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A Clinical Guide to Applied Dental Materials E-Book

A Clinical Guide to Applied Dental Materials E-Book

Stephen J. Bonsor | Gavin Pearson

(2012)

Additional Information

Book Details

Abstract

A new textbook on the practical use of dental materials suitable for undergraduate dental students and qualified dental practitioners taking post-graduate exams in dental materials, restorative dentistry, operative techniques, advanced conservative dentistry, endodontics, removable prosthodontics and implantology.

  • Highly practical and evidenced-based throughout – closing the gap between theory and practice to give readers confidence in selecting and preparing the right material for the patient and circumstance
  • Amply illustrated in full colour with over 1000 photographs, artworks and tables to clearly demonstrate both materials and techniques
  • Helps readers appreciate the important relationship between clinical manipulation and the practical use of dental materials
  • Describes how to properly select a given material for any situation, how to use materials to best effect and when and how not to use them
  • ‘Good practice’ and ‘Warning’ boxes help readers recall important information
  • Uniquely written by a practising dentist with academic experience and an academic in biomaterials with extensive clinical experience
  • Self-assessment questions with full answers helps readers consolidate learning and prepare for exams
  • Designed to improve clinical success and improve patient outcomes
  • Perfect for all undergraduate and postgraduate students studying dental material science and/or restorative dentistry

