J Pharm Bioallied Sci. 2011 Jan-Mar; 3(1): 170172.

doi: 10.4103/0975-7406.76505
PMCID: PMC3053518
Vandana Saini and Ruchi Singla
Faculty of Dentistry, Dr. H.S.J. Dental College, Punjab University, Chandigarh, India. E-mail: teena2982@yahoo.co.in
Copyright Journal of Pharmacy and Bioallied Sciences
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sir,
This clinical report describes the prosthetic rehabilitation of an edentulous patient,who was
dissatisfied from her 8-year-old denture. To give her a better fit, we opted Biofunctional
Prosthetic System (BPS) for the new prosthesis. BPS is the system designed to work with the
body in a biologically harmonious way, maximizing function, and giving comfort and
natural appearance to the patient. The functional impression technique and simulation of
the jaw movements by the Stratos 200 articulator in BPS ensure that BPS denture meets
most exacting requirements.[1]
BPS denture meets the esthetic demand of patients with its unique Ivoclear teeth, which
replicate anatomy of the natural tooth Ivoclear teeth are made up of 3 layers of cross-linked
acrylic resins that contribute to a life-like appearance and resistance to wearing. BPS system
uses a controlled heat/pressure polymerization procedure during which time the exact
amount of material flows into the flask to compensate for shrinkage, which ensures a perfect
fit. This pressure also optimizes the physical properties of the denture. [2]
A 60-year-old edentulous woman with a chief complaint of compromised function and
esthetics was treated in the clinic. Intraoral examination showed resorbed ridges and
masticatory dysfunction [Figure 1]. An extraoral examination revealed flattened mandibular
plane. She was wearing dentures with attrited teeth and worn out denture base. A
significant loss of vertical dimension affected the temporomandibular joint. Hence, a BPS
denture was planned to give her a better fitted prosthesis.
The BPS recommends impression making similar in principle to the mucostatic method that
minimally compresses tissues, using a combination of irreversible hydrocolloids of varying
densities together in the same impression.[3] Low-density impression material (syringe Acc
Gel) was syringed into the vestibular area and the occlusal centric tray was loaded with
high-density hydrocolloid and inserted into the patients mouth to get the initial vertical
dimension [Figure 2]. This vertical dimension was used for mounting the casts obtained
from initial impressions, taken with Accu-trays (different from conventional denture trays)
with an extra flange to cover the vestibular areas and extended distal part to cover the
retromandibular pad area more efficiently [Figure 3]. Custom trays were made on the
primary casts. The Gnathometer M tracing device was attached to the casts, which facilitates
the clinical procedures of secondary impression making, face-bow record and jaw
registration [Figure 4].
The secondary impression was taken with zinc oxide eugenol impression paste [Figure 5].
Casts were poured and a wax-up denture was made for the trial [Figure 6]. After checking
the fit and occlussal relations, the denture was sent to the laboratory. Dentures were cured
with injection molding technique [Figure 7] using Ivocap high-impact plus denture base
material.[4] Necessary adjustments were done and the dentures were delivered to the
patient.
The patient was recalled after 6 months and examined. There was no occlusal disharmony
or sore spots. The patient was very much satisfied with her new prosthesis and she showed
her gratification for the comfortable prosthesis and a younger look.
Acknowledgments
We are grateful to Mr. Chauhan, Dental Technician, Chauhan Dental Lab, Sec-32,
Chandigarh, India, for his laboratory work.
References
1. Available from: BPS Dentures smilebydesign_in Best Dentist In Delhi[Last cited in 2010]
2. Available from: http://www.familydentalhealthcentre.com/completedenture[Last cited in
2010]
3. Roraff AR, Stansbury BE. Errors caused by dimensional change in mounting materials. J
Prosthet Dent. 1972;28:24752.[PubMed: 4558968]
4. Patel BN. Acrylic removable prosthesis- an integral part of modern Day
Dentistry. Famdent. 2005;6:624.
Figures and Tables
Figure 1

Resorbed ridges
Figure 2

Occlussal centric tray loaded with impression for recording initial vertical dimension
Figure 3

Biofunctional prosthetic system impression trays
Figure 4

Bite registration through Gnathometer M
Figure 5

Secondary impression-making with zinc oxide eugenol paste
Figure 6

Wax-up trial for the patient
Figure 7

Acrylized denture

Articles from Journal of Pharmacy & Bioallied Sciences are provided here courtesy of Medknow
Publications
Joint Vibration Analysis in Routine Restorative Dentistry
Written by Mark W. Montgomery, DMDFriday, 10 September 2010 12:46
INTRODUCTION
Clinical Considerations
The urgency for taking the temporomandibular joint (TMJ) condition into account is the pervasiveness of occlusion-
related disease and the recent advances in restorative and prosthetic systems. Clinical best practices would include
the screening and diagnosis of the temporomandibular condition in the evaluation and treatment of the occlusion-
related diseases such as abfractions, wear, mobility, periodontal damage, fractured teeth, and abnormal
parafunctional muscle activity.
During routine dentistry, in the vast majority of dental practices, 2 oversimplified assumptions are made that then
determine the course of occlusion, mastication, and dental anatomy decisions for the patient. These assumptions are:
(1) that the asymptomatic TMJ is either healthy, or as healthy as can be expected for this patient, and (2) that
maximum intercuspal position (MIP) is the most stable position in which to reference the patients dental care.


Figure 1. Preoperative photo. Figure 2. Deprogramming appliance
(in anterior contact only).

Figure 3. Stabilized bite registration
for Joint Vibration Analysis (JVA)
(BioRESEARCH) testing.
Figure 4. Maximum intercuspal
position versus stable condylar
position on the articulator.


Figures 5a and 5b. Preoperative JVA with disc derangement.

Figures 6a and 6b. Before and after JVA.

Figure 7. Before and after case photos.
These 2 assumptions are commonly adopted as the default scenario for dental care for several reasons. Namely, the
clinical manifestations of TMJ derangements are often encountered at a later or more chronic stage that does not
lend itself easily to diagnosis and/or treatment. Many of these later-stage, chronic disc derangements are often
asymptomatic before and after routine dental care. Furthermore, most of these later-stage TMJ derangements are not
correctable with routine dentistry.
Also, the MIP is seemingly the most easily determined position of the interface between the maxilla and mandible due
to patient accommodation and preference of interdigitated teeth. Additionally, the facet-to-facet interdigitation of the
teeth is routinely utilized to relate the maxillary teeth to the mandibular teeth on laboratory models of the patients
dentition.
Relying on either or both of these assumptions creates or perpetuates the existing conditions, pathologies, and the
position of the mandibular condyles and their respective disc and ligament apparatus. This perpetuation of the current
status puts even the most limited restoration in jeopardy of early failure or worsening of the patients condition.
While the majority of patients without reported symptoms will accommodate or continue to accommodate to this
condition/position of the condyles, the glaring signs of occlusal disease and pathology are staring the practitioner in
the face. These signs are primarily being treated symptomatically or ignored, rather than systematically evaluated
and treated at the source of the problem.
This situation is frustrating for dentists, as they often feel that they dont have the opportunity or urgency of symptoms
to be able to take control of the problems. Additionally, there has been a challenge to integrate the concepts of
occlusion with the condylar position. Many dentists have studied with various occlusion camps only to become
confused regarding the relevance of the condylar position or which condylar position is correct. This debate has
continued for years as to the best way to define and establish what a normal condylar position is. As a result, the
only established norms for occlusion have relied on the systems created to produce successful clinical results and
idealistic concepts that are perpetuated in texts and academia.
Consequently, dentists end up discussing their philosophy of occlusion without regard to routine objective
measurements that could establish the relative health or normality of the stomatognathic system.
This situation is also frustrating for patients, as they are at a loss as to what is normal for them. How much
deterioration of their dentition is acceptable? Why, when they return to the dentist year after year, is something
wrong, every time? And which of their symptoms are important enough to report to their dentist? They often end up
years down the road with thousands of dollars of dentistry done only to discover that their wear and/or pain continues,
and their condition is never truly under
control, despite their best intentions and
investment.
Technological Implications of
Joint Vibration Analysis
Lou Shuman, DMD
Dr. Peter Dawson wrote, on page 3 of his latest text
Functional Occlusion: From TMJ to Smile Design,
that all occlusal analysis begins with the TM
joints. The temporomandibular joint (TMJ) is
widely considered to be the skeletal base of the
stomatognathic system. As dentists, we understand
that TMJ stability is critical to a stable and
predictable occlusion. It has become clear that a key
component of the stomatognathic health is the
interplay among the teeth, muscles, and the TMJs.
Without a pair of stable TMJs, a stable occlusion is
next to impossible, and this has a direct and obvious
impact on the success or failure of our restorative,
cosmetic, and orthodontic treatments. Without a
clear objective and detailed assessment of TMJ
function, we cannot predict the future success (or
failure) of our dental treatments, nor can we
determine if subsequent TMJ pathologies previously
existed, or were the result of our dental work.
We need a tool that can alert us to subclinical
pathology before we begin treatment, one that can
quickly and accurately assess TMJ function (or
dysfunction) and compare it to previous screenings
to see if our patients TMJs are improving, stable, or
getting worse. We also need a tool that can
immediately assess the impact of our treatments on
TMJ function. A suitable device for screening,
assessment of pathology progression, and treatment
outcome analysis has been hard to find.
The TMJ has been the subject of much confusion
because the quick and inexpensive methods of
screening for TMJ pathology are either subjective
and unreliable (auscultation, palpation, patient
report, and Doppler); or they are expensive, invasive,
and provided only static images of the joint with no
information on the dynamic function of these unique
joints (computed tomography scans, cone beam
tomography, magnetic resonance imaging). In fact,
the most recent research from the British Institute of
Radiology indicates that the interobserver agreement
on MRI scans is fair at best.1
Enter Joint Vibration Analysis (JVA)
(BioRESEARCH). The JVA system brings
Fortunately, we currently are in a new place
of discussion regarding the diagnosis and
possible therapies for occlusal, masticatory,
and temporomandibular care. With an
objective test for TMJ condition, better
treatment plans can be devised for occlusal
disease.
This new place where we are is directly
related to the development and usage of
biometric technology that gives the doctor
objective data from which to make decisions
and measured documented treatment results.
The past attempts to record and/or measure
the condylar position and condition included
axiopath recordings of joint position and
border movements, transcranial and
tomographic radiography with objective and
subjective interpretation, comparison of
condylar position on articulators with multiple
jaw position bite recordings, magnetic
resonance imaging (MRI) and functional MRI
scans, computed tomography (CT) and cone
beam CT scans, contrast arthrography,
computerized mandibular positions based on
transcutaneous electrical nerve stimulation
pulsed muscle contractions irrespective of the
condylar position, face-bow mounted casts on
various articulators referenced to numerous
closure paths from speech to swallowing,
from controlled manipulation to
deprogrammed patient closure. At best, these
methods were expensive and time
consuming; and at worst, these techniques
were dependent on the clinicians experience
and subjective analysis.
The current biometric standard with the Joint
Vibration Analysis (JVA), a system of
equipment and software manufactured by
BioRESEARCH(bioresearchinc.com), allows
the dentist to easily and objectively measure
the condition of the condyles quickly,
affordably, and irrespective of treatment
philosophy. The mandate from the ADA, as stated in 1990 and 1992, calls upon the dentist to document, assess,
note, describe, evaluate, and record the presence, location, loudness, timing, consistency, and quality of joint
vibrations. This mandate then encourages us to consider biometrics that will accomplish this effectively and
affordably with high levels of sensitivity and specificity. The JVA system achieves this standard and creates a 21st-
century documentation of objective information that will afford the treating dentist the ability to diagnose the patients
condition and monitor the patient throughout preventive or therapeutic care. By establishing objective measurements
objectivity and predictability to the assessment of
TMJ function and stability. Normal TMJs have
smooth, well-lubricated surfaces in a proper
biomechanical relationship and produce almost no
vibration. But surface changes, such as those caused
by degeneration, tears, or displacements of the disk,
generally produce friction and vibration. Different
disorders can produce different vibration patterns or
signatures. PC-assisted vibration analyses helps
identify these patterns and helps you distinguish
among various TM disorders.
JVA provides a fast, noninvasive, and repeatable
measurement of TMJ function to aid in the diagnosis
of TMJ condition. Understanding TMJ function is
vital any time you are changing the vertical, lateral,
or the anterior/posterior position of the mandible.
Common dental treatments can change mandibular
position. In addition to TMD treatment,
orthodontics, prosthodontics, restorative, and sleep
dentistry can all benefit from JVA testing.
A JVA recording takes 10 seconds of patient time,
and less than 2 minutes of staff time. In less than 5
minutes, your staff can be trained to take accurate,
repeatable data. Simply searching JVA 60-second
instructional video on youtube.com will give you an
idea of how fast and easy it is to get this data on
every one of your patients.

Reference
1. Butzke KW, Batista Chaves KD, Dias da Silveira HE, Dias
da Silveira HL. Evaluation of the reproducibility in the
interpretation of magnetic resonance images of the
temporomandibular joint. Dentomaxillofac Radiol.
2010;39:157-161.


of the condylar condition, the dentist can evaluate the effect of future events such as injury, accident, or therapy. The
doctor can also begin to correlate the condylar condition with other data, such as bite force analysis (with T-Scan)
and/or electromyography (BioPAK [BioRESEARCH]) measurements of the muscles of mastication. In addition this
JVA system can be overlaid on data regarding mastication analysis (BioPAK), range of motion, and mandibular
position.
CASE REPORT
A patient presented to our office with severe occlusal-related disease. Examination revealed abfractions, anterior
wear into the dentin, and periodontal attachment loss. The patient desired a long-term restorative solution that would
include aesthetic enhancement of the smile (Figure 1).
The case was designed with a mock-up of the anterior smile zone, followed by a determination that the envelope of
function would be well controlled without having to restore the vertical dimension. The development of the anterior
envelope of function was accomplished by first deprogramming the avoidance pattern muscle engrams with an
anterior contact (only) appliance. In the deprogrammed patient, the mandibular position is determined by an anterior
contact composite ball bite (open-bite centric). This open-bite registration is then tested with the JVA and compared
to the preoperative JVA. By testing the stability of the TMJs at the time of bite registration, we can be confident that
our diagnostic wax-up will be designed not only to the desired aesthetic result, but also that the provisionals and final
restoration will be accomplished with the condyles in a more smooth and stable position (Figures 2 and 3).
The patients preoperative casts and mock-up casts were mounted, and cross mounted, at the most stable condylar
position allowing for the desired smile design and functional anterior zone. This mounting with the apex of force
centric open-bite registration can then be studied on the articulator for a comparison of the condylar position with the
condylar position that is associated with the preoperative MIP interdigitation (Figure 4).
Commonly, the cases that have avoidance-related anterior wear and muscle engrams also show a condylar position
discrepancy between the MIP condylar position and the stabilized mandibular restorative position. These small
dislocations of the condyle in the MIP are frequently associated with disc movement and subtle changes in the
morphology of the posterior band of the meniscus. This increases the frequency of inflammation in the joint and the
likelihood that the patient will suffer a partial- or full-disc displacement, along with the associated popping and
possible retrodiscal impingement and pain (Figures 5a and 5b).
The condyle position discrepancy between stable/normal and the MIP dislocation can be in almost any direction and
position. The clinical manifestation of this discrepancy is usually referred to as a slide, or as a closure interference.
Rarely does this dental slide actually show up as the condyle being on the disc and downward and forward on the
eminence. Rather, the abnormal MIP condyle is pulled downward and away from the disc and eminence, thus
destabilizing the disc and allowing for the disc movement that is observed on the JVA.
JVA Practice Management Ramifications
Amy Morgan
If part of your practices vision is to implement the
very latest technologies and cutting-edge clinical
skills to enhance your patients experience, Joint
Vibrational Analysis (JVA) (BioRESEARCH) can
be a very significant addition. Using JVA as a tool
for diagnosing and educating your patients in a
holistic approach to their overall oral health and
well-being by addressing temporomandibular Joint
diesease prior to treatment is essential.
The initial investment in the equipment necessary to
perform JVA is approximately $10,000. This
includes the training needed to incorporate it into the
practice. In our interviews with various practitioners,
all have reported increased case acceptance,
increased fabrication of appliances, decreased
restorative remakes, and an increased number of
referrals (from both patients and specialists);
translating into a significant potential return on
investment. The more passive or qualitative returns
include more predictability in results, becoming
another tool to exceed patients expectations and
confidence in the treatment results.
The most impacted team members are the chairside
assistants (and possibly the hygienists, depending on
its incorporation into the periodic examination
schedule). Team members are trained in-office. This
helps to promote immediate comfort in utilizing this
new tool in the real environment. The learning
curve for the team can be fairly rapid. We have
reports that clinical team members can learn the
mechanics of the instrument within 10 minutes!
These new skills are very empowering and can
enhance each clinical job description, thus providing
opportunities for improvement and growth.
Lets not forget the educational impact on the dentist
as well! An extensive 3-day course provides the
initial training for the doctor in interpretation of the
data. Continued training online and or additional off-
site provide opportunities for the doctor and team to
finish certification on JVA.
The impact on the practice is usually minimal
regarding scheduling. Simply incorporating it into
your new patient evaluation as an additional
screening tool is a common approach. Patients of
record can be exposed to JVA during your periodic
or status exams. Screening questions about
headaches, tension, joint sounds, or pain are asked
and patients with positive answers are given the JVA
quick test (approximately 3 minutes). Reading and
interpretation of this screening either leads to no
further action (negative results), or, if positive
indicators result, the patient is scheduled for further
Consequently, we now pay very close
attention to any joint vibration that occurs
during the time that the teeth are sliding into
MIP, or in the timeframe just before closure.
These are the early, subclinical vibrations that
can be easily treated by elimination of the
closure interferences and/or re-establishing
the normal vertical dimension of occlusion.
Certainly, the treatment plan does not have to
include a change in vertical dimension or a
full-mouth rehabilitation; however, it must
ensure that the closure interferences (slides)
are eliminated and that any hyperactivity of the lateral pterygoid muscles related to working or nonworking
interferences be controlled with appropriate occlusal therapy. This occlusal therapy can include subtractive
coronoplasty on the interferences, but more frequently depends on appropriate additive coronal enhancement of the
anterior and canine teeth.
The use of the JVA during treatment design and provisionalization as well as postoperatively gives us the assurance
that we are not only aware of any pretreatment problems or red flags, but most importantly, that in the course of any
dentistry that influences tooth contact or occlusion patterns, we have not made changes that result in a more unstable
TMJ apparatus than we noted before treatment. We would always like the patient to finish our care better off than
when we first started (Figures 6a to 7).
DISCUSSION
Regardless of other biometrics or treatment philosophy, the JVA provides objective information to the treating doctor
as to the stability or instability of the TMJ condylar apparatus. This information can be easily utilized in the decision as
to whether (or not) MIP would be the best choice in making dental treatment plans for the best long-term patient
prognosis. Certainly, an unstable condyle being present in the attempt to treat occlusal disease would necessitate the
treating doctor to consider and document the effect of his or her treatment of the dentition on the stomatognathic
system, including the TMJs. In the authors experience, in utilizing the JVA system in literally hundreds of full-mouth
rehabilitations during the last 11 years, several conditions of the patient bring this technology to bear.
The most enlightening finding from JVA recordings has been the diagnosis of subclinical problems that represent
early or unstable condyle-disc problems that are not perceptible with any other technology, especially palpation or
auscultation. This condition shows up as disc movement, joint laxity, and/or TMJ inflammation. The ability to diagnose
this subclinical condition has revealed that appropriate treatment of the dentition can result in stabilizing or correcting
the problem in the condyle disc apparatus. This is the missing link in the conversation of the connection between the
occlusion and the TMJ condition.
If problems can be detected before they become permanent ligament or disc damage, then stabilization through
effective occlusal therapy will afford the patient the best possibility for long-term health and function


services. Patients are intrigued by the JVA and feel
this technology is yet another sign of a progressive,
high-tech, and comprehensive approach to their care.
This can definitely create a buzz and additional
referrals.
For dentists and team members who are passionate
about doing everything possible to improve the
health of their patients, JVA is another option to take
to improve your processes and procedures.

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ACADEMY
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Wednesday, July 24, 2013
ESTHETICS IN COMPLETE DENTURES

ESTHETICS IN COMPLETE DENTURE
CONTENTS
Introduction
Review of Literature
Dentogenics
Discussion
Conclusion
Bibliography


INTRODUCTION
An acceptable cosmetic effect in any dental restoration has always been regarded as important to good
dentistry. A well-made prosthesis will fail if it is deficient in this respect.
Esthetics includes the appreciation and response to the beautiful in art and
nature. Esthetics has been given many definitions in dentistry but according to
Young. It is apparent that beauty, harmony, naturalness and individuality are
major qualities of esthetics. The dentist must visualize esthetics in relation to the
patient and then translate that visualization into an acceptable esthetic result.
The success of his efforts depends upon his artistic ability, his powers of
observation and his experience.
The selection of anterior teeth for an edentulous patient is a most
important and often difficult problem for the dentist. He should select teeth which
not only embody the proper form and size, but the most ideal shade as well.



The art of selection of teeth for edentulous patients has been lost in the
maze of tooth guides, folders and pamphlets and the numerous methods of
selection advocated by researchers.
An attempt has been made in this seminar to briefly describe the various
methods advocated in the literature and to reach a practical method.
For the sake of clarity and simplicity, the matter has been dealt with under
the following sub headings.
- Introduction
- Review of Literature
o Evolution of Techniques
o Dentogenics
o The Golden Proportion
- Discussion
- Conclusion
REVIEW OF LITERATURE
I) Evolution of Techniques
Young in 1954 described the evolution of various techniques used in the
selection of the anterior tooth mold.
Technique 1
During the ivory age and early porcelain period, teeth were selected or
created mostly by dimensional measurements of the denture space and arch size
with little regard to esthetics.
Technique 2
Technique of Correspondence and Harmony projected by J.W. White in
1872. By this time, the temperamental theory was fading out of medicine but
white reached over and suggested that the temperaments called for similarity of
form in faces and teeth.
The temperamental theory is a theory of the fluids of the body, especially
the blood, the phlegm and the bile. It was conceived by Hippocrates in the
5
th
century BC and was used continuously by the medical profession in diagnosis
and treatment until the nineteenth century, when it gave way to demonstrate
science.
Choleric temperament predominance of yellow bile characterized by anger,
irritability, a jaundiced view of life. Body structures are small and finely textured.
Melancholic due to predominance of black bile and characterized by
depression.
Phlegmatic temperament due to abundance of phlegm in respiratory passages.
Alleged to make people stolid, apathetic and undemonstrative. A physical decline
occurs due to phlegm in the blood.
Sanguine temperament attributed to a predominance of blood and
characterized by cheerfulness and optimism. Red complexion, large body, strong
musculature and vigorous action.
This was the introduction of the temperamental theory into dentistry but it
was not widely used till after 1885 when temperamental forms of teeth were
manufactured as named sets.
Technique 3
The Typical form concept projected by W.R. Hall in 1887. This was the
initiation of the geometric theory later presented by Williams.
The basis of this classification was two-fold, the major basis was the
tooths labial surface curvatures (transverse and gingivo-incisal), outline form and
neck width.
Hall gave the classification of ovoid, tapering and square.
The minor basis was the labio-lingual inclination of the upper incisors in
relation to profile types. This classification apparently exerted little influence on
practice procedure at that time.
Technique 4
The temperamental technique was the first technique of selecting tooth
form from the point of view of influence and universal acceptance. It required
several years to associate and establish dental characteristics of the
temperaments and to incorporate them in manufactured tooth forms, this
occurred by 1885.
Dentists like Flagg, Laycock, Hutchinson, Kingsley et al and artists like
Madame Schimmelpeinik, spurzheim and Jacques contributed to the
development and acceptance of this theory.
However, only rarely could two dentists agree on exactly what the theory
meant, what it taught and what it required. It had an intangible quality which
could not be defined in any authoritative way.
Technique 5
Berrys biometric ratio method 1906.
Berry projected in 1903 that the outline form of the inverted central incisor
tooth closely approximated the outline form of the face. Therefore the outline
form of the edentulous face indicated the outline form of the anterior teeth to be
chosen for a denture patient.
Berrys continued investigation into the correlation between faceform and
tooth form resulted in the discovery that the maxillary central incisor was
1/16
th
the width of the face and 1/20
th
its length. Subsequent research by M.M.
House and others proved the 1/16
th
width ratio but the 1/20
th
length ratio which
was frequently not possible to use due to interference by ridge bulk. Difficulty in
practical applications discouraged the use of this technique.
Mavroskoufis et al in 1981 concluded that the inter-alar nasal width is a
reliable guide for selecting the mold of anterior teeth. The tips of the canines
were found to lie on a projection of two perpendicular lines drawn from the outer
surfaces of the nasal alae.
Thus the mesiodistal width of the artificial anterior teeth should be
determined by adding 7mm to the patients nasal width.
They found no relationship between the nasal width and the total/overall
width of the four incisors.
The authors advocate that the tips of the canine be set on a line which
passes through the posterior border of the incisive papilla which proved to be a
stable anatomic land mark.
The incisive papilla can also be used as a guide for arranging the labial
surface of the central incisors at 10mm anterior to the posterior border of the
papilla.
Kern in 1967 studied various anthropometric parameters of tooth selection
by examining over 6000 skulls. He concluded that:
1. The bizygomatic measurement did not show a high percentage consistency ratio
to the width of the crowns of the maxillary central incisors.
2. Nor did the skull length measurement prove reliable for the determination of the
length of the maxillary central incisor crown.
Significantly consistent ratios were found to occur in:
1. The nasiomenton (internasal and nasofrontal sutures and the chin)
measurement and the length of the maxillary central incisor crown showed a 11:1
ratio in 81 per cent of skulls. However this has little significance in edentulous
patients whose nasiomenton measurements depends on the degree of mouth
opening and the orientation of the occlusal plane.
2. The cranial circumference and the widths of the maxillary anteriors showed a
ratio of 10:1 in 91 percent of skulls. This has been reported by Sears also.
3. 93% of skull showed equal or near equal measurements between the nasal
widths, nasal aperture and the width of the four maxillary incisors.
4. The maxillary and mandibular anterior teeth showed a high percentage ratio of
5:4 in 90% of skulls. Sears also reported similar findings.
Technique 6
Clapps tabular dimension table method 1910.
Teeth were selected based on the overall dimension of six anterior teeth
arranged on the Bonwill circle and the vertical tooth space available in the
patient.
A table with illustrations of molds allowed the dentist to select and specify
the mold to be used by number.
Technique 7
Valderramas Molar tooth Basis was projected in 1913. This method of
only historical value used varying measurements between combinations of cusp
points to indicate the size of the individual and overall tooth measurements. The
basic problem with this technique is that edentulous patients have no molars.
Valderrama also predicted a selection of tooth size on a 1/4
th
increment of
the size of a Bonwill triangle, determined by measuring the edentulous mandible.
Technique 8
Cigrande 1913 advocated the use of the outline form of the fingernail to
select the outline form of the upper central incisor. The size was modified to meet
the requirements of tooth space and other relationships.
Technique 9
The Geometric method or Law of Harmony.
Williams Typal form method projected by J. Leon Williams in 1914 is
based on the geometric pattern created by the outline form of the bony face
frame the ovoid, square and tapering forms. William arrived at this classification
after extensive anthropological study and was able to interest a manufacturer.
The Dentists supply company to produce his systematized molds of teeth. Thus
the typal form method or geometric method of anterior tooth selection gained
universal acceptance. However further investigation by Wright in 1936, Bell in
1978 and Mavroskufis et al in 1980 invalidate this method of selection. But this
method is probably still the way in which most dentists select anterior artificial
teeth.
Technique 10
Young proposed the selection of tooth form by Mold guide sample as the
10
th
technique (in approximate chronological order).
Technique 11
Wavrin Instrumental Guide Technique presented in 1920 was based on
Berrys Biometric ratio method and Williams Typal form teeth but its use was
limited to a single manufacturers product.
Technique 12
Maxillary Arch outline form projected by Nelson in 1920. This technique
assumed that the arch outline form was a valid method since it was related to an
individuals anatomy. This was invalidated by changes in arch form due to
resorption.
Technique 13
Wrights Photometric method proposed in 1936 was based on using a
photograph of the patient with natural teeth and establishing a ratio by
comparative computation of measurements of like areas of the face and
photograph. The simple unknown mathematical fomula could be used to select
teeth or to create correct vertical dimension. Minute inaccuracies in
measurements tended to diminish greatly the reliability of the technique so it has
enjoyed little usage.
Technique 14
The multiple choice method introduced by Myerson in 1937 was based
on a need for a selective range in labial surface characteristic of transparent
labial and mesial surfaces, varying surface colour tone, and chracterization of
teeth by time and wear. Harmony of tooth size and shape with face size and
shape was associated with this technique.
Technique 15
Steins coordinated size technique presented in 1940 was based on the
coronal index of 70 to 100 commonly used in prosthetic on 4 model teeth
representing the range of maximum frequency of use and on the common
variability in size of individual natural teeth. The index is the width percent of the
length. The variability is 0.5mm ; model size varied from 7.2 to 8.7 mm.
Technique 16
Anthropometric Cephalic index method projected by Sears in 1941 was
based on the fact that the width of the upper central incisor could be determined
by dividing either the transverse circumference of the head by 13 or the
bizygomatic width by 3.3. Tooth length was in proportion to face length.
Technique 17
Frame Harmony method by the Justi company in 1949, is based on the
fact that the size and proportions of the teeth are in harmony with the general
bony proportions of the skeleton. The overall tooth size is selected by a
mathematical formula, 1/7
th
the total dimension of the upper and lower
edentulous ridges, with the dimensions of the individual anterior teeth correlated
with a developed table of tooth dimensions to give the indicated over-all
dimension. Other characteristic of tooth form are based on genetics, and the
comparison of such dental qualities of a near relative.
Technique 18
Bioform technique proposed by the Dentists Supply company in 1950 is
based on the geometric outline forms of face and teeth the House
classification for 4 basic and 3 combination typal forms, and 3-dimensional
harmony of tooth form and face form. It is associated with the tabular and mold
guide systems. This is currently in use.
Technique 19
The Trubyte tooth indicator or Selection Indicator Instrument method
advocated by the Dentists supply company which is correlated with Williams
and Houses Typal form theory and the Tabular technique.
Technique 20
House instrumental method of projecting typal outline and profile
silhouettes onto the face by means of a telescopic projector instrument and
silhouette form plates. This was correlated with designated mold numbers and
size variation. This was proposed by House in 1939 and by the Dentists Supply
company in 1950.
Technique 21
Automatic instant selector guide of the Austenal company in 1951
correlated form, size and appearance in such a manner that only a single reading
was required to select the appropriate tooth mold based on dimensions of
denture space and harmony of face and tooth form.
These were the twenty one techniques detailing the evolution of the
selection of anterior teeth as described by Young in 1954.
Then in September 1955 Frush and Fisher created a revolution in the field
of dental esthetics by the introduction of Dentogenics. In a series of six articles
published between 1955 and 1959 they described various means to more natural
dentures and many tips on how to avoid the denture look.
Krajicek in 1956 proposed methods involving the duplication of the
patients natural teeth either before or after extraction. Klein (1960), Hayward
(1968), Kafandaris and Theodoros (1974) suggested incorporating the patients
natural teeth in the denture. Van Victor in 1963 proposed the mold guide cast
technique.
DENTOGENICS
Frush and Fisher in the first, of a series of six articles, published in 1955
introduced the dental community to Dentogenic restorations. According to them,
there was nothing in the field of esthetics that had not been considered before.
Yet a vacuum existed and the Denture look prevailed.
Dentogenics describes a denture that is eminently suitable to the wearer in
that it adds to the persons charm, character, dignity or beauty in a fully
expressive smile. Dentogenics then means the art, practice and techniques used
to achieve that esthetic goal in dentistry.
The authors describe the origin of the concept Frush in 1952 met in
Zurich, Switzerland, a master sculptor by the name of Wilhelm Zech who
ground and formed teeth for his dentist father. Zech experimented with the
molding, spacing and arrangement of teeth in artificial dentures with an artists
concept of what belonged in the mouth of a living human. His work inspired
Frush to take a new look at denture prosthetics and the Swissedent foundation
was established in Los Angeles, California in 1952, from where through seminars
and workshops, the concepts of dentogenics have disseminated.
Frush and Fisher in 1956 advocated sex identity in dentures by the
application of Dentogenics. According to them, the feminine form is
characteristically spherical with a roundness, smoothness and softness that is
typical of women. Whereas the masculine form is cuboidal, with the hard,
muscular, vigorous appearance which is typical of men.
The procedure therefore is to select a basically Feminine or Masculine
mold and then harmonize it to the individual patient depending upon the
personality and age factors by modifying individual teeth.
The authors describe a procedure they call depth grinding which involves
the accentuation of the third dimensional depth to eliminate the first appearance
of the artificial upper anterior teeth. With a soft stone, the mesio-labial line angle
of the central incisor is ground in a definite and flat cut, following the same curve
as the mesial contour of the tooth in order to move the deepest visible point of
the tooth further lingually. After this cut has been made, a careful rounding and
smoothing of the sharp angle made by the stone must be accomplished and a
perfect polish must be given to the ground surface.
It is necessary to develop the desired effect in depth grinding by a
consideration of these main factors A flat thin, narrow tooth is delicate looking
and fits delicate women and involves little depth grinding. Whereas a thick,
Bony, big sized tooth, heavily carved on its labial face is vigorous and is to be
used exclusively for men. This involves rather severe depth grinding.
For the average patient, a healthy women or a less vigorous man, the
depth grinding will be an average between delicate and vigorous, the feminine or
masculine characteristics being given by other tooth shaping, incisal grinding and
the positioning of the teeth.
Depth grinding reduces the width of the central incisors according to the
severity of grinding to be accomplished. Therefore, to maintain the normal
harmony of contrast in size between the six anterior teeth, a larger sized central
incisor of the same mold should be selected.
Again in 1956, Frush and Fisher discussed another aspect of Dentogenics
the personality of a patient. They stated that the foundation for dentogenic
restorations is the personality of the patient simply because the basic male or
female tooth form is a refinement of that tooth form which has its inception in the
personality factor. Likewise age is a refinement of the personality factor. They
devised the personality spectrum and explained the precise prosthodontic
application of the otherwise abstract word personality by the 3 divisions of the
personality spectrum.
1. Delicate meaning fragile, frail, the opposite of robust.
2. Medium pleasing meaning normal, moderately robust, healthy and of intelligent
appearance.
3. Vigorous meaning the opposite of delicate, hard and aggressive in
appearance, the extreme male animal, muscular type almost primitive, ugly.
The personality spectrum can be used in our artistic endeavour to inject a
variety of tooth form and tooth position, at the comprehensive level of individual
patient personality analysis. A small percentage of patients are delicate, and a
slightly larger percentage are vigorous. The remaining majority of patients fall
into the medium section of the personality spectrum, but all of these have either
vigorous or delicate tendencies.
The use of the dentogenic concept is made easier by considering the smile
as the primary objective personality trait of the patient. This primary objective
personality trait and the personality spectrum is used for the selection of the mold
category. These fundamental shapes must then be subjected to the refining
procedure of sex and age modifications.
The age factor in dentogenics, considered by Frush and Fisher in 1957,
determines the selection of the shade of the mold to be used in the denture. Light
shades are considered appropriate for young people and darker shades are
considered esthetic for older people. Also bluish incisal tinges are preferred for
the young and grayish shades for the older. Mold refinement is done by
producing worn incisal edges and cuspid tips, attritional and abrasional facets,
development of diastemata to indicate tooth loss and subsequent drifting.
Thus the dignity of advancing age may be portrayed in the denture.
In 1958, Frush and Fisher propounded the Dynesthetic interpretation of the
dentogenic concept. Dynesthetics is a compounded word. The prefix dyn is from
the Greek word dynamis meaning power. It implies movement, action, change
and progression in the esthetic phase of prosthodontics. This dynamic value has
been described as making the difference between an artifact, any object without
life-like effect such as a spoon, and a work of art or visual objects that are alive
in meaning such as a statue.
Therefore the application of dynesthetics allows a denture to be a work of
art and have a life-like effect against a denture lacking artistic treatment and thus
remain an artifact.
The dynesthetic techniques are rules which concern the 3 important divisions
of denture fabrication.
1. The tooth.
2. Its position.
3. Its matrix (visible denture base).
The selection and modification of the tooth according to dentogenics has
already been described. The positioning and denture base considerations are
beyond the scope of this seminar.
THE GOLDEN PROPORTION
Of particular interest is the so called Golden proportion that exists between the perceived widths of the
upper anterior teeth.
Lombardi in 1973 and Levin in 1978 demonstrated that the width of the
central incisor is in golden proportion to the width of the lateral incisor. The width
of the lateral incisor to the width of the canine is also in golden proportion as is
the width of the canine to the first premolar. The golden proportion exists when
the ratio between a larger part B (for example) to a smaller part A (for example)
is 1.618.
DISCUSSION
A practical approach to the selection of the anterior teeth is to consider the
size, form and color.
SIZE:
May be determined from:
- Pre extraction records.
- Marking the corners of the mouth on the occlusal rim gives the width of the 6
anterior teeth.
- Marking the inter alar width on the occlusal rim gives the width of the 6 anterior
teeth from cuspid tip to cuspid tip.
- Length may be determined by noticing visibility of the incisal edges and relating
this to lip length and dentogenics.
FORM:
Inspite of the body of research that invalidates Williams Typal theory,
clinically, it is observed to provide esthetic results and as stated by William
Observance of this rule will always give you perfect harmony the harmony of
opposition of line.
The form may also be selected considering first the personality of the
patient and then modified according to the sex and age of the patient to
individualize the mold.
Pre extraction records may also be of value in the selection of the form of
the anterior teeth.
COLOR:
Color of the teeth is to be determined by the skin coloring of the individual.
The color selected should be so inconspicuous so as not to attract attention to
the teeth. The squint test may be helpful in evaluating colors of the teeth with the
complexion of the face. With the eyelids partially closed to reduce light, the
dentist compares prospective colors of artificial teeth held along the face of the
patient. The color that fades from view first is the one that is least conspicuous in
comparison with the color of the face.
The age of the patient will also effect the color of the teeth. The general
rule is that darker teeth are more appropriate in older patients and lighter teeth
are more harmonious in young patients.
This rule however must be overruled for the patient who does not smoke
and takes food of slight pigmentation and may continue to have a relatively light
tooth body together with the normal color texture. This is an application of
dentogenics to the color selection.
CONCLUSION
The selection of anterior teeth is an important part of the esthetic phase of
denture fabrication. It is essential not to be embroiled by the various techniques
aimed at making the task easier. What is necessary is the development of an
esthetic sense by the observation of natural dentitions in response as well as in
function so as to be able to create dentures that are living things belonging to a
human being and not just mere artifacts that are poor replicas of what has been
lost.
BIBLIOGRAPHY
1. BELL R.A. : The geometric theory of selection of artificial teeth : Is it valid ?.
JADA 97 : 637, 1978.
2. CLAPP G.W. : How the science of esthetic tooth form selection was made easy.
J. Prosthet. Dent. 5 : 596, 1955.
3. Dorlands Illustrated Medical Dictionary. W.B. Saunders, 28
th
Ed. Pg 1666.
4. FENN, LIDELOW, GIMSON (1989) : Clinical Dental Prosthetics, 3
rd
Ed., Wright.
5. FRUSH J.P. and FISHER R.D. : Introduction to dentogenic restorations. J.
Prosthet. Dent. 5 : 586, 1955.
6. FRUSH J.P. and FISHER R.D. : How dentogenic restorations interpret the sex
factor. J. Prosthet. Dent. 6 : 160, 1956.
7. FRUSH J.P. and FISHER R.D. : How dentogenics interpret the personality
factor. J. Prosthet. Dent. 6 : 441, 1956.
8. FRUSH J.P. and FISHER R.D. : The age factor in dentogenics. J. Prosthet.
Dent. 7 : 5, 1957.
9. FRUSH J.P. and FISHER R.D. : The dynesthetic interpretation of the dentogenic
concept. J. Prosthet. Dent. 8 : 558, 1958.
10. HAYWARD D.E. : Use of natural upper teeth in complete dentures. J. Prosthet.
Dent. 19 : 359, 1968.
11. HICKEY J.C., ZARB G.A., BOLENDER C.L., (1985) : Bouchers prosthodontic
treatment for edentulous patients, 9
th
Ed., Mosby, S. Louis.
12. HEARTWELL C.M. and RAHN A.O. (1986) : Syllabus of complete dentures,
4
th
Ed., Lea and Febiger, Philadelphia.
13. KERN B.E. : Anthropometric parameters of tooth selection. J. Prosthet. Dent. 17
: 431, 1967.
14. KAFANDARIS N.M. and THEODOROU T.P. : Complete denture technique using
natural teeth. J. Prosthet. Dent. 33 : 571, 1974.
15. KLEIN I.E. : Immediate denture prosthesis. J. Prosthet. Dent. 10 : 14, 1960.
16. KRAJICEK D.D. : Personalized acrylic resin anterior teeth. J. Prosthet. Dent. 6 :
29, 1956.
17. LEVIN E.I. : Dental esthetics and the Golden proportions. J. Prosthet. Dent 40 :
244, 1978.
18. MAVROSKOUFIS F. et. al : The face form as a guide for the selection of
maxillary central incisors. J. Prosthet. Dent. 43 : 501, 1980.
19. MAVROSKOUFIS F. et. al : Nasal width and incisive papilla as guides for the
selection and arrangement of maxillary anterior teeth. J. Prosthet. Dent. 45 : 592,
1981.
20. PICARD C.F. : Complete denture esthetics. J. Prosthet. Dent. 8 : 252, 1958.
21. SEARS V.H. : Selection of anterior teeth for artificial dentures. JADA 23 : 1512,
1936.
22. VAN VICTOR A. : The mold guide cast Its significance in denture esthetics. J.
Prosthet. Dent. 13 : 406, 1963.
23. WRIGHT W.H. : Selection and arrangement of artificial teeth for complete
dentures. JADA 23 : 2291, 1936.
24. YOUNG H.A. : Selecting the anterior tooth mold. J. Prosthet. Dent. 4 : 748, 1954.



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Tuesday, July 30, 2013
HIGH SPEED CUTTING INSTRUMENTS IN PROSTHODONTICS

HIGH SPEED CUTTING INSTRUMENTS IN PROSTHODONTICS
Introduction
In order to perform the intricate and detailed procedures associated with
restorative dentistry, the dentist must have a complete knowledge of the purpose
and application of the many instruments required. During each day of his clinical
experience the dentist operates on vital tissues within the oral cavity where a
millimeter or a fraction there of, is a very significant dimension. A skillful
application of sharp hand and rotary instruments requires ability and coordination
gained only by extensive training.
Before the advent of rotary instruments, removal of tooth tissue was
accomplished with sharp edged chisels, hatchets, and hoes. These hand
instruments possessed a cutting capability, which was used for clearing away
unsupported and undermined enamel resulting from dental caries. Walls and
floors of the cavity were formed by a planning and lateral scraping action of these
sharp edged instruments. At best, such efforts were crude, time consuming and
often difficult.
The first, rotary instruments for cutting tooth tissue were modified hand
instruments. These, drill or bur heads could be twisted in the fingers to produce a
cutting or abrading action. In 1846 the finger ring was introduced with a drill
socket attached for adapting a series of long bundled burs or drills. This was the
primitive application of the rotary principle. The first drill having flexible cable
drive and the first angle hand piece were introduced by Charles Merry between
1858 and 1862. In 1871, Morrison modified and adapted the dental foot engine
from the Singer Sewing machine. This was followed by the introduction of the
electric dental engine utilizing a cable arm in 1883. In 1910 the endless cord on a
jointed arm was made available. The earlier dental hand pieces were capable of
speeds from 4500 to 6000 rpm.
In 1940 the use of diamond abrasive paints became widespread. The
diamond point is compared of a number of small diamond particles bound on a
rotary blank.
In 1945 Dr. G.V. black, published a report on the non mechanical
preparation of cavities and in doing so introduced the air abrasive technique. The
impact of Dr. Blacks revolutionary cutting technique on the dental profession was
considerable. This was the first significant break in the long established
traditional method of cavity preparation. The air abrasive principle utilized
particles of aluminium oxide propelled against the tooth surface by a carbon
dioxide stream under the pressure of 110 psi, and funneled through a tungsten
carbide nozzle with a lumen of 0.018 inch. The penetration of enamel and dentin
was rapid but some what difficult to control.
In 1949 Walsh and Symons published their initial findings relating to the
removal of tooth tissue with diamond points at rotational speeds upto 70,000
rpm. This report indicated the use of lighter forces and a resulting increased
cutting efficiency at these higher speeds.
In early 1950, the ball-bearing hand piece was introduced.
In 1963, following the work of Nelson the first fluid turbine type handpiece
was introduced. This instrument was capable of rotational speeds of
approximately 50,000 rpm and was limited to diamond instruments operated at
one speed only. In 1954, air-driven hand pieces were developed. A continuous
belt-driven contra-angle which utilized a friction grip chuck and bur was
introduced, making possible cutting speeds of upto 150,000 rpm.
By 1957, many dentists were using rotational speeds upto 3,00,000 rpm. The introduction of air-
bearing hand piece in the early 1950 made possible greater rotational speeds of approximately 5,00,000
rpm.
In 1953, an ultrasonic method of tooth tissue removal was also introduced,
which used suitably shaped tips vibrating at frequencies ranging from 2,50,000 to
3,00,000 cycles per seconds.
This brief historical back ground reveals that the profession has been
searching for a suitable method of tooth tissue removal. Only during last 30
years, this hunt has slowed down still the profession is trying to refine the
procedure and instruments.
Review of literature
A search through literature reveals various methods used in the past for
removal of tooth tissue. The continuous development of newer methods till 1960,
indicates that the earlier instruments had some disadvantages. Inspite of the
introduction of numerous tooth reduction instruments, and procedures, the
principles and the biologic objectives have remained the same. These are as
follows.
1. The operator should remove the least amount of tooth tissue consistent with
necessary mechanical retention.
2. This should be done with the least barm to the periodontal tissues and the pulp.
3. It should be done with the least discomfort to the patient.
4. No pathologic reactions should be initiated in the pulp.
Advantages of high speeds
1. Smaller stones can be used at the increased speeds.
2. Less fatigue results both for the patient and operator.
3. Due to high speed, very light pressure is required.
4. Less vibrations are felt by the patient.
5. The chairside time for a given preparation is considerably reduced.
6. Trauma to the pulp is reduced.
7. The efficiency and life of the cutting tools is increased.
8. Because of small tools, control is easy.
9. Removal of old amalgam and gold restorations is easy.
Disadvantages of high speeds
1. The increased speed creates increased temperatures in the tooth. Therefore
some method of cooling the tooth more efficiently is required not to injure the
pulp. This necessitates additional equipment.
2. When a dentist changes from the lower speeds, which utilize a pressure in
pounds, to high speeds which need only a pressure in ounces, he must develop
a new technique and retrain himself to a new tactile sense.
3. To operate at high speeds good visibility of the cutting instrument is necessary to
avoid over cutting.
4. Due to the ease with which tooth tissue is removed, caution must be taken not to
injure the proximal enamel of the adjacent healthy tooth and the gingiva.
5. High speeds result in greater wear on the working parts of the handpiece,
necessitating more frequent repairs and replacements.
6. Unless used properly, high speeds have a tendency to create striations on a
tooth surface.
7. The ideal preparation for any type of restoration cannot be accomplished by
using high speed equipment alone. The final exactness and finishing line can
best be established by instruments revolving at moderate speeds.
Types of high speed instruments
Hand piece can be divided into four types depending upon their speeds as
follows.
1. Low speed upto 10,000 rpm.
2. Intermediate speed 25,000 to 45,000 rpm.
3. High speeds 50,000 to 1,00,000 rpm.
4. Ultra high speeds 1,00,000 rpm and over.
Kilpatric has further classified the ultra high speed handpiece into three classes.
Type I the gear driven centre-angle handpiece, upto1,25,000 rpm.
Type II the belt driven contra-angle handpiece upto 2,00,000 rpm.
Type III turbine driven air contra-angle handpiece upto 3,00,000 rpm and higher.
Heat generation:
Knowledge of the physics tells us that, whenever there is friction between
two surfaces, heat is generated, which may bring about rise in temperature of
either or both the surfaces. The same applies in the tooth reduction procedures.
Here the rotating cutting tools come in contact with the tooth surface and the heat
is generated.
It was not until 1930 that the workers began to investigate the heat rise in
the dental pulp.
There are many factors that influence the rise in temperature which takes
place in cutting operations. The greater the speed of rotation of the cutting tool,
the faster the tool revolves, the higher the resultant temperature. It has been
found that the temperature rise develops within 10-12 seconds, after the cutting
operation is started. Size of the cutting instrument has an important bearing on
heat generation, since, its diameter affects the cutting speed at its periphery.
Larger the size of the cutting tool more the host generation.
A third factor is the pressure applied by the dentist during cutting
operation. As the pressure increases, greater will be the rise in temperature.
Hudson and associates in 1954 conducted a study on temperature developed
in dental cutting instruments from their study they have concluded that,
1. The temperatures produced by dental burs in cutting human dentin ranged from
125F to 275F. Since these temperatures are above those, said to be tolerated
by normal human dentin, it would seem advisable to use some form of coolant.
2. A significant decrease in time required to accomplish a given operation is
apparent, when high operating speeds are used.
3. The amounts of heat transferred to the tooth from the bur decreases, at speeds
above 12000 rpm, since cutting time at these speeds is reduced and bur
temperature remains.
Substantially constant and there is less heat trauma to the vital structures.
Coolants:
From the study of Hudson and Sweeney, it is evident that the temperatures
reached during tooth reduction procedures are above those said to be tolerated
by normal human dentins. This indicates that, some form of coolant must be
used, during the cutting operations, particularly when high speeds are used.
Every means should be employed to keep the temperature down as much
as possible during cutting operations. Coolants must employed which, to be
effective, should be applied at the point of contact between the cutting instrument
and the tooth tissue. There are three types of coolants usually employed in
dental practice.
1. Water.
2. Spray of air and water
3. Air alone.
Peyton has shown that at speeds ranging from 30000 rpm to 170000 rpm
and with an application of four ounces of pressure, a temperature rise within the
tooth of less than 15C occurred when water or air-water sprays were employed.
He also found that even with a water coolant, excessive temperatures developed,
when large diameter instruments or excessive pressure were applied with
increased operating speeds. This indicates that the use of a coolant, does not
eliminate the danger of excessive temperature rise.
A reduction in concentration of the amount of water used during cutting
procedure shows the significant temperature rise of the dental bur.
The minimum volume of water to be applied was estimated at 1.5 ml per
minute.
The question whether water in spray form should be used at mouth or
temperature seems to have no significance as far as temperature rise in the tooth
was concerned. Tylman is of the opinion that if the water reservoir is kept at
100F, it is most comfortable to the patient, less liable to be harmful to the pulp
and still reduces the heat of friction during cutting.
There are certain other problems associated with the use of the highspeed
cutting tools. Most of the hand pieces are so designed that a spray or stream of
water is directed from the head of the handpiece directly onto the cutting
operation. Where the water strikes the tooth and the cutting tool directly, full
benefit is obtained from the coolant. Where however, the abrasive on the cutting
tool, is on the surface away from the stream of water, water does not flood the
tooth surface being cut, resulting in excessive temperature rise. The overcome
this difficulty perforated disks have been developed, which permit the water to go
through the openings and lubricate the disk and tooth on the cutting side. The
use of perforated disk results in less temperature rise. Consequently when disks
are non perforated, and when the stream of water cannot be directed to the
cutting contact areas, they should be used at speeds not exceeding 10,000 rpm.
Another advantage of a water coolant lies in the fact that the tooth debris
from the cutting is removed rapidly, preventing the clogging of the cutting tools.
This results in greater cutting efficiency of the stone. Also, it prolongs the life and
effectiveness of the instrument. It is essential that the water be in intimate contact
with the revolving instrument and the tooth tissue. To do this more effectively,
Nelson recommended the addition of a wetting agent to the water spray.
Because the high speed technique requires a larger quantity of water as a
coolant, there is the problem of removing this water from the mouth. To have the
dentist stop frequently to allow the patient to spit out the excess water is time
consuming. The customary saliva ejector has insufficient removal capacity.
To solve this problem, Thompson has suggested a washed field technique.
This technique adapts the suction or vacuum principle. It established and
maintains a powerful but gentle negative pressure of air in the mouth, close to
the field of operation.
Accompanying the air stream, is a flow of isothermal water which is
projected copiously onto the operative field. This water is entrained into the
vacuum air stream, which draws it rapidly across the operative area. The irrigant
pulls away with it tooth cuttings and debris. These are taken into the vacuum air
stream and disposed off in a filter system. A clean, clearly visible operative field
is provided. This technique has the distinct advantages that it facilitates the use
of high speed instruments, maintains visibility during copious irrigation of the
operative field, reduces operating time, improves the patients well being and
introduces a new concept of cleanliness. Human tissues are maintained in their
natured wet safe pain, trauma and postoperative complication, which may arise
due to ingestion of tooth debris are reduced.
Desiccation of hard and soft tissues is avoided. Heat is eliminated thus
preserved the tissues.
Vibration:
Cutting a tooth may be very annoying and unpleasant to the patient but still
not be painful. In pain there is usually an involvement of the nerve endings, either
by trauma or extreme irritation, resulting in an acute, painful reaction. Most
patients associate the sensation of vibration, noise, pressure and the slight
increase in cutting temperature with the sensation of pain. Consequently, if the
factors of vibration, heat and pressure are reduced to a minimum, the patient
usually experience reduced or no pain.
One mechanical factor that influences vibration is the dental handpiece,
whether it is friction-bearing, ball bearing, high speed belt driven or turbine ultra
speed. When the friction bearing, conventional type of handpiece is used at a
speed of 4500 rpm to 6000 rpm, it is connected by the conventional belt and
pulley system of the dental engine. In this case one may expect a high order of
vibration depending upon the condition of various mechanical parts, their
adjustment and speeds of their operation.
Pulleys that are worn, a worn belt, or an improperly adjusted belt will cause
vibrations that are transmitted down to the cutting tool. Similarly hand piece
which do not hold the cutting tool properly, which have worm bearing or are out
of adjustment will also cause vibration.
The investigations of Walsh and Symmoss showed that vibration, when
applied to tooth, produced the most unfavorable response when the frequency
was between 100 cps and 200 cps. When the frequencies were above 1000 cps,
they were generally beyond the upper threshold of perception of the average
patient. It is the lower frequencies, in the range of 100 200 cps, that are usually
developed at the lower speeds, especially if the equipment is worm and
maladjusted.
Hudson and Sweeney have reported the importance of having centricity in
the cutting tool. They found that eccentric burs when rotated at 6000 to 10000
rpm produced a lower frequency in the range of 100-200 cps, whereas a true
running bur at 10000 rpm produced vibrations in the frequency range above the
upper threshold.
Tamner pointed out that only a part of an eccentric cutting tool is used as it
rotates, thus causing unfavorable impacts and vibrations, which fall into the most
annoying frequency range. The disks and stones that are unmounted and are
screwed onto a mandrel very frequently are eccentric and therefore should not
be used in high speed cutting operations. The permanently mounted instruments
are indicated in preference to unmounted type.
Poorly built burs with blades not evenly cut or chipped will likewise cause
vibration. In using carbide burs, it is very important the see that none have
chipped blades.
Correct adjustment of the belt is important in the reduction on and
elimination of vibration. A belt that is too loose increases the vibration pattern
transmitted directly to the tooth.
In the ultra highspeed hand pieces the metal chuck holding the cutting
instrument often is replaced by a rubber or plastic chuck. This lessens the
vibration transmitted to the cutting instrument and facilitates the more rapid
cutting action.
In cutting with a water turbine handpiece at 45,000 rpm the intensity of
vibrations was well tolerates by the patient.
Morrison and Grinnel made the following observations.
The deleterious effects of vibration are two fold in origin.
1. Amplitude.
2. Undesirable modulating frequencies.
If we minimize or eliminate these factors, we can then reduce the
undesirable effects of vibration.
Amplitude: The wave of vibration consists of frequency and amplitude.
At conventional speeds, amplitude is greater but frequency is less. At higher speeds the reverse is true.
The greatest harm is caused by the amplitude of vibration which is the factor, most destructive of
instruments and which causes the most apprehension in the patient and the greatest fatigue in the
dentist.
By increasing operating speeds, the amplitude and its effects are reduced
and a more satisfactory result is attained.
Vibration waves are measured in cycles per second. It has been shown
that rotation of approximately 6000 rpm sets up a vibrational wave of
approximately 100 cps. As the rpm is increased the cps of the fundamental
vibration wave are increased until, at ranges of 100000 rpm, we have a vibration
wave of 1600 cps. It has been demonstrated that at wave of vibration of over
1300 cps, vibration is practically imperceptible to the patient. The reason for this
is not fully understood, but there are two theories for this phenomenon.
(1) The Wedensky inhibition phenomenon frequency increased to a point where
vibratory perception diminishes due to failure to perceive vibration. This is
because Stimulation occurs during Refractory Period of Recovery.
(2) Vibratory perception depends upon the product of the amount of stimulation (i.e.
pressure) multiplied by the frequency of stimulation necessary for a reaction. This
is called Chronaxie. As the speeds above 1,00,000 rpm, due to light pressure
and high speeds, chronaxie is attained, which is necessary for reaction.
Thus it can be concluded that, the more the rpm, the less the amplitude,
and the greater the frequency. Vibratory perception will be lost in the ultra
highspeed range of 1,00,000 rpm or more.
Spread of pathogenic organisms by Ultra speed cutting procedures:
Atmospheric contamination through the spread of oral organisms
particularly from air turbine action has been a concern of the dental profession for
some time. Dental procedures tend to expose the operator to infectious diseases.
Recent studies suggest that the extent of aerosol produced by air turbine may
increase the normal hazard. A report involving patients with pulmonary
tuberculosis cultures were demonstrated on all petri dishes exposed during
cutting procedures, with the heaviest concentration being at 2 feet in distances
from the patients mouth. This indicates that the dentist and his assistant are
exposed to a serious health hazard when operating with an ultra speed exposed
instrument on patients having such pathogens in their oral flora. When a patients
history suggests the existence of tuberculosis, pneumonia, influenza, infections
hepatitis or any infectious diseases including the common cold, a protective face
mask should be worn by both dentist and assistant. During all ultrahigh speed
cutting procedures, protective eye-glasses should be worm routinely.
SUCK-BACK PHENOMENON- The operation of the turbine is switched off by
closing the compressed-air valve abruptly. Then, owing to its own kinetic energy,
the turbine continues its rotation, so that the turbine starts operating as an air
pump. This causes a negative pressure in the area of the turbine shaft. The
negative pressure sucks air from the environment that can be contaminated by
aerosols of saliva and blood of the patient.
Size of cutting instrument and cutting speeds:
It has been pointed out by Peyton, and Nelson that, the important factor of
increased operating speeds is the instrument surface speed in fact per minute
rather than the revolution per minute of the instrument.
The larger the diameter of the cutting instrument, the slower the speed
required at the spindle. The specific phase in preparation of an abutment should
determine the size of the cutting instrument and the rpm that should be used.
Employing superspeed for all operations places unnecessary strain upon the
patient and equipment. If the same effect can be accomplished by using a larger
instrument at a lower speed, but still remaining above the threshold of
perception, this should be done. However, oversized cutting tools should not be
used at super speeds due to the difficulty of instrument control and accuracy of
cutting.
VIBRATION SYNDROME : the perception of vibration, pain, touch and
temperature deteriorates. The negative effect of local vibrations occurs within the
range 5-1400 hz, the most harmful being those below 16 hz. mechanical
vibrations arise because the various machines operating at the dentists
workplace contain moving parts. The main source is vibrating power-driven or
air-driven instruments, such as low- and high-speed handpieces as well as
ultrasonic instruments. The vibrations emitted by these
machines travel directly from the handles to the operators hand. These are local
vibrations.
Biologic response of dentin and pulp to high speed cutting:
Dentin: As the contents of the dentinal tubules are in direct continuity with the
odontoblasts, and pulp, cutting or grinding the dentin causes a reaction in the
pulp and this may lead to changes in the dentin.
An early experimental investigation into the effect of cavity preparation on the dentin and pulp was carried
out by Fish in 1932. He cut cavities in the teeth of dogs and left the cavities open to the saliva. By sealing
dyes into the pulp chambers of the treated teeth he has shown that one of two reactions is produced in
the dentin.
In some cases there was sclerosis of the cut dentinal tubules which forms
a protective some sealing off the pulp from the injury and underneath this region,
there is a further growth of tubular dentine. These reactions are produced by the
stimulation of the odontoblasts. The other reaction that resulted was the
formation of dead tracts. With this lesion some or all of the odontoblasts, that are
in connection with the cut tubules die. On the pulpal aspect of these tubules,
hyaline mineralized barrier, secondary dentine is laid down, thereby sealing the
lesion from the pulp.
Pulp: The changes in the pulp have been studied by Langeland and Morslard
and Shovelton. They state that the damage to the pulp is to a large extent due to
the heat generated. They have shown that when precautions are taken to
minimize heat production by using burs rotated slowly in a speed reducing
handpieces, the only evidence of pulp damage was a slight reduction of the
odontoblast layer with the displacement of a small number of odontoblasts into
the dentinal tubules. When speeds upto 5,000 rpm were employed, there was
more extensive displacement of odontoblasts associated with marked
vacuolization of the odontoblast layer, and local hemorrhages may be seen in the
pulp. As the speed was increased, the changes became more severe. When
tooth reduction was done under a stream or spray of water, the damage to the
pulp was markedly reduced.
Pulp changes associated with tooth reduction using the air abrasive technique have been studied by
Kennedy and using ultrasonic technique by Mitchell and Jenson. The changes in both the cases are
similar to those produced at the speeds of 5,000 rpm.
The effects on the pulp of using high speed rotary instruments such as the
air turbine have been investigated by Marsland and Shovelton. The changes
found are no severe than those produced at lower operating speeds provided
that adequate cooling of the cutting instrument by water jet or air/water spray is
ensured.
Alterations in the hard tissues of tooth cut by air turbines have been
observed. The enamel over a wide area of crown may show minute cracks and
the dentin shows altered staining reactions as a result a local overheating.
RECENT DEVELOPMENT:
ANTI-SUCK BACK- Planmeca compact dental units, the turbine drive air is not
shut off abruptly but controlled down by allowing the driving air to decrease
gradually. The software of the dental unit will keep on supplying the drive air into
the turbine according to carefully chosen parameters. This way there is no
possibility for the build-up of a vacuum effect that would cause suck-back.
Ceramic bearings- no need of lubrication and more resistant to autoclave
sterlization.
Use of quartz rods instead of fibre-optic.
Easy-to-use push-button bur releases.
Swivel systems.
Titanium handpieces.
Smaller head size.
ELECTRICAL HIGH SPEED HANDPIECES
advantages are:
More power and torque than air turbine handpieces.
Better bur concentricity.
Less vibration and noise.
Broad, controllable speed ranges.
Forward/reverse option are available.
With appropriate attachments, one system can be used for restorative,
prosthodontics, prophies and endodontics.
Disadvantages are :
Heavier than air turbine.
More expensive.
Learning curve may be required.
Attachment heads not as small as the small-head air turbines.
May not be able to fully replace the air turbine.
Infection control concerns.
Discussion
It is for more than 125 years, that rotary instruments have been in use, for
tooth reduction operations, in different forms, from a hand rotary instrument to
ultra sonic instruments, which have the rotational speeds ranging from very low
speeds in case of band rotary instruments to 5,00,000 rpm in case of air bearing
hand piece. These remarkable advances in the instruments have greatly reduced
fatigue in the operator because of the physical case of manipulation and have
considerably increased the comfort to the patient by reducing the actual working
time and pressures required for tooth reduction, thereby minimizing the factors of
heat generation and pain. Though high speed techniques have been a born to
the dental profession, they have their can limitations. It is interesting to not that,
in spite of considerable improvements in tooth reduction procedures and the
instruments used for the same, the principles and biologic objectives have not
changed.
These improved methods of tooth tissue removal have a potential to
damage the healthy teeth and surrounding structures, if they are used without
proper understanding of their working and if they are used without taking proper
care. Improper handling of these modern equipment may also be different to the
longevity and working capacity of the instruments themselves.
For successful and efficient use of those cutting tools, certain factors
should be given consideration. Heat that is generated, while the tooth tissue is
being removed must be kept, down to the minimum and at the sametime,
whatever heat is generated, must be eliminated as efficiently and as quickly as
possible by employing coolants, in any one of three forms commonly used i.e.
water, air/water spray or air alone. Simultaneously with the coolant, if water or
air/water spray is used, an efficient mechanism for remove of the water from the
oral cavity must be employed. Otherwise, the clinical procedure is delayed, if the
patient has to spit out the water, every now and then. By eliminating the water
evacuation equipment, we are losing one of the advantages of these high speed
instruments i.e. reduced working time for a particular preparation. Use of efficient
coolants, not only eliminate the heat generated, but at the same time, keeps the
operating area clean and free of any debris.
High speed cutting methods have a further advantages in that, they reduce
the annoyance that may be caused to the patient, when low speeds are used
with the modern high speed cutting devices, the vibration produced is of a
frequency that is generally beyond the upper threshold of perception of the
average patient.
Pressures that have to be employed in the use of high speeds are
considerably reduced, in comparison with those needed for low speeds.
Thus, when the factors of pressure, temperature and vibration are kept
within the tolerance limits, the patient comfort is certainly improved.
Size of the cutting tool to be used for particular tooth reduction procedure
is an important consideration, particularly while using high speeds. Oversized
cutting tools should be avoided, as they are difficult to control and at the same
time, the accuracy of tooth preparation on procedure is also adversely affected.
Biologic reactions of the tooth tissues, particularly dentin and pulp, should
not be over locked, when high speeds are employed for tooth reduction
operation. These responses have been studied by a number of people and they
have shown that, the response are not significantly different from those, when
low speeds are used, provided, effective coolants are employed.
Thus it can be concluded that, high speed equipments for tooth reduction if
used with proper understanding and due care, provide definite advantages over
the conventional low speed cutting procedures. This fact places the high speed
devices at definitely a higher level as against their low speed counterparts.
Conclusions
1. High speed cutting devices, if used with a thorough understanding of their
mechanism and due care to the biologic integrity of teeth and surrounding
structure, are a boon to dentistry.
2. In the process of tooth reduction using high speeds considerable amount of heat
is generated and an effective coolant is a must for preservation of tooth integrity
and patient comfort.
3. Vibration is increased with the increase in speed, but it is beyond the threshold
of prerception of the normal human beings and hence not harmful.
4. Biologic reactions of the dentin and pulp, to high speed cutting, cannot be
overlooked.
Summary
A brief history of rotary instruments has been presented. A critical
evaluation of the high speed cutting devices, as to their advantages,
disadvantages, and precautions to be taken during their use, has been assessed
at length. Biologic reactions of dentin and pulp, to high speed cutting have been
discussed in brief.

Contents
I. Introduction
II. Review of Literature
a. Advantages of high speeds
b. Disadvantages of high speeds
c. Types of high speed instruments
d. Heat generation
e. Coolants
f. Vibration
g. Spread of pathogenic organisms
h. Size of cutting instruments and cutting speeds
i. Biologic responses of dentin and pulp to high speed cutting
III. Discussion
IV. Conclusion
V.

Summary


INDIAN DENTAL
ACADEMY
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Friday, July 26, 2013
Finish lines in FPD

FINISH LINES IN FPD
Finish Lines
INTRODUCTION
The ultimate goal in fixed and removable prosthodontics is the maintenance and preservation of
the remaining dentition. The execution of this goal can be achieved initially by tooth preparations that are
clinically sound and will increase the longevity of the abutments. Likewise, proper tooth preparation and
contoured restorations that are periodontically acceptable are of major importance in maintaining optimal
periodontal health, restoration of occlusal harmony, and stability of the restored dentition. Restoration of
teeth is possible only if sufficient space is created for the application of the appropriate thickness of
material required. Preference for the shoulder with a bevel preparation allows ample room for the
periodontal tissues and the bulk of the restorative materials (metal crowns with acrylic resin veneers or
porcelain-fused-to metal). The indications and contraindications for each type of full coverage preparation
will be reviewed.

TYPES OF FINISH LINES
Over the years there is often discussion about the various types of full coverage preparations and
their advantages and disadvantages. There are four types of finishing lines for full coverage restorations:
1. Knife edge.
2. Chamfer.
3. Shoulder.
4. Beveled shoulder.
Knife-Edged Preparations:
A knife-edge, or a feather-edge preparation that is basically designed so that as the tooth is
prepared zero cutting results at the gingival termination. The dentist employs the rotary instrument and
leans the cutting stone or bur inward by rotating on that gingival termination and cutting mostly at the
occlusal end. It is a process of tipping the rotary instrument occlusally. When planning the taper of this
type of preparations, a number of problems are observed, especially with a short crowned tooth or on a
tooth with a normal anatomic crown where the preparation ends at the cementoenamel junction.
1. When using ceramometal restorations and aesthetic considerations are critical, because there is zero
cutting at the gingival termination and aesthetic concerns are of primary concern and a metal collar is not
to be used, then the resultant slip joint type of crown becomes overcontoured gingivally. Concomitant with
this, the entire contour of the crown becomes greater, as without overcontouring, color cannot be
achieved in the gingival portion.
2. The retention and resistance form of the preparation is compromised. As the preparation becomes
overtapered, the ability of the crown to be retained on the tooth structure becomes diminished. As an
illustration, altering the taper from a perfectly parallel preparation to one with a 6-degree taper, which is
considered the ideal because it is achievable, almost 50 per cent of the retention is lost. With alteration
from a 5-degree taper to about 20 degrees, 25 per cent of the retention remains. Thus, retention is
developed on the basis of the luting strength of the cement. Cement has a crystalline structure, so it does
not fracture at one time. Each time this cement is challenged, more fracturing of the crystals occur until,
finally, enough of the crystals are fractured to enable the restorations to loosen. Thus, these overtapered
preparations have compromised long-term retention.
3. Another negative aspect of overtapered preparations is that they develop internal stress wedging. As
force is applied into the ceramometal crown with a conically shaped preparation, it will act like a wedge.
The crown exerts a force on the preparation, even if cement is in between. All materials have flow, even
though they are solid. That flow is enough to cause wedging of the metal. The veneering material is
strong under compression but is weak under tension. The internal stress wedging tends to expand the
metal substructure, causing the porcelain veneer to craze and fracture over a period of time.
However, there is a place for a knife-edge preparation in the dentists armamentarium. This is the
type of preparation that the clinician should utilize with long clinical crowns found with postperiodontal
surgery cases. With a postperiodontal case, the clinical crown encompasses the anatomic crown and part
of anatomic root structure. If the preparation extends to the tissue because of old restorations, root caries,
root sensitivity, and aesthetics, very long preparations will be developed. A shoulder preparation cannot
be developed, because once the practitioner cuts past the junction of the enamel and onto the cementum,
the root may begin to taper severely. Thus, the roots become narrower, the farther apically the tooth is
prepared. In these compromised cases, if a shoulder is cut, the resultant long, thin preparation will
fracture easily. Interestingly, a knife-edge preparation when employed with a long clinically crowned tooth
is not a overtapered as on short clinical crowned tooth; therefore, diminished retention of a normal sized
preparation is not a concern with long preparations.
4. Another problem with knife-edged preparations is the resistance form. Resistance form is the ability of a
crown to withstand displacement from eccentric or lateral forces. A lateral force is applied when the
mandible goes into eccentric movements. This is a rotational force that tends to dislodge a crown.
5. Three factors reduce the resistance to dislodgement from rotation.
a . The longer preparation the more resistant to dislodgment.
b. The more parallel a preparation, the more resistant to rotation forces.
c. The smaller diameter the crown, the more resistant to rotation forces.
For example, given the same length and taper, a bicuspid is more resistant to being dislodged by
rotation that a molar. The molar then becomes the liability. In consequences, in the case of a long-span
fixed partial denture extending from a cuspid to a second molar, cementation wash out occurs on the
molar. Rarely, is it on the anterior tooth, as the molar has the larger diameter and thus the least
resistance to dislodgment. As a result the management of a large-diameter tooth requires more
parallelism and a longer preparation in order to avoid dislodgment. In addition, grooves may have to be
cut into the preparation to augment the retention and resistance forms. A light chamfer is really a knife-
edge preparation that has a greater amount of tooth removed gingivally. Another problem associated with
knife-edge preparations is that it is quite difficult to read a finishing line on the die. It disappears and thus
there is a considerable amount of interpretation by the technician. However, if the beginnings of a
shoulder or a light chamfer are cut on these long preparations and the dentist marks the end of the
preparation on the die, which is 1mm past the shoulder or a light chamfer, then the technician will know
where to end the crown restoration. An indication of a shoulder or a light chamfer simplifies the
impression procedure. Basically, there is nothing wrong with knife-edge preparations when utilized
appropriately, which is usually in periodontally compromised cases.
Summary of shoulderless preparations is follows:
1. Little resistance to marginal distortion during firing of porcelain.
2. Margin not always distinct.
3. Poor control over placement of subgingival margin.
4. Insufficient preparation in cervical area.
5. No control over reduction of cervical tooth structure, and
6. Employed with long clinical crown lengths following periodontal surgery.
The Chamfer Preparation:
A chamfer, according to Boucher is a marginal finish either curved or formed by a plane at an
obtuse angle to the external surface of a prepared tooth. One advantage of a chamfer preparation is that
any round-ended instrument employed produces the same type of a cut, no matter at what angle or
height the diamond stone is held. This facilitates the preparations of proposed abutment teeth to be
created in relationship to the soft tissue and that are not made on the same horizontal level throughout.
By following the varying soft-tissue levels. The same configuration of full coverage preparation will be
developed at all the way around the tooth, as the rotary instrument moves from one vertical height to
another. A uniform type of geometry gingivally is established with a chamfer preparation. The geometric
design obtained with a chamfer preparation will be related not only to the design of the tip of the
instrument, because the tips do vary with different manufacturers, but also with diameter of the chamfer
cutting instrument employed. There are three different chamfer types of prepartions:
1. Hybrid. Insert the chamfered stone about one third of the depth of the stone and obtain a hybrid between
a chamfer preparation and an exaggerated knife-edge type of preparation.
2. Ski-sloped. Insert the chamfered stone into the radius of the instrument or half the depth of the stone;
then a more ideal type of chamfer preparation is developed.
3. Rounded shoulder. Insert the chamfered stone into its full diameter, the resulting type of chamfer
preparation appears to approximate a rounded shoulder.
Butt Joint Preparation:
A butt joint preparation employs a ceramometal crown with a bevel created on the mesial, distal,
and lingual surfaces, but not on the labial surface. When constructing a ceramometal crown with a labial
porcelain butt joint, there are several methods used to bake porcelain to the butted shoulder accurately:
1. One method is the refractory die model concept of Sozio.
2. Use of platinum foil at the labial shoulder is another method. This is probably the most successful and
practical technique, as most laboratory technicians are comfortable using this one and it is repeatable.
Technicians are used to employing platinum foil when constructing porcelain jacket crowns.
3. A third technique consists of mixing wax and porcelain together in a ratio of six parts porcelain to one part
wax by weight. This mixture is then waxed in to the butt joint shoulder area on the die. The technicians
can then lift this section off the die for firing. The wax acts as a luting medium and burns off during firing.
During the preparations of anterior teeth, there is a concept called a trigon. A trigon is the
labiogingival contour of the termination of the preparation, it is distal to the middling of the center of the
maxillary central and lateral incisors and is usually in the midline of the maxillary cuspid. This results in a
slightly distal eccentric triangular tooth neck that produces a more aesthetic result in full coverage
restorations than an arcuate labiogingival contour. The curvature from the height of the trigon to the distal
aspect is of small radius, and mesially there is a more gentle curve of a longer radius. The desired
triangular shape will then result, which is more aesthetically pleasing. Basically, 99 per cent of the
resultant aesthetics comes from the soft tissues. If unhealthy tissues or tissues that are abnormal in
contour and form are present, an aesthetic restoration will not result. An unacceptable result is usually not
related to the ceramics it is related to diseased tissue or tissue presenting abnormal form and contour. If
the tissue is healthy with normal contours and tone, a restoration that is slightly off hue will be
acceptable, as long as it does not have the gray-green opaque hue of a nonvital tooth and is of the same
value. Thus when the dentist is having a problem with aesthetics, it is usually associated with the soft
tissues. If the clinician prepares the tooth and soft tissue properly, the ceramist will have a good
opportunity to produce an acceptable restoration.

BEVELING
Functions of the bevel are as follows:
1. To seal restoration against cement leakage and subsequent bacterial invasion.
2. To permit finishing and burnishing on die or tooth.
3. To Provide circumferential rigidity.
4. To initiate reproduction of the contour removed in preparation and provide control of the emergence
profile during framework try-in.
The factors considered in determination of margin placement, subgingivally, supragingivally, or at
tissue height are the concepts of aesthetics, crown length, caries rate, existing restorations, root
sensitivity, and predisposition of periodontal disease. The important issue involved is that most of the time
margins are going to be placed subgingivally. Crispin andWatson did a study that revealed that a
majority of people do not show the margins with normal smiling and speaking. Many patients have a
phobia about a margin showing even on a bucispid or on a molar, even though it will not show during
normal function. In this upwardly mobile society, people are interested mainly in esthetics. They do not
want to see their dental imperfections. Indeed, the state of health is a situation in which people are not
aware of their parts. As soon as a people become aware of their parts, they know that they have a part
problem and become concerned about it. Thus, in the same view, the best prosthesis is a prosthesis that
does not show. That is why these people use contact lenses instead of eyeglasses. When they brush
their teeth, if there is no margin showing, they feel good about themseleves, and they forget that crowns
are present. Thus, as much as the periodontist advises not to place crown margins subgingivally, the
reality of practice is that people want subgingival margins.
Terminating a crown margin at tissue height has the disadvantage of poor aesthetics in an area of
maximal plaque accumulation. The other extreme is margin placement 2 to 3mm subgingival.
Subgingival margins are employed for the following:
1. Aesthetics.
2. Presence of subgingival caries.
3. Presence of existing restorations with subgingival margins.
4. Short clinical crowns with greatly reduced retentive capacity.
5. High susceptibility to root caries.
A preferable compromise is to prepare a shoulder at tissue height and prepare the bevel 0.5 to
1mm below the tissue, thus burying the metal collar while minimizing the insult to the tissue. If the margin
is placed too far subgingivally, gingival inflammation results, and the restorations aesthetics will be
compromised. Thus, if the margin is carefully placed and finished ideally, good long-term results are
possible.
The biologic width is the amount of space that is necessary to house the periodontal complex,
consisting of the transeptal fibres and circular fibers 2 to 3mm between the crest of bone and any
restoration. If this width is not present, inflammation will result, and the inflammation will persist until
alveolar resorption occurs to re-establish the 2 to 3mm biologic width. As a consequence when a patient
undergoes crown-lengthening procedures, not only is tissue removed, but also bone to ensure a proper
biologic width.
When a crown is prepared on enamel, a right angle shoulder is cut. As soon as the
cementoenamel junction is passed, a shoulder that is in reality 110 to 135 is prepared. When a bevel is
placed on a 135 shoulder, the shoulder will appear to be too far supragingivally. This is only an illusion.
The gingival terminus of the bevel placed 1mm subgingivally is still in that position and should not be
altered. The mistake that can be made is to drop the shoulder, as it is thought to be too high and the
collar will show. When the shoulder is dropped, the bevel is lost and a new bevel must be cut. Then the
operator may inadvertently extend into the junctional epithelium and the fibrous connective tissues. Do
not drop the shoulder. When the metal casting is returned and at the time of its try-in, a water soluble pen
is used to mark the tissue height on the casting so the width of the metal collar can be determined by
machining the casting. If this step is not carried out intraorally, the technician may leave too wide a metal
collar. To correct this, porcelain will have to be backed on the collar resulting in poor color and
overcontour. Thus the metal must be machined properly.
Most dentists do not make bevels; they cut collars. Collars are 80 to 90 angles and extend
beyond the shoulder. The reason that most dentists make collars is because they get their primary
retention-resistance form from the collar. The preparations tend to be overtapered, and thus by making a
collar retention and resistance form is obtained. The true purpose of the bevel is for marginal integrity.
The retention and resistance form is obtained from the axial walls of the preparation. In an endodontically
treated tooth, in which the entire preparation will be on post, a long bevel is desired because it is like a
barrel hoop that holds the barrel together. It becomes important because some of the stress of retention
and resistance is taken off the post and core. The long collar binds the root together, and this is
important. With a short preparation, a long bevel is valuable for retention. However, long bevels and
collars are an aesthetic liability.
Theory and Practice of the 45 angle Bevel :
The beveled shoulder preparation properly placed in relation to the tissue has offered an
excellent solution to almost all problems faced in ceramometal design. The one exception is aesthetics,
especially the long term effect. The development of many techniques for butt joint porcelain fabrication
with metalceramic restorations and new generations of techniques and materials such as Cerestore
ceramics and castable ceramics points to the aesthetic deficiency of the beveled shoulder preparation.
These techniques have one common goal; the elimination of the metal collar and its aesthetic limitations.
A bevel is placed on a crown preparation to reduce the closing angle at the margin to
compensate for the incomplete seating of the crown. A bevel less than 60 does not substantially
decrease the closing angle. It is not effective in compensating for discrepancies of fit. Seating of cast
restorations can be improved by the use of die spacers applied to the die and by vibration during
cementation. With die spacers and this technique, a decreased closing angle of long bevel may not be
necessary.
Instrumentation during placement of a bevel can create a trough in the tissue that will aid in
obtaining accurate and predictable impressions of the gingival margin.
When subgingival placement of margins is needed for aesthetics, the preferred bevel is one that
would yield a crown designed to bring metal and porcelain to a common margin termination with good fit,
contour, and color. A bevel of 45 can produce satisfactory aesthetic result and is satisfactory from a
laboratory standpoint. Not only does a porcelain margin accumulate less plaque, but margin exposure
due to recession at gingival tissue (which occurs with time) is less objectionable from the aesthetic
standpoint. Greater discrimination in evaluation of margin adaptation is possible.
When comparing the marginal opening of cemented porcelain fused to metal crowns of three
different casting designs; 80 bevels with metal collars. 80 bevels with porcelain applied to the labial
collars, and 45 labial bevels with metal and porcelain to a common margin termination. There are no
statistically significant difference between the margin opening of the three groups. Porcelain application
and firing did not distort the facial margin. The 45 bevel with porcelain to the margin has greater
aesthetic potential and the same margin adaptation as the 80 bevel with an all-metal collar.




