Topic 1 Introduction DM_AC.pdf

Dental Materials Arief Cahyanto, DDS., M.Eng., PhD. Associate Professor Department of Restorative Dentistry Ajman University UAE Course Information & Assessment E-Learning Login ,MUST!! Text-book: 1. John M. Power, John C. Wataha. 11th Ed. 2017 2. Kenneth J. Anusavice. P...

Dental Materials Arief Cahyanto, DDS., M.Eng., PhD. Associate Professor Department of Restorative Dentistry Ajman University UAE Course Information & Assessment E-Learning Login ,MUST!! Text-book: 1. John M. Power, John C. Wataha. 11th Ed. 2017 2. Kenneth J. Anusavice. Phillip’s Dental Materials 12th Ed. General rules Office Hours Course ASSESSMENT First and Second Quizzes: 20 marks (10 each) Exams: *Mid-term: 30 marks (Written 20 / Practical 10) *Final: 40 marks (Written 30 / Practical 10 + 5 continuous evaluation) Continuous Evaluation: Profesionalism, Commitment and Involvement (5) COURSE LEARNING OUTCOMES 1. Identifiy the types and classifications of the dental materials and their indications. 2. Identify the characteristics and the properties of different types of dental materials in terms of physical, chemical, mechanical behavior and biocompatibility. 3. Describe the chemical compositions and the setting behavior of different types of dental materials. 4. Describe the proper mixing and handling methods of different types of dental materials. Course Topics 1- Introduction to dental materials 2- Properties of dental material 3- Gypsum products 4- Polymers 5- Impression materials 6- Amalgam 7-Direct tooth-colored restorative material (I) 8- Direct tooth-colored restorative materials (II) 9- Principles of bonding 10- Dental wax 11- Casting alloys 12- Dental ceramics Introduction to dental materials Terminology Biomaterials Biocompatibility Biomechanics What is Biomaterials? Biomaterials: A non-living material designed to interact with biological systems. Ex.: -Cardiovascular implants (prosthetic heart valves). -Structural implants (oral and maxillofacial implants and joint prostheses). -Dental restorative materials ( filling materials). Science of Dental Materials : is defined as…. Study of composition and properties of dental materials and the manner in which they Interact with the environment in which they are placed. Biocompatibility Biocompatibility: Ability to be in contact with a living system without producing an adverse effect. A material is said to be biocompatible when it has the quality of being non- destructive in the biological environment. Biocompatibility of dental materials: - Non-irritating to the oral cavity and tooth tissue - Non-toxic for patient, dentist and staff - Non-allergic - Non-carcinogenic Biomechanics Biomechanics is the science that studies how biological materials interact and deform when subjected to environmental challenges. Biomechanics of Dental Materials i.e., to know how well the dental materials are able to withstand the forces generated from the action of mastication and occlusion or thermal contraction and expansion due to temperature changes in the oral cavity. DENTAL DISEASE & RESTORATIVE DENTAL MATERIALS Restorative dental materials are used to prevent or repair damage to teeth caused by oral disease (Most commonly caries and periodontal diseases) or trauma. CARIES Caries is caused by a bacterial biofilm commonly called plaque, which accumulates on teeth in areas where patients do not remove it. A complex community of bacteria in the biofilm adheres to teeth and secretes acids and enzymes that dissolve the enamel, dentin, and cementum. Carious lesions occur on any tooth surface but are most common in areas where plaque accumulates unchecked— in the pits and fissures, along the gingiva, and interproximally. PERIODONTAL DISEASE Unlike caries, periodontal disease affects the tissues supporting the teeth. This includes : Gingiva, Periodontal ligament, Cementum, and Alveolar bone  Restorative dental materials are used to limit tooth mobility or replace the function of lost teeth. Materials also are used to reduce sensitivity associated with exposed root surfaces. TRAUMA, SYSTEMIC DISEASE, AND GENETIC DISORDERS Trauma may fracture only the enamel or dentin or may cause a fracture of the tooth that involves the pulp or alveolar bone. Teeth may be completely lost (avulsion) or displaced in any direction. Restorative materials are used to repair teeth, stabilize them until the supporting tissues heal, or replace them. Systemic disease sometimes destroys teeth and oral tissues, and restorative materials are used to repair this damage. Dental materials are: Classification of Dental Materials (based on dental application) 1- Preventive dental materials: Pit and fissure sealants. Fluoride gels , rinses, and varnish are highly effective at preventing caries. Fluoride also have been incorporated into direct esthetic filling material and cements. Chlorhexidine or other therapeutic agents used to prevent or inhibit the progression of tooth decay and gum disease. Prevention of Trauma To prevent trauma, mouth protectors are often used. Mouth protectors: Mouth protectors are made of polymers that absorb the energy of the facial blows and preventing this energy from affecting the teeth and facial structures. Night guards: (composed of an acrylic material) appliance to protect teeth from inappropriate occlusal forces or to prevent inappropriate occlusal contacts. 