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Dental materials

Practical Work

Introduction to Dental Materials


Science of Dental Materials is an applied basic science dealing with the physical, chemical,
biological properties and interaction with oral tissues of the materials used in clinical
dentistry. This subject also deals with the manipulative techniques, applications and uses of
dental materials.

Every dental procedure requires the use of materials so a variety of materials are available
which requires proper selection and evaluation.

Dental materials are used in:

 Dental office

 Dental laboratory

Subject is approached with the view of determining:

 Chemical nature of material

 Physical & mechanical functions

 Manipulative techniques

 Applications

 Biological considerations

To conclude it is relevant to say that the subject of dental materials is a basic science in itself
with its own tenets and principles.

 The main requirements for dental materials in general are as under:

 Why materials react and behave as they do?

 What manipulative techniques are used?


 How variation in techniques effect their properties?

 What is the effect of oral environment on the material?

 Is the material easy and convenient to use?

Dental materials used in dental office:

1. Impression materials
2. Crown restoratives
3. Cements for temporary or lasting fixing of prosthetic works
4. Calcium hydroxide based cements for pulp-dentine wound protection
5. Adhesive systems

Impression materials
1. A dental impression is a negative imprint of hard (teeth) and soft tissues in the mouth
from which a positive reproduction (or cast) can be formed.

2. A correctly made dental impression will capture a part or all of a person's dentition and
surrounding structures of oral cavity.

3. The dental impression forms an imprint ('negative' mould) of teeth and soft tissues,
which can then be used to make a cast of the dentition.

4. Casts are used for diagnostics, patient record, treatment planning, fabrication of custom
trays, fabrication of dentures, crowns or other prostheses and orthodontics.

5. Casts are accurate, three-dimensional replicas of a patient's teeth which are made by
pouring dental plaster or acrylic into "impressions" (imprints, or molds) of the teeth, and
allowing it to harden.

Impression materials can be considered as follows:

I. Ireversible Rigid Materials

 Impression Plaster

 Zinc-Oxide Eugenol Plaster

II. Reversible Rigid Materials


 Impression compound
 Impression Waxes

 Reversible Elastic Materials


o agar-agar
 Ireversible Elastic Materials
o alginate
o elastomeric impression materials: polysulfides, polyethers and silicones.

Ireversible rigid impression materials


Plaster as impression material

Description

o Dental plaster :β form of calcium hemihydrate .


o Dental stone: α form of calcium hemihydrate.

White or colored powder based on calcium sulfate.

 W/P ratio=The ratio in which water is mixed with hemihydrate.

 The strength of a stone is inversely proportional to the w/p ratio. It is better to keep the
amount of water as low as possible. Once the optimum proportion is noted , the same
must be used subsequently. An accurate graduated cylinder has to be used for water
and a proper weighing balance for powder has to be used Powder should NOT BE
MEASURED USING SCOOP

 Mixing time : Time from addition of the powder to water till the mixing is complete.

 If the mixing has to be done by hand , the bowl must be parabolic , smooth and
abrasion resistant. Spatula should have a stiff blade and a convenient handle. Stirring of
the water powder during mixing has to be done more vigorously in order to avoid air
entrapment. Wetting of all powder particles with water must be ensured.

 Setting time: Time duration between start of mix & point where material hardens.
Working time : Time from start of mix to the point where the consistency of the mix is
no longer acceptable for the usage of indented purpose.

 Use room temperature water.

 Use only water that is drinkable.


 Always place water in bowl first, then add powder to water slowly and evenly.

 Let powder soak in water at least 30 seconds while moving bowl around to wet the
powder before mixing.

 HAND MIX using back-and-forth strokes, occasionally turning the bowl and scraping
down the sides to incorporate all dry and unmixed material. Do this until a creamy
homogeneous mix is achieved. Usually 30 seconds is adequate.

 It is safe to use demineralised or distilled water.

 Quality may be affected if other liquids are used, such as water from the trimmer or
gypsum hardener liquids.

 The gypsum must be quickly and evenly sprinkled into the water within 10 seconds.

 Timing starts whenever the gypsum and water come into contact.

 After the gypsum has been soaked for 20 seconds, it can be mixed with a spatula.

 Mixing in a vacuum mixer improves the quality of the mixture and saves time.

 Manual mixing requires approx. 60 seconds and mechanical mixing 30 seconds.