CONCLUSION
The placement of finish lines has a direct bearing on the ease of fabrication a restoration and on
the ultimate success of restoration. Best results can be expected from margins that are as smooth
as possible and are fully exposed to a cleansing action. Finish lines should be duplicated by the
impression, without tearing or deforming.
Finish lines should be placed in enamel when it is possible to do so. Subgingival finish line
restorations have been described as a major etiologic factor in periodontitis. So proper diagnosis
and treatment planning ,skill in execution of tooth preparation with correct finish line contour help
to attain basic principles of tooth preparation like marginal integration and preservation
of periodontium.







CONTENTS
Introduction
Types of finish lines
Knife edge
Chamfer
Shoulder
Bevelling
Subgingival margin finish lines
Conclusion




References
Herbert.T Shi l l i ngburg JR, Sumi ya Hobo: Fundamental s of Fi xed
Prosthodont i cs; 3
r d
Edi ti on.

Stephen.F Rosenti el , Marti n F. Land, Junhei Fuj i moto:Contemporary Fi xed
Prosthodont i cs; 3
r d
Edi ti on.

Wi l l i am F.P Mal one, Davi d L Koth: Tyl man s Theory and Pract i ce of Fi xed
Prosthodont i cs; 8
t h
Edi ti on.
CASTING DEFECTS

Contents:
Introduction
Defects in casting
1. Distortion
2. Surface roughness and irregularities.
3. Porosity
a) Solidification defects
Localized shrinkage porosity
Micro porosity.
b) Trapped gases
Pinhole porosity
Gas inclusions
Subsurface porosity
c) Residual air.
4. Incomplete or missing detail.





Introduction
An unsuccessful casting result in considerable trouble and loss of time,
in almost all instances, defects in castings can be avoided by strict
observance of procedures governed by certain fundamental rules and
principles. Seldom is a defect in a casting attributable to other factors than
the carelessness or ignorance of the operator. With present techniques,
casting failures should be the exception, not the rule.
Defects in castings can be classified under four headings:
1) Distortion
2) Surface roughness and irregularities
3) Porosity and
4) Incomplete or missing detail.
Some of these factors have been discussed in connection with
certain phases of the casting techniques. The subject is summarized and
analyzed in some detail in the following sections.

DISTORTION:-
Any marked distortion of the casting is probably related to a distortion of
the wax pattern. This type of distortion can be minimized or prevented by
proper manipulation of the wax and handling of the pattern.
Unquestionably, some distortion of the wax pattern occurs as the
investment hardens around it. The setting and hygroscopic expansions of
the investment may produce an uneven movement of the walls of the
pattern. This type of distortion in part from the uneven outward movement
of the proximal walls. The gingival margins are forced apart by the mold
expansion, whereas the solid occlusal bar of wax resists expansion during
the early stages of stetting.
The configuration of the pattern, the type of the wax, and the thickness
influence the distortion that occurs, as has been discussed. For example,
distortion increases as the thickness of the pattern decreases. An would be
expected the less the setting expansion of the investment, the less is the
distortion. Generally, it is not a serious problem except that it accounts for
some of the unexplained inaccuracies that may occur in small castings.
There is probably not a great deal that can be done to control this
phenomenon.

SURFACE ROUGHNESS, IRREGULARITIES AND DISCOLORATION: -
The surface of a dental casting should be an accurate reproduction of the surface of the wax pattern
from which it is made, excessive roughness or irregularities on the outer surface of the casting
necessitate additional finishing and polishing, whereas irregularities on the cavity surface prevent a
proper seating of an otherwise accurate casting. Surface roughness should not be confused with surface
irregularities. Surface roughness is defined as relatively finely spaced surface imperfections whose
height, width, and direction establish the predominant surface pattern. Surface irregularities refer to
isolated imperfections, such as nodules, that dont characterize the total surface area.
Even under optimal conditions, the surface roughness of the dental casting is invariably somewhat
greater than that of the wax pattern from which it is made. The difference is probably related to the
particle size of the investment and its ability to reproduce the wax pattern in microscopic detail. With
proper manipulative techniques, the normal increased roughness in the casting should not be major factor
in dimensional accuracy. However, improper technique can lead to a marked increase in surface
roughness, as well as to the formation of surfaced irregularities.
Air bubble: - air bubbles that become attached to the pattern during or subsequent to the investing
procedure cause small nodule on a casting. Such nodules can sometimes be removed if they are not in a
critical area. However, for nodules on margins or on internal surfaces, removal of these irregularities
might alter the fit of the casting. As previously noted, the best method to avoid air bubbles is to use the
vacuum investing technique.
If a manual method is used various precautions cab be observed to eliminate air from the investment
mix before the investing. As previously outlined, the use of a mechanical mixer with vibration both before
and after mixing should be practiced routinely. A wetting agent may be helpful in preventing the collection
of air bubbles on the surface of the pattern, but it is by no means a certain remedy. As previously
discussed, it is important that the wetting agent be applied in a thin layer. It is best to air dry the wetting, a
because any excess liquid dilutes the investment, possibly producing surface irregularities on the casting.
Water films:- wax is repellent to water , and if the investment becomes separated from the wax pattern in
some manner, a water film may form irregularly over the surface. Occasionally, this type of surface
irregularity appears as minute ridges or veins on the surface.
If the pattern is moved slightly, jarred or vibrated after investing, or if the painting procedure does not
result in an intimate contact of the investment the pattern, such a condition may result. A wetting agent is
of aid in the prevention of such irregularities. Too high L: P ratio may also produce these surface
irregularities.
Rapid heating rates: - rapid heating results in fins or spines on the casting or may result as a
characteristic surface roughness may be evident because of flasking of the investment when the water or
steam pours into the mold. Furthermore, such a surge of steam or water may carry some of the salts used
as modifiers into the mold. Furthermore, such a mold, which are left as deposits a on the walls after the
water evaporates. As previously mentioned, the mold should be heated gradually; at least 60 minutes
should elapse during the heating of the investment- filling ring from room temperature to 700
0
c. The
greater the bulk of the investment, the more slowly it should be heated.
Under heating: - incomplete elimination of wax residues may occur if the heating time is too short or if
insufficient air is available in the furnace. These factors are particularly important with the low-temperature
investment techniques. Voids or porosity may occur in the casting from the gases formed when the hot
alloy comes in contact with the carbonaceous residues. Occasionally, the casting may be covered with a
tenacious carbon coating that is virtually impossible to remove by pickling.
Liquid: powder ratio: -the amount of water and investment should be measured accurately. The higher
the L: P ratio, the rougher the casting. However, if too little water is used, the investment may be
unmanageably thick and cannot be properly applied to the pattern. In vacuum investing, the air may not
be sufficiently removed. In either instance, a rough surface on the casting may result.
Prolonged heating: - when the high heat casting technique is used, a prolonged heating of the mold at
the casting temperature is likely to cause a disintegration of the investment, and the walls of the mold are
roughened as a result, furthermore, the products of decomposition are sulfur compounds that may
contaminate the ally to the extent that the surface texture is affected. Such contamination may be the
reason that the surface of the casitng sometimes does not respond to pickling. When the thermal
expansion technique is employed, the mold should be heated to the casting temperature- never higher
than 700
0
c and the casting should be made immediately.
Temperature of the alloy: - if an ally is heated to too high a temperature before casting, the surface of
the investment is likely to be attacked, and a surface roughness of the type described in the previous
section may result. As previously noted, in all probability the ally will not be overheated with a gas air
torch when used with the gas supplied in most localities. If other fuel is used, special care should be
observed that the color emitted by the molten gold alloy, for example, is no lighter than a light orange.
Casting pressure: - too high a pressure during casting can produce a rough surface on the casting. A
gauge pressure of 0.10 to 0.14 Mpa in an air pressure casting machine or three to four turns of the spring
in an average type of centrifugal casting machine is sufficient for small castings.
Composition of the investment:-the ratio of the binder to the quartz influences the surface texture of the
casting. In addition, coarse silica causes a surface roughness. If the investment meets ADA specification
no.2, the composition is probably not a factor in the surface roughness.
Foreign bodies:- when foreign substances get into the mold, a surface roughness may be produced.
For example, a rough crucible former with investment clinging to it may roughen the investment on its
removal so that bits of investment are carried into the mold with the molten ally. Carelessness in the
removal of the sprue former may be a similar cause.
Usually, contamination results not only in surface roughness but also in incomplete areas or surface
voids. Any casting that shows sharp, well- defined deficiencies indicates the presence of some foreign
particles in the mold, such as pieces of investment and bits of carbon form a flux. Bright- appearing
concavities may be the result of flux being carried into the mold with the metal. Surface discoloration and
roughness can result from sulfur contamination, either from investment breakdown at elevated
temperatures or from a high sulfur content of the torch flame. The interaction of the molten alloy with
sulfur content of the torch flame. The interaction of the molten alloy with sulfur produces black castings
that are brittle and do not clean readily during pickling.
Impact of molten alloy:- the direction of the sprue former should be such that the molten gold ally does
not strike a weak portion of the mold surface. Occasionally, the molten alloy may fracture or abrade the
mold surface on impact, regardless of its bulk, it is unfortunate that sometimes the abraded area is
smooth so that it cannot be detected on the surface of the casting, such a depression in the mold is
reflected as a raised area on the casting, often too slight to be noticed yet sufficiently large to prevent the
seating of the casting. This type of surface roughness or irregularity can be avoided by proper Spruing so
as to prevent the direct impact of the molten metal at an angle of 90
0
to the investment surface. A
glancing impact is likely to be less damaging and at the same time an undesirable turbulence is avoided.
Pattern position:- if several pattern are invested in the same ring they should not be placed too close
together. Likewise, too many patterns positioned in the same plane in the mold should be avoided, the
expansion of wax is much greater than that of the investment, causing breakdown or cracking of the
investment if the spacing between patterns is less than 3mm.
Carbon inclusions: -carbon, as form a crucible , an improperly adjusted torch or a carbon-containing
investment, can be absorbed by the alloy during casting. These particles may lead to the formation of
carbides or even created visible carbon inclusions.
Other causes: - there are certain surface discolorations and roughness that may not be evident when the
casting is completed but that may appear during service. For example, various gold alloys, such as
solders, bits of wire, and mixtures of different casting alloys should never be melted together and reused.
The resulting mixture would not posses the proper physical properties and might form eutectic or similar
alloys with low corrosion resistance. Discoloration and corrosion may also occur.
POROSITY
Porosity may occur both within the interior region of a casting and on the external surface. The latter is
a factor in surface roughness, but also it is generally a manifestation of internal porosity. Not only does
the internal porosity weaken the casting but also if it also extends to the surface, it may be a cause for
discoloration. If severe, it can produce leakage at the tooth-restoration interface, and secondary caries
may result. Although the porosity in a casting cannot be prevented entirely, it can be minimized by use of
proper techniques.
Porosities in noble metal castings may be classified as follows: -
I. Solidification defects
a. Localized shrinkage porosity
b. Microporosity.
II. Trapped gases
a. Pinhole porosity
b. Gas inclusions
c. Subsurface porosity
III. Residual air.

Localized shrinkage: - is generally caused by incomplete feeding of molten metal during solidification.
The linear contraction of noble metal alloys in changing form a liquid to a solid is at least 1.25%.
Therefore, there must be continual feeding of molten metal through the sprue to make up for the
shrinkage of metal volume during solidification. If the sprue freezes in its cross section before this feeding
is completed to the casting proper, a localized shrinkage void will occur in the last portion of the casting
that solidifies. The porosity in the pontic area is cause by the ability of the pontic to retain heat because of
its bulk and because it was located in the heat center of the ring. This problem can be solved in the future
simply be attaching one or more small-gauge sprues (e.g. 18 gauge) at the surface most distant from the
main sprue attachment and extending the sprue(s) surface most distant from the main sprue attachment
and extending the sprue laterally within 5mm of the edge f the ring. These small chill-set sprues ensure
that solidification begins within these sprues and they act as cooling pins to carry heat away from the
pontic.
Localized shrinkage generally occurs near the sprue casting junction, but it may occur anywhere
between dendrites, where the last part of the casting that solidified was in the low melting metal that
remained as the dendrite braches develop.
This type of void may also occur externally, usually in the interior of a crown near the area of the
sprue, if a hot spot has been created by the hot metal impinging form the sprue channel on a point of the
mold wall. This hot spot causes the local region to freezed last and result in what is called suck-back
porosity. This often occurs at an occlusoaxial line angle or incisoaxial line angle that is not well rounded.
The entering metal impinges onto the mold surface at this point and creates a higher localized mold
temperature in this region that is called a ht spot. A hot spot may retain a localized pool of molten metal
after other areas of the casting have solidified, this in turn created a shrinkage void, or suck-back
porosity, suck back porosity can be eliminated by flaring the point of sprue attachment and reducing the
mold melt temperature differential, that is, lowering the casting temperature by about 30
0
c.
Microporosity: also occurs from the rapid solidification but is generally present in fine grain alloy castings
when the solidification is too rapid for the micro void to segregate to the liquid pool. This premature
solidification causes the porosity.
Such phenomenon can occur from the rapid solidification if the mold or casting temperature is too low. It
is unfortunate that this type of defect is not detectable unless the casting is sectioned. In any cast, it is
generally not a serious defect.
Pinhole and gas inclusion porosities: - are related to the entrapment of gas during solidification. Both
are characterized by a spherical contour, but they are decidedly different in size. The gas inclusion
porosities are usually much larger than pinhole porosity. Many metals dissolve or occlude gases while
they are molten. For example, both copper and silver dissolve oxygen in large amounts in the liquid state;
molten platinum and palladium have strong affinity for hydrogen as well as oxygen. On solidification, the
absorbed gases are expelled and the pinhole porosity a results. The larger voids may also result from the
same cause, but it seems more logical to assume that such voids may be caused by gas that is
mechanically trapped by the molten metal in the mold or that is incorporated during the casing procedure.
All casings probably contain a certain amount of porosity. However, the porosity should be kept to a
minimum because it may adversely affect the physical properties of the casting.
Oxygen is dissolved by some 0f the metals, such as silver, in the alloy while they are in the molten
state. During solidification, the gas is expelled to form blebs and pores in the metal. As was pointed out
earlier, this type of porosity may be attributed to abuse of the metal. Castings that are severely
contaminated with gases are usually black when they are removed from the investment and do not clean
easily on pickling. The porosity that extends to the surface is usually in the form of small pinholes
appearing.
Larger spherical porosities can be caused by gas-occluded form a poorly adjusted torch flame, or the
use of the mixing or oxidizing zones of the flame rather than the reducing zone. Premelting the gold alloys
on a graphite crucible can minimize these types of porosities or a graphite block if the alloy has been
used before and by correctly adjusting and positioning the torch flame during melting.
Subsurface porosity:- the reasons for such voids have not been completely established. They may be
caused by the simultaneous nucleation of solid grains and gas bubbles at the first moment that the metal
freezes at the mold walls. As has been explained, controlling the rate at which the molten metal enters
the mold can diminish this type of porosity.
Entrapped air porosity: - On the inner surface of the casting, sometimes referred to as backpressure
porosity, can be produced large concave depressions. This is caused by the inability of the air in the mold
to escape through the pores in the investment or by the pressure gradient that displace4s the air pocket
toward the end of the investment via the molten sprue and button. The entrapment is frequently found in a
pocket at the cavity surface of a crown or mesio-occlusal-distal casting. Occasionally it is found even on
the outside surface of the casting when the casting temperature or mold temperature is so low that
solidification occurs before the entrapped air can escaped. The incidence of entrapped air can be
increased by the dense modern investments, an increase in mold density produced by vacuum investing,
and the tendency for the mold to clog with residual carbon when the low-heat technique is used. Each of
these factors tends to slow down the venting of gases from the mold during casting.
Proper burnout, an adequate mold and casting temperature, a sufficiently high casting pressure, and
proper L: P ratio can help to eliminate this phenomenon. It is good practice to make sure that the
thickness of investment between the tip of the pattern and the end of the ring not be greater than 6mm.

INCOMPLETE CASTINGS: -
Occasionally, only a partially complete casting or perhaps no casting at all, is found. The obvious
cause is that the molten alloy has been prevented, in some manner, from completely filling the mold. At
least two factors that might inhibit the ingress of the liquefied metal are insufficient venting of the mold ant
the mold and high viscosity of the fused metal.
The first consideration, insufficient venting, is directly related to the back pressure exerted by the air in
the mold. If the air cannot be vented quickly, the molten alloy does not fill the mold before if solidifies. In
such a case, the magnitude of the casting pressure should be suspected. If insufficient casting pressure
is employed, the back cannot be overcome. Furthermore, the pressure should be applied for at least 4
seconds. The mold is filled and the metal is solidified in 1 second or less, yet it is quite soft during the
early stages point. These are usually exemplified in rounded incomplete margins.
A second common cause for an incomplete casting is incomplete elimination of wax residues from the
mold. If too many products of combustion remain in the mold, the pores in the investment may become
filled so that the air cannot be vented completely. If moisture or particles of wax remain, the contact of the
molten alloy with these foreign substances produces an explosion that may produce sufficient
backpressure to prevent the mold from being filled. It can be seen as rounded margins with quite shiny
rather than dull appearance. The strong reducing atmosphere created by carbon monoxide left by the
residual wax causes this shiny condition of the metal.
The possible influence of the L: P ratio of the investment has been discussed. A lower L: P is
associated with less porosity of the investment. An increase in casting pressure during casting solves this
problem.
Different alloy composition and temperature probably exhibit varying viscosities in the molten state,
depending on composition and temperature, however, both the surface tension and the viscosity of a
molten alloy are decreased with an increase in temperature. An incomplete casting resulting from too
great a viscosity of the casting metal can be attributed to insufficient heating. The temperature of the alloy
should be attributed to insufficient heating. The temperature of the alloy should be raised higher than its
liquidus temperature so that its viscosity and surface tension are lowered and it does not solidify
prematurely as it enters the mold. Such premature solidification may account for the greater susceptibility
of the whit gold alloys to porosity because their liquidus temperatures are higher, thus, they are more
difficult to melt with a gas-air torch flame.
REFERENCES
1. Fundamentals of fixed prosthodontics- shillinburg
2. Contemporary fixed prosthodontics- roesensteil
3. Dental laboratory procedure- rudd and marrow
4. Dental materials and their selection-willian .j.o brien
5. Restorative dental materials-craig
6. Phillips sciences of dental materials- anusavice.
7. Removable prosthodintics- stewart
OSSEOINTEGRATION

INTRODUCTION :
Since tooth loss from disease and trauma has always been a feature
of mankinds existence, it is not surprising that the history of tooth
replacement is a long one. Evidence from ancient civilizations shows that
attempts were made to replace missing teeth by banding artificial tooth
replacements to remaining teeth with metal many centuries ago. For the
mechanism of attachment, clinicians have long sought an analog for
periodontal ligament. Experiments were made to develop a fibrous
attachment that could serve the same purpose as the periodontal ligament
but all in vain. The periodontal ligament in a specialized structure which
serves not only as an efficient attachment mechanism but also as a shock
absorber and sensory organ, so it was impossible to reproduce.
HISTORY OF OSSEOINTEGRATION :
Implants may indeed be anchored in bone by means of surrounding
sheath of connective tissue, but in general this has not shown the degree of
organization and specialization that would allow it to pass as a substitute
for the periodontal ligament. In most cases, loading leads to gradual
widening of fibrous tissue layer and loosening of implant, with consequent
implant failure. In contrast to periodontal ligament, a fibrous tissue sheath is
a poorly differentiated layer of scar tissue.
Dr. Per Ingvar Branemark, an anatomist is credited as the person who has coined the term
osseointegration. Branemark along with his team was working in the laboratory of the vital microscopy
(1952), laboratory of experimental Biology, University of Goteberg Sweden, (1960), Institute of Applied
biotechnology, Goteberg (1978). The main study of his group was to understand the mechanism of bone
healing and bone response to the thermal, mechanical, chemical injuries by using vital microscopy.
Vital microscopy, is a type of the miniature microscope, which is
introduced in to the living organisms. E.g. Rabbit in their study the titanium
(Ti) chambers were used for placing the vital microscope into the rabbits
fibula. After the studying of the bone biomechanics in one animal, the team
used to recover the vital microscope and place it into the other animal
model. While recovering Branemark observed that the Ti chambers were
firmly adherent to the bone. By this observation they concluded that the
titanium was firmly integrated to the bone and later they used Ti screws
and Ti bars for reconstruction of the long bones and mandibles of the dogs.
After ensuring the favourable bone response to the Ti, the team tried to replace the teeth for the
dogs. The Ti implants also showed good response for the mucosa and skin penetrating implants. The
implants, which used for replacement of the teeth in the dogs showed good integration upto 10 years and
the implants could bear the load of upto 100 Kgs without failure at the bone-implant interface. By
observing this property the integration between the bone and Ti screws was termed as osseointegration.
The Ti vital microscopic chambers were used to analyze
microcirculation in the healthy and diabetic human volunteers without any
signs of inflammation around the Ti chamber. In 1965, first human
edentulous patient was treated by using the Ti screws (implants) by
reconstruction of resorbed edentulous arches using autologus tibial bone
grafts.
The salient features of Branemark and
his teams work
About more than 50 designs of Ti screws (Implants) were tested and used.
The surgical protocol followed was : two stage surgery, which was proved
beneficial.
Minimal trauma during the surgery results in bone regeneration rather than
bone repair at the implant site.
Non-contaminated implants (sterile and clean implants) proved good
integration.
Prosthesis and abutments were screw attached for more technical flexibility.
There were more mechanical failures at the interface rather than biological
failures.
Mr. Victor Kuikka helped in designing the hardware parts in this study.
In the longitudinal study of the Ti implants from 1965 to 1974 showed a
success rate of 99% in mandibles and 89% in maxilla.
In the mean time Schroeder et al. (1970), the members of the
international team for development of oral implants (I.T.I) studied the Ti
plasma sprayed Cp Ti cylindrical implants in Monkey models and achieved
the firm integration between the implant and the tissues. In their study the
bone was joined to implant by fine bridges of fibrous tissue. They termed
this union as functional ankylosis.
DEFINITION AND OTHER TERMINOLOGIES :
Osseointegration :
Branemark defined it as a direct contact between the bone and metallic implants, without
interposed soft tissues layers (1969).
Later it is modified as a direct structural and functional connection between ordered, living bone
and the surface of a load carrying implant (1977). [Structurally oriented definition]
American Academy of Implant Dentistry (1986) :
Contact established without interposition of non-bone tissue between normal remodeled bone and
an implant entailing a sustained transfer and distribution of load from implant to and within the bone
tissue.
Meffert et al. (1987) Subdivided into
Adaptive Osseointegration : Osseous tissue approximating the surface of
the implant without apparent soft tissue interface at light microscopic level.
Biointegration : Is a direct biochemical bone surface attachment
confirmed at electron microscopic level.
Zarb and T. Albrektsson (1991) : It is a process whereby clinically
asymptomatic rigid fixation of alloplastic materials is achieved and
maintained, in bone during functional loading.
Schroeder et al (1970s) : Coined the term Functional Ankylosis.
[The Swiss Academy]
Other Terminologies :
Osteopreservation (Stallard R.E.) :
It is a made of tissue integration around healed functioning endosteal dental implant in which the
prime load bearing tissue at the interface is a peri-implant ligament composed of osteostimulatory collage.
It limits the further bone resorption.
Used in case of plate/blade form endosseous implants and endodontic stabilizers.
Periosteal integration :
It is a made of tissue integration around a healed, functioning, subperiosteal implant in which the
load bearing tissue is the sheath of dense collagenous tissue constituting the outer layer of periosteum.
MECHANISM OF OSSEOINTEGRATION :
After the surgical placement of implants into endosteal location, the
traumatized bone around these implants begins the process of wound
healing. As mentioned previously, it can be separated into the inflammatory
phase, the proliferative phase, and the maturation phase. This is
summarized in Table along with some of the specific aspects of bone
healing during these stages.
Phase one inflammatory phase :
The placement of implants into bone involves the creation of an
osseous defects with the subsequent filling of this defect with an implant
device. Even with the most careful surgical manipulation of osseous
tissues, the generation of a thin layer of necrotic bone in the peri-implant
region is inevitable.
In addition, exact microscopic fit between the implant and the
surgical defect is not possible, leaving local areas of dead space where the
implant does not directly contact osseous tissue. When the implant is
exposed to the surgical site, it comes to contact with extracellular fluid and
cells. This initial exposure of the implant to the local tissue environment
results in rapid adsorption of local plasma proteins to the implant surface.
Shortly thereafter, these proteins are enzymatically degraded and undergo
conformational changes, degradation, and replacement by other proteins.
Platelet contact with synthetic surfaces causes their activation and
liberation of their intracellular granules resulting in release of serotonin and
histamine, leading to further platelet aggregation and local thrombosis.
Blood contact with proteins and foreign materials leads to the initiation of
the clotting cascade via the intrinsic and extrinsic pathways, causing blood
coagulation in the aforementioned peri-implant dead spaces and within the
damaged local microvascular circulation. Activation of the clotting cascade
also leads to the formation of bradykinin, which is a strong mediator of
vasodilation and endothelial permeability.
During this initial implant host interaction, numerous cytokines
(growth factors) are release from the local cellular elements. These
cytokines have numerous functions, including regulating adhesion molecule
production, altering cellular proliferation, increasing vascularization rate,
enhancing collagen synthesis, regulating bone metabolism and altering
migration of cells into a given area. Table 4.2 lists some of the cystokines
believed to be important in tissue implant integration. These initial events in
healing of implants are largely chemical in nature and correspond to the
beginning of a generalized inflammatory response that occurs with any
surgical insult.
The next events noted to occur during this phase of wound healing
consist of a cellular inflammatory response. Initially, it is nonspecific in
nature and consists mainly of neutrophil emigration into the area of
damaged tissue. Its duration is variable but generally peaks during the first
3 to 4 days following surgery. The role of this cell is primarily phagocytosis
and digestion of debris and damaged tissue. Neutrophils are accompanied
by smaller numbers of eosinophils. Eosinophils have a similar phagocytic
function and they can also digest antigen antibody complexes. These cells
are attracted to the local area by chemotactic stimuli and then migrate from
the intravascular space to the interstitial space by diapedesis. End products
of this phagocytic process are carried away from the local area by the
lymphatic circulation. Neutrophils and eosinophils are end state cells and
thus further division is not possible. They act as a type of first stage cellular
defence and their duties are later augmented by the lymphocyte and the
monocyte.
Toward the end of the first week, the generalized inflammatory
response becomes more specific in nature. Increasing numbers of thymus
dependent lymphocytes (T cells) bursa equivalent lymphocytes (B cells),
killer (K) cells, natural killer (NK) cells and macrophages are found in the
wound at this time. These cells respond to foreign antigens such as
bacteria and plaque debris that have been introduced into the area during
the surgical procedure. These antigens are processed and presented to the
B and T cell populations by macrophages. Four functionally distinct T cell
populations respond and perform regulatory, inflammatory, cytotoxic and
augumentary functions resulting in a variety of effector modalities. Cellular
intercommunication is essential for effective immunoregulatory function and
this is accomplished with the release of soluble signal molecules called
lymphokines. Lymphokines are specific cytokines released from local
cellular elements that effect immunologic function.
Macrophages are the predominant phagocytic cell found in the
wound by the fifth to sixth postoperative day. These cells are derived from
circulating monocytes, which originate from the bone marrow via monoblast
differentiation. Macrophages have the ability to ingest immunologic and
non-immunologic particles by phagocytosis and attempt to digest these
particles with lysosomal enzymes. They have cell surface receptors that
are instrumental in the killing of bacteria, fungi, and tumor cells. As
mentioned previously, macrophages also process and present foreign
antigens to lymphocytes as part of the cellular immune response. In
contrast to the neutrophil, this cell is not an end state cell and thus has the
ability to undergo mitosis. Macrophages cal also fuse to form multinuclear
foreign body giant cells to ingest larger particles. The mechanism by which
they recognize and ingest non-immunologic materials, however, is not well
understood, but it has been shown that hydrophobic materials, such as
polytetrafluoroethylene and roughened plastics, are more easily taken up
by macrophages than are hydrophilic materials. In addition, it seems that
adsorbed proteins on the surface of the foreign bodies, particle size,
particle shape, surface texture and related free surface energy play some
role in the ingestion of these particles by macrophages.
The reaction of macrophages on exposure to foreign materials
depends on the physical and chemical nature of the material. In an in vitro
experiment examining the effects of particles of commonly implantable
metals on mouse peritoneal macrophage rate demonstrated that particles
of titanium, chromium and molybdenum were phagocytized and produced
no abnormal morphologic abnormalities or release of lactate
dehydrogenase (LDH). In contrast, particles of cobalt, nickel and cobalt-
chromium alloy cause marked changes in cellular morphology and release
of LDH. Some materials act directly on the macrophage, whereas other
materials act through the immunologic involvement of lymphocytes. The
mechanism by which they induce an inflammatory response is thought to
be through the release and activation of certain mediators of inflammation,
including lysosomal enzymes, prostaglandins, complement and
lymphokines. Ultimately the reaction of macrophages to an implant governs
the global tissue reaction to the material. A few macrophages not
associated with an overt inflammatory response are normally located on
intact implant cells long after implantation, however, is generally
problematic in nature and suggests the presence of a chronic inflammatory
reaction and probable implant failure.
Phase Two Proliferative Phase :
Shortly after the implant is inserted into bone, the proliferative phase of
implant healing is initiated. During this phase, vascular ingrowth occurs
from the surrounding vital tissues, a process called neovascularization. In
addition, cellular differentiation, proliferation and activation occur during this
phase, resulting in the production of an immature connective tissue matrix
that is eventually remodeled. As noted previously, this phase of bone repair
begins while the inflammatory phase is still active.
During the placement of implants into their endosseous locations,
interruption of the local microcirculation occurs in the surgical areas.
Regeneration of this circulation must eventually occur if wound healing is to
begin as early as the third postoperative day. Metabolism of the local
inflammatory cells, fibroblasts, progenitor cells and other local cells creates
an area of relative hypoxia in the wound area. This results in the
development of an oxygen gradient with the lowest oxygen tension near the
wound edges. This hypoxic state combined with certain cytokines, such as
basic fibroblast growth factor (bFGF) and platelet derived growth factor
(PDGF) is responsible for simulating this angiogenesis. bFGF seems to
activate hydrolytic enzymes, such as collagenase and plasminogen, which
help to dissolve the basement membranes of local blood vessels. This
initiates the process of endothelial budding, which progresses along the
established chemotactic gradient. Once the anastomoses of the capillary
buds are developed and a local microcirculation is reestablished, the
improved tissue oxygen tension results in a curtailment of the secretion of
these angiogenic growth factors. In addition, the new circulation provides
the delivery of nutrients and oxygen necessary for connective tissue
regeneration.
Local mesenchymal cells begin to differentiate into fibroblasts,
osteoblasts and chondroblasts in response to local hypoxia and cytokines
released from platelets, macrophages, and other cellular elements. These
cells begin to lay down an extracellular matrix composed of collagen,
glycosaminoglycans, glycoproteins and glycolipids. The initial fibrous tissue
and ground substance that are laid down eventually form into a
fibrocartilaginous callus and this callus is eventually transformed into a
bone callus with a process similar to endochondral ossification. Ossification
centers begin within secretory vesicles that are liberated from the local
osteoblasts. These vesicles called matrix vesicles, are rich in phosphate
and calcium ions and also contain the enzymes alkaline phosphatase and
phospholipase A2. This callus transformation is aided by improved oxygen
tension and enhanced nutrient delivery that occurs with improvement of
local circulation. The initial bone laid down is randomly arranged (Woven
type) bone that is eventually remodeled.
In vivo studies using an optical chamber (vital chamber) implanted in
along bones of animal models have been instrumental to the understanding
of the healing process that occurs in the peri-implant space. They have
revealed that vascular ingrowth precedes ossification. Capillary ingrowth
appears initially and it matures to be a more developed vascular network
during the first three weeks after implant insertion. Ossification is initially
visualized during the first week, peaks during the third to fourth week and
arrives at a relatively steady state by the sixth to eight week. Long term
follow up (> 1 year) of these unloaded implants reveals little change from
the picture seen at the 6 to 8 week period with only some condensation of
bone and some reorientation of the vascular pattern.
Phase Three Maturation Phase :
The necrotic bone in the peri-implant
space that resulted from operative trauma
must eventually be replaced with intact
living bone for complete healing to occur.
Appositional woven bone is laid down on
the scaffold of dead bone trabeculae by
differentiated mesenchymal cells in the
advancing granulation tissue mass. This
process occurs concurrently with the
ossification of the fibrocartilaginous callus
noted previously. Simultaneous resorption
of these composite trabeculae and the
newly formed bone, coupled with the
deposition of mature concentric lamellae
eventually results in complete bone
remodeling, leaving a zone of living a zone
of living lamellar bone that is continuous
with the surrounding basal bone.
Traditional placement of endosseous
implants involves a two stage surgical
procedure in which the implant is placed
during the first stage and then allowed a
healing period of several months before the
transmucosal portion is placed. When the
superstructure is fabricated, loading of the
implants can be initiated. Bone remodeling
occurs around an implant in response to a
load transmitted through the implant to the
surrounding bone. In a histopathologic
comparison of loaded and unloaded
implants, Donath et al. showed that
unloaded implants contacted small bone
lamellae that were interrupted by many
areas of bone marrow and parts of the
haversian canal system. Loaded implants
were surrounded by a more compact type
of bone with only small bone free areas
near the haversian canals. The lamellae
around the implant area remodeled
according to the exposed load, which with
passage of time, shows a characteristic
pattern of well organized concentric
lamellae with formation of osteons in the
traditional manner. The load dependent
remodeling of bone follows the same
principles that govern fracture healing.
Under normal circumstances, healing
of implants is usually associated with a
reduction in the height of alveolar marginal
bone. Approximately 0.5 to 1.5 mm of
vertical bone loss occurs during the first
year after implant insertion. After this point,
a steady state is reached and normal bone
loss occurs at a rate of approximately 0.1
mm per year. The rapid initial bone loss can
be attributed to the generalized healing
response resulting from the inevitable
surgical trauma, such as periosteal
elevation, removal of marginal bone and
bone damage caused by drilling. The later
steady state bone loss probably reflects
normal physiologic bone resorption. Factors
such as excessive surgical trauma,
excessive loading or the presence of peri-
implant inflammation may accelerate this
normal resorptive process. In a prospective
review of hydroxylapatite (HA) coated
implants Block and Kent found that the
presence of keratinized gingiva in the peri-
implant region strongly correlated to bone
maintenance in the posterior mandibular
region. Thus, if excessive losses of
marginal bone are noted, one must
consider the possibility of inappropriate
loading of the implant or the presence of
peri-implant inflammation and step should
be taken to rectify the problem before
excessive implant support is lost.
MUCOPERIOSTEAL HEALING :
Implants are placed into their
endosteal position through incisions in the
mucoperiosteum. They can be placed using
a one stage technique, in which the
endosteal and transmucosal portions of he
implant are allowed to heal as a single unit,
or a two staged technique, in which the
endosteal component is placed initially
followed some time later by the placement
of the transmucosal portion after a period of
healing. Healing of the mucoperiosteal
complex around implants is of paramount
importance for the longevity of prosthetic
reconstructions. An understanding of the
biologic processes involved in generalized
wound repair and how soft tissue wounds
heal around implant fixtures is vital
information for appropriate management of
implant patients. As in the previous section
on bone healing, there are also three
phases of wound healing in soft tissue
wounds : inflammatory, proliferative and
maturation phases. In addition, there is also
significant overlap between these phases
as they pertain to mucoperiosteal wound
healing.
Phase one inflammatory phase :
The inflammatory phase of wound
healing for the mucoperiosteal complex is
essentially the same as that mentioned in
the previous section on bone healing. It
involves an initial vascular response
followed by platelet aggregation and
activation, the clotting cascade and then an
initial non-specific cellular inflammatory
response consisting of infiltrates of
predominantly neutrophils. This is followed
shortly thereafter by a more specific cellular
inflammatory response consisting of
infiltrates of predominantly neutrophils. This
is followed shortly thereafter by a more
specific cellular inflammatory response
marked by increased number of
lymphocytes and macrophages. Cytokines
also play an important role in the healing of
soft tissue wounds.
Phase two proliferative phase :
The proliferative phase of wound healing begins within hours of the injury and is characterized by
the establishment of an active population of epithelial and connective tissue cells and the beginning of he
reestablishment of wound integrity. Migration and proliferation of epithelial cells is seen within the first 24
to 48 hours of wound healing. The stimulus for growth and migration of thee cell results from loss of
contact inhibition and from a temporary decrease in the local level of tissue specific growth inhibitors
called chalones. A watertight seal is usually established within the first 24 hours after primary wound
closure, but little structural strength is provided by the seal.
The main connective tissue cell involved in the proliferative phase of
soft tissue wound healing is the fibroblast. Differentiation of mesenchymal
cells and proliferation and migration of the preexisting population of local
fibroblasts occur as a result of hypoxia and the release of cytokines from
local cellular elements, including platelets and macrophages.
Neovascularization provides the foundation for fibroblastic proliferation by
supplying the local area with the nutritional support required to maintain this
enhanced metabolic state. Fibroblasts produce ground substance, collagen
and elastic fibers. The major components of ground substance are
proteoglycans and glycoproteins. Glycoproteins are adhesive
macromolecules. They interact with cells and constituents of the
extracellular matrix that interact with cells to promote adhesion, migration
and proliferation and alter gene expression. Proteoglycans are large
molecules composed of protein cores to which are attached side chains of
glycosaminoglycans, which are polysaccharide chains formed from
repeating disaccharide units. Proteoglycans are classified according to their
dominant disaccharide unit and include hyaluronate, chondroitin, dermatan,
keratin and heparin. These molecules retain water and form bulky gels that
fill most of the extracellular space. The major proteoglycan in connective
tissues early in inflammation is hyaluronic acid. Its concentrations decrease
after the fifth day simultaneously with an increase in concentrations of other
proteoglycans, dermatan sulfate and chondroitin-4 sulfate, the collective
function of all of the elements of the ground substance, among other things
includes the binding of connective tissue elements, stabilization and
facilitation of collagen maturation and facilitation of cellular function.
Collagen and elastic fibers, the major protein structures in connective
tissues are also produced by the fibroblast. Collagen formation is
microscopically detected between the fourth and sixth days, but
biochemical evidence of collagen formation is noted between the second
and fourth days. During the formation of collagen, three polypeptide chains
are produced and hydroxylated which occurs under the influence of propyl
hydroxylase, which is an enzyme that requires vitamin C, molecular
oxygen, ferrous iron ando - ketoglutarate as cofactors for proper function.
These molecules and the combined to form a triple helix called procollagen.
After glycosylation, procollagen is secreted from a triple helix called
procollagen. After glycosylation, procollagen is secreted from the cell and
the terminal telopeptides are then cleaved by an enzyme, procollagen
peptidase, which is also secreted by the fibroblast. The resultant molecule,
tropocollagen combines with other tropocollagen molecules to form
collagen fibrils and the collagen fibrils are then combined to form collagen
fibers. These structures are stabilized by intermolecular and intramolecular
cross linkages. Elastic fibers are also produced in a similar fashion.
Tropoelastin molecules and secreted from the fibroblast and the resultant
elastin molecules are combined with microfibrillar proteins to form elastic
fibers. Elastin is a hydrophobic protein that provide resiliency to tissues that
allows them to stretch and return to their original form.
The proliferative phase of wound healing is marked by cellular
proliferation and synthetic activity. Collagen degradation by collagenases
secreted from fibroblasts, epithelial cells, neutrophils and macrophages,
occurs simultaneously with collagen synthesis, but the net effect during the
proliferative phase of wound healing is in favour of collagen deposition.
Termination of this phase of wound healing marked by an increase in local
collagen content and a decrease in the number of local fibroblasts.
Collagen content of the wound rises rapidly between the 6
th
and the
17
th
day but increases only slightly between the 17
th
day and the 42
nd
day.
At the beginning of this phase, the tensile strength of the wound is provided
by epithelialization, blood vessel growth and aggregation of proteins.
Collagen deposition increases the tensile strength significantly during this
phase and the magnitude is proportional to the collagen content of the
tissues.
Phase three maturation phase :
During the final phase of wound
healing, maturation of the deposited
collagen occurs. There is no sharp
demarcation between the end of the
proliferative phase and the beginning of the
maturation phase because collagen
maturation occurs continuously shortly after
initial deposition. Collagen deposited during
earlier phases of wound healing shows a
non purposeful arrangement. Even though
the collagen content of wound may be near
maximal levels after 3 weeks of wound
healing, the bursting strength of the wound
in on about 15% of the normal skin level at
this time. As time proceeds however, the
unorganized fibrils are replaced larger,
thicker and better organized fibers, with the
final result being one of lacing the wound
edges together with a three dimensional
weave. This is made possible by the
continuous turnover of collagen by
fibroblasts with balanced synthesis and
degradation. Improvement in strength of the
wound is thus possible without an increase
in total collagen content. The bursting
strength of the wound is noted to improve
dramatically from 3 to 9 weeks, reaching a
level of 70% of normal skin by the end of
this period. By 6 months, the bursting
strength of the wound is approximately 90%
of the level of normal skin. It must be noted,
however, that the bursting strength of a
wound plateaus after this period and does
not usually reach that of the original tissue.
IMPLANT TISSUE INTERFACE :
It consists of implant and bone
interface.
Implant and connective tissue
interface.

Implant and epithelium interface.
Implant and bone interface :
On observing the implant and bone
interface at the light microscopic level
(100X) it shows that close adaptation of the
regularly organized bone next to the Ti
implants.
Scanning electron microscopic study
of the interface shows that parallel
alignment of the lamellae of haversian
system of the bone next to the Ti implants.
No connective tissue or dead space was
observed at the interface. Ultra microscopic
study of the interface (500 to 1000X) shows
that presence of amorphous coat of
glycoproteins on the implants to which the
collagen fibers are arranged at right angles
and are partly embedded into the
glycoprotein layer.
Mechanism of attachment :
As a general rule cells do not bind
directly to the foreign materials. The cells
binds to each other or any other foreign
materials by a layer of extracellular macro
molecules (glycoproteins).
The glycoprotein layer in between the
cells or in between the tissues will be at a
thickness of 10 to 20 nm (100 to 200 A
0
).
At the interface the glycoprotein layer
of normal thickness (10-20 nm) is adsorbed
on the implant surface within the help of
adhesive macromolecules like Fibronectin,
Laminin, Epibiolin, Epinectin, Vitronectin
(serum spreading factor), Osteopontin,
thrombospodin and others. At the molecular
level the macromolecules contains Tri-
peptides made up of Arginin-glycin-Aspertic
acid (RGD). The cells like fibroblasts and
other connective tissue cells contain
binding elements called as integrins. The
integrins recognizes the RGDs and bind to
them.
The macromolecules are adherent
more firmly to the metallic oxide layer on
the Ti implants. The mode of attachment
between the oxide layer and the
macromolecules may be of covalent bonds,
ionic bonds or van-der-walls bonding.
Implant connective tissue interface :
The connective tissue above the
bone attaches to the implant surface in the
similar manner as that of the implant bone
interface. The supra crestal connective
tissue fibers will be arranged parallel to the
surface of the implant. Because of this type
of the attachment the interface between the
connective tissue and implant is not as
strong as that of the connective tissue and
tooth interface. But the implant connective
tissue interface is strong enough to
withstand the occlusal forces and microbial
invasions.
Implant epithelial interface :
The implant epithelial interface is
considered as Biologic seal by many
authors. At this interface the glycoprotein
layer is adherent to the implant surface to
which hemidesomosomes are attached.
The hemidesmosomes connect the
interface to the plasma membrane of the
epithelial cells. Because of this attachment
the implant epithelial interface is almost
similar to the junctional epithelium. For the
endosseous implants the sulcus depth
varies from 3 to 4mm.
Factors of importance to ensure a
reliable bone anchorage of an
implanted device :
In most cases whenever an implant is
inserted in bone, healing will dependent on
the conditions like adequate cells, nutrition
to these cells and adequate stimuli for
repair. However, bone tissue is different
from soft tissue in some aspects. In the first
place bone will at least under ideal
conditions, heal without any scar formation
due to ongoing creeping substitution that
will gradually replace the bone with newly
formed hard tissue. Secondly, even if the
repair process is disturbed so that no (or
very little) healing ensures, the dead bone
may (like a dead branch of a tree) still be
capable of carrying some loads and thereby
contribute to function. This may in clinical
practice be the case in many hip and knee
arthroplasties. Such replacements may
tolerate the load put upon them by an
elderly patient, but not the more heavy
stress likely in young individuals where the
results are much less good than with senior
citizens. The delicate balance between
bone formation and bone resorption may be
exemplified through the known coupled
function between bone cellular elements of
opposing function such as osteoblasts and
osteoclasts. Many authors claim that the
one cell will need the other to be in an
active state. This is further exemplified in
the creeping substitution process.
Even if osseointegrated implants
have been documented to result in
excellent long-term results, this does not
necessarily imply that every implant system
claimed to be dependent on
osseointegration will result in an acceptable
clinical outcome. On the contrary, there are
several reasons for primary as well as
secondary failure of osseointegration.
These failures may be attributed to an
inadequate control of the six different
factors known to be important for the
establishment of a reliable, long-term
osseous anchorage of an implanted device.
These factors are :
1. Implant biocompatibility
2. Design characteristics
3. Surface characteristics
4. The state of the host bed
5. The surgical technique and
6. The loading conditions
There is a need to control these factors
more or less simultaneously to achieve the
desirable goal of a direct bone anchorage.
IMPLANT BIOCOMPATIBILITY :
With respect to metals, commercially
pure (c.p) titanium, niobium and possibly
tantalum are known to be most well
accepted in bone tissue. In the case of c.p.
titanium, there is likewise a documented
positive long term function. The reason for
the good acceptance of these metals does
probably relate to the fact that they are
covered with a very adherent, self-repairing
oxide layer which has an excellent
resistance to corrosion. Whereas the load
bearing capacity of c.p. titanium is
sufficiently documented in the case of oral
implants, there is less known about niobium
in this aspect. Other metals such as
different cobalt-chromoe-molybdenum
alloys and stainless steels have
demonstrated less good take in the bone
bed, but it is uncertain if this is valid for
every possible such alloy and if it is
biocompatibility effect alone that is
responsible for their less satisfactory
incorporation into bone, compared with c.p.
titanium. A significantly impaired interfacial
bone formation compared to c.p. titanium
has been found with titanium-6 aluminium-4
vanadium alloy, probably dependent on a
less good biocompatibility of the alloy. One
concern with metal alloys is that one alloy
component may leak out in concentrations
high enough to cause local or systemic side
effects. Ceramics such as the calcium
phosphate hydroxyapatite (HA) and various
types of aluminium oxides are proved to be
biocompatible and due to insufficient
documentation and very less clinical trials,
they are less commonly used. With respect
to HA, the available literature points to at
least a short term (<10 weeks) enhanced
interfacial bone formation in comparison to
various reference metals. This represents a
potential clinical benefit of HA, whereas the
risk or coat loosening with subsequent
problems represents a potential risk.
IMPLANT DESIGN (MACRO
STRUCTURE) :
There is at present, sufficient long-
term documentation only on threaded types
of oral implants that have been
demonstrated to function for decades
without clinical problems. However,
unthreaded implants may function too, even
if there is a total lack of positive
documentation with respect to bone
saucerisation, a problem that caused failure
of many early types of oral implants. With
currently used cylindrical implants, many
authors reported more severe bone
resorption than would have been expected
with certain screw designs. It must be
observed that there are other unthreaded
implant designs that may give an excellent
long term clinical result.
The threaded implants provide more
functional area for stress distribution than
the cylindrical implants. The design of the
threads may also influence the long term
osseointegration. For e.g. V-shaped thread
transfer the vertical forces in a angulated
path, may not be efficient in stress
distribution as that of the square shaped
threads.
IMPLANT SURFACE (MICRO
STRUCTURE, SURFACE
TOPOGRAPHY) :
With respect to the surface
topography there is clear documentation
that most smooth surfaces do not result in
an acceptable bone cell adhesion. Such
implants do therefore end up as being
anchored in soft tissue despite the material
used. Clinical failure would be prone to
occur. Some microirregularities seem to be
necessary for a proper cellular adhesion
even if the optimal surface topography
remains to be described. With a gradual
increase of the surface topographical
irregularities, problems due to an increased
ionic leakage are prone to occur. With
plasma sprayed titanium surfaces for
instance, more than 1600 ppm titanium has
been reported in implant adjacent haversian
systems, probable resulting in an
impairment of osteogenesis.
Another surface parameter is the
energy state where a high surface energy
has been regarded as positive for implant
take due to an alleged, improved cellular
attachment. One practical way of increasing
the surface energy is the use of glow
discharge (plasma cleaning). However,
published reports have not been able to
confirm the superiority of so artificially
enhanced implant energy levels. One
reason for this lack of confirmation of the
surface energy hypothesis could be that the
increased surface energy would disappear
immediately when the implant makes in
contact with the host tissues.
Many researchers recommended
various procedures for improving the
surface energy or surface characteristics of
the implants to improve the
osseointegration. Stefini C.M. et al. (2000)
recommended to apply platelet derived
growth factor and insulin like growth factors
on the implant surface before placing into
the cervical bed. According to their results
this method showed better wound healing
and rapid integration.
Musthafa K. et al (2000) reported to
sand blast the titanium implants with
titanium oxide particles (45-90) to achieve
higher rate of cell attachment.
Other authors like Lima Y.J. et al.
(2001) and Orsini Z. et al. (2000) reported
to perform acid etching of the titanium
implants by hydrofluoric acid, aqueous nitric
acid and sodium hydroxide to reduce the
contact angle less than 10
0
for better cell
attachment and utilization of 1%
hydrofluoric acid + 30% nitric acid to clean
the implant surface and to remove the
alumina particles after sand blasting which
improves the osseointegration.
Nishiguchi S. et al (2001) reported to
provide alkali + heat treatment to improve
the amount of bone bonding, i.e. 5 mol/lt
NaOH at 60
0
C for 24 hours and 600
0
C for 1
hour (Dog study).
Rich and Harris presented some of
the salient features of fibroblasts during
healing i.e. Rugophalia: attracted towards
rough surfaces, Haptotaxis: the directional
cell movement that depends upon adhesive
gradients on the substratum, Contact
guidance : the tendency of the cells to be
guided in their direction of locomotion by
the shape of substratum. These properties
denotes that the implant fixture with rough
surface topography and more surface
energy promotes faster and complete
osseointegration.


STATE OF THE HOST BED :
If available, the ideal host bed is healthy and with an adequate bone stock. However, in the clinical reality, the
host bed may suffer from previous irradiation, ridge height resorption and osteoporosis, to mention some
undesirable states for implantation. Previous irradiation need not be an absolute contraindication for the insertion
of oral implants. However, it is preferable that some delay is allowed before an implant is inserted into a previously
irradiated bed. Furthermore, some 10-15% poorer clinical results must be anticipated after a therapeutical dose of
irradiation. The explanation for less satisfactory clinical outcome found in irradiated beds could be vascular
damage, at least in part. One attempt to increase the healing conditions in a previously irradiated bed is by using
hyperbaric oxygen, as a low oxygen tension definitely has negative effects on tissue repair. This is further verified
by the finding that heavy smoking, causing among other things a local oral vasoconstriction, is one factor that will
lower the expected outcome of an implantation procedure.
Other common clinical host bed problems involve osteoporosis and resorbed alveolar ridge. Such clinical
states may constitute an indication for ridge augmentation with bone grafts. However, present clinical technique for
bone grafting are under debate and it appears that 6-year success of oral implants in the 75% range is a realistic
outcome after most such procedures. This figure is slightly alarming seen against the fact that, at least in the
maxilla, 10-20% of an average edentulous population may be in need of a bone graft to improve the host bed and
allow for the insertion of implants. On the contrary, if the bone quality and quantity in the maxilla is controlled, the
expected outcome of an oral implantation procedure is similar to that of the mandible.
As stated by Branemark et al. and Misch, the bones with D1 and D2 bone densities shows good initial stability
and better osseointegration. The bone densities D3 and D4 shows poor prognosis. Many authors have
recommended to select suitable implants depending upon the quality and quantity of the available bone, i.e., HA
coated or Ti plasma coated implants are better for D3 and D4 and conventional threaded implants for D1 and D2
bone qualities.
SURGICAL CONSIDERATIONS :
The main aim of the careful surgical preparation of the implant bed is to promote regenerative type of the
bone healing rather than reparative type of the bone healing. If too violent a surgical technique is used, frictional
heat will cause a temperature rise in the bone and the cells that should be responsible for bone repair will be
destroyed. Bone tissue is more sensitive to heat than previously believed. In the past the critical temperature was
regarded to be in the 56
0
C range, as this temperature will cause denaturation of one of the bone enzymes, alkaline
phosphatase. However, the critical time / temperature relationship for bone tissue necrosis is around 47
0
C applied
for one minute. At a temperature of 50
0
C applied for more than one minute we are coming close to a critical level
where bone repair becomes severely and permanently disturbed. This critical temperature should be seen against
observed frictional heat at surgical interventions. In the orthopaedic field, despite adequate cooling, temperatures
of 90
0
C have been measured. High drilling temperatures in the dental field are to be expected when drilling,
particularly in the dense mandible.
Erickson R.A. recommended the importance of using well sharpened drills, slow drill speeds, a graded series
of drills (avoid making, for instance, a 4mm hole in one step) and adequate cooling by profuse irrigation. By using
such a controlled technique it has been demonstrated in clinical studies that overheating may be totally avoided.
The mechanical injury will of course remain and is quite sufficient to trigger a proper healing response. Erickson
also recommended bone cutting speed of less than 2000 rpm and tapping at a speed of 15 rpm with irrigation.
Hence, the surgical preparation sequences as well as the instruments depend upon the quality of the bone as
shown in the diagram.
Another surgical parameter of relevance is the power used at implant insertion. Too strong a hand will use in
bone tension and a resorption response will be stimulated. This means that the holding power of the implant will
fall to dangerous levels after a strong insertion torque. A moderate power at the screwing home of an implant is
therefore recommended. With other implant designs there may be a need for implantation of the implant at
insertion and other rules may apply.
Surgical fit of the fixture : The accurate fit consists of more surface contact, less dead space and thus better
healing.
LOADING CONDITIONS :
From histological investigations of animal as well as human implants we know that, irrespective of control of
surgical trauma and other relevant parameters, the implant will, in the early remodeling phase, be surrounded by
soft tissue. This means that some weeks after implant insertion it will be particularly sensitive to loading that
results in movements, as movement will stimulate more soft tissue formation, leading eventually to a permanent
soft tissue anchorage. In essence, the situation is similar to that of a fracture. Loading of an unstabilized fracture
will result in soft tissue healing and poor function, whereas stabilization with plates or plaster of Paris will ensure a
satisfying rigidity leading to bone healing of the fracture. The case of an implant is, in principle, very similar.
Premature loading will lead to soft tissue anchorage and poor long-term function, whereas postponing the loading
by using a two stage surgery will result in bone healing and positive long term function. The length of time loading
should be avoided is dependent on the implantation site as well as on the bone bed quality. Furthermore, there may
be cases where an almost immediate loading would not disturb the bone healing response, but in general loading
must be controlled if osseointegration is to occur. Branemark with his controlled implant system advocated the use
of a 3 month loading delay in the mandible and a 4-6 month delay in the healthy maxilla where the bone is, as a rule,
more cancellous in character. However, these precise unloaded times are empirically based and to the knowledge
of the author there are no published studies comparing different unloaded periods and relating this to implant
success. Furthermore, from a bone biologic point of view a more suitable design would be to have the implant
unloaded and then gradually increase the load in the manner of the Sarmiento technique for functional braces in
fracture healing. In the similar way Misch et al. recommended progressive loading criteria or staged loading and
implant protective occlusion for better maturation of the bone surrounding the implants. The problem in the case of
oral implants is how properly to define to the patient how a gradual increase of load should be controlled ; a
complicated task not the least since the appropriate loading pattern also depends on individual patients factors.
Recently, many authors are reporting the results of immediate loading of the endosseous implants.
According to them the physiological loading of the healing implants promotes better osseointegration.
Sagara et al (1993) also showed evidence of osseointegration when titanium screw implants were
immediately loaded with a unilateral prosthesis. Their findings showed that osseointegration did occur,
although the immediately loaded implants exhibited less direct bone contact than with the delayed loading
which were used as controls.
Salama et al (1995) reported on two patients in whom titanium root form implants were
immediately loaded and successfully utilized to support provisional fixed restoration in the maxilla and
mandible. Both the patients were followed from 37 to 40 months after implant placement and immediate
loading. All implants osseointegrated and were restored with a fixed prosthesis.
Babbush and co-workers (1986) showed implant success rate of 88% to 97% over 5 to 13 years
with immediate loading implants.
Lederman and colleagues (1998) histologically confirmed osseointegration with 70% to 80% bone
to implant contact in a mandibular symphysis necropsy specimen after 12 years of implant and prosthesis
function in a 95 year old patient.
Peitelli and colleagues (1997) found significantly greater bone-to-implant contact in 24
immediately loaded mandibular implants compared with 24 unloaded.
THE SUCCESS CRITERIA (ALBERKTSSON ET AL) :
1) The individual unattached implant should be immobile when tested clinically.
2) The radiographic evaluation should not show any evidence of radiolucency.
3) The vertical bone loss around the fixtures should be less than 0.2 mm per year after first year of implant
loading.
4) The implant should not show any signs of pain, infection, neuropathies, parasthesia, violation of mandible
canals and sinus drainage.
5) The success rate of 85% at the end of 5 year and 80% at the end of 10 service.
METHODS OF EVALUATION OF OSSEOINTEGRATION :
Invasive methods :
1) Histological sections (10 microns sections).
2) Histomorphometric to know the percentage of bone contact.
3) Transmission electron microscopy
4) By using torque gauges
5) Pull out tests.
The invasive methods are usually used in the animal experiments.
Non-invasive methods :
1) Tapping with a metallic instruments : The fixture produces ringing sound, it osseointegrated, produces dull
sound if fibrous integration.
2) The radiographs
3) Perio test : Checks mobility and damping system.
Normal values : -5 to + 5 PTV
4) Dental fine tester : evaluates the mobility, should be less than 5.
5) Reverse torque test with 20 N cm.
6) Resonance frequency analysis : this method gives the idea of amount, rate of osseointegration. This
method can be utilized for healing or failing implants.
SCOPE OF THE OSSEOINTEGRATION :
The osseointegrated endosseous implants are utilized for providing the prosthesis or stabilizing
the various structure of the body. A schematic representation of the scope of the osseointegration is
depicted in the diagram.

CONCLUSION :
The osseointegration is a multifactorial entity. Achieving the osseointegration of the endosteal
dental implants needs understanding of the many clinical parameters.

BIBLIOGRAPHY :
1) Osseointegration in clinical dentistry Branemark, Zarb, Albrektsson
2) Osseointegration and occlusal rehabilitation Sumiya Hobo
3) Contemporary Implant Dentistry Carl. Misch
4) Endosseous implants for Maxillofacial reconstruction Block and Kent
5) Implants in Dentistry Block and Kent
6) Dental and Maxillofacial Implantology John. A. Hobkrik, Roger Watson
7) Endosseous Implant : Scientific and Clinical Aspects George Watzak
8) Optimal Implant Positioning and Soft Tissue management Patrik Pallaci
9) Osseointegration in craniofacial reconstruction. T. Albrektssson.
10) Osseointegration in dentistry : an introduction : Philip Worthington, Brein. R. Lang, W.E. Lavelle.
11) Effect of implant surface topography on behaviour of cells D.M. Brunette IJOMI 1988 ; 3 : 231-246
12) Implant stability assessment Neil M. IJP, 1998 ; 5 : 491-500.
13) Osseointegration and its experimental background. P.I. Branemark. JPD, 1983, 50 : 399-410.
14) D.C.N.A., 1986 ; 10-34, 151-160
15) D.C.N.A., 1992 ; 36, 1-17
16) Structural aspects of the interface between tissue and Titanium implants. K.A. Hanson, T. Albrektsson.
JPD, 1983 ; 50 : 108-113.
17) Biocompatibility of Titanium Implants. B. Kasemo. JPD, 1983; 50:832-37.
18) Direct Bone Anchorage. T. Albrektsson et al. IJP, 1990 ; 3 : 30-41.
19) Mechanism of Osseointegration. J.E. Davis. IJP, 1998 ; 11 :391-401.
20) The attachment mechanism of epithelial cells. T.R.L. Gould. J. Perio. Rest 1981 ; 16 : 611-616.
21) The effects of early occlusal loading on one stage titanium alloy implants in beagle dogs : A pilot study :
Sagara. M, Ahagawa Y, Nikai. H, Tsuru. H, JPD 1993 ; 69 : 281-288.
22) Immediate loading of bilaterally splinted titanium root form implants in fixed prosthodontics : Salama.K,
Rose EF, Salama.M, Betts. N.J ; Int J. Periodont Rest Dent 1995 ; 15 : 345-361.
23) Titanium plasma sprayed screw implants for reconstruction of the edentulous mandible : Bubbush C.A,
Kent J.N, Wislik DJ ; J Oral Maxillofac Surg. 1986 ; 144 : 274-282.
24) Long-lasting osseointegration of immediate located, bar-connected TPS screws after 12 years of function :
A histologic case report of a 95- year old patient : Ledermann PD ; Int J Periodont Restorative Dent 1998
; 18 : 553-563.
25) Immediate loading of titanium plasma sprayed screw-shaped implants in man : A clinical and histological
report of two cases: Peattelli A, Corigliano M, Scrano A ; J Periodontal 1997 ; 68 : 591-597.
CONTENTS

INTRODUCTION
HISTORY OF OSSEOINTEGRATION
DEFINITIONS AND OTHER TERMINOLOGIES
MECHANISM OF OSSEOINTEGRATION
- INFLAMMATORY PHASE
- PROLIFERATIVE PHASE
- MATURATIVE PHASE
FACTORS RESPONSIBLE FOR OSSEOINTEGRATION
- MATERIAL BIOCOMPATIBILITY
- IMPLANT DESIGN : MACRO STRUCTURE
- IMPLANT SURFACE : MICRO STRUCTURE
- STATE OF HOST BED
- SURGICAL CONSIDERATIONS
- LOADING CONDITIONS
CLINICAL EVALUATION OF OSSEOINTEGRATION
SCOPE OF OSSEOINTEGRATION
CONCLUSION
REFERENCES

Recent advances in Prosthetic Dentistry

ADVANCES IN FIELD OF
1. GENERAL

2. COMPLETE DENTURE PROTHESIS

3. FIXED PARTIAL DENTURE PROSTHESIS

4. REMOVABLE PARTIAL DENTURE PROSTHESIS

5. MAXILLO-FACIAL PROSTHESIS

6. ORAL IMPLANTOLOGY

7. MATERIALS AND INSTRUMENTATION























INTRODUCTION
The only thing in life that is constant is change, and developement and the developement is the
essence of any change - Human Society ever since its advant house undergone various changes
starting from discovery of wheels and fire to revolutionary invention of super computers and aircrafts
that defy all the laws of gravity.
Moreover, human beings have used and misused their power of knowledge in various ways both
for good as well as evil.
In one hand they have created nuclear weapons, gamma radiations of which is still giving bir th to
a crippled child's, on the other hands they have also invented life saving drugs, a drug which made
hearts beat back to life and drug which restored priceless vision of blinds.
Indeed this world have progressed in leaps and bounds on the similar lines too, oral and dental
health's, like many aspects of human condition, are in the midst of major transition.
The scientific and technological basis of dentistry, are expanding rapidly in a world where
alternative changes in the managements and financing of health care, the demography of our nation,
and public expectations of better "quality of life".
Dentistry has come a long way from just replacing missing teeth to replacing lost alveolus
supporting facial structures, recreating esthetics, reestablishing phonetics and many other major
developments.
Most of all we can say that in prosthetics by using all the artificial materials as well as technologies
we can give a natural appearance of an individual at the best of mankind.


OROFACIAL PROSTHESIS DESIGN AND FABRICATION USING STEREOLITHOGRAPHY
Aust Dent Journal 2000 45:4
The use of stereolithography for the manufacture of implantable prosthesis is relatively new
aspects of this dentistry. Until now, its use with the regard to mandibular resection has been to produce
pre-operative models that allows more sophisticated planning of the contour and better preparation of
the metallic framework to be implanted. The framework rejoins the mandible restoring its function.
Data extracted from Computed Tomography (CT ) scan can be used to produce computer models
of three dimensional (3D) anatomical structures. Using sterolithography, a rapid prototyping technique
these computer models can be made into solid physical models.
The surface and internal structure of the anatomical site can be reproduced by polymerization of
UV light sensitive liquid resin using a laser beam.
The laser rays progressively polymerise photomonomer on the surface of the vat solution.
The model is built vertically step by step as the polymerized section submerged beneath the
surface of the solution.
These models are then used for diagnosis and treatment planning of various cases.






LASER APPLICATION IN PROSTHETIC DENTISTRY
DCNA Vol 44 No 4, Oct 2000
The addition of laser surgery to reconstructive process can heighten the act and the science of this
multidisciplinary field.
The current use of Lasers in Reconstructive Dentistry encomposes a wide variety of soft tissue
procedures but the future may hold promise for hard tissue procedures too.

LASER USE IN FIXED PROSTHESIS
1. Complete control of the oral environment at operative site is essential.
2. Frequently cases are encountered in which gingival tissues need to be altered because of area of
inflammation, previous subgingival restoration or subgingival caries.
3. The finish line need to be placed near epithelial attachment making it impossible to retract the gingiva
without stripping the attachment, bruising the periodontal ligament and creating uncontrolled bleeding.
4. Recurrent Bleeding in gingival sulcus can make impression making impossible.
5. In such cases SULCULAR LASER GINGIVOPLASTY can be used to develop a new, healthier
gingival sulcus, to control haemorrhage, and to remove just enough epithelial attachment and
periodontal ligament to facilitate the placement of Retraction cord.
6. Laser Sulcur gingivoplasty improves impression Technique and minimizes gingival recession.



LASER USE IN IMPLANT DENTISTRY
The importance of creating an environment for soft tissues around perimucosal portion of the
implants cannot be over stated.
All implants must pass through the submucosa and overlying stratified Squamous Epithelium.
Misch considered this the weak link between prosthetis attachment and predictable bony support of
the implant.
The gingival epithelium or biologic seal become an important factor in implant longevity.
If a biological seal is created from the begining of implant uncovering using laser technology vs.
conventional surgery, the attached gingiva would heal directly around the implant, forming an epithelial
cuff.
Implants may be uncovered protectively with laser energy.
Soft tissues > then 3mm thick should be reduced with laser to create an ideal pocket depth around
the implant.










EFFECT OF LOW ENERGY LASER APLICATION IN THE TREATMENT OF DENTURE - INDUCED
MUCOSAL LESION
The use of low-energy lasers has recently gained considerable attention. They are primarily used to
relieve pain, reduce inflammation and edema and accelerate healing. Studies on the biologic effects of
low energy lasers have been concerned with the ability of such light to increase blood circulation within
regenerated tissues to increase production of collagen by fibroblast and to promote a suppresive effect on
the immune system.
Furthermore, increased mitotic activity has been reported, which indicates the growth stimulation
occurs.
Recently, the bacteriocidal effect of light from a low energy laser was introduced as an alternative
approach to Antibiotics and Antiseptics in eliminiting cariogen and periodontopathogenic bacteria from
lesion.
The greatest benefit of using a low energy laser is its effects can be achieved without damaging host
tissues and with protection to the operator.
The effect of therapeutic laser treatment on both soft tissues and bone with subsequent
improvement of denture foundation after t/t of denture induced mucosal lesions.







A CAD/CAM SYSTEM FOR FABRICATION OF COMPLETE DENTURES
UP Vol 7 No 1 1994
This study investigate, the development of Computer Aided System for designing and Fabrication of
Complete Denture.
So far the use of CAD/CAM has primarily being foccused on fixed restoration such as inlays crown
because difficulty in recording soft tissue morphologies of edentulous areas, and interocclusal
relationship.
Methods of recording and measuring 3D morphology have been greatly improved with recent
advancement of optoelectronic measuring unit CAD software.
PROCEDURE:
Involve three major steps
(1) Impression procedure
(2) Denture designing
(3) Denture fabrication
(1) Impression procedure
1. As the first step, an impression of the load bearing area of the residual ridge and denture
borders was made for the maxillary and mandibular arches using a specially designed double impression
trays with Conventional Rubber Base or Silicone impression material.
2. Maxillary + Mandibular impressions are hold at specific V.H. and HR in patients mouth

3. The double impression trays are transfered and mounted on a 3D laser scanner that has a rod around
which both the impression can rotate to full 360. Two dimensional images are recorded by spread laser
beam and Four Charged-Couple device camera while the impression is made to move / mearly. Surface
images are obtained at three different angles time required - 15 to 20 mins.
2. Denture design, Arrangement of Artificial Teeth
Denture space data are transfered to an engeenering work station. Artificial teeth and denture surface
data from the database are overlaped and matched with those of the denture space.
Placement of Artificial Teeth is done to acchive proper stress distribution.
3. Denture Fabrication
Either a numerically controlled milling machine or 3-D laser lithography machine can be used.
Laser lithgraphy create 3D models of new products based on CAD design.

Therefore, only two outer shells (occlusal/polished part) and (tissue surface part) are photopolymerised.
Tooth shade acrylic resin composites are used to fill inside the occlusal portion and two surface are
connected using reference point.
Tissue coloured autopolymerizing resin composite is then placed into the space and excess removed,
and shells are polished using conventional manner.
STAFNE' S BONE CAVITY AND ITS UTILIZATION IN COMPLETE DENTURE RETENTION
J.P.C. MARCH 2002
In 1942 Stafne's described a series of Asymptomatic Radiolucent lesions located near the angle of the
mandible. Subsequent reports have shown that these condition represents a well-defined concavity of the
cortical bone on the lingual surface of the mandible.
The origin of this developmental depression is thought to be secondary to
a) Entrapment of Salivary Gland parenchyma during the developmental process of mandible.
b) Accentuation of the cavity.
c) Indentation along the lingual aspect of the mandible that contains an extension of the submandibular
gland.
Because of their location Stafen's Bone cavities have also been called lingual/ mandibular salivary gland
depression or lingual/cortical mandibular defect.
Although the defects are thought to be developemental, they do not appear to be present at Birth.
Occasionally the defects appears bilaterally.
They often appears radiographically as a round or ovoid, well circumscribed radioluscency. This
reported incidence based on panoromic radiographic observation. They should be differentially diagnosed
out from any Mandibular Cyst. Stafen's Bone Cavity ranges from 1 to 3 cm in diameter and they often
present below the inferior Alveolar cannal.
Engagement of a mandibular denture in bilateral Stafen's Bone cavity aid in retention and stability of
mandibular dentures.


MAGNETS IN PROSTHETIC DENTISTRY
J.P.D. AUG 2001 Vol 86 No 2.

Magnets have generated great interest within dentistry and their application are numerous.
The 2 main areas of their interest are in the field of orthodontics as well as Removable
Prosthodontics.
The reason for their popularity is related to their small size and strong attractive forces allow them to
be placed in prosthesis without being obtrusive within the mouth. Over the last century, significant
advances have been made in the development of magnetic materials which have been quickly transfered
into dental applications. The main magnetic materials used is the rare earth elements Neodynaim-Iron-
Boron (Nd, Fe, B).
Other materials used include RE Alloy, Samarium-Cobalt (Sm-Co). Samarium iron nitride is a
promising new candidate for permanent magnet application because of its high resistance to
demagnetisation high magnetism and better resistance than Nd Fe B to temperature and Corrossion to
oral fluids.
Another Advancement includes the Encapsulation of the pre-existing magnets within a relatively inert
alloys such as stainless steal or titanium.







SURFACE CONDITIONS AND VISCOELASTIC PROPERTIES OF DENTURE LINER PERMAFLEX
IJP Vol 8 No 3 1995
When patients suffer from fragile supporting mucosa, excessive residual ridge resorption, substantial
undercuts and/or Traumatic or pathologic tissue, less, the clinician may opt for the use of a soft lining
material between the intaglio surface of a prosthesis and the supporting tissues.
Soft tissue are useful to attenuate the discomfort result from the instability of improper adaptation of the
prosthesis.
The selected material must
a) minimize bone resorption
b) protect supporting gingival tissues
c) provides good surface condition that is can enable to clinical adjustment.
Materials include in this family of Denture liners are those in the family of Acrylic Resins.
a) Dentimex BV
b) Perform
c) Dimethyl polysiloxanes (DMPS-Flexor)
d) Ethylene Vinyl Acetate Copolymers
All of these materials behave visco-elastically, depending of their flexibility, which can be varied according
to the selected thickness.Therefore, clinical choice between these different families is determined by the
problems presented by the supporting tissues and the design of the prosthesis.
The denture bearing mucosa also exhibit viscoelastic properties.
Among the new denture liners is Benzene dimethyl polysiloxane materials permaflex establish the
efficiency of the material as a resilient denture liners.

CENTRIC RELATION A NEW CONCEPT
A new concept of Centric Relation is defined as "A clinically determined position of the mandible
both condyles into their anterior uppermost position.
This defination defines the old defination is the centric relation is the relationship of the mandible to
maxilla when the condyles are at the most posterior portion of the glenoid fossa.
Because some author belief that in Centric Relation all the load of the mandibular residual ridge are
transfered to the joint cavity pushing the head of the condyle against the avuscular disc and the cavity
wall. Recently it has been found
that there is evidence of nerve and blood vessels in this posterior aspect which can get compressed
causing pain to the individuals. But such pains are not noted in the patient thereby suspecting the actual
position of this condylar head in the joint cavity. So recently authors have suggested their position to be
anterior uppermost position of joint cavity.









DENTAL CERAMICS: WHATS NEW
Dental Update Jan/Feb 2002
Ceramic materials new have a firmly established role in many aspects of clinical dentistry.
The success of recently introduced ceramic materials and systems may be attributed to several
factors, including Technological advences and an increasing more towards the avoidence of use of metal
in the mouth and their replacement with tooth coloured materials whenever possible.
As for all Restorative materials, improvement in strength, clinical performance and longevity, continue
to drive the search for the ideal ceramic material.
To date, those ceramic materials which appear to have the strength for use in posterior teeth as full
and partial coverage restoration include
a) In ceram (Vita Zahnfabrik Germany) b) Procera (Nobel Biocare)
c) Empress (Invoclar Vivadent)
IN-CERAM
In ceram core material is primarily crystalline in nature, whereas other forms of ceramics used in
dentistry was largely compossed of glass matrix with a secondary crystalline phase.
In ceram is said to possess sufficient strength and toughness to be used for Ant and Post all ceramic
restoration and fixed partial denture bridgework.
The types of In ceram are based on alumina, spinal (a mix of alumina and magnesia) or zirconia,
which makes possible the fabrication of framework of different transluscency by use of different
processing technique.
Flexural Strength and # Toughness of In ceram alumina are 2.5 and 3.5 times greater than those of
conventional or high leucite ceramic.
PROCERA
Procera crowns (Nobel Biocare) combine the advantage of a metal coping with high precision
processing techniques. The substructure is fabricated from titanium (a metal used widely in detnal
implants and with a proven high degree of bio compatibility) using a combination of copy milling and spark
erosion.
The aesthetic porcelain that overlays the metal core is of a low fusing composition to minimize excess
oxdn of Titanium during firing.
PROCERA ALL-CERAM~
This comprises of high-strength, densely sintered alumina core veenered with porcelain. A die
constructed from an impression of a prepared tooth, is scanned to allow remote production of a densely
sintered alumina core which is returned to the original laboratory for porcelain build up of the final crown.
Fracture resistance of ceramic restoration is dependent not only on the intrinsic strength and
toughness of the material itself overall fitting accuracy also contribute to the ability of the restoration to
withstand biting force.
IPS EMPRESS 2 (INVOCLAR VIVADENT)
Hot-pressed leucite-reinforced ceramic were introduced serving to reinforce the glossy matrix and
prevant crack propogation.
With IPS Empress, 30-40% crystals content can be introduced before the aesthetic of the core and
resulting restoration are compromised.
In IPS Empress 2, controlled crystallization production of a lithium disilicate glass ceramic enables the
creation of a 60% crystal content by volume without loss of transluscency as the refractive index of the
crystals is similar to that of glass matrix.
Furthermore the strength of the resultant material is reported to be 3 times that of original Empress.
The lithium disilicate glass ceramic serves as the underlying framework for IPS Empress 2, and the
manufactures stated that the strength of the material is sufficient to withstand masticatory forces and to
support edentulous area upto 9 mm in premolar and 11 mm in anterior region.
Fluoroapatite crystals are formed through controlled crystalization and are reported to be similar in
shape and composition to those in natural teeth providing similar wear compatibility and optical
properties.
It is also claimed that the fine grain structure and high crystallinity of the glass ceramic reduces the
potential for wear of the opposing dentition.
There are definite clinical advantages of using Empress 2.
While 1.5mm of axial reduction is usually recomended for metal ceramics only I mm is needed for
IPS Empress 2.
CAD-CAM
COMPUTER AIDED DESIGN
COMPUTER AIDED MACHINE
The first chair side produced ceramic inlay based on a CAD CAM unit. (Cerec, Siemens Germany)
was placed in 1985 since when there have been seveal related developments including introdution of
second generation in 1994 and in 2000 Cerec3.
Cerec 3 comprises both an acquisition and a milling unit which enables concurrent designs and
production of restoration.
The softwares can be supplemented with Cerec 3 crown which contains a tooth library and is said to
be suitable for the manufacture of all posterior restoration and anterior crowns.
Another option is the Cerec 3 Veneer software for producing anterior partial crowns and veneers.
The Cerec 3 milling unit has been seperated from the acquisition unit to enable simultaneous design
and milling. The milling wheel had been replaced with tapered diamond bur reducing the machining
process time by 3-5 mins.
The milling element is designed to accomodate the future option of fabricatint three unit Bridges.
Another feature is the Cerec Scan option for productin of restoration by indirect approach, in which a
conventional model of the preparation and adjacent teeth is cast.
This is scanned with an integrated laser scanner, the model is then replaced with a ceramic block and
the milling procedure commences.
SHOULDER PORCELAIN
To correct the problem of rounding or slumping of conventional porcelain margins after firing as the
fusion temperature were identical, manufactures created special shoulder porcelain containing aluminous
porcelain that fuses at temperatures 30-80 higher than the dentin and enamel porcelain.
Advantages : Stability during firing cycles
Stronger in flexure than conventional porcelain making the margin more resistance to fracture.
OPALESCENT PORCELAIN
Opalescence in dental porcelains is a light scattering effect acchived with the minute concentrations of
high index refraction oxides in a size range near the wavelength of visible light.
CASTABLE CERAMIC
The best documented member of this group is Dicor System (Trubyte Dentsply) which is a micaceous
glass ceramic.
Restoration are produced with the lost wax technique and centrifual casting of heat-treated glass
ceramic. Dicor causes less wear of opposing dentition than that of reinforced conventional porcelain.

CEROMERS
Normal mastication puts enormous pressure on opposing dentition and when conventional porcelain
comes in contact with tooth enamel, serious wear damage can occur.
Thats why you need the delicacy of Ceromer that's short for a CERamia optimised Polymer.
Targis Ceromer System provides the beauty and aesthetic capabilities of ceramic with flexural strength
and shade control of resin.
This system protects and prevents the opposing tooth wear.
Targis ceramic polymer matrix can be heat cured or light cured to create. 1) Crowns
2) Inlays 3) Onlays 4) Implant superstructure (telescopic crown)
This materials can be directly applied over the cast as need of necessary restoration can be buid up to
form crowns, inlays, onlays and bridges after heat curing or light curing method.
A -7






LITHIUM ION STRENGTHENING OF DENTAL PORCELAIN
UP Vol 8 No 3 1995
Dental Ceramics can provide unsurpased aesthetic qualities when used to restore natural teeth.
However one of the inherent disadvantages of these materials is the low tensile strength when
unsupported and subjected to occlusal loading there is a tendency to fracture.
Many developments have been directed towards a strong less esthetic material metal or reinforced
ceramic core that can be overlaid by weaker tooth coloured porcelain.
Thermal tempering and ion exchange have been used to improve the mechanical properties of
existing dental porcelain. Thermal tempering produces a low thermal expansion surface layer that is
placed in compression on cooling, thus increses resistance to tensile strengths.
Ion exchange is a similar approach that involves the replacement of monovalent ions at the surface
of the glass with larger ions.
Compressive strength are generated in the surface layer and decrease the tendency towards crack
propagation.
The effect has been attributed to the inward diffusion of potassium ions replacing the smaller sodium
ions in the glass matrix.
Alternatively, sodium containing glasses have been strengthened by ion exchange with smaller
lithium ions.
More recently the strengthening effect of leucite-reinforced porcelain by double ion exchange has
generated considerable interest. Introduction of small lithium atoms followed by exchange with
Rubidium has been reported to give superior strengthening.
Dispersive X-ray Analysis revealed that the depth of ion exchange was most marked within 1Opm
below the surface, although it extend to atleast 100 m,
EVALUATION OF A NEW OPAQUE SYSTEM FOR METAL CERAMIC RESTORATION
UP Vol 8 No 2 1995
The technical and biophysical factors/involved in the fabrication of fixed restoration are of clinical
importance for the long term prognosis for prosthodontic patients. Technical failures include loss of
retention fracture of matal components and porclain veener fractures. Fractures through the porcelain or
at the metal metaloxide layer interface are the result of metal porcelain-bond that is stronger than strength
of porcelain-porcelain or metal-metal bond itself.
Adhesive failures occur when the bond between the metal and porcelain is inadequate. The
application of the porcelain opaque layer is a critical step in preventing adhesive failure. Additionally, the
opaque layer masks the metal, allowing appropiate shades to be obtained.
The traditional application of opaque porcelain begins with the mixing of porcelain powder with a liquid
binder that commonly consisted of distilled water, alcohol and glycerine. The creamy opaque paste is
applied to the metal substructure in a minimum of two layers. The first layer acts as a wetting layer and
the subsequent layers fill in the irregularities and mask the metal.
Vita VMK-Paint-On 88 opaque and Opaque P are two conventional opaque systems. Recently a new
opaque system called BIOPAQUE become commercially available. This opaque system can be directly
applied to metal surface without mining and condensing. It offers easy application and decrease WT.



Additionally, uniform thickness and excellent opacity can be attained with Biopaque.
Opaque porcelain contains crystals having a high refractive index that disperse and reflects light
masking the metal substructure and preventing it from influencing porcelain colour.
X-ray powder diffraction analysis of Biopaque demonstrate that only the base of this system is a newly
developed material.
Biopaque attained superior clinical results with regard to technical and biologic failures as compared to
the two other traditional opaque system.

