Table of Contents

Section Title Page Action Price
Front Cover Cover
A Clinical Guide to Applied Dental Materials iii
Copyright Page iv
Contents v
Acknowledgements vi
Figure Credits vi
Foreword vii
Preface viii
Scope of the Book and Background viii
How to use this book ix
Section I: General principles 1
1. Dental materials in the oral environment 2
Introduction 2
The Hostile Oral Environment 2
The influence of the presentation of materials on success 3
Powder and liquid presentations 3
Powder versus granules 4
Rate of reaction 5
Effect of temperature and humidity 5
Clinical implications of the setting phase 6
Evolution of Material Presentations 6
Encapsulation 6
Mechanical mixers 7
Limitation of capsules 8
Compules 8
Limitations of compules 9
Automated paste/paste delivery systems 9
Cartridges 10
Summary 12
2. Clinical manipulation of materials 13
Introduction 13
Moisture Control 13
Shade Taking 14
Matching like with like 14
New digital technology for shade taking 17
Light Polymerization 17
Advantages and disadvantages of light curing 17
Mechanism of photo-polymerization 18
Photo-initiator 18
Wavelength of light 19
Types of lights available 19
Halogen light 19
Plasma light 20
Light-emitting diodes (LEDs) 21
Effects of incomplete curing 21
Factors affecting cure 21
Factors under the manufacturer’s control 21
Factors under the clinician’s control 22
Irradiance 23
Curing light maintenance and care 24
Summary 26
Further reading 26
3. Biological effects and safety aspects of dental materials 27
Introduction 27
Interaction with the Host (the Patient) 27
Thermal Changes During Setting 27
Allergy and Hypersensitivity 28
Reporting of Hazards/Interactions 28
Summary 31
4. The role of the manufacturer 32
Introduction 32
Material Development 33
Problem identification and means of resolution 33
Prototype production 33
Dental materials testing 33
Laboratory tests and their clinical relevance 33
Test specimen size 33
Mechanical Tests 34
Modulus of elasticity 36
Combination of properties 37
The limitations of laboratory testing 37
Other properties to consider 37
Radiodensity 39
Clinical handling properties 39
Laboratory versus ‘ideal’ intraoral conditions 40
Minimum standards of materials 40
Clinical Evaluation 40
Scale-Up 41
Quality Assurance and Control 41
Product Presentation and Labelling 41
Technique Cards 43
Product Promotion and Marketing 44
Promotional literature 44
Pitfalls in interpreting product promotional literature 44
Naming other competing products 44
Misleading graphs 44
Scale adjustment 44
Error bars 45
Company representatives – an educational resource 45
Weibull Modulus 46
Effect of the Number of Stages for Placement 46
Material Handling 46
Material Exchanges and Promotions 46
Summary 46
Further reading 46
5. Control and use of materials in practice 47
Introduction 47
Stock Control Management 47
Economics and stock balance 47
Rationalize materials 47
Same material, multiple indications 47
Importance of the use-by date 48
Stock ordering 49
Stock Room Environment 49
Use in the Clinic 50
Protective product packaging 51
Cross-contamination considerations 51
Material wastage 52
Material selection 53
Summary 53
Section II: Direct restorative dental materials 55
6. Dental amalgam 56
Definition 56
History 56
When to Use Dental Amalgam 56
Composition of Dental Amalgam 57
Mercury 57
The alloy 57
Conventional alloys 57
Amalgamation reaction of a conventional alloy 57
The role of zinc 57
The gamma (γ)2 phase 57
High copper amalgam alloys (Figure 6.5)\r 58
Setting reaction of high copper amalgam 58
Types of high copper amalgam alloy 58
Implications of the composition of the alloy for corrosion 59
Types of alloy 59
Lathe cut (irregular) alloys 59
Spherical alloys 59
Admixed alloys 59
Properties of Dental Amalgam 59
Strength 59
Thermal diffusivity and thermal expansion 60
Dimensional stability 60
Working time 60
Cavity design 60
Bonding of Amalgam Restorations 61
Materials for bonding 61
Encapsulated Amalgam 62
Commercially available products 62
Manipulation of Amalgam 63
Trituration 63
Amalgamators 63
Over/undertrituration 63
Condensation 63
Finishing 65
Burnishing 65
Polishing 65
Amalgam Disposal 65
Mercury Spillage 66
Mercury Toxicity 66
Mercury vapour release 67
Dental amalgam and legislation 67
Contraindications to the Use of Dental Amalgam 67
Adverse Effects of Dental Amalgam USE 67
Enamel discolouration 67
Amalgam tattoo 67
Galvanic cell 68
Lichenoid reaction 68
Summary 68
Further reading 68
7. The tooth-coloured restorative materials I: Resin composites 69
Introducing the Tooth-Coloured Restorative Materials 69
