Dental Material

Front 1

Dentrifice composition

Back 1

Abrasives
Humectants - Stabilize the composition and reduce water loss by evaporation. Glycerol or Sorbitol
Water
Detergent - Reduce surface tension and enhances the removal of debris from the tooth surface. Foaming. Sodium lauryl.
Colloidal binding agent - Carrier that prevents separation of active ingredients
Flavoring agents
Therapeutic agents
Perservatives

Front 2

Abrasives & Abrasivity

Back 2

Removes plaque and stain
- Calcium pyrophosphate
- Calcium carbonate
- Heaviest abrasive is Sodium Bicarbonate (Baking Soda)

- More loss of tooth surface with larger particle size, irregular particle size, Particle density etc

Front 3

Control Calculus formation

Back 3

Tetrasodium or Tetrapotassium pyrophosphates
- Inhibitors of Hydroxyapatite crystal growth

Side effects - Creates more alkaline environment leading to soft tissue sensitivity. Bitter taste

Front 4

Anti-caries

Back 4

Sodium flouride or Sodium monofluorophosphate
- 1000-1500ppm
- Rx - 5000ppm

- Increase uptake of Fl ion resulting in flouroapatite with increased resistance to acid demineralization

Front 5

Sensitivity agent

Back 5

Calcium and Phosphate ions
- MI paste Recaldent
- In office only for polishing and cleaning. Can be used to manage tooth sensitivity

Arginine & Calcium carbonate
- Pro-relief desensitizine prophy paste for in office. Pro-Argin technology that touts tubule occlusion and binds to negatively charged dentin surface.

Potassium Nitrate 5%. Sensodyne
- Inhibits repolarization of nerve endings to reduce pain response.

Front 6

Antimicrobial & Concerns

Back 6

Triclosan
- Potent against S. Mutans
- Direct anti-inflammatory effects
- Colgate total, Sensodyne total care

- Concerns with resistant strains of S. Mutans
- Can combine with Chlorine in tap water to form Chloroform gas
- Can react with chlorine to produce dichlorophenol and can be converted to dioxins upon exposure to UV. Very toxic and chemically table.

Front 7

Whitening agents

Back 7

Neither FDA or ADA defines what "whitening" means. So any manufacturer can use the term on product labels.

- Carbamide peroxide or sodium tripolyphosphate plus an abrasive like Silica

- Silica that does most of the work

Front 8

ADA vs FDA

Back 8

- Must meet ADA requirements for safety and effectiveness in reducing tooth decay
- Must provide clinical studies in humans and laboratory studies to determine the amount of available Flouride, flouride release in one minute, and amt of flouride absorption. Conducted in ADA lab.

- FDA requires flouride-containing toothpaste active ingredients meet certain standards, and meet their claims and qualifications. Does not test toothpastes to verify compliance.

Front 9

PPR

Back 9

Professional Product review provided free to ADA members four times a year to compare products.
- No longer eligible for ADA seal of Acceptance.

Front 10

Mouthwash main ingredients

Back 10

Three main ingredient
- Active anticaries, antimicrobial agent
- Water/alcohol - delivery solution
- Surfactant - Remove debries. Sodium lauryl sulfate
- Flavoring agents

Front 11

Active Agents Mouthwash

Back 11

Sodium Flouride OTC
- Anti caries in two stages. Layer of calcium flouride & Absorption and conversion of HA to FA

Essential oils OTC
- Effective in preventing plaque and reducing inflammation

Cetylpyridinium chloride OTC
- Crest pro health, Listerine
- Bactericidal quaternary ammonium compound
- Brown staining and dysguesia

Chlorhexidine Gluconate RX:Peridex
- Effective in preventing plaquue and redicing inflammation.
- Brown staining and increased calculus

Front 12

Acidity and Ethanol

Back 12

Ethanol - Dryness & Softening of resins
Acid - Demineralization
Both - Toxicity of biocompatibility

Front 13

Biotene products

Back 13

Glucose oxidase & Lactoperoxidase to change Glucose to H2O2 to Hypothiocyanite which is natural anti-bacterial agent.

