Exam 1 Flashcards

1
Q

Dental Materials

A

materials that are specifically designed for use in dentistry

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2
Q

One classification system for dental materials groups them in the following way

A

Preventive materials (ex. Sealants- cavities, fluoride- prevent caries)
Restorative materials
Auxiliary materials
Biomaterials

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3
Q

Preventive Dental Materials

A

Materials that slow or prevent the onset and progression of disease

Pit and fissure sealants
Materials that release therapeutic agents such as fluoride
Cements
Liners and bases
Glass ionomers (GI) restorative materials (release fluoride- change chemistry of mouth- in US used as preventative, not standard care due to history of it; other countries used as restorative)

Materials that release remineralizing agents such as casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP)

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4
Q

Restorative Dental Materials

A

Consist of synthetic components that can be used to repair or replace damaged or missing tooth structure

Includes metals, polymers, ceramics and composites
Can be further subdivided into:
Direct restorative materials (amalgam; directly on tooth)
Indirect restorative materials (crown- made in a lab somewhere; use something else to be able to bond crown on prep)
Temporary (provisional) restorative materials (before permanent crown)

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5
Q

Direct Restorative Materials

A

Cements, metals or resin-based composite materials that are placed, formed, contoured and finished (cured) INTRAORALLY to repair disease, restore damaged teeth or improve esthetics

Two of the most commonly used direct restorative materials include dental amalgam and dental composite

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6
Q

Indirect Restorative Materials

A

A ceramic, metal, metal-ceramic or resin-based composite material that is fabricated EXTRAORALLY on casts or using other means (already cured), and repairs damaged teeth, replaces missing teeth or improves esthetics

Includes crowns, ceramic veneers, inlays, onlays, and composite restorations fabricated using indirect methods

Cemented (luted)

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7
Q

Temporary (provisional) Materials

A

Materials used to restore teeth for a short period of time, ranging from a few days to more than a year, with the understanding that they are to be replaced with more durable restorative materials.

Indications:
While a definitive restoration is being fabricated
When active disease is present (e.g. perio, caries)
To guide auxiliary procedures (e.g. perio, ortho)
Symptomatic teeth with unclear pulpal health
Esthetic and trial restorations, when substantial corrections to the occlusion or tooth position are part of the care plan

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8
Q

Definitive restorations

A

Temporary dental materials; restorative services that are provided to serve as final, long-term treatment

Prevent to go farther in the pulp (restorative) that may need a root canal for example

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9
Q

Auxiliary Dental Materials

A

Materials that are used to fabricate restorations, but do not become a part of the restoration

Examples:
Dental stone
Dental waxes 
Impression materials
Tray and mouthguard acrylic
Gypsum and phosphate-bonded investments
Finishing and polishing abrasives
Etc.
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10
Q

Biomaterials

A

Any material that interacts with biological systems

Generally, biomaterials are used to restore, maintain or improve tissue and organ function

Using biomaterials to repair, shape or direct the growth of host tissues is called tissue engineering

Deeper interaction ; injection in root canals- pulp grows back (working on it?) ; most of them are used in clinical trials- quite new

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11
Q

Tissue engineering

A

Employs several strategies for repairing tissues:

Injection of cells
Guided Tissue Regeneration
Cell induction
scaffolds (help to grow bone for example)

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12
Q

Injection of cells

A

Tissue engineering; Stem cells (progenitor cells) are capable of forming new tissue with one or more phenotypes

The stem cells are injected into the general vicinity of the site in which they are intended to propagate

The injected cells then migrate to the area of injury and replicate, thereby replacing lost tissue

ex. inject cells in pulp chamber

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13
Q

Guided Tissue Regeneration

A

Tissue engineering; A surgical procedure for regenerating tissue by enhancing the opportunity for one cell type to proliferate

In periodontal applications, a membrane is used to exclude unwanted cell types

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14
Q

Cell induction

A

Tissue engineering; Growth factors and developmental proteins are administered locally to induce progenitor cells to differentiate into desired tissues

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15
Q

Scaffolds

A

Tissue engineering; Promote new tissue formation by providing a surface and void volume that encourages the migration and proliferation of desired cell types

Many scaffolds are preformed and bioresorbable

Typically, scaffolds are seeded with progenitor cells that are allowed to attach and proliferate in vitro

After suitable time in vitro, the scaffold is grafted into a host site

The implanted scaffold must then look to the host vasculature for nutrient and metabolite exchange in order to survive

Gradually, the scaffold degrades (resorbed) until it is completely replaced by new tissues

Ex. 3 types of biomaterials studied as scaffolds and carrier systems: Natural (biological derived), ceramic or glass materials, polymeric materials

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16
Q

Ideal Dental Materials

A

Biocompatible (elicit a healthy biological response from the host)

Bond permanently to tooth structure or bone

Match the natural appearance of tooth structure and other visible tissues

Exhibit properties similar to enamel, dentin, and other oral tissues

Capable of initiating tissue repair, or regenerating missing or damaged tissues

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17
Q

People are living longer

A

Research and Industry Trends

People are living longer
Regenerative endodontic pulpal therapies
Periodontal therapies are needed that allow consumers to retain their teeth longer
Because people are retaining their teeth longer, consumer demands are shifting restorative care from replacement of teeth to long-term restoration and maintenance of teeth

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18
Q

Patients who are missing one or more teeth are requesting life-like replacement options

A

Research and Industry Trends

Dental implants (coating and surfaces, root form geometries, periodontal tissue response [perimucositis, perimplantitis, gingival recession]

Periodontal tissue and bone grafting materials

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19
Q

Patients are demanding more esthetic techniques and outcomes

A

Research and Industry Trends

Tooth whitening, ceramic materials, composite materials, invisalign

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20
Q

Patients are demanding shorter treatment times

A

Research and Industry Trends

CAD/CAM lab and chairside indirect restorations

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21
Q

Each tooth contains 3 specialized calcified tissues which are?

A

Enamel (mostly mineral), Dentin, Cementum (thin, only in the roots)

Enamel is the most highly calcified tissue in the body and contains the least organic content of any of these tissues. By weight, mature enamel is 96% inorganic material (mineralized), 1% organic material, and 3% water
Dentin, cementum, and bone are vital, hydrated, biological composite structures formed mainly from collagen type I matrix reinforced with calcium phosphate mineral (hydroxyapatite)

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22
Q

Composite

A

a collective term for materials that are

  • Made from two or more constituent components with different properties
  • When combined, the individual components remain separate and distinct in the finished product
  • the composite has properties that are unique relative to the constituent materials
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23
Q

Enamel

A

Forms the outer shell of the anatomic crown of the tooth.
Dentin is joined to enamel at the dentinoenamel junction (DEJ).
Enamel is formed by cells called ameloblasts.
Enamel apposition begins at the DEJ and proceeds outward towards the surface of the tooth.

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24
Q

Enamel crystals

A

Enamel is made of very long hexagonal crystals about 40nm wide, but which span the entire enamel thickness. These crystals are then packed into enamel rods or prisms, that are about 5µm across

About 100 crystals of the mineral are needed to span the diameter of a prism- these prisms are easily revealed by acid etching, and are found in a closely-packed array

The individual crystals within a prism are further coated with a thin layer of lipid and/or protein that plays a role in mineralization; This protein coat appears to increase enamel toughness

The interface between prisms are the inter-rod enamel (contain the organic component of enamel, permit the flow of water and ions in enamel demineralization and remineralization, have physical properties essential for enamel bonding). These areas are known as prism sheaths

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25
Q

Enamel bonding

A

In enamel bonding, enamel is etched with phosphoric acid. Acid etching preferentially dissolves enamel crystals in each prism. In type I enamel etching, the prism core is preferentially etched

Creates mechanical retention; increases SA; removes junk on top of surface; due to hand instruments; breaks down part of enamel, dentin; cleans it up; creates pores- allows materials to have a better interaction
Must etch both surfaces (enamel and dentin)- used adhesives (bonding agent- have acid monomers that does the same)- need to clean it up to create better cross linking

In Type II, the prism peripherally is preferentially etched. Type III enamel etching results in a uniform or mixed pattern of etching. No difference in micro-mechanical bond strength of the different etching patterns has been established

As etching is established, the surface of the etched enamel develops a frosty appearance. This roughened surface provides a substrate for infiltration of bonding agents; After the bonding agents penetrate the roughened enamel surfaces, they are polymerized, forming a micromechanical bond to the enamel surface

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26
Q

Enamel structure

A

Enamel is not a tissue that is uniform in structure. Near the DEJ, enamel is commonly aprismatic, making it more difficult to etch
Similarly, fluoride concentration in surface enamel is significantly higher than subsurface enamel, making it more difficult to etch as well

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27
Q

The enamel mineral phase: hydroxyapatite

A

The mineral in all calcified tissues in the body is a highly defective version of the mineral hydroxyapatite (HA). HA has a hexagonal crystal structure, and the formula is Ca10(PO4)6(OH)2. Biological versions of apatites differ from ideal HA found elsewhere in nature in that biological apatite has many more defects and chemical substitutions. Defects and substitutions generally serve to make it less stable and more soluble in acids.

The variable composition of HA in enamel and dentin reflects its formative history and other chemical exposures during maturity. Enamel and dentin HA is calcium deficient, carbonate rich, and highly substituted (Mg and Na commonly substitute for Ca; Carbonate substitutes for the phosphate and OH groups) The most beneficial substitution is the fluoride ion (F-), which substitutes for the OH group; Applying fluoride changes HA- makes crystal stronger and less soluble in acids

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28
Q

Fluoroapatite Mineral

A

The most beneficial substitution is the fluoride ion (F-) which substitutes for the OH group; Formula: Ca10(PO4)6(F)2 which is less soluble than HA and more provides more protection against caries

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29
Q

Dentin

A

Complex hydrated composite structure composed of an organic matrix and a mineralized component, that forms the majority of the tooth; It is modified by aging, disease and other physiological processes resulting in a wide range of altered forms; The type of dentin you encounter performing restorative procedures may profoundly impact your ability to bond restorative materials to dentin; volumetrically dentin is composed of 50% carbonate rich, calcium deficient apatite, 30% organic material, primarily type I collagen, 20% fluid

The tubule lumen is lined by a highly mineralized cuff of peritubular dentin ~0.5-1µm thick. The peritubular dentin, also known as intratubular dentin by some, contains mostly apatite crystals and little or no organic (collagen) matrix; Tubules are separated by intertubular dentin, which has a composite structure, consisting of a matrix of type I collagen reinforced by apatite- this arrangement means that the volume of intertubular dentin in a given area of dentin will vary by location, because tubule density tends to increase as you approach the pulp from the DEJ

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30
Q

Odontogenesis

A

The development of teeth and their supporting structures from embryonic tissues; The cells responsible for dentin formation are called odontoblasts- they differentiate from the outer cells of the dental papilla in the Bell Stage of tooth development; the pulp develops from the central cells of the dental papilla; the basement membrane represents the location of the future DEJ; because dentin and pulp have similar embryonic origins, these 2 tissues are commonly referred to as the dentin-pulp complex