 Adding water or gypsum when the consistency is too thick or too thin affects the setting
process and damages the crystalline structure of the gypsum.

 MECHANICAL MIXING accelerates the working and setting time of Dental Stones and
Plasters. Because mechanical mixers are faster, place powder into the water and stir by
hand until all powder is wet, then start mechanical mixer. Mix for a shorter time, 10 to
30 seconds, then hand mix to check for a homogeneous mix. DO NOT OVER MIX.

 The impression should be poured immediately after mixing.

 Pouring the impression should be completed within the working time.

 The gypsum begins to crystallize at the end of the working stage.

 No further work can be carried out because fine details can no longer be accurately
reproduced after setting begins.

 It is important that mixing bowls and other mixing equipment for Dental Gypsum be
used ONLY FOR MIXING Dental Gypsum. Other materials such as phosphate Investment
or Impression Materials mixed in the same equipment will seriously contaminate and
change the properties of the Dental Stone.
Dental trays

• A dental impression is a negative imprint of hard (teeth) and soft tissues in


the mouth from which a positive reproduction (or cast) can be formed.

• They are made by using a container which is designed to roughly fit over
the dental arches ("trays").

• Impression materials are designed to be liquid or semi-solid when first


mixed and placed in the tray, and then quickly set to a solid (usually a few
minutes depending upon the material), leaving an imprint of the structures
in the mouth.
Impression tray

 It is a device used to carry & control impression material while making an


impression.

There are two type of trays.

 Stock trays (or standard trays) are manufactured en masse in a range of


sizes and shapes, from which the closest size and shape tray is selected that
matches the dimensions of the dental arches of the person who is to
receive the impression.

 Special trays (or custom trays) are made to fit a specific individual's mouth
by a denturist (dental technician). Special trays are constructed on a cast
from a preliminary impression which utilizes stock trays.

Stock trays

 Stock trays can be rounded, designed to fit the mouths of people with no
remaining teeth, or squared, designed to fit people with some remaining
teeth.

 They can be full arch, covering all the teeth in either the upper or lower jaw
in one impression, or they can be a partial coverage tray, designed to fit
over about 3 teeth (used when making crowns).

 Is the tray used in primary (preliminary) impression.

Requirements Of Impression Trays

1. The tray should be rigid and strong but not too thick.

2. The tray should simulate the finished denture in size and shape.

3. The border extension of the tray should be 2mm short of the vestibular
depth with no interference with muscle or frenal attachment.
4. The entire borders of the tray should be smooth and rounded.

5. The tray should retain its shape throughout the impression procedure and
pouring of impression.

6. The handle of the tray should be angulated.

Stock trays can be made out of a range of materials from plastics to metals,
and they can be perforated (to allow the impression material to run through
the holes and increase the bond of the impression material to the tray when
set).

Adhesives are commonly used to bond the impression material to the tray,
and vary in composition depending upon what material is used.

Types of stock trays

I. Depending on material:

A. Metallic:

 aluminum.

 stainless steel.

B. Non metallic:

 plastic tray which can be sterilized.

 disposable plastic trays.

II. Depending on shape

A. Square (dentulous patient).

B. Oval or rounded (edentulous patient).

III. Mode of stock trays


o Perforated trays (used with alginate).
o Non perforated or plain trays (used with impression compound).

IV. Size

Sizes: small, medium, large and extra large.

Adhesives & Perforations

 It is essential that impression materials adhere firmly to the impression


trays.

 This can be achieved by either perforations or by the use of adhesives.

 Adhesive solutions are needed for alginates, polysulphides and silicones.


Adhesives for alginates are solutions of resins in alcohol, they are supplied
in a bottle with a brush or an aerosol spray.

Special trays

 Special trays are commonly made from acrylic or shellac.

 Special trays can be give perforations if required by drilling many holes in


tray.

Dental Impression Disinfection and Cleaning

Dental impressions and casts are highly contaminated with patient saliva or blood
upon removal of the patient's mouth.

ELASTIC

Material susceptible to being stretched, compressed or distorted and then


tending to resume the original shape.
Elastic impression materials are capable of accurately reproducing both, the hard
and the soft structures of the mouth including the undercut areas and
interproximal spaces.

ADVANTAGE OF ELASTIC IMPRESSION MATERIAL OVER RIGID IMPRESSION


MATERIAL

 Elastic impression material can be used in both dentulous and edentulous


cases with undercuts.

 The distortion of elastic impression material when removed from an


undercut is minimal.

