Autumn quiz: Composites, curing lights and adhesives

Question 1

what are the 3 general parts to composite

Answer 1

• resins/initiators (make resin polymerize/harden)
• coupling agent (connects resin to filler materials)
• filler (comes in diff shapes/sizes)

Question 2

what are the qualities of monomer resin

Answer 2

resin are materials that harden as they go from monomers to polymers
monomer resin is:
-weak
-poor wear resistance
-significant shrinkage
-hydrophobic once cured
-polymerization is inhibited by oxygen, this is just a surface phenomenon- finish and polish fixes that. this allows composite to stick to more composite tho..

Question 3

what are the 3 major monomers resin

Answer 3

bis gma
udma
tegdma

—-> methacrylates?

Question 4

what are initiators?

name some common ones- general expensiveness?

Answer 4

this is what we light cure to change monomer to polymer.
common ones:
-camphorquinone (CQ) + tertiary amine (cheap.yellowish)
-1-phenyl-1,2-propanedione (PPD)
-2,4,6-trimethylbenzoyl-diphenyl-phosphine oxide (TPO)

-Both PPD and TPO are lighter color (better coloring) but more expensive and more restrictive absoprtion range

Question 5

what does light do to initiators

Answer 5

makes them interact w monomers to make polymers (light within a specific range freq)

Question 6

describe the chemical process of polymerization of resin monomers

Answer 6

-free radical creation caused by light, breaking down an unstable covalent bond, leaving two interactive/reactive free radicals.
-the free radicals react with double bonds on monomers- chain reaction of polymerization. ends when reactive monomers run out of other unreactive monomers to link with
chains take up less space than monomers- always shrinkage

shrinkage is about 7% if not filled in the hole.???
???

Question 7

what is dual-cure composite, whats it good for?

Answer 7

dual cure composites- taking two separate composites- one that is light, one that is chemical cured and combing
good for deep cavities and bulk fill (dont want to do in increments)

Question 8

what is the chem reaction of dual-cure?

Answer 8

one paste has benzoyl peroxide (BP) other has aromatic tertiary amines
-light cure by CQ (camphorquinine)/amine reaction
or will react with benzoylperoxide for chemical cure/amine reaction also

light can penetrate 2 mm, deeper, chemical helps to solidify.

Question 9

what is silane used for

Answer 9

its a coupling agent
dual sided; one reaction with glass (filler) and the other end has a covalent or organic bond reacting with resin material.

-silane molecules bond resin to filler.

Question 10

whats the purposes of filler in composite

Answer 10

• improves fracture resistance (biggest one)
• reduces polymerization shrinkage
• impart color and opacity
• improve radiopacity

pretty much all made up of glass/silica

Question 11

what are the components of filler ?

Answer 11

• glass/quartz (barium oxide glass, ba-al-fluorosilicate, dispersed silica)
• metal oxide (gives opacity, radiopacity, color) typical medals include aluminum, cobalt, chromium, magnesium, silicon and iron..

Question 12

what are the features of MACROFILL, whats its uses?

Answer 12

around since 1960s

• large and irregular (8-12 micrometers)
• good fracture resistance
• poor polish
• poor wear resistance
• low shrinkage
• horrible old anterior composites (opaque)
• milled

uses: crown build up materials, rockcore?, chemical or dual cure

(aesthetics dont matter, big hole)

Question 13

whats microfill/whats its uses and features

Answer 13

made in 1970s

• spherical shape for handling and aesthetics (more likely to fracture, higher shrinkage rate)
• colloidal silica particles
• 55% filled
• high polish
• poor fracture resistance
• good wear resistance
• high shrinkage (low fill)
• heat created
• uses; composite veneers, carious or non carious cervical lesions.

Question 14

whats microhybrid /features and uses

Answer 14

• 1st UNIVERSAL composite, 1880s-90s
• mix of glass and ceramic particles (.6-2 microns)
• 70-77% filled; highly filled!
• low shrinkage
• good polish
• good wear resistance
• uses: universal application, anterior ANd posterior, good range of opacities and shades

Question 15

whats nanofill/uses and features

Answer 15

• nano clusters
• .001 - .01 microns
• allows DENSE filling with good flow
• increase fill rate without stiffening

Question 16

whats nanohybrid/uses and features

Answer 16

mix of nano particles with conventional fillers

• highly filled
• good polish
• universal application
• good wear resistance
• low shrinkage

Question 17

what are universal composites? uses?

Answer 17

also called packable

• what we usually think of. not flowables.
• use on anterior, or posterior, make teeth pretty. we use cur ?

Question 18

what are flowable composites featuers and uses

Answer 18

lightly filled

• because they are lightly filled, they have higher shrinkage
• good wear resistance
• good adaptation to irregular tooth surfaces

-uses; Liners (deep caries/indirect pulp cap), immediate dentin sealing (IDS), small restorations, class V, repairing provisional restorations

Question 19

what is build up composite features and uses

Answer 19

• opaque
• dual cured
• uses; post endodontic treatment, large cavitation, idealize tooth for crown prep

Question 20

what is sealant ?

Answer 20

• VERY low fill (unfilled usually)
• serves as bonding agent and restorative material (just etch and place material)
• protected by tooth anatomy
• flow into narrow crevices

Question 21

what is wetting resin? & featuresuses?

Answer 21

-UNFILLED
-transparent
-RADIOLUCENT
-uses; ONLY placed on instruments? so stuff doesnt stick to other stuff.
too much will weaken composite?

Question 22

what type of curing light do we use

Answer 22

VALO.