The Resin Composites 69
Definition 70
Constituents of a Resin Composite 71
Resin component 71
Principal and diluent monomers 71
Filler component 71
Filler types 72
Glasses 72
Ceramics 73
Effect of filler particle size and shape 73
Macrofilled 73
Fine particle 73
Microfilled 73
Hybrid 74
Nanofilled 75
Effect of filler loading 75
Silane coupler 76
Chemicals required for the curing process 76
Chemically cured resin composites 76
Light cured resin composites 76
Mechanism of cure 76
Dual cured 77
Ultraviolet stabilizers 77
Polymerization inhibitors 77
Radiopaque materials 77
Pigments and opacifiers 77
Properties 77
Polymerization shrinkage 77
Strategies to overcome polymerization shrinkage 78
Sensitivity to ambient light 78
Sensitivity to water and water uptake 79
Coefficient of thermal expansion 79
Biocompatibility 79
Durability 80
Resin Composite Categories 80
Chemically cured resin composites 80
Commercially available products 80
Mixing 80
Light cured resin composites 81
Dual-cured resin composites 81
Commercially available products 81
Advantages and Disadvantages of Resin Composites 81
Indications and Contraindications 81
General Subtypes of Resin Composite Materials on the Market 81
Universal resin composites 82
Commercially available products 83
Flowable composites 83
Commercially available products 84
Applications 85
Non-carious tooth surface loss lesions 85
Preventive resin restoration 85
Fissure sealants 86
Section III: Materials used with indirect techniques 217
14. Materials used in temporization 218
Introduction 218
The Biological Importance of Good Temporization 218
The Benefits of Quality Temporization 218
Benefits for the dentist 218
Benefits to the patient 219
The Temporization ‘Balance’ 219
Types of Temporary Restoration 219
Direct Temporary Restorations 219
Preformed crown forms 219
Crown forms used to construct tooth-coloured temporaries 220
Polycarbonate crown forms 220
Clinical technique 220
Cellulose acetate crown forms 220
Metal crown forms 221
Aluminium crown forms 221
Stainless steel crown forms 222
Acrylic materials used to refine temporary crown forms 222
Higher Methacrylates 222
Setting reaction 222
Properties 223
Clinical technique 223
Commercially available products 224
Composite-Based Materials 224
Chemistry and setting reaction 224
Properties 224
The working ‘time line’ 225
Advantages and disadvantages 225
Indications 225
Commercially available products 226
Presentation 226
Clinical manipulation 226
Composite-Based Crown Template 227
Light-Cured Temporary Resin Materials 228
Constituents 228
Chemistry and setting reaction 229
Properties 229
Presentation 229
Manipulation 229
Indications and contraindications 230
Commercially available products 230
Putties 230
Commercially available products 231
Temporary Luting Cements 231
Purpose 231
Eugenol-free products 231
Modifier 231
Chemistry 232
Mixing 232
Temporary cement removal 233
Variations in temporary cement products 234
Temporary cements used as definitive lute 235
Commercially available products 235
Non Hardening Temporary Cements 235
Summary 236
15. Impression materials 237
Introduction 237
Desirable Properties of an Impression Material 237
Impression Trays and Tray Selection 238
Stock trays 238
Plastic stock trays 239
Adequate extension 239
Correct size and shape of the dental arch 239
Importance of rigidity 239
Anchor 22 240
Metal stock trays 240
Special trays 241
Tray Adhesives 241
Types of tray adhesive 242
Types of Impression Material 242
Non-Rigid Impression Materials 243
Hydrocolloids 243
Reversible hydrocolloid 243
Chemical constituents 243
Setting 243
Making the impression 244
Properties 244
Dimensional stability 244
Tear resistance 245
Practical issues 245
Irreversible hydrocolloid 245
Chemical constituents 245
Setting reaction 246
Properties 246
Mixing time 246
Working time 246
Setting time 246
Permanent deformation 246
Strength 247
Advantages and disadvantages 247
Indications and contraindications 247
Mixing 247
Disinfection 249
Storage and care of alginate impressions 249
Long-term accuracy of alginate impression materials 250
Commercially available products 251
Non-aqueous elastomeric impression materials (elastomers) 251
Polysulphides 251
Chemical constituents 251
Section IV: Other clinical materials 285
17. Preventive and periodontal materials, implants and biomaterials 286
Introduction 286
Preventive Materials 286
Toothpastes 286
Composition 286
Mode of action of desensitizing agents 288
Fluoride agents 288
Anticalculus agents 289
Abrasives 289
Commercially available products 289
Mouthwashes 291
Chlorhexidine 291