CLASSIFICATION OF ELASTIC
IMPRESSION MATERIAL
1. REVERSIBLE HYDROCOLLOIDS
Agar
2. IRREVERSIBLE HYDROCOLLOIDS
Alginate
3. ELASTOMERIC IMPRESSION MATERIAL
Polysulphide
Condensation polymerizing silicon
Polyether
Addition polymerizing silicon

HYDROCOLLOID

A colloid that contains water as the dispersion phase.


HYDROCOLLOIDS

 Reversible = impression materials containing agar.

 Ireversible= alginate impression materials

GEL

A network of fibrils that form a weak slightly elastic brush heap structure of
hydrocolloid.

AGAR

• Agar is an organic hydrophilic colloid (polysaccharide) extracted from a


certain type of sea weed.

• Agar impression material it is called

reversible impression material because of its property of reversing their phisycal


state, which is reusing the impression material for multiple number of
impressions.

• Agar hydrocolloid was the first elastic succesfull impression material to be


used in dentistry.

GELATION TEMPERATURE:

• The gelation temperature of agar is approximately 37°C if the gelation


temperature is too high it is possible that injury may result to the oral
tissues involved, a sever surface stress may also develop.

• If the gelation temperature is too low it will be difficult or even impossible


to chill the material to a temperature sufficiently low to obtain a firm gel
adjacent to the oral tissues .

PREPARATION OF THE MATERIAL :

• First step is to reverse the hydrocolloid gel to the sol form.

• Usually done at 100C for 10min.


• 3 min should be added to this time whenever the material is being reused.

• After liquefaction material may be stored in sol condition.

• Storage temperature: 65C to 68C.

CONDITIONING OF THE MATERIAL:

• This refers to the cooling of the material (also called as‘tempering’ of the
material).

• Tempering is usually done at 43C for 7min.

• Although tempering time and temperature varies according to different


product specifications and also operator choice but in any case tempering
of the material should not exceed 10min since the gelation may proceed
too far.

Uses of tempering:

• It increases the viscosity of the material so that the hydrocolloid does not
flow out.

• It reduces the temperature of the material so that it is not uncomfortable


for the patient.

IMPRESSION:

• The syringe material is first filled in the prepared cavity or the desired area
of impression.

• The tempered tray material in a tray is then seated in the oral cavity
covering the already placed syringe material with passive pressure.

• Excess water from the surface of the tray material should be removed to
facilitate proper union of the tray and the syringe material.
 Gelation is accomplished by circulating cool water at 18C to 21C through
the tray for at least 5min. Care should be taken to prevent the movement
of the tray during gelation.

 After complete gelation the impression is removed from the mouth with a
single jerk to prevent the tearing of the impression.

Advantages:

• Accurate dies can be prepared.

• Due to good elasticity reproduction of undercuts is accurate.

• It gives good model surface as it is not hydrophobic.

• It is palatable and well tolerated by patients.

• It can be re-used

Disadvantages:

• Material tears relatively easily.

• Only one model can be prepared.

• Extensive instrumentation is required to use agar.

• A soft surface of the gypsum cast results unless plaster hardener is used.

Irreversible Hydrocolloid

 Material that cannot return to a solution state after it becomes a gel.

 Alginate is the irreversible hydrocolloid most widely used for preliminary


impressions.

 Hydrocolloid because it consists of particles of a gelatinous (colloidal) state


in water (hydro) and irreversible because once it has jelled it cannot be
returned to a liquid solution.
 The Word Alginate comes from the term “ALGIN”.

 It is a peculiar mucous extract yielded by certain brown seaweed ( algae ).

 The term ‘ALGIN’ was coined by chemist from scotland @ the end of 19 th
century.

TYPES

Type I – Fast setting.

Type II – Normal setting.

Physical Phases of Alginate

 The first phase is a sol (as in solution). In the sol phase, the material is in a
liquid or semiliquid form.

 The second phase is a gel. In the gel phase, the material is semisolid, similar
to a gelatin dessert.

Alginate mixing

 Start by selecting a tray size that is slightly larger than arch (2mm).

 Fluff or aerate the powder before dispensing.

 Pour measured amount of water into a clean mixing bowl and then add
powder.

 The number of recommended scoops depends on the procedure and size of


the tray.

 Fill scoop with powder, tap side with spatula then level off do not pack
powder to tightly in scoop you will have to much powder to water ratio for
mix.
 Two scoops are generally used for full arch impressions.

