (2)
ZnO, quartz/alumina - reinforcing hydrogenated rosin
Eugenol, EBA - reactive
Similar set to ZOE
EBA encourages crystalline structure –> greater strength
Less soluble and stronger
Advantages of GI liners (5)
Feature of RMGIC
Advantages of RMGIC (4)
Disadvantage
Release F, easy to use, thermal conductivity/diffusivity < dentine, high compressive strength, radiopaque
Only material to predictably seal dentinal tubules
Reduced microleakage, prevents post-op sensitivity, release F, cytotoxic (benzoyl iodine and bromide released during polymerisation)
Complete cure required or unreacted HEMA may damage pulp
Composition of composite resin (5)
Composition of filler particles (3)
What are resins made from (2)
Function of resins
Function of camphorquinone
Function of silane coupling agent
Filler particles, camphorquinone, resin, low weight dimethacrylates, silane coupling agents
Glass of different sizes - microfine silica, quartz and borosilicate glass
Bis-GMA and urethane dimethacrylaes
Bifunctional molecules (C=C facilitates crosslinking) that can undergo free radical additional polymerisation
Photo-activator catalyst that initiates resin polymerisation when activated by blue light (430-490nm)
Coupling agents used to preferentially bond glass and resin
Uses of composite (4)
Advantages of adding filler particles to resin (6)
Advantages of light-cured composite (4)
Disadvantages of light-cured composite (4)
Safety considerations when light-curing (3)
Where aesthetics are important, labial veneers, indirect restorations, class III, IV and V restorations
Improves mechanical properties, improves aesthetics, improves abrasion resistance, improves radiopacity, reduces thermal expansion, lowers polymerisation shrinkage
Extended working time, less/immediate finishing, less porosity, less waste
Premature polymerisation from dental light, optimistic depth of cure values, recommended setting time too short, polymerisation shrinkage
Exothermic reaction, divergent light beam, ocular damage
What does surface roughness affect (3)
Types of composite (3)
Which is best and why
Composite tooth wear process
What does good material/tooth bonding lead to (2)
Typical composite bond strength
Appearance, plaque retention, sensation to the tongue
Hybrid, microfine, conventional
Hybrid - compromise - improved filler loading/coupling agents –> increased mechanical properties
Resin removed –> exposed filler particle - if enough resin removed, filler particle dislodged –> repeated
Reduced microleakage, counteract polymerisation contraction shrinkage
40MPa
Composite thermal properties (2)
Thermal expansion coefficient relationship between tooth and restorative materials
Other advantages of composite
Disadvantages of composite (2)
Thermal conductivity - low
Thermal expansion coefficient - high (should be equal to tooth to reduce microleakage)
Dentine < enamel = GIC < amalgam < composite
Radiopaque (allows detection of secondary caries), relatively biocompatible (if monomer fully polymerised)
Not anticariogenic, low polymerisation shrinkage
What is amalgam
Function of silver and tin in powder
Function of copper in powder
Function of zinc in powder
Function of mercury in powder
Composition of liquid
Types of amalgam particles (2)
Setting reaction of conventional amalgam
Alloy formed from mercury (liquid) and powder (other metals - tin, copper, mercury)
Intermetallic compound - gamma-phase reacts with mercury
Increases strength/hardness
Scavenger - oxidises preferentially
Faster reaction
Triple distilled reactive mercury
Lathe cut (coarse, fine, medium - formed by filling ingots), spherical (ranges of sizes, formed by spraying molten metal into inert atmosphere)
Ag3Sn + Hg –> Ag3Sn + Ag2Hg3 + Sn7Hg9
Features of gamma phase
Feature of gamma 1 phase
Feature of gamma 2 phase
Tensile strengths (4)
Benefit of removal gamma 2
Good strength and corrosion resistance
Good corrosion resistance
Weak strength, poor corrosion resistance (voids) - most electronegative and weakens material at margins
Gamma > amalgam > gamma 1 > gamma 2
Stronger amalgam
Traditional material setting dimensional changes (2)
Modern material setting dimensional changes (2)
Why is amalgam now zinc free (2)
Initial contraction, expansion (gamma 1 crystallisation)
Small contraction, solid solution of mercury
Zinc reacts with blood/saliva, forming H gas –> expansion (pressure), pain (pressure) and protrusion of filling
Factors decreasing amalgam strength (4)
Definition of creep
What does creep affect
Thermal properties of amalgam (2)
Under-mixing, slow packing, too high mercury content after condensation, corrosion
Repeated low level stresses for long periods of time, eventually leading to permanent deformation
Marginal integrity
Thermal conductivity high (liners), thermal expansion coefficient 3x tooth tissue
How does amalgam stay in place
Other advantages of amalgam (5)
Other disadvantages of amalgam (8)
Amalgam indication for use
Amalgam contraindications for use (2)
Mechanical retention of cavity
Strong, user friendly, durable, good long term clinical performance, cheap
Corrosion, leakage, poor aesthetics, not anticariogenic, contain mercury, no bond, amalgam tattoo, lichenoid reactions (type IV hypersensitivity)
Posterior moderate/large cavity
Limited tooth tissue remaining (retention cannot be created), excessive tooth tissue removal required
Other names for copper enriched amalgam
Types (2)
Advantages over traditional amalgam (4)
Dispersion modified setting reaction (2)
Single composition setting reaction
Non-gamma 2
Dispersion modified, single composition
Higher early strength, less creep, higher corrosion resistance, increased marginal durability
Gamma + Hg –> gamma + gamma 1 + gamma 2
Gamma 2 + AgCu –> Cu6Sn5 + gamma 1
AgSnCu + Hg –> AgSnCu + gamma 1 + Cu6Sn5