Question 23

what are the light peak ranges for the 3 main initiators

Answer 23

CQ; 420-495 (470 nm)

PPD; 390-460 (peak 440 nm)

TPO: 350-430 (peak 410 nm)

Question 24

whats the ideal curing distance

Answer 24

1 mm from light source to composite (as close as you can get without touching it)
light source should be at 90 degrees to the surface of the composite

Question 25

what impacts the depth of cure light

Answer 25

- shade - opacity - incremental layering (light cant penetrate more than 2 mm) - bulk fills are not ok to light cure really but theres usually a dual cure component so technically it could.....

Question 26

what are the 3 modes of valo and what do we use why dont we cure for too long?

Answer 26

we just use standard standard ; 1,000 mw/cm^2 High: 1400 mW/cm^2 plasma: 3200 mW/cm^2 - over curing will not damage the composite - heat can cause pulpitis! 5.5 degrees celsius for more than 10 seconds is bad

Question 27

whats the 3 tasks for bonding materials

Answer 27

- ETCH; selectively removing "smear layer" and mineral from surface - PRIME: infiltrate exposed collagen - BOND: link infiltrated collagen to active resin surface. each 'generation' of adhesive achieves tasks in a unique combo

Question 28

what are the features of enamel bonds/uses?

Answer 28

- consistent/strong and durable - etch (phosphoric acid) creates enamel tags, removes mineral between rods and removes mineral from ends of crystallites (v good for bonding) - adhesive resin flows into porosites in enamel surface - hydrophilic primer not needed - known as a micromechanical retention - uses: sealants, diastema closure, orthodontic appliances..

Question 29

what are the features of dentin bonding

Answer 29

- ionic bonding with resin NOT effective . composite is hydrophobic. hydrophilic ones break down by hydrolysis over time... - hydrophilic substrate - no opportunity for covalent bonding - fires 3 generations: were unsucessful - unable to overcome stresses of polymerization shrinkage. about 17 mPa

Question 30

whats total etch; 4th vs 5th gen

Answer 30

both use total etching; etching for enamel AND dentin. then rinse - 4th: phosphoric acid gel etchant. separate primer used. separate adhesive (bonding agent) used as well - 5th; phosphoric acid gel etchant. combined primer and adhesive.

Question 31

what does etching do to dentinal tubules

Answer 31

dentin, collagen, mineral matrix, smear layer -phosphoric etch removes smear layer completely. collagen is exposed, dentin tubules opened and release some dentinal fluids. rinsed away, left somewhat moist. keeps hydrophilic collagen permeable. resin primer has hydrophilic monomers and solvents, placed on wet surface, solvents wick resin into collagen mesh. surfaces air thinned, dries off remaining water and solvent, ethanol and acetone. this leaves just monomers permeating the mesh. primer can be light cured at this stage (depends on manufacturer) adhesive is placed on primed surface, resin mingles w primed monomers to form resin mass anchored into collagen , locked in. -light cure adhesive layer, oxygen inhibited resin layer which will bond well with composite after. composite is placed/light cured. layer of bonded tooth w tooth structure + resin is hybrid layer.

Question 32

what factors hurt bonding ? which more?

Answer 32

dentin especially but both. enamel isnt as sensitive contamination: saliva , blood, crevicular fluid, dentinal fluid, humidity - etching variability: time, location - moisture; too little= collagen collapse. too much= incomplete placement

Question 33

whats the effect of OVER etching/drying?

Answer 33

when not enough moisture, collagen collapses. hard to permeate. trapped air.. sensitivity not good

Question 34

what problems occur with composite/if things are not done right

Answer 34

-biting sensitivity is the most common (immediately after placement. failure of bond on pulpal floor) -secondary caries; gingival margins on dentin or cementum -breakdown of bond over time. gingival margins on dentin, spread of caries on pulpal floor. (class II especially?)

Question 35

whats self etch 6th/7th gen?

Answer 35

6th generation!!!!! -acidic primer; replaces phosphoric acid gel, effective on DENTIN but less effective on enamel.... adhesive; equivalent of adhesive in 4th generation , mostly hydrophobic -7th generation; acidic primer and adhesive in one containe!!!!! May need to be mixed before applying. many have failed miserably!!!!!

Question 36

describe what the acidic primer does to the dentin

Answer 36

smear layer 'dissolves' into the se primer. not washed away but air thinning gets most liquid away. - place adhesive, flows into remaining resin primer and dentin, light cure/ little or no demineralized collagen should remain without a resin coating. - composite bonds to adhesive, adhesive should be thicker than primer layer.

Question 37

whast the rationalconcerns

Answer 37

-rationale; simpler! dont worry about how long you etch or how long its there. less post op sensitivty. elimination of incomplete hybrid layer problem concern; inferior enamel bond - not as strong of an acid so bonding fails at enamel. water sorption issues; combined ingredients mixed that break down over time into hydrophilic/hydrophobic components, allowing for hydrolysis to occur???

Question 38

whats selective etch? how is it used/ features

Answer 38

best of both worlds - acid etch enamel (15 seconds) acid CANT touch dentin. - some un-etched enamel is better than some etched dentin!! - etch on dentin will expose collagen that may not be completely perfused// - rinse for 5 seconds and dry the tooth. amount of moisture is NOT critical - apply self etching primer (for dentin) - scrub (10 seconds) and air thin. scrubbing breaks up smear layer and encourages demineralization. air thinning allows maximum amount of clean strong adhesive. - apply adhesive! unadulterated resin provides strong enamel bond and link to primer in dentin. ? -light cure for 20 seconds!

Question 39

what are the 3 etch adhesives good for ?

Answer 39

universal adhesives? except they arent really..... 7th and 8th generations - self etch; good bond to dentin, mediocre to enamel - selective etch; preferred method. claims etch on dentin not a problem - total etch; good enamel bond, claims etched dentin can be perfused whether dentin is left moist or dried. currently recommended for NON CARIOUS CERVICAL LESIONS (NCCLs)