 Measure the matching amount of water with cup provided.

Water-to-Powder Ratio

 An adult mandibular impression generally requires two scoops of powder


and two measures of water.

 An adult maxillary impression generally requires three scoops of powder


and three measures of water.

 The higher the water temperature the faster the impression material will
set up. Use cooler water to allow more working time.

 If hand-mixing, rapidly mix alginate with a spatula, pressing the mixture


against the side of the bowl.

 Mixing time is approximately1 minute.

 At this point, the mix should be a smooth, creamy consistency that does not
fall off spatula.

 Collect alginate from sides of bowl with spatula and place the impression
material evenly in the tray.

 Set time is three minutes from start of mix. Fast set alginate is two
minutes.

 It is recommended to wipe alginate on occlusal surfaces before seating tray


to help prevent occurrence of trapping bubbles in impression.

 Roll the tray in the mouth one side then the other.

 Once the material is seated, remove tray.

 Wrap impression in a wet paper towel until you can pour it up.

 Spray the impression with a disinfectant and drain, before pouring with
stone or plaster.
 Do not allow the disinfectant to lay in the impression longer than the
recommended “kill time” as the solution can distort the alginate.

 For best results, the model should be poured within 30 minutes after the
impression is obtained prevent distortion.

The relief of anatomical information is a procedure of extreme importance in each


prosthetic rehabilitation.

 The possibility to read the cervical limits of a iuxta or under-the-gum


preparation in work models depends exclusively on the accurate creation of
an imprint, that extends to an apical level of such limits.

 The obtaining of an over-extended impression is the fundamental principle


for the respect of the emergent anatomy and contour during the creation
of prosthetic products. To obtain this, it is necessary to add imprint
material in the gum groove and it is indispensable that there exists a
physical gap necessary for such material. If this gap is non-existent
microscopically, it must be created through the technique of the retraction
of parodontal tissues.

 The methods actually in use for the vertical and horizontal retraction of the
groove are:

 Techniques with retraction string (or elastic) (medicated or not)

 Techniques using copper rings (no longer in use)

 Mechanical dilation of the gum groove

 Gum courettage

 Techniques by means of electrical scalpel

 Techniques with bridge guides and modification of the same.

Rigid impression materials


Zinc Oxide Eugenol (ZOE) is an Irreversible Rigid Impression material used as a
secondary technique to take impression of edentulous patients with the help of
mucocompressive technique.

Classification (ADA specificatiin No 16):

• Type I: Hard

• Type II: Soft

• Zinc oxide eugenol (ZOE) is a material created by the combination of zinc


oxide and eugenol contained in oil of cloves.

• The reaction is catalysed by water and is accelerated by the presence of


metal salts.

• Zinc oxide eugenol is used as an impression material in the mucostatic


technique of taking impressions, usually in a special tray (acrylic), produced
after primary alginate impressions.

• However, ZOE is not usually used if the patient has large undercuts or
tuberosities, whereby silicone impression materials would be better suited.

 ZOE impression pastes are dispensed as two separate pastes:

1. One tube contains zinc oxide and vegetable or mineral oil;

2. The other contains eugenol and rosin.

The vegetable or mineral oil acts as a plasticizer and aids in offsetting the action
of the eugenol as an irritant.

Manipulation:

1. Dispense equal length of the 2 pastes.

Variation in length alters setting time.

2. Paper pad used as a mixing slab& a stiff stainless steel spatula with an 8-10 cm
blade should be used.
3. Mixing is done for 30-40 sec until no color streaks in the mix are seen as a
uniform consistency is obtained.

4. The mix is then transferred to a impression tray to take an impression.

Factors decreasing setting time:

 Small amount of zinc acetate

 Accelerators

 Small drop of water mixed in the paste containing eugenol

 Increasing the mixing time

 Increasing accelerator paste while mixing

 Factors increasing setting time: Cooling the spatula or mixing slab

 Addition of inert oil or waxes during mixing to reduce hardness like: olive oil

 Increasing base while mixing

 NON-EUGENOL IMPRESSION PASTES NON-EUGENOL PASTE are developed


to overcome the burning sensation caused by eugenol.

 Bactericides and other medicaments are also incorporated.

 Used in eugenol irritant patients.

Impression compound:

 Impression compound is rigid,reversible impression material sets by


physical change.

 It softens on heating and hardens on cooling.

