Dental Material Pros/Cons/Indications/Contras Flashcards
RMGIC - constituents? resin?
GIC + water-soluble resin and modified poly(acryclic acid)
HEMA
RMGIC - key advantages?
Seals dentinal tubules and decreases risk of microleakage
Sustained release of F (increases degrade)
Ca and collagen bonding
Long working time
Limited moisture sensitivity
Releases bacteriostatic benzoyl iodides/bromides
RMGIC - key disadvantages?
Prone to staining with time Shrinkage Swelling (moisture uptake) Exothermic on curing Monomer leach Benzoyl iodides/bromides cytotoxic
RMGIC - indications?
Small-sized C I
C III and V
Non-carious tooth surface loss
Only few shades available
Core build-ups (>50% tooth remaining)
Open and Closed sandwiches
Dressing (alternative to GIC for command set)
Luting***
Restore deciduous (minimally invasive and F)
Linings (seal tubules, bacteriostatic, F and radiodense)
Bonding dental amalgam
Blocking undercuts for indirect restorations (bond tissue and easy handling)
RMGIC - presentations?
Powder/liquid
Encapsulated (less voids)
Paste/paste system (increase wear resist)
RMGIC - summary?
Limited advantages over GIC HEMA cytotoxic Improved F release Mech props > GIC Particularly for luting restorations
RMGIC - contraindications?
For direct placement on both pulpal and periradicular vital tissue
Amalgam - constituents?
Alloy + mercury
Alloy containing silver, tin and copper + mercury
Amalgam - key advantages?
Compressive strength
Early strength
Spherical alloy stronger
Amalgam - key disadvantages?
Tensile strength
Creep y1
Corrosion y1
High thermal diffusivity
Amalgam - indications?
Class I and II cavities
(Class III and V)
Cores for cast restorations
Amalgam - cavity design?
Depth - 2mm Rounded line angles Cavo-surface angles 90-110 No unsupported enamel Retention form (undercuts and slots)
Amalgam - benefits of bonding? bonding material?
Increased retention and fracture resistance
Decreased microleakage, trauma, inflammation, PostOP sensitivity, recurrent caries, cuspal deflection
Resin based composite adhesive
Little in vivo evidence
Amalgam - presentation?
Encapsulated - easier mix, dispense
Amalgam - adverse effects?
Enamel discolouration (dentine permeability) Amalgam tattoo (migrate to soft tissue) Lichenoid (hypersensitivity) Galvanic cell (2 different metals and saliva)
Amalgam - contraindications?
Pregnant women
Allergy
Aesthetics
Objection
Amalgam - summary?
Higher copper, spherical or admixed alloy performs better
GIC - name? constituents?
Glass Polyalkenoate cement
Glass and polyacrylic acid
GIC - mechanical properties?
Compressive strength = dentine
Strength increases with time
GIC - bonding?
Chemical bonding: H bond with collagen and form a Ca polyacrylate salt replacing the hydroxyapatite structure
Bonds can reform
GIC - indication?
Intervisit endodontic material Restore deciduous Atraumatic restorative technique Tunnel preps C III CV (especially nn-carious tooth loss) Long-term temporisation/intermediate restoration Core build-ups PRR Base/Liner Dressing (non-retentive cavity or composite as final material) Fissure sealants Luting (crown and bridge retainers)
GIC - key advantages?
F release (can be replenished) Less staning than composite (but less shade variation) Composite > GIC for aesthetics
GIC - contraindications?
High load C I or C II
Large posterior cavities
Core build ups with little tooth
Aesthetics
GIC - presentation?
Encapsulated
Powder/liquid
GIC - summary?
Composite > GIC mechanically but F release
Need protection from moisture contamination and desiccation
ZPC - constituents?
Zinc oxide + poly(acrylic acid)
ZPC - mechanical properties?
Lower modulus of elasticity and less likely to fracture under heavy load
ZPC - indications?
Temporary restorations (especially non-retentive cavities due to chem bonding, no entering tubules and it’s a sedative)
Future restoration to be composite
Bases (seales dentine due to adhesive props but superseded by RMGIC)
Definitive luting of metallic/ceramic crowns
Cementation of ortho bands
ZPC - summary?
Non-toxic to pulp
Bond chemically to dentine
ZPC - key advantages?
Bonds tissue and resto material
Long-term durabilty
ZPC - key disadvantages?
Hard mixing
Opaque
Hard manipulation
ill-defined set
ZOE - constituents?
Zinc oxide + eugenol -> Zinc eugenolate
ZOE - presentations?
Power/liquid
Paste/paste
ZOE - reinforced with?
Temporary cement
EBA-reinforced Zinc Oxide Eugenol cement
Ortho-ethoxybenzoic acid (EBA)
ZOE - key advantages?
Needs to be used in 2mm to function as base
Bactericidal
Bland sedative
Reduces leakage and pulpal inflammation
ZOE - key disadvantages?
