BDS2 DMS Flashcards
Types of error in PMMA dentures (3)
Flawed initial impression
Error during curing process
Usage
Potential usage problems in PMMA denture (5)
Fractures
Uncomfortable
PMMA becomes warped
Surface wear
Patient anatomy changes
3 requirements of ideal denture
Replaces function of natural dentition
Fits comfortable
Good aesthetics
Ideal properties for denture base material 7
Can accurately create dimensions that will fit well and be stable in use
High softening temperature
Unaffected by oral fluids
High thermal conductivity
High Young’s modulus and elastic limit
Low density
Non toxic/irritant
What does high Young’s Modulus mean?
High stress causes small strain
What does high elastic limit mean?
Only large stresses will cause permanent deformation
Free radical addition polymerisation
Chemical union of two molecules either the same or different to form a larger molecule without the elimination of a smaller molecule
(involves C=C bonds)
4 steps of acrylic polymerisation reaction
Activation
Initiation
Propagation
Termination
What happens in activation stage of acrylic polymerisation?
Free radicals are formed
What happens in initiation stage of acrylic polymerisation?
Free radicals break C=C bonds in each monomer, and transfer free radicals
What happens in propagation stage of acrylic polymerisation?
Polymer chain grows
What must be done to enamel surface before bonding a composite resin?
Acid etch
Advantages and disadvantages of porcelain
Aesthetically good
Hard and rigid - more easily fractured
What is stress?
Force/ unit area in N/metres squares - PASCALS
Difference in retention between amalgam and composite
Amalgam uses mechanical retention - undercuts
Composite uses adhesive retention - minimal cavity prep
Creep
Gradual dimensional change due to repetitive small force
Fatigue
Repetitive small stresses cause fracture
Deformation
Repetitive small stresses cause permanent change in material dimensions without fracture
Elasticity
Ability of a material to recover its dimensions follow application of stress
Properties of ideal dental adhesive (6)
High bond strength
Immediate bond
Durable bond
Impermeable bone
Easy to use
Safe
Why is enamel easy to bond to?
Heterogenous - densely packed prismatic structure
Acid etch process
Roughens the surface, long enamel prisms are filled with imperfectly packed hydroxyapatite crystals
Why acid etch?
Modified roughened surface produced by etch is easier to bond to resin restorative materials, increases enamel surface energy by removing surface contaminants - better wettability, allowing the resin to adapt to the roughened enamel surface
Why must enamel be dry for composite?
Moisture contamination prevents flow of resin into etched surface
What is used for etch?
30-50% aqueous phosphoric acid
Dentine composition
20% inorganic (mostly collagen)
70% inorganic (mostly hydroxyapatite)
10% water
Why is bonding to dentine difficult?
Dentine is full of permeable tubules, fluid pumps up from pulp to dentine floor making cavity wet
Hydrophilic
Low surface energy
Smear layer
Required properties for dentine bonding agent (4)
Ability to flow
Potential for intimate contact with dentine surface
Low viscosity
Adhesion to substrate by mechanical, chemical and Van der Waals forces
Describe mechanical bonding to dentine
Dentine bonding agent and dentine surface mesh and interlock together with minimal gaps
Chemical adhesion of dentine
Mineralised dentine forms ionic bonds
Organic dentine forms covalent bonds
What happens to dentine as it ages?
Becomes more mineralised
Relevance of surface energy in bonding
A liquid will only spread on a surface with higher surface energy than it
What is amalgam?
An alloy formed by the reaction of mercury (liquid) and silver, tin, copper and other metals (powder)
Purpose of copper in amalgam
Increases strength and hardness
Amalgam particle types
Lathe cut
Spherical/spheroidal
What are the gamma, gamma1 and gamma2 phases of amalgam?
Gamma - unreacted particles Ag3Sn
Gamma 1 - Ag2Hg3 and Gamma 2 - Sn7Hg9
make up the amalgam matrix
Setting reaction for amalgam
Ag3Sn +Hg -> Ag2Hg3 +Sn7Hg9
Set structure of gamma particles in amaglam
Gamma 1 holds together particles of Gamma and Gamma 2
In modern amalgam what are 2 setting dimensional changes?
Small contraction (<0.2%)
Solid solution of Hg in Ag3Sn
Why is zinc avoided in lots of dental materials?
