Year 2 Flashcards
What are the disadvantages of amalgam?
- Poor aesthetic as it is metallic and not tooth coloured
- It lacks adhesion which requires retentive features in its cavity preperation. This destroys healthy tooth structure
- Amalgam corrodes in the oral environment as it is a metal and it reacts with oxygen that leads to weakening of the material leading to marginal leakage
- Restorations in the oral environment experiences repeated occlusal loading and this subjects the amalgam to creep (up to 3%). This also leads to marginal ditching
- Mercury hazard; there are indications of some mercury vapour released upon placement of freshly mixed amalgam and also from wear and corrosion of the restoration
- Galvanic effects; reaction between metals in restoration with different degree of electro negativity resulting in a strong metallic taste in the mouth
- Because dental amalgam is brittle is has to placed in bulk which means the cavity has to be cut deep and cavo surface angle of 90 degrees. This leads to more tooth destruction
Why do we use amalgam?
- Inexpensive (compared to resin composite)
- Ease of use and manipulation (has less steps in procedure compared to composite)
- Proven track records and familiarity of more than 100 years
- Resin free; less likelihood of allergies than composite
- Durable as it has high strength, rigidity and wear retention (if placed with the right techniques)
How are alloy particles on dental amalgam produced?
- Lathe cut amalgam; machining of solid ingot of the alloy on a lathe. The alloy powder is then homogenised by heat by placing the powder in boiling water
- Spherical; various ingredients of alloy are melted together and sprayed into an inert atmosphere where droplets solidify as small spherical pellets. This process is know as atomisation. Particles could me fine cut (35 micrometer) or micro cut (25 micrometer)
How does properties of amalgam vary?
- It’s properties depends on the composition of alloy
- It’s handling properties depend on the shape and size of alloy particles;
a) NARROW head condenser is used for IRREGULAR shaped alloy particles
b) WIDE head condenser is used for SPHERICAL shaped alloy particles
* if your body is like a SPHERE may be you should wear WIDE fit clothes
What is the alloy composition for both traditional/conventional and blended amalgam?
Conventional 1. Silver (Ag); 67-74% 2. Tin (Sn); 25-27% 3. Copper (Cu); 0-6% 4. Zinc (Zn); 0-2% *silver and tin are main combination producing an intermetallic compound Ag3Sn known commonly as GAMMA Blended/dispersion modified 1. Silver (Sn); 70% 2. Tin (Ag); 16% 3. Copper (Cu); 13% 4. Zinc (Zn); 1% *dispersion modified is when 2 parts conventional lathe-cut alloy is mixed with 1 part of Ag-Cu eutectic spheres
Describe the setting reaction of conventional dental amalgam
Ag3Sn (GAMMA) + Hg > Ag2Hg3 (GAMMA 1) + Sn7Hg (GAMMA 2) + Ag3Sn (unreacted alloy)
*gamma 1 + gamma 2 = amalgam matrix component
This process is done by vigorously mixing the alloy powder with liquid mercury
Describe properties of the solid phases of conventional dental amalgam
Gamma 1. Ag3Sn 2. Original alloy 3. Some remains unreacted 4. Hard an strong (contribute to the overall strength of amalgam) 5. Highest tensile strength Gamma 1 1. Ag2Hg3 2. Small crystals 3. Brittle phase 4. Intermediate strength 5. Low melting point (127C) Gamma 2 1. Sn7Hg 2. Long blade like crystals 3. Soft phase 4. Low tensile strength 5. Prone to corrosion 6. High flow *This phase is bad and should be eliminated. That's why we use high Cu (dispersion modified) amalgam
Describe the setting reaction of dispersion modified amalgam
- Stage 1 (similar to conventional amalgam)
Ag3Sn + Hg > Ag2Hg3 + Sn7Hg + Ag3Sn - Stage 2 (reaction of gamma 2)
Sn7Hg + Ag-Cu (eutectic spheres) > Cu6Sn5 + Ag2Hg3 (production of gamma 1)
This helps to remove if not all, most of gamma 2
*however in excess Hg gamma 2 will not be completely removed
State the physical properties of amalgam
- High thermal conductivity
- High electrical conductivity
- > 2mm aluminium radiopacity (enamel and dentine have 2mm Al radiopacity)
- Thermal expansion; 25ppm/C (x3 of enamel thus reacts faster than dental tissues which could lead to marginal leakage)
- Lustrous and shiny colour
State the erosion reaction of dental amalgam
Primarily involved the gamma 2;
Sn7Hg + saliva (H20, Cl) > SnO2 + Sn(OH)6 (tin salts) + Hg (free mercury)
Describe the properties of amalgam in relation to time and strength
- It is weak 1 hour after placing the material as it hasn’t reach it’s optimum strength and is considered soft
- After 24 hours it reaches 90% of its strength
- After 7 days it reaches its maximum strength
When is a mercury toxicity most likely to occur?
- Direct contact with mercury
- Inhalation of mercury vapour due to mercury spillage in the surgery
- Placement of new and removal of old restoration (not likely to reach toxic levels)
- Hypersensitivity to mercury
What are the environmental problems related to amalgam?