Commercially available products 291
Other fluoride products 293
Fluoride gels 293
Fluoride varnishes 293
Desensitizing agents 294
Desensitizing varnishes 294
Resin-based composite desensitizing products 295
Tooth mousse 295
Denture care-related materials 296
Denture cleansers 296
Commercially available products 296
Denture adhesives 296
Commercially available products 297
Aids to Diagnosis of Dental Diseases 297
Disclosing products 297
Dental caries indicators 298
Dental caries removal solution 298
Saliva buffering capacity-checking materials 298
Products to treat xerostomia 299
Oral cancer testing 299
Materials Used in Periodontics 300
Topical antimicrobials 300
Gels 300
Other vehicles for antimicrobial delivery in periodontal cases 301
Regeneration 301
Guided tissue regeneration 302
Non-resorbable products 302
Resorbable products 302
Commercially available products 303
Grafts to replace missing bone 303
Natural bone 303
Human bone 303
Animal bone 304
Artificial grafts 304
Commercially available products 305
Periodontal dressings 305
Oral Surgical Materials 307
Achieving haemostasis 307
Commercially available products 307
Treatment of infected (dry) socket (‘fibrinolytic alveolitis’) 307
Sutures 308
Types of suture material 308
Commercially available products 308
Dental Implants 309
Implant materials 309
A brief description of the restoration of dental implants 310
Summary 310
18. Dental bleaching systems 311
Introduction 311
Chemical Reaction: An Oxidizing Process 311
Mode of action 312
Common Ingredients in Tooth Whitening Products 312
Indications and Contraindications 313
Side Effects, Risks and Hazards 313
Thermal sensitivity 313
Gingival and soft tissue irritation 313
Gastric irritation 313
Altered taste sensation 313
External cervical resorption 314
Risk of mutagenic effects 314
Adverse structural changes in the dental hard tissues and changes in translucency of enamel 314
Effects on restorative materials 314
Factors Affecting Outcome 315
Duration of application and patient compliance 315
Type of darkened tooth tissue 315
Bleaching Systems and Products 315
Over-the-counter products 315
Bleaching strips 315
Paint-on gels 316
Commercially available products 316
Whitening toothpastes 316
Professionally supervised techniques 316
Home bleaching 317
Bleaching of vital teeth 318
Bleaching of non-vital teeth 319
Commercially available products 320
In-office techniques 320
‘Walking bleach’ 320
Assisted bleaching 321
Power bleaching 321
Commercially available products 322
Use of light 322
Commercially available lights 322
Long-Term Prognosis 322
Legal Position in the UK 323
Summary 323
Further reading 323
19. Cutting instruments 324
Introduction 324
Dental Handpieces 324
Working at high speeds (in excess of 180 000 rpm) 324
High-speed handpiece 325
Internal structure 325
Cooling 326
Illumination 326
Balance 327
Grip 327
Size of head 327
The importance of torque 327
Indications for using an air rotor handpiece 328
Speed-increasing handpiece 328
Torque 328
Mode of cutting 328
Comparison of high-speed and speed-increasing dental handpieces 329
Slow-speed handpieces 329
Indications for slow-speed handpieces 329
Speed-decreasing 330
Indications for use of speed-decreasing handpieces 330
Reciprocating handpieces 331
Decontamination of handpieces 331
Handpiece maintenance 332
Dental handpieces – the future 332
Dental Burs 332
Parts of a bur 332
Diamond burs 333
Abrasivity 333
Tungsten carbide burs 333
Straight handpiece burs 335
Stainless steel burs 335
Quality products – quality results! 336
Air Abrasion 336
Advantages and disadvantages 337
Sandblasting 338
(Cutting) Lasers 339
How they work 339
Using lasers in dentistry 339
Carbon dioxide laser 339
Nd:YAG laser 340
Er:YAG laser 340
Abrasives and Polishers 342
Abrasives 342
Effect of heat during finishing 342
Types of abrasive 342
Finishing discs 342
Finishing strips 342
Rubber wheels 343
Interproximal saw (serrated strip) 343
Polishing 343
Polishing stones 344
Brushes 344
Conventional brushes 344
Brushes for polishing resin composite 344
Polishing materials 344
Lustre paste 344
Pumice slurry 344
Other polishing materials 345
Prophylaxis paste 345
Electrolytic polishing 346
Summary 346
Section V: Laboratory materials 347
20. Model and investment materials 348
Introduction 348
Types of Model 348
Dental Plaster and Dental Stones 349
Dental modelling plaster 349
Dental stone 349
High-strength dental stone (die stone) 350
Commercially available products 351
Chemical consituents 351
Setting process 351
Properties 351
Indications 352
Compatibility of gypsum-based materials with impression materials 354