Odontoblasts continue to make dentin throughout the life of the cell; they can be found on the outer wall of the pulp, immediately medial to the advancing wall of dentin; Because odontoblasts rest just inside the dentin and line the walls of the pulp chamber, the dentin-pulp complex is considered to be a vital tissue

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31
Q

Dentin tubules

A

Tubules are a distinct feature of dentin; they represent the tracks taken by odontoblasts as they retreat from the DEJ and appear as tunnels, traversing the dentin from the DEJ to the pulp. The tubules converge as they approach the pulp chamber and therefore tubule density and orientation varies from location to location

pain is the only info they send to brain; close the the pulp wider; closer to DEJ, smaller (more difficult to report pain- more time to do restoration than root canal)

The content of the tubules are odontoblastic processes and fluid; the extent that the odontoblastic process occupies the tubules has not been conclusively established, but it is believed that it extends to the DEJ

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32
Q

Types of dentin

A

The morphology of dentin varies with location and is altered by aging and disease; Primary dentin is formed by odontoblasts before the tooth erupts while secondary dentin is formed by odontoblasts after tooth eruption; tertiary dentin is reparative dentin that forms quickly and in a very localized manner in response to trauma (caries, cavity prep, attrition, etc. ) [ it is only found under dentinal tubules that have been exposed to trauma, at the outer pupal wall

Transparent dentin (sclerotic) is a type of tertiary dentin that develops following trauma, and is characterized by the tubules being partially occluded with mineral (for pulp protection) ; many types of transparent dentin have been described; the nature of the mineralization is both heterogenous and complex, and has been described in detail elsewhere bonding is a problem because the tubules are closed- etching must be different]

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33
Q

Smear layer

A

When dentin is cut or abraded with a rotary instrument, a smear layer forms (junk on top); the smear layer is a collective term for any debris left on a tooth surface following tooth preparation; This debris consists of chips of enamel and dentin, and organic matter that are resting or burnished onto the surface or into the dentinal tubules; the smear layer serves to occlude the tubules and reduce dentinal permeability, thereby providing a protective effect; however it hinders dental bonding, so it should be either removed or modified before the bonding procedure

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34
Q

Acid etching

A

Also known as conditioning; removes the smear layer and alters the external lumen of tubules, allowing better infiltration by bonding agents; as dentinal surfaces are conditioned with acid, peritubular dentin is preferentially removed since it has no organic component. The tubule lumen widens with etching creating a funnel shape that can be less retentive due to its flared nature. Longer acid etching of dentin flares the tubule lumen even further

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35
Q

Etching transparent dentin

A

Transparent dentin has a different outcome in conditioning, because the tubules are occluded with mineral- this mineral in the tubules can be very heterogeneous in its response to acid conditioning, depending upon the stimulus which led to its formation; after etching transparent dentin, peritubular dentin is preferentially removed, but the tubules may continue to retain plugs of precipitated mineral which make bonding to transparent dentin even more difficult

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36
Q

Dentin conditioning

A

Dentin is a composite material, consisting of a mineralized component (HA), and an organic component (type I collagen); acid etching removes the smear layer; acid etching also removes the mineralized component of intertubular dentin, leaving a network of collagen fibrils; engaging this network of collagen fibrils and dentinal tubules with bonding agents forms the micro-mechanical basis for dentin bonding

An important element of dentin bonding technique is to keep the demineralized dentin moist; if demineralized dentin is dried, the dentin matrix shrinks and becomes matted, making the collagen fibrils and dentinal tubules difficult to penetrate with bonding agents

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37
Q

Physical and Mechanical properties of enamel and dentin

A

Look at slide 73 on PP 1

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38
Q

The DEJ Magne and Belser

A

“The assembly of two tissues with distinctly different elastic moduli requires a complex fusion for long term functional success. Stress transfer in simple bilaminate structures with divergent properties usually induces increased focal stresses at the interface.”

“If enamel and dentin at the functional surfaces of a tooth comprised such a simple bilaminate, enamel-initiated cracks would easily cross the DEJ and propagate into dentin.”

“In reality, the situation is quite different…multiple enamel cracks…seldom affect the structural integrity of the enamel-dentin complex.”

“The explanation lies in…a complex fusion at the DEJ, which can be regarded as a fibril-reinforced bond.”

“[At] the DEJ…parallel, coarse collagen bundles (probably von Korff fibers of mantle dentin) form massive consolidations that can divert and blunt enamel cracks through considerable plastic deformation.”

“The structure of the DEJ shows two levels of scalloping, which [serves to] increase the effective interfacial area and strengthen the bond between enamel and dentin. The scalloping is most prominent where the junction is subject to the most functional stresses.”

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39
Q

DEJ

A

The morphology of the DEJ begins at the earliest developmental stage of the tooth crown; Any other sequence would not allow the creation of such a complex dentinoenamel fusion;

During odontogenesis, before the cells of the inner enamel epithelium (IEE) differentiate into preameloblasts, and the outer cells of the dental papilla differentiate into odontoblasts, they are separated by a basement membrane (represents the future location of the DEJ)

Once the cells of the IEE differentitate into preameloblasts, they stimulate the outer cells of the dental papilla to differentiate into odontoblasts. The odontoblats then begin secreting dentin matrix on their side of the basement membrane, retreating into the central cells of the dental papilla as matrix and dentin is formed

At this point, the basement membrane disintegrates, preameloblasts differentiate into ameloblasts, and the ameloblasts begin secreting enamel matrix. The junction of enamel and dentin is established as these 2 hard tissues begin to form

Before enamel forms, some of the developing odontoblastic processes extend into the ameloblast layer; When enamel formation begins, these odontoblastic processes become trapped as enamel spindles. Von Korff fibers in mantle dentin also cross the DEJ into enamel to further integrate these tissues

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40
Q

DEJ photos

A

cracks in enamel do not extend into dentin but instead stop at the scalloped DEJ

Have large scallops in molars, but smaller scallops in anterior teeth

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41
Q

Summary of Oral Hard Tissues

A

Enamel and dentin are oral hard tissues with profoundly different morphological and mechanical properties

Bonding dental materials to enamel and dentin is technique-sensitive and requires treating each as a unique tissue

Enamel and dentin bonding is micromechanical

Natural teeth, through the optimal combination of enamel and dentin, demonstrate the perfect and unmatched compromise between stiffness, strength and resilience

Restorative procedures and alterations in the structural integrity of teeth can easily violate this balance

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42
Q

What hostile environments are restorative dental materials subjected to?

A
pH
Saliva
Chewing- occlusion
Mechanical loads- depending where food is at
(temp too)
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43
Q

Research is necessary to develop products that are clinically appropriate materials

A

Must understand the properties of the different materials

Polymers- composites (powder/liquid mixed –>activated; light cure)
Ceramics
Metals

In order to conclude that a material is appropriate for clinical use we need to evaluate all kind of properties.
In vitro research is just a simulation of what we might get clinically … So… to be able to have a clinical relevance we need to set up clinical trials.
In vitro research allow us to standardize measures to compare materials and guiding the interpretation of clinical trials.
In the lab we try to simulate as much as we can the clinical conditions.
-Size
-Shape
-Conditions (temperature, proportions, humidity, etc)

When we restore a (caries, fractured) tooth it is important to select a materials that is adequate, but we need to take into account the quality of the substrates (enamel, dentin, cementum, proximity to the pulp) that we will restore

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44
Q

Different material properties

A
Mechanical
Thermal
Electrical
Electromechanical
Optical
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45
Q

Mechanical Properties

A

When we restore a tooth, we expose that restoration to challenges:
chemical- acids (lemonade, OJ)
Thermal- different temp
Mechanical- wear

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46
Q

Force

A

One body interacting with another generates a force.
Applied
- Contact of the bodies
- Distance (Eg. Gravity)

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47
Q

Results of Force

A

Deformation (rigid or deformable and constrained)

- Constrained (no movement or translate) = 		deformation or change its shape
- Free of constrains = movement or translate
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48
Q

Occlusal forces

A

The force applied on opposing teeth when the jaws are closed; posterior teeth are stronger (surface area, anatomy, muscles)
Max occlusal forces ranges from 200- 3500N

Occlusal forces are increased in posterior regions and decreased in anterior regions.

  • Forces on 1st and 2nd molar vary from 400- 800 N.
  • Average forces on the bicuspids, cuspids, and incisors is about 300, 200, 150 N respectively

Children growing up show an increase in force from 235- 494 N with an average increase yearly of about 22N

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49
Q

Forces on restorations

A

Patients with dental prosthetic devices decrease occlusal forces. about 65-235 N (partial dentures), about 100 N molars and bicuspids (complete dentures) and about 40 N incisors (complete dentures)

dentures cause face changes- lose bone therefore lose strength

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50
Q

Age and gender variations on occlusal forces

A

Women occlusal forces is about 90 N less than men; facial form and muscles can be predictors of occlusal forces (low angles and square mandibular form=high occlusal forces)

Males stronger than female; female have a more delicate facial structure; some people have strong masseters (usually square shaped)

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51
Q

Changes of max occlusal forces

A

Max occlusal forces and response of underlying tissues changes with:

  • Age
  • Anatomic location
  • Occlusal Scheme (contacts that upper teeth have with lower teeth; as the form and the arrangement of the occlusal contacts in natural and artificial dentition)
  • Placement of dental prosthesis (removal vs permanent)
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52
Q

Stress

A

When a force acts on a constrained body, the force is resisted by the body and the internal reaction is equal in magnitude and opposite in direction to the applied external force and is called stress (S or σ)

The applied force and internal resistance (stress) are distributed over an area of the body

stress= Force (N)/area

  • Pascal (1Pa -1N/m2=1MN/mm2)
    • mega Pascals (MPa) or millions of Pascals = 1MPa = 106 Pa
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53
Q

Types of stress

A

A force can be applied from any angle or direction

Complex stress= several forces

It is rare for forces and stress to be isolated to a single axis

Individually applied forces can be defined:

Axial- applying load along the axis (occlusion)

- Shear- removal of bracket; like cut
- Bending- 
- Torsional- endo files

All stresses can be resolved into combinations of 2 basic types: axial and shear

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54
Q

Tension stress

A

Results from 2 sets of forces directed away from each other in the same straight line; bonding agents (hydrophobic/ hydrophilic)?

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55
Q

Compression stress

A

results from 2 sets of forces directed toward each other in the same straight line

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56
Q

Axial- Compression stress

A

Compress or shorten

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57
Q

Axial- tensile stress

A

stretch or elongate

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58
Q

shear stress

A

2 sets of forces directed parallel to each other, but not along the same straight line

A stress that tends to resist the sliding or twisting of one portion of a body over another

Ex. orthodontics bracket removal ; like cutting?

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59
Q

Torsion stress

A

Resulting from the twisting of a body ex. endo files

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60
Q

bending or flexural

A

results from an applied bending movement

Modulus of rupture, bend strength or fracture strength is a material property, defined as the stress in a material just before it yields in a flexure test.
Depending when apply the load you can have different types of stress

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61
Q

Elasticity of solid bodies

A

Compression- resist to be forced more closely

shear- one portion of the body must resist sliding past another

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62
Q

Strain

A

Deformation in a body due to stress

Strain = ε = change in the length (ΔL= L-Lo)

Strain (ε)= Deformation/Original Length
= (L-Lo)/Lo= ΔL/Lo
It is reported as a percentage

*Lo=Change in length

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63
Q

Stress- Strain Curve

A

Amount of deformation (strain) at distinct intervals of tensile or compressive loading (stress)

If a bar of a material is subjected to an applied force (F) the magnitude of the force and the resulting deformation (δ) can be measured….. But we can apply the same F to another bar with different dimensions and that other bar will suffer different force-deformation characteristics.