NONMETAL POST SYSTEMS
Dental Update - Sept 2001
The recent years, non metal alternatives for post system have been introduced.
(A) COMPOSITES POST SYSTEM
(B) CERAMIC POST SYSTEM
COMPOSITE POST SYSTEM
Composite materials are composed of fibres of carbon or silica surrounded by matrix of polymer resin.
The philosophy behind the use of these materials lies in the belief that a post
should mimic the dentin of the root in its physical properties, distribute the stresses impossed in the root
in most favourable ways to reduce chances of root #.
a. Carbon fibre Post
1. Composipost : Composed of 8mm pretensed (fibres arranged lingitudinally
within epoxy resins. The bundles are produced industrially and then machined into desired shape.
Radioopaque in characteristic.
2. Carbonite (1.2, 1.35, 1.5mm)
Differ from composipost in that bundles of fibres 6mm in dia braided together with epoxy matrix
Arrangement gives increase Resistance to bending and torsion compared with parallel fibre arrangement.
3. Mirafit Carbon : Identical to Carbonite.
b Silica Fibre Post : Carbon post do not lend them to utilise with all ceramic that alter
aesthetics.
1. Aesthetipost : Central core of carbonfibre surrounded by quartz fibres,
arranged longitudinally.
2. Aesthetiplus post : Consisting entirely of Quartz fibre. More recently this
company has produced a transluscent quartz fibre post designed to permit light curing unit materials to be
used for luiting.
3. Snow post (l.mm,1.2mm, 1.4mm)
Composed of 60% longitudinally arranged silica zirconium glass fibres in epoxy resins. The surface is t/t
with silane to enhance bonding with resin cements.
Cylindrical in shape with 3 tapper at apex.
4. Light transmiting post
Transluscent post have been introduced in order to allow the use of light cured luiting agent, facilitate
cement placement and evaluation of post seating prior to cement setting.
The original purpose of light transmitting post to provide a means of reconstituting roots with overly flared
cannals caused by caries or over excessive endodontic procedure, the aim being to achieve union
between remaining dentin and light cured composite, thereby restoring the lost bulk and original root
strength.





B. CERAMIC POST SYSTEM
The use of ceramic to provide a core and a post retention continues the idea of using a tough but
aesthetic material to support all ceramic units.
The introduction of zirconium oxide ceramics has provided a material with over twi ce the flexure
strength of Aluminus Ceramic System.
Building a core of ceramic directly onto the zirconia post has not been possible awing to ~ in coefficient
of thermal expansion of core and post material. Ceramic cores and thus to be fabricated indirectly and
then luted around the protuded end of post.
Cosmpost (1.4mm, 1.7mm) : Cylindrically shaped with a conical tip lvoclar/
Vivadent.
Posts have smooth surfaces and are subsequently t/t to roughen the surface which increased Bond
strength between post and core.













METAL-FREE INLAY-RETAINED FIXED PARTIAL DENTURE
Quintessence Int Daniel Edelhoff
Metal free restorative material are oppening doors to new preparation methods of fixed partial denture
prosthesis.
As the results of developement in past few years various metal free systems that can be used to fabricate
short span fixed partial Denture (FPD) are now available. Generally metal-reinforced systems are the
materials of choice for fabricating posterior fixed partial denture (FPD) because of their reliability and
durability, but this system facilitate the periodontal assessment and preserving the healthy tooth structure.

Basic disadvantages in metal alloy
_

1. Base metal components that form on the surface of the alloy during the metalceramic fusing
process may have a negetive effect on adjacent soft tissues.
2. Opaque darkish appearance caused by certain metal denture retainers in abutment seem to be
unesthetic. Consequently highly aesthetically acceptable materials - High strength pressed ceramic and
fibre reinforced composites (FRC) have achieved a certain degree of popularities.


Matel free inlay retained FPD fabricated with High strength pressed ceramic.



Following pre requisites must be met of successful results are to be achieved
a) Good Oral Hygine
b) Low Susceptibility to Caries
c) Parallel alignment of abutment teeth.
d) Minimum height of Abutment teth >5mm Coronogingivally.
c) Maximum mesiodistal extension of interdental gap of 9mm if pressed ceramic and 12mm of
Fibre reinforced composites are used.

RECOMENDATION FOR PREPARATION
a) 2mm occlusal preparation depth (floor of isthmus - central groove)
b) 1.5mm preparation depth of proximal box (shoulder with rounded internal angle).
c) Isthmus width of 1.5mm to 2mm in premolars and 2.5-3mm in molars. d) Proximal angle
of the internal cavity surface to the enamel surface 100-120.
c) Minimum dia of connectors 4mm x 5mm.
f) Divergence angle of cavity approx 6.









PRIMARY ANTERIOR TOOTH REPLACEMENT WITH A FIXED PROSTHESIS USING A PRECISIOIN
CONNECTION SYSTEM
Quintessence Int Vol 33 No 4 2002
Anterior primary tooth loss frequently occurs in young children (ages 6 to 36 months) despite all the
routine preventive measures used in paediatric dentistry. Particularly susceptible to this phenomenon is
Maxillary Central Incisors. Use of Removable Functional. Space Maintainers is recomended as a
therapeutic approach to treatment.
Fixed Space Maintainers of properly designed are less damaging to the oral tissues than removable
space maintainers.
A Resinbonded Prosthesis without rigid connectors permits normal physiologic premaxillary growth
because it does not provide a rigid connection between the pontics.
The use of fixed prosthesis in children in limited by the arch modification that results from the
developement of primary and mixed dentition occlusion. However a period of stability exists in which fixed
appliances may be used i. e. in age of 3-5.5 yrs in which primary arch is completed and the sagital and
transverse dimensions are unaltered.
The Crownless Bridge Works System (CBW Co) was developed in by Nijwegen University as an
advancement of Universal Dental Anchorage (UDA) Plus System.
With this system it is possible to replace both anterior and posterior teeth with a strong prosthesis of
single or multiple pontics and at the same time to preserve abutment teeth.






The CWB system combines techniques derived from the UDA prosthesis system with a system that
utilizes precision connectors attached to Abutment Teeth, with pins comented in proximal aspect.
The CBW system combine two retention techniques, the anchorage and adhesive system.
In addition to the aesthetic advancements provided by minimal need to alter support teeth, the system
offers following advantages
1. Minimally invasive abutment preparation.
2. Improved distribution of loads compared to that with adhesive prosthesis.
3. Few periodontal problems because of absence of margins.
4. Reversible and easily repairable system.
5. No alternation in occlusion.
6. Minimal stress to patients.






CHAIR SIDE PRE FABRICATED FIBRE REINFORCED RESIN COMPOSITE FIXED PARTIAL
DENTURE
The introduction of pre impregnated fibre reinforced resin composite has provided the dental profession
with the oppurtunity to fabricate and deliver adhesive, esthetic and metal free tooth replacement.
The introduction of preimpregnated fibre reinforced composite (FRC) has provided another options for
chairside fixed partial denture (FPD) fabrication.
Indications of this FRC FPD
l. Emergency replacement of Tooth lost due to Trauma.
2. Ant Tooth extracted due to failed Endodontic procedure.
3. Fixed space maintainer, after Orthodontic Treatment.
4. Prior to loading of Implants.

The wings are composed of a strip of unidirectional FRC sandiwiched between 2 woven Fibre Reinforced
Composite Strips.
Three unpolymerized FRC wings are covered with thin foil sheath to prevent contamination and/or
premature polymerization.
The model of the edentulous space is made from Alginate Impression.
The important pre-chairside steps include positioning of the prefabricated FPD on the model trimming the
wings to fit within the Abutments creating proximal retentive locks and forming intraoral putty positioning
index.
Prefabricated FRC FPD being caried to the position in the incisal intraoral positioning matrix. The
unpolymerized listing particulate resin composite is now polymerized, with FPD in that position.
EXPA SYL GINGIVAL TISSUE RETRACTION PASTE
Impression making for all fixed prosthesis requires access to the prosthetic margin white minimally
traumatizing the tissue, so that clinician can produce as much clinical information as possible to
laboratory.
Expa-syl is newly introduced unique paste system specifically designed for gingival retraction that
ensures seperation of the gingival margin and drying of the sulcus.
Expa-syl is injected into the sulcus left in space for approx 1 to 2 mins and then thoroughly rinsed with
air/water spray. The sulcus is left open and dry ready for impression making.
Expasyl composed mainly of two materials Kaolin and A12 Cl, act as an haemostatic agent, Kaolin is
a clay like material responsible for the body or rigidity of the material.
Expasyl is an water soluble paste so it should be used without salivary contamination.
Clinician should be aware of potential interaction between Expasyl and Impression material especially
Alginates and Polyether with A1
2
C1
3
Ideally Expasyl should be used with polyvinyl siloxane impression.












FLEXIBLE CAST FOR FABRICATION OF MULTIPLE POST COPING OVEROENTURE
RESTORATION
JPD March 1999 Vol 81 No 3
Post Coping Restoration can be fabricated using a direct, indirect or combination direct -indirect
method.
Traditionally working cast are mode of stone. Stone cast requires atleast 1 hr for setting. They also
sometimes # during seperation of the cast from the impression. The use of cast that is available
chairside within mins of impression making would save valuable chairside time and improve the
accuracy of coping margins.
In this procedure custom post is fabricated directly into the root cannal space with pattern resin
(Duralay). Core is also fabricated minimal Retentive grooves are placed in resin pattern core to look the
post into the impression material.

After placing the gingival retraction cord around the teeth to provide access to intracrevicular
margins, an impression is made with Polyether Elastomeric Impression Material.
Ensure for accurate reproduction of the margin and the retention of post within the impr ession.
Lightly lubricate the posts with petrolleum jelly and a flexible working cast is poured with Mach 2 die
system using 2 stage pouring Technique.
After 6mins the flexible cast is seperated and die is made new fabrication of coping is done on the
cast using an indirect method.
CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT
COLLAR
UP Vol 9 No 5 1996
Endosseous Dental Implants of seveal designs and materials have improved the prognosis for the
successful restoration of partially or completely edentulous patient. Implant survival is primarily dependent
upon the establishment of osseointegration, characterised by lack of an intervening soft tissue layer at the
interface of implant surface and supporting bone.
In patients with poor oral hygine around implant supported fixed restoration alveolar bone loss is
greater.
The types and abundance of micro organisms in dental plaque deposits vary with the degree of
implant surface toughness at transmucosal junction. Surface properties such as hydrophobicity of various
materials also appear to be an important to dental plaque adherence.
Despite the widespread used of polished titanium collars as transmucosal elements in implant
system, relatively few studies appear to have been carried out on dental plaque formation on these
surfaces.
This study compare the responses of the peri-implant soft tissues to titanium and ceramic coated
surfaces of removable Transmucosal Element (TME) of established IM2 implant system.
Conventional IM2 TME were modified in the laboratory by addition of dental ceramic coating.




CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT COLLAR
IJP Vol 9 No 5 1996
Endosseous Dental Implants of several designs and materials have improved the prognosis for the
successful restoration of partially and completely edentulous patient.
Implant survival is primarily dependent upon the establishment of osseointegration, characterized by lack
of an intervening soft tissue layer at the interface of implant surface and supporting bone.
In patients with poor oral hygiene around implant supported fixed restoration alveolar bone loss is greater.
The types and abundance of micro organisms in dental plaque deposits vary with the degree of implant
surface toughness at transmucosal junction. Surface properties such as hydrophobicity of various
materials also appear to be an important to dental plaque adherence.
Despite the widespread used of polished titanium collars as transmucosal elements in implant system,
relatively few studies appear to have been carried out on dental plaque formation on these surfaces.
This study compares the responses of the peri-implant soft tissues to titanium and ceramic coated
surfaces of removable Transmucosal Element (TME) of established IM2 implant system.
Conventional IM2 TME were modified in the laboratory by addition of dental ceramic coating.





CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT
COLLAR (Contd.)
In a group of patients with two functional IM2 implants linked by a Dolder0type bar to support a
complete mandibular Removable prosthesis, existing THE were replaced by ceramic coated THE on one
side and a comentional TME on other side.
A range of clinical parameters was used to assess the responses of the soft tissue at i ntervals of 1, 4
and 12 weeks.
Results shows that
The scores of accumulation of plaque deposit on ceramic coated transmucosal element were significantly
lower than those recorded for titanium transmucosal elements.









PERI-IMPLANT TISSUE RESPONSE OF IMMEDIATELY LOADED, THREADED HA-
COATED IMPLANTS AND CONVENTIONAL IMPLANT
JPD Vol 87 No 2 FEB 2002
This study evaluate the implant success and periimplant tissue response of immediately loaded
threaded hydroxyapatite (HA) coated root form implants supporting mandibular bar over denture with
opposing conventional maxillary over denture. Osseointegrated Endosseous implants have been a
successful modalities for t/t completely or partially edentulous patient. To achieve this osseointegration
certain guidelines are to be followed
1. A complete aseptic and ......... surgical technique. 2. A complete soft tissue coverage.
3. An extended healing time during which no load should be given.
Periods of 3 to 4 moinths and 4 to 6 months have been recomended as heal ing times for
osseointegrated implants placed in the mandible and maxilla respectively. Faster osseous adaptation
has been demonstrated with Hydroxyapatite coated (HA) implants.
Johson reported complications associated with HA-coated implants and suggested that the HA coatings
are more succeptible to bacterial infection and rapid asseous breakdown.
Babbush et al described a technique of immediately loading 4 Titanium plasma sprayed (TPS) implants
placed in mandibular symphysis with an overdenture. The implants were rigidly splinted by metal bar
and the denture was relined within 2 to 3 days after surgery.
The final clip prosthesis were placed 2-3 weeks later.
The author reported a cumulative failure rate is more in the cases of HA coated threaded root form
implants than conventional root form implants.

PROSTHODONTIC CONSIDERATIONS WHEN USING IMPLANTS FOR ORTHODONTIC
ANCHORAGE
JPD Vol 77 1997
The use of Implants for orthodontic anchorage can produce superior preprosthetic tooth position.
Their use often requires a crown or prosthesis to be fabricated for use as a connection between the
orthodontic device and the implant.
Dental Implants because of their stability could serve as an ideal anchorage unit. Anchorage control is
fundamental to successful orthodontic treatment and Dentofacial Orthopedics.
Prosthodontic advantages of implant orthodontic anchorage
Implants have been found to produce superior preprosthetic tooth position in the following situations
1. Retruding and Realining the teeth
Proclined Anterior Teeth can present both esthetic and functional problems that may be compounded by
palatal soft tissue trauma from mandibular anteriors due to increase vertical overlap.
Strategically positioning posterior implant can be used as an anchorage to effect movements of the teeth.
2. Closing Edentulous space so prosthesis is not required
Retromolar pad implants fixation is particularly advantageous when abutment teeth use for Removable or
Fixed Denture prosthesis have large pulp unsuitable for abutment preparation.
They actually help in closing of the edentulous space by using Retromolar pad implants as an anchorage
units.
3. Correcting midline and Ant tooth spacing
Implants are particularly helpful when multiple posterior teeth are missing and the desired movement
requires teeth to be moved in only one direction around the arch circumference.
4. Reestablishing proper Anteroposterior and Mediolateral position for malposed molar
abutment
Implants facilitate acchieving positional goals when there are multiple missing posterior teeth and
particularly when the malaligned molar abutment is located at the end of an edentulous span.
5. Intruding and/or Extruding Teeth
It can be especially difficult to intrude one molar while extruding another particularly if posterior teeth are
missing.
Implant anchorage can definitely facilitate such movements.
6. Correcting a Reverse Occlusal Relationship
Correcting an anterior reverse occlusal relationship (cross bite) in class III patients can be challenging.
Retracting entire mandibular arch with ramus implants is possible. It is also possible to retract the
mandibular arch with ramus implants simultaneously protracting the maxillary arch by tuberosity implants.

A MODIFIED IMPLANT IMPRESSION TECHNIQUE
JPD Vol 87 No 3 March 2002

1. Impression copings on the implants are seated and secured them with guide pins.
2. Opening is prepared on the buccal side of the tray near the implants Holes are prepared in the
tray to allow head of the guide pins protruded without contracting the tray.
3. Light bodied Impression Material is used to record the area around the remaining teeth.
4. The tray is replaced in the mouth and ensures that guidepins are visible through the holes on
the top of the tray.
5. Injection type impression material (Kerr) is placved through the side opeing until the materials
flow from the holes at top of the tray.
6. After the impression get set impression containing the copings are removed.
RETRIEVAL TECHNIQUE FOR FRACTURED IMPLANT-SCREW
JPD Nov 2001 Vol 86 No 5 Russell, T. Williamson Fonda. G. Robinson
In implant prosthodontics abutment screws and prosthetic retaining screws both have the potential for 4.
Screw loosening and Retightening may lead to subsequent # of abutment screws or prosthetic retaining
screws.
If an abutment screw 4 above the head of the implant, haemostat may be useful to grasp the broken
screw but if the screw # below the head of the implant then other method is applicable.
After the prosthesis or abutment is removed the screw hole is vigourously flushed with an air/water spray
from a 3-way syringe.
An airstream is used to dry the screw hole.
A sharp 1/4th round bur in a high speed handpiece is activated, and lightly touched to the exposed site of
# screw.
The objective is to have spinning bur blades contract the metal surface of the screw so the screw will spin
out of the screw hole.

A TITANIUM AND VISIBLE LIGHT POLYMERIZED RESIN OBTURATOR
JPD APRIL 2002 Vol 87 No 4
BENITO RILO URBANA SANTANA
Patients with intraoral defects due to partial maxillectomy for neoplasm form a highly hetrogenous
group need the most appropriate protocol for rehabilatation.
The presence of absence of natural teeth together with the size of the resection and the extent of soft
tissue loss have major implication for prosthesis design.

When natural teeth are available as abutment, a metal frame work is indicated typically made up of
(Co-Cr).
But comercially pure titanium has been in use for more than a decade approx. weighs 40% lighter than
(Co-Cr) frame work.
Proposed approaches for reducing the weight of these components have included the use of alternative
materials.
Because the tissue surrounding the defect change rapidly after surgery as well as during or after
radiotherapy, repeated adjustment is necessary.
The use of visible light polymerized Resin (VLP) not only reduces the weight but also improves oral
hygine since these resins demonstrate a much lower porosities than conventional auto polymerized.
Advantages : 1. decrease weight
2. increase facilities in fabricatin
3. increase facilities in adjustment.
MAXILLOFACIAL MATERIAL
An ideal material for Maxillofacial Restoration is ideally yet to be achieved despite the research expended
in the post few years.
The formulative approach with chemical Acrylic analog had a brief period of product development for
maxillofacial prosthesis.
Series of Co-polymers for methylmethacrylate have been introduced. Another is Ter polymer for the use
as a synthetic acrylic latex to form a skin over elastomer scaffolding.
Polydimethylsiloxane and various proprietary silicones are premost in clinical usage, particularly where
flexible tissue anatomic reconstructing is needed.
There are two basic types
(A) RTV - Room Temperature Vulcanizing (B) HTV - Heat Vulcunizing.
Some new structural polymers
1. Silphenylene Elastomers
2. Chlorinated Polyethylene.
COMPARISON OF TITANIUM AND COBALTCHROMIUM REMOVABLE PARTIAL DENTURE CLASP
Despite some evidence of casting defects the flexibility and the long term retentive resiliency of the
clasps suggest that titanium and titanium alloys are suitable for Removable Partial dentures specially in
the cases of deep undercuts.
Titanium has modulus of elasticity that is lower than that of Cobalt Chromium (Co-Cr) which increase its
resilience.
This property allow them to place in deeper undercut areas.
Ti-6AL-4V clasps for a 0.75mm undercut showed the least amount of work hardening and permanent
deformation, as small change in retention these clasps was consistent through out the years of clinical
use.
SEM examination of cross sections of Ti-6AL-4V clasp revealed that cracking was confined to the
surface layer and thus not like to cause any permanent deformation.
OPTICAL SURVEYING OF CAST FOR REMOVABLE PARTIAL DENTURE

Surveyors are necessary to determine the path of insertion of RPD.
Basically surveyor consist of a mobile platform, on which cast is placed and titled in different directions
respect vertical marking red.
Because of this position the marker is always parallel to its previous position as it move from one part of
the cast to other.
Using same principle cast can be surveyed by parallel light beams instead of the vertical rod.
The cast is placed on a movable table and surveyed in a dark room using parallel light beams.
The survey line is the border of the light and dark zone.
The geometric location of a conventional lead marker survey line and the one created by light beams are
in the same location.
After securing most favourable path of insertion for design of RPD the table of the surveyor is fixed in
position and survey lines are marked with lead marker.
Advantages
Change of survey lines and undercuts can be easily inspected for different position of the cast.
Slight undercut that cannot be measured by lead marker can be observed by optical surveying.
IMPROVEMENTS IN ALGINATES
l. Flavour Added - Spearmint / Mango / Mint
2. Rapid Set - Hydrogum Normal Set - Neocolloid
3. Dust free - Aliginoplast
4. Chromatic Alginate - TRIALGIN / KROMALGIN
5. Paste form - (Catalyst + Base)
6. Alginate Containing Microbials
1) Chlorhexidine
2) Quantanary Aluminium (Components)
IMPRESSION MATERIAL MIXING INSTRUMENT
PENTAMIX 2

Faster dimension for perfect mixing. System for automatic mixing and dispensing.
Advantages : a) Top quality mix in less time b) More flexible mix
c) Homogenous void free mix
d) Direct filling of syringes and Trays
When changing impression materials cartridges have to be changed and change penta mixing tip.
Impregnum
TM
Penta
TM
Soft Heavy Body/Light Body Impression Material
With Impression materials, the better the detail, the more accurate the final restoration.
Introducing Impregnum
TM
and Penta
TM
Soft Heavy Body/Light Body Impression material, a precision
polyether impression material that is accurate and hydrophillic, resulting in cut standing details even in
moist environment, right from start of mixing.
The Soft Technology makes the material less rigid for easier removal from the mouth while improving the
taste for better patient's satisfaction.
Intrinsic presetting hydrophilicity helps capture and reproduce outstanding details.
INVESTING MATERIALS
CARBON FREE, PHOSPHATE BONDED INVESTMENT
(A) GC FUJIVEST SUPER
A carbon-free phosphate bonded investment for precision castings of precious semiprecous and Pd base
alloys for use in both quick heating and slow heating procedure.
Advantages : *a) With special attention to complicated implant casting
*b) Carbon free creamy consistency
c) High fluidity and wettebility
*d) Very smooth surface
*e) Controllable expansion
(B) GC FUJIVEST II
A carbon free phosphate bonded investment for precision crowns and bridge castings of all dental alloys
for use in both quick and slow heating process.
Advantages : a) Carbon free
b) High fluidity + Wettebility
*c) Controlled setting + Thermal Expansion
*d) Smooth surface
e) Detailed Reproduction
f) Ringless Technique possible in both slow and quick heating process.
(C) GC Stellavest
Same as GC FUJIVEST 11
BITE REGISTRATION MATERIAL
GC EXABITE
Polyvinyl siloxane silicone impression material with properties specially adjusted to the requirement of
Bite Registration.
Advantages
1. Fast reliable mixing and application directly from catridges.
2. Thixotropic properties with ideal balance between stability and fluidity. 3. Extremely
accurate reproduction of details.
RAMITEC PENTA
Polyether impression material for Bite registration for automatic mixing and dispensing in PENTAMIX
SYSTEM.
Advantages
1. Automatic mixing and dispensing with PENTAMIX unit.
Absolutely homogenous and void free mixing at the touch of a bulton.
DIMENSION BITE 60 seconds
Extremely foot setting Addition-cured silicone with high ultimate hardness.
Advantages
l. Extremely short ST of 60 secs.
2. Automatic mixing in new GARNAT 2 SYSTEM.
FLASKING STONE
GC ADVASTONE
Specially designed for flasking techniques in denture fabrication
Advantages : *a) Minimal S. Expansion
*b) Comfortable WT
*c) High compressive strength
*d) Yet diminished strength after setting for easy devesting
e) Excellent Accuracy
GC STONE GLAZE LIQUID
Stone Glaze liguid specifically designed for the surface t/t/ of GC Fujirock EP plaster/white
Advantages :
a) Better visibility of details
b) First class presentation of prosthesis
c) Bio compatible.
DISOLVING AGENT FOR DENTAL STONE AND PLASTER
Agent for dissolving dental stone and plaster residues by immersion
Advantages : High disolving capacity
Suitable for stone + Gypsum Bonded Investment
CEMENTS
RESIN REINFORCED GLASS-IONOMER LUITING CEMENT
GC FUJI PLUS
Due to complination of Resin + GIC this material provide wide varity of application possibilities.
Indicated for luiting all kinds of metal and Acrylic/Resin crowns, inlays, onlays and bridges as well as
luiting of Porcelain ceramic inlays.
Advantages : Easy mixing and handling like conventional cement.
Similar machanical properties to Resin cement.
*Elimination of complex and moisture sensitive bonding procedure.
*Good adhesion to metal, resin and silanated porcelain.
*No post operative sensitivity.
*Optimal Marginal Seal.
*Radiopacity.
GC FUJI PLUS EWT
Luiting of long span Bridges, Combination work and luiting of several restoration.
One step extended Working Time.
Advantages : Same as GC FUJI PLUS only l min extended Working
Time help in easy removal of excess material.
TWINLOOK
Light/Self curing luiting composite systems.
INDICATION
l. Inlays, Onlays and laminate veneers
2. Adhesive bridgework.
ADVANTAGE
Cures readily and thoroughly due to light and redox curing.
Easily and quickly polished.
iscosity is perfect for placing multiple surface inlays.
DISINFECTING SOLUTION
COEZYME
Dual enzymatic Detergent Concentrate.
Advantages
Co enzyme is highly concentrated dual enzymatic detergent.
The ionic surfactant in Coezyme help the powerful solution to access and clean hard-to-reach areas.
The synergistic enzymes dissolve and lift
proteins and the low sudsing neutral pH
detergent component remove the dissolve particulates.
DENTURE COMFORT WITH STERADENT
Steradent has launched Steradent Denture Comfort Fixative Cream.
As well as ensuring secure and comfortable hold of the Dentures, the cream includes camonite, claimed
to help prevent gum inflamation.
The current range of steradent products include.
Steradent Tripple action original and Fresh Cleaning Tablets Steradent Extra length.
GC Fit Checker
Easy flowing white condensation silicone material for location of pressure points of dentures and for
checking accuracy of Crown and Bridges.
Advantages : 1. Minimal film thickness
2. Easy to remove from metal and resin surfaces
3. Clearly visible colur contrast to denture resins and metals.
GC Fit Checker II
White Polyvinyl silicone Addition Silicone Material especially for checking pressure points and accuracy of
fit of Crown + Bridges.
Advantages :
Easy application with Thixotropic Consistency
Exact detail Reproduction
3. Optimised colour and Transparency.
GC METAL PRIMER II
This is an Adhesive for Bonding Dental Acrylic to Metal Simple bonding Technique producing a durable
bond between Composite Veneering materials and metal structures without a marginal gap.
Allow safe Adhesive bonding of resin cements to metal restorations of all dental Alloys.
Advantages : *1. Easy fast brush Technique
*2. Reliable Adhesion
*3. No leakage
*4. Resistant to Humidity
5. Can be used with all dental Alloys and Acrylic.
METALOR COMES OUT OF THE SHADE
Metalor unveiled their new digital shade system developed in collaboration with Dent Park Ltd and
Olympus Optical Company at recent FDI.
Metalor have secured the worldwide marketing rights to use software and Hardware developed by Dent
Park, bringing together an advanced olympus digital camera to address the complicated subjects of
shade selection and communication in dentistry.
The product is new generation of Hardware and Software which combine to accurately measure the
shade, shape and contour of natural tooth, transmitting the data electronically from dental office to dental
laboratory without compromising the shade information.
GC ACRON MC
GC Acron MC is an microwave curing Denture Resins in which polymerisation takes place in a microwave
at much shorter time.
This is supplied same as powder and liquid form. Advantages
* 1. 3 minutes polymerization time in a standard household microwave oven.
*2. Uniform polymerisation even in thick sections.
*3. Excellent Dimensional Stability.
*4. Excellent fit to the tissue surfaces.
* 5. High Surface Hardness.
*6. High Strength.
*7. Colour stability. GC PATTERN RESIN LS
GC Pattern Resin LS is a lose shrinkage modeling Resin use for modelling of metal casting plates,
telescopic and Konus crown, adhesive bridges palatal and lingual bars, connectors etc.
Specially developed on brud-on-Technique. Advantages
1. High precision
2. Minimum shrinkage during polymerisation 3. Dimension stable
4. High Hardness and strength 5. Short ST
6. Modelling directly on the working model.
COMPOSITE RESTORATIVE MATERIAL UNIFIL F
This is a new generation Composite Restorative Material having an unique property of Fluoride releasing
action.
Coming in shades of A2 and A3.5 Advantages
l. Unifil is a light curved, radiopaque fluoride releasing hybrid Composite for all anterior and
posterior restoration.
2. It is a non sticky, easy to place, sculpt and pack composite and is BISGMA free.
3. Consist of silans coated fluoaluminosilicote glass fillers.
4. Benefits from significant fluoride and stronium in release to strengthen, protect and remineralize
tooth structure.
I DENTAL DIAMOND BURS MADE WITH NEW TECHNOLOGY JPD JULY 1999 Vol 82 No 1 CFM
BORGES DR Med Dent Conventional Diamond Burs shows several limitations such as heterogenicity of
grain shape, the difficulty of automation during fabrication, the decrease of cutting effectiveness due to
repeated sterilization.
An additional short comming may be represented by the potential release of Niz+ ions from the metallic
binder into body fluids.
A new diamond rotative instrument made of continuous diamond rotative instrument mode of a
continuous diamond film obtained by Chemical Vapour Deposition (CVD).
Cutting Tests were followed by SEM examination and Electron microprobe analysis (EMA) to trace
mettalic residue both on the surface of the bur and the substrate.
EMA demonstrate that the metals of Ni, Cr, Si and Fe were present in the metallic binder matrix of
conventional bur and could be smeared on the surface of the substrate.
SEM showed that significant loss of diamond particles occured during cutting.
On other hand no discreate particles sheared off the CVD bur.
The new CVD burs not only proves to be more efficient in cutting, ability and longevity but also decrease
risk of metal contamination.
Posted by Indiandentalacademy ida at 3:47 PM
DIE MATERIALS AND TECHNIQUE OF FABRICATION



CONTENTS:

E INTRODUCTION
E MATERIALS USED FOR FABRICATION OF DIE
E BASIC REQUIREMENTS OF DIE MATERIALS
E GYPSUM PRODUCTS
E ELECTROPLATED DIES
E SILICO PHOSPHATE CEMENT
E EPOXY RESIN
E METAL SPRAYED DIES
E CERAMIC DIE MATERIALS
E TECHNIQUE OF FABRICATION OF STONE DIE
E CONCLUSION
E REFERENCES


Introduction
Once the tooth preparation is completed, it is necessary that it be
replicated so that a wax pattern can be developed. Although it is possible to
make the wax pattern directly in the prepared tooth. Such techniques are difficult
to master. Also direct wax patterns are difficult to make it the margins of the
finished cavity preparation extended below the gingival crest or it visibility is
limited. Further more the temperature of the oral cavity tends to make the wax
pattern more susceptible to determination. Also instrumentation for direct wax
pattern is difficult such problems can be eliminated it the wax pattern is fabricated
on a removable die with the removable die finish line margin of the wax pattern
can be carved better.
Defination
A die is a working replica of a single tooth or several teeth.
Materials used for fabrication of Die:
1. Gypsum products
2. Electroformed dies
- Electroplated copper
- Electroplated silver
3. Epoxy resins
4. Silicophosphate cement
5. Amalgam dies
6. Ceramic die materials
7. Metal sprayed dies
The selection of one of this is determined by the particular impression material in use and by the purpose
for which the die is to be used.
Basic requirements of die materials
1. Ability to reproduce fine detail and sharp margins.
2. Dimensional accuracy and stability should show little dimensional change on
setting and should remain stable.
3. Mechanical properties
a) High strength to reduce the likelihood of accidental breakage.
b) Abrasion resistance so that the die can withstand the manipulative procedures
during carving of wax pattern.
4. Compatibility with impression materials: There should be no intraction between
surface of impression and die.
5. Good colour contrast with other materials being used for ex. Inlay wax or
porcelain.
6. Economical
7. Easy to use

1. Gypsum Products
The most commonly used die materials are Type IV (dental stone, high
strength) and Type V (dental stone, high strength) improved stones.
Advantages
1. Generally compatible with all impression materials.
2. Have the ability to reproduce fine detail and sharp margins.
3. Dimensional accuracy and stability are good.
4. Produces consistent results.
5. Easy to use.
Disadvantages
Susceptibility to abrasion during carrying of the wax pattern especially with
Type IV Gypsum die.
Manufacture of Type IV and V Gypsum materials
Die materials are based on outoclaved calcium sulphate hemihydrate plus
additives to adjust the setting time and pigments for colour contrast.
To manufacture gypsum die material, calcium sulphate dehydrate is boiled
in 30% solution of calcium chloride or magnesium chloride. The hemihydrate
particles thus obtained are least porous.
Gypsum products used in dentistry are tuned by driving off part of the H
2
O
of crystallization from calcium sulphate dehydrate to form calcium sulphate
hemihydrate.
2 CaSO
4
. 2H
2
O (CaSO
4
)
2
H
2
O + 3H
2
O
dehydrate heat hemihydrate
Setting reaction
When calcium sulphate hemihydrate in the form of high strength stone is
mixed with water a chemical reaction takes place and the hemihydrate is
converted back to the dehydrate form of calcium sulphate. This is an exothermic
reaction.
CaSO
4
. H
2
O H
2
O CaSO
4
. 2H
2
O + Heat
The 1
st
stage in the process is that the H
2
O becomes saturated with
hemihydrate which has a solubility of around 0.8% at room temperature. The
dissolved hemihydrate is then rapidly converted to dighydrate which has a
solubility of 0.2% since the solubility limit of dehydrate is immediately exceed it
begins to crystallize out of solution the process continues until most of the
hemihydrate is converted to dehydrate.
The crystals of dehydrate are spherilite in nature and grow from specific
sities called nuclei of crystallization. These may be small, particles of impurity
such as unconverted gypsum crystals with in the hemihydrate powder. Diffusion
of the Ca
2+
and SO
4
2-
ions in to these nuclei also appears to be important.
As the dehydrate crystallizes more hemihydrate dissolves and the process continues.
Manipulation
a) Storage: In closed containers to prevent reaction with moisture from the
atmosphere which can cause formation of the dehydrate which can accelerate
the setting time.
b) Correct water / powder ratio
To attain maximum strength and resistance to abrasion it is necessary to
use the current H
2
O to powder ratio when preparing dies made of gypsum
products. Reducing or increasing w:p ratios, the powder to liquid ratio below that
recommended by the manufactures result in not only reduced strength and
abrasion resistance but also a deviation from the expected setting expansion.
The w/p ratio for gypsum die materials is 0.22 to 0.24 i.e. 100 gm of material
is mixed with 22 ml of water.
c) Hardening solutions
Commercial hardening solutions composed of H
2
O, 30% collided silica and
modifiers may be wed in place of H
2
O. The amount of solution is less if H
2
O were
used alone because surface active modifiers in the hardener allow the powder
particles to be more easily wetted by H
2
O.
Use of hardening solutions affects the hardness and setting expansion of
gypsum die increase in the hardness of high strength stone dies poured against
impressinos are 20% for poly silicons 20% for polysulphide, 70% for agar and
110% for polyether. High strength stones mixed with hardner show a slightly
higher setting expansion of 0.07% as compared with 0.05% for mixes with H
2
O
alone scraping resistance is also improved high strength stones mixed with
hardener.
Spatulation: Measured amounts of water and powder are added to a flexible
rubber mixing bowel. The water is dispensed in the bowl first the powder is
added and allowed to settle in to the water for approximately 30 sec. This
minimizes the amount of air incorporated in the mix during the initial spatulation.
A spatulate with a stiff blade is used. Spatulation is carried on by stirring the
mixture vigorously and at the same time wiping the inside surface of the bowl
with the spatula to be sure that all the powder is wet and mixed uniformly with
H
2
O mixing time of one minute is usually sufficient to give a smooth lamp free
slurry.
Use of an automatic vibrator helps the slurry to flow well into the impression and helps to
eliminate the air bubbles over vibration should be avoided as this may cause distortion of some
impression materials.
The time and rate of spatulation have a definite effect on the setting time and expansion with in practical
limites increase in the amount of spatulation will shorten the setting time. The setting expansion is also
increased by increase in the rate of spatulation.
Setting process: Initially a mix of hemihydrate and H2O can be poured.
Next the material becomes rigid but not hard this is called initial setting. At this
stage the material can be carved but not moulded.
The final set follows when the mix becomes hard and strong. However at this
stage the hydration reaction is not necessarily complete nor has optimum
strength and hardness necessarily been achieved.
Heat is given out during setting since the hydration of the hemihydrate is
exothermic.
Dimensional changes also takes place. A setting expansion of 0.05 0.3% is
observed for dental stones. This is caused by the outward thrust of the growing
crystals of dehydrate. If the material is placed under water at the initial set stage
a greater expansion on setting occurs. This is hygroscopic expansion.


Properties
1. Initial and final setting time
The initial setting time is also called the working time. During the working
time the material can be mixed and poured in to the impression.
As the chemical reaction proceeds more and more dehydrate crystals
form. The viscosity of the reacting mass increase rapidly and the mass no longer
flows into the fine details of the impression. At this point the material has reached
the initial setting time and should no longer be manipulated.
Initial setting time can be defected clinicaly by a phenomenon known as
loss of gloss.
The initial setting time must occur with in 8-16 minutes from the start of the
mix. The final setting time is defined as the time at which the material can be
seperated from the impression without distortion or fracture. The time at which
the chemical reaction is practically completed. This is usually measured as the
time taken for the setting material to become sufficiently rigid to withstand the
penetration of a needle of known diameter under a lesser load. Two such pieces
of apparatus or known as vicat and gillmore needles.
i) Control of setting time factors under the control of manufactures
Concentration of nucleating agents in the hemihydrate powder increase
nucleating agents decreasing setting time. Ex. Dehydrate particles.
Addition of accelerators and retarderes accelerators used are K
5
SO
4
and (CaSO
4
)
H
2
O crystals. Retarders 2% Borax.
Grinding of gypsum product during manufacture accelerates the setting (grinding
increase the surface area of the hemihydrate exposed to water. These increases
the rate of solubility of hemihydrate).
ii) Factors under the control of operator
Water / powder ratio.
Increase w/p ratio retards the setting by decreasing the concentration of
nuclei of crystallization.
Mixing time: An increase in the mixing time an accelerates the set. Mixing can
break up some of the formed dehydrate crystals these forming more nuclei of
crystallization.
Colloidal septems such as blood, saliva can retard setting time.
Temperature
Temperature variation has little effect on the setting time on increase from
a room temperature of 20C to a body temperature of 37C. The rate of the
reaction increase slightly and the setting time is shortened. As the temperature is
raised above 37C the rate of reaction decrease and the setting time is
lengthened.

2. Reproduction of detail
Gypsum dies do not reproduce surface detail as well as electroplated or
epoxy dies because the surface of the set gypsum is porous on a microscopic
level. The porosity of the set gypsum causes the surface to be rough compared
with other die materials.
The use of a hardener solution instead of water during mixing may reduce
surface roughness. Air bubbles frequently are tuned at the interface of the
impression and stone because the freshly mixed gypsum does not wet some
impression materials well.
3. Compressive strength
The strength of gypsum material is directly related to the density of the set
mass because high strength dental stone is mixed with the least amount of H
2
O it
is the densest of the gypsum materials and the strongest. The 1 hour
compressive strength of high strength dental stone is 4980 psi.
4. Tensile strength
It is 330 psi it is a brittle material and is considerably weaker in tension
than in compression.
5. Hardness and abrasion resistance
The surface hardness is related to the compressive strength. The higher
the compressive strength of the hardened mass the higher the surface hardness.
The hardness of gypsum die material is 3 times that at an epoxy die but
hart that of an electroplated die. Though it is the most resistant of the gypsum
materials to abrasion.
The use of a hardening solution in place of water may increase hardness
and improve abrasion resistance as a result of a smooth surface.
6. Dimensional accuracy
All gypsum materials show a measurabe liner expansion on setting. The
expansion result from the growth of the CaSO4 2H2O (dehydrate) crystals and
teir impingement on one another. High strength stone has a setting expansion of
about 0.01% to 0.08%.
This expansion of the die material compensates for the casting shrinkage
of the metal.
Recent developments
Two techniques have been investigated to produce dental stone with
improvement in abrasion resistance and other mechanical properties.
a) Impression of the gypsum by a polymer like polyether, polystyrene, acrylic or
epoxy resin. A solution of 10% polystyrene in amyl acetate can be painted on to
the surface of the die the excess blown off and then allowed to dry for about 5
min mineral oils like Derusil can also be used.
b) Incorporation of setting agents such as lignosulphonates can reduce the H
2
O
requirements of a stone and enable the production of a harder, stronger and
more dense set gypsum.
These aditives retarded the setting time and increase the setting
expansion (Both of these effects can be overcome by the incorporation of
K
5
SO4).
Die stone- Investment combination
In this the die material and the investing medium have a comparable
composition. A commercial gypsum bonded material called divestment is mixed
with colloidal silica liquid. The die is made from this mix and wax pattern
constructed on it then the entire assembly (Die + Pattern) is invested in a mixture
of divestment and water, thereby eliminating the possibility of distoration of the
pattern on removal from the die or during the setting of investment. The setting
expansion of the material is 0.9% and thermal expansion is 0.6% when heated to
677C. because divestment is a gypsum bonded material it is not recommended
for high fusing alloys like metal ceramic restorations. It is highly accurate
technique for conventional gold alloys especially intracoronal preparations.
Divestment phosphate is a phosphate bonded investment that is used in
the same manner as divestment and its suitable for use with high fusing alloys.
II. Electroplated dies
Metal dies can be made by copper plating compound impression or silver
plating rubber base impression when a die is made in this manner the process is
referred to as electroplating.
Advantages of electroplated dies
1. With materials such as gypsum products dimensional change may occur as the
die material sets. No such expansion or contraction occur with electroformed dies
unless the impression material shrinks before the initial plating is deposited.
2. Electroformed dies have higher strength hardness and abrasion resistance.
3. Allows satisfactory finishing and polishing of metal restoration on the die.
Disadvantages
1. Time consuming
2. Special equipment is needed
3. Not compatible with all impression materials.
Copper plating
Copper plated dies are most commonly made from compound or addition
silicone rubber impressions.
The popularity of copper plated compound dies began in the early 1930s.
The first step in the procedure is to treat the surface of the impression
material so that it conducts electrically. This process is referred to as metallizing.
The surface of the impression is rendered conductive by coating it with fine
particles of copper or graphite.
The coated impression is made the cathode (-ve electrode) and electrolytically
pure copper plate is attached at the anode. Both anode and cathode are
immersed in an electrolytic solution continuing an acidic solution of copper
sulphate (about 250 gIL) together with organic constituents like alcohol or phenol.
Which are believed to increase the hardness of the deposited metal.
A current is passed of 15 miliampher/ cm2 of cathode surface for approximately
10 hours. This cause slow dissolution of the anode and movement of copper ions
from anode to cathode this plating the impression.
The impression that contains the electrotuned die surface is then filled with dental
stone. When the stone hardens it is mechanically locked to the rough interior of
the electroformed metal shell. The impression material is then removed to
provide a die with greater surface hardness and resistance to abrasion than that
of gypsum.
Silver plating
Indicated for polysulphide polyether, and silicon rubber impression
materials.
The process of silver plating is similar to that of copper plating but a
smaller current of 5 miliamphes is sufficient.
The impression is coated with silver or graphite powder is made the cathode.
Anode is silver plate.
The electrolyte is an alkaline solution of silver cyanide (30 gm) with other
constituents like potassium (60 gm) cynide and potassium carborate (45 gm) in
distilled water (1000 ml).
Precaution: care must be taken to avoid the addition of acids to the cyanide
solution. Which can cause the release of cyanide vapor a death chamber gas.
Copper plating should not be done in the same area. In which silver plating is done because the risk of
contamination the silver plating solution with acidic copper plating solution.
Amalgam Dies
They are made by packing amalgam into impression made of impression
compound.
Advantages
Dies made of amalgam exhibit superior strength resistance to abrasion
and reproduce fine details and sharp margins.
Although a material of choice a number of years ago it has been largely
replaced by electroplated dies. Which are also resistant to abrasion the property
of amalgam dies has declined for a number of reasons.
1. It can be packed only into a rigid impression like that of impression compound.
2. (Because of the tech necessary to produce a sound die) dimensional accuracy
may vary from one die to the next.
3. Time required for fabricating an amalgam die is lengthy. Although the die
packing procedure may take only 30 minutes amalgam requires 12 to 24 hours of
hardening before it can be manipulated as a die.
4. It has high thermal conductivity and so can cool a wax pattern rapidly which may
lead to distraction of the pattern. This can be overcome by warming the die.
IV. Silico phosphate cement
It is similar to the filling and cementing material. The powder is a mixture of
silicate powder and zinc oxide liquid contains phospheric acid.
Advantages: Strength and surface hardness are superior to those of die stone.
Disadvantages: This material contracts during setting and may be dimensionally
inaccurate. There is loss of water on standing since the viscosity of these
material is relatively high. Presence of surface voids can occur.
V. Epoxy resin (polymers)
These are either self curing acrylic materials for Eg. Epoxy resins, poly
yesters and Epimines or polymeric materials with fillers (either metallic or
ceramic fillers).
Advantages
1. More abrasion resistance.
2. Less brittle than die stones.
3. Can be carved at room temperature.
Disadvantages
1. Shrinkage on polymerization
2. Less dimensional stasility
3. Expensive.
Epoxy die material can be used with polyether, polysulphide or silicone epoxy to which filler may be
added.
CH
2
CH R CH CH
2

O O
The hardner is a polyamine that when mixed with the resin for about a
minute causes polymerization. The hardness is toxic and should not come into
contact with the skin during mixing and manipulation of the unset material.
Properties
1. Working time 15 min.
2. Setting time 1 to 12 hours depending on the product.
3. Knoop hardness number is 25 KHN 15 less than that of high strength stone (77
KHN).
4. Compressive strength after 7 days is 16,000 psi.
5. Abrasion resistance is superior to stone dies.
6. Dimensional change due to shrinkage during polymerization is between 0.03%
and 0.3% and continues to occur for upto 3 days.
7. Epoxy materials are very viscous when poured hence porosity can occur.
8. Epoxy resin cannot be used with water containing agar and alginate materials
because water retards the polymerization of the resin. they are compatible with
polyether, polysulphide or silicon impression materials.
VI. Metal sprayed dies
A bismuth tin alloy which melts at 138C can be sprayed directly on to an
impression to form a metal shell which can than be filled with dental stone.
Advantage: A metal coated die can be obtained rapidly from elestomeric impression materials.
Disadvantages: The alloy is soft, care is helded to prevent abrasion of the die.
VII. Ceramic die materials
Two ceramic die materials are available
1. A material for the production of dies on which porcelain restorations are to be
fabricated without the use of a platinum foil matrix. To form the dies heating to
over 1000C is necessary.
2. A ceramic material supplied as a powder and liquid and mixed to a putty like
consistency. After 1 hour the material is removed from the impression and fired
at 600C for 8 min to produce a hard stone die.
Technique of fabrication of stone die
After the impression has been removed from the patients mouth it is
washed under running tap water blown dry inspected and disinfected.
The dowel pin should be positioned correctly over the prepared tooth with
the help of pins and sticky wax. Their correct location and orientation is
important. For example placing the head of a dowel too deep in the impression
may weaken the die positioning the dowel at an incorrect angle may make die
removal impossible.
1. Using the right w/p ratio mix Type IV or V stone with water.
2. Pick up a small amount of stone with a suitable brush or instrument and place it
in the most critical area.
Usually the occlusal aspect of narrow preparations or immediately adjust to the sulcus area. Bubbles will
be trapped it to much stone is added abruptly.
During powering the tray should be held on a vibrator.
3. Slowly release the stone into the preparation along the axil walls by tilting the
impression and guiding the material with the instrument. Be absolutely sure that
the stone flows onto the margins of the preparation without trapping any air
bubbles.
4. Place a second amount of stone on top of the first and continue with a third and
so forth until the preparation is completely filled the rest of the impression is then
filled and the head of the dowel must be covered with stone.
5. Place retentive devices in areas where there are no dowels so the two layers of
stone will not separate in the wrong places.
6. Allow the stone to set.
7. Inspect the area where separation is required. Smooth it as necessary and cool
it with a separating medium by 10% sodium silicate. Then pour another layer to
act as a base and retain the dowel. This second layer should not cover the tip of
the dowel to facilitate its retrieval later.
8. When the cast is separated from the impression it must be inspected for voids. It
found to be satisfactory it is ready for sectioning and trimming.
9. Trim the buccal and lingual sulcus area adjacent to the removable section first
so the die will separate cleanly.
10. Mark the position of each saw cut which should be parallel to the dowel with a
pencil.
11. Carefully insert the saw blade between the preparation and the adjacent tooth
being sure that neither the margin nor the proximal contact is damaged.
The cut must pass completely through the first layer of stone once the saw
cuts are made the dies can be separated out and are ready for trimming for
waxing.
Upon completion of die trimming the dies are repositioned in the master
cast and it is verified that they can be repositioned accurately and precisely.
Conclusion
All factors considered the high strength stones (Type IV and V) appear
to be the most successful die materials available with care abrasion during
carving of the wax pattern can be avoided. In case of metal ceramic restorations
gypsum dies can be damaged. Hence a resin or metal die may be prepared










REFERENCES:

Fundamentals of fixed Prosthodontics:Shillingberg.Contemporary fixed
Prosthodontics :
o Stephen F.Rosenstiel
Philips science of dental materials :Anusavice
Dental material -properties and manipulation :
o Craig ,powers


Notes on dental materials- E C Combe
Restorative dental materials- Robert G Craig
Philip Duke et al ;Physical properties of type IV gypsum, resin containing
and epoxy die materials JPD April 2000 vol 83, no. 4 p-466-73.
Jacinthe M et al in 2000 dimensional accuracy of an epoxy resin die
material using two setting methods. JPD March 2000 vol 83 no3 p 301-305


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ACADEMY
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Friday, August 16, 2013
Dental waxes
DENTAL WAXES


Contents:

Introduction.
Uses of wax in dentistry.
Components of dental waxes.
Properties of waxes.
Classification of waxes.
Description of individual waxes.
Impression procedures with impression waxes.
References




Introducti on:

Originally applied to natural occurring esters of fatty acids &
monohydri c al cohol s, the term now i s used for both naturall y occurring &
manufactured products resembling esters. They have
Dull luster
Soapy or greasy texture
Soften gradually on heating before forming a liquid

Uses in Dentistry:
Inlay pattern
Boxing of i mpression
Base plate
Casting wax
Utili ty wax
Sticky wax
Correcti ve i mpressi on
Bite registrati on

Dental waxes are combinati on of various types of natural & synthetic
waxes, gums, fats, fatty acids, oi ls, resins & pigments compounded to
provide desired physical properti es.





Components of dental waxes:

Natural Waxes Synthetic Waxes Additives
MINERAL
a) Paraffin
b) Montaux
c) Barnsdhal.
d) Ozokerite
e) Microcrystalline

a) Aerosol OT
b) Castor wax
c) Flexowax C
d) Dura wax
FATS
Stearic acid
PLANT
a) Carnauba
b) Ouricury
c) Candelila
d) Japan wax
e) Cocoa butter
NATURAL RESINS
a) Copal
b) Dammar
c) Sandrac
d) Shellac

INSECT
Bees wax
SYNTHETIC RESINS
a) Polyethylene
b) Polysterene

ANIMAL
Spermaciti



Natural Waxes
Two main group of organi c compounds in waxes are-
Hydrocarbons
Esters
Some waxes contain free al cohols and acids as well.

Syntheti c Waxes
Compl ex organi c compounds of varied chemi cal composi tion
Use in dental formulations is li mi ted
More refined than natural waxes

Types
Pol yethyl ene waxes
Pol yoxyethyl ene glycol waxes
Halogenated hydrocarbon waxes
Hyrogenated waxes
Wax esters

Composi tion
Polyoxyethylene waxes are polymers of ethyl ene gl ycol s. They have li mited
compatibili ty wi th other waxes. They have mel ting temperature. From 37 C
to 63C. but functi on as pl astici zers and toughen fil ms of wax. Others are
produced by reaction with natural waxes.

Properties
Mel ting range
Thermal expansi on
Mechani cal properti es
Flow
Residual stress
Ductil ity

Melting Range
Have a range as they contain several types of mol ecul es, each having a
range of mol ecul ar weight.

Thermal Expansion
Linear co- effi ci ent of thermal expansion change in length per unit
ori ginal length with 1 change in temp. Waxes have the largest co - effici ent
of thermal expansi on among all dental materi als. Weak secondary valance
forces are easily overcome by thermal energy, more so in mineral waxe s
than plant waxes. Many waxes exhibi t at least 2 rates of thermal expansion.
Change in rate occurs at transi tion points. At these points the internal
structural parts becomes become freer to expand. Because the ingredi ent
waxes undergo transition that do not coincide with one another, inlay waxes
exhibi t more than two changes in rate of expansion.

Mechanical Properties
Elasti c modulus
Proportional li mit
Compressive strength
All are l ow when compared to other materials

Elasti c Modulus
Elasti c moduli of carnauba wax is hi ghest
Bees wax l owest
Decreases wi th i ncrease in temperature.
Inlay wax (si mul ates a mi xture of 75% paraffin & 25% carnauba wax) 760
to 48. 2 MPa between 23C & 40C



Application
Modulus ratio for inl ay and soft green casting wax i s 7:1.
To avoid non uniform distorti on of the wax pattern during hygroscopi c
casting procedure use inlay wax (l ess expansion) for lateral wal ls and soft
green for occlusal surface.

Proporti onal Limit/ Compressi ve Strength
Decrease wi th increase in temp.
E. g. - P. L. for inlay wax decreased from 4. 82 to 0. 21 from 23C to 40C.
C. S. 82. 7 to 0. 48 MPa

F low
Resul t of sl ippage of mol ecul es over each other. In liquid state of wax i t is
synonymous wi th viscosi ty below melting temperature. It indi cates the
degree of plasti c deformati on at a given temp. Fl ow depends upon::

1. Temp of wax
2. The force appli ed
3. Ti me for whi ch the force is appli ed
4. Flow is greatly i ncreased as mel ting point is approached

Application
A direct inlay wax should have a high flow just a few degrees above the
mouth temperature so i t is not too hot i n workabl e condi ti on
Should have a no flow at mouth temperature so that i t does not distort
during removal of pattern
Yellow beeswax does not flow extensivel y till i t reaches 38C
At 40C its flow is 7%
Has been used as an impression wax

Residual Stress
Residual stresses always exist in a prepared wax pattern
Presence of such stresses can be demonstrated by comparison of thermal
expansion curves of annealed waxes wi th wax cool ed under compression
& expansion
Extent of change in thermal expansi on depends upon
1. Magnitude of residual stress
2. Ti me &
3. Temp of storage of speci men

COMPRESSI ON
When cool ed under compression, the atoms & mol ecul es are forced together
as compared to when there is no external stress
After cooling & upon load removal, moti on of molecul es is restri cte d
residual internal stresses
On heating the residual internal stresses is added to normal thermal
expansion hence more expansi on.

TENSI ON
Cooling under tension resul ts in molecul es moving away from one another
comparatively
On heating, rel ease of these internal stresses work in a direction opposi te to
thermal expansion
Large internal tensil e stresses may result even in contraction upon heating
Ductili ty
Like flow, ductil ity increases with increase in temperature of waxes
Lower the mel ti ng temperature of a wax, more will be the ducti lity
Waxes made of components having wide mel ting ranges have more ductili ty
With wide range of mel ting point of components, the softening point of
lowest is approached f irst on heating
On further heating this component liquefies, the softening point of next is
approached & so on
Entire wax mass is plasti ci zed & ducti lity increases


CLASSIFICATION OF DENTAL WAXES:

Pattern Wax Processing Wax Impression Wax
1. Inlay Wax 1. Boxing Wax 1. Corrective Wax
2. Casting Wax 2. Utility Wax 2. Bite registration Wax
3. Base plate Wax 3. Sticky Wax

Pattern Waxes
Used to form general pre determined si ze & contour of an artifi ci al
restorati on
Later it is repl aced by more durable material such as cast gold, cobal t -
chrome- ni ckel al loys etc
They exhibi t thermal change in di mension and warpage on standing

I NLAY WAXES ADA 4
Inlays, crowns & bridge units are formed by a casting process that uses lost
wax pattern technique
A pattern of wax is constructed that duplicates shape and contour of casting
After investing & spruing the wax i s el i minated by heating
Typical Composi tion
Paraffin- 60%
Carnauba- 25%
Ceresin- 10%
Bees wax- 5%

TYPES
BY FLOW
1. Hard
2. Regular
3. Soft

F low can be reduced by
Adding more carnauba wax
Using higher mel ting paraffin wax

BY TECHNIQUE
(Revised ANSI/ ADA Sp. No. 4)
Type I - Direct
Type II - Indi rect
Type I - Hard wax used for forming patterns di rectly in mouth
Type II - Softer wax used for indi rect technique


TYPE I
Lower flow at 37C to mini mi ze any distortion on removal from mouth
Working temperature for registering cavi ty detail s is around 45C
Should not be hi gh so as to avoid damage to pulp
Maxi mum linear thermal expansi on allowed
25C 30C 0. 20%
25C 37C 0. 60%
Must be mentioned by the manufacturer so that compensation is made for the
shrinkage from mouth temperature to room temperature.

Insufficient flow of wax caused by insufficient heating causes
Lack of details
Excess stress within the pattern
Excess flow by over heating makes compression of wax difficult
(because of lack of body)
From mouth temperature to room temperature (24C) there is 0. 4 %
linear contraction

TYPE II
These waxes are commercial ly avail able for crown & bridge work and
inlays in the form of
Sculpturing / modeling waxes
Dipping waxes

Sculpturing Waxes
Properties
Low shrinkage due to mi crocrystalli ne structure
Quick to appl y and quick to cool wi th its opti mum melti ng interval
High surface tension
Excell ent carving properti es due to its non-elasti c and hard quality
Wide assortment of colours

Avail abl e as
Universal
Specific purpose like
- occlusal
- cervi cal
- underlay

UNI VERSAL
Ideally suited for qui ck coverage of large areas wi th wax
Low surface tension
Low mel ting poi nt
Small contraction on hardening
Excell ent flow properti es

OCCLUSAL
High strength - no abrading of contact points
High rigidi ty
Can be easily drawn due to its high surface tensi on
Opaque appearance for defined contours and permanent control during
modeling

Difference between occlusal and uni versal wax
Occlusal wax - greater surface tensi on and hi gh rigidi ty
The surface tension all ows ball -shaped drops to form and harden
This eases work considerabl y in the waxing-up phase
The increased strength guarantees preci se modeling
Universal wax - excellent flooding properti es, can be used in many areas

CERVI CAL
Low shrinkage
Parti cularly stable
Can be adapted precisel y and thinl y to the preparation border
Excell ent carving properti es


UNDERLAY
For small undercuts and cavi ty coverage before inlay modeling
Significantly softer than cervi cal wax
Gentl e el asticity
Good adaptati on and carving properties
Very low shrinkage

Dipping Wax
The hotty LED i s a wax dipping pot which permits controll ed temperature
setting and displays the set and the actual value

Advantages
High preci sion via low shrinkage
Opti mum viscosi ty at 8991c (192196f)
Precise-fitting copings wi th an even layer thickness
High stabi lity and elasti ci ty
Contains no acrylic addi tives
Easy to cut off the preparation border

Method:
Preparation:
- Place a thin i sol ating layer on the die surface.
- Build-up of bubbles and streaks are thus prevented

Dipping:
Support your hand comfortably
Do a qui ck dip to just beyond the preparation border
Slowly and evenl y remove the di e from the wax
Just before the tip comes out hold it steady in the pot for a short ti me so
that any excess wax can drip down



Warpage
Patterns distort when all owed to stand unrestrained. It increases wi th
increase in ti me & temp. of storage. Because of the release of stresses
introduced in pattern during formation

Mini mizing Warpage
1. Use higher temperature at ti me of formation l ess force to shape l ess
residual stresses
2. Soften the wax uniformly at 50C for 15 min
3. Warmed carving instruments & di e

Casting Wax
Used for metalli c framework of RPDs
Availabl e as sheets (28 30 gage; 0. 4 0. 32 mm), readymade shapes & bulk
Serve same purpose as inlay wax, differ slightly in physi cal properties
Ingredi ents si mi lar to inlay waxes
Sheets used to establish mini mum thi ckness in some areas of RPD
framework such as palatal & lingual bar
No ADA specifi cation but only a federal specification for i ts properties

Flow
Are to be used on a cast & not in mouth
They have a higher flow as compared to inlay waxes at around 35 37C
35C 10% min
37C 60% max

Working Properties
Slightly tacky so as to maintain posi tion on cast
Pliabl e & readil y adaptabl e at 40 - 45C
Copy accurately against the surface which it is pressed
Shall not be bri ttle on cooling
Must vapori ze at 500C
Be bent doubl e on itself without fracture at 23C

Basepl ate Wax
ADA 24
The basi c use i s to form occlusal ri m on baseplate tray to set teeth for
denture
Establish VD, contour of the denture after teeth setting
Also used for MFPs, patterns for orthodonti c appli ances
Checking arti cul ating rel ati ons in mouth & transferring to arti cul ators
Supplied as sheets 7. 60 x 15 x 0. 13 cm, red, pink or orange in colour
Three types
Type I soft wax for contours & veneers
Type II medium wax for temperate cli mates
Type III hard wax for tropi cal cli mates

Mainl y di ffer in flow with type I I I havi ng least
Requi rements
Linear thermal expansion from 25 to 40C < 0. 8%
Softened sheets shall cohere readil y without becoming flaky or adhering to
fingers
No irri tation to oral tissues
Pigment not to separate on processi ng
No adhesion to other sheets or separating paper on storage

PROCESSING WAXES
Boxing Wax
Aids in forming a plaster or stone cast from an i mpression
Boxing consists of
Adapting a long narrow strip of wax around the i mpression below
peripheral hei ght
Foll owed by a wide strip of wax to form a wax box
Also call ed carding wax: ori ginall y used for placing porcelain teeth in
packing

Federal requi rements:
Smooth glossy surface on flaming
Pliabl e at 21C; retains shape at 35C
Readily adapt to i mpression at room temp.
Seal easil y to pl aster with hot spatul a

Util ity Wax
An easil y workable, adhesive wax for multiple use such as -
Improving the contour of perforated tray for hydrocoll oids
To stabili ze a pontic for a temporary bridge while index is being made

FEDERAL REQUIREMENTS:
Pliabl e at 21 to 24C; workable & easily adaptabl e at room temp.
Flow be between 65% & 80% at 37. 5 C
Tacky at 21 to 24C; adhesion for build up
Colour- green or black

Sticky Wax
Formulated from a mi xture of waxes, resins & other additives
Sticky when mel ted, adheres closel y to the surface
At room temperature fi rm, free from tackiness & bri ttle
Should fracture rather than flow when deformed

Uses
Used pri marily on dental stones and plasters
Used in repai r for holding the metal or resin parts temporaril y

Federal Requirements
Have a dark or vivid colour to distinguish from gypsum products
Shrinkage - < 0. 5 % from 43 to 28C

IMPRESSION WAXES
Impression waxes, though rarely used to record complete impressions, they can be effectively
used to correct small imperfections in other impressions. They are thermoplastic materials, which
flow readily at mouth temperature and are relatively soft even at room temperature.
I mpression waxes are classified as:
1) Corrective impression wax
2) Bite registration wax.
There are no ADA federal specifications for impression waxes.

Composition
Impression waxes consist typically of a mixture of low melting paraffin wax and bees wax in
ratio of about 3:1. In addition it may contain other wax like ceresin and also metal particles e.g.
aluminum or copper particles.
Properties
Melting range
Since waxes have several types of molecules i.e. Crystalline or amorphous of different molecular
weights, they have melting ranges rather then a point. Melting range of impression waxes is
much lower due to additions like resin. Impression waxes flow at mouth temperature under
occlusal load. Heat of fusion is the heat in calories required to convert 1gm of material from the
solid to liquid state at the melting temperature.
Melting temperature:
- Beeswax is 62.8C.
- Paraffin wax is 52C.

Melting range:
- Beeswax is 34-70 C.
- Paraffin wax is 44- 60C.

Flow
The flow of corrective temperature wax and bite registration wax is measured at 37C and is
100% and 2.5%-22% respectively, thus these waxes are susceptible to distortion on removal
from the mouth. Flow as tested by compression of cylindrical specimens is 285% at 37C.

Mechanical Properties
The elastic modulus, proportionately limit and compressive strength is low as compared with other
materials and are dependent on temperature.

Thermal expansion
Impression waxes expand when subjected to a rise in temperature and contract as the
temperature decreased. Paraffin and beeswax, which are the chief constituents of impression
waxes, have different temperature range. Because of the coefficient of thermal expansion is so
great, the impressions should be poured immediately to avoid distortion.
If the impression cannot be poured immediately, they should be stored at or near 0C.Coefficient
of linear thermal expansion is 350-700 x10
-6
/ C.
Advantages
1. Impression wax can be used in thin layers to record the impression surface of the ridge
accurately.
2. It is relatively easy to manipulate.
3. It does not need advanced equipments.

Disadvantages
1. Distortion of the impression wax can occur when the records are stored due to the release of
stresses.
2. It is technique sensitive.
3. It can be used only to record edentulous surfaces,

Applications
1. Corrective impression wax is used as wax veneer over an original impression tocontact and
register the details of soft tissues. It is claimed that it records the mucous membrane
and underlying tissues in a functional state in which movable tissue is displaced to such a degree
that functional contact with the base of the denture is obtained.
Functional impressions materials with thermoplastic waxes for reline procedures:
Historically, wax was one of the first materials used to make impressions of the edentulous
arch. The first commercially available "mouth temperature" waxes appeared in 1930's they
were composed of natural waxes in paraffin base. In late 1950's, thermoplastic resinous materials
became available; e.g. adaptol and stalite plastic impression material. These fluid materials were
designed to record tissue under an occlusal load and accomplish the same objectives as the
waxes.

Technique
When used for a distal extension mandibular removable partial denture that has been in service along
time, provision must me made for correcting the disorientation of the framework that
occurs when resorption of the supporting tissue allows the base to settle. This can be accomplish
by building up the distal third of the base with red modeling compound and seating
framework with pressure on the rests and indirect retainers with a blunt instrument but no
force should be exerted.
Pre impression procedure
Mucosa should be allowed to recover prior to starting the impression procedures. Recovery maybe
facilitated by adjusting the existing prosthesis, instructing the patient to remove the prosthesis at
night and consume a soft diet, surgical intervention or use of a tissue conditioning material.
Impression procedure
The border of the prosthesis must be satisfactory before the impression material is added.
Theimpression will distort too easily if it is not supported 1to 2 mm beyond the border of
theprosthesis. The impression material is placed in a hot water bath or on a hot plate to allow
thematerial to become fluid. The entire denture base is then coated liberally with the fluid
material. A No.2 or larger brush is an acceptable applicator. The prosthesis is placed in the
patient's mouth and the patient is instructed to bring the teeth into light occlusal contact. After 4
to 5 minutes, the impression material will have reached mouth temperature. The patient should
then bring the teeth into maximum occlusal contact guided by the dentist. The border areas are
moulded by the manipulation of the dentist and the patient. The prosthesis is then removed and
inspected for voids, which can be filled with more fluid impression material. The prosthesis is
reinserted in the patient's mouth and again allowed to reach mouth temperature. The patient is
given a stick of chewing gum and instructed to chew the gum on both sides of the mouth for 5
minutes. After disposing the gum the patient rinses with ice water. The prosthesis is removed
and immediately submerged in an ice water bath.
An alternative impression material for this technique could be one of the tissue
conditioningmaterial. The advantage that the wax or fluid resin has over the tissue conditioning
material is that it results in a smooth glass like surface on the finished denture base. This is of
particularimportance when a great deal of denture base movement is anticipated and when the
tissue is thin, fragile and easily abraded.
A simple formula for producing & corrective impression wax from paraffin wax and bees waxis
described by Mc Crorie i.e. mixture of yellow bees wax and thermowax or paraffin wax
with flow characteristics at 37C similar to those of Korecta wax Nos. 2,3 and 4.
Wax Mixture (% flow at 37C)
75% yellow bees wax: 25%parafiin wax (80)
50% yellow bees wax: 50% paraffin wax (85)
25% yellow bees wax: 75% paraffin wax (89)
Korecta wax is available in four grades, each with a different degree of plastic deformation at
mouth temperature. Each grade is designed for a specific purpose.
1. Extra hard No.1 (pink): A reinforcing material used only on the external surface to support -
wax extensions beyond tray margins.
2. Hard No. 2 (yellow): Used in rebasing as a hard foundation for Korecta waxes 3 and 4 when
extensive absorption (alveolar resorption) necessitates a bulk of material. Also, used to restore
occlusion in a partial denture or a removable partial denture, which has settled due to severe
tissue change.
3. Soft No. 3 (red): Used for minor tray correction and as an initial lining to stabilize the tray.
4. Extra soft No. 4 (orange): Used to secure a completely adapted impression under natural
masticatory pressure. It leaves a finished surface and registers fine tissue details.

Wax %flow at 37C
KorectaNo.l (extrahard) 3
Korecta No. 2(hard) 80
Korecta No.3 (soft) 85
Korecta No.4 (extra soft) 90
2. These waxes can also be used to produce a muco-
compressive impression of theedentulous saddles for a lower, free-
end saddle partial denture. This is called as theApplegate technique.
Korecta wax No.1 and 4 are no longer available which were originally used for making
edentulous impressions. However necessary waxes like extra soft No. 4 -orange are available
again and can be used.
Technique
The wax is melted in a water bath before being applied to the area of the impression that is
faulty or to the impression tray. The impression tray is then returned to the mouth and should be
reseated with firm finger pressure. The impression is left in the mouth for sufficient time to raise
the wax to oral temperature so it will undergo plastic flow under pressure to record accurately the
denture bearing area.
The results obtained are good but the procedure is difficult. It is hard to stabilize the metal
framework on the remnant cast and it becomes necessary to add special stabilizing extensions to
the structure. It is also difficult to box and pour the second stage of the techniques and obtain a
good union between both parts of the casts.
Heartwell and Rahn plainly state that wax cannot be used. Henderson, McGivney and
Castlebery state that polysulphide rubber or wax can be used for final impression of an
edentulous area of a complete or partial denture. In some applications wax may have advantages
over polysulphide rubber or other impression materials.
Holmes J B found that an impression of the edentulous area of a removable partial denture
made with fluid wax created the best stability when compared with other materials.
Mc Cracken stated that in some instances placement of the tissue is necessary to obtainmaximum
support of mandibular dentures. He advocated the use of fluid wax for this purpose.This is
particularly important for older patients with atrophied mandibular residual ridges whomay have
contra indications for implants or other surgical procedures.
Levin, Jogleker and Sinkford used a resinous wax for border molding and Carlile used wax
for correction of a functional impression. However, in addition to Heartwell and Rahn,
Phillips, Boucher, Renner and Clark do not mention wax as an impression material.
Wrinkles do not appear when fluid wax is used as the flow properties of wax prevent
thedistortion. However, wax must flow with minimum pressure and must not overly displace
tissue. An advantage of wax is that it may be used with patients in whom saliva is a problem
(dementia, hypersialogenous
sialorrhea pancreatica) and in whom pharmacological intervention is contraindicated. Also
wax impressions are corrected without redoing the procedure.

Other advantages include:
- Low cost
- Easy handling
- No need for adhesive
- Odorless
- Clean material to work with
- Absence of tissue reactions

Disadvantage:
- Distortion while removing from the undercut if care is not taken.
PPS Technique
Fluid Wax Technique
- The anterior and posterior in vibrating lines are marked as for the conventional techniques on the
final wash impression.
- Impressions made with zinc-oxide eugenol or plaster are preferred over the elastic
impressionmaterials as they set rigid, are slightly resilient and when reseated in the mouth
under pressure, it may distort the relationship between the wax added to the posterior border and
the rest of the denture bearing surface. Also, wax will not adhere to elastic materials.
Hence, either the material in the seal area must be removed prior to the wax application or
laboratory varnish must be applied to the elastic material in the seal area before the wax is
placed.

Waxes which can be used are:
IOWA Wax (white) developed by Dr. Earl S. Smith.
Korecta Wax No. 4(orange) developed by Dr. O.C. Applegate.
H-L physiologic paste (yellow-white) developed by Dr. C.S. Harkins.
Adaptol (green) developed by Nathan G. Kaye.
These waxes are designed to flow at mouth temperature.
Technique
- The melted wax is painted onto the impression surface within the outline of the seal area.
- The wax is applied slightly in excess of the estimated depth and allowed to cool to below mouth
temperature to increase its consistency and make it more resistant to flow.
- The impression is carried to the mouth and held in place under gentle pressure for four to six
minutes to allow time for the material to flow.
- Position of the head and tongue.
- According to Nelson, the soft palate should be impressioned in its most functionally depressed
position. The maximum depression (downward and forward position) of the soft palate will be
recorded when the Frankfort plane (porion - orbitale) is 30 below the horizontal and the tongue is
firmly positioned against the mandibular anterior teeth. The patient should not protrude the
tongue beyond the approximated position of the incisal edges, as this will foreshorten the
posterior border of the final impression. The head and tongue position translate the mandible
anteriorly. The soft palate will then be passively brought downward and forward due to the
indirect attachment of the soft palatal tissues to the body of the mandible and the insertion of the
palatoglossus muscle into the side of the tongue. Flexion of the head also contributes to moving
excess impression material and saliva out of the mouth, rather than progressing down the
pharynx.
- While maintaining the 30 flexion of the head and the anterior tongue position, the patient is
asked to periodically rotate the head so that all the functional positions of the soft palate are
recorded.
- After 4-6 minutes, the impression tray is removed from the mouth and the wax examined for
uniform contact throughout the PPS area.
If tissue has been contacted, the wax will have a glossy appearance and if not contacted, it will
have a dull surface.
Addition of wax can be done, if deficient and excess can be trimmed with a hot scalpel if it
protrudes from the end of the tray.
3.
A technique of impression making whereby an accurate impression of the teeth andcorrect
border extension of the ridges are obtained with the use of a single custom tray in conjunction
with one impression material or with a combination of materials of different physical and/or
chemical properties provides for seating the tray in a firm and positive manner- in the position
that has been previously determined by a spacer.
The mouth is divided into two zones that are to be registered successively and with one of them
always serving as a support for the other. A problem with successive impressions of sections of a
partially edentulous mouth is that on making the impression of the second zone, some of the
material used slips under the impression of the first zone. To avoid this, it is suggested that
before making the impression of zone II, the tray with the impression of zone I be first placed
inthe mouth, correctly located, and then the impression material for zone III injected through the
tray by means of built-in-tubes.
Technique
- Outline the extension of the custom tray on the diagnostic cast. Determine zone I and zone II of
the future impression and mark their limits.
- Block out undercuts in zone II.
- Apply the spacer. If wax is being used, cover it with metallic foil to avoid its adhesion to the
acrylic resin tray material. If a firmer support is desired, the spacer can be made of acrylic resin.
- Prepare the custom tray and place the tubes that will permit the injection of the impression
material for zone II. Provide adequate venting.
- Try the tray in the mouth. Verify its easy placement and withdrawal and its correct extension,
especially over the distal-extension ridge or ridges.
- Remove the spacer from zone I and prepare tray with adhesives or perforations for retention of
the selected impression material.
- Make the impression of zone 1.
- Remove the spacer from zone II and prepare the tray to retain the impression material. With a
sharp knife, exactly delineate the impression of zone I because some of the impression material
has probably spread over the spacer.
- Replace the tray in the mouth, with the impression of zone I now acting as a support, and firmly
keep it in position. Prepare an elastic impression material, load it in an adequate syringe, and
inject it through the tubes embedded in the tray.

Advantages
- Because a single tray is used, a stable spatial relation is assured between the impressions of the
dentulous and edentulous segments. The technique offers an unlimited choice and combination
of impression materials to obtain the best possible results.
- Working with a support ensures that the tray will maintain a stable and predetermined position
not only during try-in, but while the impression itself is made.
4.
Impression wax can be applied with a brush in small quantities to 'fill' in areas ofimpressio
n in which insufficient material has been used or in which an 'air blow' or crease has caused a
defect.
5. Wax can be used as inter occlusal recording material. However, because of its properties of
having a high coefficient of thermal expansion and high resistance to closure, this material has
been graded as most inaccurate among the interocclusal record materials. Wax plus zinc oxide-
eugenol paste results in an increase in a vertical dimension, which is attributed to the distortion
of the wax material.
Bite registration wax is used to articulate accurately certain models of opposing
quadrants/obtaining occlusal records e.g. Aluwax.
Technique
Aluwax is available in sheets and in arch form, or, two sheets of wax with a cloth from
center.Ideally, a maxillary cast is obtained before the wafer to be used for registration is
fabricated. The model is placed on the Aluwax sheet or wafer. A line outlining the maxillary arch
form of the teeth is inscribed on the sheet, with 3-4 mm excess left projecting facially,
completely around the arch. Excess that will touch the tuberosity or retro molar area should not
be touched when centric registration is recorded. When the size and shape of the wafer desired is
obtained, the wafer is reinforced first with Ash-No 7 metal. A strip of metal approximately 4
inches long and 1inch width is cut and placed so that center of the wafer between the two
pieces of the doubled metal. The metal is then luted to the wafer with sticky wax on the
mandibular and maxillary sides. The metal should cover as much as of the palatal and tongue
areas as possible but should not extend anteriorly past the medial of the mandibular first
bicuspid. Sufficient space must also be left for occlusal surfaces of the posterior teeth.
After the metal has been luted to the wafer, the anterior portion is reinforced. Place the wafer
over the occlusal and incisal surfaces of the mandibular cast and inscribe a mark at the distal of
each cuspid. Place the wafer on a sheet of base plate wax and inscribe the outline of the anterior
portion of the wafer to the distal marks of the cuspids on the base plate wax. The piece of base
plate wax is luted to the mandibular side of the wafer with a hot spatula. The wafer is prevented
from bending by the metal, in to the palatal area by the tongue and mandibular anterior teeth
during closure.
The maxillary study cast is moistened or lubricated with vaseline. The wafer is warmed lightly
on a flame or water bath for about 15 seconds. The maxillary side of the wafer is placed on the
moistened cast. With light finger pressure, the wafer is keyed to the cusp tips and incisal edges
of the cast. It is then chilled with water/air.
The wafer is then tried in to the mouth. The keyed portion of the wafer is placed on the
maxillary teeth, held lightly and secured with thumb and finger. The mandible is manipulated to
the terminal hinge position and hinged upwards until the mandibular anterior teeth lightly touch
the base plate reinforcement. Patient is instructed to relax and not to close or bite. Wafer is
checked for fit and made certain that it does not impinge on palatal tissues, retro molar pad area
and tuberosity area. Posteriorly, it should extend 1-2 mm distal to the posterior teeth.
Strips of Tenax wax are luted to the mandibular side of the wafer with a hot spatula. It extends
from the posterior border of the wafer to the edge of the base plate wax reinforcement. The
keyed wafer is again placed and the mandible guided into closure. The mandibular teeth should
touch evenly and without pressure. When the fit is verified and perfected, centric relation
position is recorded. The completed wafer is lightly warmed; keyed side placed on maxillary
teeth and wafer is supported lightly. The mandible is manipulated into most retruded and hinged
position. The mandible is guided and closed into centric relation, imprinting just the cusp tips of
posterior teeth in to Tenax wax. The mandibular teeth will slightly indent the base plate
wax. As the mandibular teeth close the wafer, it should be left loose to avoid maxillary teeth
from imprinting too deeply into the recording wafer.
The wafer is chilled and removed in a snap to avoid distortion with the wafer still on the
mandibular teeth the mandible is guided back into centric closure. The wafer is then snapped
inwards the mandible, removed in one motion and chilled.
The centric relation record is verified by rechecking. For greater accuracy, a correction wash is
taken with zinc oxide eugenol paste, mixed and placed into the cusp indentation on each side of
the wafer. Centric relation record can be easily recorded with aluwax and impression paste in
cases with edentulous posterior regions that do not have posterior stops. The wafer is then
removed and placed on the cast. A small pillar or post of wax width in diameter formed of
boxing wax is placed over each I
st
and 2
nd
molar edentulous area and luted to aluwax wafer with
hot spatula. The wax pillars are shortened with a hot spatula until approximately inch of space
is created between the ridge and end of pillar extending to the wafer.
The maxillary and mandibular casts are fitted into the Aluwax wafer, held and distance is
estimated. The wafer with wax pillars is checked in the mouth. A wash impression is taken by
placing a mound of paste on each wax pillar. The centric relation is recorded with wash and a
static impression of edentulous ridge areas. The record is chilled and with a sharp scalpel,
carefully trimmed such that impression area of about 4 mm square is present.
6. Wax can be used to make functional wax patterns.
Certain problems of occlusal harmony lend themselves to solution by the use of the functional wax
pattern taken in the mouth immediately following cavity preparation. The manner of gaining this
functional pattern is not unlike the initial steps in forming the direct wax pattern. The particular
situation may or may not indicate the use of a matrix band and retainer. Should a matrix be
indicated in order to confine the wax, it is trimmed and festooned so that soft tissues are not
traumatized nor the movements of functional occlusion restricted. Thoroughly conditioned wax
is placed in the matrix band, the band seated under a heavy sustained force forabout ten
seconds. Centric occlusion and lateral excursions are then initiated. Wax may beadded to any
occlusal area if under contouring is suspected. Finally the matrix band and retainer, which have
been slightly lubricated with petroleum jelly, are removed and the cervical excess
is trimmed. Following removal, the pattern is subsequently refined and the margins are
perfected upon the complete die. The result should be excellent harmony of this casting with the
occlusal function.



