cavity lining materials Flashcards
what materials are placed in cavities
- composite resin
- glass ionomer
- amalgam
- precious metal
- ceramic
what are the disadvantages of restorative materials
- may not make intimate contact with the tooth surface (especially dentine) = gaps allow ingress of fluids and bacteria
- heat is released during curing/setting reaction
- release of chemicals = may cause pulpal irritation and lead to pain or pulpal damage, often happens if not cured well
- micro leakage = when doesn’t bond well and gaps form
what is the solution to the problems of restorative materials
- intermediate restorative material
- a lining material = prevents gaps, acts as a protective barrier
where does the lining sit
- below the restorative material at the base of the cavity, protects the pulp
what is a base
- a thick lining (lining and base are the same thing)
what is a lining
- a thin base (lining and base are the same thing)
how does a cavity base work
- thick mix placed in bulk
- dentine replacement used to minimise the bulk of the material or block out undercuts
- more common in metal restorations = direct or indirect
how does a cavity lining work
- thin coating (<0.5mm) over exposed dentine
- a dentine sealer able to promote the health of the pulp by adhering to the tooth structure or by an antibacterial action
what is the purpose of a liner
- pulpal protection
- therapeutic
- palliative
- want something bond to surface of tooth and be impenetrable
how does the liner protect the pulp
- chemical stimuli = form unreacted chemicals in the filling material or the initial ph of the filling
- thermal stimuli = exothermic reaction of composite or heat conducted through metal fillings
- bacteria and endotoxins = micro leakage, the penetration of oral fluids and bacteria and their toxins between restorative material and the cavity walls
how is the liner therapeutic
- to calm down inflammation within the pulp and promote pulpal healing prior to or at the same time of a permanent restoration being placed
how is the liner palliative
- to reduce patient symptoms prior to definitive treatment being carried out
- most commonly in patients with reversible pulpitis
how is a lining material easy to use
- easy to mix = if it was made difficult then a mess would be made of it
- working time should be long enough to allow easy placement
- setting time is short = but ideally would want on command set which we don’t have yet
what is the thermal conductivity of lining materials
- should be low
- denture bases should be high, restorative material should be low, cavity lining as low as possible
- want as little heat as possible going to pulp (especially under metal restoration)
what is thermal’s conductivity
how well heat is transferred through a material
- heat flow through a cylinder of unit cross-sectional area and unit length, with a temperature difference of 1 degree between the ends
- units are W/m-1/oC-1
what is the thermal coefficient
change in length per unit length for a temperature rise of 1oC
- units are ppmoC-1
what should be the thermal coefficient for a lining materials
- ideally a liner should match the thermal coefficient of the tooth
- enamel = 8.3 ppmoC-1
- dentine = 11.4
- GIC = 11
- RMGIC = 20
- composite and amalgam = 25 (not very good)
what is the thermal diffusivity
similar to conductivity
- measured in cm2/second
what should the thermal diffusivity of a lining material be
- similar to dentine or lower
- ideally at least as low as tooth - enamel = 0.0042, dentine = 0.0026
- all commercially available liners have a similar or lower thermal diffusivity than tooth enamel
- amalgam is 1.7cm2/sec (500 x more than dentine)
what are the mechanical properties of a lining material
- high compressive strength = needs to be as filling going to packed on top so needs to not break (dentine around 275MPa)
- modulus similar to dentine = around 15GPa, if material bent too much bond would eventually break and restoration would fracture
are lining material radiopaque
yes
what is good about lining materials being radiopaque
- should be easy to see difference between lining and tooth
- makes it easier to see if there if any leakage or secondary caries
what is the marginal seal formed by lining materials
- ideally lining should form a chemical bond to dentine
- bond should be permanent and impenetrable
what is the solubility of a lining material
low
what does a cariostatic lining material do
- releases fluoride
- is antibacterial
- is important in preventing secondary caries around the restoration
what is the biocompatibility of a lining material
- non-toxic
- not damaging to the pulp = ph neutral, no excessive heat during setting
- low thermal conductivity
- compatible with restorative materials
what are the different types of lining material
- palliative cement
- setting calcium hydroxide liner
- zinc oxide based cements
- zinc polycarboxylate cement
- zinc oxide eugenol (ZOE)
- ethoxybenzoic acid (EBA)
- glass ionomer lining materials
what is palliative cement
- base
- seldom used nowadays
- contain antibiotics or steroids
- dampen down inflammation of pulp or bacteria
what is setting calcium hydroxide
- 2 pastes = Life, Dycal
what are the constituents of setting CaOH
- base
- calcium hydroxide 50%
*zinc oxide filler (10%)
*zince stearate filler <1%
*N-ethyl toluene sulphonamide plasticiser 40%
(has few fillers) - catalyst
*butylene glycol disalicylate (reactive part) 40%
*titanium dioxide (filler) 13-14%
*calcium sulphate (filler) 30%
*calcium tungstate (filler and radiopaque) 15%