If the applied F is normalized by the cross-sectional area (A) of the bar (stress) and the deformation is normalized by the original length of the bar (strain), the resulting stress-strain curve is independent of the geometry of the bar

It is better to report the stress-strain curve of a material rather than the force-deformation characteristics.

Stress-strain relationship = measure load and deformation and then calculate the corresponding stress-strain

Universal testing machine

If we assumed that the cross-sectional area of a specimen remains constant during the testing then S-ε curve is engineering S-ε

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64
Q

Stress- Strain curve Example

A
  • Look at graph

A=PL proportion limit- will come back to original (marble will have a higher vs glass) – stress and strain are linearly proportional [after exceed PL can not come back (deformation); straight line)
B=yield point (constants: 0.1, 0.2. 0.3, 0.5 [doesn’t change the results]; most common is 0.2)- way to calculate in a more accurate way- (constant of the behavior of the material) starts acting like a plastic material
Difficult to calculate proportional limit (arrrow in graph)
C= ultimate tensile strength- max stress before failure
D= fracture point (strength)

Elastic limit is not known on this graph

Elastic region- can return to original shape, size
Plastic- will never return to initial dimensions

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65
Q

Proportional Limits on Stress Strain Curve

A

Plastic deformation from PL to failure point (FP)

The value of the stress at A is known as proportional limit (PL)
- (Spl or σpl) below the PL = no permanent deformation, material is elastic in nature.
After PL= permanent deformation, irreversable strain occurs = plastic region = non-linear
Super elastic materials (exception)

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66
Q

Elastic Limit on Stress Strain Curve

A

Elastic deformation it is up to the proportional limit (PL)

(SEL or σEL)
Is the maximum stress that a material will withstand without permanent deformation
Elastic limit and proportional limit differ in fundamental concepts
-Elastic limit: describes the elastic behavior of the material region)
-Proportional limit: deals with the proportionality of strain to stress in the structure (slope)
***So they are different values

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67
Q

Yield strength (YS or σY) on stress strain curve

A

The stress at which the materials begin to function in a plastic manner
At YS a small defined amount of permanent deformation has occurred in the material.
Amount of permanent strain is indicated as 0.1%, 0.2% (often) or 0.5% = offset

Stiff material (small elongation) will have a greater offsets than material with larger elongation or deformation.
Elastic limit and yield strength define the transition from elastic to plastic behavior
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68
Q

Ultimate strength on stress strain curve

A

Ultimate tensile strength or stress (UTS): Maximum stress that a material can withstand before failure in tension

Ultimate compressive strength (UCS): Maximum stress a material can withstand in compression before failure in compression

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69
Q

Fracture strength or fracture stress

A

Point at which a brittle material fractures

if the material does not fracture at the point at which the max stress occurs they might elongate resulting in necking

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70
Q

Elongation

A

Deformation as a result of the application of a tensile force.
Divided in 2:
1. Increase in length of specimen below the PL (0-A) = not permanent
2. Increase in length of specimen after PL (A-D) = permanent
Total elongation is reported as a %
%Elongation = (Increase in length/original length) *100%

An alloy with high value for total elongation can be bent permanently without danger of fracture

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71
Q

Elastic modulus or Modulus of elasticity or Young modulus

A

The measure of elasticity of a material is descirbed by the term elastic modulus = E; modulus = ratio.
E= stiffness of a material within the elastic range.
E= stress/strain; E=S/ε
Units GPa or MPA (1GPa=1000MPa)

To calculate E select 2 stress and 2 strains coordinates in the elastic or linear range .
The slope is therefore:
(σ1 -σ2 )/(ε1- ε2)

Relative rigidity or stiffness of the material within elastic range
Young’s modulus of elasticity
Elastic modulus = Stress/Strain

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72
Q

Poisson’s Ratio

A

During axial loading in tension or compression there is a simultaneous strain in the axial and transverse or lateral directions.(Relative change in lateral dimension and elongation in the longitudinal direction)

Tensile loading: as material elongates in load direction = reduction in cross-section known as “necking” during elastic deformation and deformation continues until the material is fractured.

Compressive loading: increase in cross sectional within elastic range, the ratio of the lateral to the axial strain is called “Poisson’s Ratio”.

Is unitless value because it is ratio of two strains

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73
Q

Ductility

A

Ductility: Its ability to be drawn and shaped into a wire by means of tension ex. Orthodontics

Eg. Gold and silver: are used extensively in dentistry because are the most malleable and ductile materials

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74
Q

Malleability

A

Malleability: Its ability to be hammered or rolled into thin sheets without fracturing

Eg. Gold and silver: are used extensively in dentistry because are the most malleable and ductile materials

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75
Q

Resilience

A

Resistance of a material to permanent deformation

Is an indicator of the amount of energy necessary to deform the material to the PL.
Area under the elastic portion of the S-εcurve
Units: mMN/m3 or mMPa/m

Ex. Mouth guards- need resilient material

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76
Q

Toughness

A

Resistance of a material to fracture
Indication of the amount of energy necessary to cause fracture.
Units: mMN/m3 or mMPa/m

includes all aspects of the SS curve

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77
Q

Fracture toughness (KIc)

A

The ability to be plastically deformed without fracture, or the amount of energy required for fracture.
It is proportional to the energy consumed in plastic deformation

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78
Q

Stiffness

A

Is the RIGIDITY of an object
The extent to which it resists deformation in response to an applied force
The more flexible an object is less stiff

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79
Q

Properties and S- E curves

A

The slope of S-ε curve and the magnitude of the stress and strain allow classification of materials with respect to their general properties

The properties of stiffness, strength and ductility are independent
Materials may exhibit various combinations of these 3 properties

*** look at graphs on slide 52

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80
Q

Tensile properties of brittle materials

A
Brittle materials are difficult to test because they fracture easily.
Grips
Slow loading
Axial tensile loading 
Low stress on the material
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81
Q

Viscosity

A

The mechanical properties of many dental materials (alginate, elastomeric, waxes, amalgam, polymers) and substrates (bone, dentin, etc) depend on how fast they are loaded

Materials with mechanical properties dependent of loading rate and with viscous and elastic behavior are = Viscoelastic

Materials with mechanical properties independent of loading rate = Elastic (strain is produced when load is applied)

Other materials exhibit a “Lag” response to load = Viscoresponse.

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82
Q

Fluid behavior and Viscosity

A

Same materials are solid dental materials that show some fluid characteristic or many dental materials, such as cements and impression materials are in the fluid state when formed

Therefore, fluid (viscous) phenomena are important.
Viscosity (η) is the resistance of a fluid to flow and is equal to the shear stress/shear strain rate
Or,
η = τ/[dε/dt]
Units: poise, p (1p= 0.1 Pa; S= 0.1Ns/m2) or centipoise (100cp = 1p)

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83
Q

Viscoelastic materials

A

In this case the strain rate can alter the stress-strain properties
Eg. Tear strength of alginate increases ≈ 4 times when rate of loading is increased from 2.5 to 25 cm/min (remove quickly from mouth to increase tear resistance)

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84
Q

Dynamic Mechanical Properties

A

Involves cycling loading or loading at high rates (impact).

Dynamic Modulus (ED)

The ratio of stress to strain for small cyclical deformations at a given frequency and at a particular point on the stress-strain curve.
ED=mqp2
m= mass of the loading element
q= height/twice the area of the cylindrical specimen
p= angular frequency of the vibrations

Ex. endo files

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85
Q

Hardness

A

Surface Mechanical Properties

Resistance to permanent surface indentation or penetration

-A measure of the resistance to plastic deformation and is measured as a force per unit area of indentation

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86
Q

Friction

A

Surface Mechanical Properties

The resistance between contacting bodies when one moves relative to another.

The friction force (Fs) is proportional to the normal force (FN) between the surfaces and the (static) coefficient of friction (μs)
Fs=μs FN

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87
Q

Wear

A

Surface Mechanical Properties

Is a loss of material resulting from removal and relocation of materials through the contact of two or more materials

Types of wear:
Adhesive wear
Corrosive wear
Surface fatigue wear
Abrasive Wear

Examples:
Metals: are susceptible to adhesive, corrosive and three body wear
Polymers: are susceptible to abrasive and fatigue wear

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88
Q

Adhesive wear

A

formation and disruption of micro junctions.

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89
Q

Corrosive wear

A

Secondary to physical removal of protective layer and it is related to the chemical activity of the wear surfaces (common in metals)

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90
Q

Surface fatigue wear

A

free particles with small areas of contact contribute to high localized stress and produce surface cracks.

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91
Q

Abrasive Wear

A

Involves a harder material cutting into a softer material ex. crowns

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92
Q

The colloidal state

A

Colloid is used now to describe a state of a matter rather than a kind of matter.

The main characteristic of colloidal materials is their high degree of microsegmentation.

These fine particles also have certain physical properties, such as electrical changes and surface energies that control the characteristics of the colloids.

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93
Q

Nature of colloids

A

Substances are called colloids when they consist of two or more phases, with the units of at least one of the phases having a dimension slightly greater than simple molecular size.

Size ≈1 to 500 nm in maximum dimensions

Colloidal state represent a highly dispersed system of the fine particles

They can be fine dispersions:
-Gels (hand sanitizer) – Films – Emulsion - Foams

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94
Q

Typical Colloid Systems

A

Divided in Sol and Gel

Sol resembles a solution, it is made up of colloidal particles dispersed in a liquid. When we add suitable chemicals the Sol can be transformed to GEL = semisolid, jelly like quality.

The liquid phase of a GEL or Sol is usually water or an organic liquid such as alcohol.

When it is water = hydrosols or hydrogels = hydrocolloids

Ex: In dentistry (alginate gels)

When the system has an organic liquid as a component = organosol or organogel.

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95
Q

Diffusion through membranes and Osmotic pressure

A

Osmotic pressure is the pressure developed by diffusion of a liquid or solvent through a membrane.

Osmotic pressure has been used to explain the hypersensitivity of dentin.

The changes in pressure in carious, exposed dentin from contact with saliva causes diffusion throughout the structure that increases or decreases the pressure on the sensory system.

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96
Q

Adsorption

A

A liquid or gas adheres to the surface of a solid or liquid firmly by the attachment of molecules, decreases their surface free energy

Ex. Alginate (viscoelastic material)- don’t want it too wet; external

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97
Q

Absorption

A

The substrate diffuses into the solid material by a diffusion process, and the process is characterized by concentration of molecules at the surface (Eg. alginate = swelling)

fuses into- in alginate

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98
Q

Sorption

A

When adsorption and absorption exist at the same time and it is unknown which one predominates.

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99
Q

surface tension and wetting

A

Measured in terms of force (dynes) per centimeter of the surface of liquid.