Manipulation 354
Epoxy resin and other die materials 355
Die spacers 357
Implant fabrication models 357
Mounting plasters 357
Cleaning of dental stones 357
Casting Investment Materials 357
Chemical constituents 358
Types of investment material 358
Properties 358
Effect of heating the investment 358
Manipulation 359
Commercially available products 359
Summary 359
Further Reading 360
21. Alloys used in dentistry 361
Introduction 361
Alloys 361
Structure of alloys 361
General mechanical properties 362
Strength 362
Effect of heat on alloys 363
Biocompatibility 363
Economic considerations 363
Types of alloy 363
Casting alloys for tooth restorations 364
High noble and noble alloys 364
Addition of copper: order hardening 364
Other constituents 366
Indications 366
Contraindications 366
Bonding gold alloys to tooth tissue 366
Alternative metal alloys used for metal crowns 367
Chemical constituents of alternative metal alloys and their functions 367
Properties 367
Commercially available products 368
Bonding alloys 368
Bonding ceramic to metal 369
Chemical compositions of bonding alloys 370
Compatibility of the alloy with the ceramic 370
Properties 370
Base metal bonding alloys 371
Constituents 372
Properties 372
Advantages and disadvantages 372
Chemical bonding 373
Acid treatment versus sandblasting 373
Titanium 373
Alloys for denture substructures 373
Constituents 373
Casting and finishing 374
Methods of manufacture 374
Casting 374
Dimensional accuracy of the lost wax process 377
Ease of casting 378
Coring 378
Troubleshooting with casting 378
Porosity 378
Sprue placement 379
Wrought alloys 379
Swaging 379
Other base metal alloys used in dentistry 379
Stainless steel 379
Tempering 380
Annealing 380
Nickel titanium 380
Summary of indications of base metal alloys 381
Soldering and Welding 381
Soldering 381
Welding 382
Communication with the Dental Laboratory 382
Metal-Free Dentistry 382
Summary 382
Further reading 382
22. Dental ceramics 383
Introduction 383
Conventional Dental Ceramics 384
Manufacture of the ceramic powder 385
Types of dental ceramic 385
Dental laboratory procedure 386
Building up the restoration: dentine portion 386
Building up the restoration: enamel portion 386
Firing: first bake 386
Firing: subsequent bakes 387
Some considerations in firing 387
Staining 388
Glazing 388
Properties of fired dental ceramics 388
Aesthetics 388
Chemical stability 389
Thermal properties 389
Dimensional stability 389
Mechanical properties 389
Effects of tooth preparation 389
Vacuum versus air firing 389
Methods of Reinforcing Dental Ceramics 390
Producing a coping in a stronger material 390
Metal alloy 390
Methods of ceramic retention on the metal coping 390
Problems to overcome with the metal-ceramic system 392
Alumina 393
Glass-infiltrated alumina 394
Laboratory fabrication stages 394
Spinel 396
Zirconia 396
Commercially available products 397
Casting and pressing ceramics 397
Casting ceramics 398
Pressing ceramics 398
Commercially available products 399
CAD-CAM 399
CAD-CAM scanner systems 399
Commercially available products 401
Laboratory scanning devices 401
Materials used in CAD-CAM systems 402
Commercially available products 402
Resin-Bonded Ceramics 402
Indications and Contraindications of Ceramic Restorations 404
Tooth Preparation 404
Biscuit Try-In 404
Cementation 405
Summary 405
Further reading 405
23. Polymers in prosthodontics 406
Introduction 406
Denture Base Resins 406
What is required of a denture base resin? 406
Constituents 407
Polymer 407
Monomer 407
Alternative presentations 408
Setting reaction 408
Structure 408
Properties 408
Mechanical properties 408
Thermal properties 409
Dimensional stability 409
Crazing 410
Shade of denture base acrylics 410
Radiodensity 411
Other properties 411
Types of Acrylic 411
Heat-cured acrylic 411
Colouring of the acrylic 411
Process 412
Cold-cured acrylic 413
Constituents 413
Properties 414
Polymerization efficiency 414
Porosity 414
Mechanical properties 414
Stability 414
Indications 414
The procedure of a cold-cure repair 414
Light-cured acrylics 414
Injection technique 415
High-impact acrylics 415
Other dental appliances constructed with acrylic 415
Flexible dentures 416
Commercially available products 417
Denture Teeth 418
PMMA denture teeth 418
Choice of teeth 418
Bonding the denture teeth to the denture base 419
Commercially available products 419
Ceramic denture teeth 420
Soft Lining Materials 420
Plasticized acrylic resins 420
Silicone 420
Soft liners 420
Extra soft liners 421
Care and cleaning 421
Commercially available products 421
Tissue Conditioners 421
Index 425