- Left over amalgam from capsules that are not disposed properly
- Mercury spillage
- Residual mercury in capsule
Compare the strength of amalgam and composite
- Initially composite performs better but deteriorates over time
- Amalgam initially performs worse but gradually stabilises and performs better
However the strength of amalgam is subject to the operators skill. Poor condensation leads to porosity and presence of excess mercury which reduces th strength of amalgam. Poor condensation also causes marginal adaptation to be poor and this increases the potential of marginal leakage. Undertrituration results in dry amalgam that won’t pack properly
List the ideal property requirements for denture based material
- Ease of fabrication and repair
- Biocompatible
- Ease of cleaning
- Resistance to bacterial growth
- No taste or odour; does not comprise quality of life
- Clinically, dimensionally, mechanically, thermally stable in oral fluids, drinks and moisture (as oral environment is aggressive and constantly under attack)
- Low cost and good shelf life
- Radiopacity; denture can fracture which could the be inhaled or swallowed. We need to be able to detect where it is
List the thermal properties of denture based material
- High softening temperature; hot drinks can have temperature up to 60C
- High thermal diffusity; dentures isolates area of soft tissues from any sensation. If the thermal diffusity is low we won’t be able to convey the message fast enough and the food/drink would have scalded the mouth
- Expansion coefficient similar to that of artificial teeth; so that changes in base causes similar change to teeth
Describe the strain and stress curve
- When we increase stress the strain on the material increases
- The first part of the curve is a straight line known as “elastic modulus” of the material where you have direct representation of the stress-strain relationship
- It then reaches a point “proportional limit” where it slowly loses elasticity
- At “yield stress” it reaches its “elastic limit” and loses elasticity
- Region from starting point to “yield stress” is known as “elastic region”. When we apply steed and remove it, the material returns to its original dimension
- Region from “yield stress” onwards is knows as “plastic region”. Any stress applied is permanent (the material loses stability)
What are the mechanical requirements of denture based material
- High elastic modulus to prevent permanent deformation (when chewing forces are removed it will retain its original structure). Enables us to use it in thin section
- High proportional limit to prevent permanent deformation
- High flexural/tensile strength to resist intraoral forces
- High fatigue strength (fatigue: constant applying of small forces that eventually break the material). In the oral environment we experience forces that are continuous. We need the material to withstand the multiple loading
- High impact strength to withstand fracture if dropped
- Hard, abrasion resistant surface so it is polishable
State 3 basic characteristic of methyl metracrylate (MMA)
- Clear colourless liquid with intense odour
- Inhibited by hydroquinone/or it’s derivates
- Can be polymerised (forms C=C)
What happens when we combine materials of different moduli?
Different moduli = different differential stress = materials will fail and detach from one another as they don’t respond the same way to stress
*to combine material with different moduli you need good adhesion
How is PMMA for surgical use designed?
Two part formulation of powder and 1 part liquid ready for “dough processing”
State the volume shrinkage of 100% MMA?
1 MMA monomer > 1 PMMA polymer ~21% shrinkage (huge gaps leads to dimensional change that would be too much to compensate)
State the volume shrinkage of MMA in two part powder/liquid mixture
2 part powder (already polymerised PMMA) + 1 part MMA liquid = 6-7% shrinkage
*techniques could be used to further reduce this shrinkage
State the principal constituent of acrylics
Powder
1. Acrylic polymer beads (PMMA); long chains of molecules that react with one another
2. Initiator; benzoyl peroxide
3. Pigments
4. Dyes
5. Opacifiers
Liquid
1. MMA monomer
2. Cross linking agent; EGDMA which connects one polymer chain to another making the material stronger
3. Inhibitor; hydroquinone which prevents the monomers from polymerising on its own (extends shelf life)
What happens go PMMA spheres upon contact with liquid MMA?
- The PMMA spheres swell up
- Their consistency change and they become sticky
- The mutually adhere to one another
State the 4 physical stages of mixing acrylic
- Sandy mixture; momomer and PMMA spheres are like sand and water
- Tacky mixture; diffusion of MMA into PMMA spheres has begun
- Dough stage; should be packed into flask to minimise shrinkage and porosity
- Rubbery stage; polymerisation reaction has gone too far
Describe the radical polymerisation activation phase (the follows the physical mixing of powder and liquid)
- Benzoyl peroxide is the initiator
2. At 60C it undergoes thermal decomposition (gets cleaved in the middle) to produce 2x free radicals
Describe the 4 stages of free radical polymerisation
- Activation; either by mixing or heat producing free radicals
- Initiation; attack of first free radical on monomer molecules (when the radicals attack monomer they cause the monomers to come together and form polymers)
- Propagation; the auto accelerating growth of one linear polymer chain (more monomers come together)
- Termination; the reaction comes to a stop by various radical annihilation (you have no free radicals) or inhibition of segmental movement (you have no free monomers). The chains of polymers with a free radical at the end come together to form a long chain and the free radicals become inactive