References:
Anusavice, Philipps: Sci ence of dent al mat eri al s, 11
t h
editi on, Elsevi er.
Craig RG, Powers JH: Rest orati ve dent al mat eri als, 11
t h
edi ti on, Mosby.
William J. O bri en: Dent al mat erials and thei r sel ection, 2nd edition.
McCabe JF, Walls AWG: Appli ed dent al mat eri als, 8
t h
editi on, Bl ackwell Science.
DIFFERENT THEORIES OF IMPRESSION MAKING AND RATIONALE
FOR THE DIFFERENT TECHNIQUES IN COMPLETE DENTURE
TREATMENT
Introduction
Theory means observation based on principles and concept is the
application of these theories. Impression forms a important virtue for the success
of compete denture treatment and hence the concepts of impression should be
properly understood. From time immemorable there have been different theories
that had been advocated. Green Brothers were the first to introduce the principle
of muco compression during impression technique. The shortcomings of this
principle gave rise to the mucostatic technique by Hary L. Page with high regard
for tissue health. But again due to the disadvantage of this technique, there was
an impetus for the introduction of the selective pressure technique which
combined the concepts of both the previous techniques. There are various
techniques adopted by different practitioners and there may be as many
techniques as the number of dentists regarding impression which in general
means negative likeness but in prosthodontics it is the negative registration of the
denture bearing denture stabilizing, denture bracing and peripheral limiting
structures obtained in one of the plastic / semiplastic materials which is
registered at the moment of crystallization of the impression material.
At the moment of crystallization means that the tissues are registered at a
particular moment. Since the denture bearing tissues are always in a state of flux
with new cells being generated and cells being shed of at different moment of
time, the tissues at the time of impression making will differ from that at the time
of denture insertion.
It is not feasible to group all the techniques into rigid compartments but a
broad classification is possible. They may be classified as scientific / empheric
depending on whether they are based on knowledge of anatomy.
b. They may be classified as open / closed mouth impressions depending on the
condition of the mouth at the time of impression making.
c. They may be classified as either pressure, nonpressure / minimal pressure, and
selective pressure depending on the amount of pressure applied at the time of
making impressions.
Prior to 1600 complete denture replacement were not made due to lack of
understanding of retention.
In 1711, Mathian Gottfried Purman recorded the use of wax.
In 1728 Pieree Fauchard made dentures measuring the mouth with compases
and cutting bone into an approximate shape for the space to be filled.
In 1736, Phillip Pfaff of Germany made impressions in wax sections of half of the
mouth at a time.
1845-1899
In 1886 Richardson mentioned about making plaster impressions of tissues at
rest and achieving adhesion by contact.
- Concepts of atmospheric pressure, maximum extension of the denture bearing
area, equal distribution of pressure and close adaptation of the denture bearing
tissues were stressed.
- Many changes in impression making became evident during this era. A single
impression formely deemed sufficient, advanced to a method using priliminary
impression of guttapercha, beeswax or modelling compound followed by
secondary wash impression made of plastic within preliminary impression.
1900 1929
A concentrated effort was directed towards accuracy.
Most impression were of compressive type and by the closed mouth
technique. To prevent buildup of excessive pressures vents were made.
Closed mouth technique
In this technique the supporting tissues recorded in a functional relationship.
The movement of all related tissues were in normal functional movements such
as swallowing, talking, sucking and occlusal contacts.
A pressure similar to that of mastication was developed through the occlusal rins.
This according to Stanley P Freeman-amount of tissue compression is like that in function.
Selective pressure technique.
The disadvantage of closed mouth technique is the tendency of overextention or
underextention.
Release of pressure of occlusion may permit a rebound of denture.
It is contraindicated in the presence of considerable amount of movable tissue.
The open mouth technique is preferred because the operator can see whether the border molding
is done properly.
The functional manipulation cannot be used routinely not all patients can truly move the
impression materials as needed, some may use extreme movements and others use.
Two techniques were developed for the management of flabby ridge.
1
st
technique it was of muco compressive type compound impression which
displaced the flabby tissue paratally.
2
nd
technique it was advocated by Greene Brothers, which captured the tissue
in its passive form.
Concepts of posterior palatal seal were developed by Liberthal and Greene.
For the first time there were references to movement of tissues and the mandible
during impression making.
Border molding was done against the direction of muscle fibres as advocated by
Wilson.
There were others like Nichais, Neil Fish, Swenson et al who advocated
manipulation in border molding in the direction of its fibres.
It was during this era that the concept of esthetics in impression making was
introduced.
MUCOCOMPRESSIVE TECHNIQUE
The muco compressive technique was initiated by Greene Brothers. They
introduced a modeling plastic, a method for manipulating it and a technique that
is said to have been the first to utilize all the denture bearing area for denture
retention.
They were the first to teach the closed mouth all modeling plastic technique called
the Greene Brothers all compound impression.
The main objective of this technique was to attain better retention of the dentures.
The typical technique by Greene brothers was as follows.
- A preliminary impression was made in impression compound and a custom tray
was constructed using baseplate with its periphery 1/8
th
inch shorter than the
denture outline.
- With this tray another impression with compound was taken.
- Well fitting rinse with uniform occlusal surface were made and the height of the
bite adjusted against a similar bite rim on the mandibular ridge.
- Areas to be relieved like median raphe was softened on the impression and was
again inserted in the mouth and was held under biting pressure for one / two
minutes.
- The peripheral margins of the impression was then softened and border molding
was done by asking the patient to give various cheek and lip movement as in
whistling and smiling.
- The posterior palatal seal was obtained by swallowing movements by the patient
under biting pressure.
- The claims made by the advocates of this technique was that since border
molding was done in their functional positions, the final dentures would retain
well and cannot be dislodged during functional movements of the jaw.
Variations in this technique
- Some used the preliminary impression itself as the tray and impression to be
improved by border molding.
- Some preferred to make custom trays in a more stable and stronger material
than compound for better results.
- Relief in hard areas was obtained in number of ways. Some custom trays were
made with escape holes in areas overlying the hard tissues and close adaptation
provided in those areas covering the soft tissues.
- Some use low fusing compound by softening and adapting it to the soft tissues.
- Some advocate unnatural movement of the mouth along with massaging of the
cheeks and lips from outside during border molding.
- Post dam is obtained in number of ways.
- The addition of soft wax like carding wax or low fusing compound for this
purpose is common.
- Scraping of cast is also used.
The amount of pressure applied to the tissues in the muco compressive
technique was not only great but was applied to the centre of the palate and the
peripheral tissues which were not well suited to receive the maximum biting load
this interferes with normal blood supply of the tissues resulting in their
breakdown.
As soon as this change took place both the peripheral seal and excellent
retention were lost. Hence the retention achieved by these means was transient
and harmful to the health of tissues.
Dentures made by this technique would fit well during mastication i.e. only
a short period each day, but would not be closely adapted to the tissue when the
patient was at rest. This is because of the rebounding of tissues.
These disadvantages indicated a need for spacer in the custom tray
fabrication.
1930-1948
- Concept of mucostatics was introduced by Harry L. Page in 1938.
- Addison in 1944 also mentioned the same principle of making impressions of
displaceable tissue in its passive state and considered interfacial surface tension
as one of the main factors of retention.
- With new materials like zincoxide eugenol, waxes, elastomers, individual tray
construction was emphasized.
Minimal pressure technique based on
mucostatic principle
- In a Brochure published by Hary L. Page in 1946 he stated that all soft tissues
were cheifly fluid and 80% or more of the tissues are composed of water.
According to pascals law which states that any pressure applied to a confined
fluid is transmitted undiminished and equally in all directions. Page contended
that since the soft tissues are confined under a denture, any pressure applied will
be transmitted in all directions.
- The advocates of this principle considered interfacial surface tension as the only
important retentive mechanism in complete dentures. Therefore they did not
resist vertical displacement, which was the only movement capable of
interrupting surface tension. However, Dykins recommended a short lingual
flange to resist lateral displacement.
- According to the principle of mucostatics the impression material had to record
without distortion, every detail of the mucosa so that a completed denture would
fit all minute elevations and depressions. So much emphasis was placed on
recording details that separating substances could not be used at any point in the
procedure.
- Mucostatics further demanded a metal base. Gold, one of the most accurate
metals was bypassed in favour of chrome alloy which are not considered to be
quite so accurate as gold.
A typical impression method representing this technique was as follows.
- A compound impression was made in a suitable tray and a cast was made.
- On this base plate wax was adapted which acted as a spacer according to
denture outline.
- Custom tray was fabricated over this spacer.
- A soft ribbon of carding wax was applied at the posterior margin of the maxillary
tray and it was placed in the mouth under light pressure and patient was asked to
do swallowing movements inorder to obtain a posterior palatal seal.
- A small amount of impression plaster mixed into a smooth consistently was
placed in the tray, introduced in the mouth and was slowly raised to position and
held with as little pressure as possible.
- No border molding was advocated but the soft plaster was expected to mold
itself to the relaxed vestibular tissues.
- The impression was held till the impression hardened and was then removed.
Variations in the technique
- Some techniques use compound instead of wax for obtaining post dam.
- Some techniques advocate post dam over the final impression.
- Zinc oxide eugenol and alginate had also been used for similar results.
- Pages application of Pascals law to the field of denture impressions is only
partly correct because the tissues involved are not wholly incompressible and
fluids may escape through the borders of the denture.
- Pages claim that retention is a function of surface tension alone is also
objectionable because this tensile force itself is dependent upon adhesion and
cohesion.
- The elimination of use of separating media results in distortion of the cast.
- The use of chrome cobalt as denture bases results in failure of accurate detail
reproduction.
- The mucostatic principle ignores the value of dissipating masticatory forces over
as largest possible basal seat area. Further the mucostatic denture minimized
the retentive role of the musculature as described by Fish in 1948.
The merit of this technique was its high regard for health and preservation
of tissue.
1948 1964
- There was an increased emphasis on biologic factors of complete denture
impression making.
- Selective pressure concept by Boucher became popular.
- Craddock, Landa et al advocated use of escape vents.
- More attention was given to esthetics in the impression techniques usedgreater
emphasis was on flanges, border molding, posterior palatal seal and denture
extension.
- In 1948, the mucoseal technique a variation of the mucostatic technique was
introduced.
- Vacustatics concept was developed by Milo V. Kubalib and C. Buffington to
eliminate the functional limitations of impressions.
Selective pressure technique based on selective pressure theory
- Advocated by Boucher in 1950 it combines the principles of both pressure and
minimal pressure techniques.
- The philosophy of the selective pressure technique is that certain areas of the
maxilla and mandible are by nature better adapted for withstanding extra loads
from the forces of mastication. These tissues are recorded under slight
placement of pressure while other tissues are recorded at rest or relieved with
minimal pressure in a position that will offer maximum coverage with the least
possible interference with the health of surrounding tissues.
- Here an equillibrium between the resilient and the non resilient tissues is
created.
Primary stress bearing areas of maxilla are crest of alveolar ridge and the
horizontal plate of palatine bone and in the mandible it is the buccal shelf area.
Secondary stress bearing areas of the maxillary foundation are rughae area and the slopes of the
ridge in the mandibular foundation.
Areas requiring minimum pressure are incisive papilla, midpalatine suture,
tori in the maxilla and crest of mandibular residual ridge.
In the maxilla, the tissue underlying the region of posterior palatal seal has
glandular and soft tissue between the mucous membrane lining and the
periosteum covering the bone. This tissue can be more readily displaced for the
maintenance of peripheral seal of the maxillary denture.
An earlier technique representing this
group consisted of the following steps:
A well fitting tray with a uniform clearance of about 5mm was selected and a
compound impression was obtained with little border molding done on the
peripheries.
This compound impression was separated from the metal tray and its peripheral
borders were trimmed 1 2 mm short.
The base portion of the impression was then scrapped evenly to a depth of about
2mm except in the posterior seal area where no scraping was done.
A sufficient amount of creamy mix of plaster was spread over this impression and
was placed in the mouth with little pressure.
The cheeks and lips were lightly patted from outside while the plaster was
still soft. This procedure gave sufficient value like seal without exaggerated
pressure on soft tissues.
Variations in the technique
Most of the techniques prefer taking a preliminary impression and using a custom
tray rather than use the initial compound impression for further improvement.
The preliminary impressions are usually taken in compound but materials
like alginate, elastomeric impression materials are also used.
Certain methods advocate the use of three small compound stops in the base
area of special tray before doing border molding. This prevents the periphery of
the tray from impinging on the tissues and it standardizes the relation of the tray
to limiting tissues for every insertion of tray.
The amount of material, consistency of material, use of space or escape vents
and the manual pressure with which the impression is made are all possible
variable which have been used to advantage by different techniques.
The mucoseal technique was stated by Pryor in 1948 which was introduced as a variation to the
mucostatic technique.
- The anterior lingual border is molded by the floor of the mouth with the tongue in
repose.
- The tray is extended horizontally backward, over the sublingual glands towards
the tongue to effect a border seal.
- Thus this technique utilizes the benefit of minimal pressure and also provides
maximum extension of denture borders and maximum coverage of denture
bearing area.
Sub-atmospheric pressure technique
based on the concept of mucostatics
Milo V. Kubalik and Bert C. Buffington developed this technique the objective of
which was to reduce the stress on any given tissue by increasing load bearing
area. the form of the tissue is recorded vertically and laterally, when a controlled
partial vacuum is established in impression tray specially built for the patient. It is
maintained in the mouth without direct mechanical support of any kind. The
difference between the subatmospheric pressure within the tray and the
atmospheric pressure outside the tray is all that is needed to centre the tray over
the ridges in a static position. A vacuum is developed between the soft tissues
and the tray. A recording material in a fluid state flows from the border region into
the evacuated space and develops the basal tissues. Border seal is determined
by the readings remaining constant.
Materials used
1. Alginate, modeling plastic or a reversible hydrocolloid for preliminary impression.
2. Clear acrylic resin for making the final impression.
3. An adequate sealing agent for use around special fittings in the tray.
4. Thermoplastic border recording impression material.
5. A fluid (low viscosity) impression material that seats firmly enough to avoid
distortion.
6. A periphery wax to be used as a flexible material between impression and the
boxing wax.
Molding Exercises
For the maxillary impression the patient is told
1. To suck on the tube (this pulls the cheeks in a starts border molding).
2. To say 00000 and EEEE alternately (This refines the border molding of the
buccal and labial flanges and provides space for the frenum.
3. To blow against closed nostril (This flexes the soft palate and molds the
posterior palatal seal area. Wipes of any excess adapted extending beyond the
border of the tray.
4. To move the mandible from side to side (This molds the flanges lateral to the
tuberosities.
5. To swallow warm water (This allows for swallowing movements in the shape of
the posterior palatal seal.
6. To open and close the mouth (This records the shape and action of the
paramusculature used in extreme opening and closing movements.
For mandibular impression the patient is
instructed
1. To suck on the tube (This flexes the labial, buccal and lingual vestibular
structures and mold the flanges in these regions).
2. To force the tip of the tongue against the palate (This forcibly molds the flange in
the sublingual space with the paralingual musculature.
3. To say 0000 and EEEE alternatively (This further molds the buccal and labial
flanges)
4. To lick the upper and lower lip (This molds the flanges in the lingual space in the
region of Whartons ducts and genioglossus muscle.
5. To place the tongue in the right cheek and left cheek (This further molds the
flange in the sublingual fold space).
6. To swallow warm water (This molds the posterolingual flange in relation to the
palatoglossus and mylohyoid musculature).
7. To tense and flex the lower jaw as if clenching ones teeth (This molds the
buccal flange from the external oblique ridge to the retromolar pad.
1965 1982
New techniques had been developed to manage compromised conditions.
For poor mandibular ridges Sublingual flange technique by Tyrde and Robert Flange technique by
Lott and Levin.
For hyperplastic alveolar ridges by Zafarulla Khan, William H. Filler.
Impression techniques for severely
resorbed foundation
Flange technique by Lott and Levin introduced in 1966 involves making
impressions of soft tissues of mouth adjacent to the buccal, lingual, labial, palatal
surface and incorporating the resulting extensions or flange in the denture.
Flange wax was rolled from the retromolar pad area to the sublingual region,
large enough to restore the diameter of estimated resorption and patient is asked
to forcefully perform functions of swallowing etc to give border extensions which
covers maximum surface area (genial tubercles and sublingual gland).
Tyrde in 1965 used the dynamic impression method on the same principle
to obtain sublingual flange.
Roberto Von Krameck et al in 1982 used modeling compound to record the
extensions. This sublingual flange extension increases the tissue surface without
interfering the functions of mastication, deglutition and phonation. The active
incorporation of tongue activity also stabilizes the denture.
Impression technique for patients with unsupported movable tissue (Hyperplastic or flabby tissue):
William H. Filler described a technique using two trays.
a. Preliminary maxillary and mandibular impressions were made in stock trays with
alginate impression method and casts were poured.
b. The maxillary and mandibular casts were placed on the surveyor and all the
tissue undercuts were blocked out with utility wax.
c. A single thickness of baseplate wax was formed over the casts to form a spacer.
The spacer is terminated short of the posterior palatal seal area so that the tray
material would contact the tissue in this area.
d. A tinfoil sustitute was applied to the casts and the first of the two trays was made
in autopolymerizing acrylic resin. Most of the basal surface of the tray was
removed except for the lattice work of acrylic resin which strengthens the trays.
e. The maxillary and mandibular trays are then keyed to orientate the second tray
in atleast three places. These keyed positions correspond with an extension of
the second tray and will insure proper seating of the second tray over the first
tray.
f. The entire first tray was covered with a single thickness of baseplate wax,
ensuring that the keyed positions here kept free of wax. Both the first resin tray
and the casts were painted with tin foil substitute.
g. The second trays were made in the same manner as the first and extend past
the relieved area of maxillary and mandibular trays and fit into keyed positions.
h. With round bur, numerous holes were made in the second tray.
i. The deepest portion of the vault of maxillary tray was removed to create a stop
when the final impression was made. The initial tray was sealed with minimum
pressure and autopolymerizing resin on a tongue depressor was gently placed in
the opening in the vault. When the resin had set a stop was created on the firm
and stable palatal tissue.
Clinical impression procedure
The borders of the maxillary tray are formed by adding low fusing compound and
border molding it. A finger placed over the resin stop will ensure a stable tray.
The basal plate was removed and the flanges reduced 1-2mm with the exception
of the part over the tuberosites and posterior palatal seal area of the maxillary
tray.
The mandibular tray was stabilized by the addition of modeling plastic on the
buccal flanges in the region of first and second molars and in the anterior part of
the tray in the incisor area. The mandibular tray was border molded and
baseplate wax was removed from the mandibular tray every where except at the
three points used for stabilization.
Both the trays were painted with permlastic adhesive. Light body permlastic was
used in initial tray as a corrective wash impression material. After it set the tray
was removed from the mouth and all excess material was trimmed from the
borders and from the area where the second tray would come into contact with
the first tray to key themselves.
The second impression was made with plastogum used in corrective wash
impression and plastogum was painted over the entire vault and all available
tissue surface not included in the first impression. The second tray was filled with
plastogum and gently vibrated into place until keyed parts of the tray were in
contact. The two trays were held lightly together until the impression material set
and then the impression was removed as a unit and the two trays were sealed
together with sticky wax.
Zafarulla Khan described a technique where a window was cut in the
custom tray where the unsupported area was present. The unsupported area
was recorded with impression plaster and the remaining area was recorded with
perrmlastic impression material.
Other techniques used in case of flabby
tissues
a. Hobrick described a technique where only a single custom tray was used.Border
molding was done in the usual manner and impression was madewith heavy
bodied addition silicone. The area of movable tissue was cut out and relief holes
were made and wash impression was made with light bodied impression
material.
b. Joh D. Watter recorded the healthy denture bearing tissue with ZnoE and
the displaced tissue with impression plaster.
c. Split method by Allan Mack is useful if tissues are exceptionally flabby. A loosely
fitting tray made with heavy relief over the flabby areas was taken.Plaster was
mixed and applied over the flabby area to a thickness of about 3mm and was
allowed to set tray was filled with 2
nd
mix of plaster and the impression was made
with the initial coating of flabby areas thus acting as a splint while the impression
was made and being removed.
Other techniques used for poor
foundation
a. Modified Fournet Tuller technique by Allan Mack also utilizes the principle of
achieving maximum peripheral seal together with minimal pressure on the crest
of the ridge to obtain retention and stability.
b. Winkler described a technique which used tissue conditions and over extended
primary impression of alginate was made. Occlusal wax rims were constructed
and the borders were adjusted so that the lingual flange and sublingual crescent
area were in harmony with the resting and active phases of the floor of the mouth
by as open and closed mouth technique 3 applications of conditioning material
were used each application for approximately 8-10 minutes. The third and final
wash was made with light bodied material. The technique resulted in an
impression that had tissue placing effect with relatively thick buccal lingual and
sublingual crescent area.
Miller used mouth temperature waxes instead of tissue conditioners. Klein
proposed the development of impression without a tray, as a stock tray may
cause some distortion of the tissue and may result in a over extended
impression. He used a moldable material (putty silicone) reinforced by an internal
metallic core which was placed over the residual ridge and the borders molded
by speech exercises. A low viscosity material was placed on the impression
surface of this tray and functional impression was made.
Impression technique for restricted
access to the mouth
Walter described a technique with the use of sectional stock trays.
Impressions of each side of the jaw was made on at a time and two holes were
joined and cast was poured.
The recording of denture borders may be done by either hand
manipulation and functional movement.
Hand manipulation
The contour of the denture borders may be obtained by the dentist with the
use of manipulation of lips and cheeks within functional limits. Patients tongue
movements record the lingual borders.
Functional movements
The denture borders are also formed by having the patient make functional or physiological movement
such as swallowing sucking, grinning, licking etc.
Tenchs neuromuscular concept values the functions of sucking and
swallowing while making the impression to bring the denture base into harmony
with the physiological behaviour of the muscles. Forming an impression by
neuromuscular concept develops a completely passive contact of all impression
borders to the basal seat tissues, passively fills all marginal spaces and develops
basal seat area coverage that is compatible with function.
Barone states that normal or natural movements will provide better borders than by manipulation.
The only truly functional or physiological method of making impressions is the so called dynamic
impression. In this technique the basal seat and borders are obtained with the use of impression
materials that continue to flow over an extended period of time such as tissue conditioning materials or
wax. This material is placed in the patients transitional denture and the patients normal activities mold the
borders over a period of time.
Functional reline rebase technique is based on the same principle.
Discussion
In the mucostatic principle
Clinical procedure in selective pressure technique:
1. Preliminary examination and conditioning of the patient.
2. Seating the patient:
i. Patient should be in a upright position and relaxed.
ii. The jaw should be at the level of the operators elbow for maxillary and at the
level of operators shoulder for mandibular impression.
3. The hands should be washed in the view field of the patient even though they
may have been previously washed.
4. The tray should be selected from the stock trays which should be kept ready
sterilized while inserting the tray in the patients mouth using a rotatory
movement. There should be an equal clearance of 6-8 mms. Between the tray
and the tissues all round.
5. Operators position:
i. Right back side of the patient for upper impression.
ii. Right side front of the patient for lower impression.
The selected tray should cover the entire denture bearing area. Check the
tuberosity area in the maxillary and lingual pouch in the mandibular foundation.
6. Compound is softened in chotwater.
i. A large bowl should be used.
The compound is kneaded thoroughly to soften it uniformly. In case
maxillary impression the compound is molded to a rounded form, placed in the
centre of the tray and thoroughly spread over the surface of the tray.
In case of mandibular impression the compound is formed into a rope form
and spread over the surface of the tray.
In case of maxillary impression, the tray is centered slightly anterior to the final position assumed by the
tray when it is correctly seated. It is then moved upward and backward direction. The compound is
manipulated by index finger into the deep buccal sulcus area. In case of mandibular impression the tray is
centered exactly over the ridge and seated straight down. With the index finger the compound should be
manipulated into the deep lingual pouch.
Simulation of the tissue should then be done.
The compound is allowed to harden and withdrawn from the mouth.
The impression is chilled in cold water and examined thoroughly. It is examined
for completeness border tissue functions, distortion and gross physical defects.
Materials used:
a. Low fusing impression compound sticks Advocated by Boucher.
b. Autopolymerizing acrylic resins
Advocated by Jones not used due to the heat of polymerization and monomer irritant.
c. Tissue conditioning materials (modified resins)
Chare has described the use of one such tissue conditioning material.
They are effective when used correctly. They set slowly and continue to flow
under pressure at a rate inversely proportional to time becoming stiffer but never
losing resiliency.
d. Metallic pastes and elastomeric materials.
Ideally body elastomeric impression material is used. Smith Dale E has
advocated one technique where the border molding is done in one step with
polyether impression material.
e. Impression waxes
Use of impression wax adapted for border molding was reported by Knapl.
But these waxes distort easily.
f. Perio pack : Kerk and Idolt has described one step border molding with the use
of periopack.
The diagnostic cast is made of dental plaster. The form of the custom tray
helps us to make impression based on specified theory. The areas to be
retrieved on the casts and undercut areas are marked and blocked with wax.
Care must be taken while providing relief, as excessive relief causes flabby
tissue formation. The custom tray must be 2mm less than the denture outline
except in the posterior palatal seal and retromolar pad area. The peripheries of
the tray should not be sharp / rough.
The custom trays are checked in the mouth. The tray should cover the
entire denture bearing area. If the tray is underextended, compound should be
added wherever necessary. If the tray is overextended the tray should be
trimmed where required. The tray is also checked for retention and stability.
Border molding is done quadrant by quadrant (By hand manipulation)
within the functional limits of tolerance.
Border molding:
The shaping of the border areas of an impression tray by functional or manual manipulation of the tissue
adjacent to the borders to duplicate the contour and size of the vestibule.
Glossary of prosthodontic lesions 7
th
edition.
The anterior limit of posterior palatine seal area is marked using T burnisher.
The line of minimal function is marked by asking the patient to tell Ah.
The low fusing impression compound is softened and placed in this area the tray
is seated in the mouth to obtain posterior palatine seal.
The tray is then checked for completed border molding. It should have same
appearance as the finished denture. The tray is reinserted and border seal and
retention and stability are checked.
The different material used for final impression are
a. Impression plaster (Rarely used).
b. Zinc oxide eugenol paste 2mm.
c. Irreversible and reversible hydrocolloids 6mm
d. Elastomeric impression materials 4mm, 2mm.
e. Mouth temperature waxes
f. Soft acrylic resins (functional impression) 1-2mm
The relief wax spacer is removed. If zinc oxide eugenol paste is used, it should be mixed fairly stiff and a
ribbon of even thickness of paste should be applied to the tray. The tray is quickly inserted and sealed in
the correct position and border molding is carried out by gently simulating tissue function in those areas.
Conclusion
Although there are many techniques with varied logic, the success of the prosthodontics treatment
depends on the clinical diagnostic alumen, understanding of the theories of impression making and its
application by the operator.
References
1. Boucher : Prosthodontic treatment for edentulous patients.
2. Boucher C.O. : A critical analysis of mid century impression technique for full dentures. J. Prosthet. Dent.,
1 : 472-491.
3. Ellinger Charles W. Synopsis of complete denture.
4. Edgar N. Starke : Historical review of complete denture impression materials. JADA, 91 : 1037-1041.
5. Filler W. H. : Modified impression technique for hyperplastic alveolar ridges. J. Prosthet. Dent., 25 : 609-
612, 1971.
6. Glossary of Prosthodontics. J. Prosthet. Dent., Edition 7
th
, 81 : 48-110, 1999.
7. Heartwell Charles M. : Syllabus of complete dentures.
8. Luin Bernard : Impressions for complete dentures.
9. Lott F. and Luin B. : Flange technique : An anatomic and physiologic approach to increase retention,
function, comfort and appearance of dentures. J. Prosthet. Dent., 13 : 394-413, 1966.
10. Milo V. Kubalek and Bert C. Bufington : Impressions by the use of substathmospheric pressure. J.
Prosthet. Dent., 16 : 213-223, 1966.
11. Page H.H. : Mucostatics, A principle not a technique by Harry L. Page, Chicago, 1946.
12. Portar C.G. : Mucostatics A panaua or propagan. J. Prosthet. Dent., 3 : 464-466.
13. Sharry J.J. :Complete denture prosthodontics.
14. Tyrde G.K. : Dynamic impression method. J. Prosthet. Dent., 15 : 1023-1034, 1965.
15. Udani T.M. : Critical analysis of complete denture impression procedures (unpublished article).
16. Victor O. Lucia : Mucostatics, text book of treatment of edentulous patients. 17-21.
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INDIAN DENTAL ACADEMY: STRUCTURE OF MATTER AND PRINCIPLES OF
ADHESION
INDIAN DENTAL ACADEMY: STRUCTURE OF MATTER AND PRINCIPLES OF ADHESION:
INTRODUCTION The principle goal of dentistry is to maintain or improve the oral health of the
patient. A wide variet...
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Thursday, August 29, 2013
STRUCTURE OF MATTER AND PRINCIPLES OF ADHESION

INTRODUCTION

The principle goal of dentistry is to maintain or improve the oral health of the patient. A wide variety
of dental materials are involved in the clinical application. Material should be carefully selected. Through
understanding and experimentation it is possible to maximize any one property, but in no application is it
possible to select a material for one property above. It is precisely in the balance of one factor against
another that the materials are used successfully. Hence it is essential to know, the properties of the
dental materials, to be able to understand the properties and reactions of the material and predict the
outcome.
STRUCTURE OF MATTER AND
PRINCIPLES OF ADHESION

To better understand the properties of a material it is essential to known them from the atomic point
of view. All matter is made up of atoms and these atoms are further held together by atomic interactions
to form larger particles called molecules.
Atom Smallest particle of a chemical element.
Molecule group of atoms.
Eg : When H
2
O vapor condenses to form a liquid, energy in the form of
heat is released, known as the heat of vaporization. One can conclude that
the gaseous state possesses more energy than does the liquid state.
Although the molecule in the gaseous state exerts a certain amount of
mutual attraction, they can diffuse readily and need to be confined in order
to keep the gas intact.
Although the atoms may also diffuse in the liquid state, their mutual
attractions are greater, and energy is required for separation as described.
If the energy of the liquid decreases sufficiently by virtue of a decrease in
temperature, a second transformation is state may occur and the liquid
changes to a solid or freezes. Again energy is released in the form of heat.
In this case the energy evolved is known as the latent heat of fusion. In as
much energy is required from a change of solid to liquid one can conclude
that the attraction between the atoms (or molecules) in the solid state is
greater than liquid or gas. If this were not true the metal would deform
readily and gasify at low temperature.
Change can also take place from a solid to a gas by a process
known as sublimation, but this phenomenon is not likely to be of practical
importance so far as the dental materials are concerned.
INTERATOMIC BONDS
The forces that holds atoms together are of the cohesive type. These
inter atomic bonds may be classified as
Primary Secondary
a) Ionic a) Hydrogen bonding
b) Covalent b) Van der waals forces
C) Metallic

Ionic bonds : Are simple chemical type bonds resulting from mutual
attraction of positive and negative charges. Classic eg. Na and Cl.
These type of bonds exist in certain crystalline phases of some
dental materials such as gypsum and zinc phosphate cement.
Covalent bonds : In many chemical compounds, two valence electrons
are shared. H
2
is an example of this type of bond.
It occurs mainly in dental resins.
Metallic bonds : One of the chief
characteristics of a metal is its ability to
conduct heat and electricity. Such energy
conduction is due to the mobility of the so
called free electrons present in metals. The
outer valence shell can be removed easily
from the metallic atom, leaving the balance
of the electrons tied to the nucleons, thus
forming a positive ion. The free valence
electrons are able to move about in the
metal space lattice to form what is
sometimes described as an electron cloud
or gas.
The electrostatic attraction between this
electron cloud and the positive ions in the
lattice provides the force that bonds the
metal atoms together as a solid. The free
electrons act as conductors of both thermal
energy and electricity. They transfer energy
by moving readily from areas of higher
energy to those of lower energy, under the
influence of either a thermal gradient or an
electrical field.

Deformability is associated with slip
along crystal planes, and thus the ability to
easily regroup and still retain the cohesive
nature of the metal as deformation occurs.




INTER ATOMIC SECONDARY BONDS
In contrast to primary bonds
secondary bonds do not share electrons.
Instead, charge variations among
molecules or atomic groups include polar
forces that attract the molecules.
Hydrogen bonding
This bond can be understood by
studying a water molecule. Attached to the
oxygen atom are two hydrogen atoms.
These bonds are covalent because the
oxygen and hydrogen atoms share
electrons.
As a result the protons of the
hydrogen atoms pointing away from the
oxygen atoms are not shielded effectively
by the electrons. Thus the proton side of the
water molecule becomes positively
charged. On the opposite side of the water
molecule, the electrons that fill the outer
orbit of the oxygen provide a negative
charge. Thus a permanent dipole exists that
represents an asymmetric molecule.
H
2
bond, associated with the positive
charge of hydrogen caused by polarization
is an important example of this type of
secondary bonding.
When a H
2
O molecule intermingles
with other water molecules, the hydrogen
(+ve) portion of one molecule is attracted to
the oxygen portion of its neighboring
molecule, and the hydrogen bridge is are
formed.

VAN DER WAALS FORCES
It is a more a physical than chemical bond. These forces form the bases of a dipole attraction. Eg :
in an inert gas, the electron field is constantly fluctuating. Normally the electrons of the atoms are
distributed equally round the nucleus and produce an electrostatic field around the atom. However this
field may fluctuate so that its charge becomes momentarily positive and negative. A fluctuating dipole is
thus created that will attract other similar dipoles. Such interatomic forces are quiet weak.

Inter atomic bond distance and bonding energy
Regardless of the type of matter, there is a limiting factor that prevents the atoms or molecules from
approaching each other too closely, that is the distances between the center of an atom and that of its
neighbor is limited to the diameter of the atoms involved.
If the atoms approach too closely, they are repelled from each other by their electron charges. On
the other hand, forces of attraction tend to draw the atoms together. The position at which these forces of
repulsion and attraction become equal in magnitude is the normal or equilibrium position of the atoms.
Thermal energy
Thermal energy is accounted for by the kinetic energy of the atoms or molecules at a given
temperature. The atoms in a crystal at temperatures above absolute zero temperature are in a constant
state of vibration and the average amplitude will be dependent on the temperature, the higher the
temperature the greater the amplitude, and consequently, the greater the kinetic or internal energy. The
overall effect represents the phenomenon known as thermal expansion.
If the temperature continues to increase the interatomic spacing will increase, and eventually a
change of state will occur.
The thermal conductivity depends mainly on the number of free electrons in the material.
As metallic structures contain many free electrons and most metals are good conductors of heat as
well as electricity, whereas non-metallic materials do not include many free electrons and consequently
they are generally poor thermal and electrical conductors.

CRYSTALLINE STRUCTURE
Dental materials consist of many millions of atoms or molecules. They are arranged in a particular
configuration.
In 1665 Robert Hooke simulated the characteristic shapes of crystals by stacking musket balls in
piles.
The atoms are bonded by either primary or secondary forces. In solid state they combine in the
manner that will ensure a minimal internal energy.
For eg. Sodium and chlorine share one electron as described previously. In the solid state,
however they do note simply pair together but rather all of the positively charged sodium ions attract all of
the negative chlorine ions, with the result that they form a regularly spaced configuration known as space
lattice or crystal, here every atom is spaced equally from every other atom.
There are 14 possible lattice types, but many of the metals used in dentistry belong to the cubic
system.
Non crystalline structure eg. Glass and waxes structures other than the crystalline form that occur
in the solid state eg. Glass and waxes.
Waxes solidify as amorphous materials meaning that the molecules are distributed at random.
Though there may be a tendency for the arrangement to be regular.
Glass is considered to be a noncrystalline solid, yet its atoms tend to forma short range order
lattice instead of the long-range order lattice characteristic of crystalline solids. In other words, the
ordered arrangement of the glass is more or less localized with a considerable number of disordered units
between them.
Such an arrangement is also typical of liquids such solids are sometimes called supercooled
liquids.
Non crystalline solids do not have a definite melting temperature but rather they gradually softer as
the temperature is raised and gradually hardens as they cool. The temperature at which there is an
abrupt decrease in the thermal expansion cuff, is called the glass transition temperature or glass
temperature.
Below Tg a glass loses its fluid characteristics and has significant resistance to deformation.
Eg : synthetic dental resins.
DIFFUSION
Diffusion of molecules in gases and liquids is not known. However molecules and atoms diffuse in
the solid state as well.
At any temperature above absolute zero, the atoms of a solid possess some amount of kinetic
energy as previously discussed. However the fact is that all the atoms do not possess the same amount
of energy, these energies vary from very small to quiet large. With the average energy related to the
absolute temperature. Even at very low temperatures some atoms will have large energies. If the energy
of a particular atom exceeds the bonding energy, it can, move to another position is the lattice.
Atoms change position in pure solids, even under equilibrium conditions, this is known as self
diffusion.
Increase temperature greater the rate of diffusion .The diffusion rate will however vary with the
atom size, interatomic or intermolecular bonding, lattice.
ADHESION AND BONDING
Adhesion is a phenomenon involved in many situations in dentistry.
Eg. Leakage adjacent to dental restorative material is affected by the adhesion process. The
retension of artificial dentures is probably dependent, to some extent on the adhesion between denture
and saliva and between saliva and soft tissue.
Plaque and calculus to tooth adhesion.
When 2 subs are brought together into ultimate contact with each other the molecules of one sub
adhere or are attracted of molecule of another.
Unlike molecule adhesion
Like molecule cohesion
Material or film that produces adhesion adhesive
Material to which it is applied adherend
MECHANICAL BONDING
Screws, bolts, undercut.
Acid etching composite.
SURFACE ENERGY
For adhesion to exist, the surfaces must be attracted to one another at their interface.
Energy at the surface is more than at the centre. Because at the outer surface the atoms are not
equally attracted in all directions.
Increase in energy per unit are or surface is referred to as the surface energy or surface tension.
Eg. Molecules in the air may be attracted to the surface and become adsorbed on the material
surface.
Silver, platinum and gold adsorb O
2
.
With gold bonding forces are 2
0
but in case of silver the attraction may be controlled by chemical or
1
0
bonding and silver oxide may form.
When 1
0
bonding is involved, the adhesion is termed chemisorption.
In short, greater the surface energy, greater the capacity for adhesion.
MECHANICAL BONDING
Strong attachments of two substances can also be accomplished simply by mechanical bonding or
retention rather than molecular attraction. Even structural retention may be somewhat gross, as by
screws, bolts and undercuts. It may also involve more subtle mechanisms as by penetration of the
adhesive into microscopic or submicroscopic irregularities (eg. Revices and pores) in the surface of the
substrate.
A fluid or semiviscous liquid adhesive is best suited for such a procedure, since it readily
penetrates into these surface discrepancies. Upon hardening the multitude of adhesive projections
embedded in the adherand surface provides the footholds for mechanical attachment.
Acid etching resin projections provide retention as it flows into the minute pores created by 37%
phosphoric acid.
WETTING
It is difficult to force two solid surface to adhere.
When placed in apposition only high spots are in contract. Because these areas usually constitute
only a small percentage of the total surface, no perceptible adhesion takes place. The attraction is
generally neglible when the surface molecules of the attracting substances are separated by distances
greater than 0.7 nm.
One method of overcoming this difficulty is to use a fluid that flows into these irregularities and thus
provides contact over a greater part of the surfaces of the solid.

To produce adhesion in this manner, the liquid must flow easily over the entire surfaces and
adheres to the solid. This characteristic is referred to as welting.
Ability of an adhesive to wet the surface is influenced by number of factors.
Cleanliness
Eg. Oxide film on metallic surfaces.
Some substances have + surface energy hence only a few liquids wet their surface.
Close packing of the structural organic groups and the presence of halogens may prevent wetting.
Metals interact vigorously with liquid adhesive because of increase surface energy.
CONTACT ANGLE OF WETTING
The extend to which an adhesive wets the surface of an adherand may be determined by
measuring the contact angle between the adhesive and adherand.
The contact angle is the angle formed by the adhesive with the adherend at their interface. If the
molecules of the adhesive are attracted to the molecules of the adherend as much as or more than they
are to themselves, the liquid adhesive will spread completely over the surface of the solid, and no angle
(u = 0 degrees) will be formed. Thus the forces of adhesion are stronger than the cohesive forces holding
the molecules of the adhesive together.
Tendency of liquid to spread increases with decrease in contact angle. Therefore contact angle is
the indication of spreadability or wettability. Thus the smaller the contact angle between an adhesive and
an adherend, the better the ability of the adhesive to fill in irregularities on the surface of the adherend.
Also the fluidity of the adhesive influences the extent to which these voids or irregularities are fitted.
ADHESION TO TOOTH STRUCTURE
Associated principles of adhesion can be readily related to dental situations. For eg. when contact
angle measurements are used to study the wettability of enamel and dentin. It is found that the wettability
of these surfaces is markedly reduced after the topical appreciation of an aqueous fluoride solution.
Thus fluoride treated enamel surface retains less plaque over a given period, presumably because
of a decrease in surface energy. Therefore decreases in dental caries.
Higher surface energy of many restorative materials compound with that of the tooth, there is great
tendency for the surface and margins of the restoration to accumulate debris. Therefore increases
marginal caries.
Under certain instances,
1) Recurrent caries
2) Pulpal sentivity
3) Deterioration of the margins of restoration can be associated with a lack of adhesion between restoration.
Enamel and dentin of tooth have varying amounts of organic and inorganic components. A
material that can adhere to the organic components may not adhere to the inorganic components, and an
adhesive that bonds to enamel may not adhere to dentin to the same extent.
After cavity preparation, tenacious microscopic debris covers the enamel and dentin surfaces.
This surface contamination called the smear layer, reduces wetting.
Greatest problem asso with bonding to tooth surfaces is water or saliva contamination.
Inorganic components of tooth structure have a strong affinity for water. To remove the water, the enamel
and dentin would have to be heated to increase temperature.
MECHANICAL PROPERTIES
Most restorative materials must withstand forces, during either fabrication or mastication
mechanical properties are therefore important in understanding and predicting a materials behavior under
load. Because no single mechanical property can give a true measure of quality, understanding the
principles involved in a variety of mechanical properties is essential to obtain the Maximum service.
An important factor in the design of a dental prosthesis is strength, a mechanical property of a
material that ensures that the prosthesis serves its intend of firm a effectively safely and for a reasonable
period.
FORCE
It is gained thru one body pushing or pulling on another. Forces applied thru actual contact or at a
distance.
The result of force is
(a) Change in position of body at rest
(b) Motion of the body.
If force applied to body results in no movement of body thru deformation results
Force is defined by 3 characters
a) Point of application
b) Magnitude
c) Direction
The unit of force is NEWTON (N)
Occlusal forces Most important application of physics in dentistry is the study fo forces applied to teeth
and dental restorations.
Biting forces in case of molars incisors
Adults 400-800N (molar)
Child 235-494 with 22N yearly
We can surmise that the forces of occlusal and response of the underlying tissue change with
anatomical location. Therefore a material or design sufficient to withstand the forces of occlusion on the
incisor of a child may not be sufficient for the first molar of an adult who has a malocclusion or bridge.
STRESS
When an external force acts upon a solid body, a reaction force results within the body that is equal
is magnitude but opposite in direction to the external force. The external force will be called the load on
the body.
The internal reaction is equal in intensity and opposite in direction to the applied external force, and
is called stress.
Both the applied force and internal resistance (stress) are distributed over a given area of the body
and so the stress in a structure is designated as the force per unit area in this respect stress resembles
for
Stress = Force
Area
Unit Megapascals MPa
FORCES ON RESTORATIONS
Equally important to the study of forces on natural dentition is the measurement of force and
stresses on restorations such as inlays, fixed bridges removable partial dentures and complete
dentures.One of the first investigations of occlusal forces showed that the average biting force on patients
who had a fixed bridge replacing a first molar was 250N on the restored side and 300 N on the opposite
side, where they had natural dentition.
Force measurements on patients with removable partial dentures are in the range of 65 to 235 N
for patients with complete dentures.
The average force on the molars and bicuspids was about 100 N whereas the forces on the
incisors averaged 40 N. The wide range in results is possibly caused by age and gender variations in the
patient populations. In general the biting force applied by women in 90 N less than that applied by men.
These studies indicate that
Chewing forces on the 1
st
molars of patients with fixed bridges is about 40% of the force exerted by
patients with natural dentitions.
Decrease in force is obtained with CD or RPD. In such patients only 15% of force is applied.
We can therefore surprise that the forces of occlusion and the response of underlying tissue
changes with anatomic location, age, malocclusion and placement of a restorative appliance.
Therefore a material or design sufficient to withstand the forces of occlusion on the incisor of a child
may not be sufficient for the first molar of an adult with a malocclusion or bridge.
Internal resistance to force application is impractical to measure, the more convenient procedure is
to measure external forces (F) applied to the cross sectional area (A), which can be described as the
stress typically denoted as S or o. The unit of stress therefore is the unit of force (N) divided by a unit of
area or length squared and is commonly expressed as Pascal.
1 Pa = 1N /m
2
= 1 MN /mm
2

Stress in a structure varies directly with force and inversely with area, it is therefore necessary to
determine the area over which the force acts. Particularly true with dental restorations, as forces applied
over small areas eg. clasps on RPD, orthodontic wires.
Stress is always stated as though the force were equivalent to that applied to 1m
2
section, but a
dental restoration obviously does not have a square meter of exposed occlusal surface area. A small
occlusal pit restoration may have no more than 4mm
2
of surface area, if it were assumed that the
restoration were 2mm on a side. If a biting force of 440 N should be concentrated on this area, the stress
developed would be 100MPa, therefore stresses equivalent to several hundreds of MPa occur in many
types of restorations.
TYPES OF STRESS
A force can be directed to a body from any angle or direction and often several forces are
combined to develop complex stresses in a structure. In general individually applied forces may be axial
(tensile or comp), shear, bending or torsional. All stresses however can be combined into 2 basic types
axial and shear.
Tension results in a body when it is subjected to two sets of forces directed away from each other
in the same straight line.
Compression results when the body is subjected to two sets of forces directed towards from each
other in the same straight line.
Shear results when two sets of forces are directed parallel to each other.
Torsion results from the twisting of a body. Bending results from an applied bending moment.
TENSILE STRESS
It is caused by a load that tends to stretch or elongate a body. It is always accompanied by tensile
strain.
The deformation of a bridge and the diametral compressive loads of a cylinder represent samples
of these complex stress situations.
COMPRESSIVE STRESS
If a body is placed under a load that tends to compress or shorten it, the internal resistance to such
a load is called a compressive stress. A compressive stress is associated with compressive strain. To
calculate either tensile stress or compressive stress, the applied force is divided by the cross-sectional
area perpendicular to the force direction.
Although the shear bond strength of dental adhesive systems is often advertised, most dental
prosthesis and restorations are not likely to fail because of pure shear stresses.
SHEAR STRESS
Shear stress tends to resist the sliding of one portion of a body over another. Shear stress can also
be produced by twisting or torsional action on a material. For example, if a force is applied along the
surface of a tooth enamel by a sharp edged instrument parallel to the interface between the enamel and
orthodontic bracket, the bracket may debond by shear stress failure of the resin luting agent. Shear stress
is calculated by dividing the force by the area parallel to the force direction.
In the oral environment shear failure is unlikely to occur for many of the brittle material because
restored tooth surfaces are generally rough in surface morphology and they are not planar.
The presence of chamfers, bevels, or changes in curvature of a bonded tooth surface would make
shear failure of a bonded material highly unlikely. Further more to produce shear failure the applied force
must be located immediately adjacent to the interface.
FLEXURAL STRESS (Bending)
Flexural stress is exhibited in a 3 unit bridge and a 2 - unit cantilever bridge. It is produced by
bending force in dental appliances in one ways
1) By subjecting a structure such as a FPD to three point loading, where by the endpoints are fixed and a
force is applied between these endpoints,
2) By subjecting a cantilevered structure that is supported at only one end to a load along any part of the
unsupported section.
When patient bites into an apple the anterior teeth receive forces that are at an angle to their long
axes, thereby creating flexural stresses within the teeth.
Tensile stress develops on the tissue side of the bridge and compressive stress develops on the
occlusal side. Between these two areas is the neutral axis that represents a state of no tensile stress and
no compressive stress.
For a canteliver bridge the maximum tensile stress develops on the occlusal surface or the
surface that is becoming more convex.
STRAIN
In the discussion of force, it was pointed out that a body undergoes deformation when a force is
applied to it. It is important to recognize that each types of stress is capable of producing a corresponding
deformation in a body.
The deformation resulting from a tensile or pulling force is an elongation of a body in the direction
of applied force, where as a compressive or pushing force causes compression or shortening of the body
in the direction of loading.
Strain E is described as the change in length per unit length of the body when it is subjected to a
stress. Strain has no unit of measurement but is represented a pure number obtained from the full
equation.
Strain E Deformation = L L
0
= AL
Original length L
0
L
0


Regardless of the composition or nature of the material and type of stress applied to the material,
deformation and strain result with each stress application.
Significance : A Restoration material such as a clasp or an orthodontic wire which can with stand a large
amount of strain before failure can be bent and adjusted with less chance of fracturing.


STRESS STRAIN CURVES
Consider a bar of material subjected to an applied force F. We can measure the magnitude of the
force and the resulting deformation.
If we next take another bar of the same material, but diff dimensions the force deformation
characteristic change.
However if we normalize the applied force by the cross sectional area A (stress) of the bar and
neuralize the deformation by the original length (strain) of the bar, the resultant stress strain curve now
becomes independent of the geometry of the bar.
It is therefore preferential to report the stress strain deformation characteristics. The stress
strain relationship of a dental material is studied by measuring the load and deformation and then
calculating the corresponding stress and strain.
An s-s curve for a hypothetical material that was subjected to increase tensile stress until is show.
The stress is plotted vertically and the strain is plotted horizontally. As the stress is increase the
strain is increases. In fact in the ventral portion of the curve from 0 to A, the strain is linearly proportional
to the stress and as the stress is doubled, the amount of strain is also doubled when a stress that is
higher than the value registered at A is achieved, the strain changes are no longer linearly proportional to
the stress changes. Hence the value of the stress at A known as proportional limit.
PROPORTIONAL AND ELASTIC LIMITS
The proportional limit is defined as the greatest stress that a material will sustain without a
deviation from the proportionality of stress to strain. Below the proportional limit, no permanent
deformation occurs in a structure when stress removed it return to its original dimensions. Within this
range of stress application, the material is elastic in nature, and if the material is stressed to a value
below the proportional limit, an elastic or reversible strain will occur. The region of the stress strain curve
below the proportional limit is called the elastic region. The application of a stress greater than the
proportional limit results in a permanent or irreversible strain in the sample, and the region of the stress
strain curve beyond the proportional limit is called the plastic region.
The elastic limit is defined as the maximum stress that a material will withstand without permanent
deformation. For all practical purposes, therefore, the proportional limit and elastic limit represent the
same stress with in the structure, and the terms are often used interchangeably in referring to the stress
involved.
The concepts of elastic and plastic behavior can be realized with a schematic model of the
deformation of atoms in a solid under stress. The atoms are shown in (Fig A) with no stress applied, and
in (Fig B) with an applied stress that is below the value of the proportional limit.
When the stress shown in B is removed, the atoms return to their positions shown in A. When a
stress is applied that is greater than the proportional limit, the atoms move to a position as shown in (Fig
C) and after removal of the stress, the atoms remain in this new position. The application of a stress
greater than the proportional or elastic limit results in an irreversible or permanent strain in the sample.
YIELD STRENGTH / YIELD STRESS
It is the property that is used to describe the stress at which the material begins to function in a
plastic manner. At this stress, a limited permanent strain has occurred in the material.
The yield it is defined as the stress at which a material exhibits a specified limiting deviation from
proportionality of stress to strains.
When a structure is permanently deformed, even to a small degree, it does not return completely to
its original dimensions when the stress is removed. Therefore prop limit, elastic limit, yield it of a maternal
are among its most important properties.
Any dental structure that is permanently deformed through the forces of mastication is usually a
functional failure to some degree.
For eg. bridge that is permanently deformed thorough the application of excessive biting forces would be
shifted out of the proper occlusal relation for which it was originally designed.
The prosthesis becomes permanently deformed because a stress equal to or greater than the yield
strength was developed.
Recall also that malocclusion changes the stresses placed on a restoration, a deformed prosthesis
many therefore by subjected to greater stresses than originally intended. Usually a # does met occur
under such conditions but rather only a permanent deformation results, which represents a destructive eg
of deformation.
A constructive eg of permanent deformation and stresses in excess of the elastic limit is observed
when an appliance or dental structure is adapted or adjusted for purposes of design for eg in the process
of shaping an ortho appliance or RPD clamp it may be necessary to endure stress into the structure in
excess of the yield at if the material is to be permanently bent or adapted.
ULTIMATE STRENGTH
The test specimen is subjected to its greatest stress at point C. the ultimate tensile strength or
stress is defined as the maximum strength or stress a material can withstand before failure in tension.
The ultimate strength of an alloy is used in dentistry to give an indication of the size or cross
section required for a given restoration. Note
Fracture Strength
Point D
Stress at which a material fracture
Note that a mat does not necessarily fracture at the point at which the maximum stress occurs.
After a max stress is applied some materials begin to elongate excessively and the stress calculated from
the force and the original cross sectional area may drop before final fracture occurs.

MECHANICAL PROPERTIES BASED ON ELASTIC DEFORMATION
There are several important mechanical properties and parameters that are measures of the elastic
or reversible deformation behavior of dental materials.
Viz
Elastic modulus / youngs modulus
Dynamic youngs modulus
Flexibility
Resilience
Poissons ratio
ELASTIC MODULUS
The term describes the relative stiffness or rigidity of a material.
Here is a fig of a stress strain graph for a stainless steel were that has been subjected to a tensile
test ultimate tensile strength, yield, prop limit elastic modulus are shown.
This fig represents a plot of true stress versus strain because the force ahs been divides by the
changing cross sectional area as the wire being stretched. The straight line region represents reversible
elastic deformation, because the stress remains below the prop limit of 1020mpa and the curved region
represents irreversible plastic deformation that is not recovered when the wire fractures at a stress of
1625 mpa. However the elastic deformation is fully recovered when the force is removed or when the wire
fractures.
We can see this easily while bending a wire in our hands a slight amount and then reducing the
force. It straightens back to its original shape as the force is decreases to zero and assuming that the
induced stress has not exceeded the proportional limit.
This principle can be illustrated by demonstrating a burnishing procedure for an open metal margin,
where a dental abrasive stone is shown rotating against the metal margin to close the marginal gap as a
result of elastic plus plastic strain. However after the force is removed the margins springs back an
amount equal to the total elastic strain. Only by removing the screws from a tooth or die can total closure
be accomplished. Because we must provide at least 25m of clearance for the cement, total burnishing
on the tooth or die is usually adequate since the amount of elastic strain recovery is relatively small.
The term used to designate it E elastic modulus of a material is a constant and is unaffected by
the amount of elastic or plastic stress that can be induced in a material.
Force per unit area / giganewtons per square meter. GN/m
2
or giga pascals (GPA)
Dynamic Youngs Modulus : Elastic modulus can be measured by a dynamic method as well as the
static techniques that were described in the previous section since the velocity at which sound travels
through a solid can be readily measured by ultrasonic longitudinal and transverse wave transducers and
appropriate receivers. Based on this velocity and the density of the material, the elastic modulus and
poissons ratio can be determined. This method of determining dynamic elastic moduli is less complicated
than conventional tensile or compressive tests, but the values are often found to be higher than the
values obtained by static measurements. For most purposes, these values are acceptable.
If, instead of uniaxial tensile or compressive stress, a shear stress was induced, the resulting shear
strain could be used to define a shear modulus for the material. The shear modulus (G) can be calculated
from the elastic modulus (E) and Poissons ratio (v). It is determined by the equation,





DUCTILITY AND MALLEABILITY
Two very significant properties of metals and alloys. These properties cannot always be determined
with certainly from a stress strain curve.
Ductility is the ability of a material to be plastically deformed, and it is indicated by the plastic strain.
A high degree of compression or elongation indicated a good malleability and ductility.
Ductility:- if a material represents its ability to be drawn into wire under a force of tension. The
material is subjected to a permanent deformation. While being subjected to these tensile force. The
malleability of a substance represents its ability to be hammered or rolled into thin sheets without
fracturing.
Ductility is a property that has been related to the work ability of a material in the mouth. Ductility
has also been related to burnishability of the margins of a casting.
Metals tend be ductile, whereas ceramics tend to be brittle
Ductility Malleability
Gold Gold
Silver Silver
Platinum Aluminium



Iron Copper
Nickel Tin
Copper Platinum
Al Lead
Zinc Zinc
Tin Iron
Lead Nickel

RESILIENCE
Resilience of a material to permanent deformation. It indicates the amount of energy necessary to
deform the material to the proportional limit. This term is associated with springiness. The material with
the larger elastic area has the higher resilience.
When a dental restoration is deformed during mastication, the chewing force acts on the tooth
structure, the restoration, or both and the magnitude of the structures deformation is determined by the
induced stress. In most dental restorations, large strains are precluded because of the proprioceptive
response of neural receptors in the periodontium. The pain stimulus causes the force to be decreases
and induced stress to be reduced, thereby preventing damage to the teeth or restorations.
Eg in an inlay (proximal) excessive movement of the adjacent tooth is seen if large proximal strains
develop during compressive loading on the occlusal surface. Hence the restorative material should exhibit
a moderately high elastic modulus and low resilience, thereby limiting the elastic strain that is produced.
Mn/m
3
Mega newtons / cubic meter
Resilience has particular importance in the evaluation of orthodontic wires because the amount of
work expected from a particular spring is having a tooth is of interest. There is also interest in the amount
of stress and strain at the proportional limit because these factors determine the magnitude of the force
that can be applied to the tooth and how for the tooth will have to move before the spring is no longer
effective.
POISSONS RATIO
During axial loading in tension or compression there is a simultaneous axial and lateral strain.
Under tensile loading, as a material elongates in the direction of load, there is a reduction in cross
section. Under compressive loading, there is an increase in the cross section.
Within the elastic range, the ratio of the lateral to the axial strain is called Poissons ration.
In tensile loading, the Poissons ratio indicates that the reduction in the cross section is proportional
to the elongation during the elastic deformation. The reduction in cross section continues which the
material is fractured.
Values of Poissons Ratio of some restorative dental materials
Mat Ratio
Amalgam 0.35
Zn phosphate 0.35
Enamel 0.30
Resin composite 0.24
Brittle subs such as hard gold alloys and dental amalgam show little permanent reduction is cross
section during a tensile test, whereas ductile materials such as soft gold alloys, which are high in gold
contents show a high degree of reduction in cross section area.

TOUGHNESS
It is defined as the amount of elastic and plastic deformation energy required to fracture a material
and it is a measure of the resistance to fracture.
It can be measured as the total area under the stress-strain curve from zero stress to the fracture
stress. Toughness depends on strength and ductility. The higher the strength and the higher the ductility,
the greater the toughness. Thus it can be concluded that a tough material is generally strong, although a
strong material is not necessary tough.
Units MN/m
3
or Mpa /m
Therefore toughness is the energy required to stress that material to the point of fracture.
FRACTURE TOUGHNESS
Mechanical property that describes the resistance of brittle materials to the catastrophic
propagation of flows under an applied stress.
Fracture mechanics characterizes the behavior of materials with cracks or flows, which may arise
naturally in a material or nucleate after a time in service. In either case, any defect generally weakens a
material and sudden fractures can arise at stresses below the yield stress. Sudden catastrophic fractures
typically occur in brittle materials that point.
Fracture toughess of selected dental mats.
Material Mpa m
Amalgam 1.3
Ceramic 1.5 2.1
Resin composite 0.8 2.2
Porcelain 2.6
Enamel 0.6 1.8
Dentin 3.1

We have the ability to plastically deform and redistribute stresses.
2 simple examples illustrate the significance of defects on the fracture of materials. If one takes a
piece of paper and tries to tear it, grater effort is needed than if a tiny cut is made in the paper.
Similarly, it takes a considerable force to break a glass bar, however, if a small notch is placed on
the surface of the glass bar less force is needed to cause fracture.
If the same experiment is performed on a ductile material, we find that a small surface notch has no
effect on the force required to break the bar, and the ductile bar can be bent without fracturing for a brittle
material, such as glass, no local plastic deformation is associated with fracture whereas for a ductile
material, plastic deformation such as the ability to bend, occurs without fracture.
The ability to be plastically deformed without fracture or the amount of energy required for fracture
is the fracture toughness.
Therefore larger flow lower stress needed to cause fracture. This is because the stresses which
would normally be supported by material are not concentrated at the edge of flaw.
Presence of fillers in polymers substantially increases fracture toughness. 50 wt% zinconia to
porcelain increases fracture toughness.
HARDNESS
May be broadly defined as the resistance to permanent surface indentation or penetration.
Measure as a force per unit area of indentation and in mineralogy, the relative hardness of a
substance is based on its ability to resist scratching. In metallurgy and in most other disciplines, the
concept of hardness that is most generally accepted is the resistance to indentation. It is on this precept
that most modern hardness tests are designed.
It is apparent that hardness is important. It is indicative of the case of finishing of a structure and its
resistance to in-service scratching. Finishing or polishing a structure is important for esthetic purposes
and as discusses previously scratches can compromise fatigue strength and lead to permanent failure.
Some of the most common methods of testing the hardness of restorative are the
Brinell
Knoop Micro hardness test
Vickers
Rockwell
Share A
BRINELL HARDNESS TEST
It is among the oldest methods used to test metals and alloys used in dentistry. The method
depends on the resistance toe the penetration of a small still or tungsten carbide ball typically 1.6 nm in
diameter, when subjected to a weight of 123M. in testing the Brinell hardness of a material the
penetration remains in contact with the sample used for a fixed time of 30 seconds. After which it is
removed and the indentation diameter is carefully measured. Used to determined hardness of metals and
metallic materials in dentistry. It is related to proportional limit and ultimte strength of dental gold and
alloys.

BHN =

L is the load in kg.
D is the diameter of the ball in millimeters
d is the diameter of the ball in indentation millimeter
Smaller the area of the indentation, the harder the material and
the larger the BHN value.
Advantage Test is good for determining average hardness values.
Disadvantage poor for determining very localized values.
(PN) not suitable for brittle materials or dental elastic that exhibit elastic recovery.
KNOOP HARDNESS TEST
This test was developed to fulfill the needs o a microindentation test method. A load is applied to a
carefully prepared diamond indenting tool with a pyramid shape, and the lengths of the diagonals of the
resulting indentation in the material are measured. The shape of the indenter and the resulting indentation
are measured.
KHN = L/I
2
C
p

L load applied
l = length of the long diagonal of the indentation.
Cp = constant relating l to the projected area of the indentations.
Units kg/mm
2

Advantage : materials can be tested with a great range of hardness simply by varying the test load.
Disadvantage : high by polished and flat test samples time consuming.
VICKERS HARDNESS TEST
The 136 degree diamond pyramid, or Vickers hardness test, is also suitable for testing the surface
hardness of materials. It has been used to a limited degree as a means of testing the hardness of
restorative dental materials. The method is similar in principle to the Knoop and Brinell tests except that a
136 degree diamond pyramid shaped indenter is forced into the material with a definite load
applications. The indenter produces a square indentation, the diagonals of which are measured as shown
in pic previously.
Useful for brittle stuff therefore measure hardness of tooth.
ROCKWELL HARDNESS TEST
Was developed as a rapid method for hardness determinations. A ball or metal cone indenter is
normally used and the depth of the indentation is measured with a sensitive deal micrometer. The
indenter balls or cones are of several diff diameters, as well diff load applications (60-150) with each
combination described as a special Rockwell scale.
no suitable for brittle materials
how hardness read directly.
Good for testing viscoelasticity of materials.
Disadvantage preload needed increases time
Indentations may disappear immediate when the load is removed.

BRITTLENESS
Is generally considered to be the opposite of toughness. For eg. glass is brittle at room temp, it will
not bend appreciably without breaking. In other words, a brittle material is apt to fracture at or near its
proportional limit.
However a brittle material is not necessarily lacking in strength. For eg. shear strenght of glass is
low, but its tensile strength is very high.
it is the relative inability of a material to sustain plastic deformation before fracture of a material
occurs.
Eg. amalgams, ceramics and composite are brittle at oral temps (5-55
0
C) they sustain little or no
plastic strain before they fracture. Therefore a brittle material fractures at or near its proportional limit.
Therefore amalgam nonresin luting agents will have little or no burnishability because they have no
plastic deformation potential.

ABRASION, FRICTION AND WEAR
Friction is the resistance to motion of one material body over another. If an attempt is made to
move one body over the surface of another a restraining force to resist motion is produced. This
restraining force is the (static) frictional force and result from the molecules of the two objects bonding
where their surfaces are in close contact. Frictional force, Fs is proportional to the normal force (F)
between the surfaces and the (static coefficient of friction (s).
Similar materials have a greater coefficient of friction and if a lubricating medium exists at the
interface, the coefficient of friction is reduced.
Frictional behavior therefore arises from surfaces that, because of microroughness, have a small
real contact area.
An example of the importance of friction dental implant surface roughed to reduce motion
between implant and adjacent tissue. It is percieved that a rough surface and resultant less motion will
provide better osseointegration.
Wear
Is a loss of material resulting from removal and relocation of materials through the contact of two or
more materials. When 2 solid materials are in contact, they only touch at the tips of their highest
asperities.
Wear is usually undesirable but during finishing and polishing wear is beneficial.
4 types of wear
Adhesive
Corosive
Surface fatigue
Abrasive
Abrasive wear involves soft surface in contact with a harden surface. In this type of wear, particles
are pulled off of one surface and adhere to the other during sliding.
Corrosive - 2
0
to physical removal of a layer therefore related to chemical activity.
Metals adhesive wear
Polymers abrasive and fatigue over.

FLEXIBILITY
In case of dental appliances ad restorations a high value for the elastic limit is a necessary
requirement of the materials from which they are fabricated, because the structure is expected to return to
its original shape often it has been stressed. Usually a moderately high modulus of elasticity is also
desirably because only a small deformation will develop under a considerable stress, such as in the case
of an inlay.
There are instances in which a larger strain or deformation may be needed with a moderate or
slight stress. For example, in an orthodontic appliance, a spring is after bent a considerable distance
under the influence of a small stress. In such a case, the structure is said to be flexible and it possesses
the property of flexibility. Maximum flexibility is defined as the strain that occurs when the material is
stressed to its proportional limit.

VISCOELASTICITY
In the previous discussions of the relationship between stress and strain, the effect of load
application rate was not considered. In many metals and brittle materials, the effect is rather small.
However the rate of loading is important in many materials, particularly polymers and soft tissues.
The mechanical properties of many dental materials, such as agar, alginate, elastomeric,
impression materials and waxes, amalgam and plastics, dentin, oral mucosa and pdl are dependent on
how fast they are stressed, for these materials increasing the loading (strain) rate produces a different
stress -strain curve with higher rates giving higher values for the elastic modulus, proportional limit and
ultimate strength. Materials that have mechanical properties dependent on loading rate termed elastic.
Materials that have mechanical properties dependent on loading rate are termed viscoealstic. In other
words these materials have characteristics of an elastic solid or a viscous fluid.
FLUID BEHAVIOR AND VISCOCITY
In addition to the many solid dental materials that exhibit some fluid characteristics, many dental
materials, such as cements and impression materials, are in the fluid state when formed. Therefore
(viscous) fluid phenomena are important. Viscosity (n) is the resistance of a fluid to flow and is equal to
the shear stress divided by the shear strain rate.
When a cement or impression material sets, the viscosity increases, making it less viscous and
more solid like
The unit of viscosity are POISE
Or centipoise cp
The behavior of elastic solids and viscous fluids can be understood from simple mechanical
models. An elastic solid can be viewed as a spring when the spring is stretched by a force F it displaced
a distance c. the applied force and resultant displacement are proportional and the constant of
proportionality is the spring constant R . Therefore
F = R x X
Note that the model of an elastic element does not involve time. The spring acts instantaneously
when stretched therefore an elastic solid is nondependent of loading rate.
Although the viscosity of fluid is proportional to the shear rate, the proportionality differs for different
fluids. Fluids may be classified as
Newtonian
Pseudoplastic
Dilatant depending on how their viscosity varies with shear shear rate certain dental cements and
impression materials are Newtonian. The viscosity of a N liquid is constant an independent of shear rate.
The viscosity of a pseudoplastic liquid decreases with increasing shear rate. Several endodontic cements
are pseudoplastic, as are monophase rubber impression materials.
When subjected to low shear rate during spatulation or while an impression is made in a tray, these
impression materials have a high viscosity and possess body in the tray. These materials, however can
also be used in a syringe, because at the higher shear rates encountered as they pass through the
syringe tip, the viscosity decreases as much as tenfold the viscosity of a dilatant liquid increases with
increasing shear rate.
Eg of dilatant liq fluid denture base resins.
Two additional factors that influence the viscosity of a material are time and temp.
The viscosity of a non setting liquid is typically independent of time and decreases with increasing
temperature. Most dental materials, however, begin to set after the components have been mixed and
their viscosity increases with time, as evidenced by most dental cements and impression materials.
A notable exception is ZnO that requires 2% of moisture to sit on the mixing pad then materials
maintain a constant viscosity that is described clinically as a ling working time once placed in the mouth
however the ZnO materials show rapid increases in viscosity because exposure to heat and humidity
accelerate the setting reaction.
In general for a material that sets, viscosity increases with increasing temperature. However the
effect of heat on the viscosity of a material that sets depend on the nature of the setting reaction.
For eg. Zn phosphicum, Zn polycarb
The setting reaction of A is highly exothermic, and miningat reduced temp results in a lower
viscosity than when mixed at high time. The setting reaction of B is less affected by temp. addi working
time is achieved by axis a cool or frozen mixing slab.
RELAXATION
After a substance has been permanently deformed, there are trapped internal stresses. For eg in a
crystalline substance the atoms in the space lattice are displaced and the system is not in equilibrium.
It is understandable that such a situation is not very stable. The displaced atoms may be said to be
uncomfortable and wish to return to normal regular positions given time by diffusion they will move back.
The result is a change in the shape or contain of the solid as a gross manifestation of the rearrangement
is atomer or molecular positions. The material is said to warp or distort. Such a relief of stress is known as
relaxation.
Rate of relaxation will increase with an increase in temperature. For example if a wire is bent, it
may tend to straighter out if it is heated to a high temp. At room temp any such relaxation or diffusion may
be negligible. On the other hand, there are many noncrystalline dental materials eg waxes, resins, gels
that can relax during storage at room temp after being bent or molded.

PHYSICAL PROPERTIES
Introduction :
Physical properties are based on the laws of mechanics, acountics, optics, thermodynamics,
electricity, magnetism radiation, atomic structure, or nuclear phenomenon. Hue, Chroma and Value and
translucency are physical properties that are based on the laws of optics, which is the science that deals
with phenomena of light, vision, and light. Thermal conductivity and coefficient of thermal expansion are
physical properties based on the laws of thermodynamics.

ABRASION AND ABRASION RESISTANCE
Hardness has often been used as in index of the ability of a material to resist abrasion and wear.
The ability of enamel by ceramic and other restorative material is well known. Along with hardness of
material other factors affecting enamel wear are biting force, frequency of chewing, abrasiveness of the
diet, composition of liquids, temperature changes, physical properties of the material and surface
irregularities of the material. Although dentists cannot control the biting force, they can polish the abrading
ceramic surface to reduce the rate of destructive enamel wear.
VISIOSITY : The resistance of liquid to motion is called viscosity and it is controlled by internal frictional
forces within the liquid. Viscosity is the measure of the consistency of a fluid and its inability to flow.
An ideal fluid has shear stress that is proportional to strain rate and the plot is a straight line in the
graph . Such behaviors is called Newtonian. A Newtonian fluid has a constant viscosity and straight like
resembles elastic portion of a stress-strain curve.
Viscosity is measured in units of MPa/sec. Or POISE. Higher the value, the more viscous is the
material.
Eg. Pure water at 20
0
C viscosity = 1.0 centipoise. (cP)
Agar hydrocolloid impression viscosity = 281, 100 cP
Material at 45
0
C
Light body polysulfide viscosity = 109,000 cP
At 30
0
C
Heavy body polysulfide viscosity = 1,360,000 cP
At 36
0
C
Pseudoplastic : For many dental material viscosity decreases with increasing shear rate until it reaches
a constant value. E.g. Polysilicon pseudoplastic material, cements like zinc phosphate, zinc oxide
Eugenol.
Dilatant : These liquids become more rigid as the rate of deformation increases. E.g. cold cure resin
dough.
Plastic : Some classes of material behave like a rigid body until some minimum value of shear stress is
reached. E.g. catsup. (a sharp blow to the bottle is required to produce initial flow)
- Viscosity of most liquids decrease rapidly with increasing temperature.
- A liquid that becomes less viscous and more fluid under pressure is referred to as thixotropic. E.g. Dental
prophylaxis paste, plaster, resin cements, agar.
CREEP AND FLOW
- Creep is defined as the time dependent plastic strain (deformation)of a material under static load or
constant stress.
- Metal creep usually occurs as the temperature approaches within a few hundred degrees of the melting
range. Metals used in dentistry for cast restorations or substrates for porcelain veneers have melting
points much higher than mouth temperature and thus are not susceptible to creep deformation except
when they are heated to very high temperature.
- The most important exception is dental amalgam, which has components with melting points slightly
above room temperature. Because of low melting range, dental amalgam can slowly creep from a
restored tooth under stress as produced by patients who clench their teeth.
- According to American Dental Association specification creep must be <8%.
Following are the approximate value for various types of alloys :
1) Low copper lathe cut 2%
2) Low copper spherical 1%
3) High copper admix 0.5%
4) High copper single composition 0.05 0.1%
FLOW : Is the time dependent deforming property of amorphous material such as waxes to deform under
a small static load or even load associated with its own mass.
Static creep : Is the time dependent deformation produced in a completely set solid subjected to a
constant load.
Dynamic creep : Refers to this phenomenon when the applied stress is fluctuating such as fatigue type
test.
COLOUR
Another important goal of dentistry is to restore the colour and appearance of natural dentition.
Aesthetic considerations in restorative and prosthetic dentistry have assumed a high priority within past
several decades. For e.g. the search for an ideal general purpose, direct filling tooth coloured restorative
material is one of the challenges of present dental material research.
Light is electromagnetic radiation that can be detected by the human eye. The eye is sensitive to
wavelengths from approximate 400mnm (violet) to 700nm (dark-red) (fig)
The reflected light intensity and the combined intensities of the wavelength present in a beam of
light determines the appearance properties (hue, value and chroma). For an object to the visible, it must
reflect or transmit light incident on it from an external source. The latter is the case for objects that are of
dental interest. The incident light is polychromatic, i.e. mixture of various wavelength.
The eye is most sensitive to light in the green-yellow region (wavelength 550 nm) and least
sensitive at either extreme i.e. red or blue.
Three dimensions of colour : Verbal description of colour are not precise enough to describe the
appearance of teeth or restoration surface. To accurately describe our perception of a beam of light
reflected from a tooth or restoration surface, three variables must be measured. Quantitatively, the colour
and appearance must be described in three dimensional colour space by measurement of hue, value and
chroma.
Hue : Describes the dominant colour of an object. E.g. red, green or blue. This refers to the dominant
wavelength present in the spectral distribution.
Value : Is the lightness or darkness of a colour, which can be measured independently of the hue. Teeth
or other object can be separated into lighter shades (higher value) and darker shades (lower value).
Chroma : Represents the degree of saturation of a particular bone. The higher the chroma, more intense
is the colour. Chroma is always associated with hue and value.
In dental operatory, colour matching is usually done by the use of shade guide to select the colour
of ceramic veneers, inlays or crowns. (fig)
One of the common method to define and measure colour quantitatively is Mullur system. This
system is viewed as cylinder. Hues are arranged sequentially around the perimeter of the cylinder
Chroma. Increases along a radius out from the axis. Value varies along the length of the cylinder from
black at bottom, to neutral gray at the centre, to white at the top.
Because, spectral distribution of light reflected from or transmitted through an object is dependent
on the spectral content of the incident light, the appearance of an object is quite dependent on the nature
of the light by which object is viewed. Daylight, incandescent and fluorescent lamps and common sources
of light in dental operatory and they have different spectral distributions. Objects that appear to be colour
matched under one type of light may appear different under another light source. This phenomenon is
called METAMERISM. If possible, colour matching should be done under two or more different lights and
one being daylight.
Sometimes, natural tooth absorbs light at wavelengths too short to be visible to human eyes ie.
between 300 400 nm called as near ultraviolet radiation. The energy absorbed is converted into light
with longer wavelengths and tooth actually becomes a light source. This phenomenon is called
FLUORESCENCE. The emitted light, blue white colour, is primarily in the 400 450 nm range.
Fluorescence makes a definite contribution to the brightness and vital appearance of human tooth. A
person with ceramic crowns are composite restorations that lacks fluorescing agent appears to be
missing teeth when, viewed under a black light in a night club.
THERMOPHYSICAL PROPERTIES
Thermal Conductivity : Heat transfer through solids most commonly occurs by means of conduction. It
is the thermophysical measure of how well heat is transferred through a material by the conductive flow.
Thermal conductivity or co efficient of thermal conductivity is the quantity of heat in calories per
second that passes through a specimen 1 cm thick having a cross sectional area of 1 cm
2
when
temperature differential between the surface perpendicular to the heat flow of specimen is 1
0
C.
According to II
nd
law of thermodynamics, heat flows from points of higher temperature to points of
lower.
Material having high thermal conductivity are called conductors. Whereas of low thermal
conductivity are called insulators (higher the value, greater is the ability to transmit thermal energy).
Unit W/m/
0
k
e.g
- Silver - 385 W/m/
0
k
- Copper 370 W/m/
0
k
Thermal diffusivity : It is the measure of the rate at which a body with a non uniform temperature
reaches state of thermal equilibrium.
Although thermal conductivity of ZnOE is slightly less than dentin, its diffusivity is more than twice
of dentin.
Mathematically, thermal diffusivity (h) is related to thermal conductivity (k) as :
H = k
c
p
p
Where c
p
= temperature dependent specific heat capacity.
P = temperature dependent density.
e.g.
- Silver 1.64 cm
2
/sec.
- Copper 1.14 cm
2
/sec.
Linear coefficient of thermal expansion : Defined as change in length per unit original length of a material.
When its temperature is raised 1
0
C.
e.g
- Polymethyl metha acrylate 81 x 10
-6
/
0
c
- Dentin 8.3 x 10
-6
/
0
c
- Enamel 11.4 x 10
-6
/
0
c
CONCLUSION

Little knowledge is dangerous as rightly said, thus a thorough understanding of properties of
dental materials enables a professional to ensure the eventual success of the treatment. It is a must for
every dentist that they should posses sufficient knowledge of properties so that they can exercise the
best judgement possible in selection of an appropriate material right from the impression procedures to
the fabrication of the prosthesis.The efficacy of the end product depends on the type of material used and
in turn its proper handling.
REFERENCES

1. Science of Dental Materials : by Anusavice (Skinners), 11
th
Edn.
2. Restorative Dental Materials : by Robert G. Craig, 9
th
Edn.
3. Elements of Dental Materials : by Ralph W. Phillips, 4
th
Edn.
4. Notes on Dental Materials : by E.C. Combe, 5
th
Edn.
5. Applied Dental materials : by John F. McCabe, 7
th
Edn.
CONTENTS

Introduction
Structure of matter and principles of adhesion
Interatomic bonds
o Primary
o Secondary
Crystalline structure
Noncrystalline structure
Diffusion
Adhesion and bonding
Adhesion to tooth structure
Mechanical property
o Forces
o Stress
Tensile
Compressive
Shear
Flexural
o Strain
o Proportion and Elastic limit
o Yield stress and yield strain
o Strength
Mechanical property based on elastic deformation
o Elastic modulus
o Dynamic youngs modulus
o Ductility and Malleability
o Resilience
o Toughness
o Hardness
o Brittleness
o Abrasion and Friction wear
o Flexibility
o Fluid behaviour and viscosity
o Relaxation
Physical property
o Abrasion and abrasion resistance
o Creep and flow
o Color
Value
Hue
Chroma
Thermophysical Properties
o Thermal conductivity
o Thermal diffusivity
Conclusion
References
gypsum products



CONTENTS:


Introduction
Desirable Properties
Chemical & Physical nature of gypsum products
Manufacture of dental plaster & stone
Types of gypsum products
- Impression Plaster
- Model Plaster
- Dental Stone
- Dental Stone, High Strength
- Dental Stone, High Strength, High Expansion
- Synthetic Gypsum
Setting Reaction
Theories of Setting Reaction
Setting Time
Control of Setting Time
Setting Expansion
Control of Setting Expansion
Hygroscopic Setting Expansion
Strength
Surface Hardness & Abrasion Resistance
Viscosity
Reproduction of Details
Proportioning, Mixing & Caring for Gypsum Products
Conclusion
References
















INTRODUCTION


- Gypsum is a naturally occurring white powdery mineral mined in various parts
of the world, with chemical name calcium sulfate dihydrate ( CaSO4.2H2O ).
- Gypsum is derived from a greek word Gypsas (chalk).



FORMS

1. ROCK: - Dull colored rock.


2. ALABLASTER: - Fine grained variety.


3. GYPCRETE (gypcrust): - Hard layer formed on soil.


4. SELENITE.


5. SATIN SPUR: - Fibrous with silky luster.

USES

1. For construction purposes.

2. Used in industry for making pottery, moulds etc.

3. Used in orthopedics to make plaster casts.

APPLICATION IN DENTISTRY

1. For cast preparation.

2. Models and dies.

3. Impression Material.

4. Investment Material.

5. Mounting of Casts.

6. As a mold material for processing of complete dentures.

DESIRABLE PROPERTIES:-

1. Accuracy

2. Dimensional Stability

3. Ability to reproduce fine detail.

4. Strength & resistance to abrasion.

5. Compatibility with the impression materials.

6. Colour

7. Biological safety

8. Ease of use

9. Cost.

CHEMICAL & PHYSICAL NATURE OF GYPSUM PRODUCTS

- As gypsum is dihydrate form of calcium sulphate (CaSO
4
.2H
2
O), on heating, it

loses 1.5gm mol of its 2gm mol of water & is converted to calcium sulphate

hemihydrate (CaSO
4
.1/2H
2
O).

CaSO4. 2H2O on heating CaSO4. H2O + 1H2O (1)
(gypsum) (calcium sulphate (water)
hemihydrate)


- When calcium sulphate hemihydrate is mixed with water, the reverse reaction


takes place & calcium sulphate hemihydrate is converted back to calcium

sulphate dihydrate.


CaSO4.H2O + 1H2O CaSO4. 2H2O + 3900 (2)
(plaster of paris) (water) (gypsum) (cal)

- Reaction is exothermic.

MANUFACTURE OF DENTAL PLASTER & STONE

- Formed by calcining of gypsum.




- Gypsum is ground & subject to heat 110C - 130 C to drive off a part of water

of crystallization

- As the temperature is raised further the remaining water of crystallization is
also

removed & products are formed.

CaSO4 . 2H2O 110-130C(CaSO4)2 H2O130-
200CCaSO4200-1000CCaSO4
gypsum plaster/stone hexagonal ortho-
(calcium sulphate (calcium sulphate anhydrite rhombic
dihydrate) hemihydrate) anhydrit
e



-hemihydrate(plaster)-

- Gypsum is heated in a kettle, vat or rotatory kiln open to air.

- Crystals spongy & irregular.










-hemihydrate(stone)-

- Gypsum is heated to 125c under steam pressure in an autoclave or boiled in
a

solution of CaCl2 .

- Crystals- more dense & prismatic.