Front 14

Flouride gels

Back 14

In-Office
- Acidulated phosphate flouride
- Sodium Flouride
- Nupro - 2% neutral sodium fluoride
- Few clinical studies on effectiveness of fluoride foams

At home prescription of sodium fluoride gel contains 5,000 ppm of flouride

Front 15

Fluoride varnish

Back 15

Contains 5% Sodium flouride ion in an ethyl alcohol varnish solution
Evaporates after application leaving thin film

Front 16

Bis-GMA resins

Back 16

Most commonly used sealant & much more fluid than restorative resins
- Fluoride impregnated for 24hrs

Front 17

Glass ionomers vs Flowable composites

Back 17

GI
- Flouride release for first 15 days
- Viscosity lack penetration and therefore retention. Brittle and less resistant to wear

Flowabel - Low viscosity composite. Application not well supported with data

Front 18

Mouth protectors properties & types

Back 18

More polyethylene makes it harder. and greater than 65% impact absorption

Shock mouthguard - Cheap and least protective. Bulky and held in place by biting down

Mouth formed boil and bite - Most common OTC mouth protector formed from thermoplastic material. Inadequate protection

Custom - Thermoplastic mouthguard from cast. Laboratory pressure lamination procedure for 3-4mm occlusal. Hard occlusal guards

Front 19

High Noble, noble vs non-noble alloys

Back 19

High noble - Composition over 60% Noble metal of gold, palladium an platinum. 40% of which must be gold

Noble alloy - Atleast 25% Noble metal content

Non-noble - aka Base metals. Less than 25% noble metals, and mostly nickel, chromium or berryllium

Front 20

Cast gold alloys

Back 20

80-90% gold with platinum or palladium to harden it.

Good corrosion resistance and good bonding to porcelain

- Minimum alloy thickness of 0.5mm required

Front 21

Corrosion occurs

Back 21

Oxidizes at Anode surface areas

Front 22

Creep

Back 22

High temperature and constant stress resulting in progressive deformation of a material

Front 23

Stainless Steel

Back 23

Alloy of Iron and Carbon. Also contains chromium for corrosion resistance through passive oxide layer on surface.

Front 24

Wrought alloys

Back 24

Increased tensile strength and hardness
Decreased ductility and resistance to corrosion compared to cast

Front 25

Agar hydrocolloids composition, Components

Back 25

Derived from marine plant

Mannuronan regions for elasticity but weak and Guluronan regions for strength, but brittle.

Reactant - Calcium sulphate
Retarder - Sodium phosphate
Filler - Zinc oxide & Silica from Diatomaceous earths and siliceous particles.

Front 26

Alginate mixing proportion, accuracy, and storage

Back 26

- Regular set is 2-3.5min
Fast set is 1min
- Cold water at 18-24deg C increases set time

- Capture detail at 25 nanometer

- Store at 100% humidity. Wrapped in moist paper towel in a plastic bag
Inaccurate storage:
- Syneresis leading to dehydration and shrinkate
- Imbibition leading to absorption of water & Expansion

Front 27

Reversible Hydrocolloid

Back 27

Good for Fixed prosthodontics
Made fluid by 103F heat & requires water cooled trays to form elastic solid

Cumbersome and high startup cost

Front 28

Types of cements according to setting reaction

Back 28

Acid-Base
- Zinc phosplate, Silicate, & Polyalkenoate - Polycarboxylate, Glass ionomer - are water based. CaOH and ZOE

Free radical polymerization
- Hybrid glass ionomer is water based
- Resin cement

Front 29

Working time vs Setting time

Back 29

Working - Time measured from beginning of mixing to maximum time at which viscosity is low enough to flow

Setting - Time from beginning/end of mixing till cement reaches such a resistance that external force will not cause permanent deformation

Front 30

Water-based cements

Back 30

Setting reaction: Neutralization reaction
- Base powder + Acid liquid in water to form Salt + Water matrix
- Water is needed to dissolve acid, dissociation of acid groups, and hydrate cement particles to release alkaline ions from their surface.

Front 31

Fast mixing and setting time

Back 31

Prolongs setting time by breaking formed cement structure into fragments

Front 32

CaOH cements

Back 32

Paste A: Ca(OH)2, plasticizer
Paste B: Salicylates, disalicylates, fillers

- Low strength but as base, they can neutralize acid to have antibacterial effect. Induces formation of secondary dentin.