 Supplied as sheets,sticks,cakes and cones.

Applications:

 Making preliminary impression of edentulous mouth.


 For individual tooth impression.

 To make a special tray.

 Border moulding.

 To check undercuts in inlay preparations.

Composition:

Presentation

 L.F. Cakes for full impression

 H.F. Cakes for making special trays

 L.F. Green sticks for border tracing

 L.F. Cones for copper ring impressions

Dental waxes

 Waxes are thermoplastic materials which are solids at room


temperature but melt without decomposition to form mobile liquids.
 They consist of two or more components which may be natural or synthetic
waxes, resins, oils and pigments

Elastomeric impression materials

Elastomeric = Rubber-like polymers that show an elastic behavior at the time


of load application.

 Higher tear strength

 More stable dimensionally in storage

(No Synersis, Imbibation or Evaporation)

 Ability to be electroplated

But, Quite Expensive !!!!

Materials’
Consistency
Presentation forms

Light

Medium

Heavy

Putty
Silicone
materials only

Polysulfide Rubber Impression Material

These materials are also known as thiokol rubbers as they are derived from
thiols.
Base: polysulfide. and an inert filler, such as titaniumdioxide and activator
paste containing lead dioxide, which gives the distinctive brown colour.

Catalysts: Copper hydroxides, zinc peroxide, organic hydroperoxide.

Manipulation and Technique Considerations for Polysulfide Material

 -Dispense pastes at the top of the mixing pad.

 -Mix pastes with the tip of a spatula to incorporate the material first.

 Transfer the material to the fresh surface of the mixing pad and
tyhinnen polysulfide film.

 InitIal mixing of polysulfide Initial mixing is conducted with the tip of


the spatula and performed with circular motions.

 With such an approach, the base and reactor pastes are rather quickly
dispersed.

 Unfortunately, such a mixing technique also results in air bubbles being


incorporated into the impression material. Because of the latter, the
mixing technique has to change during the remaining mixing.

 Thinnen polysulfide film After the initial mixing with circular motions
over a rather small area, the mixed material is now spread over a large
area and mixed with long even strokes back-and-forth.

 During this phase of the mixing procedure, the material is forced to a


thin film.

 The combination of a thin film and a longer time from passing over a
certain region until the spatula returns to the same region allows
incorporated air bubbles to float up to the surface and escape from the
impression material.

 Impression should be removed quickly after setting-do not rock the tray.
 The setting process or the polysulphide impression material is highly
susceptible to changes in environmental conditions, such as temperature
and humidity variation.

POLYETHER IMPRESION MATERIAL

The main shortcoming with condensation polymerized impression materials is


that a by-product is formed that evaporates and cause shrinkage over time.

 To overcome that problem, the German manufacturer of dental materials,


ESPE, developed an impression material that was originally designed for
dental use.

 That material was named a polyether and reacted through an addition


polymerization process.

 This material was patented and introduced on the market during the early
60's.

 Permadyne is a polyether material available as a low viscous and high


viscous impression material.

 The material is manually mixed and the proportions are 7 parts base and 1
part catalyst.

 To achieve good adhesive to the tray, the tray need to be coated with a
polyether adhesive.

 The adhesive need to dry for a min of 60 s while 15 min is recommended.

 The mixing time for Permadyne low viscous paste is 30 .

 Working time from start of mixing is 3 min and time from start of mixing
until removal is 6 min.

Silicones

There are two important groups of silicone impression materials:


 One group is known as the condensation-cured silicones and the other as
the addition-cured silicones.

 Both are based on the polydimethyl siloxane polymer but have different
end groups, giving rise to different curing mechanisms.

 The first c-silicones were introduced a few years after the first polysulfide
impression materials.

 These materials are virtually odorless and have a neutral taste and thereby
overcome some of the disadvantages with the polysulfides.

 However, their tear strength showed to be lower than that of polysulfides,


and the dimanional stability was inferior to that of the polysulfides.

CONDENSATION SILICONES

Also known as conventional silicones.

Composition:

 Base paste : Containing silicone fluid and a filler.

 Activator paste: tetra-ethyl silicate (the crosslinking agent).

It is important that the amount of activator paste used is carefully controlled.


Insufficient TES gives rise to an incomplete cure, leaving a material with poor
mechanical characteristics, such as high permanent set. Conversely an excess
of TES also gives an incomplete cure, leaving many unreacted ethyl end
groups.