Surface tension is a contractive tendency of the surface of a liquid that allows it to resist and external force.

The wetting power of a liquid is represented by its tendency to spread on the surface of the solid. And it measure by the degree to which something can be wet.

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100
Q

Color

A

The perception of color is the result of a physiological response to a physical stimulus.

The sensation is a subjective experience, whereas the beam of light, which is the physical stimulus that produces the sensation is entirely objective

color of an object is determined on the spectrum and the intensity of the incident light on it and the changes of the light in contact with it as well. Consequently, the color is determined on the reflected light composition (wavelengths). A body, reflecting particular spectrum range to the white light and absorbing the rest, is colored with the color of the reflected light

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101
Q

Grassman’s Law

A

The eye can distinguish differences in only 3 parameters of color.

These parameters are dominant wavelength, luminous reflectance, and excitation purity.

The dominant wavelength (λ) of a color is the wavelength of a monochromatic light that, when mixed in suitable proportions with an achromatic color (gray), will match the color perceived.

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102
Q

Light

A

Electromagnetic radiation resulted in changes of the state of electron cover, including ultraviolet, infrared and x ray radiation

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103
Q

Dual character

A

steam of material particles- photons wide spreading as electromagnetic wave

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104
Q

Visible light

A

has wavelength in a range of ~380 nm to about 760 nm with a frequency range of ~405THz to 790 THz

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105
Q

polychromatic

A

When light is refracted by a prism, dispersion causes separation of colors ROYGBV. Consequently, the white light is polychromatic, which is a mixture of the various wavelengths

106
Q

Coulor and brightness

A

For an object to be visible, it must reflect or transmit light incident on it from an external source
The reflected light intensity and the combined intensities of the wavelengths presented in the incident and reflected light determine the appearance properties- hue, value, and chroma
Consequently, to understand the color, we have to know the nature of the optical processes reflection, refraction, and absorption

107
Q

Reflection

A

Reflection of light is either specular (mirror like) or diffuse depending on the nature of the interface

108
Q

Brightness

A

color property, expressed mainly in metals. It depends on quantity of reflected light
High brightness- nearly all incident light is reflected

109
Q

Mirror- like reflection

A

the incident angle is equal to the reflected angle

110
Q

Scattered diffusive reflection

A

When the surface roughness is higher than the incident light wavelength

111
Q

Directed diffusive reflection

A

If the surface roughness is commensurable with the incident light wavelength

112
Q

Reflection in dentistry

A

In dentistry mirror like reflection of ceramic construction can be resulted only if the opaque layer is backed in temperature higher than recommended. After correct backing the opaque porcelain diffusively reflects the light

113
Q

Refraction

A

the change in direction of a wave due to change in its speed. This is commonly observed when a wave passes from one medium to another

114
Q

Absorption

A

the property of the material to let the light pass through it

115
Q

opacity

A

Is a property of materials that prevents the passage of light.
When all the colors of the spectrum from a white light source such as sun light are reflected from an object with the same intensity as received, the object appears white.
When all the spectrum colors are absorbed equally, the object appears black.

the object does not let the incident light to pass through it. An opaque substance transmits no light, and therefore reflects, scatters or absorbs all of it

116
Q

Black body

A

absorbs all light

117
Q

white body

A

reflects all light

118
Q

transparency

A

nearly all the light passes through an object

119
Q

glass

A

Can be used as a standard for transparency- about 90% of incident light can pass through it

120
Q

translucency

A

Is a property of substances that permits the passage of light but disperses the light, so objects cannot be seen through the material
(Eg. ceramics, resin composite, and acrylics)

Not all, but some light passes through it

121
Q

Semi-transparent object

A

Matt glass; with transparency coefficient of about 50%

122
Q

metamerism

A

properties of the materials to have different colors in illuminating by different light sources.

Metameric colors are color stimuli of identical tristimulus values under a particular light source but with different spectral energy distributions.

Under some lights the pairs would appear to match, but under other lights they would be different whenever possible, shade matching should be done in conditions where most of the patients activities will occur.

Daylight, incandescent and fluorescent lamps are common sources of light in the dental operatory or aboratory, and each of these have a different spectral distribution. Objects that appear to be color matched under one type of light may appear different under another light source

123
Q

metameric pair

A

a pair of objects whose colors match when viewed in a described way but which do not match if the veiwing conditions are changed

124
Q

Opalescence

A

opalescent materials- Materials that are able to scatter shorter wavelength of light (Eg. Dental enamel)
Mimic the natural appearance of the tooth
(Eg. Porcelain veneer, and resin composite)

Originating of a rainbow inside a material with little opacity due to the interference of light waves owing to the inside defects and microstructural inhomogeneity. The phenomenon is named after the appearance of opals

125
Q

Teeth opalesence

A

is result of interaction of light with enamel prisms- refraction, reflection and interference

126
Q

Luminescence

A

the property to absorb the energy and to emit as visible light

2 types: fluorescence and phosphorescence

127
Q

Fluorescence

A

Is the emission of luminous energy by a material when a beam of light is shone on it

Emission of light by a substance that has absorbed light of other electromagnetic radiation of a different wavelength.

In most cases, emitted light has a longer wavelength.

fluorescence as distinguished from phosphorescence does not persist for an appreciable time after the termination of the excitation process

128
Q

phosphorescence

A

a specific type of photo luminescence related to fluorescence. Unlike fluorescence, a phosphorescent material does not immediately re-emit the radiation it absorbs and emits it a long time after excitation

129
Q

In dentistry

A

Natural tooth structure absorbs light at wavelengths too short to be visible. These wavelengths between 300-400nm are referred to as near IV radiation.

Natural sunlight, photo flash lamps, certain types of vapor lamps and UV lights used in decorative lighting are sources containing substantial amounts of near IV radiation.

The energy that the tooth absorbs is converted into light with longer wavelengths in which case the tooth actually becomes a light source- the fluorescence process
The emitted light, a blue-white color, is primarily in the 400-450nm range

Ex. a person with ceramic crown or composite restoration that lack fluorescent agent appear to be missing teeth when viewed under a black light in a night club

130
Q

Color parameter

A

(visual method) munsell color system is color space that specifies colors based on 3 color dimensions: hue, value, chroma

Hue- measured by degrees around horizontal circles (as you move around the center)

Chroma- measured radially outward from the neutral vertical axis (as you move from center outwards)

Value- changes from top to bottom; measured vertically from 0 (black) to 10 (white)

131
Q

Hue

A

describes the dominant colors of an object- red, green, or blue. This refers to the dominant wavelengths present in the spectral distribution. The continuum of these hues creates the color solid

Light having short wavelengths (400nm) is violet in color, and light having long wavelengths (700nm) is red. Between these two λ’s are those corresponding to blue, green, yellow, and orange light. This attribute of color perception is also known as hue.

132
Q

Value

A

Identifies the lightness or darkness of a color

The quality lightness or darkness. That is black is a dark value or low value. White is a light value or high value

It increases towards the top to white (value= 10) decreases toward the bottom to dark or more black (value=0) and can be measured independently of the hue. Neutral grays lie along the vertical axis between black and white

133
Q

Chroma

A

represents the degree of a saturation of a particular hue; The quality of a color’s purity, intensity or saturation.

Example:  A gray color is a neutral – an extreme low chroma Fire-engine red maybe a high-chroma 			     red. Brick red maybe a middle-chroma red

It varies horizontally in Munsell system. The higher the chroma, the more intensive the color. Chroma is not considered separately in dentistry. It is always associated with hue and value of dental tissues, restoration and prostheses. In changing the chroma, the value also has to be changed. The higher the chroma, the darker the value

134
Q

Color wheel

A

color wheel or circle is an abstract illustrative organization of color hues around a circle, that show relationships between primary colors, secondary colors, complimentary colors, etc.

Primary colors- red, yellow, blue
secondary colors- green, orange, and violet

complimentary colors- pairs of colors that are “opposite” hue in the color wheel
ex. Red and green

135
Q

Systems for color determination

A

in the dental operatory or lab, color matching is usually performed by the use of a shade guide to select the color of ceramic veneers, inlays or crowns to be made by a lab tech.

Using these shade tabs, one can specify the color characteristics (hue, value, chroma) and translucency to the tech who will produce the proper appearance in the lab.

If the tech can see the actual teeth, the probability of achieving an acceptable color match is even greater

136
Q

VITA shade guide

A

most commonly used for determining the teeth color in dentistry. The arrangement of the shades in the VITA classical A1-D4 shade guide is as follows:

A1-4 (reddish-brownish)
B1-4 (reddish-yellowish)
C1-4 (greyish shades)
D2-4 (reddish- grey)

The chroma increases and the value decreases with increasing the number from 1 to 4

137
Q

Tips for shade taking

A

if possible, determine the shade under daylight conditions or standardized daylight lamps, and not under normal indoor lighting conditions.

The shade taking environment should preferably be in muted colors. Patients should be asked to remove lipstick or any cosmetic which could have an influence on shade taking. Clothing in pronounced colors should be covered with a grey overall.

Make your choice swiftly; always accept your first decision, since the eyes begin to tire after ~ 5-7sec

138
Q

CHROMASCOP shade guide

A

same principle of arrangement like VITA shade guide- increasing of the number shows increasing the chroma and decreasing the value of the color. All 20 tooth shades are positioned on individual supports that can be removed from the shade guide for detained shade selection.

Differences:
5 color groups: 100, 200, 300, 400, 500
Designation- only by number

139
Q

Tips for shade selection

A

for the accurate selection of the tooth shade, the surrounding conditions and the correct procedures should be observed. Color of the room: neutral colors (ex. grey) with only minor color effects; artificial light: ideally a daylight lamp (D65) with an illumination of 1200-1500 lux. Daylight: northern light, preferably at 10’o clock in the morning. Patient: cover clothes with a neutral cloth

140
Q

More tips

A

Carry out shade selection prior to the actual treatment. Prevent the teeth from dehydrating. Determine the amber or grey color type of the patient according to the Ivoclar Vivaddent color typology. Determine the definite base shade of the patient and remove the corresponding shade group. Determine the shade intensity within the shade group. Compare the selected shade once again with the natural tooth

141
Q

Technological properties

A

technology (technological process) is combination of different methods and operations for treatment of materials. Technological properties- determine the possibility for treatment of materials in definite conditions: plasticity, fluidity of molten metal, welding ability, etc.

142
Q

plasticity

A

technological and mechanicl property of a material to undergo permanent deformation under load

In dentistry, waxes, restorations, and impression materials possess this property. The plasticity of metals and alloys is used in forgin, stamping rolling and drawing processes

143
Q

Fluidity of a molten metal

A

ability of a molten metal to flow and fill a channel or cavity

Factors influencing the fluidity:
chemical composition of the alloy
viscosity- the higher viscosity, the lower fluidity of the molten metal
Temperature of over heating the molten metal above the melting point- the fluidity increases with its increasing temperature. But the excessive overheating leads to increasing of the molten reactivity resulting in formation of undesired compounds- oxides, nitrides, carbides, etc.
The temperature interval of melting- the narrower interval leads to the higher fluidity
the pressure on the metal during casting process- the fluidity increases with increasing pressure

144
Q

Methods for measuring fluidity

A

method of Kaminski- the test specimen is of mesh type, consisting of 100 squares (10X10 mm) made of wax. The material is of high fluidity if all the squares are filled.