2- Auxiliary dental materials: Substances used in the process of fabricating dental prostheses and appliances but do not become part of these devices. i.e: 3- Restorative dental materials: Synthetic components that can be used to repair or replace tooth structure. Restorative Dental Materials Restoration of damaged teeth Intracoronal Restorations: Used to repair damage that is restricted to internal parts of tooth, by either direct cavity preparation (in situ) or indirect technique. Several types of restorative materials are used for intracoronal restorations materials such as amalgam, resin composites , Glass ionomer cement, cast alloys ,ceramics , or less often gold foil. If the damage is restricted to the internal parts of the tooth (A–C), tooth preparation modifies the tooth for an intracoronal restoration, and the remaining external tooth structure retains the restoration Intracoronal Restorations: A. Direct Restorations 1. Metal Amalgam: A metallic restoration may be preferable for the restoration of the portion of a posterior tooth subject to considerably greater biting forces because of strength and wear resistance considerations. Intracoronal Restorations: A. Direct Restorations 2. Resin composite materials Usually chosen for the restoration of a portion of an anterior or posterior tooth that may be caused by either injury or caries. Their strength is a secondary factor. Weaker than metals, their excellent appearance and acceptable durability are the main reasons for their choice. Intracoronal Restorations: B. Indirect (Inlays) It is an intracoronal restoration that is fabricated outside the oral cavity and placed in the prepared cavity. Types of inlays: - -Cast alloys (metal) - -Ceramic -Cured composite resin Extracoronal Restorations Used to restore teeth with more extensive damage that cannot be managed with intracoronal restorations. Almost always using indirect techniques. Onlays: Is a combination of intracoronal and extracoronal cast restoration when one or more cusps are covered. Esthetic veneers Used to cover labial aspect of anterior teeth that are severely discolored, malformed, or eroded. Types: Resin composite Ceramic veneer Crown: A restoration that restores the anatomy and function of part or all of the coronal portion of the tooth. Types : “According to materials” Metal crown : Made of cast alloys ,suitable for the posterior portion of the mouth, where high strength is needed, and appearance is secondary. Porcelain fused to metal (PFM) crown: Consist of a metal crown with a veneer of porcelain. All ceramic crown : When the entire crown portion of an anterior or posterior tooth requires restoration, a crown made from ceramics can be used since this material combines strength with excellent esthetic properties. ENDODONTIC TREATMENT Endodontic treatment is necessary if oral disease or trauma involves the pulp of the tooth. The pulpal tissues are removed, and the resulting space is cleaned and sealed with restorative materials. Endodontic treatment “Root canal materials” Filling materials frequently used is gutta percha with special sealer cement then restoration of coronal portion of tooth by extra coronal restorations. Temporary Restorative materials: Are subcategory include products used for dental restorations and appliances that are not intended for long-term applications. e.g., Zinc oxide-eugenol cement, acrylic temporary crown. REPLACEMENT OF LOST OR MISSING TEETH The type of restoration depends on whether : A- Some teeth are missing (partial edentulism) or, B- All the teeth are missing (edentulism) A - Partial Tooth Loss (Partial Edentulism) 1. Fixed partial denture “Dental bridge” A bridge is prepared by placing extracoronal restorations (usually crowns) on the teeth adjacent to the edentulous space. These teeth are called abutment teeth, and the artificial replacement teeth are called pontics. A dental bridge consists of two components : Anchor/Retainers: The anchor crowns (also known as retainer crowns) are two (or more) dental crowns that are cemented on the teeth adjacent to the toothless gap to support the bridgework restoration. The two anchoring teeth are called abutment. Pontics : The artificial (or false) teeth are placed between the anchor crowns and basically replace the missing tooth or teeth. 2. Removable partial denture Removable partial dentures are prostheses designed to replace multiple missing teeth in the anterior or posterior areas of the mouth. Teeth are made of acrylic and bonded to the alloy framework. The appliance has rests that use the remaining teeth to absorb the forces placed on the missing teeth and clasps to retain the appliance. Partial dentures are common in situations when multiple teeth are missing in multiple locations and also when there is no distal abutment tooth available to anchor a fixed bridge. Removable partial dentures are advantageous to the patient from the standpoint of cleaning and inspection of the remaining teeth, but they are generally less esthetic and less comfortable for the patient to wear than permanently fixed prostheses such as bridges or implants. 3. Endosseous dental implants Are increasingly used to replace missing teeth. Dental implants are fabricated from special titanium-based alloy or more recently from ceramics. Endosseous implants are placed into bone with special techniques to ensure integration with bone, and then indirect restorations are placed on the implants. B. Loss of All Teeth (Edentulism) Complete denture A complete denture is a removable prosthesis that replaces all the teeth of the lower or upper arch. The denture consists of a base with artificial teeth. Most denture bases are made from acrylic resins that are pigmented to match the pink shades of the oral tissues. Ideal Restorative Material An ideal restorative material should: Be biocompatible Match the natural appearance of tooth structure and other visible tissues Exhibit properties similar to those of tooth tissues (enamel and dentine) Bond permanently to tooth structure or bone Be capable of initiating tissue repair or regeneration of missing or damaged tissues  THE ESTABLISHMENT OF CRITICAL PHYSICAL PROPERTIES FOR VARIOUS TYPES OF DENTAL MATERIALS HAS LED TO THE DEVELOPMENT OF MINIMUM STANDARDS OR SPECIFICATIONS. The American National Standards Institute (ANSI) and the American Dental Association (ADA), in conjunction with the International Organization for Standardization (ISO) and federal organizations (FDI), have established more than 100 standards, or specifications for dental materials and maintain lists of materials that satisfy the minimum standards of quality. It helps select materials for dental practice and ensures the quality control of materials. It is important that the dental practitioner is able to distinguish between a materials failure and a design failure. The clinical performance of dental restorations depends on: 1. Appropriate material selection is based on knowledge of their properties. 2. The optimum design of the restoration. 3. A knowledge of how the material will interact with the biological environment. Thank you…. Any Questions?