May contains air voids Never place on vital pulp - cytotoxic Mechanical retention Poor interaction with resin composite Opaque
ZOE - indications?
Temporary restorations Base Temporary luting Long-term temporary restorations Root end filling Endodontic sealer Impression material Long-term temporisation
ZOE - contraindications?
Temporary restorations in non-retentive cavities Direct on pulp Under/With resin composite Definitive luting Exposure to oral fluids
Compomer - constituents?
Dimethacrylate and difunctional resin monomer containing both carboxyl and methacrylate groups
Compomer - mechanical properties?
Lower compressive, flexural strengths and elastic moduli compared to composite
Compomer - bonding?
Intermediate bonding system
Compomer - key advantages?
Release F (much lower than GIC/RMGIC) Less wear resistance than composite
Compomer - key disadvantages?
Staining from oral fluids
Compomer - indications?
C III - strong and aesthetic CV - flexible for abfraction lesions Fissure sealants - flowable Luting - metal based and indirect restorations Resto deciduous (bonding)
Compomer - contraindications?
Aesthetics (composite better) Core-build ups (not strong enough) Luting ceramics (fracture risk) C I, II and IV (fracture risk) Inter-visit restorations (poor sealing for microleakage)
CaOH cement - base vs lining?
Base:
- function as a barrier against chemical irritation, providing thermal insulation and resists forces applied during condensation of restorative material (structural forms)
Lining:
- Placed as thin coatings and their function is to provide a barrier against chemical irritation (no thermal insulation) (no structural form)
CaOH - indications?
Lining
CaOH - constituents?
CaOH + salicylate ester forming Ca disalicylate complex
CaOH - mechanical properties?
Weakest material
Deforms
Thin sections only
CaOH - key advantages?
Formation of reparative (tertiary) dentine
Forms physical barrier over exposed pulp allowing material to seal tubules
CaOH - key disadvanatges?
Low compressive strength No adhesion to dentine Local irritation Exothermic reaction Shrinkage
CaOH - indications?
Deep cavity over pulpal floor
Indirect and direct pulp capping
Ca3SiO5 - physical properties?
Compressive and hardness to dentine
Flexural modulus as dentine
High dimensional stability
Doesn’t discolour
Ca3SiO5 - indications?
Placed on dentine and vital pulp tissue (pulpal cell proliferation) Deep cavities Reversible pulpitis (dressing) Carious or iatrogenic exposure Trauma Pulpotomy in primary molars Perforation repairs
Ca3SiO5 - contraindications?
Don’t layer with GIC or ZOE
Don’t etch with H3PO4 (use selective)
Need >2mm of resin composite to mask opacity
Don’t desiccate
Composite - constituents?
Resin + filler bound together by a silane coupling agent
Composite - key advantages?
Aestehtics Minimally invasive Command set Repaired Bonded to enamel and dentine Reduced microleakage Lowe thermal conductivity
Composite - key disadvantages?
Time consuming Hydrophobic Photophilic Shrinkage Technique sensitive Decreased longevity with higher # of surfaces Attract more bacteria than amalgam (unless well polished) Difficult to finish
Composite - presentation?
Universal - all applications
Flowable - for ultraconservative restorations
Packable - posterior situations
Universal composite - indications?
C III
C IV
Incisal non-carious tooth surface loss
Reinforcing fibres for splinting
CV where retention is by undercut (carious)
C I and C II if indicated by manufacturer
Universal composite - contraindications?
Aesthetics are critical
Moisture control can’t be achieved
Inadequate enamel
Flowable composite - mechanical properties?
Compared to universal: Less compressive strength Less wear resistant Greater shrinkage Lower modulus of elasticity (increased flexibility)
Flowable composite - indications?
Small C I (with enamel only or small amount of dentine perm or decid)
CV (non-carious)
Repair ditched amalgam margins
Lining material (with packable composite)
Block undercuts (inlay prep)
Enhance bond between enamel and heavily filled composite at bottom of C II box
Ceramic repairs in non-stress situations
Repair bis-acryl composite temporary restorations
Flowable composite - contraindications?
High stress situations (edges and cusps)
Resto of anything greater than small C I
Any C II
Moisture control can’t be achieved
Packable composite - mechanical properites?
Increases fracture resistance
Increased void risk
Packable composite - indications?
Posterior use
Bulk fill composite - mechanical properties?
Good wear resistance Strength Sculptable Good radiodensity Good adaptation for cavity Fewer voids Increased modulus of elasticity Reduced shrinkage Bond resin-based materials
Bulk fill composite - disadvantages?
Less compressive, decreased hardness and decreases wear resistance
Bulk fill composite - indications?
Direct anterior and posterior resto Lining under direct resto Core build ups Splinting Indirect resto Resto deciduous Fissure seal and PRR Repair defects in ceramic resto and temporaries