Front 33

Impression material classification system

Back 33

Rigid - Plaster, Compound, ZOE. Non elastic

Water based gel - Alginate, Agar-Agar. Elastic

Elastomers- Polysulfide, Silicone, Polyether, PVS. Elastic

Front 34

Polysulfide rubber chemistry and setting reaction

Back 34

Continuous phase: Mecapto-functional polymer crosslinked with sulfur or oxygen from lead peroxide
Fillers: Filled to reduce shrinkage using least expensive material at the time. Typically TiO2 or Zinc sulfate

Front 35

Condensation reaction silicone

Back 35

Catalyzed with Tin octoate, Not dibutyl tin diiaurate, and is thus a medical grade silicone rubber.

Silica is primary filler

Front 36

Polyether rubber

Back 36

Amine terminated polyethers are crosslinked in the presence of aromatic sulfonates.

Front 37

Polyvinyl Siloxane

Back 37

Double bond functional silicone polymer with Chloroplatinic acid as crosslinking agent.

Fillers has to be silica

Use Palladium absorber to prevent bubble formation from hydrogen gas

Front 38

Impression materials key properties

Back 38

Accuracy - PVS highest wetting of tissues, but lowest wetting of stone. Alginate is poor tissues but high stone

Dimensional stability - PVS highest, then PS and Alginate is lowest

Tear resistance - PS is highest, PVS then Alginate

Front 39

LCTE

Back 39

Coefficient of thermal expansion of metal must be higher than porcelain

Front 40

PFM bonding mechanism

Back 40

No Physical bonding

Mechanical bonding from sandblasting the casting alloy

Chemical from oxides of metal and porcelain mixing. In gold alloys, Fe impurities or added iron produces iron oxide film for bonding. In all other alloys, Sn, In, or Zn is added for binding. Indium is most widely used.

Front 41

Types of PBM allous

Back 41

Type 1 - Over 90% gold platinum or palladium. Little iron, indium, tin

Type 2 - 80% precious

Type 3 - Palladium-silver alloys

Front 42

Effects of components in alloys

Back 42

Ag, Au, Pt, and Pd for corrosion resistance
Ag - counteracts orange color and decreases cost
Pt - Increases melting point
Pd - Increases melting point and hardness
Cu - Increases hardness
Zn - Oxygen scavenger
Fe, In, Sn - Oxide formers
AgPd - 85% of PFMs

Front 43

Clinical indications for alloys

Back 43

Long span can't use Pd-Cu because it can cause soldering or joining problems

Front 44

High thermal expansion coefficient

Back 44

Created by addition of potassium oxide and formation of high expansion phase called Lucite.

Front 45

ADA gold classification and use

Back 45

Type 1 - 83% non heat hardenable - Inlays
Type 2 - 78% Non heat hardenable - largers Inlays & onlays
Type 3 - 78% Heat hardenable - Large onlays & Crown
Type 4 - 75% Heat hardenable - Crown & Bridge

Front 46

Cold cure

Back 46

Nature-cryl

Quick cure under pressure and hot water
- Used for denture repairs, relines and flippers

Front 47

Heat Cured Denture acrylic shades

Back 47

Lucitone 199
Original shade
Meharry shade
Clear shade

Front 48

To prevent denture resin from sticking to stone during processing

Back 48

Add a coat of COE sep as soon as steam evaporates from flask

Front 49

Trial packing

Back 49

Add acrylic to teeth area and press under plastic sheet
- Insert into denture press and repeat 3 times at 1500lb and 1 time at 3000lbs

- Reduces possibility of changes in vertical dimension after curing

Front 50

Zinc oxide Eugenol reaction, uses, precautions, and modifications

Back 50

Zinc Oxide + Eugenol with water to produce Zinc eugenolate. Reversible reaction

- Sedative temporary restorations
- Temporary cementing of crowns and provisionals

- Cannot use with composites because of inhibition of free radical polymerization

Can add EBA to add strength to inhibit free radical polymerization

Front 51

Zinc phosphate cements reaction, advantages and disadvantages

Back 51

Use phosphoric acid instead of eugenal to form amorphous zinc phosphate.