HYDRATES OF CALCIUM SULPHATE

Mineral source By product of other
industries

Calcium Sulfate Dihydrate( gypsum)



Heat in an open Heat in autoclave Heat ground gypsum Heat in
boiling30%
vessel, 120c under steam in H2O with small aqueous solution
of
pressure, 120-130c quantity, organic CaCl2/ MgCl2
acid or salt, in an
autoclave,140c






Calcined CaSO4 Autoclaved CaSO4 Autoclaved
CaSO4 CaSO4 hemihydrate

hemihydrate hemihydrate hemihydrate ( DENSITE)
(- hemihydrate) (HYDROCAL or (- hemihydrate)
- hemihydrate)

TYPES OF GYPSUM PRODUCTS

Classification:-

1. Depending on the method of calcination:-

- Dental plaster or - hemihydrate

- Dental stone or - hemihydrate or hydrocal

- Dental stone, high strength or densite

2. Other Gypsum Products:-

- Impression plaster

- Dental Investments:-

a) Gypsum bonded investments

b) Phosphate bonded investments

c) Silica bonded investments

Five types of gypsum products & their properties


























1. IMPRESSION PLASTER(Type 1)-

- They are composed of Plaster of Paris to which modifiers have been added to

regulate setting time & setting expansion.

- Impression plaster is rarely used any more for dental impression because it
has

been replaced by less rigid materials, such as hydrocolloids & elastomers.

- Modifiers such as:-

- Potassium sulphate decreases setting expansion so as to prevent
warpage

of impression & also decreases setting time drastically.

- Borax

- Advantage:- Records excellent fine details.



- Disadvantages:- Small dimensional changes.

Fracture on removal from undercuts

Separating media is required

Non toxic but causes dryness

2. MODEL PLASTER ( Type 2):-

- hemihydrate

- Powder particles are porous & irregular.

- It is usually white in colour.

- Use:- For primary cast for complete dentures.

For articulation purposes.

For flasking in denture construction.


- Advantage:- Inexpensive

- Disadvantage:- Low strength

Porosity



3. DENTAL STONE( Type 3):-

- Discovered in 1930

- hemihydrate or Hydrocal

- Powder particles are more dense & regular in shape.

- Comes in different colours, like yellow, green.

- Use:- - Making casts for diagnostic purposes & for complete or partial
denture

construction.

- Advantages:- Greater strength & surface hardness.

- Disadvantage:- More expensive than plaster.

4. DENTAL STONE, HIGH STRENGTH(Type 4):-

- Modified hemihydrate, Densite or Die stone.

- Powder particles are very dense, cuboidal in shape &has reduced surface
area.

- Use:- For making casts or dies for crown, bridge & inlay fabrication.

- Advantages:- High strength

Surface hardness

Abrasion resistant

Minimum setting expansion

5. DENTAL STONE, HIGH STRENGTH, HIGH EXPANSION(Type 5):-

- Most recent gypsum product.

- Use:- When inadequate expansion has been achieved during the
fabrication

of cast crowns.

- Advantages:- Higher compressive strength

Higher setting expansion(0.10-0.30%)

SYNTHETIC GYPSUM:-

- & - hemihydrates can also be made from the by products/ waste
products

of the manufacture of phosphoric acid.

- Synthetic product is more expensive than that made from natural gypsum.



SETTING

- It follows reversal in reaction of calcium sulfate hemihydrate powder with

water to produce gypsum.

(CaSO4)2.H2O + 3H2O 2CaSO4.2H2O
+
unreacted (CaSO4)2.H2O + heat

- The product of the reaction is gypsum & the heat evolved in the exothermic

reaction is equivalent to the heat used originally in calcinations.

- The products formed during calcination react with water to form gypsum,

but at different rates.

- Eg Hexagonal anhydrite reacts very rapidly, whereas when orthorhombic

anhydrite is mixed with water the reaction may require hours since, the

orthorhombic anhydrite has a more stable & closely packed crystal lattice.




SETTING REACTION

- Gypsum is a unique material.

- Various hydrates have a relatively low solubility, with a distinct difference

between the greater solubility of hemihydrate & dihydrate.

- Dihydrate is too soluble for use in structures exposed to atmosphere.

-
The setting reaction of gypsum occurs by:-

1. Dissolution of calcium sulphate hemihydrate.

2. Formation of saturated solution of calcium sulphate.

3. Subsequent aggregation of less soluble calcium sulphate dihydrate.

4. Precipitation of the dihydrate crystals.

THEORIES FOR SETTING REACTION:-

1. Colloidal/ Gel Theory.
2. Hydration Theory.
3. Crystalline Theory.
4. Dissolution- precipitation Theory.

1. Colloidal/ Gel Theory:-

- Originated in 1893 by M. Michaelis.

- When plaster is mixed with water, plaster enters into the colloidal state through

a sol- gel mechanism.

- In the sol state, hemihydrate particles are hydrated to form dihydrate, thereby

entering into an active state.

- As the measured amount of water is consumed, the mass converts to a solid
gel.


2. Hydration Theory:-

- The rehydrated plaster particles join together through hydrogen bonding to the

sulfate groups to form the set material.

3. Crystalline Theory:-

- Originated in 1887 by Henry Louis Le Chatelier

- In 1907, supported by Jacobus Hendricus vant Hoff

- The difference in the solubilities of calcium sulphate dihydrate & hemihydrate

causes setting differences.

- Dissolved CaSO4 precipitates as calcium sulphate dihydrate, since it is less

soluble than hemihydrate.

- X-ray diffraction studies not all hemihydrate is converts to dihydrate.








- In a setting mass of plaster 2 types of centers are there:-

a) Dissolution center- around CaSO4 hemihydrate

b) Precipitation center- around CaSO4 dihydrate

4. Dissolution- Precipitation Theory:-

- Based on dissolution of plaster & instant recrystallization of gypsum to

interlocking of crystals.

Solubility of gypsum & gypsum products












The Setting Reaction is as follows:-

1. When the hemihydrate is mixed with water, a suspension is formed that is

fluid & workable.

2. The hemihydrate dissolves until it forms a saturated solution.

3. This saturated solution of hemihydrate, supersaturated in dihydrate,
precipitates

out dihydrate.

4. As the dihydrate precipitates, the solution is no longer saturated with the

hemihydrate, so it continues to dissolve. Dissolution of hemihydrate &

precipitation of dihydrate as either new crystals or further growth on the

already present. The reaction continues until no further dihydrate precipitates

out of solution.

The reaction rate is followed by the exothermic heat evolved as shown in fig.



















Temperature increases during the setting of plaster of paris

- As the gypsum forming increases, mass hardens into needle- like clusters
called

SPHERULITES.

- The intermeshing & entangling of crystals lead to a strong, solid structure.





W: P ratio:-

- The amount of water & hemihydrate should be gauged accurately by weight.

- W: P ratio is an important factor in determining the physical & chemical

properties of the final gypsum product.

ed W: P ratio ed Setting Time


ed Strength


ed Setting Expansion




- Typical recommended ranges are:-

W: P ratio

Type 2 plaster 0.45-0.50

Type 3 stone 0.28-0.30

Type 4 stone 0.22-0.24

Temperature:-

2 main effects on setting reaction:-

1. Change in temperature causes change in the relative solubilities of







hemihydrate & dihydrate, which alter the rate of the reaction.



Solubility of hemihydrate & dihydrate at different temperatures
















- Temperature es Solubility ratio es


- Solubility ratio es Setting Reaction es& Setting Time es




















- Solubility ratio es Setting Reaction es & Setting Time es


2. There is change in ion mobility with temperature.


in temperature in the mobility of Ca & SO4 ions


ed setting time in rate of reaction

- Practically the effects of these 2 phenomena are superimposed, & the total

effect is observed.

- Therefore, by increasing the temperature from 20C to 30C, the solubility ratio

decreases from 4.5 3.44, which should retard the reaction.

- At the same time as the mobility of ions increases, it should accelerate the












setting reaction.

- Experimentation has shown that, by increasing the temperature from room

temperature of 20C to body temperature of 37C increases the rate of
reaction

& decreases the setting time.

pH:-


- Liquids with low pH(saliva) in setting reaction


- Liquids with high pH in setting reaction

SETTING TIME

- Measured by Penetration Test( time taken from the start of mix until the
needle

no longer penetrates to the bottom) with the help of Vicat & Gillmore needles.

There are number of stages in the setting of a gypsum product:-







- MIXING TIME:- The time from the addition of powder to the water until the

mixing is completed.

Mechanical mixing 20-30 secs.

Hand spatulation - 1 min.

- WORKING TIME:- The time available to use a workable mix.

Working time 3min.
- LOSS OF GLOSS TEST FOR INITIAL SET:- Some of the excess water is

taken up in forming the dihydrate so that the mix loses its gloss.

- INITIAL GILLMORE TEST FOR INITIAL SET:- The mixture is spreadout, &

the needle is lowered onto the surface. The time at which it no longer leaves an

impression is called the Initial Set.

This is marked by a definite increase in strength.





















- VICAT TEST FOR SETTING TIME:- Vicat Penetrometer is used.

The needle with a weighed plunger rod is supported & held just in contact with

the mix. After the gloss is lost, the plunger is released.

The time elapsed until the needle no longer penetrates to the bottom of the
mix



is known as the Setting Time.


- GILLMORE TEST FOR FINAL SETTING TIME:-

Heavier Gillmore Needle is used.

The time elapsed at which this needle leaves only a barely perceptible mark
on

the surface is called the Final Setting Time.

-
- READY- FOR- USE CRITERION:- The subjective measure of the time at

which the set material may be safely handled in the usual manner.

Ready for use state is reached in approx. 30 min.

CONTROL OF SETTING TIME


- The setting time depends on :-

1. Temperature

- Effect of temperature on setting time may vary from one plaster or stone to

another, little change occurs between 0C & 50C.

- If the temperature of plaster water mixture exceeds 50C, a gradual

retardation occurs.

- As the temperature approaches 100C, no reaction takes place.

- At higher temperature range (50-100C), there is a tendency for any gypsum

crystals formed to be converted back to the hemihydrate form.

2. W:P ratio

- The more water used for mixing, the fewer nuclei there are per unit volume,

consequently, setting time is prolonged.

3. Fineness

- The finer the particle size of the hemihydrate, the faster the mix hardens,
the

rate of hemihydrate dissolution increases & the gypsum nuclei are also

more numerous. Therefore, a more rapid rate of crystallization occurs.

4. Humidity

- Increased contamination by moisture produces sufficient dihydrate on

hemihydrate powder to retard the solution of hemihydrate.

- Contamination of gypsum with moisture from air during storage increases

setting time.

Factors that control setting time :-

a) Factors controlled by the operator:-

1. W:P ratio

- More the w/p ratio, fewer the nuclei per unit volume so prolonged setting

time.

2. Mixing time

- Within practical limits, longer & rapid mixing leads to shorter setting time.

- Some gypsum crystals form immediately when the plaster comes in

contact with water & as the mixing begins, formation of crystals
increases.

- Some crystals are also broken up by mixing spatula & are distributed

resulting in the formation of more nuclei of crystallization resulting in

decreased setting time.



Effect of W:P ratio & Mixing time on the Setting time of plaster of paris



















b) Factors controlled by the manufacturer:-

1. By the addition of Accelerators & Retarders:-


Accelerators:-



- Gypsum (<20%) - es setting time.

The set gypsum used as an accelerator is calledTerra Alba.

- Potassium Sulphate(conc. 2-3%) & reduces the setting time of model
plaster

from approx. 10min. to 4min.

- Sodium Chloride(<28%)





Retarders:-

- Organic materials glue, gelatin & some gums.

- Potassium citrate, borax, sodium chloride(20%), sodium citrate.

SETTING EXPANSION

- Expansion may vary from 0.06% to 0.5%

- Volume of dihydrate formed is less than equal volume of hemihydrate & water.

i.e. actually a volumetric contraction should occur during setting reaction, but

instead a setting expansion is observed.


- PHENOMENON:- Based on crystallization mechanism.

- The crystallization process occurs as an outgrowth of crystals from nuclei of

crystallization.

- The dihydrate crystals growing from the nuclei not only intermesh with but

also obstruct the growth of adjacent crystals.

- If this process is repeated by thousands of crystals during growth, an
outward

stress or thrust develops that produces an expansion of the entire mass.

- The crystal impingement & movement results in the formation of
micropores.


- RESULT:- The gypsum formed is greater in external volume but less in

crystalline volume, therefore, the set material must be porous.




CONTROL OF SETTING EXPANSION


1. W: P ratio:-

- Increase in w/p ratio, decreases the nuclei of crystallization per unit volume,

so there is less growth of dihydrate crystals which leads to less outward
thrust.

- Decreased w/p ratio increased mixing
time increased setting
expansion

Effect of W:P ratio & Mixing time on Setting expansion of plaster of paris
















2. Accelerators & Retarders:- Chemicals added by the manufacturer to regulate

setting expansion.

Accelerators:-

- Sodium Chloride ( upto 2% of hemihydrate)

- Sodium Sulfate ( max. effect at 3.4%)

- Potassium Sulfate (>2%)

- Potassium Tartrate

Retarders:- Chemicals that form a coating on the hemihydrate particles &

prevent the hemihydrate from going into the solution in the normal manner.

Citrates, acetates & borates.

HYGROSCOPIC SETTING EXPANSION

- Setting expansion that occurs under water is called as Hygroscopic Setting

Expansion.

- Setting expansion without water immersion is called Normal Setting

Expansion.

Stages of Hygroscopic setting expansion:-

Stage I Initial mix stage.

- Represented by 3 round particles of hemihydrate surrounded by water.

Stage II Initial crystal growth stage.

- Crystals of dihydrate have started to form.

- In NSE, the water around the particles is reduced by hydration & particles are

drawn close together by surface tension of water.
- In HSE, the setting is taking place under water so that water of hydration is

replaced & the distance between the particles remain the same.

Stage III Solid phase contact stage.

- As the dihydrate crystals grow, they contact each other & setting expansion

begins.

- In NSE, the water around the particles is reduced. The particles with their

attached crystals are drawn together as before, but the contraction is opposed
by

the outward thrust of the growing crystals.

- In HSE, the crystals are not inhibited, because the water is again replenished

from the outside. Infact, the original particles are now separated further as the

crystals grow & setting expansion occurs.

Stage IV & V Expansion & Termination.

- Effect becomes more marked.

- The crystals that are inhibited in NSE become intermeshed & entangled much

sooner than in HSE in which the crystals grow much more freely during the

early stages before the intermeshing.






- The observed setting expansion that occurs when the gypsum product sets
under

water may be greater than that which occurs during setting in air.

STRENGTH


- Strength of gypsum product is expressed in terms of compressive strength.

- Strength of plaster & stone increases rapidly as the material hardens after
initial

setting time.
- Free water content of the set product affects its strength.

- 2 Strength properties of gypsum are:-

1. WET STRENGTH ( Green Strength):-


Strength obtained when the water in excess of that required for hydration of

the hemihydrate is left in the test specimen.

2. DRY STRENGTH:-

Strength obtained when the excess water in the specimen has been driven
off

by drying.

Dry strength is two or more times as high as wet strength.

- Strength depends upon:-

1. Addition of Accelerators & Retarders decrease the wet & dry strength of

gypsum products.

2. Increase in W:P ratio increases porosity, which decreases dry strength.





Effect of W:P ratio & Mixing time on the Compressive Strength of plaster of paris



















COMPRESSIVE STRENGTH:-

- Compressive strength is inversely related to the W:P ratio of the mix.

Effect of W:P ratio on the Compressive Strength of different materials





















- After final setting time the hardened gypsum material appears dry & has

maximum strength.







Effect of Drying on the Compressive Strength of plaster of paris


































- Effect of drying is reversible, soaking a dry cast in water reduces its strength to

the original level.


SURFACE HARDNESS & ABRASION RESISTANCE



- Surface hardness of gypsum materials is related to their compressive strength.

- Surface hardness increases at a faster rate than the compressive strength.


- Abrasive Resistance of gypsum product is ed by impregnating the set gypsum

with epoxy resins.

- Surface hardness of set gypsum is improved by mixing stone with a hardening

solution containing colloidal silica( about 30%).



VISCOSITY:

- It is the resistance of a fluid to flow.








Viscosity of several High Strength Dental Stones & Impression Plaster


















REPRODUCTION OF DETAIL

- ADA Specification No. 25 requires that types I & II reproduce a groove 75m in

width, whereas types III, IV & V reproduce a groove 50m in width.

- Gypsum dies do not reproduce surface detail as well as electroformed or epoxy

dies because, the surface of set gypsum is porous on a microscopic level.


-



Air bubbles are formed at the interface of impression & gypsum cast because,

freshly mixed gypsum does not wet some rubber impression materials well.

-
Contamination of the impression ( by saliva or blood) in which the gypsum die is

poured can also affect the detail reproduction. Rinsing the impression & blowing

away excess water can improve the surface detail recorded by gypsum die

materials.

PROPORTIONING

- Strength of a stone is inversely proportional to the W:P ratio.

MIXING

- Trapping of air should be avoided while mixing to avoid porosity weak spots &

surface inaccuracies.


- Longer spatulation es working time




- Method of mixing:-


Add measured water






Gradual addition of the preweighed powder







CARING FOR THE CAST

- Once the setting reaction in the cast is completed, its dimensions remain
constant

under room temperature & humidity.

- If stone cast is immersed in running water, its linear dimensions may 0.1%
for




every 20min. of immersion.

- If storage temperature is raised to 90 &110C shrinkage occurs

SPECIAL GYPSUM PRODUCTS

- White stone or plaster longer working time

- Gypsum products used for mounting casts are called as mounting stones or


plasters- fast setting & ed setting expansion.

CARING FOR GYPSUM PRODUCT

- All types of gypsum products should be stored in a dry atmosphere.

- Products should be sealed in a moisture proof metal container.


INFECTION CONTROL

- If an impression has not been disinfected, it is necessary to disinfect the stone

cast.




- Disinfection solutions that do not adversely affect the quality of the gypsum

product can be used.

- Dental stone containing a disinfectant may also be used.

- Useful disinfectants for stone casts include spray disinfectants, hypochlorites, &

iodophores.

CONCLUSION

- Gypsum products are used for making positive reproductions or replicas of oral

structures.

- These replicas are called casts, dies or models.

- The criteria for selection of a GP depends on its use & physical properties.

REFERENCES

1. Anusavice K.J.-Phillips Science of Dental materials 11th edition , 2003

2. Combe E.C. Notes on Dental Materials6th edition , 1992

3. Craigs R.G., Powers J.M. Restorative Dental Materials 11thedition, 2002

4.Gladwin M, Bagby M Clinical Aspects of Dental Materials 2nd edition,
2004

5. Mc Cabe J.F. Applied Dental Materials 7th edition , 1992

6. Phillips R.W.-Skinners Science of Dental Materials9th edition , 1992
solidification and microstructure of metals



CONTENTS:





1. Introduction
2. Metals
3. History of Metals
4. Properties of Metals
5. Classification of Metals
6. Inter Atomic Bonds
7. Microscopic Structure of Metals
8. Space Lattices
9. Lattice Imperfection
10. Heat Treatment
11. Strengthening of Metals
12. References








INTRODUCTION:

Metals and alloys play an important role in dentistry. These form one of the four possible groups of materials
used in dentistry which include ceramics, composites and polymers. These are used in almost all the aspects of
dentistry including the dental laboratory, direct and indirect dental restorations and instruments used to prepare and
manipulate teeth. Although the latest trend is towards the metal free dentistry, the metals remain the only
clinically proven material for long term dental applications..

METALS:
Chemical elements in general can be classified as 1. Metals
2. Non-metals
3. Metalloids
Metalloids are those elements on the border line showing both metallic and non metallic properties, e.g.
carbon and silica. They do not form free positive ions but their conductive and electronic properties make them
important.
Metals constitute about 2/3
rd
of the periodic table published by DMITRI MEDELEYEV in 1868. Of the 103
elements which are categorized in the periodic table according to the chemical properties, 81 are metals.
According to the metals hand book, they can be defined as AN OPAQUE LUSTROUS CHEMICAL
SUBSTANCE, THAT IS A GOOD CONDUCTOR OF HEAT AND ELECTRICITY AND WHEN POLISHED IS
A GOOD REFLECTOR OF LIGHT

HISTORY OF METALS:
Metals have been used by man ever since he first discovered them. In ancient and pre-historic times, only a
few metals were known and accordingly these periods were called as COPPER AGE, BRONZE
AGE and IRON AGE. Today more than 80 metallic elements and a large number of alloys have been
developed. Ore is a mineral containing one or more metals in a free or combined state.

PROPERTIES OF METALS:
All metals are solids except for mercury and gallium which are liquid at room temperature and hydrogen
which is a gas. The properties of metals can be listed out as follows:
1. They have a metallic luster and mirror like surface
2. They make a metallic sound when struck
3. Are hard, strong and dense
4. Ductile and malleable
5. Conduct heat and electricity
6. Have specific melting and boiling points
7. Form positive ions in solution and get deposited at the cathode during electrolysis. E.g. copper in copper plating.

The outer most electrons of the atom are known as valence electrons. These are readily given up and are
responsible for most of the properties.
Metals are tough and this is due to the fact that the atoms of the metals are held together by means of
metallic bonds.
The chemical properties of metals are based upon the electromotive series which is a table of metals
arranged in decreasing order of their tendency to lose electrons. The higher an element is in the series, the more
metallic it is. This tendency of metals of lose electrons is known as oxidation potential.

CLASSIFICATION OF METALS:
They can be done in many ways like:
1. Pure metal and mixture of metals (alloys)
2. Noble metals and base metals :
Noble metal is one whose compounds are decomposable by heat alone, at a temperature not exceeding that of
redness. E.g. Au, Ag, and Pd.
Base metal is one whose compounds with oxygen are not decomposable by heat Alone, retaining oxygen at high
temperature. E.g. Zn, Fe, and Al
3. Case metal and wrought metal
Cast metal is any metal that is melted and poured into the mould
Wrought metal is a cast metal which has been worked upon in cold condition
4. Light metal e.g. Al and heavy metal e.g. Fe
5. High melting metal e.g. chromium and low melting metal e.g. tin
6. Highly malleable and ductile metal e.g. gold and silver

INTER ATOMIC BONDS:
The atoms are held together in place by atomic bonds or forces. They may be
1. Primary
2. Secondary

Primary bonds or inter atomic bonds:
These are very strong bonds and may be of either type:
a. Ionic - These are seen in ceramics
b. Covalent - They are seen in organic compounds
c. Metallic bonds - They are seen in metals and are non
directional


Secondary bonds or inter molecular bonds:

These are weak forces and are otherwise known as Vander waals forces. The various types are:
a. Hydrogen bonds
b. Dipole bonds
c. Dispersion bonds
Of all these, the most important one is the metallic bond which was explained for the first time by LORENTZ, a
Dutch scientist in 1916. It can be explained by using the atomic and sub atomic structures.
The sub atomic structures
1. Protons positive charge
2. Neutrons neutral charge
3. Electrons - negative charge

The center or the nucleus of an atom consists of proton and neutrons and are therefore positively
charged. This is balanced by the revolving electrons which are negatively charged and arranged in concentric shells
with progressively increasing energy. The electrons in the outer most shell are known as VALENCE ELECTRONS.
These are loosely bound and are therefore readily given up by the atom to form positive ions. The cations
thus formed behave like hard spheres and the electron cloud formed by the freed valence electrons roam about freely
in the interstices formed by the arrangement of the solid spheres. The electrons act like glue to hold all atoms
together and are known as INTER ATOMIC CEMENT. Because of this, the metals are strong, hard, malleable,
ductile and good conductors of heat and electricity.
MICROSCOPIC STRUCTURE OF METALS:
In the solid state, most metals have crystalline structure in which atoms are held together by metallic
bonds. This crystalline array extends for many repetitions in 3 dimensions. In this array, the atomic centers are
occupied by nuclei and core electrons. The ionisable electrons float freely among the atomic positions.
The space lattice is a 3 dimensional pattern of points in space and hence called as point lattice. In this the
simplest repeating unit is called as the UNIT CELL. The size and shape of the unit cell are described by three
vectors. They are a,b,c, and known as crystallographic axes. The length and angle between them are known
as LATTICE CONSTANTS AND LATTICE PARAMETERS.
When a molten metal is cooled the solicitation process is one of crystallization. These are initiated at
specific sites called nuclei. These in the molten metal are present as numerous unstable atomic aggregates or
clusters that tend to form crystal nuclei. These temporary nuclei are known as EMBRYOS. These are generally
formed from impurities within the molten metal. In the case of pure metals, the crystals grow as dendrites which
can be defined as a three dimensional network which is branched like a tree. The critical radius is the minimal
radius of the embryo at which the first permanent solid space lattice is formed.
The crystals are otherwise known as grains since they seldom exhibit the customary geometric forms due to
interference from adjacent crystals during the change of state. The grains meet at grain boundaries which are
regions of transition between differently oriented crystals. These are regions of importance as they are sites of:
1. Less resistance to corrosion
2. High internal energy and non crystalline
3. Collection of impurities
4. Barriers for dislocations
The nuclei can be homogeneous or heterogenous based upon whether they are developed from the molten
liquid or formed as a result of foreign bodies incorporated into the molten metal. When the crystals meet at the
grain boundaries they stop growing further. The grain boundaries are about 1-2 atomic distances thick. Grain
boundaries can be high angles (>10-15 degrees) or low angled (< 10 degree).
The grain structure can be fine where in, it contains numerous nuclei as obtained during the rapid cooling
process (quenching) or refined when foreign bodies are added to obtain the fine grain structure.
EQUALIXED GRAINS
When cooling occurs and grains are formed, the grains start growing from the nuclei peripherally. This takes
the shape of a sphere and are equalized in structure meaning that they have the same dimensions in any direction.
COLUMNAR AND RADIAL GRAINS
In a square mould,
crystals grow from the edges towards the centre to form columnar grains whereas in the cylindrical mould the grains
grow perpendicular to the wall surface and form radial grains. Columnar grains are weak due to interferences in the
converging grains. Sharp margins have columnar grains.
GRAIN SIZE:
The grain size can be altered by heating. When the metal is heated above the solidus temperature to the
molten state and rapidly quenched, small grains are formed whereas, when they are allowed to cool slowly to room
temperature the grains tend to grow due to atomic diffusion and this results in an increased grain size and subsequent
decrease in the number. The more fine the grain structure, the more uniform and better are the properties.
ANISOTROPHY:
Alloys with uniform properties due to the presence of fine grain structure are said to be anisotropic.
METHODS OF FABRICATION OF METALS AND ALLOYS
1. CASTING: It is the best and most popular method.
2. WORKING ON THE METAL: They can be worked in the hot or cold conditions. They are known as wrought
metals. They can be pressed, rolled, forged or hammered.
3. EXTRUSION: A process in which a metal is forced through a die to form metal tubing.
4. POWDER METALLURGY: It involves the pressing of the powdered metal into the mould of desirable shape and
heating it to a high temperature to cause a solid mass.


SPACE LATTICES:
The structure of the crystal can be determined using the BRAGGS LAW OF X-RAY
DIFFRACTION. There are 14 lattices known as BRAVIS LATTICES and these are grouped under six
families. These vary depending upon the crystallographic axes and lattice constants which are the length of the
vertices and the angle between them. The six families are:
1. Cubic
Simple
Body centered
Face centered
2. Triclinic
3. Tetragonal
Simple
Body centered
Rhombohedral
4. Orthorombic
5. Hexagonal
Simple
Body centered
Face centered
Base centered
6. Monoclinic
Simple
Base centered















The arrangement of atoms in the crystal lattice depends on the atomic radius and charge distribution of atoms.
The most commonly used metals in dentistry have one of the following space lattices: body centered cubic, face
centered cubic or hexagonal lattice.





SIMPLE CUBIC LATTICE
SYSTEM





LATTICE IMPERFECTIONS AND DISLOCATIONS
Crystallization from the nucleus does not occur in a regular fashion, lattice plane by lattice plane. Instead, the
growth is likely to be more random with some lattice positions left vacant and others overcrowded with atoms being
deposited interstitially. These are called defects and can be classified as:
A. POINT DEFECTS OR ZERO DIMENSIONAL DEFECTS
1. Vacancies or equilibrium defects:
Absence of an atom from its position. This can be:
Vacancy
Divacancy
Trivacancy
2. Interstitialcies:
Presence of extra atoms in the interstitial spaces.
3. Impurities

4. Electronic defects







Point defects are responsible for increased hardness, increased tensile strength, electrical conductance, and phase
transformations.

B. LINE DEFECTS OR SINGLE DIMENSIONAL DEFECTS:
These can be
1. Edge dislocation
2. Screw dislocation
The planes along which a dislocation moves is called as slip planes and when this occurs in groups it is called
as slip bands. The crystallographic direction in which the atomic planes move is called as the slip direction and the
combination of slip plane and slip direction is called as slip system.
These are responsible for ductility, malleability, strain hardening, fatigue, creep and brittle fracture.
The face centered cubic consists of large number of slip systems and therefore is very ductile. This is seen
in gold.
The hexagonal closely packed system seen in zinc possesses relatively few slip systems and is therefore
very brittle.
In between these is the body centered cubic with intermediate properties.
The
strain required to initiate movement is the elastic limit. The method of hardening of metals and alloys is based on
the impedance to the movement of dislocations.











C. SURFACE DEFECTS OR PLANE DEFECTS OR TWO
DIMENSIONAL DEFECTS:
1. Grain boundaries
2. Twin boundaries:
These are seen in the NiTi wires responsible for transformation between the austenitic and martensitic
phases. These are important for the deformation of the titanium alloys. The atoms have a mirror relationship.








3. Stacking fault
4. Tilt boundaries
D. VOLUME DEFECTS
These include cracks

ALLOTROPHY AND ISOMORPHOUS STATE:
ALLOTROPHY
This ability to exist in more than one stable crystalline form is called as allotrophy. The various forms have
the same composition but different crystal structure.
ISOMORPHOUS STATE
The ability to exist as a single crystal at any atomic composition of binary alloys is known as iomorphous state
e.g. Au-Ag, Au-Cu.

HEAT TREATMENT OR SOLID STATE REACTIONS:
Heat treatment of meals (non-melting) in the solid state is known as solid state reactions. This is a method to
cause diffusion of atoms of the alloy by heating a solid metal to a certain temperature and for a certain period of
time. This will result in changes in the microscopic structure and physical properties.
Important criteria are:
1. Composition of the alloy
2. Temperature to which it is heated
3. Time of heating
4. Method of cooling slowly or quenching.
The purpose of heat treatment is:
1. Shaping and working on the appliance in the laboratory is made easy when the alloy is soft. This is the first stage
and called as softening heat treatment.
2. To harden the alloy to withstand high oral stresses, it is again heated and this is called hardening heat treatment.

i. ANNEALING OR SOFTENING HEAT TREATMENT
This is done for structures that are cold worked. These cold worked structures are characterized by:
1. Low ductility
2. Distorted and fibrous grains
When cold work is continued in these, they will eventually fracture. This may be:
1. Transgranular through the crystals and occur at room temperature
2. Intergranular in between the crystals and occurs at elevated temperature
These can be reversed by annealing. The various phase are:
1. Recovery
2. Recrystallization and
3. Grain growth


Technique:
The alloy is placed in an electric furnace at a temperature of 700 C for 10mins and then rapidly
quenched. Annealing temperature should be half that necessary to melt the metal in degrees Kelvin.
Recovery
During this phase, the cold work properties begin to disappear. There is a slight decrease in tensile strength
and no change in ductility. The tendency for warping decreases in this stage.
Recrystallization
There is a radical change in the microstructure. The old grains are replaced by a set of new strain free
grains. These nucleate in the most severely cold worked regions in the metal. The temperature at which this occurs
is the recrystallization temperature. During this the metal gets back to the original soft and ductile nature.
Grain growth
If the fine grain structure in a crystallized alloy is further heated, the grains begin to grow. This is essentially
a process in which the larger grains consume the smaller grains. This process minimizes the grain boundary
energy. This does not progress until the formation of a coarse grain structure.










Properties of an annealed metal:
1. There is an increase in ductility
2. Makes the metal tougher and less brittle

Stress relief annealing is a process which is done after cold working a metal to eliminate the residual
stress. This is done at relatively low temperatures with no change in the mechanical properties.

ii. HARDENING HEAT TREATMENT
This is done for cast removable partial dentures, saddles, bridges but not for inlays. This is done for clasps
after the try in stage so that adjustments can be carried out during the try in when the metal is soft.
Technique
The appliance is heat soaked at a temperature between 200-450 C for 15-30 minutes and then rapidly
quenched. The result is:
1. Increased strength
2. Increased hardness
3. Increased proportional limit
4. Decreased ductility

Microscopic changes
Diffusion and rearrangement of atoms occur to form an ordered space lattice. Therefore this is called as order
hardening or precipitations hardening.


iii. SOLUTION HEAT TREATMENT OR SOLUTION HARDENING
When the alloy is soaked at 700C for 10 minutes and then rapidly quenched like that for a softening
treatment, any precipitation formed during the earlier heat treatment will become soluble in the solvent metal.
iv. AGE HARDENING
This is a process in which following solution heat treatment; the alloy is once again heated to bring about
further precipitation as a finally dispersed phase. This causes hardening of the alloy and it is known as age
hardening because the alloy will maintain the quality for many years. E.g. Duralium.

METHODS OF STRENGTHENING METALS AND ALLOYS :
All metals possess an inherent barrier to dislocations. This is relatively small and known as pearls
stress. This is imposed by the bonds associated with the arrangement of atoms in a given crystal structure. Thus to
improve the mechanical properties, other methods of hardening are used. These are:
1. GRAIN BOUNDARY HARDENING OR GRAIN REFINEMENT HARDENING
A poly crystalline metal contains numerous grains or crystals. These meet at the grain boundaries. The grain
boundary is non crystalline and contains impurities. These act as barriers to dislocations as it moves by slip planes
from one grain to another.
Finely grained structure contains large grain boundaries and hence the obstacle to motion of dislocations is
higher. Therefore dislocation density rises rapidly due to plastic deformation. These dislocations at the grain
boundaries increase and therefore the stress necessary to continue the plastic deformation also increases. Therefore,
there is an increase in the yield strength and ultimate tensile strength. The yield strength varies inversely with the
square root of grain size (hall petch equation).
Grain refinement can be done by:
1. Heat treatment
2. Addition of grain refiners which act as nucleating agents.
Grains refiners are metals or foreign bodies of high melting temperature. They crystallize out at high
temperature and act as nuclei or seeds for further solidification. e.g. iridium, rhodium.
The best method to improve properties of alloys and metals is by the addition of grain refiners. Finely
reined grains structure contain grain size >70m.

2. SOLUTION HARDENING OR SOLID SOLUTION STRENGTHENING
An alloy is a solid solution; it has a solute and a solvent. The atomic diameter of a solute and solvent will
never be the same.
The principle of solid solution hardening is by introducing either tensile or compressive strain depending on
whether the solute atom is smaller or larger than the solvent respectively and finally distorting the grain
structure. This solute can be either:
- Substitutional
- Interstitial

3. PRECIPITATION HARDENING
Another method of strengthening alloys is by means of this technique. In this, the alloy is heated so that
precipitates are formed as a second phase which blocks the movement of dislocations. The effectiveness is greater if
the precipitate is part of the normal crystal lattice which is known as coherent precipitation.

4. DISPERSION STRENGTHENING
It is a means of strengthening a metal by adding finely divided hard insoluble particles in the soft metal matrix
as a result of which, the resistance to dislocations is increased. This increases hardness and tensile strength.
The ideal properties are seen when the particles range from 2-15% by volume with spacing at 0.1 1.0m
intervals and particle size from 0.01 0.1.
The ideal shape of the dispersed particle is a needle like LAMELLAR SHAPE which can intersect with the
slip planes. Powdered metallurgy makes use of this method for strengthening.

5. STRAIN HARDENING OR WORK HARDENING
This is seen in wrought metals. The metals are worked after casting to improve their mechanical
properties. They may be forged, hammered, drawn as wires, etc. All this is done below the re-crystallization
temperatures. This working causes vast number of deformations within the alloys or metals. These interact with
each other mutually, impeding the movements. The increased stress required for further dislocation movement to
achieve permanent deformation provides the basis for work hardening. This result is distorted grain structure with
the grains being fibrous.

REFERENCES:

1. Andersons Applied Dental Materials John F.Mc. Cabe
2. Dental Materials Craig. OBrien Powers
3. Essentials of Dental Materials S.H. Soratur
4. Material and Metallurgical Science S.R.J. Shantha Kumar
5. Phillips Science of Dental Materials (Eleventh Edition) Anusavice
6. Restorative Dental Materials (Eleventh Edition) Robert G. Craig and John. M. Powers
7. Restorative Dental Materials Floyd. A. Peyton
8. J.P.D. April 2002 Volume 87 No.4 Page 351 363.

RETRIEVEL OF DENTURE, CORRECTION OF OCCLUSAL
DISCREPANCIES,FINISHING AND POLISHING PROCEDURES.

RETRIEVEL OF DENTURE, CORRECTION OF OCCLUSAL
DISCREPANCIES,FINISHING AND POLISHING PROCEDURES.

Contents
Introduction
Review of Literature
Definitions
Deflasking procedure
Problems cause during Deflasking
Causes for dimensional changes in complete denture during processing
Lab remounting procedure
Correction of Occlusal discrepancies by selective grinding
Advantages of selecting grinding
Removal of denture from cast
Finishing of complete denture
Polishing of complete denture
Summary & conclusion
References.





Introduction

Successful fabrication of complete dentures requires a combination of sound clinical as well as
laboratory procedures. Clinical procedures however accurate are not of much use if the laboratory
procedures are not properly carried out from the pouring of casts to retrieval of denture & finishing &
Polishing of dentures all go a long way in the success of the prosthesis.

Carelessness in the final stages of denture fabrication such as during retrieval of dentures from
the flasks, failure to correct the Occlusal discrepancies induced as a result of processing & inadequate
finishing & polishing will result in dentures which are far below the result that could have been achieved if
a little more time & efforts would have been invested in the final stages. This seminar deals with these
steps in the making of a denture which are generally given least importance but if properly done, greatly
enhance the comfort function & esthetics of the final prosthesis.







Review of the Literature:
1. Nikazad s Javing 1973 : Described a method the top half of molds for processing dentures were
made in the top half of the flask. This technique speeds up the removal of processed dentures from their
molds and reduces the possibility of fracturing either the denture base or the teeth.
2. Majid Bissasu 1998 : Described a easy procedure to facilitate the removal of the palatal and lingual
portions of flasking stone. So it reduces the hazards of denture base fracture or deformation during
Deflasking of the processed denture. Advantage of this procedure is it reduces the flasking and
Deflasking time.
3. Than-E-Holf 1977 : Conducted a study that incited that numerous benefits from remounting dentures to
correct occlusion and recon touring the tissue side of the bases at the time of insertion. He showed that
post insertion complaints were decreased by remounting procedures.
4. Garrent D Barrett 1985 : Described a reprocible split cast technique for accurate demounting and
remounting of a Pre or post processing complete denture master cast without stress or fracture.
5. Sigmund 1953 : Conducted a study on investing changes during flasking may lead to malocclusion in
complete duve. There is sufficient evidence to indicate that there is some shifting of the teeth during the
investing procedure & described methods to reduce this shifting.
6. Robert C. Wesley 1973 : Conducted study in 50 patient regarding posterior tooth contact and pin
opening during processing changes in complete denture it was found that there was a definite shift of the
tooth contacts to the more posterior teeth after processing but that the amount of pin opening did not
seems to be related to the number of location of the tooth contacts.
7. William A walker, Donal C Kramer and Rager Marcev 1978 : Described a detailed step by step
procedure for finishing and polishing denture based produce highly polished surfaces free from all
imperfection.
8. Mutahhar Ulusay, Nuron Ulusoy, Keveser Aydin 1986 : Evaluated polishing techniques of surface
roughness of acrylic resin. 9 methods of grinding & polishing heat cute resins were evaluated. They
found that the best surface finish was obtained when abrasive stones coarse medium fine abrasive discs
rotating felt come and rotating soft brush C chalk powder were used progressively.











Definitions:
Definition for Deflasking:


Definition of Remounting:
Any method used to relate restorations to an articulator for analysis and for to assist in development of a
plane for occlusal equilibration or reshaping.
Definition of Selective Grinding:
The intentional alteration of the occlusal surfaces of teeth to change their form .
Definition of finishing:
It is process to put a final coat or surface on, the retirement of form prior to polishing.
Definition of Polishing:
The act of process of making a denture or casting smooth and glossy.

Deflasking: When Deflasking complete dentures it is best to use a Deflasker which allows retrieval from
the flask without damage to the dentures or flask. Deflasking with a hammer can damage. The flask and
results in unnecessary breakage of the dentures.
Procedures for Deflasking of complete denture :
1. Remove the Lid from the flask containing the bench cooled denture.
2. Place the flask bottom side up in the Deflasker and tighten the thumb screw until it contacts the bottom
plate.
3. Place the pry bars through the slots in the side of the Deflasker and engage. The slots in the flask
between both halves of the flask.
4. Press down on the engaged pry bars first and then pry up these movements readily separate the flask
from the stone enclosed denture.
5. Place a Knife-blade in contact with the junction between the stone cap and the rest of the stone
enclosing the denture. Tap the back of the knife blade with a plastic mallet to separate the stone cap and
to expose the cusp tips and incisal edges of the denture teeth.
6. Use care in separating the stone cap from dentures with acrylic teeth.
7. With a saw and a spiral blade, cut through the stone that encloses. The denture opposite the central
incisor teeth take care to avoiding sawing into teeth or denture blast.
8. Place more saw cuts at the distobuccal corners of the flasked denture. So that the stone enclosing the
denture has three cuts.
9. Place a knife in the anterior saw cut and pry gently to separate the stone from the buccal and anterior
flanges of the denture.
10. Place a knife in the posterior cut, and pry laterally to separate any posterior section of stone may have
adhered to the buccal flange of the denture.
11. Remove stone from the palate or tongue area of the mandibular dentures by first relieving the stone
adjacent to lingual surfaces of the denture teeth with a knife take care to avoid cutting teeth or denture
base.
12. After reliving the stone adjacent to the lingual surfaces of the denture teeth, gently pry the stone in the
lingual area of the denture or the palate of the maxillary denture, and lift it away from the denture.
13. Make more cuts lingual to the heel area of the mandibular dentures if necessary.
14. Remove the denture from the investing stone except where it encloses the cast.
15. Protect the teeth with the hand and with a plastic mallet carefully tap away the stone enclosing the
cast. Exercise care to avoid damaging the teeth by striking them with the mallet.
16. Use a tooth brush to clean out the index groove on the base of the cast. This cleansing makes if
possible to position the cast accurately on the mounting stone for correction.
17. After retrieval from the stone the dentures are ready for remounting on the articulator.
Problems that occur during Deflasking are
1. Breaking of the denture
2. Breaking of the cast
3. Breaking of the both cast and denture.
4. Denture base or denture teeth broken during Deflasking as result of using a hammer to tap stone from
the flask.
Attention to the details of flasking to eliminate under cuts, proper use of tinfoil substitute, and careful
Deflasking procedures minimize breakage of dentures and facilitate raid retrieval.
Causes for dimensional change in denture during processing.
1. Polymerization shrinkage.
2. Processing stresses.
3. Incorrect registration of centric occlusion.
4. Irregularities in setting teeth.
5. Tooth movement when flasking and packing.
6. Incomplete flask closure.
7. Wear in moving parts of articulators.
Polymerization shrinkage: When methyl methacrylate monomer is polymerized to form poly (Methyl
Metharcylate), the density of the mass changes from 0.94 to 1.19 g/cm. This change in density results in
volumetric shrinkage of 21%. When a conventional heat activated resin is mixed at the suggested
powder Liquid ratio, about one third of resultant mass is liquid. Consequently the volumetric shrinkage
exhibited by the polymerized mass should be approximately 7%. In addition to volumetric shrinkage, one
also must consider the effect of linear shrinkage. Linear shrinkage exerts significant effects on denture
base adaptation and cuspal interdigitation. By convention, linear shrinkage values are determined by
measuring the distance between two predetermined reference points, in the second molar region of a
completed tooth arrangement. After polymerization of the denture base resin and removal of prosthesis
from the master cast the distance between prepolymerization and post polymerization measurements is
recorded as linear shrinkage the greater the linear shrinkage the greater the discrepancy observed in the
initial fit of a denture. Based on a projected volumetric shrinkage of 7%, an acrylic resin denture base
should exhibit a linear shrinkage of approximately 2%. In reality linear shrinkage generally is observed to
be less than 1%.
Examination of the polymerization process indicates that thermal shrinkage of resin is primarily
responsible for the linear shrinkage phenomenon in heat activated systems. During initial stages of
cooling process the resin remain relatively soft. Therefore the pressure maintained on the flask assembly
causes the resin to contract at approximately the same rate as the surrounding dental stone.
As cooling proceeds, the soft resin approaches its glass transition temperature (Tg). The Tg lies
with in a thermal range in which the polymerized resin passes from a soft, rubbery state to a rigid, glassy
state. Hence, cooling the denture base resin beyond the Tg. Yields, a rigid mass. In turn this rigid mass
contracts at a rate different from the surrounding dental stone. The shrinkage occurring below Tg is
thermal in nature and varies according to the composition the resin.
To illustrate the effect of thermal shrinkage, consider the following example. The Tg for poly
(Methylmethacrylate) is approximately 105
0
C room temperature is 20
0
C. The generally accepted value
for linear co-efficient of thermal expansion for poly (methyl methacrylate) is 81 x 10
-6
per degrees
centigrade therefore as the denture base resin is cooled from the Tg. To room temperature it undergoes
linear shrinkage that may be expressed as.
L T = (81 x 10
-6
/
0
C) (105
0
C - 20
0
C) (100%) = 0.69%
2. Processing Stresses : When ever a natural dimensional change is inhibited, the affected material
contains stresses. If stresses are relaxed, a resultant distortion or warpage of the material may
occur. This principal has important reminification in the fabrication of denture bases, because stresses
invariably are induced during processing.
Stress also are produced as the result of thermal shrinkage as a polymerized resin is cooled
below its Tg. The resin becomes relatively rigid. Further cooling yields thermal shrinkage. A denture base
resin generally is encased in a rigid investing medium, such as dental stone, during this
process. Because denture base resins and dental stones contract at markedly different rates, a
contraction differential is established. Hence a disparity in contraction rates also yields stresses with in
the resin. Additional factors that may contribute to processing stresses with in resin. Additional factors
that may contribute to processing stresses include improper mixing and handling of the resin and poorly
controlled heating and cooling of the flask assembly.
The release of stresses yields dimensional changes that a cumulative in nature. Fortunately,
these dimensional changes are quite small total dimensional changes occurring as a result of processing
and service are in the range of 0.1 to 0.2 mm (as measured from Second molar to Second
molar). Therefore it is doubtful such changes would be clinically significant and they detectable by
patient.
3. Incorrect Registration of Centric occlusion: This is probably the most common cause of error in the
occlusion of finished dentures when registering the position of centric occlusion considerable care is
taken to obtain a correct vertical dimension and physiological fully retruded position of the mandible, but
often the record rims when brought together exert uneven pressure on their respective supporting
alveolar ridges. This is due to premature contacts of the record rims on side of the mouth in Second
molar region. This causes uneven compression of mucosa supporting the record blocks and often
displaces them from ridges.
Another fault causing errors in the occlusion of the finished dentures results from slight movement
of record blocks on the ridges during centric registration due to their imperfect fit and inadequate
retention.
Another error of occlusion may result from the manner in which the models and record blocks are
set in the articulator. The models may not be placed accurately in the blocks or the articulator may not
handled with due care when the models are being attached with plaster.
4. Irregularities in setting the teeth :
The technician when setting up teeth is unlikely to produce a perfectly even contact in centric and lateral
occlusions. Some teeth will be in good occlusion whilst others will be slightly out of occlusion, thus
producing areas of heavy pressure. In waxing up following the setting of teeth it is possible for them to
more slightly due to the contraction of the wax on cooling, causing irregularities in the articulation and
occlusion of complete dentures.
5. Tooth movement when flasking and packing :
Movement of the teeth may occur at the time of boiling out the wax trial base after the dentures have
been flasked and it such teeth are not correctly repositioned they will cause minor Occlusal
irregularities. Also, when packing, teeth may be driven into the enveloping plaster, particularly when
packing follows soon after investing and the plaster is in the green state. The possibility of such an error
occurring is increased when the methyl methacrylate is used in a slightly advanced stage of dough, and
when the posterior teeth have been ground to fit close to the ridge. Rapid closure of the flask in the piets
will add to the hazard.
6. Incomplete flask closure :
This causes not only, an increase of vertical dimension but also results in an upset of balanced occlusion.


7. Articulator wear :
All articulators are subject to wear and the older and more worn the articulator the greater will be the
errors in occlusion and articulation. Every piece of mechanical apparatus exhibits some play in its moving
parts and when this becomes easily detectable the bearing should be replaced.
Split-cast procedure for remounting the complete denture master cast
Accurate remounting of the detached complete denture master cast to its mounted articulated base is
essential to maintain the original articulated interarch and occlusal relationship. Inaccurate remounting
will result in occlusal discrepancies. In this technique describes a reproducible split-cast technique for
accurate demounting and remounting of a pre-or past processing complete denture master cast without
unwarranted stress or fracture.
Technique:
1. Require the master cast from the boxed final impression boxing will preserve the appropriate
morphologic border contours and master cast base thickness.
2. Finish the base of master cast with a fine model trimmer wheel.
3. Cut two posterior and one anterior index grooves into the master cast base. After refinement apply a thin
coating of petroleum Jelly to each index groove with a cotton pellet. It is not necessary to lubricate the
entire base.
4. Using Jaw relation records, mount the moist master cast in the articulator using fast setting
plaster. When the plaster sets, smooth and refine the mounted master cast an articulated base so that a
crisp demarcation interface exists between the cast and plaster base.
5. Remove the master cast and its articulated base from the articulator. Fill a standard mixing bow 1 with
near boiling water (minimum temperature of 180
0
F) to a level approximately 1 inch greater than the height
of the articulated base.
6. Place the articulated base with the mounted master cast into the hot water and adjust the water level to a
point 2 to 4 mm above the interface. Leave the mounted master cast in water for 10 seconds or until the
cast and base separate. The sudden temperature change and expansion of the base plaster causes
separation. Do not completely immerse the mounted master cast.
7. When remounting the cast wet the entire articulated plaster base and only the base portion of the master
cast. Fit the plaster base and base portion of master cast together, and allow them to dry. A perfect
readaptation of the master cast and articulated base will result.
8. Cut parallel horizontal grooves on the lateral surface to secure the master cast to the articulated
base. After the surfaces are moistened, apply a thin mix of plaster into grooves and extended over both
the cast and base. Smooth and position the remounted cast and its base on the articulator.
Procedure :
1. After remounting the dentures in the articulator check the relationship of the incisal guide pin to
the incisal guide table. After the incisal guide pin does not contact the incisal guide table because of
changes during processing a processing error of 1 mm though not insignificant, is correctable. However,
an error of more than 1 mm which often requires considerable reduction on the Occlusal surfaces of the
denture teeth to regain the vertical dimension of occlusion is undesirable.
2. Check contacts between the heel of mandibular dentures and the tuberosity region of maxillary dentures
to make certain that the increase in vertical dimension is not result of an overly thick denture base resin in
these areas.
3. Place articulating paper between the teeth and gently tap the articulator together to indicate defective
occlusal contacts.
4. Adjust these contacts with a stone bur, if the teeth are porcelain or if the teeth are resin, continue to
adjust the occlusion in the centric relation position and in the eccentric positions, according to the rules of
selective grinding. Do not adjust the cusps in centric relation position unless they are high not only in the
centric relation position, but also in the right-and left lateral and protrusive positions. Generally, reduction
results in grinding of the fossae rather than the cusp tips. When adjusting the working position, adjust the
buccal cusps of the upper teeth and the lingual cusps of the mandibular teeth to eliminate defective
contacts. On the non working, or balancing side defective contacts are usually on centric holding cusps
and grinding requires a compromise we prefer to grind the inclines of the maxillary lingual cusps rather
than the buccal cusps of the mandibular dentures.
5. Move the articulators into a working position and examine the relationship of the working cusps, mark the
defective contacts with articulating paper and examine the resulting pattern. Eliminate defective contacts
on porcelain teeth by adjusting the buccal cusps of the maxillary lingual teeth and the lingual cusps of the
mandibular teeth with a stone.
6. Examine the balancing contacts in a similar manner and adjust the lingual cusps of the maxillary teeth or
the buccal cusps of the mandibular teeth to corrective defective contacts.
7. After completing the selective grinding, move the articulator into the various positions, and check the
occlusion into the various positions, with tissue paper strips. Now the incisal guide pin should contact the
incisal guide table and there by indicate reestablishment of the original vertical dimension of
occlusion. Do not complete definitive polishing of the Occlusal surfaces of the teeth at this time because
the dentist usually remounts the dentures on the day of insertion.
8. Recheck the occlusion on the articulator in the centric relation position using articulator paper, and
evaluate the pattern of contacts. Equalize the contacts on the right and left sides to assure a uniform
distribution.

Correction of Occlusal discrepancies by selective grinding:
In order to produce a satisfactory result it is important to carry out the selective grinding
systematically to ensure that.
1. Vertical dimension is maintained.
2. An even distribution of occlusal stress is obtained in centric occlusion.
3. An even distribution of stress is maintained in lateral positions.
The vertical dimension is controlled by the lower buccal cusps and the upper palatal cusps and their
opposing fossae there fore it is essential that these zones must receive careful consideration when
establishing centric and lateral occlusion.

Grinding into centric occlusion:
Place thin blue articulating paper on the Occlusal of the lower teeth and close the articulator for with
sufficient pressure to record just the first contact areas. Observe the prominent cusp or cusps and decide
whether the cusp or its opposing fossa should be ground by checking this cusp in its lateral working
position and then its balancing position. If the offending cusp makes premature contact in both centric
and lateral working positions then the cusp and not the fossa should be ground to produce even centric
occlusion. When, however, a cusp producing premature contact in the centric position does not cause
premature contact when in working and balancing positions then the fossa is ground to accommodate the
cusp. (The lateral contacts can be marked with red articulating paper for purposes of differentiate on this
principle is followed until an even centric occlusion is obtained through out the dentition.
Grinding in for Lateral excursions:
To enhance the retention and stability of the dentures and to reduce the stress applied to the Alveolar
ridges of the mandible moves laterally, it is most important to provide a free sliding lateral articulation and
elimination of cusp lock.
Red articulating paper is placed between the occlusal surface of the teeth and the dentures
moved with light pressure from centric occlusion into right lateral occlusion. If the upper and lower buccal
cusps make premature contact and balancing side is out of occlusion then the upper buccal cusp is
ground as the lower buccal cusp is required to maintain vertical dimension and even pressure in centric
occlusion when the lower lingual and upper palatal cusps occlude prematurely in this lateral position the
lower lingual cusp is ground to produce balance of both sides of the denture. The upper palatal cusp is
required for the maintenance of vertical dimension in centric occlusion. The grinding of the buccal upper
and lingual lower cusps to produce balance in lateral movements is often referred to as grinding to the
Bull rule.
Should the balancing side exhibit premature occlusion between the lower buccal cusp and the
palatal upper cusp it will be necessary to grind the palatal upper cusp and not the lower buccal cusp since
this cups is required to maintain vertical dimension and even pressure is centric occlusion and contact in
the working lateral position.
The procedure having been completed for the right lateral position it is then repeated for the left
lateral excursion having established a free lateral sliding movement of the occlusion of the protrusive
contacts is studied.
Correction of contacts in protrusion:
As we are dealing with an artificial dentition, and are not concerned with the possible over eruption of
teeth as may occur with a natural dentition. Most of the grinding for correction of premature contacts of
incisal edges of anterior teeth, when in protrusive occlusion, can be carried out at the expense of the
lower incisors. A limited amount of grinding lower of the upper anterior teeth to simulate attrition, related
to the patients age, can enhance the appearance of the dentures.
Perfecting Articulation with Grinding-in paste:
The main correction of occlusal irregularities must be carried out with small mounted abrasive stones in a
hand-piece so that the vertical dimension is kept under control. The amount of adjustment made with
grinding-in paste must be small as this will reduce all occluding surfaces and if excessive will result in loss
of vertical dimension. A paste of course grit carborundum powder mixed one with Vaseline or tooth paste
is used first. Followed by one of fine grit carborundum to smooth the previously ground tooth surfaces
and produce a perfectly even occlusion.
Reduction of sharp edges of Ground teeth:
On completion of all grinding, sharp edges present buccally and lingually must be rounded to prevent
tongue and cheek irritation rubber wheels, water of Air stone, and finally pumice paste used with polishing
brushes will produce a smooth finish.
Advantages of Remounting and Selective grinding:
The Patient remount method is to remount the dentures on articulators.
1. It reduces patient participation.
2. It permits the dentist to see better what he is doing.
3. It provides a stable working foundation; bases are not shifting on resilient tissues.
4. The absence of salvia makes possible more accurate markings the articulating paper or tape.
5. Corrections can be made away from the patient, thus preventing occasional objections when patients
see their dentures being ground.
Removing Dentures from Cast:
After correction of processing error and construction of a face-bow index if requires, the dentures are
ready for removal from the cast and finishing and polishing.
Procedure for removing dentures from cast:
1. Using a cast trimmer, thin the casts with the dentures seated on them, but avoid trimming the
denture base.
2. Remove the stone from the denture in small sections. Use a bur or a saw judiciously in removing the
stone in sections without damaging the dentures.
3. A shell blaster also is useful in removing stone from the interior of the denture.
4. A pneumatic chisel aids in removing stone from the denture however, Great care is essential to prevent
damage to the denture. Particularly to the denture teeth. Do not attempt to pry the denture from the cast
because it can result in fracturing the denture. After removal from the cast, the dentures are ready for
finishing and polishing.
Various abrasives that are used for finishing and polishing Procedures of Complete denture
Abrasives are rough gritty and wear producing particles .abrasive is a substance which is used to remove
excess material by cutting. Substance used to grind objects in order to give them desired size, shape or
finish.
Pumice: A substance of volcanic origin consisting chiefly of complex silicates of aluminum, potassium and
sodium occurring as a very light, hard, porous grayish powder. It is used as a polishing agent. The effect
will be depending on particle size. It is used for smoothening of denture base and polishing teeth in
mouth.
Chalk: Chalk is calcium carbonate prepared by a precipitation method. There are various grades of
physical forms of calcium carbonate available for different polishing technique. It is used for polishing
denture base.
Sand: Sand particles consist of small grains of Silica (SiO2) it is formed by the decomposition of sand
stones due to various effect of weather.
Types are: Pit Sand, River Sand, Sea Sand.
Sand should contain sharp, angular and durable grains. It is used in the form of sand paper.
Finishing & Polishing instrument.
1. Finishing burs: It should at least 12 fluted, however some of them are 40 fluted. They may be
made up of stainless steel or tungsten carbide. They wont cut the restorative materials, but only removes
excesses creating a smoother surface.
2. Paper carried abrasives: These are usually sand cuttle garnet or baron carbide. Guide to paper disc or
strips the paper disc should be attached to mandrel.
3. Brushes: They will be available in different forms like wheels, cylinders, cones.
4. Rubber: Plain rubber ended rotary tools are essential for any polishing procedures. They will be
available in different shape. E.g.: Cups, Wheel, cones.
5. Cloth: Cloth carried on a metal wheel is used in final stages of polishing, either with or without a polishing
medium.
6. Felt: Different shape of felt is wheel, cone and cylinders usually with polishing agents.
Polishing the Complete Denture:
Two methods of polishing complete dentures will be presented.
Method used for Polishing of the Complete Denture.
1. After taking the complete denture from the cast use a shell blaster to remove any stone that
adheres to the denture take care to avoid burning the surface of the acrylic resin shell blasting.
2. Trim the flash from the complete denture with an arbor band or a large bur mounted on a laboratory
lathe.
3. Finish the frenum attachments with a small carbide bur to create the desired freedom.
4. With a chisel carefully remove stone adhering to the gingival margins. Make a chisel by grinding a
broken Instrument to form sharp triangular edges which facilitate the removal of stone from the gingival
margin.
5. Check the interior of the denture carefully with a finger. Locate any modules of acrylic resin and remove
them with a round bur.
6. Complete the relief for the frenum attachment by using No. 558 or a No. 771 bur to do the final finishing
and to open the frenum attachment.
7. Finish the lingual border area of the mandibular complete denture with a hand piece-mounted small
carbide bur. Frequently a standard size arbor band is too large for this area.
8. Thin the palate if necessary take care to avoid producing grooves when using an arbor band. A large
lathe-mounted Laboratory bur also is useful for these procedures.
9. Pumice the dentures with a prepared rag wheel.
Preparing rag wheel: Special preparation of a rag wheel makes it more effective for pumicing and
polishing. The procedure described also conditions used rag wheels by giving them the flexibility and
flutiness necessary to achieve a smooth finish.
Procedure:
1. Place the rag wheel on a spiral chuck, run the lathe at low speed, and use a knife to cut the
threads holding the rag wheel plies together. Hold the knife firmly while cutting the threads.
2. Stop the lathe, separate the plies of the rag wheel and make certain to cut the thread completely.
3. With the rag wheel on the spiral cheek rotate the lathe low speed and hold a stainless steel plaster
spatula against the rag wheel to remove the cut threads and make the wheel fluffy.
4. Single the strayed threads with a lighted match to make the wheel uniform. Place a metal pan beneath
the wheel, and have the lathe and any suction device in the non operating position. Have a bowl of water
available to douse the wheel if it flares.
5. After placing the rag wheel in water, return it to the lathe and start the lathe at low speed. Rotate the
singed wheel against the stainless steel spatula again to fluff it and remove any remaining threads.
6. Modified rag wheel is ready for use.
Pumicing denture:
Procedure:
1. Make slurry of fine flour of pumice with water, using copious amounts to the slurry, wet the rag wheel and
polish the denture at low speed more the denture throughout the polishing to prevent formation of plane
surface. Use a brush or prophy cup with slurry to polish areas less accessible to the rag wheel.
2. Polish the palate and areas of the denture not readily accessible to the rag wheel by using a prophy cup
or a Dixon brush with slurry of flour of pumice smooth the denture in this manner because a larger
polishing instrument would obliterate anatomic details. After completing the pumicing wash the denture
thoroughly in water, dry it and examine it for scratches. It any scratches are visible on the pumiced
surface. Repeat the pumicing and post pone the high polishing until after removing all scratches.
3. Stipple the denture with a No. 200 finishing bur Rotate this bur slowly in a hand piece and hold it in light
contact with the surface of the denture to be stippled that is, the area of the attached gingiva. Use light
random circular movement of the bur against the resin surface to produce an egg shell or stippled, effect
that breaks up light reflections and corrects minor imperfections in the resin.
4. Go over the stippled area lightly with a rubber prophy cup and slurry of flour of pumice.
5. Put a high shine on the denture with No. 341 Tigeleam or prepared chalk slurry and a modified rag
wheel. Do not use this rag wheel with any other polishing material. Examine the denture carefully for
scratches and polish out any missed previously. Take care when polishing or pumicing the denture to
keep from abrading anatomic details of the plastic teeth.
6. Brush the denture with green soap to remove all traces of polishing material, and examine the denture
carefully rinse the denture in water, and store it in a plastic container of water until needed.
Method II for Polishing the complete denture
1. Remove the denture from the cast.
2. Remove the stone that adheres to the gingival margin area of the denture with bard-parker handle and a
No. 25 blade. Trim away excess flash with a Laboratory Lathe-mounted carbide bur place the denture in
an ultrasonic cleanser containing a solution for removal of gypsum products. Adjust for frenum clearance
with No. 558 bur mounted in a Laboratory Lathe.
3. Use a rubber point mounted on a mandrel and a dental lathe to remove scratches from the denture base
in areas in accessible to the larger pumice wheel. Pumice the denture using flour of pumice or fine
pumice mixed with water and a modified rag wheel as described previously.
4. Polish areas between the teeth with a bristle brush and pumice slurry.
5. Put the initial high shine on the denture with a soft rag wheel and prepared chalk mixed with water.
6. Put the final high shine on the denture with a soft chalmois wheel and gold rouge.
7. Stipple the denture with a straight hand piece No. 4 round bur bent slightly to rotate eccentrically.
8. Place the bur in a lathe and with the lathe running at slow speed; stipple the surface of the denture base
in a random motion. Apply a high polish to the dentures again, scrub them with soap and water and place
them in a container of water until ready for use by the dentist.
Polishing Teeth:
Acrylic resin teeth are polished by the same method as the denture base material. A rubber prophy cup
and fine pumice or flour of pumice is used to restore the surface luster of acrylic teeth after
modification. A high luster is restored to the surface of these teeth with a soft rag wheel and a high-shine
material, such rouge or prepared chalk slurry. Care should be taken when polishing resin teeth to avoid
removing too much material from the Occlusal surfaces and thereby, effecting the occlusion. One
disadvantage of using plastic teeth by inadvertent contact between teeth and polishing wheel.
A technique for finishing and polishing denture bases William A Welker, D.D.S., M.S.D., Donal C Kramer,
D.D.S., M.S. and Roger W. Mercer USAF Medical center, wright wright patterson AFB, Ohto.
A common complaint of denture wearers is that they are unable to keep their dentures clean and free
from stains. This results from improper home care by the patient or improper finishing of the art portion of
the denture. T alleurate this common complaint patients should receive explicit instructions in home care,
and dentures should be finished and polished so that they are free ali surface,scratches and
imperfections.
When the dentures are poorly finished food debris will not be trapped on the surface, thus preventing
objectionable odor, and taste and an unsightly appearance.
The following technique proven successful in producing blemish-free dentures:
Materials and Method:
1. Deflask the dentures and remove the resin flash from the borders.
2. Use chisels to remove excess acrylic resin or stone from around the necks of the teeth. The chisels
should include one with a right bevel, one with left bevel, one with a fine point. They are easily made from
old dental hand Instrument.
3. Smooth the interproximal spaces, papillae and rugae area with a soft bristly brush and flour of pumice
large brushes and rag wheels destroy the anatomy and should not be used.
4. Polish the cervical surface of each artificial tooth with a rubber polishing cup. This will produce smooth
surface at the junction of the tooth and acrylic resin. A region most difficult for patients to keep clean.
5. Remove scratches from the borders with a large rag wheel and pumice.
6. Lightly buff the remainder of the denture base with a rag wheel and pumice. Light pressure will not
destroy the anatomy or the tinting of the denture base.
7. Rinse the denture in water to remove the pumice thoroughly dry, and inspect for remaining
imperfections. It imperfections are visible, repeat the rag wheel and pumice procedure.
8. Hard-to-reach regions such as the curve of the palate. The rugae area and the lingual surfaces of lower
incisors and canines, are smoothed with midget rubber points. Followed by pumice applied on a small
cotton point made by winding cotton on a suitable used bur.
9. Wash the dentures thoroughly with soap and water, dry and inspect the base material under
magnification. All denture surfaces, with the exception of the basal seat area should present a smooth
egg shell texture tree of imperfection. If not the previous steps must be repeated.
10. Apply Ti-gloss to a new rag wheel and lightly buff the denture surface.
11. Wash and dry the denture and again inspect it for imperfection small, hard-to-reach imperfections are
now removed with the rubber points and cotton points using Ti-gloss.
12. Use Ti-gleem on a rag wheel with a light buffing action to produce on final high shine.
Dentures bases finished by this technique will produce highly polished surfaces free from all
imperfections. The denture bases will remain free of stains and odors with normal home care.






SUMMARY & CONCLUSION :


Method of Retrieval of denture, correction of occlusal discrepancies finishing & Polishing
procedures are discussed in this seminar. These are the end procedures before the denture is finally
deserved to the patient. A little extra effort & time are required for these & there is not excuse, Which will
justly a compromise in these final steps. This procedure will enhance the comfort, function & esthetics of
the denture which is the final aim every prosthesis is fabricated for.









Remounting Dentures:
After the index grooves or notches are cleaned the dentures and casts are seated to the mounting
stone with sticky wax. After remounting of denture and casts, occlusal discrepancies caused during
processing.
Every dentist who treats patients with complete dentures is probably aware that the planned
contact relationship of apposing. Posterior teeth are not the same in the processed dentures as it was
before the dentures were processed. Correction of Occlusal discrepancies should be accomplished at
the appointment for the initial placement of the dentures.
There are two main factors in the production of Occlusal discrepancies in the processed denture.
1. A change in the relationship of a tooth or teeth to the master cast during processing procedures.
2. Warp age of the denture base through release of inherent strains when the denture is separated from the
cat upon which it was processed. In the first instance the tooth may change its relationship to the master
cast as a result of investing procedures (exothermic reaction of investing stone causing an expansion of
wax).
3. Cure less packing of acrylic resin in the molds.
4. Improper closure of the flask halves.
Several methods of processing procedures have been suggested to minimize the risk of causing such
change.
casting laws


Laws of casting
- Ingersoll & Walding (1986) formulated an expanded set of 17 separate
recommendations for spruing, investing, burnout, melting & casting procedures.
Collectively these guidelines are referred to as the laws of casting.



1
st
Law of Casting

- Attach the pattern sprue former to the thickest portion of the wax pattern:
This provides the molten metal to flow from larger diameter to thinner sections
Penalty: cold shuts, short margins and incomplete casting





2
nd
Law of Casting

Orient wax patterns so all the restoration margins will face the trailing edge when
the ring is positioned in the casting machine:
Add a wax dot to the crucible so that, it will guide us in placing the ring in casting
machine
Penalty: cold shuts and short margins

3
rd
Law of Casting

- Position the patterns in the cold zone of the investment and reservoir in the heat
center of the casting ring:
Adherence to this law causes porosity in the reservoir
Penalty: shrinkage porosity






4
th
Law of Casting

- A reservoir must have sufficient molten alloy to accommodate the shrinkage
occurring within the restorations:
Molten metal shrinks and creates a vacuum, for complete casting vacuum must be
able to draw additional metal from adjacent source.
Penalty: shrinkage porosity and/or suck-back porosity.


5
th
law of casting

- Do not cast a button if a connector bar or another internal reservoir is used:
With indirect spruing the largest mass of metal should be the reservoir
A button can draw available molten alloy from the bar, shift the heat centre and
reduce the feed of the metal to the restorations
Wax patterns should not be larger than the connector bar
Weigh the sprued patterns and use the wax pattern-alloy conversion chart
Penalty: shrinkage porosity and suck back porosity (potential distortion during
porcelain firing).

6
th
law of casting

- Turbulance must be minimized, if not totally eliminated
Eliminate sharp turns, restrictions, points or impingements that might create
turbulance and occlude air in the casting
Restrictions or constrictions can accelerate the metals flow and abrade the mold
surface (mold wash)
Penalty- voids and /or surface pitting

7
th
law of casting

- Select a casting ring of sufficient length and diameter to accommodate the patterns
to be invested
The casting ring should permit the patterns to be inch apart and inch from the
top of investment and 3/8 inch of investment between pattern and ring liner
Penalty- mold fracture, casting fins and shrinkage porosity

8
th
law of casting

- Increase the wettability of wax pattern
Wetting agent should be brushed or stained on the patterns and dried before
investing
Too much wetting can weaken the investment and produce bubbles or fins on the
casting
Penalty- bubbles (due to air entrapment)

9
th
law of casting

- Weigh any bulk investment and measure the investment liquid for precise powder
liquid ratio
A thick mix of investment increases investment expansion and produces loose
fitting castings
Thinner mix yields less expansion with tighter fitting castings
Penalty- ill fitting casting



10
th
law of casting

- Eliminate the incorporation ofair in the casting investment and remove the ammonia
gas by product of phosphate bonded investments by mixing under vacuums
Vacuum mixing removes air and gas providing an uniform mix without large
voids
Entrapped air can affect the expansion at various sites of the investment
Penalty- small nodules, week mold and distortion of the casting

11
th
law of casting

- Allow the casting investment to set completely before initiating the burn out
procedure
The mold may not withstand steam expansion during burnout if the mold is not set
Advise to wait till the recommended setting time by the manufacturer
Penalty- mold cracking/ blowout or fins on the casting

12
th
law of casting

- Use a wax elimination technique that is specific for the type of patterns involved
and recommended for the particular type of casting alloy selected
Plastic sprues should be heated slowly, so they can soften gradually and not exert
pressure, so use a two stage burnout
Recommended atleast a 30 min heat soaking at 800F for the first burnout
Penalty- cold shuts, short margins, cold welds, mold cracks and/or casting fins

13
th
law of casting

- Adequate heat must be available to properly melt and cast the alloy
Selected heat source should be capable of melting the alloy to the point of
sufficient fluidity
Too much heat or high temperature can burn off minor alloying elements and /or
oxidation (burned metal)
Penalty- cold shuts, short margins and cold welds (too little heat) or rough castings
and investment breakdown (too much heat)

14th law of casting

- When torch casting, use the reducing zone of the to melt the alloy and not the
oxidizing zone
Melt achieved by the exclusive use of reducing zone minimizes the likelihood of
metal oxidation and gas absorption and ensures the proper melt
Penalty- gas porosity and/ or a change of alloys quotient of thermal expansion



15th law of casting

- Provide enough force to cause the liquid alloy to flow into the heated mold
Low density metal generally needs four winds of a centrifugal casting arm as
compared to higher density, gold based alloys
Do not over wind
Penalty- cold shuts, short margins, cold welds (insufficient force), or mold fracture
and fins (too much force)

16th law of casting

- Cast towards the margins of wax patterns
Place the heated ring in the casting cradle using the orientation dot, so the pattern
margins face the trailing edge
Penalty- cold shuts, short margins and otherwise incomplete castings

17th law of casting

- Do not quench the ring immediately after casting:
Uneven cooling and shrinkage between alloy and investment can apply tensile
forces to the casting dot
It can reduce strength
Penalty- hot tears
HYDROCOLLOIDS

Contents:

1. Introduction.
2. History.
3. Ideal requirements.
4. Classification of impression materials.
5. Impression materials.
Hydrocolloids:
a). Alginate.
b). Agar.
7. Recent advances.
8. References.












INTRODUCTION:

Constructing a model
or cast is an important step in numerous dental procedures. Various types of cast
& models can be made from gypsum products using an impression mold or
negative likeness of a dental structure. An impression is a negative replica of the
tissue of the oral cavity. It is used to register or reproduce the form and relation
of the teeth & surrounding tissue.

HISTORY:

1558 - Celline described a wax model to make impression in his book
MEMORIES.
1700 - Matheus G. Purenam suggested that wax models can be used in
prosthetic work.
1728 Pierre Fauchard described various impression materials in his book LE
CHIRURGEEN DENTISTE.
1756 Persian Phillip Pfaff first used plaster models prepared from sectional
wax impression of the mouth.
1810 R C Skinner describe about many materials and techniques in his first
American book.
1928 ADA developed specification No. 19 for impression material
1930 Zinc Oxide Eugenol a rigid impression was introduced
1930 Polysulfide was first used as a commercial synthetic rubber as a
copolymer of Ethylene Chloride & sodium.
1937 Agar was introduced by Sears.
1949 Alginate was developed during World war II.
1950 Polysulfide was used in dentistry.
1955 Condensation Silicone was introduced in Germany.
1975 Addition Silicone was introduced.
1977 Costell introduced Dual tray technique.
1980 A Visible light cure Polyether Urethane Dimethacrylate rubber
impression material was introduced.
1996 Blare & Wassed considered a no. of solution used to disinfecting
impression material.

IDEAL REQUIREMENTS OF IMPRESSION MATERIAL:
1. Pleasant taste & odor
2. Not contain any toxic & irritating ingredients
3. Adequate shelf life
4. Satisfactory consistency and texture
5. Easy to disinfect with out loss of accuracy
6. Compatible with die and cast material
7. Dimensional stability
8. Good elastic properties
9. Easy manipulation
10. Adequate setting characteristics
11. High degree of reproduction details
12. Adequate strength
13. Should not release any gas
14. Economical
15. Should not be technique sensitive.

Classification of impression materials:
Impression materials can be classified into various types based on the following characters:
1. Based on rigidity/elasticity: -
a. Rigid (non-elastic).
b. Elastic.
2. Based on viscosity: -
a. Mucostatic.
b. Mucocompressive.
c. Pseudoplastic.

3. Based on setting of material: -
1. a. chemical reaction.
b. Physical change of state.
2. a. reversible.
b. Irreversible.

4.Based on interaction with saliva/water: -
1. Hydrophobic.
2. Hydrophilic.

5.Based on chemistry:-
1. Impression Plaster.
2. Impression compound.
3. Metal oxide (zinc oxide eugenol).
4. Reversible hydrocolloid.
5. Irreversible hydrocolloid.
6. Poly sulfides.
7. Condensation silicones.
8. Addition silicones.
9. Polyether.
10. Visible light curing polyether urethane dimethacrylate.

6.Based on use: -
1. Primary impression materials.
2. Secondary impression materials.
3. Duplicating materials.


HYDROCOLLOIDS:

- Colloids are often classified as fourth state of matter, the Colloidal state. In
a solution of sugar in water, the sugar molecules are uniformly dispersed
in the water & there is no visible physical separation between the solute &
the solvent molecules. If sugar molecules replaced with large & visible
particles such as sand, the system is Suspension or if molecules are liquid
such vegetable oil, then system is Emulsion.
- True solution exists as a single phase. However, both the colloid & the
suspension have to phase- The dispersed & Dispersion phase. In the
colloid, the particles in the dispersed phase consist of molecules held
together either by primary or secondary force. The size of the particles
range is 1 200nm.

Gels:
- Colloids with a liquid as the dispersion medium can exist in two different
forms known as Sol & Gel.
- A sol has the appearance & many characteristic of a various liquid.
- A gel, on the contrary, is a semi solid & produced from a soldering
process of gelation by the formation of fibrils or chains called Micelles.
- Gelation is the conversion of a sol to gel, & the temperature at which this
occurs is called Gelation Temperature.

Gelation may be brought about in one of these ways:

Lowering the temperature:- It is done by reducing the thermal energy of
effectively. These forces are secondary molecular forces. The bond between the
fibrils is weak & they break at slightly elevated temperature. Gelation temp. is 37-
50degree centigrade.
Liquefaction temperature:- It is considerable higher than gelation temp. & this
property is known as Hysteresis. This temp. is between 70 -100 degree
centigrade.
Chemical reaction:- Gelation may also induced by chemical reaction, where in
the dispersed phase of soil is allowed to react with a substance to give a different
type of dispersed phase. The process is not reversed by an increased
temperature.

Types of Hydrocolloids:

REVERSIBLE HYDROCOLLOIDS: - Reversible hydrocolloids are those sol can
be changed to gel, but gel cant be reversed back to the solution.
Eg: Alginate impression material.

IRREVERSIBLE HYDROCOLLOIDS: - Irreversible hydrocolloids are those
materials, where the change from the sol to gel can be brought by lowering the
temp. of the sol & the gel can be converted back to sol condition by heating.
Eg: Agar Agar.

ALGINATE IRREVERSIBLE HYDROCOLLOID

The word alginate comes from Algin & named by a chemist of Scotland. It was
identified as a liner polymer with numerous carboxyl acid groups. It is called
as irreversible hydrocolloids because gelation is induced by chemical reaction
& transformation is not possible. It is the most widely used dental materials.
The principal factors responsible for the success of this type of impression
materials are:-
Easy to manipulate
Comfortable for the patients.
Relatively inexpensive.

Composition:
Potassium or Sodium Alginate:- 15% It is the chief active ingredient
Calcium Sulfate:- 16% It is used as a reactor.
Zinc Oxide & Diatomaceous Earth:- Zinc oxide 4% & Diatomaceous
earth 60%
Potassium Titanium Fluoride :- 3%
Sodium Phosphate :- 2%

Gelation Process:

The typical sol-gel reaction is a soluble alginate with calcium sulfate & the
formation of an insoluble calcium alginate gel. Calcium sulfate reacts rapidly to
produce the in soluble Ca alginate from the potassium or sodium alginate in a
aqueous solution. The production of calcium alginate is rapid that it does not
allow sufficient working time. Thus third water soluble salt, such as a trisodium
phosphate, is added to the solution to prolong the working time. Thus the
reaction between the calcium sulfate & the soluble alginate is prevented as long
as there is uncreated trisodium phosphate.
2Na3Po4 +n CaSo4 nKaSo4 +Ca. alginate
When the supply of the trisodium phosphate is exhausted, the ca ions begin to
react with the potassium alginate to produce calcium
alginate. Kzn Alg +n
CaSo4 n KaSo4 + Cal. alginate
The added salt is retarder.

Controlling of gelation time:-
An increase in the temp. of water used for mixing, shorten the working &
setting time.
The proportion of powder & water also effect the setting time.

PROPERTIES:
Alginate is of two types
Type I: - Fast setting
Type II: - Normal setting.

According to ADA Specification No. 18 properties are:-
1. Mixing time:- Creamy consistency come in 45 60 sec.
2. Working time:-
- Fast setting material: - 1.2 2 min
- Normal set material: - 2 4.5 min
3. Setting or gelation time:-
- Optimum gelation time: - 3-4 min at room temp.
- For fast setting material: - 1 -2 min
- For normal setting material: - 2 4.5min
4. Permanent deformation: - ADA specification requires 97% recovery & where
3% is permanent deformation. Alginate has 98.8% recovery & 1.5 % permanent
deformation.
5. Flexibility:- ADA specification permits10 20% at the stress of 1000gm/
cm2. Hard material has value of 5-8%.
6. Strength:-
The compressive strength:- 5000-8000gm/cm2
Tear strength :- 350-700gm/cm2
7.Viscoelasticity:
Usually an alginate impression material does not adhere to the oral
tissue as strongly as some of the non aqueous elastomers, so it is easy
to remove the alginate impression rapidly.
8.Accuracy:
Most alginate is not capable of reproducing the finer details that are absorbed
in impression with Agar & other elastomeric impression material.
9. Dimensional effects: - The gel may loss water by evaporation from its surface
& it shrinks.
- If the gel placed in the water it absorbed water & gel swells.
- Thermal change also contributes to dimensional change. The alginate shrinks
slightly due to difference in temp. between mouth temp.(30c) & room temp(23c).
10. Biocompatibility :-
No chemical or allergic reaction associated with alginate.
11. Shelf life :-
Alginate impressions have shorter shelf life. Strong temp. & moisture
contamination are two factor which effect the self life of alginate.

MANIPULATION OF ALGINATE:

PREPARING THE MIX
A measured powder is shifted into pre measured water, that has been
placed in a clean rubber bowl. Care should be taken to avoid whipping air into the
mix. A vigorous figure 8 motion is best, with the mix being swiped or stropped
against the side of the mixing rubber bowl with intermittent rotation ie.180 degree
of the spatula to press out air bubbles. The mixing time is 45sec -1 min.
A variety of mechanical devices are also available for mixing impression
material. There benefits are convenience, speed & elimination of human error.