145
Q

weldability

A

also known as joinability, of a material refers to its ability to be welded.

A materials weldability is used to determine the welding process and to compare the final weld quality to other materials.

2 main methods of welding:
by melting
by pressure

146
Q

Meaurement of color

A

Dental restorative materials are most commonly measured in reflected light using a color measuring instrument or a visual method

Instrument
Curves spectrol reflectance (%) vs wavelength (nM0 can be obtained over the visible range (405-700nm) with a spectrophotometer integrating sphere

147
Q

surface finish and thickness

A

when white light shines on a solid, some of the light is directly reflected from the surface and remains white light

This light mixes with the light reflected from the body of the material and dilutes the color. As a result, an extremely rough surface appears lighter than a smooth surface of the same material

Ex. unpolished or worn glass ionomers, resin composite restoration

148
Q

Pigmentation

A

esthetic effects are sometimes produced in restorations by incorporating colored pigments in non metallic materials (resin composites, dentures, ceramic)

When colors are combined with proper translucency, restorative materials can be made to closely match the surrounding tooth structure or soft tissue

149
Q

Index of refraction

A

is the ratio of the velocity in a vaccum (or air) to its velocity in the medium. When light enters a medium, it slows from its speed in air (300,000 km/sec) and may change direction

150
Q

optical constants

A

As light interacts with an object, several phenomena can be observed. Incident light reflected, absorbed, scattered (or backscattered) or transmitted

These parameters can all be calculated to more objectively characterize the optical properties of the materials

151
Q

Scattering coefficient

A

the fraction of incident light flux lost by reversal of direction in an elementary layer
Scattering coefficient, S.
S = (1/bX) Ar ctgh [1-a(R+Rg) +RRg/b (R-Rg)], mm-1

152
Q

Absorption coefficient (s)

A

The fraction of incident light flux lost by absorption in an elementary layer. The absorption coefficient, K, for a unit thickness of material is define as follows:
K= S (a-1), mm-1

153
Q

Light Reflectivity (RI)

A

Is the light reflectance of a material of infinite thickness, and is defined as:
RI=a-b

154
Q

masking ability

A

dental restorations are often used to restore esthetic problems even when carious lesions are not present.

The ability of masking depends on optical constants and thickness of the dental materials used

155
Q

Temperature

A

We can measure the temperature of a substance with a thermometer or a thermocouple

In dentistry temperature has an important applicability because we need to measure the heat produced during different procedures (Eg. cavity preparation and resin composite polimerarization) because the heat can affect other tissues (pulp and gums) and produce pain or irreversible pulpitis.

156
Q

Transition temperatures

A
The arrangement of atoms and molecules in materials is influenced by temperature. As a result, thermal techniques are important in understanding the properties of dental materials
Some of the techniques:
	-Differential thermal analysis (DTA)
	-Thermo-mechanical analysis (TMA)
	-Dynamic mechanical analysis (DMA)
157
Q

Heat of Fusion (L)

A

Is the heat in calories, or joules, J, required to convert 1g of material from solid to liquid state at the melting temperature

L=Q/m

158
Q

Thermal Conductivity (K)

A

Is the quality of heat, in calories, or joules, per second passing through a body 1 cm thick with a cross section of 1 cm^2 when the temperature difference is 1°C.

Units: cal/sec/cm2/(°C/cm)

159
Q

Specific Heat (Cp)

A

Is the quality of heat needed to raise the temperature of 1g the substance 1°C

160
Q

Thermal Diffusivity(Δ)

A

Is a measure of transient heat-flow and is defined as the thermal conductivity, K, divided by the product of the specific heat, Cp, times the density, ρ
Δ = K/(Cp p) Units: mm2/sec

161
Q

Coefficient of thermal expansion

A

The change in length (lfinal – loriginal) per unit length of a material for a 1°C change in temperature is called the linear coefficient of thermal expansion, α, and is calculated as follows:
(lfinal – loriginal) /[ loriginal) x (°Cfinal - °Coriginal)] = α

162
Q

Electrical Conductivity and Resistivity

A

The ability of a material to conduct an electric current may be stated as either specific conductance or conductivity, or conversely, as the specific resistance or resistivity

163
Q

Dielectric Constant

A

A material that provides electrical insulation is known as a dielectric

164
Q

Electromotive force

A

Is the voltage developed by any source of electrical energy

165
Q

Galvanism

A

The presence of metallic restorations in the mouth may cause a phenomenon called galvanic action, or galvanism.

These results from a difference in potential between dissimilar fillings in opposing or adjacent teeth.

These filling in conjunction with saliva or bone fluids (electrolytes) make up an electric cell. When two opposing fillings contact each other, the cell is short-circuited, and if the flow of current occurs through the dental pulp, the patient will experience PAIN and corrosion in restorations.

Metallic restoration may cause galvanism. The restorations + saliva make up an electric cell and when two opposing restoration contact each other the cell is short circuited and can produce a flow of current affecting dental pulp and producing pain and corrosion in the restorations.

166
Q

Electrochemical corrosion

A

Corrosion that is accompanied by a flow of electrons, between cathodic and anodic areas on metallic surfaces

167
Q

Zeta potential

A

also called electrokinetic potential

the potential difference existing between the surface of a solid particle immersed in a conducting liquid (Ex. saliva, water) and the bulk of the liquid

168
Q

Tarnish and Discoloration

A

Lose of luster, especially as a result of exposure to air or moisture
color change
common in cements, resin composite restorations

169
Q

water sorption

A

represents the amount of water absorbed on the surface and into the body of the material during fabrication or while restoration or service

ex. dentures= dimensional changes due to water soprtion

170
Q

setting time

A

Time required for a specimen of X material to attain a specific degree of rigidity compared to the initial time

171
Q

shelf life

A

The general deterioration and change in quality of materials during shipment and storage (temperature, humidity, and time of storage)

172
Q

Compressive strength

A

when a specimen is tested in compression, failure might occur as a result of a complex stress in the object

Compressive forces= shear forces along the cone- shaped area at each end= tensile forces central portion of the mass

If we have a cylinder and compression forces are applied =as forces of shear along the cone-shape area at each end and, as a result of the action of the two cones on the cylinder = tensile forces in the central portion of the mass.

173
Q

Flexure and Flexural strength

A

When one loads a simple single beam supported at each end with a load applied in the middle (three point bending/ flexure stress)

The max stress measured in the test is called the flexural strength= max stress that it can withstand without breaking

174
Q

Permanent bending

A

normally use to measure the number of bends the specimen will withstand and to compare different composition and dimensions as well as its treatment in fabrication

Many dental restorations are subjected to permanent bending The adjustment of removable partial dentures clamps and the shaping of orthodontic wires are two examples of such bending operations.

175
Q

Diameter tensile strength

A

A test for tensile strength that is only used for materials that exhibit predominately elastic deformation and little or no plastic deformation (brittle)

176
Q

Shear strength

A

The maximum stress that a material can withstand before failure in a shear mode load

ex. removing brackets in ortho

177
Q

Torsion

A

Results in a shear stress and a rotation of the specimen

178
Q

Fatigue strength

A

Progressive fracture under repeated loading. Is the stress level at which a material fails under repeated loading. Fatigue test are performed by subjecting a specimen to alternating stress applications below its yield strength until fracture occurs (tensile, compressive, shear, bending, and torsion)

179
Q

Fracture toughness

A

a property which describes the ability of a material containing a crack to resist fracture, and is one of the most important properties of any material for many design applications

180
Q

Toughness

A

resistance of a material to fracture

181
Q

Fractographic Analysis

A

Fractography is the study of the fracture surfaces of materials; helps to define the cause of failures and aid in structural design, as well as to improve existing materials

182
Q

Tear strength and tear energy

A

Tear strength is a measure of the resistance of a material to tearing forces

ex. elastomaterial must have very high tear strength

183
Q

Hardness

A

The relative resistance of a material to suffer indentation, scratching or bending

Hardness testing is done by applying a standardized force or weight to an indenter

Ex. Brinell Hardness Test (spherical indentation piece; Test force F/ Surface area of indentation A), Knoop Hardness Test (diamond shaped, measure H and L), Vickers Hardness Test (pyramid shaped diamond indentor- 4 sided, measure length of the 2 diagonals; test force F/ Surface area of indentation A), Rockwell Hardness Test ( C braile, crate handle, made of conical diamond indentor) , Barcol Hardness Test (handle that must be tested at multiple locations), Shore A Hardness Test (testing rubbers and plastics, use durometer and test 12 different ways)

184
Q

Nano- Indentation

A

Many materials have micro or nano structural constituents such as resin composites (indenter needs to be small). Need to create indentations of a smaller size and spatially control the location of the indentation

Traditional indentation tests use loads as high as several kilograms and result in indentations as large as 100 μm … Those tests previously mentioned are valuable but they have limitations with recent technologies in the development of dental materials

Able to apply loads of ~0.1 to 500 mg- f resulting in indentations of ~1µm in size; eliminates the need to image the indentations to calculate the mechanical properties because the indentation depth is continuously monitored

If testing hardness usually using these

The nano-hardness of dentin = 696 MPa agrees with Knoop value = 666 MPa.
The nano-hardness of enamel = 4.48 MPa higher than with Knoop value = 3.36 MPa.
WHY? The smaller indentation used in nano-indentation test in relation to the size of the enamel rods (tiny)

Thanks to nano-indentation we obtained the dentin-enamel junction (values which is intermediate to the values for enamel and dentin) elastic modulus (53.2 GPa)

185
Q

Wear

A

Traditional wear test measures the volume of material lost but don’t reveal mechanism of wear

Has been studied by

  1. service or clinical testing
  2. simulated service measurements
  3. model systems using various wear machines
  4. measurements of related mechanical properties such as hardness
  5. exam of the amount and type of surface failure from a single or low number of sliding strokes

Important clinical points!!!!

- The resistant to wear of the composite resins to 	abrasion depends on the nature of the filler particles	 (glass or quartz) and on silanation of the filler.
- Enamel is ≈ 5 to 20 times more resistant to 	abrasion 	than dentin. Cementum is the least resistant to abrasion.
- After a 30 sec prophylaxis the fluoride can be removed from enamel substrate.
- Enamel can be remove from 0.6 to 4μm depending on 	the abrasive.
186
Q

Setting time

A

the time required for the reaction of the material to be completed; sometimes the reaction is too fast so it is needed to have an operator that works fast and sometimes its slow so needs longer time to cpmplete the operation. Proper setting time is very important

Measurement- the temperature rise of the mass, because the chemical reaction is exothermic

187
Q

working time

A

time after which the material can’t be manipulated without creating distortion in the final product

188
Q

final setting time

A

Very important characteristic of materials such as GYPSUM
The final setting time is defined as the time at which a material such as alginate can be withdrawn without distortion or tearing.