- Gold standard of cements
- Very high compressive str
- However, is acidic and can be pulpal irritant and difficult to mix

Front 52

Polycarboxylate cements chemistry and characteristics

Back 52

Replace phosphoric acid with polyacrylic acid
- Very short working time and bonds to tooth and everything else

Front 53

Silicate cements chemistry,

Back 53

Replace Zinc oxide with Silicate
- Old esthetic filling material, but soluble and picks up stains due to rough surface

Front 54

Glass Ionomer cements vs Resin modified glass ionomers

Back 54

Sets via Acid base
- High compressive strength, bonds to tooth, slow set, and *Flouride release.

Resin modified glass ionomers
- Modified to set via polymerization as well as acid/base
- Sets faster, so no post-op sensitivity
- But expands on setting

Front 55

Resin cements characteristics and uses

Back 55

Basically a flowable composite that can be light cured, chemical cured, or both.
- Low solubility and high strength

- Used for all porcelain crowns, crowns and posts with poor retention, and CAD/CAM restorations.

Front 56

Zinc phosphate cements reaction, advantages and disadvantages

Back 56

Use phosphoric acid instead of eugenal to form amorphous zinc phosphate.

- Gold standard of cements
- Very high compressive str
- However, is acidic and can be pulpal irritant and difficult to mix

Front 57

Polycarboxylate cements chemistry and characteristics

Back 57

Replace phosphoric acid with polyacrylic acid
- Very short working time and bonds to tooth and everything else

Front 58

Silicate cements chemistry,

Back 58

Replace Zinc oxide with Silicate
- Old esthetic filling material, but soluble and picks up stains due to rough surface

Front 59

Glass Ionomer cements vs Resin modified glass ionomers

Back 59

Sets via Acid base
- High compressive strength, bonds to tooth, slow set, and *Flouride release.

Resin modified glass ionomers
- Modified to set via polymerization as well as acid/base
- Sets faster, so no post-op sensitivity
- But expands on setting

Front 60

Resin cements characteristics and uses

Back 60

Basically a flowable composite that can be light cured, chemical cured, or both.
- Low solubility and high strength

- Used for all porcelain crowns, crowns and posts with poor retention, and CAD/CAM restorations.

Front 61

Polymer cements advantage and disadvantages

Back 61

aka Composites
- Bond to enamel, dentin, ceramic, composite, low solubility
- However, may be too thick, difficult to remove excess, and may be too strong.

Front 62

Compomers chemistry, characteristics

Back 62

Polyacid modified resin composite to allow for acid-base reaction
- Greater F- release, improved flow, and retains composite properties

Front 63

Giomers

Back 63

Includes pre-reacted glass ionomers
- Filler becomes product of acid/base reaction + Glass particles

Front 64

Matrix content

Back 64

More matrix: Low str, high flow and good wetting

less matrix: Long setting time, high str, low solubility, low acidity

Front 65

Pulp irritation, Tensile str, Solubility

Back 65

Pulp Irritation: Least is ZOE, Most is composite without bonding

Tensile: Composite is highest, ZOE lowest

Solub: CaOH highest, composite lowest

Front 66

Relyx Unicem & Relyx Luting

Back 66

Unicem - Compomer
Luting - RMGI

Front 67

Porcelain classifications

Back 67

1- Glass based: Mostly silica with very little crystal phase. Weak, and most be bonded to substructure. Can be etched and bonded.

2- Glass based with crystalline 2nd phase added Leucite(Empress) or Lithium Disilicate(e-max). Can still bond.

3 - Interpenetrating phase. No glass phase, therefore, no binding.
-In-ceram Spinell is most translucent with good str. Ideal for anterior esthetic teeth
- In-ceram Alumina has high str and moderate translucency for ant and post crowns
- In-ceram ZirconiaL High str and low translucency and used mostly for 3 unit bridges

4- Polycrystalline solids: Formed by sintering crystals together. 20% shrinkage and no bonding.

Front 68

E.max CAD

Back 68

High strength glass ceramic block for CAD/CAM

- Can be veneered

Front 69

Crown pyramid

Back 69

Higher is increased esthetics but decreased strength

- Feldspathic porcelain is highest with Zirconia at the lowest.