MAKING THE IMPRESSION
Before setting the impression, the material should have developed
sufficient body so that it doesnt flow out of the try. A perforated tray is generally
used. If plastic try or metal rim lock try is selected a thin layer of adhesive should
be applied & allowed to dry before mixing and loading the try. The thickness of
the alginate between the tray & tissue should be at least 3mm.

Recent developments:
1. Dust-free alginates:
- Inhaling fine airborne particles from alginate impression material can cause silicosis and
pulmonary hypersensitivity.
- Dustless alginates were introduced which give off or no dust particles so avoiding dust
inhalation. This can be achieved by coating the material with glycerine or glycol. This causes the
powder to become more denser than in uncoated state.

2. Siliconised alginates:
- It is a two component system in the form of two pastes, one containing the alginate sol and the
second containing the calcium reactor.
- The components incorporate a silicone polymer component which makes material tear resistant
compared to unmodified alginates. However the dimensional stability is reported to be poor.

3. Low dust alginate impression material:
Introduced by Schunichi, Nobutakwatanate in 1997.
This composition comprises an alginate a gelation regulator and a filler as major components
which further comprises sepiolite and a tetraflouroethylene resin having a true specific gravity of
from 2-3.
The material generates less dust, has a mean particle size of 1-40microns.

4. Antiseptic alginate impression material:
Introduced by Tameyuki Yamamoto, Maso Abinu patented in 1990.
An antiseptic containing alginate impression material contains 0.01 to 7 parts by weight of an
antiseptic such as glutaraldehyde and chlohexidine gluconate per 100 parts by weight of a cured
product of an alginate impression material.
The antiseptic may be encapsulated in a microcapsule or clathrated in a cyclodextrin.

5. CAVEX Color change:
The alginate impression material with color indications avoiding confusion about setting time.
Color changes are visualizing the major decision points in impression making
end of mixing time
end of setting time ( tray can be removed from mouth)

it indicates two color changes
Violet to pink indicates the end of mixing time.
Pink to white indicates end of setting time.
Other advantages of this material are
-improved dimensional stability (upto 5 days)
Good tear and deformation resistance
Dust free
Smooth surface, optimum gypsum compatibility.

ADVANTAGES & DISADVANTAGES:
Advantages:
1. Easy to mix and manipulate.
2. Minimum requirement of equipment.
3. Accuracy (if properly handled)
4. Low cost
5. Comfortable to the patient
6. Hygienic (as fresh material is used for each impression)
Disadvantages:
1. Cannot be electroplated.
2. Distortion occurs easily
3. Poor dimensional stability (poured within 15 min.)
4. Poor tear strength
AGAR REVERSIBLE HYDROCOLLOIDS

- When agar hydrocolloids heated, they liquefy or go into the sol state & on
cooling they return to the gel state. Because this process can be repeated, a
gel of this type is described as Reversible hydrocolloid. The preparation of
the agar hydrocolloids for clinical use requires care full control & yields
accurate impression. It has been largely replaced by alginate hydrocolloids
& rubber impression materials.

COMPOSITION:

Borates :- 0.2 0.5% Its works as retarder.
water :- 85.5% It is reaction
medium.
Agar:- 13-17% It is main active
constituent of reversible hydrocolloid impression material.
Sulfates :- 1 2% Accelerators
Fillers :- 0.5 -1% Diatomaceous earth, silica, wax
rubber etc used as filler.
Bactericide :- Thymol & glycerin are used
Color & flavor

GELATION PROCESS:

The setting of the reversible hydrocolloid is called gelation. The reaction can be
expressed a sol- gel reaction. The physical changes from to gel does not return to
the sol at the same temp. at which it solidified. The gel must be heated at the
liquefaction temp. ie 70 - 100c to form sol. Sol transform into a gel at 37-50c. the
exact gelation temp depended on several factor, including the molecular wt. the
purity of the material & the ratio of agar to other ingredients.
The gelation is critical. If the temp. is high, the heat from sol may injury to the
soft tissue, or if the surface of the sol transforms to a gel as soon as the sol may
injure the oral tissues, a high surface stress may develop. If the gelation temp. is
too far below the oral temp. it will be difficulty or even impossible to chill the
material sufficiently to obtain a firm gel to adjacent to the oral tissue. The temp.
lag between the gelation & liquefaction temp. of the gel makes it possible to use
as a dental impression material.

PROPERTIES:

Gelation temperature :-
After tempering, the sol should be homogenous and should set to a gel
between 37 50
0
c when cooled.
Viscoelastic properties :-
It demonstrates the necessity of deforming the impression rapidly when
it removed from the mouth which reduces the amount of the permanent
deformation. The elastic recovery of the hydrocolloid is never complete & it does
not return entirely to its original dimension after deformation. The amount of
permanent deformation in clinical is negligible, provided that :-
a) The material has adequately gelled.
b) The impression has been removed rapidly.
c) The under cuts present in the cavity preparation are minimal.
Permanent deformation :-
The ADA specification requires that the permanent deformation should
be less than 1.5% after the material compressed 10% for 30sec. This impression
material readily meets this requirement with the value of about 1%.
Distortion during gelation :-
If the material is held rigidly to the tray, then the impression material
shrinks toward the center of its mass. Rapid cooling may cause a concentration
of stress near the tray where gelation first takes place.
- Flexibility :-
The ADA specification requirement for flexibility allows a range of 4-
14% & most agar materials meet this requirement.
Strength :-
The compressive strength of Agar impression material is 8000gm/cm2
The tear strength of Agar is 7000gm/cm2
Flow :-
Agar is sufficiently fluid to allow detailed reproduction of hard & soft
tissue.
Compatibility with gypsum :-
Not all the agar impression materials are equally compatible with all
gypsum products. The impression should be washed of saliva & any trace of
blood, which retarded the setting of gypsum.
Manipulation of agar impression:
The use of agar hydrocolloid involves special equipment called
conditioning unit for agar. The hydrocolloid is usually supplied In two forms:
syringe and tray materials. The only difference between the materials is the color
and the greater fluidity of the syringe material.


Impression tray:
It is rim locked trays with water circulating device. This types of trays
should allow a space of 3mm occlusally and laterally and extend distally to cover
all the teeth. After the tray has been properly positioned, water is circulated at 13
degrees through the tray until gelation occurs.



Preparation of material:
Proper equipment of liquefying and storing the agar impression material
is essential.
At first reverse the hydrocolloid gel to the sol stage. Boiling water is a
convenient way of liquefying the material. The material must be held at this
temperature for a minimum of 10mins. Propylene glycol can be added to the
water to obtain 100 degrees. After it has been liquefied, the material must be
stored in the tray. The material can be stored for several days. Usually, there are
three compartments in the conditioning unit, making it possible to liquefy, store
and temper the material.

Conditioning and tempering:
Because 55 degree is the maximum tolerable temperature, the storage
temperature of 65 degrees would be too hot for the oral tissues, especially given
the bulk of the tray material. Therefore, the material that is used to fill the tray
must be cooled and tempered. Eliminating the effect of imbibition is the purpose
of placing the gauze pad over the tempering tray materials. When the tray
material is placed into the tempering bath, the gauze is removed and the
contaminating surface layer of material clings to the gauze and is removed as
well.

Making the impression:
The syringe material is taken directly from the storage compartment and
applied to the prepared cavities. It is first applied to the base of the preparation
and then the reminder of the tooth is covered. By the time the cavity preparation
and adjoining teeth have been covered, the tray material has been properly
tempered and is now ready to be placed immediately in the mouth to form the
bulk of impression. Gelation is accelerated by circulating cool water,
approximately, 18 21 degrees through the tray for 3 5 minutes.

Disinfection of hydrocolloid impression:
As the hydrocolloid impression material must be poured within short
time after removal from the mouth. The disinfection procedure should be
relatively rapid to prevent the dimensional change. Most manufacturers
recommended a specific disinfectant. The agent may be iodophor, bleach or
gluteraldehyde. The distortion is minimal if the recommended immersion time is
followed and if the impression is poured properly. The irreversible hydrocolloid
may be disinfected by 10 minute immersion in/or spraying with the antimicrobial
agent such as NaOCl and glutaraldehyde without sufficient dimensional change.
The current protocol for disinfecting hydrocolloid impression is to use household
bleach, iodophor, and synthetic phenols as disinfectants. After the immersion, it
is thoroughly rinsed. The disinfectant is sprayed liberally o the exposed surface.
The immersion should not be submerged or soaked in the disinfectant solution.


Recent techniques:
Laminate technique:
- A recent modification of the conventional procedure is the combined agar alginate technique.
The hydrocolloid in the tray is replaced with a mix of chilled alginate that bonds with the agar
expressed from a syringe.
- The alginate gels by a chemical reaction whereas the agar gels by means of contact with cool
alginate rather than with the water circulating through the tray. Since the agar not the alginate is
in contact with the prepared teeth maximum detail is reproduced.

Advantages
- syringe agar records tissues more accurately
- Water cooled tray is not required
- Sets faster.

Disadvantages:
- Agar alginate bond failure can occur
- Viscous alginate may displace agar
- Technique sensitive

Wet field technique:
- This is a recent technique
- The oral tissues are flooded with warm water. The syringe material is then injected in to the
surface to be recorded.
- Before syringe material gels tray material is seated.
- The hydraulic pressure of the viscous tray material forces the fluid syringe material down in to
the areas to be recorded.
- The motion displaces the syringe material as well as blood and debris through out the sulcus.
ADVANTAGES & DISADVANTAGES:
Advantages:
1. Hydrophilic Impression material
2. Good elastic properties, Good recovery from distortion
3. Can be re-used as a duplicating material
4. Long working time and low material cost
5. No mixing technique
6. High accuracy and fine detail recording

Disadvantages:
1. Only one model can be used
2. Extensive and expensive equipment required
3. It can not be electroplated
4. Impossible to sterilize for reuse
5. Low dimensional stability & tear resistance



TYPES OF FAILURES:
1. Distortion:- due to
Delayed pouring of impression
Movement of tray during setting
Removal from mouth too early
2. Grainy impression:- due to
Inadequate mixing
Prolonged mixing
Less water in mix
3. Tearing: - due to
Inadequate bulk
Moisture contamination
Removal from mouth too early
Prolonged mixing
4. Bubbles:- due to
Early gelation, preventing flow
Air incorporated during mixing
5. Irregular voids:- due to
Excess moisture &debris on

REFERENCES:

1. Anusavice Skinners science of dental materials. Tenth Edition.
2. Dental materials and their selection-willian .j.o brien
3. Restorative dental materials-craig
4. Removable prosthodintics- stewart
STRUCTURE OF MATTER




Contents:

1. Introduction.
2. Matter
3. Interatomic bonding
a). Primary bonding
Ionic
Covalent
Metallic
b). Secondary bonding
Hydrogen bonds
Vanderwaals forces
4. Interatomic bond distance & Bond energy.
5. Crystalline structure Lattice types.
6. Diffusion.
7. Adhesion & bonding.
8. Factors influencing adhesion.
a). Wetting.
b). Surface energy.
c). Contact angle.
9. Solubility and sorption.
10. Adhesion to tooth structure.
11. References.


INTRODUCTION:

An object can occupy one of the three different states of matter, such as solid, liquid, gas.
In dentistry we make use of all of them although dental materials
exist primarily as solids or liquids.
The state of a material is a function of temperature. The more energy
that is put into a material by increasing its temperature, the more difficult it
is to keep the atoms (or) molecules in close proximity to one another. Thus,
the atoms (or) molecules tend to move apart and expand as heat is
applied. Therefore increasing the energy within a given material through
the application of heat can have a destabilizing effect on both its structure
and dimensions. The structure of a material can be described on both a
microscopic and macroscopic level.
On the microscopic level, we experience the material through the
arrangement of its atoms and their bonding schemes. On the macroscopic
level we see a material as a solid liquid or gas.
The principle goal of dentistry is to maintain or improve the oral health of the patient. A wide variety
of dental materials are involved in the clinical application. Material should be carefully selected. Through
understanding and experimentation it is possible to maximize any one property, but in no application is it
possible to select a material for one property above. It is precisely in the balance of one factor against
another that the materials are used successfully. Hence it is essential to know, the properties of the
dental materials, to be able to understand the properties and reactions of the material and predict the
outcome.
MATTER:
It is the substance from which all physical things are made. Matter is any thing that occupies
space and has weight. Every thing that exists in the universe (seen or unseen) is matter and it is
composed of millions of tiny particles called molecules.
Molecules are composed of still smaller units called atoms and atoms themselves are made up of
even tinier particles called protons, neutrons and electrons.

Properties of matter:
1) All matter has mass and weight. Mass is the measure of the quantity (or) amount of matter, and this
remains same always. Weight of an object is the force of attraction exerted on the object by gravitation,
and this varies at different places.
For Ex: An object weighing one pound on earth would weigh only a few ounces on the moon, which has a
weaker gravitational pull, but its mass would not change as in the case of space travelers who float in
the space.
2) All matter has inertia : That means, matter has a tendency to remain at rest if at rest, or to continue
moving in a straight path with constant speed if in motion. Inertia of matter depends on its mass-greater
the mass of an object, greater is its inertia.
3) Density: All matter has density.
This is the mass per unit volume of a substance.
4) Matter can conduct heat and electricity.
5) There are three states of matter.
Solid, liquid and gas.

Molecule:
It is the smallest particle of a substance, which can exist on its own, and retains the properties of
that substance.
Molecular weight: is the weight of a molecule relative to that of an atom of carbon 12 taken as 12. This is
expressed in gram molecule.
Atom: Is the smallest particle of any element that shows the chemical behaviour of that element. Atom
cannot be divided as it is the smallest. There are many kinds of atoms as there are elements. An element
is made up of only one kind of atoms.
Element: Is a basic substance that cannot be separated into different substances.
Atom is the basic unit from which molecules and aggregates of molecules, which represent
particular matter are built. Atom is made up of a 3 types of fundamental particles like protons, neutrons
and electrons. Number of protons and number of neutrons, gives the mass to the nucleus and also the
atomic weight.

INTERATOMIC BONDING:
Atoms do not exist singly, instead are joined with other atoms of the same kind, to form molecules.
The number of atoms joining together may be two or in thousands. When such a thing happens there
exists a real thing or substance. The mechanism of atoms coming together is through forces of attraction
and the atoms going away from each other is through forces of repulsion.
Forces of attraction that make the atoms to come together are called interatomic bonds.
These bonds are classified as
1) Primary bonds Chemical in nature, permanent and strong
a) Ionic bond
b) Covalent bond
c) Metallic bond
2) Secondary bonds Physical in nature, weak bonds also called Vander-walls forces.

PRIMARY BOND:
Ionic bond: Normally atom is electrically neutral because of balance of positively charged proton and
negatively charged electron. An atom can become ion if it loses or gains one of its outermost circulating
electron. This can be a positive ion or negative ion. Atom can be a positive ion or a negative ion. Such
differently charged two atoms will be attracted to each other because of differing polarity, and a bond
takes place between atoms.
Ex: Such a bond is seen in sodium chloride molecule.
When such 2 atoms come together sodium atom loses its one outermost electron and becomes
positive ion. Chlorine atom takes one more electron from sodium and becomes negative ion. Thus +ve Na
and ve Cl attract each other and stay together to form an NaCl molecule.
Ex: Such bonding takes place with glass ionomer or polycarboxylate cement and tooth enamel. The bond
in this case is between negatively charged atoms in the cement and positively charged atoms in the tooth
enamel.
This is called as true form of chemical adhesion.

Covalent bond:
This kind of bond, takes place by sharing of electron between 2 atoms.
Ex: Such a bond is seen when 2 hydrogen atoms come together each hydrogen
atom has only one electron surrounding it when 2 hydrogen atoms come together
one electron of each atom is shared by both atoms.

Similarly chlorine atom will join with another chlorine atom and share the outer electrons by
covalent bond to form Cl
2
covalent bond is very strong and stable.
This kind of bond is seen with carbon-carbon bond that takes place
in denture base resin (acrylic) or dental composite resin. Also seen in
silicon-oxygen bond of dental ceramics.

Metallic bond:
This is seen in metallic elements. The atoms of the metal are arranged in orderly rows. The atoms
lose their outermost valence electrons to form metal ions with a net positive charge called cations .
The freed valence electrons roam about together like a gaseous cloud in the interstices formed by
the arrangement of solid spheres. This electron cloud acts like a glue that holds together different atoms.
This is called metallic bond, which is responsible for the strength, conductivity, of heat and electricity of
metals. This bond is strong and stable.


INTER ATOMIC SECONDARY BONDS
In contrast to primary bonds
secondary bonds do not share electrons.
Instead, charge variations among
molecules or atomic groups include polar
forces that attract the molecules.
Hydrogen bonding
This bond can be understood by
studying a water molecule. Attached to the
oxygen atom are two hydrogen atoms.
These bonds are covalent because the
oxygen and hydrogen atoms share
electrons.
As a result the protons of the
hydrogen atoms pointing away from the
oxygen atoms are not shielded effectively
by the electrons. Thus the proton side of the
water molecule becomes positively
charged. On the opposite side of the water
molecule, the electrons that fill the outer
orbit of the oxygen provide a negative
charge. Thus a permanent dipole exists that
represents an asymmetric molecule.
H
2
bond, associated with the positive
charge of hydrogen caused by polarization
is an important example of this type of
secondary bonding.
When a H
2
O molecule intermingles
with other water molecules, the hydrogen
(+ve) portion of one molecule is attracted to
the oxygen portion of its neighboring
molecule, and the hydrogen bridge is are
formed.

VAN DER WAALS FORCES
It is a more a physical than chemical bond. These forces form the bases of a dipole attraction. Eg :
in an inert gas, the electron field is constantly fluctuating. Normally the electrons of the atoms are
distributed equally round the nucleus and produce an electrostatic field around the atom. However this
field may fluctuate so that its charge becomes momentarily positive and negative. A fluctuating dipole is
thus created that will attract other similar dipoles. Such interatomic forces are quiet weak.

Inter atomic bond distance and bonding energy:
Regardless of the type of matter, there is a limiting factor that prevents the atoms or molecules from
approaching each other too closely, that is the distances between the center of an atom and that of its
neighbor is limited to the diameter of the atoms involved.
If the atoms approach too closely, they are repelled from each other by their electron charges. On
the other hand, forces of attraction tend to draw the atoms together. The position at which these forces of
repulsion and attraction become equal in magnitude is the normal or equilibrium position of the atoms.

Thermal energy
Thermal energy is accounted for by the kinetic energy of the atoms or molecules at a given
temperature. The atoms in a crystal at temperatures above absolute zero temperature are in a constant
state of vibration and the average amplitude will be dependent on the temperature, the higher the
temperature the greater the amplitude, and consequently, the greater the kinetic or internal energy. The
overall effect represents the phenomenon known as thermal expansion.
If the temperature continues to increase the interatomic spacing will increase, and eventually a
change of state will occur.
The thermal conductivity depends mainly on the number of free electrons in the material.
As metallic structures contain many free electrons and most metals are good conductors of heat as
well as electricity, whereas non-metallic materials do not include many free electrons and consequently
they are generally poor thermal and electrical conductors.

CRYSTALLINE STRUCTURE:
Dental materials consist of many millions of atoms or molecules. They are arranged in a particular
configuration.
In 1665 Robert Hooke simulated the characteristic shapes of crystals by stacking musket balls in
piles.
The atoms are bonded by either primary or secondary forces. In solid state they combine in the
manner that will ensure a minimal internal energy.
For eg. Sodium and chlorine share one electron as described previously. In the solid state,
however they do note simply pair together but rather all of the positively charged sodium ions attract all of
the negative chlorine ions, with the result that they form a regularly spaced configuration known as space
lattice or crystal, here every atom is spaced equally from every other atom.
There are 14 possible lattice types, but many of the metals used in dentistry belong to the cubic
system.
Non crystalline structure eg. Glass and waxes structures other than the crystalline form that occur
in the solid state eg. Glass and waxes.
Waxes solidify as amorphous materials meaning that the molecules are distributed at random.
Though there may be a tendency for the arrangement to be regular.
Glass is considered to be a noncrystalline solid, yet its atoms tend to forma short range order
lattice instead of the long-range order lattice characteristic of crystalline solids. In other words, the
ordered arrangement of the glass is more or less localized with a considerable number of disordered units
between them.
Such an arrangement is also typical of liquids such solids are sometimes called supercooled
liquids.
Non crystalline solids do not have a definite melting temperature but rather they gradually softer as
the temperature is raised and gradually hardens as they cool. The temperature at which there is an
abrupt decrease in the thermal expansion cuff, is called the glass transition temperature or glass
temperature.
Below Tg a glass loses its fluid characteristics and has significant resistance to deformation.
Eg : synthetic dental resins.

DIFFUSION
Diffusion of molecules in gases and liquids is not known. However molecules and atoms diffuse in
the solid state as well.
At any temperature above absolute zero, the atoms of a solid possess some amount of kinetic
energy as previously discussed. However the fact is that all the atoms do not possess the same amount
of energy, these energies vary from very small to quiet large. With the average energy related to the
absolute temperature. Even at very low temperatures some atoms will have large energies. If the energy
of a particular atom exceeds the bonding energy, it can, move to another position is the lattice.
Atoms change position in pure solids, even under equilibrium conditions, this is known as self
diffusion.
Increase temperature greater the rate of diffusion .The diffusion rate will however vary with the
atom size, interatomic or intermolecular bonding, lattice.

ADHESION AND BONDING
Adhesion is a phenomenon involved in many situations in dentistry.
Eg. Leakage adjacent to dental restorative material is affected by the adhesion process. The
retension of artificial dentures is probably dependent, to some extent on the adhesion between denture
and saliva and between

Three states of matter:
Three states of matter are solids, liquid and gas.
Solid:
Solid has definite shape and volume. Ex: Block of wood, stone work is necessary to change the
shape of solid. They have definite atomic arrangement and are resistant to deformation. The molecules of
the solid are moving about in a restricted area, atoms of solid have high attraction force between them
and low kinetic energy.


Crystalline solid:
Crystalline solid is one in which molecules are arranged in a definite geometric pattern Ex: metals.

Amorphous solid:
Amorphous solid is one in which molecular arrangement is irregular ex: Glass, wax, dental resin.
Glass if also called as supercooled liquid, because it is basically a liquid, at a low temperature
which can be rigid or semirigid. It is highly viscous and has little resistance to deformation.
Glass has no fixed melting or solidifying point, it gradually changes to liquid and in reverse
gradually solidifies. The temperature at which this change occur is known a glass transition temperature
which is designated as Tg.

Liquid:
Liquid has a definite volume, but not a definite shape. Liquid takes the shape of the container in
which it is kept. The molecules in a liquid are free to move about. The molecules are sufficiently close to
each other to have mutual attraction on each other and on this depends the liquids fluidity or viscosity.

Gas:
Gas has molecules which have freedom of movement and are not restricted to a given area. Gas
has no definite shape and no definite volume. It expands to fill its container.

Change of state: When a solid is heated, the molecules acquire more kinetic energy and vibrate more
rapidly. They acquire enough energy to breakout of their positions and move about among the other
molecules. When this happens solid turns into liquid and the process is called melting.
When a liquid is heated, the molecules gain more KE and some gain enough energy to break
away from the surface of the liquid and become gas. This is evaporation when bubbles are formed during
this change it is called boiling.
Change of state is basically controlled by proper temperature and pressure on the mass.
Crystal Crystal is any solid whose atoms are arranged in an orderly and repeated pattern ex: Crystals
of quartz metals.
Uses of crystals: In jewellary, in watches, hearing aids, microphones mica crystals are used as
insulators in electrical equipments.

PROPERTIES:
Physical Properties: most crystals have sharp melting point ex: Metal many crystals cleave or split along
change planes, which are planes of weak bonding that run parallel to one another through out the crystal.
This is due to the orderly and repeatition of atomic structure. Crystals conduct heat and electricity in one
direction but act as insulator in other direction.

Optical properties: light is refracted in crystals.
X-ray diffraction breaking up spread
The structure of the crystals can be studied by X-ray diffraction.
Classification of crystals: Crystals are classified by the form of the unit cells.
- The unit cell is the basic 3 dimensional repeating structure of which crystals are composed.
- The unit cell may grow in 7 basic different shapes, determined by the relative lengths of their axis and the
angle that these axes make with each other.
- The seven forms of unit cell define the crystal systems and every crystal is classified by the position of the
atoms or ions in these cells.
- In a simple cubic type, only the corners of the cells are occupied by atoms.
- In body centered cells, the corners and the centers of the cell are occupied by atoms.
- In face centered cells, the corners and the centers of the faces are occupied by atoms.
- There are 14 different combinations of cell structures and atomic arrangement. These combinations are
called space lattices rocks, metals and ice are not single crystals, but are composed of many small
crystalline material.
- Substances composed of single crystal are called monocrystalline unit crystal cell is the smallest
repeating unit of atoms.

Diffusion of atoms in solids: Diffuse = Spread out
Atoms have energy particles means they have internal energy, some atoms have high energy
level than others. High energy atom can move or change its place and occupy another position in the
material.
Rate of diffusion depends on temperature, higher the temperature greater will be the diffusion.

Consequences of diffusion of atoms:
1) Solid state reactions: Number of solid state reactions occur in a solid substance and it is due to the
diffusion of atoms.
For ex: In gold-copper alloys, gold and copper atoms may be distributed randomly in the space lattices
leading to disordered lattice. Due to heat treatment this pattern may change in which gold atoms occupy
the center of the cubic type of space lattice and copper atoms occupy the corner positions in the space
lattice.
This will change the physical properties of hardness, brittleness strength and conductivity of a
material.
2) Diffusion can bring about change in the shape or contour of a material known as warpage or distortion.

1) ADHESION:
Adhesion is attraction between unlike molecules. i.e., if two different substances are made to come
in contact with each other at their inter surfaces and if the two surfaces are stuck together it is said that
adhesion has taken place.
For example gum and paper.
Gum and paper are two different types of materials having different types of molecules. When gum
is applied to the surface of the paper, the attraction between the molecules of gum and molecules of
paper takes place and it is adhesion.

2) COHESION:
Cohesion is attraction between like molecules. In this case only one materials is involved. For
example water.
It is mad up of molecules of hydrogen and oxygen. The two together form water molecule such as
H
2
O. There are innumerable numbers of water molecules in water. Water remains as water as long as
there is attraction between one water molecule and another molecule. This attraction between similar
type of molecules is cohesion.
Adhesion and cohesion help in the retention of complete dentures as follows.
When the denture is placed in the mouth in contact with mucous membrane, adhesion and
cohesion both play a role.
In this three materials (or) three types of molecules are involved, they are
Denture material
Saliva
Mucous membrane.
Fitting surface of denture has saliva layer, and saliva is in contact with mucous membrane. Thus,
there is adhesion between denture surface molecules and saliva molecules. There is cohesion between
saliva molecules and saliva molecules. There is adhesion between saliva molecules and mucous
membrane surface.
In dentistry, adhesion is an important requirement of any restorative materials so that there is a
bond between tooth enamel and artificial restorative materials, which helps in retention of the restoration
in the tooth.
Adhesive is a material (or) film of material used to produce adhesion.
Adherand is the materials or surface of a material to which adhesive is applied.
For ex: Gum is an adhesive, paper on which it is applied is adherand. Attraction between molecules of
gum and paper is adhesion.

Factors influencing adhesion:
These are
1) Wetting
2) Surface energy
3) Contact angle.

1) WETTING:
It is the ability of a liquid (adhesive) to flow and adapt to the surface of a solid.
It is mainly dependent on surface tension. Surface tension is the molecular attraction at the surface
of liquids and so the surface of a liquid is actually in a state of tension as if it were being pulled tight. This
property makes the surface of a liquid to behave like thinly stretched rubber sheets. Such surfaces tend to
become as small as possible.
For example: A drop of water is round in shape, mercury also forms a droplet of round shape. But water
as such has low surface tension, where as mercury has high surface tension.
Therefore a drop of water may be round in shape but spreads immediately and flows on the
surface. On the other hand drop of mercury remains same and does not spread out, but will wet the
surface only if the surface is clean.
It is difficult to force two solid surface to adhere.
When placed in apposition only high spots are in contract. Because these areas usually constitute
only a small percentage of the total surface, no perceptible adhesion takes place. The attraction is
generally neglible when the surface molecules of the attracting substances are separated by distances
greater than 0.7 nm.
One method of overcoming this difficulty is to use a fluid that flows into these irregularities and thus
provides contact over a greater part of the surfaces of the solid.

To produce adhesion in this manner, the liquid must flow easily over the entire surfaces and
adheres to the solid. This characteristic is referred to as wetting.
Ability of an adhesive to wet the surface is influenced by number of factors.
Cleanliness
Eg. Oxide film on metallic surfaces.
Some substances have + surface energy hence only a few liquids wet their surface.
Close packing of the structural organic groups and the presence of halogens may prevent wetting.
Metals interact vigorously with liquid adhesive because of increase surface energy.

2) SURFACE ENERGY:
For adhesion to exist, the surfaces must be attracted to one another at their interface. The energy
at the surface of a solid is greater than in its interior inside the lattice all of the atoms are equally attracted
to each other. The interatomic distances are equal and the energy is minimal.
At the surface of the lattice the energy is greater because the outermost atoms are not equally
attracted in all directions.
The increase in energy per unit area of surface is referred to as the surface energy. In liquids the
surface energy is known as surface tension.


3) CONTACT ANGLE:
The contact angle is the angle formed by the adhesive with the adherend at their interface. The
extent to which an adhesive will meet the surface of an adherend may be determined by measuring the
contact angle, between the adhesive and the adherend.
The greater the tendency to wet the surface, the lower the contact angle, until complete wetting
occurs at an angle equal to zero.
Capillary rise : The penetration of liquids into narrow crevices is known as capillary action.


This equation relates the differential capillary pressure developed when
a small tube of radius r is inserted in a liquid of surface tension (usually
expressed in dynes / cm) and with a contact angle u.
If the contact angle of the liquid on the solid is less than 90
0
AP will be negative and the liquid will
be depressed.

CONTACT ANGLE OF WETTING
The extend to which an adhesive wets the surface of an adherand may be determined by
measuring the contact angle between the adhesive and adherand.
The contact angle is the angle formed by the adhesive with the adherend at their interface. If the
molecules of the adhesive are attracted to the molecules of the adherend as much as or more than they
are to themselves, the liquid adhesive will spread completely over the surface of the solid, and no angle
(u = 0 degrees) will be formed. Thus the forces of adhesion are stronger than the cohesive forces holding
the molecules of the adhesive together.
Tendency of liquid to spread increases with decrease in contact angle. Therefore contact angle is
the indication of spreadability or wettability. Thus the smaller the contact angle between an adhesive and
an adherend, the better the ability of the adhesive to fill in irregularities on the surface of the adherend.
Also the fluidity of the adhesive influences the extent to which these voids or irregularities are fitted.

SOLUBILITY AND SORPTION:

One of the required of a dental restorative material is that, it should be stable in the oral
environment.
It should undergo a minimal amount of dimensional change and chemical alteration.
All dental materials are soluble to some extent and dissolve in water.
The least soluble of dental materials are the porcelains and ceramics.
In polymers the unreacted molecules may be readily extracted or dissolved into oral fluids.
The loss of small organic molecules from soft tissue conditioners and denture liners is
responsible for them hardening in the mouth and becoming irritating.
Metallic ions are slowly released from cast restorations and amalgams.
Sorption is the uptake of fluids or substances by a material.
This process is usually confined to polymeric materials and can also occur at the union between 2
materials, such as porcelains and a metal interface as a PFM restoration. Sorption may lead to subtle
discoloration of the porcelain. The result of sorption in a polymeric material is often a swelling or increase
in dimension.
The uptake of foreign materials can lead to chemical disintegration that occurring in dental
cements at the margin between the cast restoration and the tooth. This results in loosening of restoration
and decay of possible tooth structure.




ADHESION TO TOOTH STRUCTURE:

Associated principles of adhesion can be readily related to dental situations. For eg. when contact
angle measurements are used to study the wettability of enamel and dentin. It is found that the wettability
of these surfaces is markedly reduced after the topical appreciation of an aqueous fluoride solution.
Thus fluoride treated enamel surface retains less plaque over a given period, presumably because
of a decrease in surface energy. Therefore decreases in dental caries.
Higher surface energy of many restorative materials compound with that of the tooth, there is great
tendency for the surface and margins of the restoration to accumulate debris. Therefore increases
marginal caries.
Under certain instances,
1) Recurrent caries
2) Pulpal sensitivity
3) Deterioration of the margins of restoration can be associated with a lack of adhesion between restoration.
Enamel and dentin of tooth have varying amounts of organic and inorganic components. A
material that can adhere to the organic components may not adhere to the inorganic components, and an
adhesive that bonds to enamel may not adhere to dentin to the same extent.
After cavity preparation, tenacious microscopic debris covers the enamel and dentin surfaces.
This surface contamination called the smear layer, reduces wetting.




REFERENCES

1. Anusavice K.J.-Phillips Science of Dental materials 11th edition , 2003

2. Combe E.C. Notes on Dental Materials6th edition , 1992

3. Craigs R.G., Powers J.M. Restorative Dental Materials 11thedition, 2002

4.Gladwin M, Bagby M Clinical Aspects of Dental Materials 2nd edition,
2004

5. Mc Cabe J.F. Applied Dental Materials 7th edition , 1992

6. Phillips R.W.-Skinners Science of Dental Materials9th edition , 1992



CASTING PROCEDURES

CASTING: casting is the process by which
the wax pattern of a restoration is converted
to a replicate in a dental alloy. The casting
process is used to make dental restorations
such as inlays, onlays, crowns, bridges and
removable partial dentures.

CASTING PROCEDURE: It involves both
the clinical and the laboratory steps:
Step 1: Mouth preparation
Step 2: Direct wax pattern is done on the tooth or the impression of the prepared tooth is taken and the
die is made for indirect wax pattern.
Step 3: Preparing the wax pattern for investing.

Spruing the pattern:

The sprue former or the sprue pin acts as the channel or passage for the entry of the liquid metal into the
mold in an investing ring after wax elimination. The diameter and length of the sprue former depend to a
large extent on the dimensions of the flask or ring in which the casting is to be made.
Sprue former gauge selection is often empirical, is yet based on the following five general principles:
1. Select the gauge sprue former with a diameter that is approximately the same size as the
thickest area of the wax pattern. If the pattern is small, the sprue former must also be small because a
large sprue former attached to a thin delicate pattern could cause distortion. However if the sprue former
diameter is too small this area will solidify before the casting itself and localized shrinkage porosity may
result.
2. If possible the sprue former should be attached to the portion of the pattern with the largest
cross-sectional area. It is best for the molten alloy to flow from the thick section to the surrounding thin
areas. This design minimizes the risk of turbulence.
3. The length of the sprue former should be long enough to properly position the pattern in the
casting ring within 6mm of the trailing end and yet short enough so the molten alloy does not solidify
before it fills the mold.
4. The type of sprue former selected influences the burnout technique used. It is advisable to use a
two-stage burnout technique whenever plastic sprue formers or patterns are involved to ensure complete
carbon elimination, because plastic sprues soften at temperatures above the melting point of the inlay
waxes.
5. Patterns may be sprued directly or indirectly. For direct sprueing the sprue former provides the
direct connection between the pattern area and the sprue base or crucible former area. With indirect
spruing a connector or reservoir bar is positioned between the pattern and the crucible former. It is
common to use indirect spruing for multiple stage units and fixed partial dentures.
Reservoir:
Reservoir is the piece of wax that is attached to the sprue former approximately 1mm from the pattern as
an added precaution to prevent localized shrinkage porosity. When the liquid metal in the mold solidifies
first and shrinks the liquid metal in the reservoir will flow into the mold and thus overcomes that shrinkage.
Reservoir is necessary only with sprue formers of very small diameter.

Wax pattern removal:
Sprue former can be used to remove the pattern. If not the pattern is removed with a sharp probe. Then
the sprue former is attached to it. The pattern should be removed directly in line with the principle axis of
the tooth or the prepared cavity. Any rotation of the pattern will distort it. Hollow sprue pin is advisable
because of its greater retention to the pattern.

Crucible former:
It is also known as the sprue base. It is like a stand to hold the sprue former along with the pattern within
the casting ring while the pattern is being invested with the investment material. The shape of the crucible
former is such that when it is removed after the investment is set it forms a funnel like shape which is
most suitable to pour liquid metal into it. Crucible former can be made of metal, rubber or resin.

Casting ring: It is a hollow tube fitted over the crucible former encircling the wax pattern to a height of
or so above the edge of the pattern. The ring and the crucible former provide a seal and so the
investment material can be poured inside the ring to surround the wax pattern and sprue former.

Casting ring liners:
For the setting and hygroscopic expansion of an investment to take place more uniformly, some
allowance must be made for the lateral expansion of the investment. Solid rings do not permit the
investment to expand laterally during the setting, hygroscopic and the thermal expansions of the mold. To
overcome this lateral restriction a liner is placed inside the ring. With the metal casting ring is used it must
be lined with a liner of moistened paper made of glass fibre. This liner provides a cushion for the
hardening investment material to expand into, during the setting reaction. The ceramic paper liner is cut
to fit the inside of the metal ring and is and held in place with the fingers. The ring containing the liner is
then soaked into the water until it is completely wet. The liner is moistened because a dry liner would
absorb water from the investment and minimize the setting expansion.
The liner is done in two layers inside the ring, and the thickness must be not less than 1mm, so that ring
can accommodate more expansion. The liner is placed somewhat short of ends of the ring to enable the
investment to obtain a grip and provide a seal. And this also restricts the longitudinal expansion, so that a
more uniform expansion takes place and less distortion of the wax pattern.

Step 4: INVESTING
Mixing investment with distilled water is done according to the manufacturers ratio in a clean dry bowl
without entrapment of the air into the mix.
Mixing methods:
a. Hand mixing and the use of the vibrator to remove air bubbles.
b. Vacuum mixing- This is the better method because it removes air bubbles as well as
gases that are produced and thus produces a smoother mix.


Methods of investing:
a. Hand investing
b. Vacuum investing

Hand investing:
First the mixed investment is applied on all the surfaces of the pattern with a soft brush. Blow off any
excess investment gently, thus leaving a thin film of investment over the pattern, then apply again.
Then the coated pattern can be invested by two methods;
1. Placing the pattern in the ring first and then filling the ring full with investment.
2. Filling the ring with the investment first and then force the pattern through into it.

Vacuum investing :
Vacuum investing unit: This consists of the chamber of small cubic capacity from which air can be
evacuated quickly and in which casting ring can be placed.
Evacuation of air can be done by electrically or water driven vacuum pump.
Procedure:
The ring filled with investment is placed in the vacuum chamber. Air entry tube is closed. Then the
vacuum is applied. The investment will rise with froth vigorously for about 10-15 sec and then settles
back. This indicates that air has been extracted from the ring. The pressure is now restored to
atmospheric by opening the air entry tap gradually at first and then more rapidly as the investment settles
back around the pattern. Then the ring is removed from the chamber and the investment is allowed to set.
Modern investing unit does both mixing and investing under vacuum and is considered better than hand
mixing and pouring.
Then there are two alternatives to be followed depending upon what type of expansion is to be achieved
in order to compensate for metal shrinkage. They are:
1. If hygroscopic expansion of the investment is to be achieved then immediately immerse
the filled ring in water at the temperature of 37C.
Or under controlled water adding technique. A soft flexible rubber ring is used instead of usual lined
metal ring. Pattern is invested as usual. Then specified amount of water is added on top of the investment
in the rubber ring and the investment is allowed to set at room temperature. In this way only enough water
is added to the investment to provide the desired expansion.
2. If thermal expansion of the investment is to be achieved, then investment is allowed to set by
placing the ring on the bench for 1 hour or as recommended by the manufacturer.

Step 5: WAX BURNOUT AND HEATING THE RING
After the investment has set hard, the crucible former and the metal sprue former is removed carefully,
and any loose particles at the opening of the sprue hole are removed with small brush.
The purpose of the wax burnout is to make room for the liquid metal. The ring is placed in the oven at
250C with the sprue end down, thus allowing the melted wax to flow, out for 30min or even up to 60min
may be a good procedure to ensure complete elimination of the wax and the carbon.

Heating the ring: The object is to create a mold of such dimension, condition and temperature so that it
is best suited to receive the metal.

Hygroscopic Low-Heat Technique.
After the wax elimination the temperature of the same furnace can be set to a higher temperature for
heating or else, the ring can be transferred to another furnace, which has already set to the higher
temperature. In any case accurate temperature control is essential and therefore these furnaces have
pyrometer and thermocouple arrangement. The ring is placed in the furnace with the sprue hole down
and heated to 500C and kept at this temperature for 1 hour. In this low heat technique the thermal
expansion obtained is less but together with the previously obtained hygroscopic expansion the total
expansion amounts to 2.2 percent, which is slightly higher than what is required for gold alloys.
So this technique obtains its compensation expansion from three sources:
(1) The 37 C water bath expands the wax pattern
(2) The warm water entering the investment mold from the top adds some hygroscopic expansion
(3) The thermal expansion at 500' C provides the needed thermal expansion.

High-Heat Thermal Expansion Technique.
After the wax elimination, the ring should be placed in the furnace which is at room temperature and then
the temperature is gradually raised, until it comes to 700C in 1 hour. Then the ring is heat soaked at this
temperature for hour. This slow rise in temperature is necessary to prevent
This approach depends almost entirely on high-heat burnout to obtain the required expansion, while at
the same time eliminating the wax pattern. Additional expansion results from the slight heating of gypsum
investments on setting, thus expanding the wax pattern, and the water entering the investment from the
wet liner, which adds a small amount of hygroscopic expansion to the normal setting expansion.

Step 6: CASTING THE METAL
Casting Machines:
Alloys are melted in one of the three following ways, depending on the available' types of casting
machines:

Centrifugal Casting Machine.
This method makes use of centrifugal force to thrust the liquid metal into the mold. The aim is to force the
liquid metal under sufficient pressure, so that the pressure can be maintained for at least four seconds
after the metal has been cast. Pressure is necessary because the liquid with high surface tension will not
enter the mold on its own.
Centrifugal casting machine also known as broken arm casting machine has an arm which is supported in
the middle by a rotating spindle. One side of the arm has the weights to balance the machine. Other side
of the arm has crucible to melt the metal and an arrangement to hold the casting ring. The spindle is
spring loaded.

Procedure:
1. The force exerted by the machine is adjusted by turning 3-4 turns of the arm to wound
the spring and kept in that wounded position with the help of a stop rod.
2. Balancing the machine should have been done before the ring is heated by placing the
ring on the casting machine so that the arm is balanced to compensate for the weight of the ring
and the investment.
3. Preheating the alloy to its melting point is done by using the reducing zone of the torch
flame in ceramic crucible attached to the broken arm of the casting
machine. Use of reducing zone only is necessary to avoid
carburization of the metal and because it is the hottest part of the flame. Reducing zone is blue in
color.
During the heating of the alloy reducing flux such as borax is sprinkled over the alloy as soon as it is hot
enough for the flux to adhere to it. Applying flux removes the oxide skin on the surface of the alloy and
reduces its surface tension so that the liquid metal becomes fluidy.
4. Then the ring is immediately taken out of the heating furnace and place firmly against the
back plate of the machine. Then the crucible is moved up against the sprue hole end of the ring.
The crucible also has a hole in it. Thus both the holes are up against each other.
5. The alloy is reheated again until it spins, and looks bright red hot (1100C) with shiny
mirror like surface. This indicates its proper fusion.
6. At this stage torch flame is removed and arm of the machine is released by dropping the
stop rod simultaneously.
The machine begins to spin and stops on its own. This act will throw the metal through the hole and
directly through the sprue hole into the mold cavity, in the investment material.
Two things are important during this final stepone is metal must be in full liquid state- that means flame
must be held at the metal until the arm of the machine is released.
Secondly, there must be enough rotational force to fill the mold cavity quickly before the metal solidifies in the
sprue area.

As the metal fills the mold there is a hydrostatic pressure gradient develops along the length of the casting. The
pressure gradient from the tip of the casting to the bottom surface is quite sharp and parabolic in form, reaching zero
at the button surface. Ordinarily, the pressure gradient at the moment before solidification begins reaches about 9.21
to 0.28 MPa (30 to 40 psi) at the tip of the casting. Because of this pressure gradient, there is also-a gradient in the
heat transfer rate such that the greatest rate of heat transfer to the mold is at the high pressure end of the gradient
(i.e., the tip of the casting). Because this end also is frequently the sharp edge of the margin of a crown, there is
further assurance that the solidification progresses from the thin margin edge to the button surface.

Electrical Resistance-heated Casting Machine.
In this instance there is an auto-6iatic melting of the metal in a graphite crucible within a furnace rather
than by use of a torch flame. This is an advantage, especially for alloys such as those used for metal -
ceramic restorations, which are alloyed with base metals in trace amounts that tend to oxidize on
overheating.
Another advantage is that the crucible in the furnace is located flush against the casting ring. Therefore,
the metal button remains molten slightly longer, again ensuring that solidification progresses completely
from the tip of the casting to the button surface. A carbon crucible should not be used in the melting of
high palladium or palladium-silver alloys, where the temperature exceeds 1504' C or with nickel-chromium
or Cobalt-Chromium base metal alloys.

Induction Melting Machine.
With this unit, the metal is melted by an induction field that develops within a crucible surrounded by
water-cooled metal tubing. Once the metal reaches the casting temperature, it is forced into the mold by
air pressure, vacuum, or both, at the other end of the ring. The device has become popular in the casting
of jewelry but has not been used as much as the other two techniques for noble alloy castings. It is more
commonly used for melting base metal alloys.
There is little practical difference in the properties or accuracy of castings made with any of the three
types of casting machines. The choice is a matter of access and personal preference

Casting Crucibles.
Generally, three types of casting crucibles are available: clay, carbon, and quartz (including zircon-
alumina). Clay crucibles are appropriate for many of the crown and bridge alloys, such as the high noble
and noble types. Carbon crucibles can be used not only for high noble crown and bridge alloys but also
for the higher-fusing, gold-based metal-ceramic alloys.
Quartz crucibles are recommended for high-fusing alloys of any type. They are especially suited for
alloys that have a high melting range and are sensitive to carbon contamination. Crown and bridge alloys
with a high palladium content, such as palladium-silver alloys for metal-ceramic copings, and any of the
nickel-based or cobalt-based alloys are included in this category.

Step 7: CLEANING THE CASTING
After the casting has been completed, the ring is removed and quenched in water as soon as the button
exhibits a dull-red glow. Two advantages are gained in quenching: (1) the noble metal alloy is left in an
annealed condition for burnishing, polishing, and similar procedures, and
(2) when the water contacts the hot investment, a violent reaction ensues. The investment becomes soft
and granular, and the casting is more easily cleaned.

Often the surface of the casting appears dark with oxides and tarnish. Such a surface film can be
removed by a process known as pickling, which consists of heating the discolored casting in an
acid. Probably the best pickling solution for gypsum-bonded investments is a 50% hydrochloric acid
solution. The hydrochlo ric acid aids in the removal of any residual investment as well as of the oxide
coating.
The disadvantage of the use of hydrochloric acid is that the fumes from the acid are likely to corrode
laboratory metal furnishings. In addition, these fumes are a health hazard and should be vented via a
fume hood. A solution of sulfuric acid is more advantageous in this respect. Ultrasonic devices are also
available for cleaning the casting, as are commercial pickling solutions made of acid salts.

The best method for pickling is to place the casting in a test tube or dish and to pour the acid over it. It
may be necessary to heat the acid, but boiling should be avoided because of the considerable amount of
acid fumes involved. After pickling, the acid is poured off and the casting is removed. The pickling
solution should be renewed frequently because it is likely to become contaminated with use.

Step 8: FINISHING AND POLISHING:
Finally the sprue is removed and the restoration may be stoned and polished on the external surfaces
except at the edges, in the laboratory. Edges are finished in the clinic after cementing.
Finishing tools and polishers:
1. mandrels, abrasive disks.
2. Rubber cup polishers, bristle brushes.
3. Pumice
4. Wool mop

Casting procedure for chrome cobalt removable partial denture:
As usual impression of the jaw is made and the master model an dental stone is made. This stone model
is then duplicated to make a refractory cast of the casting investment. Wax pattern is then made on this
refractory cast.
-Wax sprue formers are are used and more than one are necessary because of the large size of the
pattern. Vents are made by attaching very thin sprues at the strategic areas before the pattern is
invested.
-The pattern is not removed from the model instead the whole model along with the pattern and sprue
formers is invested in a large ring or the casting flask.
The investment material is either silica bonded or phosphate bonded. This is necessary for 2 reasons:
1. Investment must withstand the high temperature of melting chrome-cobalt alloy that is
above1250C.
2. investment must have sufficient expansion to compensate for the high casting shrinkage
of the metal.
Both of these investment give high thermal expansion of an average 1.5 to 2%.
Even then this value may be less considering the casting shrinkage of chrome cobalt which is around 2.2
%. However other factors like shape of the casting, method of spruing etc, also contribute to this and
provide adequate compensation for the shrinkage. Casting temperature of the investment to achieve this
much thermal expansion is between 800 to 1100C in any case above 1000C.
Chrome cobalt alloy is melted using an oxy-acetylene gas flame or by an electric source. As usual the
centrifugal casting machine is used for the casting. The flask is cooled slowly after casting and the casting
is separated form the investment. The surface of the appliance is smoothened by sand blasting and
highly polished.


DEFECTIVE CASTINGS
Defects in castings can be classified under four I-leadings: (1) distortion; (2) surface roughness and
irregularities; (3) porosity; and (4) incomplete or missing detail. Some of these factors have been
discussed in connection with certain phases of the casting techniques. The subject is summarized and
analyzed in some detail in the following sections.

Distortion: Any marked distortion of the casting is probably related to a distortion of the wax pattern.
This type of distortion can be minimized or prevented by proper manipulation of the wax and handling of
the pattern.
Unquestionably, some distortion of the wax pattern occurs as the investment hardens around it. The
setting and hygroscopic expansions of the investment may produce an uneven movement of the walls of
the pattern.
This type of distortion occurs in part from the uneven outward movement of the proximal walls. The
gingival margins are forced apart by the mold expansion, whereas the solid occlusal bar of wax resists
expansion during the early stages of setting.

Surface Roughness, Irregularities, and Discoloration:
The surface of a dental casting should be an accurate reproduction of the surface of the wax pattern from
which it is made. Excessive roughness or irregularities on the outer surface of the casting necessitate
additional finishing and polishing whereas irregularities on the cavity surface prevent a proper seating of
an otherwise accurate casting.
Causes of these surface defects:

Air Bubbles: Small nodules on a casting are caused by air bubbles that become attached to the pattern
during or subsequent to the investing procedure. Such nodules can sometimes be removed if they are
not in a critical area. However, for nodules on margins or on internal surfaces, removal of these
irregularities might alter the fit of the casting.
Prevention:
-By vacuum investing
-using of mechanical mixer
Water Films: Wax is repellent to water, and if the investment becomes separated from the wax pattern in
some manner, a water film may form irregularly over the surface. Occasionally, this type of surface
irregularity appears as minute ridges or veins on the surface.
Prevention:
-Use wetting agent on the pattern before investing.
Rapid Heating: It results in fins or spines on the casting or characteristic surface roughness may be
evident because of flaking of investment when the water or steam pours into the mold. Furthermore, such
a surge of steam or water may carry some of the salts used as modifiers into the mold, which are left as
deposits on the walls after the water evaporates
Prevention:
As previously mentioned, the mold should be heated gradually; at least 60 minutes should elapse during
the heating of the investment-filled ring from room temperature to 700 C. The greater the bulk of the
investment, the more slowly it should be heated.

Underheating: Incomplete elimination of wax residues may occur if the heating -time is too short or if
insufficient air is available in the furnace. These factors are particularly important with the low-
temperature investment techniques. Voids or porosity may occur in the casting from the gases formed
when the hot alloy comes in contact with the carbonaceous residues. Occasionally, the casting may be
covered with a tenacious carbon coating that is virtually impossible to remove by pickling.

Liquid:Powder Ratio: The amount of water and investment should be measured accurately. The higher
the L: P ratio, the rougher the casting. However, if too little water is used, the investment may be
unmanageably thick and cannot be properly applied to the pattern. In vacuum investing, the air may not
be sufficiently removed. In either instance, a rough surface on the casting may result.

Prolonged Heating: When the high-heat casting technique is used, a prolonged -heating of the mold at
the casting temperature is likely to cause a disintegration of the investment, and the walls of the mold are
roughened as a result. Furthermore, the products of decomposition are Sulfur compounds that may
contaminate the alloy to the extent that the Surface texture is affected. Such contamination may be the
reason that the surface of the casting sometimes does not respond to pickling. When the thermal
expansion technique is employed, the mold should be heated to the casting temperature-never higher
than 700 C and the casting should be made immediately.

Temperature of the Alloy: If an alloy is heated to too high a temperature before casting, the surface of
the investment is likely to be attacked, and a surface roughness of the type described in the previous
section may result. As previously noted, in all probability the alloy will not be overheated with a gas-air
torch when used with the gas supplied in most localities. If other fuel is used, special care should be
observed that the color emitted by the molten gold alloy, for example, is no lighter than a light orange.

Casting Pressure: Too high a pressure during casting can produce a rough surface on the casting. A
gauge pressure of 0.10 to 0.14 MPa in an air pressure casting machine or three to four turns of the spring
in average type of centrifugal casting machine is sufficient for small castings.

Composition of the Investment: The ratio of the binder to the quartz influences -the surface texture of
the casting. In addition, a coarse silica causes a surface roughness. If the investment meets ADA
Specification No. 2, the composition is probably not a factor in the surface roughness.

Impact of Molten Alloy: The direction of the sprue former should be such that the molten gold alloy
does not strike a weak portion of the mold surface. Occasionally, the molten alloy may fracture or abrade
the mold surface on impact, regardless of its bulk. Such a depression in the mold is reflected as a raised
area on the casting, often too slight to be noticed yet sufficiently large to prevent the seating of the
casting. Prevention:
This type of surface roughness or irregularity can be avoided by proper spruing so as to prevent the direct
impact of the molten metal at an angle of 90 degrees to the investment surface.

Porosity:
Porosity may occur both within the interior region of a casting and on external surface. The latter is a
factor in surface roughness, but also it is generally a manifestation of internal porosity. Not only does the
internal porosity weaken the casting but if it also extends to the surface, it may be a cause for
discoloration. If severe, it can produce leakage at the tooth-restoration interface, and secondary caries
may result. Although the porosity in a casting cannot be prevented entirely, it can be minimized by use of
proper techniques.

Porosities are classified as :
-Those caused by solidification shrinkage
-Localized shrinkage porosity
-Micro porosity
Those caused by gas
Pinhole porosity
-Gas inclusions
-Sub surface porosity
Those caused by air trapped in the mold(back pressure porosity)

Shrink spot or localized shrinkage
porosity:
These are large irregular voids usually found near the sprue casting junction. It occurs when the cooling
sequence is incorrect and the sprue freezes before the rest of the casting. During the correct cooling
sequence the sprue should freeze last. This allows more molten metal to flow into the mold to
compensate for the shrinkage of the casting as it solidifies. If the sprue solidifies before the rest of the
casting no more molten metal can be supplied from the button. The subsequent shrinkage produces voids
or pits known as shrink spot porosity.
Avoid by:
Using sprue of correct thickness
Attach sprue to the thickest portion of the pattern.
Flaring the sprue at the point of attachment or placing a reservoir close to the pattern.

Suck back porosity:
It is the variation of the shrink spot porosity. This an external void seen in the inside of the crown
opposite to the sprue. A hot spot is created by the hot metal impinging on the mold wall near the sprue.
The hot spot causes this region to freeze last. Since the sprue has already solidified no more molten
material is available and the resulting shrinkage causes a peculiar type of shrinkage called suck back
porosity. It is avoided by reducing the temperature difference between the mold and the molten alloy.

Microporosity: these are fine irregular voids within the casting. It is seen when the casting freezes too
rapidly. Rapid solidification occurs when the mold or casting temperature is too low.

Pin hole porosity:
The voids are spherical and small in size. Gases like oxygen and hydrogen are dissolved in the liquid
metal. Then during solidification these gases will be expelled, and cause pinpoint holes known as pin
hiole porosity.

Gas inclusion porosity:
The voids are spherical but large in size. This is due to gas mechanically trapped by the molten metal in
the mold or carried in during the casting procedure.

Subsurface porosity:
This occurs just beneath the surface. This may be due to simultaneous nucleation of the solid grains and
gas bubbles at the first moment that the metal freezes at the mold walls.
Prevention:
By controlling the rate at which the liquid metal enters the mold.

Back pressure porosity:
This is seen as surface irregularity on the fitting surface of the casting. But may also be seen on the
outside surface. Is due to inability of air in the mold to escape out due to non-porous investment. Air in the
mold must be eliminated first and then only the liquid metal is made to enter. It is because no two things
occupy the same space at one and the same time.
This is also due to very low casting or mold temperature leading to solidification before the entrapped air
can escape.
Prevention:
Proper burnout.
Adequate proper mold and casting temperature.
Adequate casting pressure.
High w/p ratioMaking sure that the thickness of the investment between the tip of the pattern and the end
of the ring is not more than .

Incomplete or missing detail: Causes:
a. Due to inhibition of the entry of the liquid metal into the mold. This is in turn is due to insufficient venting
or due to high viscosity of the liquid metal.
Prevention:
There must be sufficient casting pressure and that pressure must be maintained at least for few after
casting. The metal must be heated to its correct fusion temperature so that it is less viscous and flows
readily into the mold. Since it takes less than a second for the liquid metal to solidify, the casting must be
done immediately done when the metal is fused.

b. Due to incomplete elimination of the wax.
Prevention:
Proper time and temperature adapted during burnout.
Too large size casting is due to excessive mold expansion and this is prevented by the use of correct type
of investment and correct temperature.
Too small casting is due to, too little mold expansion and it is prevented by heating the mold sufficiently.
REFERENCES:
1. Kennth J Anusavice, Philips science of dental materials 11
th
edition W B Saunders
publication 2003
2. Rossenstiel, Land, Fujimoto : Contemporary Fixed prosthodontics 3
rd
edition Missouri
Mosby 2001
3. Shilingburg, Herdert : Fundamentals of fixed prosthodontics ;3
rd
edition Chicago
4. Stress and force factors in Implants
5.

6. CONTENTS:
7.
8. Introduction
9. Stress factors
10. Early crestal bone loss
11. Various hypotheses related to early crestal bone loss
12. Force factors
13. Para function
14. Masticatory dynamics
15. Position of the abutment in the arch
16. Direction of load forces
17. Nature of the opposing arch
18. Effect on treatment planning
19. Summary
20. References
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32. Introduction:
33. An understanding of the etiology of early crestal bone loss, unretained restorations,
and fracture of components enables the practitioner to develop a treatment plan capable
to reduce force factors.
34. These factors are evaluated in magnitude, duration, direction, type, and magnification
effects.
35. Various methods to reduce these factors are employed.
36. Implant complications from stress:
37. 1. Implant failure
38. 2. Early crestal bone loss
39. 3. Occlusal overload bone loss
40. 4. Screw loosening (prosthesis or abutment)
41. 5. Implant fracture (body or component)
42. 6. Prosthesis fracture (occlusal material or framework)
43. Early crestal bone loss:
44. It varies in amount and dramatically decreases after the first year. This phenomenon is
described as saucerization.
45. The initial transosteal bone loss around an implant forms a v- or a u-shaped
pattern,which has been described as ditching or saucerization around the implant.
46. The current hypotheses for the early crestal bone loss:
47. 1. Periosteal Reflection Hypothesis.
48. 2. Implant Osteotomy Hypothesis.
49. 3. Autoimmune Response of Host Hypothesis.
50. 4. Biological Width Hypothesis.
51. 5. Stress Factors Hypothesis.
52.
53.
54.
55. Periosteal Reflection Hypothesis:
56. It causes a transitional change in the blood supply to the crestal cortical bone. Cutting
cones develop from monocytes in the blood and precede new blood vessels into the
crestal regions of bone.
57. The greater the amount of trabecular bone under the crestal cortical bone, the less
crestal bone loss is observed.
58. To place the implant in sufficient available bone, an implant ridge is usually 5mm or
wider at the crest.
59. This theory would lead to a generalized horizontal bone loss of the entire residual
ridge reflected not the localized ditching pattern around the implant.
60. Implant Osteotomy Hypothesis:
61. The implant osteotomy causes trauma to the bone in immediate contact with the
implant, and a devitalized bone zone of about 1mm is created around the implant.
62. The crestal region is more susceptable to bone loss during initial repair because of its
limited blood supply and the greater heat generated in this denser bone.
63. If heat and trauma during implant osteotomy preparation were responsible for early
crestal bone loss, the average bone loss of 1.5mm from the first thread is not observed at
second-stage uncovery surgery 4 to 8 months after implant placement.
64. Autoimmune Response of Host Hypothesis:
65. The primary cause of bone loss a round natural teeth is bacteria induced. Bacteria are
the causative element for vertical defects around implants.
66. Occlusal trauma may accelerate the process, but trauma alone is not a determining
factor.
67. If bacteria were causal agent for initial bone loss, why does most bone loss occur the
first year (1.5mm) and less (0.1mm) each successive year?
68. The bacteria theory does not explain adequately the early crestal bone loss phenomenon.
69. Biological Width Hypothesis:
70. Average biological width-2.04mm
71. The periimplant tissues exhibit histologic sulcular and junctional epithelial zones
similar to a natural tooth.
72. The primary difference is the lack of connective tissue attachment and the presence of
primarily 2 fiber groups, rather than 11 with the natural tooth.
73. James and keller explained biological seal phenomenon.
74. Hemidesmosomes help from a basal lamina-like structure on the implant, which can
act as a biological seal.
75. Hemidesmosomal seal only has a circumferential band of gingival tissue to provide
mechanical protection against tearing.
76. Biological seal around dental implants can prevent the migration of bacteria and
endotoxins into the underlying bone, but it is unable to constitute junctional epithelial
component of the biologic width similar to the natural tooth.
77. Components of the linear body cannot physiologically adhere to or become embedded
into the implant body.
78. Stress Factors Hypothesis:
79. Bone modeling and remodeling are controlled by the mechanical environment of
strain.
80. Remodeling also is called bone turnover and allows the implant surface to adapt to its
biomechanical situation.
81. Dental implants are fabricated from titanium or its alloy.
82. Modulus of elasticity of titanium is 5 to 10 times greater than bone.
83. When two materials of different moduli are placed together with no intervening
material and one is loaded, a stress contour increase will be observed where the two
materials first come into contact.
84. The stress contours form a v- or u-shaped pattern, with greater magnitude near the
point of the first contact.
85. The stresses found at the crest when beyond physiologic limits may cause
microfracture of bone or strain in the pathologic overload zone and resorption.
86. Occlusal loads on an implant may act as a bending moment that increases stresses at
the crest.
87. Screw loosening and crestal bone loss are repeated with increased frequency before
the fracture of the implant body.
88. The bone is less dense and therefore weaker at implant uncovery than it is after 1 year
of prosthetic loading.
89. Bone is 60% mineralized at 4 months and takes 52 weeks to completely mineralize.
90. Partially mineralized bone is weaker than completely mineralized bone.
91. Woven bone first forms around an implant.
92. Woven bone is unorganized and weaker than lamellar bone, which is organized and
load bearing structure.
93. Lamellar bone forms several months after the woven bone has replaced the devitalized
zone around the implant at insertion.
94. The bone changes from a fine trabecular pattern after initial healing to a coarse
trabecular pattern after loading, especially in the crestal half of the implant interface.
95. Density of the bone is related directly to the strength and elastic modulus, the crestal
bone strength may increase in relation to the functional loading.
96. Absence of radiographic bone loss is most often observed when stress factors are
reduced.
97. The stress is greatest at the crest, compared with other regions of the implant body.
98. The denser the bone, the less crestal bone loss observed.
99. The maxillary arch often exhibits greater bone loss than the mandibular arch.
100. A very dense bone captures the stress closer to the crestal region. Avery soft
bone allows the stress to be transmitted farther along the implant interface.
101. The softer the bone, the farther the stress pattern apical progression.
102. Implants that maintain crestal bone negate the hypotheses of periosteal
reflection, osteotomy preparation, and biological width.
103. STRESS FACTORS:
104. The etiology of early crestal bone loss and early implant failure after loading is
primarily from excess stress transmitted to the immature implant-bone interface.
105. One biomechanical approach to decrease stress is to increase surface area.
106. Another method to decrease stress is to decrease forces.
107. Force may be decreased in
108. 1. Magnitude
109. 2. Duration
110. 3. Type
111. 4. Direction
112. 5. Multiplication factors.
113. Force factors:
114. Stress is directly related to force.
115. As a result any force factor magnifies the stress.
116. Once the prosthesis type is determined, the potential force levels that will be
exerted on the prosthesis should be evaluated and accounted for in the over all treatment
plan.
117. The initial implant survival, early loading survival, early crestal bone loss,
incidence of abutment or prosthetic screw loosening, and unretained restorations,
porcelain fracture, and component fracture are influenced by the factors of force.
118. Dental factors that affect stress primarily include:
119. 1.Parafunction
120. - Bruxism
121. - Clenching
122. - Tongue thrust
123. 2. Masticatory dynamics
124. 3. The position of the abutment in the arch
125. 4. The nature of the opposing arch
126. 5. Direction of load forces
127. 6. The crown-implant ratio.
128.
129.
130. NORMAL BITE FORCE:
131.
132. Bite Forces
133.
134. Perpendicular to occlusal plane
135. short duration
136. Brief total period(9min/day)
137. Force on each tooth:20 to 30 psi
138. Maximum bite force:50 to 500 psi
139.
140. Perioral Forces
141.
142. More constant
143. Lighter
144. Horizontal
145. Maximum when swallowing(3 to 5 psi)
146. Brief total swallow time(20 min/day)
147.
148.
149. PARAFUNCTION:
150.
151. Parafunctional forces on teeth or implants are characterized by repeated or
sustained occlusion and have long been recognized as harmful to the stomatognathic
system.
152. The most common cause of implant failure after successful surgical fixation or
early loss of rigid fixation during the first year of implant loading is the result of
parafunction.
153. Complications occur with greater frequency in the maxilla, because of a
decrease in bone density and an increase in the moment of force.
154.
155. Nadler has classified the causes of parafunction or non functional tooth contact
into the following six categories:
156. 1. local.
157. 2. systemic.
158. 3. psychological.
159. 4. occupational.
160. 5. involuntary.
161. 6. voluntary.
162.
163. Local factors include:
164.
165. Tooth form or occlusion and soft tissue changes such as ulcerations or
pericoronitis.
166.
167. Systemic factors include:
168.
169. Cerebral palsy, epilepsy, and drug related dyskinesia.
170.
171. Psychological causes include:
172.
173. The release of emotional tension or anxiety.
174.
175. They occur with greatest frequency.
176.
177. Occupational factors:
178.
179. Concern professionals such as dentists, athlets, and precision workers,
musician who develops altered oral habits.
180. Involuntary movement:
181.
182. That provokes bracing of the jaws.
183.
184. Voluntary causes:
185.
186. Chewing gum or pencils,pipe smoking.
187.
188. The parafunction may be categorized as:
189.
190. Absent.
191. Mild.
192. Moderate.
193. Severe.
194. Bruxism:
195.
196. It is vertical or horizontal, non functional grinding of teeth.
197.
198. Biting force was greater (4 to 7times normal).
199.
200. Diagnosis:
201.
202. Symptoms include repeated headaches, a history of fractured teeth or
restorations, repeated uncemented restorations, and jaw discomfort on awakening.
203. Signs include an increase in size of the temporal and masseter muscles,
deviation of the lower jaw on opening, limited occlusal opening, increased mobility of
teeth, cervical abfraction of teeth, fracture of teeth or restorations, and uncemented
crowns or fixed prosthesis.
204. The best and easiest way to diagnose bruxism is to evaluate the wearing of
teeth.
205. Severe bruxism changes normal masticatory forces by magnitude (higher bite
forces), duration (hours rather than minutes), direction (lateral rather than vertical), type
(shear rather than compression), and magnification (4 to 7 times normal).
206.
207. Clenching:
208.
209. It generates constant force exerted from one occlusal surface to the other
without any lateral movement.
210. The direction of load may be vertical or horizontal.
211.
212. Diagnosis:
213. Signs include tooth mobility, muscle tenderness and hypertrophy, deviation
during occlusal opening, limited opening, stress lines in enamel, cervical abfraction, and
material fatigue.
214. The clenching patient has the sneaky disease of force.
215. Fremitus, a vibration type of mobility of a tooth, is often present in the
clenching patient.
216. Other signs stress lines in enamel, stress lines in alloy restorations.
217. A common clinical finding of clenching is a scalloped border of the tongue.
218. The tongue is braced against the lingual surfaces of the teeth during clenching,
exerting lateral pressures and resulting in the scalloped border.
219.
220. FATIGUE FRACTURES:
221. Increase in force magnitude and duration.
222. Clenching patient suffer from a phenomenon called creep, which also results
in fracture of components.
223.
224. Tongue Thrust and Size:
225. Parafunctional tongue thrust is the unnatural force of the tongue against the
teeth during swallowing.
226. A force of 41 to 709g/cm on the anterior and lateral areas of the palate has
been recorded.
227. The force of tongue thrust is of lesser intensity than in other parafunctional
forces, it is horizontal and can increase stress at the permucosal site of the implant.
228. The placement of implants and prosthetic teeth in patients with large tongue
results in an increase in lateral force, which may be continuous.
229. A prosthetic mistake is to reduce the width of the lingual contour of the
mandibular teeth.
230. The lingual cusp of the restored mandibular posterior teeth should follow the
curve of Wilson and include proper horizontal overjet to protect the tongue during
occlusion.
231.
232. MASTICATORY DYNAMICS:
233. They are responsible for the amount of force exerted on the implant system.
234. The force is related to the amount and duration of function.
235. The size of the patient can influence the amount of bite force.
236. Forces recorded in women are 20lb less those in men.
237. The sex, muscle mass, exercise, diet, state of the dentition, physical status, and
age may influence muscle strength, masticatory dynamics, and therefore maximum
biteforce.
238.
239. POSITION WITH IN THE ARCH:
240. The maximum biting force is greater in molar region and decreases as
measurements progress anteriorly.
241. Mansour et al. evaluated occlusal forces and moments mathematically using a
ClassIII lever arm, the condyles being the fulcrum and the masseter and temporalis
muscles supplying the force.
242. The anterior biting force is decreased in the absence of posterior tooth contact
and greater in the presence of posterior occlusion or eccentric contacts.
243.
244. DIRECTION OF LOAD:
245. The direction of occlusal load results in significant differences in the amount
of force exerted on an implant.
246. Forces are tensile, compressive, or shear to the implant system.
247. Bone is strongest to compressive forces, 30% weaker to tensile loads, and 65%
weaker to shear loads.
248. All the stresses occur in the coronal half of implant bone interface.
249. Much less stress occur with vertical loads compared with an angled load on an
implant.
250. A lateral load on an implant crown makes the crown height act as a lever and
force magnifier.
251.
252. Lateral forces represent a 50% to 200% increase in stress compression
compared with vertical loading, and tensile streses may increase more than tenfold.
253. The direction of forces may be one of the more critical factors to be evaluated
during implant treatment planning.
254. The average occlusal load of natural dentition is at 12 degrees to the tooth
root.
255. Mandibular premolar implants are best positioned for axial loading.
256. Mandibular posterior implants are placed with a facial inclination of the
implant apex, to avoid perforation of the submandibular fossa.
257. If the forces of occlusion are not axial to the implant body, additional
implants, wider implants, stress relievers in the prosthesis or overdentures should be
considered.
258.
259. OPPOSING ARCH:
260. Natural teeth transmit greater impact forces through occlusal contacts than do
softer-tissue borne complete dentures.
261. Implant overdentures improve the masticatory performance and permit a more
consistent return to centric relation occlusion during function.
262. The maximum force is related to the amount of tooth or implant support.
263. CROWN HEIGTH:
264. It affects the amount of forces distributed to the implant-prosthetic system in
the presence of lateral or cantilevered forces.
265. The greater the crown height, the greater the moment of the force under the
lateral loads.
266. The crown height acts as a lever with any lateral force.
267. Since stresses are concentrated at the crest of the rigidly fixated implant, the
crown height multiplier increases stress rapidly.
268. For every 1 mm crown height increase, a force increase may be 20%.
269. An indirect relationship is found between the crown and implant height.
270. The lesser the bone volume, the greater the crown height and the greater the
number of implants indicated.
271.
272. AREA FACTORS:
273. ABUTMENT NUMBER:
274. The overall stress to the implant system may be reduced by increasing the
surface area over which the force is applied.
275. Most effective method to increase the number of implants used to support the
prosthesis.
276. The retention of prosthesis is improved with greater no. of splinted abutments.
277. With this the amount of stress to the system is reduced, and the marginal
ridges on the implant crowns are supported by the connectors of the splinted crowns,
which applies compressive forces rather than shear loads on the porcelain.
278. One implant for each tooth missing may be indicated in the posterior regions
of the mouth, for a large, young, male patient with severe parafunction.
279.
280. ABUTMENT POSITION:
281. Implant positioning is related to implant number because more than two
implants are needed to form a biomechanical tripod.
282. Cantilevers are a force magnifier and represent a considerable risk factor in
implant support, screw loosening, crestal bone loss, fracture.
283. Therefore implant no. & position should aim at eliminating cantilevers,
especially when other force factors are increased.
284. The best way to reduce risk factors is to increase implant no.
285.
286. IMPLANT SIZE:
287. The surface area of implant support may also be increased by the size of the
implant.
288. Each 3mm increase in height can improve surface area support by more than
20%.
289. The significance in increased length is not found at the crestal bone interface
but rather in initial stability and the overall amount of bone implant interface.
290. The increased length also provides resistance to torque or shear forces when
abutments are screwed into place.
291. The surface area of implant support system is directly related to the width of
the implant.
292. Each 0.25mm increase in implant diameter may increase the overall surface
area app. 5 to 10%.
293. Bone augmentation in width may be indicated to increase implant diameter by
1mm or app. 25% increased surface area.
294.
295. IMPLANT DESIGN:
296. Implant macrodesign may affect surface area even more than an increase in
width.
297. A cylinder implant provides 30% less surface area than a conventional
threaded implant of same size.
298. A threaded implant with 10 threads for 10mm has more surface area than one
with 5 threads.
299. A thread depth of 0.2mm has less surface area than an implant with 0.4mm.
300.
301. SCREW LOOSENING:
302. The platform of the implant body is larger in the larger diameter implant. So
less force is transmitted through screws during occlusal loads.
303. Screw loosening may be decreased by a preload with a torque wrench on the
screw.
304. The threads of the screw form a 30 degree angle.
305. A rotational force on the screw places a shear force on the incline of the
thread.
306. Most systems use a 30 to 35 Ncm rotational force on the abutment screw to
preload or stretch the screw without risk of fracture.
307. A more effective method to preload the screw is to tighten the screw to the
recommended amount and then untighten the screw after a few minutes and retighten it to
the required torque force again.
308. Screw loosening is affected by the no. of threads.
309. The height of the antirotational component of the implant body also can affect
the amount of the force applied to the abutment screw.
310. The higher the hexagonal height, the less stress applied to the screw.
311.
312. FATIGUE FRACTURES:
313. Materials follow a fatigue curve, which is related to the number of cycles and
the intensity of force.
314. The magnitude of the force increases over time because the muscles become
stronger and the number of cycles on the prosthetic components is greater as a result of
the parafunction.
315.
316. BONE DENSITY:
317. The density of bone is in direct relationship with the amount of implant-bone
contact.
318. The less area of bone contacting the implant body, the greater the overall
stress.
319. Progressive bone loading changes the amount and density of the implant-bone
contact.
320. The body is given time to respond to a gradual increase in occlusal load.
321. This increases the quantity of bone at the implant interface, improves the bone
density, and improves the overall support system mechanism.
322. The very dense bone of resorbed anterior mandible (D1) has the highest
percentage of lamellar bone in contact with an endosteal implant.
323. Amount of stress to the implant increases in D4 bone because fewer regions of
bone contact are present.
324.
325.
326. EFFECTS ON TREATMENT PLANNING:
327. Solution is an increase in implant-bone surface area.
328. Additional implants are the solution of choice to decrease stress, rather than
only an increase in implant width or height.
329. The amount of bone in contact with the implant is also increased as a multiple
of the no. of implants.
330. The greater the diameter of the implant, the lesser the stress transmitted to the
surrounding crestal bone.
331. An increase of 0.5mm of the abutment post diameter may increase the fatigue
strength by 30%.
332.
333. The implant treatment plan is modified primarily in two ways when implants
are inserted in the posterior region.
334.
335. 1. additional implants.
336. 2. occlusal considerations.
337. The elimination of posterior lateral occlusal contacts during excursive
movements is recommended when opposing natural teeth or an implant or tooth
supported fixed prosthesis.
338. This benefits in two aspects:
339. Use of a night guard is helpful for the bruxism patient with a fixed prosthesis
to transfer the weakest link of the system to the removable acrylic appliance.
340. Anterior guided disocclusion of the posterior teeth in excursions is strongly
suggested in the night guard, which may be designed to fit the maxilla or mandible.
341. A soft night guard, which is slightly relieved over the implants, is used in
clenching patient.
342. A night guard with a hard acrylic outer shell and soft resilient liner has
biomechanical advantage to reduce the impact of the force during parafunction.
343. Unlike teeth, implants do not extrude when no occlusal force is present. As a
result, the night guard can be relieved around an immediate implant, so the teeth bear the
entire load.
344. Implant failure during healing is parafunction found with a patient wearing a
soft tissue supported prosthesis over a submerged implants.
345. The time intervals between prosthodontic restoration appointments may be
increased through progressive bone loading techniques.
346. Anterior implants submitted to lateral parafunction forces require further
treatment considerations.
347. Additional implants are indicated with greater diameter.
348. The excursions are canine guided if natural, healthy canines are present.
349. Mutually protected occlusion, is developed if the implants are in the canine
position or if this tooth is restored as a pontic.
350. The forces must be disturbed along the long axis of the implant, narrow
occlusal tables to prevent inadvertent lateral forces, decrease the forces necessary for
mastication, and leave greater space for the tongue.
351. Enameloplasty of the cusp tips of the opposing natural teeth is indicated to
improve the direction of vertical forces, within the guidelines of the intended occlusion.
352. Submerged, two-phase protocols are recommended in patients with horizontal
force factors such as lateral tongue thrust.
353. Myofunctional therapy and autogenous bone grafts to modify the bone
division for endosteal-two stage implant placement, cantilevered bridges from the
anterior teeth, or conventional removable partial dentures are valid treatment objectives.
354. If the anatomical conditions do not permit the placement of implants, a
removable overdenture (RP-4 or RP-5) is indicated.
355. RP-4 or RP-5 may be removed during periods of parafunction.
356. Stress distributors may be used in the attachment system.
357.
358. CONCLUSION:
359. Additional implants are the solution of choice to decrease, along with an
increase in implant width or height to decrease the no. of pontics and dissipate stresses
more effectively to the bone structure, especially at the crest.
360.
361. REFERENCES:
362.
363. 1. Dental implant prosthetics Carl E. Misch
364. 2. Principles and practice of implant dentistry Charles Weiss, Adam
Weiss.
365. 3. Tissue integrated prosthesis. Osseointegration in clinical dentistry
Branemark, zarb, Albrektsson
366. 4. Oral rehabilitation with implant supported prosthesis -Vincente
367. 5. ITI dental implants- Thomas G.Wilson
368.
369.
370.
371. DESIGN CONSIDERATIONS & PARTS OF IMPLANTS.
372. IN THE IMPALNT BODY:-
373. 1.crest module:- the crest module of an implant is that portion
designed to retain the prosthetic component.
374. It represents the transition zone from implant body design to
transosteal region of the implant at the crest of the ridge.
375.
376.
377.
378.
379.
380.
381.
382.
383.
384.
385.
386.
387.
388.
389. Implant collar:-
390. Designs that incorporate a microscopic component into the
implant bodies by coatings with hydroxyapatite, at the superior
aspect of the crest module.
391.
392. The collar allows functional remodeling to occur to a more
consistent region on implant.
393.
394. It suggests that crestal modeling is limited to the smooth
region of the implant.
395. COVER SCREW:-
396. At the time of insertion of the implant body or stage 1
surgery, a first stage cover is placed into the top of implant to
prevent bone, soft tissue, or debris from invading the abutment
connection area during healing.
397.
398.
399.
400.
401.
402.
403.
404. Abutment :- is the portion of the implant that supports and\or
retains a prosthesis or implant super structure.
405. Three categories of implant abutments are available.1.screw
retained
406. 2.cement retained
407. 3.abutment for attachment uses an attachment device
to retain a removable prosthesis.
408.
409.
410. HYGIENE COVER SCREW:-place over the abutment to prevent
debris and calculus from invading the internal portion of abutment
during prosthesis fabrication.
411.
412.
413.
414.
415. TRANSFER COPING:-transfer coping is used to position an
analog in an impression and defined by the portion of implant it
transfers to the master cast, either the implant body transfer coping
or the abutment transfer coping.
416.
417.
418.
419.
420. HEALING SCREW:-
421.
422. After a prescribed healing period sufficient to allow a
supporting interface to develop, the second stage may be performed
to expose the implant and\or attach a transepithelial portion.
423. This Tranepithelial portion is termed a permucosal extension
because it extends the implant above the soft tissue and results in
development of permucosal seal around the implant.
424.
425.
426.
427.
428.
429.
430.
431.
432.
433.
434.
435.
436.
437. IMPLANT ANALOG:-used in the fabrication of the master cast
to replicate the retentive portion of the implant body or abutment.
438.
439. After the master impression is obtained, the corresponding
analog is attached to the transfer coping and assembly poured in the
die stone
440.
441.
442.
443.
444.
445. PROSTHETIC COPING:-
446.
447. Usually designed to fit the implant abutment for screw
retention and serve as connection between the implant and
prosthesis.
448.
449.
450.
451.
452.
453.
454.
455.
456.
457.
458.
459.
460.
461.
462.
463.
464.
465.
466.
467.
468.
469.
470.
471.
472.
473.
474.
475.
476.
477.
478.
479. DESIGN CONSIDERATIONS:-
480. The macroscopic body design can be cylinder, threaded,
plateaued, perforated, solid, hollow and vented.
481.
482. Their surface can be smooth, coated, non coated, or textured.
483.
484. They are available in submergible or non submergible forms.
485.
486.
487.
488. There are three primary basic designs of the implant.
489. 1.CYLINDER- this form of implants depend on the coating to
provide microscopic retention and/or bonding to bone and are
usually pushed or tapped into the bone.
490.
491. 2.SCREW- This form of implants are Threaded into a bone site
and have a microscopic retentive elements for initial bone fixation.
492.
493. Three basic screw thread geometries are available:-
494. A) V- thread.
495. B) Buttress thread.
496. C)Square thread design.
497.
498.
499. 3.combination of root forms are available:-cylinder and screw-
this root form design may also benefit from microscopic retention
to bone by addition of coatings.
500.
501.
502.
503.
504.
505.
506.
507. Different smaller or larger implant diameters for use in limited
anatomic situations or surgical complications.
508.
509. The functional area of threaded implant is greater cylinder
implant by a minimum of 30% and may exceed 500%, depending on
the thread geometry.
510.
511. The cylinder implant design system offer the advantage of
ease placement, even in difficult access locations.
512.
513. Cylinder implants are essentially smooth sided and bullet
shaped implants that require a bio active or increased surface area
coatings for retention in the bone.
514.
515. Smooth sided tapered implants allows for a component of
compressive loads to deliver to the bone to implant interface.
516.
517. The larger the taper the greater the compressive loads deliver
to the implant interface.
But unfortunately the taper cannot be more than 30 degrees

Recent advances in Dental materials

CONTENTS:

INTRODUCTION

CLASSIFICATION

HISTORY

IMPRESSION MATERIALS

DENTAL LUTING AGENTS

DENTAL CERAMICS

DENTURE BASE RESINS

CONCLUSION

REFERENCES
















INTRODUCTION:

The overriding goal of dentistry is to maintain or improve the life of the
dental patient. The goal can be accomplished by preventing disease, relieving
pain, improving masticatory efficiency, enhancing speech and improving
appearance. The main challenges for centuries have been the development and
selection of biocompatible, long lasting, direct filling tooth restoratives and
indirectly processed prosthetic materials that can withstand the adverse
conditions of the oral environment.