ADDITION SILICONES

These materials are similar to the condensation-cured silicones, in that they


are also based on a polydimethyl Siloxane polymer; however, in this case the
terminal groups are vinyl’s group.

The addition-cured silicones present as a :


 Base paste :polyvinyl siloxane, silanol and a filler

 Catalyst paste: polyvinyl siloxane, platinum catalyst and a filler.

The elastomeric impression materials are available in a range of viscosities,


depending on the amount of filler that is incorporated:

Polysulphides

Heavy, medium and light bodied impression ,paste forms are available, there is
no putty version.

Polyethers

 These materials are available only in a single viscosity and can be used in a
special tray using a single viscosity mix.

CCS & ACS

 A wide range of viscosities are available, varying from a putty, to a heavy, a


medium and a light bodied material. Thus, these materials can also be used
in a wide range of impression techniques.

MIXING SYSTEMS hand mixing,

 static Automixing,

 dynamic mechanical mixing

Hand mixing

 hand mixing is with the two putty systems, offered both with
condensation and addition silicones. Scoops are supplied by the
manufacturer for dispensing, and the putties are most often kneaded
with fingers until free from streaks.

Dynamic mechanical mixing

 The catalyst and base are supplied in large plastic bags housed in a
cartridge, which is inserted into the top of the mixing machine.
A new, plastic mixing tip is placed on the front of the machine, and when the
button is depressed parallel plungers push against the collapsible plastic bags,
thereby opening the bags and forcing material into the dynamic mixing tip.

Dental acrylic resins

Poly(methyl methacrylate) (PMMA), also known as acrylic or acrylic glass


= polymers of acrylic acid, methacrylic acid, or
acrylonitrile, such as acrylic resins
used in making dental restorations, prostheses,and appliances.

Cast post and core (CPC) system

 A post and core (colloquially known as a "post" or "dental post") is a type


of dental restoration used either to stabilize a weakened tooth or provide
an anchor for a crown.

DENTAL CEMENTS

 Dental cements are hard, brittle materials formed by mixing powder and
liquid together.

 They are either resin cements or acid-base cements. In the latter the
powder is a basic metal oxide or silicate and the liquid is acidic.

 An acid base reaction occurs with the formation of a metal salt which acts
as the cementing matrix.

 Dental cements are used for a variety of dental applications, including use
as luting agents, pulp-protecting agents or cavity-lining material, to form an
insulating layer under metallic or ceramic restorations, and protect the pulp
from injury.
 Requirements Be non irritant to pulp and gingiva (gums) and should not
support the growth of secondary caries. (This last property is called
cariostatic or anticariogenicity).

 Form a strong bond with enamel and dentin.

 Provide good marginal sealing to prevent marginal leakage.

 Be resistant to dissolution in saliva, or in any oral fluid.

 Have good aesthetics and good thermal and chemical resistance. (Opacity
to X-rays is also preferred for diagnostic purposes).

 Be translucent.

 Have a low film thickness (ideally 25microns).

classification

Cements can be classified based on the type of their matrix:

1. Phosphate (zinc phosphate, silico phosphate)

2. Polycarboxylate (zinc polycarboxylate, glass ionomer)

3. Phenolate (Zinc oxide–eugenol and EBA)

4. Resin (polymeric)

Type I: Luting agents that include permanent and temporary cements.

Type II: Restorative applications.

Type III: Liner or base applications.

Luting Agent

A material that acts as an adhesive to hold together the casting to the tooth
structure. Luting agents are designed to be either permanent or temporary.
Permanent Cement

For the long-term cementation of cast restorations such as inlays, crowns,


bridges, laminate veneers, and orthodontic fixed appliances.

Temporary Cement

Temporary cements are used when the restoration will have to be removed.
Most commonly, temporary cement is selected for the placement of
provisional coverage.

Mixing Dental Cements

Before mixing, read and carefully follow the manufacturer's directions for the
brand being mixed.

Determine the use and then measure the powder and liquid according to the
manufacturer's instructions.

Place the powder toward one end of the glass slab or paper pad and the liquid
toward the opposite end (the space between allows room for mixing).

Divide the powder into increments.

When increment sizes vary, the smaller increments are used first.

Incorporate each powder increment into the liquid and then mix thoroughly.