189
Q

Initial setting time

A

the time at which a certain arbitrary stage of firmness is reached in the setting process

Measurement- measured arbitrarily by some form of penetration test, although occasionally other types of test methods have been designed

Ex. Vicat apparatus is commonly used to measure it in gypsum products

190
Q

Dynamic Mechanical Analysis (DMA)

A

Through DMA some properties of materials can be measured, such as dynamic elastic modulus (E’) and glass transition temperature (Tg) in polymers

This property allows us to predict the strength and structure of the tested material and applicability in the clinical setting

191
Q

Rheology

A

The study of deformation and flow of materials;

Working and setting times in cements and direct filling composites have been transitionally determined through rheology, with the increase in viscosity monitored during setting

192
Q

Differential Scanning Calorimetry (DSC)

A

Another tool to determine temperature transitions in materials
Ex. Glass transition temperature (Tg) and melting temperature (Tm)

193
Q

Spectrometric Technique

A

Fourier transformed infrared (FTIR) spectrosccopy is useful for molecular characterization and for following chemical reactions

Vibrational characteristic of the chemical bonds between the atoms can produce interference in electromagnetic waves at highly specific wavelengths

194
Q

Pycnometry

A

A technique used to determine material density

195
Q

Bond Strength Test Methods

A

Abundant in dental literature because they are easy to perform and are not equipment intensive.

Can be characterized depending in the area as:
- Macro: (4-28 mm2) and Micro; (≈ 1mm2).
The tests can be tensile or shear.
Limitations:
-Stresses at the interface are not uniformly distributed
-Results of different studies are not comparable
-Bond strength tests lack clinical significance

-Stresses at the interface are not uniformly distributed: Debonding occurs due to stress concentration around a critical flaw or void, at the interface that causes a crack to propagate.
Results of different studies are not comparable: result values can vary a lot among studies due to differences in bonding substrates, specimen preparation, storage conditions, loading method, operator.

196
Q

Macroshear

A

Typical dentin bond strength values are 10-50 MPa. Cohesive and mixed failure 55% of specimen

197
Q

Macrotensile

A

Typical bond strength values are 10 MPa. Cohesive and mized failur 35% of specimen

198
Q

Microtensile

A

Typical bond strength values are 30-50 MPa. Cohesive and mixed failure less than 20% of specimens

199
Q

Microshear

A

Typical bond strength values are 20 MPa. Cohesive and mixed failure 50% of specimens

200
Q

Methods for measuring shrinkage and stress during cure of resin composites

A
Mercury Dilatometer
Bonded Disk
AcuVol
Managing Accurate Resin Curing (MARC) test
Cavity configuration Factor (C-Factor)
201
Q

Stress Analysis and Design of Dental Structures

A

The materials used in dentistry must be able to withstand the stress and strain caused by repetitive forces of mastication. The design of dental restorations is particularly important to probide the best properties of the restorative material. Stresses in dental structures have been studied by alot of techniques such as:

brittle coatings analysis, strain gauges, holography, 2 and 3D photoelasticity, finite elements analysis and other numerical methods

202
Q

Polymerization stress test

A

was developed to evaluate the stresses developed at the bonded interface due to resin composite polymerization while bonded to cavity walls

Devices and methods:
Tensilometer
Tensometer
crack analysis

203
Q

Composition of Dentin

A

50% mineralized apatite crystals
20% water
30% organic matrix (collagen fibrils)

composites are hydrophobic

204
Q

Superficial vs Deep Dentin

A

Water content varies from superficial to deep dentin

Diameter and number of tubules increases near pulp
20,000 tubules/mm^2 at DEJ
45,000 tubules/mm^2 close to pulp

The composition and properties of dentin vary with location

Resin tags (adhesion) travel within dentin (form cross linking)

205
Q

Specifications for Restorative Materials

A

American National Standards Institute (ANSI)/ American Dental Association Standards Committee of Dental Products any standard developed and approved by this committee are reviewed by the Council of Scientific Affairs of the ADA.

Federal Specifications and Standards regulates requirements of federal government service agencies for the purchase and use of materials.

1963 a program for international specifications was established by FDI World Dental Federation and the International Organization for Standardization (ISO).

American Dental Association (ADA)

206
Q

Biocompatability

A

Ability of a material to elicit an appropriate response (continue doing what that tissue did originally) in a given application in the body- implication of function

207
Q

Histocompatability

A

Tissue compatability as a whole

208
Q

Cytocompatability

A

individual cells being compatible

209
Q

Lack of biocompatability

A

Context is key ex. mineralization occurs at one location over another

Examples of inappropriate responses that don’t have biocompatability :

  1. cell/tissue death
  2. inflammation
  3. fibrosis
  4. Tumor formation- dividing inappropriately (CONTEXT)
210
Q

In vitro

A

“In glass;” experiments using isolated populations of cells cheapest to do

Direct in vitro test- relevant cells (primary/cell line) placed directly in contact with material; simplest

cytotoxicity/proliferation: Do cells die? proliferate normally? Ex. dye exclusion (trypan blue) observation of morphology, cell number

Functionality: Do cells differentiate, make proteins or otherwise change their behavior? Ex. MTT assay, BrdU assay

Mutagenesis: Do cells change their core genetic function in response to a material? Ex. Ames (bacterial) and Styles (mammalian cell) tests [tumor formation]

These divisions are fairly artificial, often an experiment setup covers multiple categories

211
Q

Ex vivo

A

“Out of the living”; experiments performed using whole tissues extracted from organisms
Removal of whole tissues and exposure to material; increased physiological relevance but much more complex, making analysis more difficult

Ex. cut mandible; culture- cells stay where they are suppose to- apply materials for testing
Not totally relevant because removed from vasculature

Ex. rats have continuous ameloblast because continually grow cells- we do not; material broken down by cells; taking a whole tissue- regeneration possibility- watch what happens

212
Q

In vivo

A

“In the living” experiments performed in whole, live organisms, cost most, most complex

Material placed into an animal system; Not necessarily in a clinically relevant location ex. sticking enamel in random places; usually smaller animals like rats, mice, hamsters

Ex. dorsal sub-cutaneous injection (implantation tests, mucous membrane irritation tests, placment of material into bone etc.) ex. material in the back of the rat
Increased complexity of system (why did organism die? more things to consider) analysis more difficult
physiological relevance always in question

213
Q

usage tests

A

in vivo experiments using a material within its clinical context ex. putting amalgam where it’s suppose to go

In dentistry, mini-pigs and dogs are common. Direct clinical application of material in a full living system. Prohibitive cost, last ages, huge ethical and legal to do; other types of testing used initially to “screen” materials

Clinical trials- usage test in humans (no in vivo testing- HAS to be in relevant location)

Ex. how type 2 diabetes and bone healing (after implant) relate in rats (in clincally relevant location)
colagen, stem cells; culture new pulp- regrew pulp in dog teeth

Ex. dental pulp irritation test: tissue necrosis, inflammation
material directly on pulp- class V defect created

Mucosa and gingival usage test: tissue necrosis, inflammation
material placed next to soft tissue to see if affected

214
Q

From cells to organisms

A

(less complex to more complex)
Single cell –> tissue (multiple types of cells) –> organ (specialized tissue working together) –> organism (made of all these organs together; most complex)

215
Q

Direct In Vitro Testing

A

Cells placed directly on material; choice of a relevant cell type important ex. pulp derived cells for pulp capping materials

Can tell us many things about the basic compatability of material, BUT very limited in terms of complexity (single cells)

Ex. resin composite- how do pulp cells react to it? Does not tell you if histocompatability is present- talking about one cell

rodent incisors continually grow

Ex. How many cells grow over time over different types of materials? those that have more cell growth- cytocompatible

216
Q

Indirect In vitro Testing

A

cells placed on the opposite sides of a relevant barrier to a material; Ex. dentin slab, diffusion of material over agar;
allows assessment of a material’s impact on cells through a barrier- quite relevant in dentistry

Ex. bonding to dentin vs putting directly on pulp
Diffusion across detin- can’t get through dentin= compatible

217
Q

Combined Approach to Materials Testing

A

Results from in vitro, ex vivo, in vivo, and usage tests over time result in an overall idea of biocompatability

Ex. Zinc oxide cement testing: toxic to cells directly, but caused minimal disruption in usage tests (when in location in question) (because zinc does not penetrate dentin)

pyramid is a good abstract way to think of this:
Progress of testing increases as you go up: bottom–> up:
Unspecific toxicity (primary) , specific toxicity (secondary), clinical trials (usage)

218
Q

Legislative Standardization

A

Dental materials are typically medical devices;

1976 Medical Device Regualtion Act: basic safety assurances, some requirements for safety/efficacy testing

ANSI/ADA Specification 41 (current 2005): outlines standard practices for ensuring biological safety of devices, NOT “pharmacologically active medicaments”

ISO 10993/ ISO 7405;2008 give similar international standards for testing

Initial tests: 1) In Vitro: Cytotoxicity
Hemolysis
Mutagenesis
Carcinogenesis
2) In Vivo: Physiological Distress
Death; Horrible, Boring Death
Zombification

Secondary testing: In Vivo: Inflammatory/Immunogenic reactions in soft/hard tissues

Final testing: Usage Tests: Large Animals (primates)
Clinical Trials*

*with FDA approval

219
Q

Biological Responses of Tissues to Materials

A

Dental pulp reactions: restorative and bleaching agents- can bleach get into pulp? what effects if it does?

Oral soft tissue reactions

Reaction of oral tissues to implants: ceramics, metals and alloys, and resorbable materials ex. pulp capping materials

Does it cause cell death/growth?

220
Q

The tooth

A

Dentin: tubules key consideration: how well can stuff diffuse into pulp

odontoblasts key: make dentin- make it continuously throughout life of tooth

221
Q

Dentin bridge formation and microleakage

A

Teeth as living organs: can respond to external stimuli by producing new dentin

critical that material bonds tightly with dentin to prevent microleakage

microleakage of bacteria, food, saliva, etc. causes pulpal irritation (causes pain/root canal) and can lead to reestablishment of caries

Want odontoblasts to keep making dentin after restoration
Want to recreate DEJ
New dentin to form in response to restorative material- protecting pulp

Want restoration to stimulate odontoblasts –> form dentin

222
Q

Etchants and dentin bonding

A

Dentin bonding: attachment of restorative material to dentin
Better bonding= better dentin formation, less microleakage
Bonding difficult due to organic components of dentin (primarily collagen type I like bone)
After cutting/site preparation, a ‘smear layer’ of debris remains
Etchant removes this layer, allowing better attachment to material (ex. EDTA, citric acid, sodium hypochlorite and many more) because exposes tubules- better adhesion (BUT open door into pulp-affect diffusion into pulp)

223
Q

Smear Layer

A

exposes collagen present in dentin, allowing direct contact with materials, particularly resin composite- ‘hybrid layer’

Removal of smear layer through etching (decreases mineralization in the area) directly exposes pulp to material via dentinal tubules; removal increases the potential for microleakage; etchant (acids) themselves may have cytotoxicity when they contact the dental pulp

0.5mm of dentin generally sufficient to prevent diffusion into pulp-depends how deep prep is

Release of sequestered bioactive factors in dentin through acid etching too- increases chances of making dentin

224
Q

Jello Principle of Pulpal Toxicity

A

Consider rainbow Jello- each layer sets and forms a barrier maintaining the positon of the previous layer
In the same way, multiple barriers between the pulp and a potentially cytotoxic material can reduce penetration of that material

the ability of a material to penetrate dentin is often a good indicator of how biocompatible it is

minimizing microleakage is also vital for protecting the pulp: the layer of Jello must form a good seal

Cytotoxicty of material is directly proportional in its ability to get to pulp

Like Building a restoration- ex. Lining material (barrier) build on top of that – keeping material that may be cytotoxic material away from pulp
Liners may cause minor irritation but not as much as putting direct composite

Bleaching agents- harmful to pulp if left on for too long

Important of dental bridge!