Dental materials may be classified as
1. preventive materials
2. restorative materials
3. auxiliary materials

1. Preventive materials include
Pit and fissure sealants
Sealing agents that prevent leakage
Liners and bases

2. Restorative materials:
Restorative materials can be classified as direct restorative materials and indirect
restorative materials
Direct restorative materials indicated to use intra orally to fabricate restorations or
prosthetic devices directly on the tissues.
Indirect restorative materials which are to use extra orally in which the materials
are formed indirectly on casts or other replicas of the teeth and other tissues.

3. Auxiliary dental materials are substances that are used in the process of
fabricating dental prosthesis and appliances but do not become part of these
devices.
Eg: etching materials, impression materials, casting materials, dental waxes,
acrylic resins, gypsum cast and model materials, finishing and polishing
abrasives.

Historical use of restorative materials:
Dentistry as a speciality is believed to have begun about 3000 B.C Gold bands
and wires were used by the Phoenicians (After 2500 B.C).
Around 700B.C The Etruscans carved ivory or bone for the construction of partial
denture teeth that were fastened to natural teeth by means of gold wires and
bands. The gold bands were used to position the extracted teeth in the place of
missing teeth.
Around 600 A.D The Mayans used implants consisting of sea shell segments that
were placed in anterior teeth sockets.
The Incas performed tooth mutilations using hammered gold but the material was
not placed for decorative purposes.
Fauchard (1678-1761) the father of modern dentistry used tin foil and lead
cylinders for filling the tooth cavities.
Gold shell crowns were described by Monton in 1746.
In 1756 Phlipp Pfaff of Germany described a method for making impressions of
the mouth in wax from which he constructed a model with plaster of Paris.
In 1774 Duchateau a French pharmacist designed a process for producing hard,
decay proof porcelain dentures.
In 1808 Fonzi an Italian dentist developed an individual porcelain tooth form that
was held in place with an embedded platinum pin.
Planteau, a French dentist first introduced porcelain teeth in 1817.
Ash further developed an improved porcelain tooth in England around 1837.
In 1839 Charles Goodyear has invented vulcanized rubber denture bases, and in
1935 polymerized acrylic resin was introduced as a denture base material to
support the artificial teeth.
In 1907 Taggert developed a more refined method for producing cast inlays.
Mason developed a detachable facing to a crown to hold an artificial tooth.

In prosthetic dentistry auxiliary materials play a major role in fabrication of
removable and fixed prostheses.


IMPRESSION MATERIALS

These materials can be classified according to the mode through which the
ingredients react (set or harden) to solids, their mechanical properties, and their
uses.
Based on setting mechanism
- Materials set by irreversible reaction eg: alginate, zinc oxide eugenol impression
paste, impression plaster, and elastomeric impression materials.
- Materials set by reversible reaction eg: agar hydrocolloid, and impression
compound.

Based on the mechanical properties:
- Rigid material eg: ZOE impression paste, impression plaster and impression
compound
- Elastic materials eg: non aqeous elastomers, hydrocolloid impression materials.


Based on the uses;
For preliminary impressions
- impression compound (if patient doesnt have undercuts)
- alginates (if patient have undercuts)

For final impressions
- Impression plaster, ZOE impression paste, elastomeric impression materials,
alginate hydrocolloids, mouth temperature waxes, soft acrylic resins.

Based on their use in dentistry
- For edentulous: for C.D eg; impression compound, ZOE paste, alginate,
elastomers.
- For dentulous: for both FPD and RPD eg; agar hydrocolloid, alginate and
elastomers

Based on amount of pressure applied
- muco compressive eg; impression compound
- mucostatic eg: impression plaster
- selective pressure eg: ZOE IMPRESSION PASTE

Based on the manipulation
- Kneading eg:Imression compound and putty consistency elastomers
- Circular motion eg: ZOE impression paste and Polysulphides.

Based on tray used for impression
- Special trays or custom made trays eg; ZOE impression paste, elastomeric
impression materials.
- Stock trays ; rim lock- alginate; water cooled- agar hydro colloid

Desirable properties of the impression materials:
- A pleasant odor, taste, and acceptable color
- Absence of toxic and irritant constituents
- Adequate shelf life for requirements of storage and distribution.
- Economically commensurate with the results obtained.
- Easy to use with the minimum of equipment.
- Setting characteristics that meet clinical requirements.
- Satisfactory consistency and texture.
- Readily wet oral tissues
- Elastic properties with freedom from permanent deformation after strain.
- Adequate strength so it will not break or tear or removal from the mouth.
- Compatibility with cast and die materials
- Accuracy in clinical use.
- No release of gas or other by products during the setting of the impression or
cast and die materials.

HYDROCOLLOIDS:

Agar hydrocolloids:
Composition:
Agar- 13-17% is an organic hydrophlilic colloid (polysaccharide) extracted from
certain types of sea weed.
Borates- 0.2-0.5% strengthens the gel
Sulfates- 1-2% accelerator
Diatomaceous earth, clay, silica, wax, rubber can be used as fillers
Thymol- bactericidal agent
Glycerin- plasticizer

Manipulation:
The hydrocolloid is usually supplied in two forms syringe material and tray
material.
The manipulation includes liquefying the gel, placing it in the impression tray,
tempering it to a lower temperature that the patient can tolerate and maintaining
it in its fluid state to capture the details of the oral structures.
The equipment includes 3 compartments for liquefying the material, storing after
boiling and tempering the tray hydrocolloid.

Making the impression in conventional technique:
The syringe material is taken directly from the storage compartment and applied
to the prepared teeth.
Then the tray material is tempered and the tray is filled and immediately brought
in to position and seated with light pressure and held with a very light force.
Gelation is accelerated by circulating cool water (appx18-21 degree c) through the
tray for 3-5 min.

Recent techniques:
Laminate technique:
- A recent modification of the conventional procedure is the combined agar
alginate technique. The hydrocolloid in the tray is replaced with a mix of chilled
alginate that bonds with the agar expressed from a syringe.
- The alginate gels by a chemical reaction whereas the agar gels by means of
contact with cool alginate rather than with the water circulating through the tray.
Since the agar not the alginate is in contact with the prepared teeth maximum
detail is reproduced.

Advantages
- syringe agar records tissues more accurately
- Water cooled tray is not required
- Sets faster.

Disadvantages:
- Agar alginate bond failure can occur
- Viscous alginate may displace agar
- Technique sensitive

Wet field technique:
- This is a recent technique
- The oral tissues are flooded with warm water. The syringe material is then
injected in to the surface to be recorded.
- Before syringe material gels tray material is seated.
- The hydraulic pressure of the viscous tray material forces the fluid syringe
material down in to the areas to be recorded.
- The motion displaces the syringe material as well as blood and debris through
out the sulcus.




ALGINATE HYDROCOLLOID

The word alginate comes from the term algin. The term was coined by a
scotttish chemist S.Williams received the first patent to use alginate as an
impression material. It is a mucous extract obtained from certain brown sea
weed. The substance is called anhydro-beta d-manuronic acid or alginic acid.

Composition:
Potassium alginate 18%- to dissolve in water and react with calcium ions
Calcium sulfate dehydrate 14% - to react with potassium alginate to form an
insoluble calcium alginate gel.
Potassium sulfate, potassium, zinc flouride, silicates or borates 10% - to
counteract the inhibiting effect of the hydrocolloid on the setting of gypsum,
giving a high quality surface to the die.
Sodium phosphate 2% - to react preferentially with calcium ions to provide
working time before gelation.
Diatomaceous earth or silicate powder 56% to control the consistency of the
mixed alginate and the flexibility of the set impression.
Organic glycols in small amounts to make powder dustless.
Winter green, peppermint, pigments in traces to present a pleasant taste.
Pigments in traces to produce colour.
Disinfectants like quarternary ammonium salts and chlorhexidine 1-2% to help in
the disinfection of various organisms.




Recent developments:
1. Dustfree alginates:
- Inhaling fine airborne particles from alginate impression material can cause
silicosis and pulmonary hypersensitivity.
- Dustless alginates were introduced which give off or no dust particles so
avoiding dust inhalation. This can be achieved by coating the material with
glycerine or glycol. This causes the powder to become more denser than in
uncoated state.

2. Siliconised alginates:
- It is a two component system in the form of two pastes, one containing the
alginate sol and the second containing the calcium reactor.
- The components incorporate a silicone polymer component which makes
material tear resistant compared to unmodified alginates. However the
dimensional stability is reported to be poor.

3. Low dust alginate impression material:
Introduced by Schunichi, Nobutakwatanate in 1997.
This composition comprises an alginate a gelation regulator and a filler as major
components which further comprises sepiolite and a tetraflouroethylene resin
having a true specific gravity of from 2-3.
The material generates less dust, has a mean particle size of 1-40microns.

4. Antiseptic alginate impression material:
Introduced by Tameyuki Yamamoto, Maso Abinu patented in 1990.
An antiseptic containing alginate impression material contains 0.01 to 7 parts by
weight of an antiseptic such as glutaraldehyde and chlohexidine gluconate per
100 parts by weight of a cured product of an alginate impression material.
The antiseptic may be encapsulated in a microcapsule or clathrated in a
cyclodextrin.

5. CAVEX Color change:
The alginate impression material with color indications avoiding confusion about
setting time.
Color changes are visualizing the major decision points in impression making
end of mixing time
end of setting time ( tray can be removed from mouth)

it indicates two color changes
Violet to pink indicates the end of mixing time.
Pink to white indicates end of setting time.
Other advantages of this material are
-improved dimensional stability (upto 5 days)
Good tear and deformation resistance
Dust free
Smooth surface, optimum gypsum compatibility.

NON AQEOUS ELASTOMERIC IMPRESSION
MATERIALS:

Elastomers refer to a group of rubbery polymers which are either chemically or
physically cross linked.
Chemically there are four kinds of elastomers used as impression materials.
-poly sulfide ; introduced in 1950
- condensation silicones ; introduced in 1955
-addition silicones ; introduced in 1965
-poly ethers ; introduced in 1975

These impression materials are typically supplied in several consistencies
- low (syringe or wash)
- medium (regular)
- high (tray)
Addition silicones are available in these three viscosities plus
--extra low
--monophase and putty (extra high)
Condensation silicones are usually supplied in
--loe
--putty consistencies
Poly ethers were available in
--low
--medium
--high consistencies.

Mixing systems
Three types of mixing systems are available to mix catalyst and base
--hand mixing
--Static auto mixing
--dynamic mechanical mixing



Hand mixing:
Equal lengths of catalyst and bases are dispensed on a paper pad, initial mixing is
accomplished with a circular motion and final mixing to produce a mix free from
streaks.

Automixing systems:
- The base and the catalyst are in separate cylinders of the plastic catridge.
- The plastic catridge is placed in a mixing gun containing two plungers that are
advanced by a ratchet mechanism to extrude equal quantities of base and
catalyst.
- The base and catalyst are forced from the static mixing tip containing plastic
internal spiral, the two components are folded over each other resulting in a
uniform mix at the tip end.

Dynamic mechanical mixer:
- Its the newest system the catalyst and base are supplied in large plastic bags
housed in a catridge, which is inserted in to 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 the material in to the dynamic mixing tip.
- The mixing tip has rotating internal spiral accomplishes rotation plus forward
motion of the material through the spiral.
- In this manner thorough mixing can be ensured and high viscosity material can
be mixed with ease.

Disadvantages:
The equipment is expensive
There is slightly more material retained in the mixing tip.

Composition and reactions:

Polysulfide:
They are supplied in tubes of base paste and catalyst paste.
They are available in low , medium and high viscosities

Composition:
Base paste:
Poly sulfide polymer- 80-85%
Titanium dioxide
Zinc oxide, copper carbonate or silica- 16-18%
Accelerator paste:
Lead dioxide 30%
Dibutyl or dioctyl 17%
Phthalate
Sulfur 1-4%
Other substances such as magnesium stearate and deodorants 2%

Reaction:
- The lead dioxide catalyzes the condensation of the terminal and pendant SH
with SH groups on other molecules, resulting in chain lengthening and cross
linking. In the process the material changes from a paste to a rubber.
- This reaction is accelerated by increase in temperature and by the presence of
moisture.
- Water is the byproduct in this condensation reaction.

Manipulation:
- These materials are mixed on a mixing pad with a spatula
- Adequate mixing time is 45-60sec; the working time is about 5-7min.
- They stain clothing permanently, they can be electroplated, and some products
can be silver plated.
- Polysulfides must be poured within 1hour and cannot be repoured.
- Polysulfide impression materials are low to moderately hydrophilic and make an
accurate impression in the presence of saliva or blood. Because the material has
a low wetting angle it makes impressions more easily than poly ether and poly
vinyl siloxanes.

Poly ether impression material:
It was introduced in Germany in the late 1960s.
Available as two paste system and available in different viscosities light, medium,
heavy bodies and putty consistencies.

Commercial names;
Impregum(F), Permadyne.

Composition:
Base paste;
- Imine terminated polymer (polyether) crosslinks to form the set material
- A colloidal silica as the filler gives bulk
- Glycol ether or phthalate acts as a plasticizer.
Accelerator:
Alkyl aromatic sulfonate initiates cross linkage.
Colloidal silica as a filler to form the paste
Plasticizers such as glycoether or phthalate.

Setting reaction:
- When the base paste is mixed with the catalyst paste ionic polymerization occurs
by ring opening of the ethylene imine group and chain extension.
- It sets by additional polymerization and no byproduct is formed.
- Cross linking occurs by cationic polymerization via the imine end groups
- The set material is hydrophilic. It can absorb water and swell resulting in
dimensional change
- Setting time 8.3min
- Mixing time -30sec
- Improved polyether formulations such as soft polyethers are easier to remove,
maintain proper rigidity for a wide range of applications nad capture fine details
even in moist conditions.
- This material taste bitter, currently its flavoured to offset the taste.

Condensation silicones:
- It was the first type of silicone impression material
- These materials are available two paste or paste-liquid-catalyst systems or putty
in jars.
- Multi phase materials available in different viscosities
- Monophase- available in a single viscosity.

Composition:
Base paste;
Poly dimethyl siloxane
Colloidal silica or microsized metal oxide filler
- Putty viscosity- 60-70%
- Medium viscosity 35-75%
- Low viscosity 5-15%
Color pigments

Accelerator paste:
Alkyl silicate such as orthoethyl silicate cross linking agent
Stannous octoate catalyst
Inert filler
Setting reaction:
stannous

Dimethyl siloxane + ortho ethyl silicate silicone rubber
+ethyl alcohol
Octoate

- Its a condensation reaction
- Cross linkage occurs between orthoethyl silicate and the terminal hydroxyl
groups of dimethyl siloxane.
- Ethyl alcohol forms as a byproduct which results in shrinkage.
- Setting time 8-9 min, mixing time- 45 sec.
- The setting occurs at room temperature and so called as (room temperature
vulcanization) RTV silicones.
- They are ideal for single unit inlays.
- Electroplating is possible. Because of the high polymerization shrinkage the cast
or die must be poured as soon as possible.

Addition silicones (poly vinyl silicones)
They were introduced in 1975.
They were available as
1. Two paste systems
2. Putty in jars
3. Multiple materials available in different viscosities
4. Monophase available in a single viscosiy.

Commercial names:
Multi phase materials Reprosil, Provil, President
Monophase materials Imprint, Blue mouse

Composition:
Base paste:
- Poly (methyl hydrogen siloxane)
- Other siloxane prepolymers
- Fillers to give bulk and viscosity

Accelerator paste:
- Divinyl poly siloxane
- Inert oils and fillers forms the bulk of the paste
- Palladium salt catalyst (chlorplatinic acid)
- Palladium or hydrogen absorber
- Retarder
- Filler

Polyvinyl siloxane Pt salt
+ silicone
rubber
Silane siloxane


- Its an addition polymerization reaction.
- The vinyl groups of the base paste reacts with the silane groups of the
accelerator paste and cross linking occurs.
- There is no production of by product.
- If the pastes are in improper proportion, hydrogen gas may be liberated during
the setting mechanism.
- Palladium is added to absorb hydrogen to prevent dimensional change.
- Latex gloves have been shown to adversely affect the setting reaction of addition
silicones.
- Sulfur compounds that are used in vulcanization of latex rubber gloves can
migrate to the surface of stored gloves.
- These compounds can be transferred on to the prepared teeth and adjacent soft
tissues during tooth preparation.
- These compounds can position the platinum containing catalyst which reacts in
retarded or no polymerization in the contaminated area of the impression.
- Vinyl and nitrile gloves donot have such an effect.
- Residual monomer in acrylic resin provisional restorations and resin composite
cores has a similar inhibiting effect on the set of addition silicone materials.


Recent advancements:
- Surfactants have been added to addition silicones by manufacturers to reduce
the contact angles, improve wettability, and simply pouring of gypsum models,
known as hydrophilized addition silicones.
- The hydrophilization of addition silicones is gained with the incorporation of non
ionic surfactants as micelles. The molecules consist of a hydrophilized part and a
silicone compatible hydrophilic part.
- The mode of action of these surfactants is thought to be a diffusion controlled
transfer of surfactant molecules from the poly vinyl siloxane in to the aqeous
phase. In this manner the surface tension of the surrounding liquid is altered.
- This increased wettability allows the addition silicones to spread more freely
along the surface. (ref: Craig pg298.)
- Miller and coworkers reported a significant reduction in the number of voids and
an overall increased quality of polyvinyl siloxane impression when a modified
polydimethyl siloxane wetting agent (extrinsic surfactant) was applied to the
prepared tooth surface before impressions made.
- Recently radiofrequency glow discharge has been advocated for use as a
didinifecting procedure for polyvinyl siloxane impressions. Whilst this procedure
is claimed to clean and improve the wettability of the impression surface, its not
clear if glow discharging results in sterilization.
(ref: Polyvinylsiloxane impression materials: An update in clinical use, Australian
dental journal, 1998, 43(6),428-434)



Monophase impression materials:
- Impression materials are available as single viscosity pastes called monophase
materials.
- These materials can be used as both light bodied and heavy bodied materials.
- The amount of pressure given during mixing determines the viscosity. The
greater the shear the thinner the viscosity.
- If more pressure is used it can be used as a lightbodied material if less pressure
is used it acts as a heavy bodied material.

Visible light cured polyether urethane:
The composition of the resin matrix is similar to that of light cured composites.
These materials are available as
-light bodied
- heavy bodied
Composition includes:
-polyether urethane dimethacrylate
- diketone photo initiator
- Transparent silica filler (40-60%)

Manipulation:
- The undercuts should be blocked out before making the impression. Transparent
stock trays are available.
- The light bodied material is syringed and the heavy body material is placed
above it.
- Blue light is used for curing. The exposure should be done from the posterior to
anterior region. Each region should get an exposure of 30sec.
- After removal the impression can be filled and re exposed to light.

Advantages:
- Long working time, but short setting time.
- Impressions can be corrected.
- Dimensional stability, flow, detail reproduction.

Disadvantages
- Expensive
- Requires special equipment

The effect of disinfection and a wetting agent on the wettability of addition
silicone impression materials
- Paul J.Milward et al. had conducted a study on the effect of disinfection
procedure and the use of surface wetting agent on the wettability of 4 addition
polymerized silicone impression materials.
- They use testing specimens made from 4 addition silicone materials (light bodied
president, light bodied Extrude, medium bodied Extrude, and Aquasil)
- Two disinfection solutions (actichlor and perform) were used.
- They concluded that application of an external disinfectant actichlor is
recommended in preference to Perform the wettability of materials. Treatment
with a surface wetting agent after disinfection is recommended to obtain accurate
and void free casts and dies.
(Ref: JPD 2001, 86,165-7)

LUTING CEMENTS

A dental cement used to attain indirect restorations to prepared teeth is called a
luting agent . Luting agents may be definitive or provisional depending on their
physical properties and the planned longevity of the restoration.

REQUIREMENTS:
- It must not harm the tooth or tissues.
- It must allow sufficient working time to place the restoration.
- It must be fluid enough to allow complete seating of the restoration.
- It must not dissolve or wash out and must maintain a sealed intact restoration.
- It must quickly form a hard mass strong enough to resist functional forces.
- It must not dissolve or wash out and must maintain a sealed intact restoration.

Classifications:
Craigs classification based on the chief ingredients eg: zinc phosphate, zinc
silicophosphate, zinc oxide eugenol, zinc polyacrylate, glass ionomer, and resin.
OBrien classified dental cements by matrix and bond type (eg: phosphate,
phenolate, poly carboxylate, resin, resin modified glass ionomer)
Donovan classified cements into conventional (eg:zinc
phosphate,polycarboxylate, glass ionomer) and contemporary (eg:resin modified
glass ionomer, resin )

Contemporary definitive luting agents:

Resin modified glass ionomer (RMGI):
- Introduced in 1980s.
- In the original glass ionomer cement, part of the water component of glass poly
alkenoate cement was replaced with a water hydroxyl methyl methacrylate
(HMMA) mixture plus an initiator/ activator for the added resins.
- Resin modified glass ionomer is a dual cure hybrid, because setting occurs by a
combination of the long term, complex acid- base reaction typical of glass
ionomer cement and chemical or light iniated polymerization of the added resin.
- The acid base reaction continues to develop a polysalt hydrogel matrix which
hardens and strengthens the existing polymer matrix.

Compomers:
- The compomers , also known as polyacid- modified composite resins appeared
in the late 1990s, and were described as being a combination of composite resin
(comp) and glass ionomer (omer), offering the advantages of both.
- Compomers are anhydrous resins that contain ion leachable glass as part of the
filler and dehydrated poly alkenoic acid.
- The physical behaviour of the compomers is more like composite resins than
glass ionomer, with higher compressive and flexural strength than RMGI, but
inferior to unmodified composite.
- Tooth addition is very little, fluoride release is very limited and its less than that
of conventional glass ionomer .

Resin:
- Resin cements are methyl- methacrylate, Bis- GMA dimethacrylate or Urethane
dimethacrylate based with fillers of colloidal silica or barium glass 20-80% by wt.
- They are available as powder/liquid, encapsulated or paste/paste systems and
may be auto, dual or light cured to form the polymer matrix.
- Resin bonding to enamel is by mechanical interlocking into an acid etched
surface. Bonding to dentin is also micromechanical but is more complex usually
requiring multiple steps that include removal of the smear layer and surface
demineralization, then application of unfilled resin bonding agent or primer to
which the resin commercially bonds.
- Non eugenol provisional cement is recommended for provisional restorations,
when resin will be used for definitive restoration. Since the residual eugenol from
provisional cement can interfere with the setting reaction of the bonding agent.
- Many new resin luting systems have recently appeared that reduce luting
procedures by including the use of a self etch primer built in. eg:Unichem by 3M
ESPE,Maxcem by Kerr Orange ,California.
- Light cured resin cements are cured more completely after initial placement.
Where as auto and dual cured resins slowly gain strength.
- Resin cements chemically bond to etched silane treated prcelainit has been
postulated that resin cement bonded to considered tooth on oneside and etched
/silane coated porcelain on the other helps diffuse stresses across the tooth.
- Compressive and tensile strength, toughness and resilience of resin cement
equal or exceed those of other luting agents.
- The resin luting cement offers no fluoride release or uptake, film thickness
maybe relatively high, removal of restoration may require total destruction.
- They are more technique sensitive and expensive.

Adhesive resin:
- In the early 1980s conventional Bis GMA resin cement was modified by adding
a phosphate ester to monomer component to improve the degree of chemical
bonding as well as micromechanical bonding to tooth structure and base metal
alloys.
- Eg; Panavia contained the bifunctional adhesive monomer 10- methacryloyloxy
deci dihydrogen phosphate (MDP) and was a powder/ liquid system.
- In 1994, Panavia was modified to include a dentin/enamel primer containing
hydroxyethyl methacrylate (HEMA), N-methanyloyl 5- aminosalicylic acid and
MDP intended to improve bond strength to dentin.
- Eg;Panavia 21, marketed as a two paste system offered 3 shades, tooth colored
9T.C, translucent), white (EX,semitranslucent) and opaque (OP).
- The current product Panavia F is a two paste system that is dual cured , self
etching and self adhesive plus fluoride releasing.
- C&B metabond modified Bis GMA composite by decreasing filler and adding
3% 2 hydroxy-3b naphthoxypropyl methacrylate in methyl methacrylate with 4-
methacryloyloxy ethyl trimellitate anhydride (4-META) and tri-n-butyl borane.
- Its a powder liquid autocuring system and may be used for resin bonded
prostheses.
(Ref: DCNA, July 2007, vol51, No.3)

Development of a novel comonomer free light cured glass ionomer cement
for reduced cytotoxicity and enhanced mechanical strength (Ref: Journal of
Dental materials 23(2007), 994-1003).
Dong xie, Youfun yang et al had developed a novel comonomer free light cured
glass ionomer system based on 4 arm star shape poly acrylic acid.
The mechanical strengths and invitro cytotoxicity of the formed system were
evaluated and compared with those of several representative commercial glass
ionomer cements.
The 4- arm poly (acrylic acid) was synthesized using ATRP and tethered with
glycidyl methacrylate (GM). The GM tethered polymer was formulated with water,
photoinitiators and fujiII, fuji II LC and vitremer were used for comparision.
Compressive strength (CS) and MTT assay were used as tools to evaluate the
mechanical strengths and invitro cyto toxicity of the cements respectively.
They concluded that this novel comonomer free light cured glass ionomer cement
has significantly improved mechanical strength, and no invitro cytotoxicity
observed.



Fuji CEM Automix;
GC America announces Fuji CEM Automix , the first automix delivery system
available ina resin modified glass ionomer.
Fuji CEM Automix requires no hand mixing and dispences a consistent mixing
ratio directly into the restoration.

Cavity liner:
Calcium hydroxide:commonly employed as adirect or indirect pulp capping agent.
Two paste system employed as a direct or indirect pulp capping agent.
Available as
Twp paste systems containing base and catalyst pastes in collapsible tubes
Light cured systems
Powder and liquid
Single paste system

Commercial names:
- CRCS (calciobiotic canal sealer):
- Its essentially a zinc oxide eugenol sealer to which calcium hydroxide has been
added for its osteogenic effect.

Sealapex (by manufacturing company):
- The base is zinc oxide with calcium hydroxide as aell as butyl benzene
sulfonamide and zinc stearate.
- Calasept (by scania dental AB, Sweden ): it contains calcium hydroxide +
potassium chloride + sodium chloride+ calcium chloride+ sodium bi carbonate +
distilled water

Calen; it contains calcium hydroxide + zinc oxide + colophony + poly ethylene
glycol.

DENTAL CERAMICS

The word ceramics is derived from the greek word Keramos meaning pottery or
burnt stuff. Ceramics is an inorganic compound with non metallic properties
typically composed of metallic or semi metallic and non-metallic elements (eg.
Al2O3 CaO and Si3N4).
Def:
An inorganic compound with nonmetallic properties typically consisting of oxygen
and one or more metallic or semimetallic elements (eg: aluminium, calcium,
lithium, magnecium, potassium, silicon, sodium, tin, titanium and zirconium) that
is formulated to produce the whole or part of a ceramic based dental prosthesis.

Ceramic:
Def: an inorganic compound with non metallic properties typically composed of
metallic (or semi metallic0 and non metallic elements (eg:Al2O3, and Si3N4)

Ceramics can be classified in one of four categories
silicate ceramics
oxide ceramics
non oxide ceramics
glass ceramics

Dental ceramics fall in category of silicate ceramics, which are characterized by
an amorphous glass phase with a porous nature.
History:
The porcelain tooth material was patented in 1789 by French dentist de
Chemant in collaboration with a French pharmacist Duchateau.
In 1808, Fonzi an Italian dentist invented a terrometallic porcelain tooth that was
held in place by a platinum pin or frame.
Planteau, a French dentist introduced porcelain teeth to united states in 1817
and Peale an artist.
Ash developed an improved version of the porcelain tooth in 1837.
Dr Charles land introduced one of the first ceramic crowns to dentistry in 1903.
The first commercial porcelain was developed by Vita Zahnfabrik in about 1963.
A significant improvement in the fracture resistance of porcelain crowns was
reported by Mclean and Hughes in 1965 when a dental aluminous core ceramic
consisting of a glass matrix containing between 40 and 50 wt % Al2O3 was used.
Improvements in all ceramic systems developed by controlled crystallization of a
glass (dicor) was demonstrated by Adan and Grossman (1984)
This glass was melted and cast in to a refractory mold and subsequently
crystallized to form the dicor glass ceramic that contained tetrasilicic flouramina
crystals in a glass matrix.
Pressable glass ceramic (IPS Empress) was introduced in early 1990s,
containing 34% vol. of leucite. A more fracture resistant, pressable glass ceramic
(IPS Empress 2) containing appx. 70% vol. of Lithia disilicate crystals was
introduced in the late 1990s.



Classification:
Dental ceramics can be classified based in many factors.
1. Based on chemical composition
a)Silicate ceramics:
Silicate ceramics have oxides of silicon and other atoms of aluminium,
potassium, magnecium calcium eg:potash felds, sodium feldspar.

b).Non silicate ceramics:
Without silica the other ingredients being the same eg: alumina (Al2O3), Spinell
(MgO, Al2O3)

c).Non oxide ceramics:
This includes silicon carbide, tungsten carbide or graphite.

2. Based on crystalline nature:
Crystalline ceramics; eg:feldspathic porcelain contains leucite (crystal phase)
Non crystalline ceramics eg:glass

3. Based on fusion temperature:
1. High fusing- 1300degree C
2. Medium fusing 1101 1300 degree C
3. Low fusing 850- 1100 degree C
4. Ultra low fusing less than 850 degree C
The medium fusing and high fusing types are used for production of denture
teeth.
The low fusing and ultra low fusing porcelains are used for crown and bridge
construction.

4. Based on type:
- Feldspathic porcelain
- Aluminous porcelain
- Glass infiltered alumina
- Glass infiltred spinell
- Castable glass ceramic
- Injection molded glass ceramics (IPS Impress: Optec)
- Leucite reinforced porcelain.

5. Based on the method of fabrication:
- Pressure moldingband sintering
- Condesnsation and sintering
- Casting and ceramming
- Slip casting
- Sintering and glass infiltration
- Milling by computer control
- Copy milling

6. Based on application
- Core porcelain
- Opaque porcelain
- Dentine or body porcelain
- Enamel porcelain

7. Based on sub structural material
1. Cast metal poecelain
2. Swaged metal porcelain
3. Glass ceramic
4. CAD-CAM porcelain
5. Sintredceramic core

8. Based on use
- Denture teeth
- Metal ceramicsveneer, inlays, onlays , crowns
- Fixed partial denture

9. Based on firing
- Air fired porcelain
- vaccum fired porcelain
- Diffusible gas firing

10. Classification based on recent types of ceramics
1. castable glass ceramics eg: Inceram, alumina, Inceram, spinell
2. pressable ceramics EG: Optec HSP, IPS empress
3. CAD CAM ceramics eg: cere vitablock markI, vitablock mark II
4. Injection molded ceramics eg: Optec HSP

CASTABLE GLASS CERAMICS:
- EG Inceram, alumina, Inceram, Spinell, Dicor and Dicor MGC
- Castable ceramic systems are used to cast crowns by the lost wax process.
- Indicated in cases of single anterior and posterior crowns.
- Tooth preparation is either90 degree shoulder with a rounded internal line angle
or 120 degree chamfer with adequate tooth reduction from 1mm. Minimum on
gingivo axial aurfaces to 1.5-2 mm incisally and occlusally.
- The restoration is waxed on to the die and the wax pattern of the crown is
invested in a phosphate bonded investment.
- An ingot of the ceramic material is placed in a special crucible and melted and
cast with a motor driven centrifugal casting machine at 1380 degree C.

Advantages:
- Ease of fabrication
- Improved esthetics
- Minimal processing shrinkage
- Good marginal fit
- Low thermal expansion, near to the enamel
- Minimal abrasiveness to tooth enamel

Disadvantages:
- Limited use in low stress areas
- Inability to colour internally
- Low tensile strength.

Hot pressing:
Eg: IPS Empress, IPS Empress 2, IPS e max press, OPC
- Pressure molding is used to make small intricate objects. This method used a
piston to force a heated ceramic ingot through a heated tube in to a molod,
where the ceramic form cools and hardens to the shape of the mold.
- IPS Empress is a glass ceramic provided as core ingots that are heated and
pressed until ingot flows in to a mold. It contains a higher conc. Of leucite crystals
that increase the resistance to crack propagation (fracture).

Machinable ceramics:
Computer aided design / computer aided manufacturing:the evolution of CAD
CAM systems for the production of machined inlays, onlays and crowns led to
the development of a generation of machinable porcelains.
There are two popular systems available for machining all ceramic restorations
- CEREC System (siemens, Bensheim, Germany)
- Celay system (Mikrona technologies, Switzerland)

CEREC System:
- CEREC is a dental restoration product that allows a dental practitioner to
produce an indirect ceramic dental restoration using a variety of computer
assisted technologies including 3D photography and CAD/CAM.
- The cavity preparation is first photographed and stored as a three dimensional
digital model and proprietary software is then used to approximate the restoration
shape using biogenic comparisions to surrounding teeth.
- When the model is complete a milling machine carves the actual restoration out
of a ceramic block using Diamond Head cutters under computer control.
- CEREC is an acronym for chairside economical restoration of esthetic ceramics.

HISTORY:
- It was introduced by Werner H.Mormann (1980) at the University of Zurich.
- The first chair side CEREC introduced in 1985.
- In 1994 CEREC -2 was introduced.
- In 2000 CEREC -3 was introduced.
- In 2003 , 3D soft ware version is released, allowing users to see 3D views of
teeth and models
- In 2008, Sirona release the MCXL milling unit, this milling unit can produce a
crown in 4 minutes.

CEREC I:
- introduced in 1985
- chief indications are single and dual surface inlays and the material is vitablocs
markII
- The concept of grinding inlay bodies externally with a grinding wheel along the
mesiodistal axis suggested itself.
- In this arrangement we could turn the ceramic block on the block carrier with a
spindle and feed it against the grinding wheel which ground from the full ceramic
and new contour with a different distance from the inlay axis at each feed step.

CEREC -2
- introduced in 1994
- Additional cylinder diamond enabling the firm grinding of partial and full crowns.
- An upgraded 3D camera was provided.

CEREC -3
Skipped the wheel and introduced the two bur system.
Its a compact windows based CAD- CAM system.
In 2006 a step bur was introduced, reduced the diameter of the top one third of the
cylinder bur to a small diameter tip enabling high precision form grinding with
reasonable bur life.
The three dimensional virtual display of the preparation of the antagonist and of
the functional registration became available with the introduction of the three
dimensional version of the soft ware in 2003.
The current CEREC 3 System can fabricate inlays, onlays and posterior crowns
as well as anterior crowns and veneers.
Two materials can be used with this system:
Vita mark II (VIDENT, BALDWIN PARK ca)
Dicor MGC (Dentsply international, York, PA)

Vita mark IIcontains sanidine (KAl Si3O8) as a major crystalline phase within a
glassy matrix.
Dicor MGC is a machinable glass ceramic similar to Dicor, with the exception that
the materials cast and cerammed by the manufacturer.

Celay system:
The celay system (Mikrona technologie, spreitenbach, Switzerland) uses a copy
milling technique to manufacture ceramic inlays or onlays from resin analogs.
The Celay system is a mechanical device based on pantographic tracing of a resin
inlay or onlay fabricated directly on to the prepared tooth or on to the master die
(Eidenbenze U/1994).
One ceramic system material available for use with the celay system is vita celay
(vident, Baldwin park, CA). this material contains sanidine as the major
crystalline phase within a glassy matrix.
Recently, n-ceram presintered slip cast alumina blocks (vident, Baldwin park,
CA) have been machined with the celay copy milling system used to generate
coping for crowns and fixed partial dentures.
(mclare and Sorensen)

Review of new materials:

Sintered porcelains:
Alumina based ceramics:
Aluminous core porcelain is a typical example of strengthening by dispersion of a
crystalline phase (mclean and kedge, 1987). Alumina has a high modulus of
elasticity (350 GPa) and high toughness (3.5-4Mpa).
Its dispersion in a glassy matrix of similar thermal expansion coefficient leads to
significant strengthening of the core. Hiceram is a more recent development in
this system.

Magnesia based core porcelain:
Magnesia core ceramic wad developed as an experimental material in 1985
(OBrien, 1985). Its high thermal expansion coefficient (14.5 x 10-6 /degreeC)
closely matches that of the body and incisal porcelains designed for bonding to
metal (13.5x 10-6 ).
The flexural strength of unglazed magnesia core ceramic is twice as high (131
MPa) as that of conventional feldspathic porcelain.

Zirconia based porcelain:
Mirage II (Myron international, Kansas city, KS ) is conventional feldspathic
porcelain in which tetragonal zirconia fibres have been included.
Zirconia undergoes a crystallographic transformation from monalinic to tetragonal
at 1173 degree C)
Partial stabilization can be obtained by using various oxides such as CaO, MgO,
y2o3 and Ceo which allows high temperature tetragonal phase to be retained at
room temperature.
The result of this transformation is that compressive stresses are established on
the crack surface, there by arresting its growth. This mechanism is called
transformation toughening.
The addition of yttria stabilized zirconia to conventional feldspathic porcelain has
been shown to produce substantial improvements in fracture toughness, strength
and thermal shock resistance.



Leucite reinforced feldspathic porcelain:
Optec HSP material is a feldspathic porcelain containing up to 45 vol% tetragonal
leucite (Schmid et al 1992, Pinche etal 1994, Demy and Rosensteil , 1995)
The greater leucite content of Optec HSP porcelain compared with conventional
feldspathic porcelain for metal ceramics leads to a higher modulus for rupture
and compressive atrength.
The larger amount of leucite in the material contributes to a high thermal
contraction coefficient. In addition the large thermal contraction mismatch
between leucite (22-25x10-6/degreeC ) and the glassy matrix (8x10-6 /degreeC)
results in development of tangential compressive stresses in the glass around
the leucite crystals when cooled.
These stresses can act as crack deflectors and contribute to increase the
resistance of the weaker glassy phase to crack propagation.

Slip cast all ceramic materials:
Slip casting involves the condensation of an aqueous porcelain slip on a refractory
die. The porosity of the refractory die helps condensation by absorbing the water
from the slip by capillary action. The piece is then fired at high temperature on
the refractory die.
The fired core is later glass infiltered a unique process in which molten glass is
drawn in to the pores by capillary action at high temperature.
Advantages include reduced porosity, fewer defects from processing and higher
toughness than conventional feldspathic porcelains.
Disadvantages include high opacity and long processing times.
Materials used in this technique are
-Alumina based materials
-Spinell and zirconia based materials.

Glass ceramics:
Mica based :
Glass ceramics obtained by controlled devitrification of glasses with a suitable
composition including nucleating agents. Depending on the composition of the
glass, various crystalline phases can nucleate and grow within the glass.
The advantage of this process is that dental restorations can be cast by means of
lost wax technique, thus increasing the homogeneity of the final product
compared with conventional sintered feldspathic.
Dicor is a mica based glass ceramic
Micas are classified as layer type silicates.
Cleavage planes are situated along the layers and this special crystal structure
dictates the mechanical properties of the mineral itself. Crack propagation is not
likely to occur across the mica crystals and is more probable along the cleavage
planes of these layered silicates.
In the glass ceramic material the mica crystals are usually highly interlocked within
the glassy matrix, achieving a house of cards microstructure (Grossman 1972).
The interlocking of the crystal is a key factor in the fracture resistance of glass
ceramic.

Hydroxyl apatite based:
Cera pearl (Kyocera, Sandiego CA) is a castable glass ceramic in which the main
crystalline phase is oxyapatite transformable into hydroxyapatite when exposed
to moisture (Hobo and Iwata 1985).

Future directions:
The future of ceramics for dentistry is clearly open to new technologies. Research
is now focusing on fractrographic analysis of clinically failed restorations,
measure of fatigue parameters and lifetime prediction of ceramic restorations.
The metal ceramic technique is still the most commonly used procedure in
restorative dentistry and the success of new all ceramic systems will depend as
much on developmental as on analytical research.


DENTURE BASE RESINS

Poly (methyl methacrylate) polymers were introduced as denture base materials
in 1937.
Previously materials such as vulcanite , nitrocellulose, phenol formaldehyde,
vinyl plastics and porcelain were used. Later other polymers vinyl acrylic
polysterene epoxy, nylon, vinyl sterene, poly carbonate, poly sulfone-
unsaturated polyester, polymethane, polyvinylacetate ethylene, hydrophilic
polyacrylate, silicones, light activated urethane dimethacrylate, rubber reinforced
acrylics and butadiene reinforced acrylic were used.

Ideal requirements of denture base materials:
1. Strength and durability
2. Satisfactory thermal properties
3. Processing accuracy and dimensional stability
4. Chemical stability
5. Insolubility in and low sorption of oral fluids
6. Absence of taste and odour
7. Biocompatibility.
8. Natural appearance
9. Color stability
10. Adhesion to plastics , metals and porcelains
11. Ease of fabrication and repair
12. Moderate cost.

Classification of denture base materials:
1. Based on the duration of use
2. Based on the material used
3. Based on the chemical composition of the resins
4. Types of acrylic resins
-based on their mode of activation
-based on filler particles.

1. Based on duration of use:
Temporary : its used to construct occlusal rims for jaw relations
Permanent: its a final prosthesis
Its made in heat cure resin or in casting alloys

2. Based on the material used
Non metallic- acrylic resins and waxes
Metallic - base metal alloys, type IV gold alloys.

3. Based on the chemical composition of the resins:
Type1: acrylic
Type2: dimethacrylate
Type3: composites

Types of acrylic resins:
Based on their mode of activation:
Heat activated
Chemically activated or self cure or cold cure or autopolymerized resins
Light activated resins.


Based on the filler particles
Unfilled resins for direct filling eg:acrylic resins
Filled resins for direct filling eg: composites

Evolution of acrylic resins:
Acrlic acid and its derivatives came to be well known by the 1890s
Dr.ottorohm is considered as the father of Recent acrylic. He introduced polymers
of acrylic acid in 1901.
1927 acryloid and plexigum both polymers of polymethylmethacrylate were
introduced by Rohm and Haas.
In 1931 commercial production of harder poymethyl methacrylates occurred with
the introduction of plexiglass (also known as organic glass, leucite I plexite)
Acrylic resins came in to use in dentistry between 1930 and 1940. they are used in
dentistry as denture base materials.

ANSI/ADA specifications No: 12 (1567) for denture base resins:
Categories include the following types and classes:
Type 1: heat polymerizable polymers (class 1 powder and liquid; class 2: plastic
cake)
Type 2: auto polymerizable polymers (class1: powder and liquid, class2: powder
and liquid pour type resins)
Type3: thermoplastic blank or powder
Type4: light activated materials
Type5: microwave cured materials

The ADA specifications for non processed materials are
The liquid should be as clear as water and free of extraneous material and the
powder, plastic cake or procured blank should be free of impurities such as dirt
and lint.
A satisfactory denture base results when the manufactures instructions are
followed. The denture base should be nonporous and free from surface defects.
The cured plastic should take a high gloss when polished
The processed denture should not be toxic to a normal healthy person
The color should be as specified
The plastic should be translucent
The cured plastic should not show any bubbles or voids.



Specific requirements:
Water sorption shall not be more than 0.8mg/cm2 after immersion for 7days/ at
37degreeC.
Stability shall not be more than 0.04mg/cm2 after water soaked specimen is dried
to constant weight.
Plastic shall show no more than a slight color change when exposed to a 24hr
specified UV lamp test.

Recent advances in denture base materials:
Pour type acrylics:
The chemical composition of the pour type denture resins is similar to poly (methyl
methacrylate) materials that are polymerized at room temperature.
The principle difference is in the size of the polymer powder or beads. The pour
type denture base resins commonly referred to as fluid resins, have much
smaller powder particles, when mixed with monomer the resulting slurry is very
fluid.
The mix is quickly poured in to an agar hydrocolloid or modified plaster mold and
allowed to polymerize under pressure at 0.14MPa.
Centrifugal casting and injection molding are technique s used to inject the slurry
into the mold.


High impact strength acrylics:
Denture base materials that have greater impact strength have been introduced.
These polymers are reinforced with butadiene styrene rubber. The rubber
particles are grafted to methyl methacrylate to bond to the acrylic matrix.
These materials are supplied in a powder- liquid form and are processed in the
same way as other heat accelerated methyl methacrylate materials.

Rapid heat polymerized acrylics;
These hybrid acrylics are polymerized in boiling water immediately after being
packed in to a denture flask.
The initiator is formulated from both chemical and heat activated initiators to allow
rapid polymerization without the porosity.
After placing the denture in boiling water the water is brought back to afull boil for
20min.
After bench cooling to room temperature, the denture is deflasked, trimmed and
polished in the conventional manner.

Light activated resins:
This denture base material consists of a urethane dimethacrylate matrix with an
acrylic copolymer, microfine silica fillers and a photoinitiator system.
Its supplied in premixed sheets having clay like consistency.
The denture base material is adapted to the cast while its still pliable
The denture base can be polymerized in a light chamber with blue light of 400-
500nm.
The denture base can be polymerized in a light chamber without teeth and used as
a record base.
The teeth are processed to the base with additional material and the anatomy is
sculptured while the material is still plastic.
The denture rotates in chamber to provide uniform exposure to the light source.
Reinforced denture base with glass fillers:
(Ref: JOP1999, 18-26, vol-8, no.1)
- Mona K.Marie has conducted a study to evaluate the effect of short glass fibers
on the transverse strength of a heat polymerized denture base material.
- In their study they incorporated glass fibers (Sio2- 54%, Al2O3-14%, B2O3-9%,
MgO-5% and CaO-18%) that were 3.8 micrometers in diameter.
- Optimal adhesion between the fibers and the polymer matrix can be obtained by
mixing with silane coupling agents.
- Incorporation of glass fibers in a continuous roving form increases the strength of
dentures and enhances the fracture resistance.
- Main disadvantage of this system is difficulty in handling the fibers and
inadequate degree of impregnation of fibers with the resin.

Other materials used for reinforcement of acrylic resin materials are

Polymer-fiber composites:
- Polymer fiber composites are materials that are composed of a polymer matrix
and reinforcement.
- The fiber reinforcement is characterized by its length being much greater than
its cross sectional dimensions.
- In polymer free composites the fibers are embedded in a polymer matrix which
binds the fibers and forms a continuous phase surrounding the fibers.
- The polymer matrix transfers the loads to the fibers which are stronger
component of the composite.
- The composites with long fibers are called continuous fiber composites and
those with short fibers are called short fiber composites.
- The chemical bond between the polymer and the fibers should ideally be of a
covalent nature.
- proper adhesion makes it possible to transfer the stresses from the matrix to the
fibers.


Carbon /graphite fibers:
The carbon / graphite fiber reinforcement of the denture base materials was
published in the early 1970s
The study reported a 100% increase of the transverse strength of PMMA.

Aramid fibers:
- Aramid fiber is the generic name for aromatic polyamide fibers, which are more
commonly called Kevlar fibers after the first commercially available AF produced
by Du pont.
- Fibers have been shown to significantly increase the impact strength of acrylic
denture base material.
- The Aramid yellow color of the aramid fibers might limit their use to certain intra
oral applications.

Metal fillers:
They improve the thermal conductivity of PMMA and enhances its strength, but
also contribute to poor esthetics for complete dentures.

Ultra high modulus polyethylene fibers (UHMP):

The effect of unidirectional UHMP fiber reinforcement on the transverse strength
of the PMMA depends on the amount of fibers present.
Fiber contents as high as 40-70% wt considerably enhanced transverse strength
of the composite.


Aluminium oxide addition:
- Ayman E.Ellakwa et al. conducted a study on the effect of adding from 5.2% by
wt Al2O3 powder on the flexural strength and thermal diffusivity of heat
polymerized acrylic resin.
- In their study aluminium oxide powder was added to polymer of heat
polymerized acrylic resin.
- The monomer and the polymer of the heat polymerized acrylic resin were
proportioned, mixed packed and pressed in to the mold following manufacturers
directions.
- Aluminium oxide commonly referred to as alumina possess strong ionic,
interatomic bonding giving rise to its desirable material characteristics.
- Can exist in several crystalline phases which hexagonal alpha phase is the most
stable form.
- They conclude that the incorporation of Al2O3 powder from 5% to 20% by weight
in to conventional heat polymerized denture base resin results in an increase in
both it flexural strength and thermal diffusivity.

Introduction of a denture injection system for use with microwavable acrylic
resins;
- GC lab technologies (LOCK PORT IL) introduced a denture base processing
system that combines injection molding and microwave activation techniques that
accelerate the polymerization process.

- In the GC INJECTION system a pneumatic press is used to force unpolymerized
acylic resin into the mold cavity. A modified microwavable flask is used to
facilitate this process. The modified flask has a small channel in its lid that
permits a small diameter sprue (7mm) to pass from the external surface of the
flask in to the mold cavity.

Advantages:
The injection process eliminates the need for direct handling of resin during the
packing process

Disadvantages:
The additional cost of the pneumatic press and associated flask components.
The necessity of adding and removing screws.

- Ali pervizi (2004) et.al compared the three dimensional changes of 3 injection
molded denture base materials to that of conventionally processed polymethyl
methacrylate (PMMA) Resin.
- They compare the dimensional accuracy of maxillary complete denture, which
are processed in 4 types of materials. 1. PMMA (microlon). 2. Injection molded
PMMA (Northern) 3.injection-molded nylon (valplast). 4. Injection molded
styrene.
- They concluded that for all groups the greatest distortion occurred with nylon and
the least with styrene.

Development of a radio opaque auto polymerizing dental acrylic resin:
- There are many materials which can act as radio opaque additives
Eg: Barium sulfate, Barium acrylate, Bismuth bromide)
- But these materials weaken the resin and decrease the transverse and impact
strengths.
- Patrik A.Mattie et al (19940 proposed a component that is Triphenyl Bismuth
found to be soluble in avariety of monomers and polymers seems to overcome
the problems of the bismuth trihalides and has a very low level of cytotoxicity
which indicates significant biocompatibility.
- TPB doesnot leach from the resin and provides radioopacityequivalentto
aluminium.
- And the authors concluded that TPB doesnot significantly alter required
performance and processing properties.

CONCLUSIONS:
It is the goal of medical procedure to provide the best treatment
for the patient while following the Hippocratic oath: First, do no harm. As
dentists, we are challenged to restore function while providing a highly esthetic
result. The choices available for esthetic restorations are expanding continually
as more private and public research is aimed at improving clinical results.
An examination of material properties should lead us to select
those
systems engineered to provide the patient with best clinical out come with
respect to esthetics , function , longevity and compatibility with surrounding
natural tissues.



REFERENCES

1. Restorative Dental materials: G Craig & John M Powers-11th edition2002.
2. Phillips science of dental materials: Anusavice; 11th edition
3. DCNA, July 2007, 994-1003.
4. OBrien, Dental Materials & their Selection 1997
5. Evolution of dental ceramics in the twentieth century, John W.Mclean, JPD
VOL-85, NO.1, Jan-2001.
6. A novel comonomer free light-cured glass ionomer cement for reduced
cytotoxicity and enhanced mechanical strength. Dong Xie, J of Dental
materials 23 (2007) 994-1003.
7. The effect of disinfection and a wetting agent on the wettability of addition
silicone Impresion materials; Paul J.Milward, JPD 2001; 86.165-7.
8. Introduction of a denture injection system for use with microwaveable
acrylic resins; R,D Phoenix, JOP, V ol 6, No.4, DEC1997, pg286-291.
9. JOP , 2004,VOL13, NO.2(june), pg 83-89
10. JOP; VOL-2, No.3 ,sept 1993; pg 174-177
11. JOP; VOL-3,No.4 DEC.1994;pg 213-218
12. Poly vinyl siloxane impression materials; an update on clinical use;
Michael N.Mandiko; Australian dental journal ,1998, 43 (6); 428-434.
13. JOP; xx (2008) 1-6
14. JOP; VOL-5, No.4 DEC,1996, PG 270-76
15. JOP; VOL-8, No.1 march 1999, pg 18-26
16. Clinical performance of chair side CAD/CAM restorations;JADA,
VOL 137, 22-31
17. The evolution of the CEREC system; Werner H. Mormann, JADA,
vol 137, 2006
18. Materials for chairside CAD/CAM produced restorations, Russell
GIORDANO;JADA, vol 137 ,2006 14




SELECTIVE GRINDING IN COMPLETE DENTURE

SELECTIVE GRINDING IN COMPLETE DENTURE


INTRODUCTION: -
Occlusal harmony in complete denture is necessary if the dentures
are to be comfortable, to function efficiently, and to preserve the supporting
structures. It is difficult to see occlusal discrepancies intraorally with
complete denture. The resiliency of the supporting soft tissues and
displaceability of the tissues in varying degrees tend to disguise premature
occlusal contacts. The tissues permit the dentures to shift; as a result, after
the first interceptive occlusal contact the remaining teeth appear to make
satisfactory contacts. The eye cannot be relied upon to observe occlusal
discrepancies, and the patient cannot be depended upon to diagnosed
occlusal faults. It is the responsibility of the dentist to find and correct these
occlusal discrepancies and permit the patient to depart free of occlusal
disharmony. Occlusal faults can be determined by obtaining and
interocclusal record from the patient and remounting the dentures on an
articulator. These faults can be corrected by careful selective grinding
procedures. Remounting of the dentures on the articulators and selective
sliding procedures should be carried out at the time of placement of the
dentures.

DEFINITION: -
Selective gliding is defined as the, intentional alteration of the occlusal
surfaces of the teeth to change their form.
-- Glossary of the Prosthodontic terms 1999.

Teeth are altered by selective grinding to make simultaneous cusp tip to
cusp tip contact on both sides of the arch when the jaws are in left or a right
lateral position, balanced occlusion in a static eccentric position exists.
When the mandible is in a straight protruded relation with the maxilla and
the posterior teeth are altered to make cusp contacts at the same time to
anterior teeth make incisal edges contact balanced occlusion protrusion
exists.


REVIEW OF LITERATURES: -

Schuyler, Friedrich and Vaeghan in 1935 observed the disturbances in
occlusal relationship and opening of the bite of full dentures made of acrylic
resin, even when the flask was completely closed during processing.

Osborne and Taylor in 1941 have noted the disturbance and attributed
it to over packing and the accompanying displacement of teeth in the mold.
It was felt, however, that these changes were caused in part by the
volumetric change of acrylic resin during polymerization. They used the
following method to estimate the amount of change in occlusal relationship
-
The top of the incisal guide pin was flush with the top of the articulator
at the time the cases were waxed. The distance that the pin dropped in
order to make contact with the incisal guide plane when the finished
dentures were placed in centric position on the articulator gave a rough
means of comparison of the amount of disturbance of occlusal relationship
in each case.
Avoiding remounting the dentures on articulator and selective grinding
leads to,
1) A deformation of underlying soft tissues,
2) Discomfort, and
3) Destruction of the underlying supporting bone. Later occlusal errors may
be concealed and impossible to locate and correct because of distorted
and swollen tissues.


CAUSES OF OCCLUSAL DISHARMONY: -
1) Incorrect registration of retruded contact position (RCP)
2) Irregularities in setting the teeth.
3) Tooth movement when flasking and packing
4) Incomplete flask closure.

1) Incorrect registration of retruded contact position (RCP)
This is probably the most common cause of error in the occlusion of
finished dentures. During registration considerable care is taken to obtain a
correct vertical dimension and the physiological fully retruded position of
the mandible, but often, when brought together, the record blocks exert
uneven pressure on their respective supporting alveolar ridges, and this
condition passes unnoticed. On finishing the denture the teeth are found to
occlude only in the area where the premature contact of the occlusal rims
occurred the remainder of the teeth being slightly out of degree of contact.
The degree of separation will be related the degree of premature contact
occurring between the rims.
Another fault causing errors in the occlusion of the finished dentures
results from slight movement of record blocks on the ridges during
registration due to their imperfect fit and inadequate retention. All these
errors can usually be lessened by using an accurately fitting acrylic base in
preference to a shellac base which invariably warps slightly.

2) Irregularities in setting the teeth
When setting up teeth the technician is unlikely to produce a perfectly
even contact in retruded, protruded and lateral occlusions. Some teeth will
be in good occlusion while others will be slightly out of occlusion, thus
producing areas of heavy pressure. This cannot happen when the teeth are
held firmly in the final denture base material and results in premature tooth
contacts in the occlusion and articulation of the finished dentures

3) Tooth movement when flasking and packing
Movement of the teeth may occur at the time of boiling out the wax trial
base after the dentures have been flasked and if such teeth are not
correctly repositioned they will cause occlusal irregularities. Repositioned
they will cause occlusal are not correctly repositioned they will cause
occlusal irregularities. When packing acrylic dough, teeth may be driven
into the investing plaster, particularly when packing follows soon after
flasking and the plaster has a low crushing strength. Raped closure of the
flask in the bench press will add to the hazard. Injection moulding
techniques for packing acrylic are an obvious improvement.

4) Incomplete flask closure
Such an occurrence not only causes an increase of vertical dimension
because of the alteration in tooth / cast relationship but also result in
derangement of the occlusion which usually necessitates the total remake
of the denture.
Remounting dentures with check records --
It can be appreciated that even with care on the part of dentist and
technician errors may occur which influence the finical occlusion and
articulation of finished dentures. In some instances these errors may
corrected by careful use of marking paper or tape at the chair side, but
such correction is often proved false when check records are taken for
confirmation. It is far satisfactory, and often less time-consuming clinically,
to register the retruded contact position of the finished denture with check
record, mount the finished dentures on an adjustable articulator and then
refine the occlusion either at the chair side or in the laboratory.


OBJECTIVES OF CORRECTING OCCLUSAL DISHARMONY : -

The objectives as stated by Schuyler in 1935 are,
1) Maximum distribution of stress in centric maxillo-mandibular relation.
2) Retention of the maxillo-mandibular opening.
3) Harmony of guiding inclines, which distributes eccentric occlusal stresses.
4) Reduction of the incline of guiding tooth surfaces, that occlusal stresses
may be more favorably applied to the supporting tissues.
5) Retention of sharpness of cutting cusps.
6) Increase in food exits.
7) Decrease in contact surfaces.

It must be remembered that the occlusion of the natural dentition and
the occlusion of the complete denture may differ in many respects, to the
advantages and convenience of the dentures. For instance, a denture is a
unit of 14 teeth fastened rigidly together, while natural teeth are anchored
independently of each other. The natural teeth must be considered
individually for occlusion, while the 14 teeth can be treated as one whole
unit. We can have balanced occlusion in complete denture with some teeth
out of contact or some inclines out of contact. The dentures would be
balanced as far as 3 point contact is concerned if only the cuspids and
second molars worked in harmony.


ELIMINATING OCCLUSAL ERRORS IN ANATOMIC TEETH: -

Articulating paper of minimum thickness is used for marking the actual
contacts of the teeth. Paper is interposed between the teeth and marking
are obtained by tapping the teeth together. This can be done on both sides
at the same time.
Grinding is done with mounted chayes stones no. 16, 11, 05.
The marking process and the grinding are repeated until practically all the
teeth contact in Centric Occlusion. During this grinding procedure, the
incisal pin is relieved of contacts on the incisal guidance table to allow for
the slight reduction in Vertical Dimension that must necessarily take place.
After centric deflective occlusal contacts have been removed the pin is
placed in contact with the incisal table and is kept in contact through the
remainder of the grinding procedure.





I] TYPES OF OCCLUSAL ERROR IN CENTRIC OCCLUSION AND THEIR
CORRECTION: -
3 types of occlusal errors can exist in Centric Occlusion, and each can
be corrected by specific grinding for that error.

1) Any pair of opposing teeth can be too long and hold the other teeth out of
contact.
Correction: - The fossae of the teeth are deepened by grinding so the
teeth will in effect, telescope into each other. The cusps are not shortened.

2) The upper and lower teeth can be too nearly end to end.
Correction: - For correction of this error grinding in such a way as to move
the upper cusp inclines bucally and the lower cusp inclines lingually. In the
process the central fossae are made broader, the lingual cusp of the upper
tooth is made more narrow when it is ground from the lingual side, and the
buccal cusp of the lower tooth is made more narrow when it is ground from
the buccal side. The cusps are not shortened

3) The upper teeth can be too far buccal in relation to the lower teeth.
Correction: - The lingual cusp of the upper tooth is made more narrow by
broadening the central fossa, and the buccal cusp of the lower teeth is
moved buccally by broadening the central fossa.
In effect, the upper lingual cusps is moved lingually and the lower
buccal cusp is moved buccaly so the tooth telescope into each other.
Cusps are not shortened.


II] TYPES OF WORKING SIDE OCCLUSAL ERRORS AND THEIR
CORRECTION: -
6 types of errors can exist in the occlusal contacts on the working
side. Each of these will cause other teeth to be hold out of contact in
working occlusion, and each requires selective grinding of specific cusp
inclines for its elimination.


1) Both the upper buccal cusp and the lower lingual cusp are too long.
Correction: - The length of the cusps is reduced by grinding to change the
incline extending from the central fossa to the cusp tip. The central fossa is
not made deeper, but the upper buccal cusps and the lower lingual cusps
are made shorter so the other teeth will touch in that position.

2) The buccal cusps make contact but the lingucal cusps do not.
Correction: - Buccal cusps of the upper teeth are ground from the central
fossa to the cusps tip to shorten the cusp and change the lingual incline of
the cusps so it will be less steep.

3) The lingual cusps make contact but the buccal cusps do not.
Correction: - The lower lingual cusps are shortened by changing the
buccal incline of the lower lingual cusp so it is not as steep. Upper lingual
cusp is not shortened and the central fossa is not made deeper.

4) Upper buccal or lingual cusps are mesial to their intercuspative positions.
This error may occur along positions. This error may occur along with any
of the 3 above listed.
Correction: - Grinding is done so the mesial inclines of the upper buccal
cusps are moved distally when the cusps are narrowed and the distal
inclines of the lower cusps are moved forward. The same cuspal inclination
is maintained in this procedure.

5) Upper buccal or lingual cusps are distal to their inter cusping positions.
This error may occur along with the bucco-lingual errors.
Correction: - Grinding is dome from the distal of the upper cusps and from
the mesial of the lower cusps.

6) Teeth on the working side may not contact.
Cause of this error is excessive contact on the balancing side.







III] TYPE OF BALANCING - SIDE ERRORS AND THEIR CORRECTION: -


There are 2 types of balancing side errors
1) Balancing side contact is so heavy that the working side teeth are held
out of contact
Correction: - Paths are ground through the buccal cusps of the lower teeth
to reduce the incline of the part of the cusp that is preventing the teeth on
the working side from contacting.
No grinding is done from the lingual cusps that may be involved in this
contact.

2) There is no contact on the balancing side.
Correction: - Shorten the buccal cusps of the upper teeth and the lingual
cusps of the lower teeth on the working side. In this process, the lingual
inclines of the buccal cusps of upper teeth and buccal incline of lingual
cusps of lower teeth are made less step. No grinding is done on central
fossae.





ELIMINATING OCCLUSAL ERRORS IN NON ANATOMIC TEETH:-
An Interocclusal Centric Relation record is made in a bite registration
material with the opposing teeth just out of contact. Dentures are mounted
on articulators and the following procedures are undertaken.

1) After being detected by articulating paper between the teeth, gross
premature contact in Centric Relation are removed by grinding. Same
procedures are used to locate and remove all occlusal interferences lateral
and protrussive movements. The grinding is done that appear to have been
ripped or elongated in processing. In Centric Occlusion no grinding is done
on the distobuccal portion of the lower second molar. All balancing- side
grinding is done on the lingual position of the occlusal surfaces of the upper
second molar.

2) Abrasive paste is placed on the teeth on the articulator. These teeth are
milled when the upper member of the articulator moves in and out of
protrusive and right and left lateral excursions. When the teeth slide
smoothly through all excursions, the dentures are removed from the
articulators and washed. Seldom is any correction necessary to attain a
bilaterally balanced occlusion.

3) Spot grinding is done to correct any small discrepancies in Centric
Relation that remain after the grinding with abrasive paste. The dentist
adjust them after identifying the discrepancies with articulating paper
using a light tapping motion with the articulator and grinding the marks to
ensure even occlusal contact in Centric Occlusion.

SUMMARY AND CONCLUSION :
Selective grinding in complete denture Prosthodontics is an important
laboratory procedure which is carried out by remounting of the dentures
after processing is completed. This remounting may either be laboratory
remount or patient remount.
Inspite of carrying out each step in denture construction very carefully it
is seen that in the end when the dentures are remounting there is an
occlusal prematurities or interferences may be needed.


















REFERENCES

1. I George, Charles, Judson: Bouchers Prosthodontic Treatment for
edentulous Patients. U.S.A. 1997, Mosby Company, ed 10; 500-503.

2. Charles Heartwell: Syllabus of Complete Denture. U.S.A. 1992, ed 4; 394-
406.

3. Merrell Swenson: Complete Dentures. U.S.A. 1959, Mosby Company,
ed 4: 273-294.

4. Holt J : Research on remounting procedures.
J Prosthet Dent 1977, 38:388.

5. Moore P : Indicate pastes - Their behavior and use.
J Prosthe Dent 1979, 41:258



IMPRESSIONS IN FIXED PARTIAL DENTURES



IMPRESSIONS IN FIXED PARTIAL DENTURES

CONTENTS

DEFI NI TI ONS
I DEAL REQUI REMENTS OF I MPRESSI ON MATERI ALS
CLASSI FI CATI ON OF I MPRESSI ON MATERI ALS
I MPRESSI ON TRAYS
I MPRESSI ON TECHNI QUES FOR DI FFERENT I MPRESSI ON MATERI ALS
SPECI AL CONSI DERATI ONS
CONCLUSI ON
REFERENCES







Definitions
Impressi on
An i mpr i nt or negat i ve l i keness of t he t eet h and/ or edent ul ous ar eas wher e t he
t eet h have been r emoved, made i n a pl ast i c mat er i al whi ch becomes r el at i vel y har d or
set whi l e i n cont act wi t h t hese t i ssues.

I mpressi on mat eri al
Any subst ance or combi nat i on of subst ances used f or maki ng a negat i ve
r epr oduct i on or i mpr essi on.

I mpressi on t ray
A devi ce whi ch i s used t o car r y, conf i ne and cont r ol an i mpr essi on mat er i al
whi l e maki ng an i mpr essi on.

I deal requi rement s of i mpressi on mat eri al ( Accordi ng t o Tyl man)
Compl et e pl ast i ci t y bef or e use
Suf f i ci ent f l ui di t y t o r ecor d f i ne det ai l
The abi l i t y t o wet t he or al t i ssues
Di mensi onal accur acy
Di mensi onal st abi l i t y
Compl et e el ast i ci t y af t er cur e
Opt i mal st i f f ness
Have a good shel f l i f e
Be non- t oxi c and non- i r r i t at i ng
Have accept abl e t ast e and odor
Have sui t abl e wor ki ng and set t i ng t i mes
Have st r engt h t o r esi st t ear i ng
Be compat i bl e wi t h model and di e mat er i al
Faci l i t at e cl i ni cal i dent i f i cat i on of begi nni ng and end of cur e
Faci l i t at e vi sual i zat i on of t he f i ni sh l i ne
An i mpr essi on f or a f i xed r est or at i on shoul d meet t he f ol l owi ng r equi r ement s
I t shoul d be an exact dupl i cat i on of t he pr epar ed t oot h, i ncl udi ng al l of t he pr epar at i on
and enough uncut t oot h sur f ace beyond t he pr epar at i on f or t he dent i st and t echni ci an
t o be cer t ai n of t he l ocat i on and conf i gur at i on of t he f i ni sh l i ne.
Teet h and t i ssues adj acent t o t he pr epar ed t oot h must be accur at el y r epr oduced t o
per mi t pr oper ar t i cul at i on of t he cast and cont our i ng of t he r est or at i on.
I t must be f r ee of bubbl es, especi al l y i n t he ar ea of t he f i ni sh l i n e and occl usal
sur f aces of ot her t eet h i n t he ar ch.
I mpr essi on mat er i al s t hat ar e used i n f i xed pr ost hodont i cs ar e
Rever si bl e hydr ocol l oi ds
Pol ysul f i de
Condensat i on si l i cone
Addi t i on si l i cone
Pol yet her
ur et hane di met hacr yal t e

Classification
Accor di ng t o chemi cal nat ur e
Hydr ocol l oi d i mpr essi on mat er i al
El ast omet r i c i mpr essi on mat er i al
Each of t hem ar e f ur t her cl assi f i ed accor di ng t o t he vi scosi t y
Heavy body
Regul ar / medi um body
Li ght body
Ver y heavy/ put t y

Reversi bl e hydrocol l oi d ( Agar)
The cr edi t f or i t s f i r st use i n Uni t ed St at es f or f abr i cat i ng cast r est or at i ons i s
gi ven t o J. D. Har t ( 1930) . I t i s a pol ysacchar i de ext r act ed f r om cer t ai n t ypes of
seaweed.

Composi t i on
I ngredi ent s Percent age by
wei ght
Funct i on
Agar
Bor at es


Pot assi um sul f at e
Wax har d di at omaceous ear t h
Si l i ca
Cl ay
Al kyl benzoat es
Thi zot r ophi c mat er i al s
Col or i ng agent s
Wat er
13 17%
0. 2 0. 5%


1 2%
0. 5 1. 1%



0. 1%
0. 3%
-
Bal ance
Basi c const i t uent
I mpr oves st r engt h of t he gel
r et ar ds pl ast er or st one

Gypsum har dener
Fi l l er



Pr eser vat i ves
Pl ast i ci zer s
-
Di sper si on medi um



Gel l at i on process
The set t i ng pr ocess of r ever si bl e hydr ocol l oi d i s cal l ed as a gel l at i on pr ocess i t
i s due t o change i n t emper at ur e.

I t i s avai l abl e as t r ay mat er i al , or as syr i nge mat er i al as semi - sol i d gel i n
pol yet hyl ene t ubes.

The cycl e i s
Gel - - - - - - - - - - Sol - - - - - - - - - - - - - Gel
( Tube) ( Condi t i oner ) ( Tr ay)

Agar r equi r es a condi t i oni ng uni t whi ch has t hr ee compar t ment s one f or
l i quef yi ng wer e t he t ubes ar e pl aced at 1000C as i t i s t oo hot f or i nt r a or al use i t i s
cool ed i n t wo st ages: st or age and t emper i ng. Addi t i on t o l ower i ng t he t emper at ur e i t
al so i ncr eases t he vi scosi t y. The st or age t emper at ur e i s 700C and can be kept f or 5
days. Temper i ng i s done j ust bef or e t he i mpr essi on i s made t hat i s bet ween 370C
500C. Af t er l oadi ng i n t he t r ay and pl aci ng i n t he mout h wat er i s ci r cul at ed at 170C
210C unt i l t he mat er i al i s compl et el y gel l ed. Thi s i s done usi ng wat er cool ed r i ml ock
t r ay

El ast omeri c i mpressi on mat eri al s
Pol ysul f i de ( Mercapt an, Thi okol )
Composi t i on
Base
Li qui d pol ysul f i de pol ymer 80 85%
I ner t f i l l er s ( Ti O, Zn Sul f at e, Copper car bonat e) 16 18%
Pl ast i ci zer s ( Di but yl phat hal at e)

Accel erat or past e
Lead di - oxi de 60 68% - React or
Di but yl phat hal at e 30 35% - Pl ast i ci zer
Sul f ur 3% - Ret ar der

Set t i ng react i on
Thi s pol ymer i s usual l y cr oss l i nked wi t h an oxi di zi ng agent such as l ead
di oxi de. I t i s t hi s l ead di oxi de t hat gi ves pol ysul f i de i t s char act er i st i c br own col or .
Thi s i s a condensat i on r eact i on wher e al l t he pol ymer chai ns gr ow si mul t aneousl y and
a r eact i on by pr oduct i s f or med l i ke wat er .

They ar e avai l abl e as
Li ght body
Regul ar body
Heavy body

Pol ysul f i de i mpr essi on mat er i al i s hydr ophobi c and shoul d be pour ed wi t hi n 1
hour of r emoval f r om t he mout h and i t i s a r adi o opaque i mpr essi on mat er i al because
of t he pr esence of l ead di oxi de.

Condensat i on si l i cone
Composi t i on
Base past e
Pol y di met hyl si l oxane 25 65%
Col l oi dal si l i ca or mi cr oni ze met al oxi de f i l l er ( Dependi ng upon t he vi scosi t y) 35
75%
Col or i ng agent s

Accel erat or past e
Or ht oet hyl si l i cat e cr oss l i nki ng agent
St annous oct at e cat al yst

Avai l abl e as
Li ght body
Regul ar body
Heavy body
Put t y



Set t i ng react i on
Thi s i s condensat i on pol ymer i zat i on r eact i on whi ch r eact s wi t h t r i f unct i onal and
t et r af unct i onal al kyl si l i cat es l i ke or t hoet hyl si l i cat e i n t he pr esence of st annous
oct at e. Et hyl al cohol i s a by pr oduct whi ch i s r esponsi bl e f or shr i nkage of t he
mat er i al .

The condensat i on si l i cone i mpr essi on mat er i al s ar e suppl i ed as a base past e
and a l ow- vi scosi t y l i qui d or cat al yst past e. Si nce et hyl al cohol i s t he by pr oduct t hey
ar e di mensi onal l y st abi l i t y i s poor and t hey shoul d be pour ed i mmedi at el y af t er t he
r emoval f r om t he mout h. They have a ver y poor shel f l i f e because of t he i nst abi l i t y of
al kyl si l i cat es i n t he pr esence of or gano- t i n compounds, whi ch may r esul t i n t he
oxi dat i on of t i n.

Addi t i on si l i cone
Base past e
Pol y met hyl hydr ogen si l oxane
Ot her si l oxane pol ymer s
Fi l l er s

Accel erat or past e
Di vi nyl si l oxane
Ot her si l oxane pr epol ymer s
Pl at i num sal t ( chl or opl at i ni c aci d) cat al yst
Pal l adi um hydr ogen absor ber
Fi l l er s





Avai l abl e as
Li ght body
Regul ar / medi um body
Heavy body
Put t y

Set t i ng react i on
I t i s addi t i on pol ymer i zat i on r eact i on t er mi nat ed wi t h vi nyl gr oups and i s cr oss
l i nked wi t h hydr i de gr oups act i vat ed by a pl at i num sal t cat al yst . Ther e i s no r eact i on
by pr oduct s as l ong as cor r ect pr opor t i ons of vi nyl si l i cone and hydr i de si l i cone ar e
mani pul at ed and t her e ar e no i mpur i t i es, i f t he pr opor t i on i s out of bal ance or
i mpur i t i es ar e pr esent t hen si de r eact i ons wi l l pr oduce hydr ogen gas. Thi s i s avoi ded
by t he manuf act ur er addi ng nobl e met al s or pal l adi um or pl at i num t o act as
scavenger s anot her way i s t o wai t f or 1 hour bef or e pour i ng up t he i mpr essi on.

Tr ays used
Cust om t r ay / r esi n t r ay
St ock t r ay


Pol yet her
Base past e
Pol yet her pol ymer
Col l i dal si l i ca
Gl ycoet her or di but yl phat hl at e
Accel erat or past e
Ar omat i c sul f onat e est er cr oss l i nki ng agent
Col l i dal si l i ca
Di but yl phat hal ae or gl ycoet her

Avai l abl e
Si ngl e vi scosi t y ( bot h syr i nge and t r ay mat er i al )
Regul ar

Set t i ng react i on
I t i s a addi t i on pol ymer i zat i on r eact i on wi t h no by pr oduct s t he r eact i on i s
bet ween azi r i di ne r i ngs whi ch ar e at t he end of br anched pol yet her mol ecul es. The
mai n chai n i s a copol ymer of et hyl e oxi de and t et r ahydr of ur an. Cr oss l i nki ng and
set t i ng i s br ought about by an ar omat i c sul f onat e whi ch Act s as an i ni t i at or by
r el easi ng a cat i on R+ an al kyl gr oup. Thi s pr oduce t he cr oss l i nki ng by cat i oni c
pol ymer i zat i on vi a t he i mi ne end gr oups.




Trays used
Cust om / r esi n t r ays
St ock t r ay



Compari son of advant ages and di sadvant ages
Materi al Advantages Di sadvantages Recommended
uses
Precauti ons
Reversi bl e and Hydrophi l i c Low t ear Mul t i pl e Pour
hydrocol l oi d Long worki ng
t i me
Low cost
No cust om t ray
requi red
resi st ance
Low st abi l i t y
Equi pment
needed

preparat i ons
Probl ems wi t h
moi st ure

i mmedi at el y
use onl y wi t h
st one
Pol ysul f i de Hi gh t ear
st rengt h
Easi er t o pour
t han ot her
el ast omers

Messy
Unpl easant
odor
Long set t i ng
t i me
St abi l i t y onl y
f ai r
Most
i mpressi ons
Lat ex gl oves
use i n
cont ra-
i ndi cat ed f or
al l t he
el ast omers.
Pour wi t hi n 1
hour.
Addi t i on
si l i cone
Di mensi onal
st abi l i t y
Pl easant t o use
Short set t i ng
t i me
Aut omi x
avai l abl e
Hydrophobi c
Poor wet t i ng
Some mat eri al
rel ease
hydrogen
Most
i mpressi ons
Del ay pour
some
mat eri al s,
care t o avoi d
bubbl es
when
worki ng
Condensat i on
si l i cone
Pl easant t o use
Short set t i ng
t i me
Hydrophobi c
Poor wet t i ng
Low st abi l i t y
Most
i mpressi ons
Pour
i mmedi at el y,
care t o avoi d
bubbl es
when
pour i ng
Pol yet her Di mensi onal
st abi l i t y
Accuracy
Short set t i ng
t i me
Aut omi x
avai l abl e
Set mat eri al
ver y st i f f
Most
i mpressi ons
Care not t o
break t eet h
when
separat i ng
cast

Trays
Var i ous t ype of t r ays ar e used f or f i xed par t i al dent ur es i mpr essi on pr ocedur es.

1. Stock tray
Met al l i c
Non met al l i c

2. Custom made trays
Aut opol ymer i zi ng acr yl i c r esi n
Ther mopl ast i c or phot o i ni t i at ed r esi n

3. Water cool ed ri m l ock trays

Cust om t rays
Advantages
I mpr oves t he accur acy of an el ast omer i c i mpr essi on by l i mi t i ng t he vol ume of t he
mat er i al , t her eby r educi ng t he 2 sour ces of er r or
a. St r ess dur i ng r emoval
b. Ther mal cont r act i on
No need f or st er i l i zat i on
Uni f or m t hi ckness of t he i mpr essi on mat er i al mi ni mi zes di st or t i ons r esul t i ng f r om cur i ng
shr i nkage
Pr ocur i ng of t he t r ay mat er i al i s not r equi r ed

Di sadvantages
Ti me t aken f or t he f abr i cat i on
Agi ng f or 24 hour s t o mi ni mi zes t he di st or t i on
Sensi t i vi t y t o monomer

St eps i n f abri cat i on
Soak r epl i cas of di agnost i c cast s i n sl ur r y wat er f or 10 mi ns.
Tr ay ext ensi ons ar e mar ked wi t h t he penci l l i ne at ei t her t he cer vi cal r egi on of t he t eet h
or 5mm bel ow t he cer vi cal l i ne.
Base pl at e wax i s adapt ed ( f or 2 sheet s t hi ckness 2- 3mm) af t er sof t eni ng on t he
Bunsen bur ner and t r i m t he excess wi t h t he kni f e unt i l t he mar ked penci l l i ne . ( Ri gi d
or st i f f mat er i al l i ke pol yet her r equi r es of wax spacer of 4mm t hi ckness) .
Cover t he wax wi t h t i n f oi l , or al umi ni um f oi l f or pr event i ng t he wax t o mel t dur i ng t he
exot her mi c heat pr oduced dur i ng t he pol ymer i zat i on of t he r esi n ( aut ocur i ng) .
Wax i s r emoved ei t her i n 4 or 3 t r i podal ar eas 3 sq. mm and l ocat ed not on t he pr epar ed
t oot h but on non- f unct i onal or non- cent r i c cusps. I f al l t he t eet h ar e pr epar ed t hen sof t
t i ssues st ops ei t her on t he pal at al ar ea or t he cr est of t he r i dge i s pl aced.
Needed amount of pol ymer s and monomer s of aut opol ymer i zi ng r esi n i s mi xed as per
manuf act ur er i nst r uct i ons t i l l t he dough st age i s at t ai ned.
Then i t i s f l at t ened t o al most 4mm t hi ck put t y. I t i s t hen adapt ed and mol ded over t he
t i n f oi l separ at i on and excess i s t r i mmed of f .
A handl e i s f or med al ong wi t h 2 buccal wi ngs or r i dges on ei t her si de f or t he easy
r emoval .
Af t er t he set i t i s sl owl y r emoved f or m t he cast , check i f t he st ops ar e pr oper .
I t can t hen be pl aced i n t he wat er f or 9 24 hour s ( Rosenst i el ) or 5 mi nut es i n boi l i ng
wat er bef or e use.
A t r ay adhesi ve can be appl i ed 15 mi nut es bef or e pl aci ng t he i mpr essi on mat er i al and
al l ow i t t o dr y ( i nsi de and out si de t he bond of t he t r ay)

Advant ages of st ock t ray
El i mi nat i ng t he t i me and expenses of f abr i cat i ng a cust omi zed t r ay.
They ar e r i gi d met al and suscept i bl e t o di st or t i on.