When zinc reacts with water it forms ZnO and H2 causing bubbles of H2, causes pressure which can cause expansion, pulpal pain or cause restorations to sit above the surface
4 factors affecting amalgam’s properties
Handling
Cavity design
Corrosion
Variation between products
5 advantages of spherical amalgam particles
Earlier high tensile strength
Higher tensile strength
Less sensitive to condensation
Easier to carve
Less mercury required
Describe early (1hr) and late (>24hr) strength of amalgam
Early - poor
Late - fairly good
Abrasion resistance of amalgam
High, suitable for posterior teeth
Too high for deciduous
5 factors decreasing strength of amalgam
Undermixing
Too high Hg content after condensation
Too low condensation pressure
Slow rate of packing - increments don’t bond
Corrosion
3 factors affecting marginal integrity of amalgam
Creep
Cavity design
Corrosion
What is creep?
When a material flows slightly as a result of repeated low level stresses. This is a kind of permanent deformation
Thermal conductivity of amalgam and relevance
High thermal conductivity so in deep cavities it may be necessary to use a liner
How is amalgam bonded to tooth?
It is not bonded. It uses mechanical retention
What is added to amalgam to resist corrosion?
Copper
Is it easier to bond a material to enamel or dentine?
Enamel
What acts as a “wetting agent” when carrying out a restoration?
Bonding agent
4 benefits of copper enriched amalgam
Higher early strength
Less creep
Higher corrosion resistance
Increased durability of margins
Advantages of amalgam (5)
Strong
Hard
Durable
Radiopaque
User friendly
Disadvantages of amalgam (4)
Corrosion
Leakage
Poor aesthetics
Mercury - potential toxicity and environmental impact
5 potential restorative materials
Composite
GIC
Amalgam
Precious metal
Ceramic
Why is release of chemicals an undesirable property in restorative materials?
Could be pulpal irritants and lead to pain or pulpal damage
What is the purpose of intermediate restorative materials (cavity liners)?
Prevent gaps
Act as protective barrier
What is a cavity base?
Thick mix placed in bulk
Replaces dentine to minimise restoration material used or block out undercuts
Which type of restorative material more often requires a cavity base?
Metal
What is a cavity lining?
Thin coating <0.5mm over exposed dentine
Able to promote pulp health by adhering to the tooth structure or by anti-bacterial action
Pulpal protection by lining material (3)
Chemical stimuli from unreacted chemicals in the filling material or initial pH of filling
Thermal stimuli e.g. composite exothermic setting reaction
Bacteria and endotoxins, microleakage of oral fluids and bacteria between restoration and cavity walls
Therapeutic effect of lining materials
Calm down pulp inflammation and promote healing
3 properties to make cavity liner easy to use
Easy to mix
Long working time
Short setting time/command set
3 thermal properties of ideal lining material
Low thermal conductivity
Thermal expansion coefficient similar to dentine
Thermal diffusivity similar or lower than dentine
Ideal thermal conductivity of denture base and reasoning
High, otherwise pt may ingest too hot liquid/food, causing burns to oesophagus
What is thermal expansion coefficient?
Change in length per unit length for temp rise of +1 celsius measured in ppmC-1
What is thermal diffusivity?
Similar to conductivity, measured in cm2/sec
Thermal conductivity units
W/m-1/(degrees)C-1
Benefit of radiopaque cavity lining material
Easy to see difference between lining and tooth, makes it easier to see secondary caries or leakage
Why is it important that lining materials are cariostatic?
Prevent secondary caries
Two potential cariostatic properties of cavity liners
Fluoride releasing
Antibacterial
3 required characteristics for biocompatibility of cavity liners
Non toxic
Not damaging to pulp (pH neutral and no excessive heat on setting)
Low thermal conductivity
Examples of cavity lining materials
Setting calcium hydroxide - liner
Zinc oxide based cements - base
GlC/RMGIC - base or liner
Two components of setting calcium hydroxide
Base
Catalyst
Setting reaction of calcium hydroxide
Chelation reaction between ZnO and butylene glycol disalicylate
What is the reactive element in the catalyst used in calcium hydroxide?
Butylene glycol disalicylate
Initial pH of calcium hydroxide cement
around 12
What effect does CaOH have on dentine?
It stimulates production of reparative tertiary dentine by causing irritation to odontoblast layer
Relevance of CaOH pH
pH 12
Bactericidal to cariogenic bacteria as they survive in acidic conditions
3 useful properties of CaOH
Quick setting
Radiopaque
Easy to use
Before mixing how does CaOH appear?
Two pastes
2 undesirable properties of CaOH liner
Low compressive strength
Soluble
Zinc oxide based cement examples (5)
Zinc phosphate
Zinc polycarboxylate
Zinc oxide eugenol ZOE
Resin modified ZOE
Ethoxybezoic acid (EBA)ZOE