225
Q

Resin based restoratives

A

Combined organic/inorganic components, thus “resin composites” (polymer +filler)
Generally speaking, these are also cytotoxic (to pulp)
freshly set resins are more cytotoxic, this decreases over time and a thicker dentin barrier
Dentin bridge formation also decreased pulp exposure to resin restoration (build more dentin)
Use of basement materials and bonding agents helps reduce pulp irritation- no contact, no irritation
Resin based restoratives can shrink slightly as they cure- not ideal- can enhance microleakage

226
Q

Hybrid layer

A

Resin composites are intersting as they can form a hybrid layer with exposed collagen on an etched surface; basically the polymer can chemically attach collagen, allowing a tight association with dentin; this generally is good, but this hybrid layer is susceptible to enzymatic attack. However, this means enzymes capable of degrading extra cellular matrix can degrade the attachment of the material to the tooth

***Resin + collagen intertwined- good biochemical attachment; but bad because anything that affects collagen will affect this seal- degradation of ECM- root cause of restoration failures

227
Q

Controlling Matrix Degradation: Matrix Metalloproteases (Metalloproteinases)

A

Zinc dependent proteases, present in both dentin and pulp; play a major role in matrix remodeling (normal physiological) and response to foreign bodies (introduced materials); released from dentin which is demineralized, secreted from microbial sources and cells; produced by many cell types (ex. fibroblasts, odontoblasts, osteoblasts, macrophages, neutrophils) increased expression often associated with inflammation. They are also secreted in the saliva. Bacteria create conditions which activate host MMPs and can interfere with the function of MMP inhibitors, TIMPs (Tissue Inhibitors of Matrix Metalloproteases)
Inhibition currently topical in dentistry (chlorhexidine, galardin)- preventing breakdown of organic matrix near restorations (hybrid layer/dentin bridge)

Thus, mechanical/physical forces are not the only considerations, but also biological reactions to materials

70% of work is replacing restorations that have failed

MMP- cause degradation of ECM (collagen)- useful for tissue remodeling sequestered in dentin- inhibited , but activated by destruction of tissue, etc.
Ex. Microleakage- bacterial biofilm on restoration- biofilm secretes acid –>releases MMP from endogenous tissues- bad for restoration- breaks collagen matrix that hybrid layer is linked with

Shrinkage –> microleakage –>MMP –> inhibitors of TIMPS (bacteria does this) –> activate MMPs more
Acid production activates MMP; destroys collagen/ hybrid layer

228
Q

Amalgam

A

“corrosion products” released from amalgams are the primary consideration over time, particularly mercury.

In vitro:mercury= cytotoxic, copper= cytotoxic (much worse)

In vivo implantation: high copper amalgams cause severe tissue responses

Usage tests: amalgams very well tolerated, high copper amalgams similar to older low copper restorations

generally amalgams don’t cause pulpal damage, but can cause pulp inflammation in deep, unlined restorations, resulting in pain

Thermal/electrical conductivitiy can also cause discomfort, depending on cavity depth, and lining (want lining becuase conduction of heat)
There is initial microleakage around margins, which diminishes as corrosion products build up

Resin composites shrink due to polymerization reaction

Amalgam- less leaky over time ; always have leaky margin- pulp irritation, but seal

Last a long time, biohazard

229
Q

Bonding agents

A

Serve to attach restoration to tooth; generally are toxic, however are safe if exposure is minimized; repeated washes to remove unbound elements (remember the tubules)

Resin based bonding agent examples:
Hydroxyehtyl methacrylate (HEMA)
Bis-GMA
Urethane dimethacrylate (UDMA)
Triethylene glycol dimethacrylate

Dentin barrier generally protects pulp- thinner dentin barrier= increased cytotoxicty (liner)

can get through dentin so allow them to set and then wash them off

230
Q

Glass ionomers

A

Polyacrylic acid used as cement, lining material, base and restorative material; release fluoride as they set

In vitro: cytotoxicity reported, reduces over time (when set, release acid, but reduced over time)

usage test: doesn’t cause sustained adverse reactions in pulp tissue- polyacryclic acid is relatively large and doesn’t diffuse through dentin

may etch the dentin, potentially releasing bioactive factors which enhance dentin bridge formation, but also MMPs

231
Q

Calcium Hydroxide

A

Liners and Non-resin cements; frequently used as a lining material (not very cytotoxic)

In vitro: high pH, cytotoxic. better when combined with resin (Dycal)
Usage test: direct exposure to pulp causes immediate necrosis. Necrosis is significantly reduced/eliminated when combined with resin; Resin- calcium hydroxide used as a pulp capping material; may release bioactive factors from dentin, although mechanism is unclear

Resin- buffer- puddy

Top layer of pulp died- fossilized- creation of layer
They are buffered- don’t cause much pulp irriation

Resin, calcium OH, dentin

232
Q

Zinc Phosphate, Zinc Polyacrylate, ZOE

A

Liners and Non-resin cements; zinc based cements used as lining cements in restorations;

In vitro: zinc phosphate( cytotoxic, perhaps due to leaching of zinc ion, although dentin is an effective barrier); zinc polyacrylate (possibly less cytotoxic); ZOE (eugenol has cytotoxic effects, although this is buffered effectively by the dentin. Also has anesthetic properties)

Usage test: zinc phosphate (causes necrosis in direct contact with pulp) zinc polyacrylate and ZOE (mild inflammation, which resolves relatively quickly)

these materials don’t strongly stimulate the formation of a dentin bridge

233
Q

Liners and Non- resin cements: MTA

A

MTA: mineralized trioxide aggregate: modified Portland cement, the main soluble component is calcium hydroxide

In vitro: not cytotoxic, increases cell proliferation/migration and synthesis of mineralized matrix specific proteins

usage test: does not cause pulp necrosis, appears to encourage dentin bridge formation

Not bad for pulp; drive proliferation/migration
Pulp capping material (difficult in adults)

234
Q

Bleaching agents

A

Almost all contain peroxide;

In vitro: As you might imagine, high levels of cytotoxicity

These agents can rapidly transverse enamel, dentin, and come in contact with pulp; also capable of burning gingiva and causing soft tissue damage

Caused by poorly formed trays – get black triangles

Don’t bleach tooth under stress

235
Q

Response of Oral Soft Tissues to Restorative Materials

A

The restoration is in contact with oral soft tissues; buffered by the oral cavity, but not a dentin barrier; a main concern is the formation of bacterial plaques on the external surface of the material (more bacteria= more inflammation in surrounding tissues); areas where saliva doesn’t frequently wash, gingival pockets, under fixed appliances, etc.

Cements: generally well tolerated after they set

Resin composites: can be highly cytotoxic to fibroblats in direct contact (PDL) and cause an inflammatory response

Amalgam: can be cytotoxic, generally copper and zinc > silver or mercury in vitro

Most materials not good for oral soft materials- isolation of an area

236
Q

Resorbable Materials

A

Materials designed to be biodegradable; release bioactive molecules, stimulate a particular response from surrounding cells or simply be vulnerable to remodeling; many types, including polyactic acid, polyglycolic acid, collagen, starch, cellulose, synthetic peptides, and many more. Generally, these are biocompatible, non- cytotoxic. Resorption by a combination of physiological conditions, phagocytosis by cells and digestion by cell products ex. matrix metalloproteinases

237
Q

Prevention is a foundation of dentistry

A

a. Low fluoride in water reduced caries incidence
b. Introduce fluoride to community water to get exposed during teeth formation.
Fluoride as a dietary supplement; high risk patients; Trying to expose them to prevent caries incidence.
c. Systemic and topical fluorides for 50 years have decreased prevalence of caries on smooth surfaces
d. Pits and fissures of posterior teeth are more resistant to fluoride uptake because of irregular occlusal surface. Retention of food and can’t brush well here either so starting carious lesion.
e. Sealant-fill irregularities to reduce risk of carious lesion. Make smoother surface to clean easily

238
Q

Pit and fissure sealants

A

a. Common sealant= Bis-Gma resin and are light cured, but some available as self cured
b. Sealants are more fluid so they can penetrate pits and fissures easily and etched areas on the enamel which promote retention of sealant
c. Fumed silica added to provide stiffness and improve wear resistance

239
Q

light cured sealants

A

a. Apply sealant to pit and then cure with light for 20 sec
b. Sealants applied to thin sections so time is enough
c. Advantage of light cured sealant-working time controlled by operator (most are light cured; ex. diketone and aliphatic amine)

240
Q

Air inhibition of polmerization

A

a. During polymerization there’s a surface layer of air inhibition that varies in depth w/ different commercial products
b. Make sure to apply enough material to coat all pits/fissures w/ a thick layer to ensure complete polymerization
c. Uncured, air inhibited layer can easily be removed after curing (with a prophy cup in a rotary hand piece) using an abrasive pumice with a handpiece. It’s more effective than wiping

241
Q

Properties of sealants

A

Sealants are circumscribed by enamel and are not subjected to occlusal stress so their mechanical properties are less important that those of resin composite restoratives.
a. Add ceramic or glass filler particles (up to 40% by weight) and all properties except tensile strength show improvement (improved elastic modulus, wear resistance, more visible on clinical inspection)
b. Modulus of elasticity shows the most improvement and the increased rigidity makes the filled material less subject to deflection under occlusal stress
c. Filler added to improve wear resistance and make material more visible on clinical inspection
d. Optimal adhesion of sealant to enamel-occurs when sealant has high surface tension, good wetting, and low viscosity
i. These properties allow sealant to flow easily along the enamel surface
e. A drop that spreads readily produces a low contact angle
f. This highly wetted surface is conducive(more likely) to a strong adhesive bond
g. Polymer tags-formed when the resin flows into the surface irregularities made by acid etching and are responsible for the mechanical bond that retains the sealant to enamel
h. Durability of the sealant bond related to stresses induced by:
. Shrinkage of the resin during curing, Thermal cycling, Deflection from occlusal forces, Water sorption, Abrasion
j. Sealants have variety of features so must select carefully
k. Most current materials are light cured instead of self cured because easier controlled rate
l. Tooth colored or clear resins available for natural look
m. Also available in opaque or tinted material to make recall exam easier
n. New color reversible, photosensitive sealants developed
i. They are similar to light cured sealants in resin composition and filler loading
ii. Photosensitive pigments are added that change to green and pink when exposed to dental curing light
iii. Color change lasts 5-10 min to help determine whether the sealant covers the pit/fissures
o. Increasing number of sealants are marketed claiming that they release fluoride. Release is highest in first 24hrs after placement and then tapers (may not be sufficient to provide extended clinical protection against caries