Types of Cements

 Zinc-oxide eugenol
 Zinc phosphate
 Polycarboxylate
 Glass ionomer
 Composite resin

Zinc Oxide Eugenol

Supply of Zinc-Oxide Eugenol


 Liquid/Powder

– Mixed on an oil-resistant paper pad.

– Mixing time ranges from 30 to 60 seconds.

– Setting time in the mouth ranges from 3 to 5 minutes.

 Paste

– Supplied as a two-paste system as temporary cement.

– Pastes are dispensed in equal lengths on a paper pad and mixed.

Zinc Phosphate

Supply of Zinc Phosphate

Powder/liquid

– Powder is divided into increments that vary in size.

– It is critical that the powder be added to the liquid in very small


increments.

– Cement must be spatulated slowly over a wide area of a cool, dry,


thick glass slab to dissipate the heat.

Polycarboxylate Cements

Zinc Polycarboxilate cement was the first cement developed with the property
of an adhesive bond to tooth structure along with some metallic cast
restorations.

 Used as a permanent cement for cast restorations, stainless steel crowns,


and orthodontic bands.

 Used as a nonirritating base under both composite or amalgam


restorations.

 Used as an intermediate restoration.


Manipulation

1. Dispense one drop of liquid and powder on a mixing pad. Powder/liquid


ratio is 1.5 parts of powder to 1 part of liquid by weight.
2. Incorporate half of the powder in the luiquid in patting and folding
motions using a small area of the pad surface. proper

3. Add small increments of powder to the mix, using the same mixing
motions until acquiring the proper consistency.

4. Mixing time is 30 to 60 seconds.

5. Cement should be used immediately because the working time is short.

6. The cement is no longer usable when it looses its lustre or start to


“cobweb”.

7. Setting time is 6 to 9 minutes.

8. Polycarboxylate cement will adhere to instruments particularly those


made od stainless steeel. Thus useful is to use alchohol, i.e. spirit or dry
powder as a release agent for the mixing spatula.

9. Instruments should be cleaned before the cement sets on them.

Glass Ionomer Cements (GIC)

Glass-ionomer is the generic name of a group of materials that use silicate


glass powder and aqueous solution of polyacrylic acid, an ionomer.
Mixing of the cement

Full spoon, no excess

Yawar

Tip liquid bottle to side, then invert


completely.

Yawar
Liquid should not stay on paper pad longer than
1minute (some of it may soak into it).

Yawar

Composite resins

 Dental composite resins are types of synthetic resins which are used in
dentistry as restorative material or adhesives.

 Synthetic resins evolved as restorative materials since they were insoluble,


aesthetic, insensitive to dehydration, easy to manipulate and reasonably
inexpensive.

Supply of Composite Resin

Powder and liquid mix

 Syringe-type applicator

 Base and catalyst

 Light cure/dual cure system

– Recommended portions of either application are dispensed onto a


paper pad and mixed rapidly with a spatula.

Direct dental composites


Direct dental composites are placed by the dentist in a clinical setting.
Polymerization is accomplished typically with a hand held curing light that
emits specific wavelengths keyed to the initiator and catalyst packages
involved.

 Polymerization is accomplished typically with a hand held curing light that


emits specific wavelengths keyed to the initiator and catalyst packages
involved. When using a curing light, the light should be held as close to the
resin surface as possible, a shield should be placed between the light tip
and the operator's eyes.

 Curing time should be increased for darker resin shades. Light cured resins
provide denser restorations than self-cured resins because no mixing is
required that might introduce air bubble porosity.

Direct dental composites can be used for:

 Filling cavity preparations

 Filling gaps (diastemas) between teeth using a shell-like veneer or

 Minor reshaping of teeth

 Partial crowns on single teeth

Indirect dental composite

Indirect composite is cured outside the mouth, in a processing unit that is


capable of delivering higher intensities and levels of energy than handheld
lights can.

 Indirect composites can have higher filler levels, are cured for longer times
and curing shrinkage can be handled in a better way.

 As a result, they are less prone to shrinkage stress and marginal gaps.

Indirect dental composites can be used for:

 Filling cavities in teeth, as fillings, inlays and/or onlays


 Filling gaps (diastemas) between teeth using a shell-like veneer or

 Reshaping of teeth

 Full or partial crowns on single teeth

 Bridges spanning 2-3 teeth

POLYACID MODIFIED RESIN


COMPOSITE / COMPOMER
FLUORIDE
RELEASING DURABILITY
CAPABILITY OF
OF GIC COMPOSITES

COMPOMER