242
Q

Bis GMA resin sealant Clinical studies

A

Study with light cured sealant showed retention rate of 42% and effectiveness of 35% in caries reduction over 5yrs
Similar study with filled resin sealant showed retention of 53% and effectiveness of 54% over 4yrs
Results of quicker setting unfilled resin-> retention rate 80% and effectiveness of 69% after 3 yrs.
The longest published study on sealant effectiveness is a 15 year evaluation of a self cured unfilled material which showed 27.6% complete retention and 35.4% partial retention.
Study comparing fluoride releasing sealant (91% retention) vs non-fluoride sealant(95%)…and yet the caries incidence was the same for both groups (10%)
Almost all studies show a direct correlation btw sealant retention and caries protection
Therefore important to use materials that are retentive to enamel, resistant against occlusal wear, and easily applied with little surface contamination opportunities
Current evidence indicates sealants are most effective on occlusal surfaces where pits/fissures are defined

243
Q

Application of sealants

A

Handling characteristics of a sealant depend on composition of material and surface it’s applied to (read manufacture instructions). Optimal preparation of the 2 aspects leads to->close adaption of the sealant to the tooth enamel, a strong seal against the ingress of oral fluids and debris, and long term material retention

244
Q

Enamel surface prep

A

Penetration of sealant to bottom of pit is important
Wettability of the enamel by the sealant is improved by etching(some suggest pretreatment with silanes)
Must fill pit/fissure without voids- air/debris trapped in there prevents it from being completely filled
Must control viscosity of sealant to get optimal results. Viscosity determines the penetration of resin into the etched areas of enamel to provide retention of sealant

Etching the pit/fissure for specified time(15 to 30sec) w/ 35-40% phosphoric acid is recommended. Acid etchant should be flushed with water and dried. If you don’t rinse well then phosphate salts remain on surface and will interfere w/ bond formation
Enamel surface should not be rubbed during etching and drying because the developed roughness can be destroyed
Important to isolate the site throughout the procedure to get optimal tag formation and clinical success
If saliva contaminates during treatment, the surface needs to be rinsed and the etch needs to be reapplied
Acid etching enamel-should appear white and dull w/ rough(chalky) texture. If appearance isn’t uniform then you need to etch for 30 more seconds
Etched area should extend beyond anticipated area for sealant application-reduce leakage and bonding of margins (completely cover all exposed pits and provide a smooth transition along the inclines of the enamel cusp)
Place light cured bonding agent on etched enamel before placing sealant-> improves retention
Single step etching provide weaker bond to uncut enamel than to cut enamel

245
Q

Selant application

A

Depending on viscosity and setting time, sealant may best be applied with a thin brush, ball applicator, or syringe
Avoid buildup of excess material- could interfere with occlusion
Place sufficient amount of material to cover all exposed pits
Overworking light cured sealants on tooth surface during application can introduce air voids that appear later as surface defects
Air inhibited surface layer should be wiped immediately after curing, and inspect the coat for voids or areas of incomplete coverage
Defects can be covered at this time by repeating the entire reapplication procedure (including acid etch and applying fresh sealant only to areas with insufficient coverage)
After sealant is applied and cured, occlusion should be checked and adjusted to get rid of premature contacts

Possible problems: air or debris, control of viscosity (penetration of the sealant) and sealants can penetrate a depth of 25-50µm

246
Q

Glass ionomers as sealants

A

Have been tested for ability to function as a fissure sealant because ability to release fluoride/ provide caries protection on tooth surfaces at risk
Viscous property and difficult to gain penetration to the depth of a fissure
Lack of penetration makes it difficult to obtain mechanical retention to the enamel surface to the same degree as with BIs- GMA resins
More brittle and less resistant to occlusal wear
Studies show lower retention rates than resin sealants but greater fluoride deposition in enamel surface (greater potential for later caries protection after sealant loss)
Areas with high risk kids- conservative caries management technique used to seal caries in a fluoride rich environment establishing some remineralization
Ex. Atraumatic restorative treatments- opening a lesion, removing soft surface decay and filling or sealing surface with highly filled glass ionomer with fast set time

247
Q

Flowable (low viscosity) composites as sealants

A

For preventive resin restorations, cavity liners, restoration repairs and cervical restorations
Packed in syringes/ compules for direct application to pit/fissures
Trapping of air in sealant must be avoided
They have a higher filler content compared to most resin sealants then they have better wear resistance- provide good retention/ caries resistance after 24 months

248
Q

Glass ionomers to prevent the progression of caries

A

Slowly release fluoride so used in cervical restorations (esthetics not critical)
Recommended for patients with high caries risk

249
Q

GI Composition and reaction

A

Glass ionomers supplied as powders (not shades?) (Ion leachable aluminosilicate glass) of various shades and a liquid (water solution of polymers and copolymers of acrylic acid)
Material sets because of metallic salt bridges between Al and Ca ions (when powder and liquid are mixed, the glass surface gets attacked by acid. Then Na, F, Al and Ca ions leached into aqueous medium)
Reaction is slow
Chelation effect with Ca on exposed surface- adhesive bond
Surfaces of new restorations should be protected from saliva with protective coating

250
Q

GI Properties

A

Elastic modulus that is similar to dentin
Bond strength to dentin of 2-3 MPa
Expansion coefficient comparable to tooth structure
Low solubility
Fairly high opacity
Fluoride is released slowly from glass providing anticariogenic effect
Retention of glass ionomers in areas of cervical erosion are better than for composites even though bond strength to dentin is lower (75% retention rate after 5 years)
Pulp reaction to glass ionomer is mild
GI surface might look rough but fewer Streptococcus mutans exist in plaque next to a glass ionomer restoration
Packed in bottles and vacuum capsules- mechanical mixing
Liquid in unit dose capsule is forced into powder by a press and mixed
Mix then injected into cavity prep (must be done quickly or else physical properties will be low and adhesion lost
Maintain isolation, use proper etch procedure, protect restoration from saliva, delay final finishing for a day or longer

Population that benefits for GI: the elderly, patients with xerostomia, kids with high caries risk

251
Q

Resin Modified Glass (Hybrid) Ionomer

A

Used in lower stress bearing restorations

Recommended for patients with high caries risk

252
Q

RGM Composition and Reaction

A

Powder is similar to glass ionomer/ liquid has monomers, polyacids, water
Placing a bonding agent before decreases fluoride uptake by dentin/enamel

RMG set by combined acid-based ionomer reaction and light cured resin polymerization of 2 hydroxyethyl methacrylate

253
Q

RGM Properties

A

Bond to tooth structure without use of bonding agent
Flexural strength is almost double of standard glass ionomer
Release more fluoride than compomers/ composites but same as glass ionomers
Glass and Hybrid ionomers recharge after exposed to fluoride treatments or dentifrices
Plaque next to resin modified glass ionomer had higher fluoride than that next to compomer restoration

254
Q

RGM Manipulation

A

Mixing of unit dose capsules makes uniform mix with fewer larger air voids
Need optimum powder/liquid ratio for long term maintenance
Set immediately when light cured, finished 5-10 min after initial set
Finishing with wet environment then recoating with protective varnish/bonding agent helps maintain color/surface texture

255
Q

Resin Modified Glass Ionomers as cavity liners

A

Used to line the dentin walls of a deep cavity
Provide thermal insulation
Sandwich technique- use this to seal dentin releases fluoride; then cover with resin composite
Use to relieve stresses that occur with shrinkage of composite during curing
Lining cements release fluoride ions and are radiopaque

256
Q

Calcium hydroxide cavity liners

A

Used for lining specific areas of deep cavities or for direct pulp capping (have antibacterial action)
Initially a paste that then hardens (has a base paste [calcium tungstate, tribasic calcium phosphate, zinc oxide in glycol salicylate] and catalyst paste [CaOH, Zinc oxide, zince stearate in ethylene toulene sulfonamide] that are mixed)
CaOH and salicylate are responsible for setting reaction
Important properties of these cements: mechanical/thermal properties, solubility, antibacterial activity and pH
Can create secondary dentin bridges when applied to direct pulp exposure
Have low values of tensile/compressive strength or elastic modulus
Restrict usage to specific areas not critical to support restoration
Setting time varies between 2.5-5.5 min, but compressive strength increases over 24 hour period
Solubility necessary to achieve therapeutic properties
Acid etching procedures and varnish must be done with care
Free CaOH in excess stimulate secondary dentin close to pulp/ show antibacterial activity
Mostly used in direct pulp capping, specifically deep spots of a cavity prep
Light cured resin modified glass ionomers are better for general lining of cavities (fluoride release, decreased solubility, and superior mechanical properties)

257
Q

Fluoride varnishes

A

Deliver fluoride topically to surface of teeth in those at risk for caries
Used routinely after prophylaxis

5% NaF (2.26% F or 22,600ppm) 1% difluorsilane (0.1% F or 1000ppm)
Fluoride is dissolved in organic solvent that evaporates when applied when exposed to moisture leaving thin film of material covering all exposed tooth surfaces
CaF deposited on tooth→ converted to fluorapatite (remineralization)
Advantage is extended time of exposure on tooth surface (hours before wears)
research study: release of F up to 6 months after restoration with RGM+Fluoride varnish
Efficient at treating young kids at risk for caries (reduction up to 70%)
Potential Use for prevention of root caries in older populations

258
Q

Remineralization

A

Natural repair process for carious lesions
Elevated levels of fluoride in toothpaste effective in rehardening root caries lesions

Concept of caries balance
Pathological factors:
1. Acid producing bacteria
2. Frequent consumption of fermented carbohydrates
3.Below normal salivary flow and function

Protective factors:

  1. Normal salivary flow and components
  2. Fluoride
  3. Antibacterials
    - Salivary components required for remineralization are CALCIUM AND PHOSPHATE. FLUORIDE enhances remineralization
259
Q

Additional

A

Calcium phosphate added to toothpaste, varnishes, and gum
Ex. Calcium phosphate remineralization technology based on Casein phosphopeptide- amorphous calcium phosphate (CPP-APC) effective in remineralizing enamel subsurface lesions by stabilizing high levels of Ca and phosphate ions
Sugar free gun in a RTC after 24 months showed a reduction in caries progression of 18%

Bioactive glass (calcium sodium phosphosilicate) originally developed as a bone- regenerative material, has been show to deposit onto dentin surfaces and mechanically occlude dentinal tubules when delivered in a dentifrice but when combined with fluoride, increases remineralization of caries lesions still in the mouth

260
Q

Sealant seminar facts

A

Composite resin are thicker so withstand restoration
Sealant still has to be able to withstand occlusal forces-has to be viscous. Withstand thermal changes. Set time.
Isolate tooth
Clean tooth without using fluoride
Etching with phosphoric acid 35-40% for 20 seconds
wash /rinse/dry
Should look frosty/white looking to see if it’s ready. 1mm out of edges to make sure boundaries are covered
Apply sealant with ball and tip or syringe
Cured for 20 seconds
Check for occlusion- using articulating paper
15 year study showed 27%retention
Glass ionomer-releases fluoride.more brittle.higher viscosity than sealant/resins.
Sandwich technique- put glass ionomer then cover with composite
Use for kids and older pple(taking drugs that affect salivary flow)