I mpressi on t echni ques
For reversi bl e hydrocol l oi d
I t r equi r es a hydr ocol l oi d condi t i oni ng uni t . A condi t i oni ng uni t has t hr ee uni t s.
Li quef yi ng bat h
St or age bat h
Temper i ng bat h
1. Li quefyi ng bath
Tubes of i mpr essi on mat er i al s and syr i nges ar e boi l ed at 2120F ( 1000C) f or 10
12 mi nut es.

2. Storage bath
St or ed at 1500F ( 650C) at l east f or 10 mi nut es. The mat er i al can be st or ed f or
5 days.

3. Temperi ng bath
Loaded i mpr essi on t r ays ar e t emper ed i n t hi s bat h at 1100F t o 1150F ( about
400C) f or 5 10 mi nut es i mmedi at el y bef or e pl aci ng i n t he mout h.

Procedure
Because onl y one accur at e cast can be made f r om a hydr ocol l oi d i mpr essi on,
t wo i mpr essi ons ar e made
1. A sect i onal i mpr essi on f or maki ng a di e ( made f i r st )
2. A f ul l ar ch i mpr essi on f or t he wor ki ng cast
Af t er sel ect i ng a pr oper t r ay and pl aci ng st ops i n t he pr oper ar ea.
Tr ay mat er i al i s kept on t he t r ay f or t emper i ng.
Low vi scosi t y syr i nge mat er i al i s pl aced i n t he bat h whi ch i s t hen r emoved and appl i ed
af t er t he r et r act i on cor d i s r emoved and t hen t he t r ay wi t h heavy body i s pl aced i nt o
t he mout h and col d wat er i s ci r cul at ed.
I t i s t hen r emoved af t er hol di ng wi t hout movement wi t h a r api d mot i on, washed wi t h
col d wat er , i nspect ed, di si nf ect ed and i mmedi at el y t ype 4 st one i s pour ed.

Wet f i el d t echni que
The ar eas of t he t eet h and t i ssues ar e f l ooded wi t h war m wat er .
Syr i nge mat er i al i s t aken di r ect l y f r om t emper i ng compar t ment and added t o pr epar ed
cavi t i es, f i r st at base of pr epar at i on and t hen t he t oot h i s cover ed.
The mat er i al used t o f i l l t he t r ay shoul d be cool er or t emper ed.
Gel at i on i s accel er at ed by ci r cul at i ng cool wat er , t hr ough t he t r ay f or 3 5 mi nut es.
I t i s post ul at ed t hat t he hydr aul i c pr essur e of t he vi scous t r ay mat er i al f or ces t he f l ui d
syr i nge hydr ocol l oi d i nt o t he ar ea t o be r est or ed.

Lami nat e t echni que
A r ecent modi f i cat i on t o t he t r adi t i onal agar pr ocedur e i s t he combi nat i on of agar and
al gi nat e i mpr essi on mat er i al s.
The t r ay hydr ocol l oi d i s r epl aced wi t h a mi x of chi l l ed al g i nat e, t hat bonds wi t h t he
syr i nge agar .
The al gi nat e gel s by chemi cal r eact i on, but agar gel s by means of cont act wi t h cool
al gi nat e r at her t han wat er ci r cul at i ng t hr ough t he t r ay

Advantages
Less pr epar at i on t i me and l ess compl i cat ed when compar ed t o t he wet f i el d t echni que.
Di sadvantages
Bond bet ween agar and al gi nat e i s not st r ong
Hi gh vi scosi t y al gi nat e di spl aces agar dur i ng seat i ng
Di mensi onal i naccur acy of al gi nat e l i mi t s t he use t o si ngl e uni t s.

Techni ques f or el ect romet ri c i mpressi on mat eri al s
1. Usi ng stock tray
Synonyms Put t y wash
Mi xi ng met hod doubl e mi x and si ngl e mi x

Advantages
El i mi nat es t i me and expense of f abr i cat i ng cust om t r ay
Met al st ock t r ays ar e r i gi d and ar e not suscept i bl e t o di st or t i on.
Di sadvantages
Mor e i mpr essi on mat er i al i s r equi r ed.
Must be st er i l i zed

Techni que
Sel ect a st ock t r ay and coat wi t h adhesi ve
Mi x hi gh vi scosi t y l put t y and r ol l i t i n t he shape of t he cyl i nder and l oad i t on t he t r ay,
gi ve a space whi ch i s a sheet of pol yet hyl ene and seat wi t h r ocki ng mot i on and wai t
t i l l t he i ni t i al set ( 2 mi nut es) and t hen r emove f r om t he mout h wi t h t he mi ni mal
si dewar d movement .
Gi ngi val r et r act i on done
Af t er l ubr i cat i ng t he O- r i ng of t he syr i nge, t he needed amount of t he l ow vi scosi t y
mat er i al i s mi xed on a pad and ei t her l oaded i n t he syr i nge by scr api ng or by maki ng a
paper cone and t hen f i l l i ng t he syr i nge.
Remove t he r et r act i on cor d gent l y and syr i nge i naccessi bl e ar eas f i r st ( e. g. ) di st o
l i ngual f i ni sh l i nes.
Now i nser t t he t r ay wi t h l ow vi scosi t y i mpr essi on mat er i al
Posi t i on t he t r ay over t he ar ch
Appl y f or ce i n a ver t i cal di r ect i on unt i l f ur t her seat i ng i s i mpossi bl e.
Af t er mat er i al i s set , i nser t t wo i ndex f i nger s under each si de of t he t r ay t o br eak t he
seal .
Remove t he t r ay i n t he di r ect i on par al l el t o t he pr epar at i on.
Eval uat e t he set i mpr essi ons.


Di f f erence bet ween si ngl e mi x and doubl e mi x t echni que
I n si ngl e mi x t echni que one vi scosi t y mat er i al ( r egul ar body) i s used t o f i l l t he t r ay and
l oad t he syr i nge.
I n doubl e mi x t echni que, t he l i ght body i s l oaded i n t he syr i nge and syr i nged ar ound
t he t oot h pr epar ed and heavy body i s mi xed and l oaded i n t he t r ay.

2. Usi ng cust om t ray
Procedure
Do t he gi ngi val r et r act i on and Pr epar e t he syr i nge
I n a mi xi ng pad mi x t he l ow vi scosi t y i mpr essi on mat er i al as per manuf act ur er s
i nst r uct i on. Fi r st use ci r cul ar mot i on combi ni ng t he t wo st r ands t hen a f i nger of ei ght
mot i on, obt ai ni ng a st r eak f r ee mi xt ur e i n a l ess t han 1 mi nut e.
Load t he syr i nge as wel l as t he t r ay.
Syr i nge t he mat er i al i n t he i naccessi bl e ar ea f i r st t hen subsequent l y r emovi ng t he
r et r act i on cor d gent l y and t hen syr i nge t he i mpr essi on mat er i al .
Now i nser t t he t r ay. Seal f r om post er i or t o ant er i or al l owi ng excess t o ext r ude i n an
ant er i or di r ect i on.
Cont i nue seat i ng i n a ver t i cal di r ect i on unt i l t he t r ays st ops pr event f ur t her pr ogr ess.
Af t er t he mat er i al i s compl et el y set , r emove t he i mpr essi on par al l el t o t he pr epar at i on
pat h.
Eval uat e t he i mpr essi on.

Closed bite double arch method
Al so cal l ed as Dual Quad t r ay, doubl e ar ch, t r i pl e ar ch and cl osed mout h
i mpr essi on.

Mi ni mum condi t i ons
Ei t her nat ur al t eet h or an i nci sal pi n and t abl e shoul d be pr ovi ded i n t he ar t i cul at or as
ver t i cal st ops.
Suf f i ci ent space di st al t o t he l ast t oot h shoul d be pr esent t o al l ow t r ay appr oxi mat i on.
I nt act dent i t i on, cl ass I occl usi on, bounded on ei t her si de by i nt act t eet h, opposi ng
t oot h havi ng i nt act occl usal cont act i s i deal .

Advantages
Physi cal def or mat i on of t he i mpr essi on by mandi bl e dur i ng openi ng i s mi ni mi zed.
Seat i ng of t eet h dur i ng maxi mum i nt er cuspat i on i s capt ur ed.
Less mat er i al i s needed and pat i ent i s mor e comf or t abl e.
Di sadvantages
Tr ay i s not r i gi d and i t depends on t he i mpr essi on mat er i al s r i gi di t y.
Not a f unct i onal l y gener at ed t echni que so l i mi t ed t o one cast i ng per quadr ant .


Types of dual arch t rays
Met al
Pl ast i c ( bot h wi t h or wi t hout si de wal l )

Dependi ng on t he l ocat i on
Post er i or / ant er i or sexant
Quadr ant
of an ar ch
Ful l ar ch

Techni que
Fi t of t he t r ay i s checked such t hat t he t r ay ext end di st al t o t he l ast t eet h of t he ar ch by
and t hen ask t he pat i ent t o cl ose, obser ve f or t he bi l at er al cl osur e and see t hat t he
pat i ent i s comf or t abl e.
Gi ngi val r et r act i on i s done.
Ready t he t r ay mat er i al and t he syr i nge mat er i al whi ch i s pl aced on t he t oot h af t er cor d
r emoval .
Tr ay pl aced i nsi de mout h whi l e obser vi ng t he di st al ext ent and sl owl y aski ng t he
pat i ent t o cl ose t he mout h.
Af t er wai t i ng f or t he set ( 2 mi nut es) , t he pat i ent i s asked t o open t he mout h, and t hen
t he t r ay adher es t o one ar ch. Af t er pl aci ng f i nger s on ei t her si de of t he t r ay i t i s
r emoved wi t h equal pr essur e bi l at er al l y t o mi ni mi ze t he di st or t i on of t he t r ay.
The handl e shoul d not be used f or r emoval of t he t r ay and t he mat er i al i s r emoved f r om
t he sul cus t he i mpr essi on i s t hen washed and t he r et r act i on cor ds i s r emoved and
checked.

Di f f erent t echni ques f or maki ng a dual arch i mpressi on
One step techni que
St ock t r ays ar e used, l i ght body i s i nj ect ed ar ound t he pr epar ed t oot h and put t y
or bi t e r egi st r at i on past e i s i nser t ed on bot h si des of t he t r ay and t he pat i ent i s asked
t o bi t e i n cent r i c occl usi on.

Dual arch hydraul i c pressure techni que
Low or medi um vi scosi t y i mpr essi on mat er i al i s i nj ect ed on t he pr epar ed and
pr eoper at i ve i mpr essi on of t he unpr epar ed t oot h. The t r ay i s pl aced and pat i ent i s
asked t o bi t e i n cent r i c occl usi on, t he hydr aul i c pr essur e cr eat ed, wi l l f or ce t he
mat er i al i nt o t he sul cus and t hr ough t he vent hol es cr eat ed i n t he buccal or t he l i ngual
si des of t he pr e- oper at i ve i mpr essi on.

Dual arch l ami nar i mpressi on techni que
A pr e- oper at i ve i mpr essi on i s made. The post oper at i ve i mpr essi on of t he t oot h
t o be pr epar ed i s r el i eved t o a dept h of 0. 5mm i n t he cer v i cal ar ea. Two hol es ar e
dr i l l ed f r om t he buccal sur f ace and one on t he mesi al and one of t he di st al .


Auto-mi x techni que
Sever al manuf act ur er s of t en suppl y i mpr essi on mat er i al i n pr e- package car t r i dges t o
whi ch a di sposabl e mi xi ng t i p i s at t ached.
The car t r i dge i s i nser t ed i n a caul ki ng- gun l i ke devi ce, and t he base and cat al yst ar e
ext r uded i nt o t he mi xi ng t i p, wher e mi xi ng occur s as t hey pr ogr ess t o t he end of t he
t ube.
The homogenousl y i ncor por at ed mat er i al can be di r ect l y pl aced on t he pr epar ed t oot h
and i mpr essi on t r ay.

Mat ri x i mpressi on syst em
Thi s i s a new syst em t hat r equi r es a ser i es of t hr ee i mpr essi on pr ocedur es
usi ng t hr ee t ypes and/ or vi scosi t i es of i mpr essi on mat er i al s.

St eps
A mat r i x of occl usal r egi st r at i on el ast omer i c mat er i al i s made over t he t oot h
pr epar at i on.
Mat r i x i s t r i mmed t o pr escr i bed di mensi on and r et r act i on cor d i s r emoved.
A def i ni t i ve i mpr essi on i s made i n mat r i x of t he pr epar at i on wi t h a l ow vi scosi t y
el ast omer i c i mpr essi on mat er i al .
Af t er t he mat r i x i mpr essi on i s seat ed, a st ock t r ay i s f i l l ed wi t h a medi um vi scosi t y
el ast omer i c i mpr essi on mat er i al i s seat ed over t he mat r i x and r emai ni ng t eet h t o
cr eat e an i mpr essi on of t he ent i r e ar ch.

Advantages
Thi s syst em ef f ect i vel y cont r ol s t he f our f or ces ( r el apsi ng, r et r act i on, di spl acement and
col l apsi ng) t hat i mpact on t he gi ngi va dur i ng t he cr i t i cal phase of maki ng i mpr essi on
when at t empt i ng t o r egi st er t he subgi ngi val mar gi ns.
The desi gn of t he mat r i x al so gent l y f or ces t he hi gh vi scosi t y i mpr essi on mat er i al s
al ong t he pr epar at i ons and i n t o t he sul cus wher e i t cl eanses t he sul cus of unwant ed
debr i s and f i l l s t he sul cus.
The hi gh vi scosi t y mat er i al gent l y ext ends i nt o t he sul cus and does not per mi t i t t o
col l apse as t he medi um vi scosi t y mat er i al i n t he st ock t r ay a seat ed f or t he pi ck up
i mpr essi on.
The mat r i x f aci l i t at es t he f or mat i on of t he opt i mum f l ange.
Tear i ng i s vi r t ual l y el i mi nat ed because of t he i mpr oved conf i gur at i on of t he sul cul ar
f l ange and by t he el i mi nat i on of voi ds or cont ami nant s i n t he sul cus.





Copper band impression
Fi tti ng copper band to preparati on
Sel ect a copper band of cor r ect di amet er by t r i al and er r or met hod. Def or m t he t ubes t o
semi el l i psoi dal cr oss sect i on and t r y i n.
Appr oxi mat e posi t i on of t he f i ni sh l i ne and mar k i t on t he band wi t h an expl or er and cur
wi t h a sci ssor s. Smoot hen t he r ough edges usi ng a car bor undom st one.
Eval uat e t he f i t of t he band such t hat i t ext ends 1mm beyond t he f i ni sh l i ne.
Or i ent at i on hol es ar e cut on t he t op one f i f t h of f aci al sur f ace of t he t ube.

Make compound pl ug
Fi nger s ar e cover ed wi t h pet r ol act um j el l y
A war m r ed st i ck compound i s i nser t ed i n t he t op one t hi r d of t he copper t ube. The
compound shoul d t ouch t he occl usal sur f ace. I t i s t hen cool ed and r emoved by
Bachi ns t owel cl amp by gr aspi ng t op one f i f t h of t he copper band.
Excess i s r el i eved by cut t i ng wi t h a no. 6 or no. 8 r ound bur and under sl ow speed and
by f r equent l y r emovi ng debr i s. 0. 2mm of compound i s r emoved f r om t he i mpr essed
occl usal sur f ace. Thi s cr eat es a space f or t he heavy body pol yvi nyl si l oxane.


Maki ng an i mpressi on
Coat t he i nner sur f ace wi t h adhesi ve
Mi x heavy body pol yvi nyl si l oxane
Load i t i n t he copper band
Posi t i on t he f i nger and on t he t op of band, or i ent and seat cust omi zed copper b and
St abi l i ze t he band
Wai t t i l l t he f i nal set . Usi ng t owel cl i p r emove t he band eval uat e t he i mpr essi on and
f ol l owed t he or i ent at i on i mpr essi on.

Speci al consi derat i ons
Pi n retai ned restorati ons
El ast omer i c i mpr essi on mat er i al s ar e st r ong enough t o be used i n t hese
si t uat i ons but shoul d be i nt r oduced wi t h
Cement t ube or Lent ul o spi r al t o avoi d any bubbl es
Speci al nyl on br i st l es or Pr ef abr i cat ed pl ast i c pi nscan be put i n t he pi n hol e and t he
i mpr essi on i s made

Post and cores
Thi s pr ocedur e i nvol ves r ei nf or ci ng t he i mpr essi on wi t h a pl ast i c pi n or sui t abl e
wi r e ( e. g. or t hodont i c wi r e) el ast omer i c i mpr essi on mat er i al s can be used.

I mpressi on t echni que wi t h t he use of pref ormed crown shel l s
Sel ect pr ef or med cr owns ( pol ycar bonat e) adj ust t he gi ngi val mar gi n sl i ght l y api cal t o
f i ni sh l i ne.
Adhesi ve appl i ed t o i nner si de
Regul ar body i s l oaded
Then seat ed pr oper l y
Wai t t i l l i t set s and r emove
Then f ul l ar ch pi ck up i mpr essi on made
I mpressi on procedure f or a subgi ngi val l y prepared shoul der margi n
An i ndi vi dual t r ay i s pr epar ed di r ect l y wi t h acr yl i c, whi ch shoul d not cover t he shoul der
mar gi n. Gi ngi val r et r act i on done.
The t r ay i s r ebased wi t h f l ui d r esi n and some pl aced on t he t eet h and pr essed t i l l
cont act i s f el t wai t t i l l t he acr yl i c becomes har d.
An out l i ne i s mar ked and excess i s r emoved. Space i s cr eat ed f or t he i mpr essi on
mat er i al s except t he shoul der mar gi n ar ea.
An adhesi ve i s t hen appl i ed and t he t r ay f i l l ed wi t h el ast omer . Thi s i mpr essi on i s t hen
pi cked up wi t h el ast omer or hydr ocol l oi d i n a st ock t r ay.

Impressions for CAD/CAM procedures
Pr epar ed t oot h
+
Appl y r ubber dam
+
I magi ng powder + l i qui d i s coat ed on t he pr epar ed ar ea f or phot o r ecept i vi t y
+
Symmet r i cal opt i c beam i s passed
+
3D pi ct ur e i s pr oduced on a comput er f or mi l l i ng pr ocedur e

Thi s t echni que i s most l y advocat ed f or t he CEREC I I syst em.
Eval uat i on of i mpressi on
Upon r emoval t he i mpr essi on must be i nspect ed f or accur acy.
Bubbl es or voi ds i n t he mar gi n necessi t at e di scar di ng t he i mpr essi on and st ar t i ng over .
An i nt act uni nt er r upt ed cuf f of i mpr essi on mat er i al shoul d be pr esent beyond ever y
mar gi n.
St r eaks of base and cat al yst mat er i al i ndi cat e i mpr oper mi xi ng and may r ender an
i mpr essi on usel ess.
I mmedi at el y af t er r emoval f r om t he mout h i mpr essi on i s r i nsed under t ap wat er and
dr i ed wi t h an ai r syr i nge.
Di si nf ect i on i s an essent i al st ep f or pr event i on of cr oss i nf ect i on and exposur e of
l abor at or y per sonnel .
I mpressi on mat eri al Recommended di si nfecti on procedures
1. Reversi bl e hydrocol l oi d
2. I rreversi bl e hydrocol l oi d
3. Pol ysul f i de
4. Addi t i on si l i cone
5. Condensat i on si l i cone
6. Pol yet her
Di l ut ed bl each, I odophor spray
Di l ut ed bl each, I odophor spray
I mmersi on i n i odophor or 2% gl ut aral dehyde
I mmersi on i n 2% gl ut ar al dehyde or hypochl ori de
sol ut i on
I mmersi on i n 2% gl ut aral dehyde or hypochl ori t e
sol ut i on
I odophor spray or chl or i de di oxi de

Done pr oper l y i t has no cl i ni cal l y si gni f i cant ef f ect s on t he accur acy or sur f ace
r epr oduct i on of t he el ast omer s.


Conclusion
Devan states that the impression should be in the dentists mind before it is in his hand. Based on
this statement I conclude the use of impression material and technique should be purely the dentists
choice.





REFERENCES:



1. Restorative Dental materials:G Craig & John M Powers-11th
edition2002, pg 329-378
2. Phillips science of dental materials:11th edition
3. GPT Academy of prosthodontics JPD,july 2005 vol 94
4. Tylmans Theory and Practice Of Fixed Prosthodontics,
8
th
edition, pg 237-254.
5. Fundamentals Of Fixed Prosthodontics by Herbert T.
Shillingburg, 3
rd
edition, pg 281
6. Contemporary Fixed Prosthodontics, by Rosenstiel, 4
th
edition,
pg452- 462.
7. Notes on dental materials by E.C. Combe, 6
th
edition,pg 115- 126.


IMPRESSION MATERIALS FOR COMPLETE DENTURES

REVIEW OF IMPRESSION MATERIALS FOR COMPLETE DENTURES.


DEFINITION
A negative imprint of an oral structure used to produce a positive
replica of the structure to be used as a permanent record or in the
production of a dental restoration or prosthesis.


DESIRABLE PROPERTIES OF IMPRESSION MATERIALS.

A. COMPATIBILITY WITH PATIENT: -
1.Pleasant odor.
2.Pleasant taste.
3.Non-toxic.
4.Non-irritant.
5.Decreased setting time.
6.Esthetic color.

B. EASE OF MANIPULATION: -
1. Minimum equipment.
2. Consistency & Satisfactory texture.
3. Adequate flow property.
4. Readily wets oral tissues.
5. Clinically satisfactory setting characteristics & time.
6. Dimensional accuracy: Should have elastic properties with freedom from permanent
deformation after strain.

7. Adequate mechanical strength to resist tearing.


C. STORAGE:-
1.Unused materials should have adequate shelf life
for requirements of storage & distribution.
2.Used/set impression should be dimensionally stable over clinical
& lab procedures for a period long enough to permit production of
cast/die.

D. Impression materials should be economically commensurate with
the results obtained.

E. They should be readily disinfected without loss of accuracy.


CLASSIFICATION OF IMPRESSION MATERIALS:-
Impression materials can be classified into various types based on the following characters:
1. Based on rigidity/elasticity: -
a. Rigid (non-elastic).
b. Elastic.

2. Based on viscosity: -
a. Mucostatic.
b. Mucocompressive.
c. Pseudoplastic.

3. Based on setting of material: -
1. a. chemical reaction.
b. Physical change of state.
2. a. reversible.
b. Irreversible.

4.Based on interaction with saliva/water: -
1. Hydrophobic.
2. Hydrophilic.

5.Based on chemistry:-
1. Impression Plaster.
2. Impression compound.
3. Metal oxide (zinc oxide eugenol).
4. Reversible hydrocolloid.
5. Irreversible hydrocolloid.
6. Poly sulfides.
7. Condensation silicones.
8. Addition silicones.
9. Polyether.
10. Visible light curing polyether urethane dimethacrylate.

6.Based on use: -
1. Primary impression materials.
2. Secondary impression materials.
3. Duplicating materials.


HISORICAL REVEW OF COMPLETE DENTURE IMPRESSION MATERIALS

1756 Bees wax was the first material to be used for the purpose
of impression making.
1840 Charles De Loude gave the first references to impression trays.
1842 Montgomery discovered Gutta Percha.
1847 Desirabode gave references to an impression tray.
1848 Gutta percha was introduced as an impression material.
High working temperature and stiffness made it difficult to
achieve satisfactory results.
1844 Plaster of paris was used for the first time as an
impression material.
1862 Franklin first corrected impression, followed by a plaster
wash.
Until the early 1900s wax or plaster used directly.
1857 Modeling plastics were developed by Charles Stens.
1874 modeling plastics developed by S.S.White.
1900 Green brothers introduced a method for manipulating
modeling plastics.
First to use term posterior damin describing posterior palatal seal.
S.G.Supplee introduced the hot water heater for modeling plastics.
1915 Rupert Hall perfected the first moderate heat modeling plastic
for making individual impression trays.
1925 Poller introduced Agar for impressions.
Late 1920s first functional waxes were developed. Waxes used before
this time were paraffin and bees wax .
1930 Ward and Kelly first use ZOE for impressions.
1939Trapozzano introduced an early technique for using ZOE.
1936 Alginate3 impression material introduced.
1940 Alginate impression material used first time for corrective
wash procedures.
1938 mucostatics PASCAL's law tissue under a mucostatic
impressions theory developed.
1950 Elastomeric impression materials were introduced.
1955 Pearson reported on polysulfide base materials for use as an
impression for inlays, crowns &FPDs.



IMPRESSION PLASTER
ADA specification no 25.

Composition:-
1.Calcined calcium sulfate hemihydrate.
2.Anti-Expansion agents. - Potassium Sulphate was added which had a
tendency to decrease working time.
3.Accelerators accelerators that were added were
Potassium Sulphate.
Potassium chloride.
4.Retarders.
5.Colloidal materials/Gelatin.
6.Gum Tragacanth.
7.Pigments.


Uses:
1.Primary impression material.
2.Secondary/corrective impression material.

Water-powder ratio:-
1.60 ml of water for 100 gm of plaster. Fluidity is required for recording finer details.
2.
If water-powder ratio is increased, then the following characters were affected.
a. It had a thin consistency.
b. Setting time was increased.
c. Strength was decreased.

Mixing time:- 60 seconds.

Strength: -
Impression plaster had less compressive strength and tensile
strength and is considered to be a very brittle material.
Accuracy: -
Very accurate. It is hydrophilic and has intimate contact with oral
tissues by absorbing surface moisture. Plaster undergoes minimal
dimensional change on setting.

IMPRESSION PLASTER - PRODUCTION
These materials are the result of calcining of calcium
Sulphate Dihydrate or gypsum. Depending on the method of calcination
different forms of hemihydrates can be obtained. Commercially gypsum is
ground and subjected to temperatures of 110-120 degrees to drive off part
of the water of crystallization. This corresponds to the first stage of the
equation. As the temperature is further raised, the remaining water of
crystallization is driven off and products are obtained.

The principal constituent of dental plaster or stone is Calcium
Sulphate Hemihydrate. The difference between the two forms is mainly
between the crystal size, surface area & degree of lattice perfection.

Caso4.2H2OCaso4.1/2H2OCaso4





SETTING OF GYPSUM PRODUCTS:
Calcination Of Calcium Sulphate Dihydrate Forms Calcium Sulphate
Hemihydrate
(Caso4).1/2H2O+3H20 ---------> 2caso4.2H20+Heat
The product of the reaction is gypsum and the heat evolved in the
exothermic reaction is equivalent to the heat used originally in
calcination.

When hemihydrate is mixed with water, a suspension is formed that is fluid and
workable. Hemihydrate dissolves in it until it forms a saturated solution. This saturated
hemihydrate solution is supersaturated with dihydrate, so the later precipitates out. As the
dihydrate precipitates, the solution is no longer saturated with hemihydrate and so it
continues to dissolve. The reaction is continuous and proceeds until no further dihydrate
precipitates out of solution.

ADVANTAGES: -
1.Good detail reproduction.
2.Inexpensive.
3.Easy to handle.
4.Viscosity can be altered by minor alterations of w/p ratio.
5.Non-toxic.
6.If stored airtight-increased shelf life.
7.Decreased dimensional change on setting.
8.Setting time can be precisely controlled by use of additives.

DISADVANTAGES:-
Requires separating medium for pouring and removing casts. (Varnish,
water glass solution).
Dry sensation in patients mouth because it absorbs moisture.


IMPRESSION COMPOUND
ADA specification no 3
Type I: low fusing.
Type II: high fusing, more viscous when soft & more rigid when hard.

COMPOSITION:-
Compounds are composed of a mixture of waxes, thermoplastic resins, filler, and a
coloring agent. One of the first substances used, as an impression material was bees wax.
Because such waxes were brittle, substances such as shellac, Stearic acid and gutta percha
are added to improve plasticity and workability.

Rosin: 30 parts. -Thermoplastic material
Copal resin: 30 parts.
Carnauba wax: 10 parts.
Stearic acid: 5 parts.-increase plasticity.
Talc/soap stone/wax: 15 parts. -Decrease flow; increase strength.
Coloring agents: appropriate amount.

USES:-
Type-1 -Primary impression, peripheral tracing &tube impression of single tooth with copper band.
Type-2 -As a tray to support other materials.



MANIPULATION:-
The compound can be softened with either dry heat or oven or in a water bath. Care should
be taken when compound is softened with dry heat. The compound should not be over heated
since this causes volatility of its constituents. The compound is broken into small pieces. This
aids in faster and uniform heating and also a uniform mix. If large amount of compound is
heated, it is difficult to heat the compound uniformly. The compound is heated in a water bath
with the help of a gauze piece. After the mass is removed from the water bath, it is kneaded.
This gives a uniform plasticity to the mass. Prolonged immersion into water has to be avoided
since this causes leaching out of low molecular weight ingredients.


FUSION TEMPERATURE: -
1. Approximately 43.5 centigrade.
2. Fusion temperature indicates a definite reduction in plasticity on cooling. 3.Above these
temperatures, fatty acids become liquids and plasticised material softens.



THERMAL CONDUCTIVITY:-
The thermal conductivity is low. Hence has to be thoroughly cooled
before removal.
Average linear contraction of compound on cooling from mouth
temperature to room temperature of 25 degrees is 0.3 0.4 percent.
This magnitude of contraction is unavoidable.

FLOW: -
After the compound has softened, and during the period it is impressed against the tissues, the
material should flow easily to confirm to the tissues so that every detail and landmark are recorded
accurately. On the other hand, if the amount of flow at mouth temperature is too great, distortion can
occur.

For type 1:flow at mouth temperature is 6%. When placed against tissues
it is 65%.
For type 2:flow at mouth temperature is 2%. When placed against tissues
it is 85%.
If the material is older it is uncomfortable for the patient.

ADA Specifications:-
1. The material should be homogenous.
2. It should have a smooth & glossy appearance on flaming.
3. When trimmed with sharp knife at room temperature margin should be firm & smooth.


GLASS TRANSITION TEMPERATURE.
The non-crystalline solids do not have a definite melting temperature but rather they
gradually soften as the temperature is raised & gradually soften as they are cooled. The
structural arrangement of non-crystalline solids does not give a particular melting point to the
compound. They gradually soften as the temperature is raised and gradually harden as the
temperature is lowered. The temperature at which they form a rigid mass is called the glass
transition temperature.

The temperature at which there is as abrupt increase in the thermal expansion
coefficient is an indication of formation of short range & is called the glass transition
temperature. The glass transition temperature of the compound is 39 degrees or 107
Fahrenheit.


ADVANTAGES:-
1. Non-toxic.
2. Hardens in reasonably acceptable time.
3. Compatible with gypsum products.
4. No separating medium required.
5. Adequate shelf life.

DISADVANTAGES:-
1. Although plastic not fluid enough to record fine detail.
2. Distorts over undercuts.
3. Considerable shrinkage on cooling.
4. Dimensional change on storage.





LOW FUSING COMPOUND
They are used to carry the impression material to the depth of the
vestibule.

MODELLING COMPOUND:-
Introduced by Green brothers.
Compound softens easily but remains quite hard at mouth temperature.
The areas of periphery can be border molded with least possibility of
distortion or breakage.
Very useful for the making of final impressions& when boxing & pouring
the cast.

DIFFERENT TYPES :-
1.BROWN (highest working temperature)
Stronger at room temperature.
Suitable for extending short borders on the custom tray.
Cake form is used for preliminary impressions.

2.GREEN(lowest working temperature)
It has easy flow & good handling properties.
It is the most popular type.

3.GRAY:-
Average working temperature.
Long period of flow.
Little brittle.

GENERAL CONSIDERATIONS.
1.Modelling compound sticks require relatively high working temperature.
2.Great care must be taken not to burn the patient.
3.Working time is limited.
4.The fear of harming the patient and delay in seating the tray may lower
the temperature of the material and result in over extended borders.




METALLIC OXIDE PASTES.
ADA specification no.-16
Type-1 (hard)
Type-2 (soft)

USES:-
1.Impression paste.
2.Cement.
3.Temporary filling.
4.Root canal filling.
5.Bite registration paste.
6.Temporary reline material.
7.Surgical dressing.

AVAILABILITY:-
1.Two pastes/tubes: zinc oxide (active ingredient) & eugenol+ rosin.
2.Powder (ZnO+rosin) & liquid eugenol.

COMPOSITION:-
Tube-1:
1.ZnO (French processed or u.s.p) : 87%
2.Fixed vegetable oil olive oil/linseed oil: 13%
3.Plasticiser acts as the vehicle and forms paste. It also helps to
masks irritation effect of eugenol.
Tube-2:
1. oil of cloves (75%-85% eugenol): 12%
2. Gum/polymerised
rosin: 50%. 3.Filler(silica/talc/diatomaceous
earth): 20%.
4. Kaolin: 3%.
5. Resinous balsam (Canada balsam): 10%.
6. Accelerator solution & color: 5%.
7. Retarders Glycerin & petrolatum.




SETTING REACTION: -
Setting reaction consists of zinc oxide hydrolysis and a subsequent
reaction between zinc hydroxide and eugenol to form a chelate. Water is
needed to initiate the reaction and it is also the by-product of the
reaction. Hence the reaction is called as an autocatalytic reaction. Hence
the reaction occurs more rapidly in humid environment. The setting
reaction is accelerated by the presence of zinc acetate dihydrate, which
can supply zinc ions more readily. Acetic acid is a more active catalyst for
the reaction. High atmospheric temperatures also accelerate the setting
reaction.


MIXING: -
The mixing of the two pastes is generally accomplished on an oil
impervious paper. Two strips of the same length are taken from the two
tubes and a flexible stainless steel spatula is used for mixing. The pastes
are mixed for about a minute till a uniform color is obtained.

SETTING TIME: -
It should take place within 10 minutes for type 1 paste and within 15 minutes for type 2
pastes.

MIXING TIME: -1 min /30-40 seconds.
Final set is said to have occurred when metal rod of Krebs
penetrometer fails to penetrate more than 0.2mm under 50gm/load.

Control of setting time:-
1.Setting time decreases with increase in temperature, humidity &
addition of
accelerators.
2.Setting time increases
with addition of retarders.

CONSISTENCY & FLOW:
Material should be
1. Homogenous.
2. Flow uniformly.
3. Mucostatic.
4. Flow related to setting time.

DIMENSIONAL STABILITY: -

The dimensional stability of impression pastes is quite satisfactory.
A negligible shrinkage (<0.1%) may occur during hardening. Impressions
can be preserved indefinitely without change in shape.

REMOVAL OF SET MATERIAL FROM GLASS SLAB/SPATULA.
1.Solvents such as Naphtha and oil of orange can be used.
2. The instrument can be heated and the material can be wiped off.



SURGICAL PASTES:
1.they are less brittle.
2.material is weaker after hardening.
3.it takes a longer time for setting.
4.it should be capable of being formed into a rope for dressing.
5.material contains more eugenol.

ADVANTAGES:-
1. Adheres well to tray.
2. It is sufficiently fluid to record fine details of tissues.
3. Does not undergo any dimensional change during setting process.
4. Has adequate working time & setting time.
5. Sufficient resistance.
6. It is compatible with gypsum products.
7. No separating medium required for gypsum products.
8. It has a satisfactory shelf life.
9. It is Non-toxic.


DISADVANTAGES:-
1. Burning/tingling sensation of eugenol is a major disadvantage.
2. Persistent taste of eugenol added disadvantage.
3. As it adheres to tissues, lips should be coated with petrolatum jelly.




NON EUGENOL PASTES: -
One of the chief disadvantages of zinc oxide eugenol pastes is the possible stinging or
burning sensation caused by eugenol when it contacts soft tissues. Moreover ZoE reaction is
never completed with the result that the eugenol may leach out. Some patients find the taste of
eugenol extremely disagreeable, and in patients who wear surgical pastes for a long time may
develop gastric disturbances.

If zinc oxide reacts with carboxylic acid, the reaction is
ZnO+2RCOOH(RCOO)2Zn+H2O
Most commonly used carboxylic acid is ortho ethoxy benzoic acid.
It is not greatly affected by temperature or humidity.
Bactericides and other medicaments can be incorporated without
interfering with the reaction.









ALGINATE(Irreversible Hydrocolloid)
ADA specification no.-18

DEFINITONS OF COLLOID:-
1. Colloid represents a soluble particle distribution quantitatively similar to
Molecular liquid in the solvent.
2. A material in which is suspended a constituent in a finely divided state.
3. A colloid system in which water is the dispersion medium; those
materials described as colloid sols in water.


HYDROCOLLOID is a material consisting of a sol of alginic acid having a physical state
that is changed by an irreversible chemical reaction forming insoluble calcium alginate.



COMPOSITION:-
1. ALGINIC ACID: 15%
2. SOLUBLE SALTS: -Na/k/ammonium salts- 18%.
3. Calcium sulfate dihydrate- (reactor)- 14%.
4. Potassium sulfate/Potassium titanium fluoride/
Silicates/ Borates- 10%.
5. Na/K Oxalates/Carbonates- 2%.
6. Diatomaceous earth-ZnO/Silicate powder-FILLER- 56%.
7. GLYCOLS/DIHYDRIC ALCOHOL- small %.
8. WINTER GREEN/PEPPERMINT- small %.
9. PIGMENTS.
10.REACTION INDICATOR.

The chief ingredient of irreversible hydrocolloid is one of the soluble alginates such as
sodium, potassium, or triethanolamine alginates.

CHEMISTRY OF HYDROCOLLOID:-
Colloid state represents the highly dispersed system of fine particles of one phase in
another. The colloidal state of system has dispersed and dispersion phase. If this has water as
the dispersion phase it is called as a HYDROCOLLOID.

In alginate the dispersion phase is water and the dispersed phase is alginic acid. The
molecular weight of alginic acid is greater than that of water, hence it does not dissolve in
water and forms a gel. If the concentration of dispersed phase in the hydrocolloid is of the
proper amount, sol changes into gel when temperature is decreased. The temperature at which
this change occurs is called as the GELATIONTEMPERATURE and is in the range of 18-20
degrees. The fibrils of the gel are formed chemically by primary bonds. Hence these are not
affected by temperature changes. They can be returned to the sol state by reversal of the
reaction and not by heat. Hence these materials are called as irreversible hydrocolloid.


GELATION PROCESS: -
Soluble alginate + CaSo4 Insoluble Ca alginate.

The typical sol-gel reaction can be described as a reaction of soluble
alginate with calcium Sulphate and the formation of insoluble calcium
alginate gel. Calcium Sulphate reacts rapidly to produce the insoluble
calcium alginate from the potassium or sodium alginate in an aqueous
solution. The production of calcium alginate is so rapid that it does not
allow sufficient working time. Thus, a third water-soluble salt, such as
trisodium phosphate, is added to the solution to prolong working time.
Calcium sulphate reacts with this in preference to soluble alginate &
hence increases the working time. Thus, the reaction between the
calcium Sulphate and the soluble alginate is prevented as long as there is
unreacted trisodium phosphate. When the supply of trisodium phosphate
is exhausted, the calcium ions begin to react with the potassium alginate
to produce calcium alginate.

Insoluble alginate reacts with Ca Sulphate & forms
insoluble calcium alginate gel in the aqueous medium.
2Na3PO4 +3Caso4 -> Ca3 (Po4) 2+3Na2So4

GEL STRUCTURE: -
1.Sodium Or Potassium alginate is formed. The cation is attached to the carboxyl group.

2 .when the insoluble salt formed by the reaction of the sodium alginate in solution reacts with
the calcium salt, calcium ions may replace the sodium ions in two adjacent molecules to
produce cross-linking between them.

3. As the reaction progresses, cross-linking becomes more extensive and a complex polymer
network is formed. This constitutes the brush heap structure of the gel.

GEL STRENGTH: -
1.Stiffness and strength of the gel are directly related to the brush heap structure.
2.Greater the concentration of the dispersed phase, greater will be the fibrils formed on gelation.
3.Temperature also affects the gel strength of the material in the case of reversible hydrocolloid.
But temperature does not show any effect on irreversible hydrocolloid.
4.Lower the temperature, stronger the gel.
5.Gel strength also depends on the presence of modifiers such as fillers and other chemicals.
6.The gel strength of alginate is 343 Mpa.
7.The type and amount of alginate used also influence the strength.
8.Manipulative factors that affect the strength are
1.too much or too little water affect the strength.
2.insufficient spatulation.
3.overspatulation.

MIXING TIME: -
Type-1 (fast) 45 seconds.
Type-2(slow) 4 minutes.

SPATULATION: -
The measured powder is sifted into premeasured water that has
been placed in a clean rubber bowl. Powder is incorporated into the water
by careful mixing with a metal spatula. Care should be taken to prevent
whipping air into the mix. A vigorous figure- eight motion is best, with
the mix being swiped or stropped against the sides of the rubber-mixing
bowl with intermittent rotations (180 degrees). Mixing time of 45seconds
to 1 minute is generally sufficient. A smooth creamy mix should be
obtained.

Clean equipment is important because many of the problems and related failures are
attributed to dirty contaminated mixing or handling devices. The bowl should be free of any
previous mix of plaster or alginate.

WORKING TIME: -
Type-1: 1.5-2 minutes.
Type-2: 3-4 minutes.

45 secs of mixing time + 30-75secs working time acc.to
ADA sp.No. 18 not <1.5min. 60 secs mixing time + 2-3.5 minutes
working timeaccording to ADA sp.no.18 not < 2 min.

CONTROL OF GELATION TIME: -
1. Altering water: powder ratio.
2. Alteration of temperature of water.

STRENGTH: -
1. Maximum gel strength is required to prevent fracture and to ensure
recovery of the impression on its removal from the mouth. All
manipulative factors that are under the control of the clinician affect
gel strength.
2. Manipulative factors that are under the control of the clinician are:
a. Proper water: powder ratio.
b. Insufficient spatulation.
c. Over mixing.

VISCOELASTICITY: -
Hydrocolloids are strain rate dependent. Thus the tear strength is
increased when the impression is removed with a snap. Usually an
alginate impression does not stick to the oral tissues as strongly as some
of the non-aqueous elastomers, so it is easier to remove alginate
impressions rapidly. It is always best to avoid torquing/tearing the
impression.

ACCURACY: -
Most alginate impressions are not capable of reproducing the finer
details that are observed in impressions with other Elastomeric
impression materials. Increase in alginic acid results in increased
roughness & does not improve dimensional stability. The roughness of the
impression material is sufficient to distortion at the margins of prepared
teeth. Surfactants can be added to produce a smooth surface, but the
addition of a layer of solutin also obscures the accuracy.

DIMEMSIONAL STABILITY: -
1. Dimensional stability is very poor.
2 .If exposed to air at room temperature, shrinkage occurs due to
processes such as syneresis and evaporation.
3 .If immersed in water, imbibition of water takes place.
4. 2% potassium sulphate or 100% relative humidity are suggested to solve
the problem.
5. Exertion of pressure during gelation process results in the production of internal
stresses. Relaxation of such internal stresses also results in syneresis & dimensional
changes.
6.Thermal changes also contribute to thermal changes because of changes in room and mouth
temperature.


GENERAL CONSIDERATIONS:
1.RETENTION OF MATERIAL TO TRAY:
Perforated trays or tray adhesive like molten sticky wax.

2.OPTIMUM BULK/THICKNESS OF MATERIAL:
3-6 mm to reduce the chance of tearing.

3.TRAY EXTENSION / BORDERS:
Refined trays.

4.Less material is loaded posteriorly,patient upright/leaning forward to
prevent posterior flow of material & minimize gagging.
5.Loaded material smoothened with moist finger.
6.REMOVAL: - Break peripheral seal with tissues; then single firm rapid
movement to avoid tearing.
7.Chance for permanent deformation under 10%.
8.Compressive strength 3500 gm/Sq .cm.
9.Tearing strength 300-700 gm/cm.

COMPATIBILITY WITH GYPSUM PROCUCTS: -
The surface of a gypsum cast obtained from the hydrocolloid impression
material may sometimes be too soft for waxing procedures. To avoid this,
1.Impression is immersed in a solution containing an accelerator for setting of gypsum products.
2. By incorporating a plaster hardener or accelerator in the material by the manufacturer.
3. The surface of the impression should not be dried completely.
a. This causes the gel to adhere to the cast on its removal.
b. Many commercially available products give a satisfactory surface for the stone cast without
using any hardeners.
c. After the impression is removed from the mouth it is rinsed under water to remove oral fluids
from the surface.
d. Surface of the impression should be shiny but there should not be any visible moisture.
e. Pouring of the cast should be done from one end to the other of the impression.
f. The stone should be kept in contact with the impression for a minimum of 30 minutes & a
maximum of 60 minutes.
g. If the cast is allowed to remain in contact with the impression overnight, a chalky stone surface
may be produced.



FAILURES: -
1. GRAINY: -
a. Improper mixing.
b. Prolonged mixing.
c. Under gelation.
d. W: P ratio too low.

2. TEARING: -
a. Inadequate bulk.
b. Moisture contamination.
c. Premature removal.
d. Severe undercuts.
e. Thin mix.
f. Slow removal.

3.BUBBLES: -
a. Air incorporation during mixing.
b. Undue gelation preventing flow.

4. ROUGH/CHALKY STONE CAST: -
a. Inadequate cleaning of impression.
b. Excess water left in the impression.
c. Premature removal of cast.
d. Cast left too long.
e. Improper manipulation of stone.

5. DISTORTION: -
a. Impression not poured immediately.
b. Movement of tray during gelation.
c. Premature removal from mouth.
d. Improper removal from mouth.
e. Tray held in mouth for too long.

6.DECREASED WORKING TIME/ SETTING TIME: -
a. Non homogenous mix.
b. Temperature.
c. Contamination- set plaster left in the mixing bowl.

ADVANTAGES: -
1. Non-toxic, non-irritant.
2. No special equipment required.
3. Acceptable odor, taste.
4. Sufficiently elastic to be used in undercut area.
5. Sufficiently fluid to record fine detail.
6. Compatible with gypsum products/no-separating medium required.


DISADVANTAGES: -
1. Dimensionally unstable.
2. Tears if undercuts are severe.
3. Difficult to sterilize.
4. Poor shelf life if stored.


ELASTOMERIC IMPRESSION MATERIALS

INTRODUCTION TO ELASTOMERS: -

These materials are classified as synthetic rubbers but mimic natural rubber. Hence they are
called as rubber base materials or rubber base impression materials or elastomers or
Elastomeric impression materials.
1. Due to the elastic properties, they are called as elastomers.
2. These materials consist of large molecules or polymers that are joined by small amount of cross-
linking.
3. The amount of cross-linking determines the stiffness and the elastic behavior of the material.
4. The first synthetic rubber materials were developed by the process of vulcanization.
5. Setting of these materials occurs through a combination of chain lengthening polymerization or
cross-linking or either condensation or addition reactions.


HANDLING: -
The working time of an acceptable material must exceed the time required for mixing and
loading the syringe and the tray.
1. The material distorts soon after removal from the mouth.
2. If the material is not adequately set, the material will not have sufficient elastic properties to
respond to the strain that occurs when removing it from the mouth.
3. The setting reaction converts them into a visco-elastic solid.
4. The flow behavior of the material is important to obtain an accurate impression.
5. The ideal impression material accurately records the oral structures, releases from the mouth
undistorted.
6. The impression material should be removed from the mouth rapidly.
7.while removing the impression, the seal has to be broken and remove the impression rapidly.
8. Loss of reaction by products and the imposed loads of stone or plastic used to make cast results
in the distortion of the impression.


DESIRABLE PROPERTIES OF IMPRESSION MATERIALS.
1.should have an infinite shelf life.
2. Be non-toxic.
3. Should have acceptable odor, taste & color.
4. Should have suitable working & setting times.
5.should have strength to resist tearing.
6. Should be compatible with model & die materials.
7. Should be inexpensive.
8. Should be easy to clean up.
9. Should be easy to dispense, proportion& mix.
10. Permit multiple die pours.
11. Facilitate visualization of the finish line.
12. Facilitate the clinical identification of beginning and end of cure.
13. Completely plastic before cure.
14. Sufficient fluidity to record final detail.
15. The ability to wet oral tissues.
16. Dimensional stability.
17. Complete elasticity after cure.
18. Optimal stiffness.

SOLOMON E G R 1973 used silicone material for complete denture
impression a high viscosity material for border molding and low
viscosity material for secondary impression. He concluded that silicone
impression material was preferable to conventional low fusing impression
compound.


POLYSULFIDES

COMPOSITION: -
Base paste: -
1. Polysulfide polymer: - 80-85%
2. Filler: - Lithopone/Titanium dioxide: 16-18% - for strength.
3. Plasticizer- Di-n-Butyl phthalate- for appropriate viscosity.
4. Sulfur- 0.5% - to enhance reaction.

Reactor paste: -
1.Cross-linking agent.
a. Lead oxide.
b. Organic hydro peroxides-T-Butyl hydro peroxides.
c. Inorganic hydroxides-Hydrated copper hydroxide.
2.Inert oil or Plasticizer.
3.Filler.
4.Oleic/Stearic acid.

CHEMISTRY
The basic ingredient of polymer paste is polyfunctional mercaptan or
polysulfide polymer. This polymer contains approximately 1 mol% of
branches to provide enough pendant mercaptan groups as chain cross-
linking sites. This polymer s usually cross-linked with an oxidizing agent
such as lead dioxide. During the condensation reaction of the lead dioxide
with the polysulfide polymer two reactions take place. They are
1. Chain lengthening polymerization and
2. Cross linking reaction.

Because the pendant group comprises only a small percentage of
available SH groups, initially, the reaction results in chain lengthening,
which causes viscosity to increase. The subsequent cross-linking
reactions tie the chains together, forming a three dimensional network.

Curing reaction starts at the beginning of mixing and reaches its
maximum after spatulation is complete, at which stage a resilient
network has started to build. This gives adequate elasticity and strength
to be removed over undercuts readily. The polymerization reaction is
exothermic. Hot, humid conditions accelerate the setting reactions.

MANIPULATION: -
With the proper length of the two pastes squeezed on to a glass slab
or a mixing pad, the catalyst paste is first collected on a stainless steel
spatula and then distributed over the base paste and the mixture is spread
over the mixing pad. This procedure is continued till the mix is of
uniform color with no streaks of the base or the catalyst paste appearing
in the mixture. If mix is not homogenous, curing will not be uniform.

MIXING TIME: 45 seconds 4 minutes.

SETTING TIME: 8 minutes.

WORKING TIME: 5-7 minutes.

WORKING AND SETTING TIMES: -
1. Measured by oscillating rheometer.
2. Increase in temperature decreases both working & setting times.
3. Cooling the material is a practical method of increasing the working time & when the material is
carried to the mouth, setting time is decreased by higher oral temperature.
4. Adding a drop of water accelerates curing time.


ELASTICITY: -
Elastic properties of these materials improve with curing time.
Longer the impression can remain in the mouth before removal, greater
the accuracy. The impression material must undergo some distortion as it
is removed from the mouth, but the elastic properties of the impression
material help minimize this distortion. Distortion can occur if the tray is
torqued. Recovery of elastic deformation after strain rate is less rapid for
polysulphides than for other kinds of materials. Polysulphides exhibit the
most permanent deformation following strain in compression compared
with the other materials. Polysulphides also sustain more distortion when
the strain rate is slow.

RHEOLOGY
Polysulfide is one of the least stiff of the Elastomeric impression
materials. This flexibility allows the set material to release from undercut
areas with minimum stress. Despite the lack of stiffness the unset
material has high level of viscosity. This thick consistency of the uncured
material helps displace any unwanted fluid present while seating the
impression. Due to the high level of viscosity the material does not flow
out of the tray when it is placed in the mouth.

TEAR SRENGTH: -
Polysulphides have highest tear resistance About 4000 gm/cm (8 times that of
hydrocolloid).

DIMENSIONAL STABILITY
The stone cast must be poured immediately since the impression is most
accurate immediately after removing it from the mouth. Sources of dimensional
change are
During setting, most polymers contract slightly due to cross-linking.
After setting, the by-product of condensation reaction (water) is lost
which causes shrinkage.
After setting, there is incomplete recovery of deformation because of
the visco-elastic properties.
Dimensional changes are greater for polysulfide than for Polyether & for
addition silicone.
If maximum accuracy is to be maintained, the stone die or cast should
be constructed within 30 minutes. Although the material is fluid
repellant, it can absorb water, disinfectant etc. when exposed for a long
time.


BIOCOMPATIBILITY: -
1. Probability of allergic or toxic reactions.
2. Cytotoxic.

HANDLING OF TRAY: -
One way to minimize the effects of polymerization shrinkage, loss of by products, and
deformation associated with distortion is to minimize the amount of material that is used to
make the impression. The most accurate polysulphides impressions are made by using a
custom acrylic tray, because uniform thickness of material can be obtained.

A stone cast is constructed from an impression of the tissues and a
custom tray is fabricated. Important parts of the cast, such as prepared
teeth are covered with one or two layers of base plate wax & tin foil to act
as spacer for the impression material. Chemical curing or light curing
resin is used to prepare the tray. Adhesion can be obtained by the
application of minimal, uniform thickness of adhesive to prepared tray,
before the insertion of the impression material. The adhesive then forms
a tenacious bond between the rubber material and the tray.

HANDLING TECHNIQUES.
The impression material is currently available in two consistencies:
Available in 2 consistencies:
1. Tray material.
2. Syringe material.

Syringe material may have longer working & setting time. Syringe material contains
lesser filler particles, hence has greater polymerization shrinkage and more thermal
contraction. Hence it is not advisable to use syringe material alone.

THE TECHNIQUE OF USING BOTH TRAY AND SYRINGE MATERIAL IS
CALLED MULTIPLE MIX

1. Mix the tray material first & fill the tray with a uniform thickness of
the material & set it aside.
2. Second person begins mixing &filling the syringe.
3. The material is injected from the filled syringe within around the
prepared teeth.
4. The filled tray is then placed over the syringe material so that both
materials cure together.

DISINFECTION OF IMPRESSIONS: -
Polysulphides can be disinfected by most of the various anti microbial solutions without
adverse dimensional changes, provided the disinfections time is short. Prolonged immersion
may produce minimal distortion. One recommended procedure is a 10-minute immersion in
a 10% solution of sodium hypochlorite.

SHELF LIFE: -
1. The material does not deteriorate appreciably when stored under normal environment.
2. The tubes should be kept tightly closed when not in use.
3. Storage in a cool environment is advisable.

ADVANTAGES: -
1. No special equipment required.
2. Superior strength in deep sulcus.
3. Finish line can be easily read.
4. Cast pouring can be delayed up to one hour.
5. Can be poured more than once.
6. Adequate shelf life.

DISADVANTAGES: -
1. Custom trays required.
2. Hydrophobic.
3. Sensitive to heat & humidity.
4. Severe undercuts must be blocked.
5. Objectionable odor.
6. Long setting time.
7. Moderately high shrinkage.
8. Fairly high permanent deformation.


RECENT DEVELOPMENTS.
POLYETHER PUTTY MATERIAL + POLYSULPHIDES ARE USED AS WASH
MATERIAL.


CONDENSATION SILICONES.

COMPOSITION:

The condensation silicone impression materials are supplied as a base paste and a low
viscosity liquid or catalyst paste. Because the silicone polymer is a liquid, colloidal silica is
added as a filler to form a paste. The particles should be within the optimum range of 5-10
microns.

BASE PASTE:
1.Poly dimethyl siloxane/Liquid silicone polymer.
2.FILLER-Colloidal silica/Micronised metal oxide.

REACTER PASTE:
1.Tri/Tetra functional alkyl silicates.
2.Tin compound Stannous Octoate.
Properties of impression material are influenced by properties of filler,
according to Law Of Mixtures.
Different colors are available: Pastel pink, blue, Green, Purple.

CHEMISTRY: -
1.The polymer consists of a hydroxy terminated polydimethyl siloxane. Condensation
polymerization reaction of this material involves a reaction with trifunctional and tetra
functional alkyl silicates, commonly tetraethyl ortho silicate, in the presence of
stannous octoate. These reactions can take place at room temperature & hence these
materials are called as ROOM TEMPERATURE
VULCANISATION silicones.

Formation of the elastomer occurs through a cross-linking between terminal
groups of the silicone polymer & the alkyl silicate to form a three dimensional network.
Ethyl alcohol is the reaction by product. Its evaporation accounts for the shrinkage
seen in the set polymer.

MANIPULATION: -
1. Supplied as base paste & liquid catalyst.
2. A length of the base paste is dispensed onto a graduated mixing pad.
3. One drop of liquid catalyst is added for each unit length of base.
4. Both pastes are mixed till a uniform color is obtained.
5. Putty material very thick paste and a liquid accelerator. Manufacturers directions
are followed to mix the material.
6. Two-paste putty system-best mixing technique is to knead the material with the fingers.

7. Wearing gloves adds another complication; some latex gloves contain sulfur component & this
inhibits setting.



ELASTICITY: -
Condensation silicones impression materials are more ideally elastic
than polysulphides. They exhibit minimal permanent deformation and
recover more rapidly when strained.

RHEOLOGY: -
The material is more likely to respond as elastic if it is strained rapidly. Hence,
impressions must be removed quickly so that the deformation is elastic and
recoverable.

TEAR STRENGTH: -
Tear resistance is low. They must be handled carefully to avoid
ruining a margin of a crown preparation. Applying a force rapidly ensures
the highest tear resistance. 3000 gm/cm.


WORKING TIME: -up to 5 minutes

SETTING TIME: -10-12 minutes.
Chilling the material or mixing on cool slab slows reaction rate.


DIMENSIONAL STABILITY:
1. Material exhibits excessive polymerization shrinkage. Hence a putty-wash technique is used.
2. The amount of linear contraction is 2-4 times greater than others.
3. This is caused by release of ethyl alcohol as an end product.
4. Polymerization reaction continues after material is clinically set.
5.Accurate model is obtained by pouring up the impression immediately-within 30minutes.

HANDLING TECHNIQUE: -
Because the putty wash impression technique is used with this material, custom tray
fabrication is not necessary. Disposable stock trays can be used to support the putty material.

1. Thick putty material placed in the tray & preliminary impression is
made (Intra oral custom tray).
2. Space for light body wash material is provided by scraping the tray
putty or polyethylene sheet used as a spacer.
3. Thin consistency wash impression material is placed over the putty
impression.

This is called as TWO STAGE PUTTY WASH TECHNIQUE OR
RELINE TECHNIQUE.

ADVANTAGES: -
1. No special equipment.
2. Finish lines easily read.
3. Pleasant odor & appearance.
4. Adequate shelf life.

DISADVANTAGES: -
1. Requires special care in pouring.
2. Should be poured immediately after removal.
3. Easily distorted.




POLYETHER
INTRODUCED IN GERMANY DURING LATE 1960S

COMPOSITION: -
1. Low molecular weight Imine terminated prepolymers.
2.Inert filler.
3.plasticiser-Glycol ether phthalate.
4.Ester derivative of aromatic sulphonic acid.

Polyether is supplied as two pastes. Base paste contains Polyether polymer, colloidal
silica as filler, and a plasticizer such as glycolether or phthalate. The accelerator paste contains
the alkyl aromatic suldonate in addition to the aforementioned filler and plasticizer.

WORKING TIME: 5-7 minutes.

SETTING TIME: 5-6 minutes.
The curing time of Polyether is less sensitive to temperature changes.
MIXING TIME: 30-45 seconds.
Working time can be altered by Base: accelerator ratio.

ELASTICITY:
Polyethers have been considered to be the stiffest of all the materials. The original material was
extremely difficult to remove from undercut areas because of the high modulus of elasticity.


TEAR STRENGTH: -
Tear resistance is better than that of condensation silicones. But Polyether is more
prone to tearing than polysulphides. Because of this, the margin should be carefully inspected
immediately after removing the impression.

DIMENSIONAL STABILITY: -

The dimensional changes of Polyether are relatively small. They
have no reaction by product. Although the residual polymerization
continues beyond the clinical time, it is much shorter than that of
polysulphides. The stiffness of the material means that the force needed
to remove the impression is greater for Polyether but the recovery is
nearly complete.

BIOCOMPATIBILITY: -
1.Hypersensitivity.
2.Contact dermatitis.
3.High cell toxicity.

SHELF LIFE: -
Good shelf life: - Storage at room temperature.

Storing in a cool dry environment prolongs shelf life.
ADVANTAGES: -
1. No special equipment required.
2. Finish line easily read.
3. Superior Dimensional stability.
4. Fast setting.
5. Cast can be poured 1-7 days later.
6. Pleasant odor & appearance.
7. Good shelf life.

DISADVANTAGES: -
1. Custom tray required.
2. Very stiff.
3. Short working time.
4. Least tear strength.
5. More expensive.
6. Aromatic sulphonic acid ester catalyst Skin irritant.



ADDITION SILICONES
COMPOSITION: -
BASE: - polyvinyl siloxane or vinyl poly siloxane.
ACCELERATOR: -
1.divinyl siloxane
2.Platinum salt-catalyst (chloroplatinic acid)
3.Palladium- hydrogen absorber.
4.Retarders.
5. Fillers.


Both the base paste and the catalyst paste contain a form of vinyl silicone. The base paste
contains polymethyl hydrogen siloxane as well as other siloxane prepolymers. The catalyst
paste contains divinyl polydimethyl siloxane other siloxane polymers. If the catalyst contains
the platinum salt activator, then the paste labeled base must contain the hybrid silicone.

CHEMISTRY: -
Addition silicones are hydrophilic in contrast to all other silicone impression materials.
In contrast to the condensation silicones, the addition polymer is terminated with vinyl groups
and is cross-linked with hybrid groups activated by platinum salt- catalyst. Actually, there will
not be any by-products as long as correct proportions of vinyl silicones and hybrid silicones are
present. If the proportions are out of balance then hydrogen gas is produced as the by-product.
The hydrogen gas that evolves from the set material can result in pinpoint voids in the stone
cast.


MANIPULATION: -
The light body and medium body Vinyl poly siloxane are supplied as
two pastes and the Putty is supplied as two jars of high viscosity base and
catalyst materials. These materials are suitable for an automatic
dispensing & mixing device. With the mechanical mixing device there is
greater uniformity in proportioning & mixing, less air is incorporated into
mix and mixing time is reduced. The mixed impression material is ejected
directly into adhesive coated tray or onto the prepared tooth. The basic
automatic mixers sold by manufacturers are interchangeable. The tips
vary in diameter, length & perhaps more importantly in number of spiral
units within the tips. More units provide more thorough mixing. Thus an
impression material that is adequately mixed in a spiral unit may be
inadequately mixed with another spiral tip.

WORKING AND SETTING TIMES.
More sensitive to temperature than polysulphides.Adding suitable
retarders & cooling the mixing slab can alter both. Working and setting
times can be extended by the addition of a retarder and by cooling the
mixing slab.

ELASTICITY: -
The vinyl polysiloxane impression materials are the most ideally
elastic of all the currently available materials. Distortion on removal from
undercuts is virtually non-existent. Material is extremely difficult to
remove from undercut areas because of high molecular elasticity. stiffness
is proportional to consistency of the material.

RHEOLOGY: -
As one of the most pseudoplastic impression materials, the effect of
increased strain rate on the unset material is quite pronounced for vinyl
polysiloxane. This large discrepancy between flow properties of the
material under strong force such as syringing, and light force such as
during seating the tray can be used for advantage as a one step material.
Medium body material is used to capture the fine detail and is available as
a one-stage material. The basic difference between the material used for
injection and tray is the viscosity.
TEAR ENERGY: -
The resistance to tearing is adequate. These materials if not handled
properly will tear rather than stretch like polysulphides. Polyether is
more prone to tearing than polysulphides.

DIMENSIONAL STABILITY: -
The vinyl polysiloxane impression materials are the most dimensionally stable of all the current
materials. No volatile by product is released to cause shrinkage of the material. The clinically set material
is close to being completely cured, so that little residual polymerization occurs later to contribute to
polymerization shrinkage. Impression does not have to be poured immediately.

BIOCOMPATIBILITY: -
The danger of leaving a piece of the material during removal of the
impression can be avoided by proper handling. A foreign body of
impression material can cause severe gingival inflammation.

HANDLING OF THE TRAY: -
Stock tray is used for reline material. The primary putty impression
actually serves as a custom tray for wash or reline material.

HANDLING TECHNIQUE: -
Putty wash technique has been popular for vinyl siloxane impression
material. Putty wash technique is more convenient and the bulk of the
material is formed by the highly filled putty material that has relatively
low polymerization shrinkage and a low thermal contraction coefficient.
Supplied as single phase or monophase.

DISINFECTION: -
These impression materials are easily disinfected by immersing it in either of the following solutions.
1.10% Hypochlorite.
2. 2% glutaraldehyde.

SHELF LIFE: -
Material has a shelf life of about 2 years. The containers must be
tightly closed. Viscosity not affected by temperature. shelf life can be
prolonged by storing it in a cool, dry environment.

ADVANTAGES: -
1. Superior dimensional stability.
2. Can be poured more than once.
3. Pleasant odor and appearance.
4. Good shelf life.
5. Shorter setting time.
6. Adequate tear strength.
7. Extremely high accuracy.
8. Less distortion on removal.

DISADVANTAGES: -
1. Custom tray required for double mix technique.
2. Hydrogen gas may evolve from some materials.
3. Most difficult to pour, requires special care.
4. Expensive.

RECENT ADVANCES
Visible light cured polymer urethane dimethacrylate.
The advantages of this material are that its working time is controlled by
the operator.

Composition: -
1.polyether urethane dimethacrylate.
2. Photo initiators.
3. Photo accelerators.
4.silicone dioxide fillers.




SETTING PROPERTIES OF ELASTOMERS

Material
Consistency Viscosity
(in Cp)
W.T
(min)
S.T
(min)
Dimensional
change in 24
hours
Polysulfides Low 60,000 4-7 7-10 0.40
Medium 110,000 3-6 6-8 0.45
High 450,000 3-6 6-8 0.40
Condensation
silicones
Low 70,000 2.5-4 6-8 0.60
High 70,000 2-2.5 3-6 0.38
Addition silicones Low 150,000 2-4 4-6.5 0.17
Medium 150,000 2-4 4-6.5 0.15
High 150,000 2.5-4 4-6.5 0.14
Very high 150,000 1-4 3-5 0.15
Poly ether Low 130,000 2.5 4.5 0.23
Medium 130,000 2-3 3.4-5 0.24
Medium+ thin 130,000 3-4 4.5-5 0.23
High 130,000 2.5 4-5 0.19











MECHANICAL PROPERTIES OF ELASTOMERS

Material Consistency Permanent Flow Hardness Tear
deformation strength
(gm/cm)
Polysulfides Low 3-4 0.5-2 20 2500-7000
Medium 3-5 0.5-1 30 3000-7000
High 3-6 0.5-1 35 ----
Condensation
silicones
Low 1-2 0.05-
0.1
15-30 2300-2600
Very high 2-3 0.02-
0.05
50-65 ----
Addition
silicones
Low 0.05-0.4 0.01-
0.03
35 1500-3000
Medium 0.05-0.3 0.01-
0.03
50 2200-3500
Very high 0.2-0.5 0.01-
0.1
75 2500-4300
Polyether Low 1.5 0.03 35-40 1800
Medium 1-2 0.02 35-60 2800-4800
Medium+ thin 2 0.04 30-50 2500
High 2 0.02 40-50 3000

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Thursday, August 8, 2013
BIOMECHANICS OF DENTAL IMPLANTS - SEMINAR

Contents:

E Introduction.
E Loads applied to dental implants.
E Mass, force and weight.
E Types of forces.
E Stress, strain relationship.
E Force delivery and failure mechanisms.
E Fatigue failure.
E Scientific rationale for dental implant design.
E Single tooth implant and biomechanics.
E Cantilever prosthesis and biomechanics.
E Biomechanics of frame works and misfit.
E Treatment planning based on biomechanical risk factors.
E Conclusion.
E References.






INTRODUCTION:
Biomechanics comprises of all kinds of interactions between tissues
and organs of the body and forces acting on them. Its the response of the
biologic tissues to the applied loads.
Dental implants function to transfer load to surrounding biological
tissues. Thus the primary functional design objective is to manage
(dissipate and distribute) biomechanical loads to optimize the implant
supported prosthesis function.
Definition
Process of analysis and determination of loading and deformation of
bone in a biological system.
Natural tooth Vs Implant:

Natural tooth Implant
1. Natural tooth is anchored in to the bone
by flexible periodontal
ligament.
2. The periodontal ligament around the
natural tooth significantly reduces the
amount of stress transmitted to the bone
and facilitates even force distribution.
3. The pdl acts as viscoelastic shock
absorber serving to decrease the
magnitude of stress to the bone.
4. The precursor signs of a premature
contact or occlusal trauma on natural teeth
are usually reversible and include signs of
cold sensitivity, wear facets, pits, drift
away and tooth mobility.
5. This condition often helps in the patient
seeking professional treatment by occlusal
adjustment and a reduction in force
magnitude in force magnitude which
further reduces the stress magnitude.
6. The elastic modulus of a tooth is closer
to the bone than any of the currently
available dental implant biomaterial. The
greater the flexibility difference between
the two materials, the greater the potential
relative motion generated between the two
surfaces at the endosteal region.
7. The proprioceptive information relayed
by teeth and implants also differs in
quality. Natural teeth deliver a rapid,
sharp, high pressure that triggers
proprioceptive mechanism.
8. The surrounding bone of natural teeth is
developed slowly and gradually in
response to biomechanical loads.
9. A lateral force on natural tooth is
dissipated rapidly away from the crest of
bone toward the apex of the tooth.
1. Implant is rigidly fixed by functional
ankylosis.

2. The concentration of stresses mainly
occurs at the crestal region.


3. The implant is fixed and rigid.


4. These initial reversible signs and
symptoms of trauma donot occur with
implants.


5. The magnitude of stress may cause
bone microfracture, bone loss which
ultimately leads to mechanical failure of
implant components.


6. The implant materials differs by 5-10
times from the surrounding bone
structure.



7. Implants deliver a slow dull pain that
triggers a delayed reaction if any.

8. Where as the bone loading around an
implant is performed by the dentist in a
much more rapid and intense fashion.

9. Lateral forces in implants concentrates
at the crestal region.




CHARACTER OF FORCES APPLIED TO DENTAL IMPLANTS:
Excess loads on an osseointegrated implant may result in mobility of
supporting device and excessive loads also may fracture an implant
component or body. The internal stresses that develop in an implant
system and surrounding biological tissues under imposed load may have a
significant influence on the long term longevity of the implants in vivo. A
goal of treatment planning should be to minimize and evenly distribute
mechanical stress in implant system and contiguous bone.
LOADS APPLIED TO DENTAL IMPLANTS:
o In function occlusal loads
o Absence of function Perioral forces
Horizontal loads
o Mechanics help to understand such physiologic and non physiologic loads
and can determine which t/t renders more risk.
MASS, FORCE AND WEIGHT:
Mass A property of matter, is the degree of gravitational attraction the
body of matter experiences.
Unit kgs : (lbm)
FORCE (SIR ISAAC NEWTON 1687):
Newtons II law of motion
F = ma
Where a = 9.8 m/s2
Mass Determines magnitude of static load
Force Kilograms of force

WEIGHT:
Is simply a term for the gravitational force acting on an object at a
specified location.
FORCES AND FORCE COMPONENTS:
Magnitude, duration, direction, type and magnification
Vector quantities
Direction dramatic influence
MOMENT / TORQUE:
The force which tends to rotate a body. Units N.m; N.cm, lb.ft ; oz.in
In addition to axial force, there is a moment on the implant which is
equal to magnitude of force times (multiplied by) the perpendicular distance
(d) between the line of action of the F and center of the implant.



FORCES ACTING ON THE IMPLANTS:
Three types of forces acting on the dental implants
E Compressive
E Tensile
E shear
Compressive:
i) Tend to push masses towards each other.
ii) Maintains integrity of bone implant interface.
iii) Accommodated best.
iv) Cortical bone is strongest in compression.
v) Cements, retention screws, implant components and bone implant
interfaces can accommodate greater compressive forces than tensile or
shear forces.
vi) Hence compressive forces should be Dominant in implant prosthetic
occlusion.



TENSILE FORCES SHEAR FORCES
+ +
Pull objects apart Sliding
Distract / disrupt bone implant interface.
Shear forces are most destructive, cortical bone is weakest to accommodate
shear forces.
Cylinder implants in particular are highest risk for shear forces at the
implant tissue interface unless an occlusal load directed along the long axis
of the implant body.
They require a coating to manage the shear forces to manage the shear
forces through a more uniform bone attachment.
Threaded / finned implants impart a combination of all three types of forces
at the interface under the action of single occlusal load. This conversion of
a single force in to three types of forces is controlled by the implant
geometry.
STRESS:
The manner in which a force is distributed over a surface is referred as
mechanical stress.
= F/A
The magnitude of stress depends on two variables:
- force magnitude.
- cross sectional area over which the force is dissipated.
Force magnitude may be decreased by reducingmagnifiers of force that
are:
1. Cantilever length
2. Crown height
3. Night guards
4. Occlusal material
5. Over dentures
Functional cross sectional area may be optimized by:
1. increased by Number of implants
2. Selecting an Implant geometry that has been designed carefully to
maximize the functional cross sectional area.
DEFORMATION & STRAIN:
A load applied to a dental implant may induce deformation of the implant
and surrounding tissues
Deformation and stiffness of implant material may influence
A. Implant tissue Interface
B. Ease of implant manufacture
C. Clinical longevity



STRESS STRAIN RELATIONSHIP:

+ A relationship is needed between the applied stress that is imposed on the
implant and surrounding tissues and the subsequent deformation.
+ The load values by the surface area over which they act and the strain
experienced by the object produces a stress strain curve.
+ The slope of the linear portion of the curve is referred to as the modulus of
elasticity and its value indicates the stiffness of the material.
+ The closer the modulus of elasticity of the implant to the biological tissues,
the less the relative motion at the implant tissue interface.
Once a particular implant system is selected the only way for an
operator to control the strain experienced by the tissues is to control the
applied stress or change the density of bone around the implant.
Greater the strength stiffer the bone
Difference in stiffness is less for CpTi & D1 bone but more for D4 bone
Stress reduction in such softer bone
To reduce resultant tissue strain
Lower Ultimate strength
Hooks law
Stress = Modulus of elasticity x strain
= E.c
BITING FORCES:
Axial component of biting force: (100 2500 N) / (27 550 lbs)
It tends to increase as one moves distally
Lateral component - 20 N (approx.)
Net chewing time per meal = 450 sec
- Chewing forces will act on teeth for = 9 min/day
- If includes swallowing = 17.5 min/day
- Further be increased by parafunction
FORCE DELIVERY AND FAILURE MECHANISM:
+ The manner in which forces are applied to the dental implant restorations
within the oral environment dictates the likelihood of system failure.
+ An understanding of force delivery and failure mechanisms is critically
important to the implant practitioner to avoid costly and painful
complications.
+ The moment or torque is the product of the force magnitude multiplied
by the perpendicular distance from the point of interest to the line of the
action of the force.

Moment loads are destructive in nature and may result in:
Interface breakdown
Bone resorption
Screw loosening
Bar / bridge fracture
A total of six moments may develop about the three clinical coordinate
axes:
- occlusoapical
- faciolingual
- mesiodistal
These moment loads induce microrotations and stress concentrations at
the crest of the alveolar ridge at the implant to tissue interface , which lead
inevitably to crestal bone loss. Three clinical moment arms in implant
dentistry
- occlusal height
- cantilever length
- occlusal width


Minimization of each of these moment arms is necessary to prevent
unretained restorations, fracture of components, crestal bone loss or
complete implant system failure.
1) Occlusal height:
- Occlusal height serves as the moment arm for force components directed
along the faciolingual axis:
- working or balancing occlusal contacts, tongue thrusts or peri oral
musculature, and the force components directed along the mesiodistal axis.
- force components along the vertical axis is not affected by the occlusal
height because there is no effective moment arm.
- in division A bone initial moment load at the crest is less than in division C
or D bone because the crown height is greater in Cand D.
2) Cantilever length:
Large moments may develop from vertical axis force components in
prosthetic environments designed with cantilever extensions or offset loads
from rigidly fixed implants.
A Lingual force component may also induce a twisting moment about the
implant neck axis if applied through a cantilever length.
Force applied directly over the implant does not induce a moment load or
torque because no rotational forces are applied through an offset distance.
Antero posterior spread is the distance to the center of the most anterior
implant and the most distal aspect of the posterior implants.
The greater the A-P spread the smaller the resultant loads on the implant
system from cantilevered forced because of the stabilizing effect of the
antero-posterior distance.
According to MISCH
Cantilever length is determined by the amount of stress applied to system
Generally Distal cantilever not be > 2.5 times of A-P spread
Patients with parafunction not to be restored by cantilever.
Square arch form involves smaller A-P spreads between splited implants
and should have smaller length cantilever.
Tapered arch form largest A-P spread larger cantilever design.
3). Occlusal width:
Wide occlusal tables increase the moment arm for any offset occlusal
loads. Faciolingual tipping (rotation) can be reduced significantly by
narrowing the occlusal tables or adjusting the occlusion to provide more
centric contacts.
A vicious destructive cycle can develop with moment loads and result in
crestal bone loss.

FATIGUE FAILURE:
Fatigue failure is characterized by Dynamic cyclic loading conditions,
four factors significantly influence the fatigue failure.

1) Biomaterials
2) Geometry
3) Force magnitude
4) Loading cycles
1) Bio materials:
+ Fatigue behaviour of biomaterials is characterized to a plot of applied stress
vs no. of loading cycles
+ High stress few loading cycles
+ Low stress infinite loading cycles
+ Ti alloys exhibits a higher endurance limit compared with commercially pure
titanium (Cp Ti)
2) Macro geometry:
The geometry of an implant influences the degree to which it can Resists
bending and torque
Lateral loads also causes fatigue fracture
The fatigue failure is related as 4th power of the thickness difference
Also affected by the difference in Inner and outer diameter of screw and
abutment screw space
3) Force magnitude:
The magnitude of loads on dental implants reduced by careful
consideration of arch position
Higher loads on posteriors
Limitation of Moment loads
Geometry for functional area
Increasing the No. of implants
4) Loading cycles
Reducing the No. of loading cycles
Elimination of parafunction
Reducing the occlusal contacts
SCIENTIFIC RATIONALE FOR DENTAL IMPLANT DESIGN
+ Dental implants function to transfer of load to surrounding biologic tissues.
+ Thus the primary functional design objective is to manage (dissipate and
distribute) biomechanical loads to optimize the implant supported
prosthesis function.
+ Biomechanical load management depends on two factors that are
1) Character of applied load. 2) Functional surface area
+ Forces applied to dental implant characterized in terms of Magnitude,
duration, type, direction and magnification.
FORCE MAGNITUDE:
The magnitude of biting force varies as a function of anatomic region and
state of dentition. The magnitude of force is greater in molar region and
lesser in canine region.
Higher magnitude demands increased bone density and Influence the
selection of biomaterials.
Materials such as silicon hydroxyapatite and carbon are characterized by
lesser ultimate strengths even though they are highly compatible with the
biological tissues.
In contemporary applications, these materials are considered for use as
coatings applied to stronger substrate materials.
Silicone, HA, carbon has- High biocompatibility
- Low ultimate strength
Titanium and its alloy Excellent biocompatibility
- Corrosion resistance
- Good ultimate strength
- Closest approx. to stiffness of bone
FORCE DURATION:
The duration of bite forces on dentition has a wide range under ideal
conditions; the total time of those brief episodes is less than 30 minutes per
day.
Patients who exhibit bruxism, clenching or other parafunctional habits may
have their teeth in contact several hours each day.
The endurance limit or fatigue strength is the level of highest stress through
whish a material may be cycled repetitively without failure. The endurance
limit of a material is often less than one half its ultimate tensile strength.
The ability of implants and abutment screws to resist fracture from bending
loads is related directly to the moment of inertia of the component.
This parameter is a function of the cross sectional geometry of the
component.
Implant bodies are particularly susceptible to fatigue fracture at the apical
extension of the abutment screw within the implant body or at the crest
module around abutment (eg: with an internal hexagon)
The formula for the bending fracture resistance in these conditions is related
to the outer diameter radius to the fourth power minus the inner diameter
radius to the fourth power.
The wall thickness of the implant body in this region controls the resistance
to fatigue failure. Even a small increase in wall thickness results in a
significant increase in bending fracture resistance because the dimension
is multiplied to a power of four.
TYPE OF FORCE:
Three types of forces may be imposed on dental implants within the oral
environment
-Compression
-Tension
-Shear
Bone is strongest when loaded in compression. 30% weaker when subjected
to tensile forces and 65% weaker when loaded in shear
A smooth sided implant may be called a cylinder design, and this cylinder
implant body result in essentially a shear type of force at the implant to
bone interface. Thus this body geometry must use a microscopic retention
system by coating the implant with titanium plasma spray or hydroxyl
apatite
If the hydroxyapatite resorbs from infection or bone remodeling, the
remaining smooth sided cylinder is severely compromised for healthy load
transfer to the surrounding tissues
A threaded implant may use microscopic and macroscopic design features
to load the bone in compression and tensile loads
Threaded implants have the ability to transform the type of force imposed at
the bone interface through careful control of the thread geometry. Thread
shape is particularly important in changing force type at the bone interface
Thread shapes in dental implant design include square, v shape and
buttress
Under axial loads to a dental implant a v thread face (typical of paragon, 3i
and Nobel Biocana) is comparable to the buttress thread and has a 10
times greater shear component of force than a square or a power thread
A reduction in shear load at the thread to bone interface reduces the risk of
overload; which is particularly important in compromised D3 and D4 bone.
A threaded implant also may have a surface condition such as
hydroxyapatite, TPS or other roughed surface.
FORCE DIRECTION:
The anatomy of the mandible and maxilla places significant constraints on
the ability to surgically place root form implant suitable for loading along
their long axis.
Bony undercuts further constrain implant placement thus force direction.
Most of all undercuts occur on the facial aspects of the bone, with the
exception of the submandibular fossa in posteroior mandible. Hence
implant bodies often are angled to the lingual to avoid penetrating the facial
undercut during insertion.
As the angle of the load increases, the stresses around the implant
increases, particularly in the vulnerable crestal bone region. As a result all
implants are designed for placement perpendicular to the occlusal plane.
This placement allows a more axial load to the implant body and reduces
the amount of crestal loss.
FORCE MAGNIFICATION:
There are various factors which can magnifies the forces on dental
implants
Surgical placement resulting in extreme angulation of the implant
Para functional habits
Cantilever and crown height
Increase in functional area
Increased density of the bone
Increase in implant number decreases cantilever length and limits the force
magnifier.
FUNCTIONAL SURFACE AREA:
Functional surface area is defined as the area that actively serves to
dissipate compressive and tensile non shear bonds through the implant to
bone interface and provides initial stability of the implant following surgical
placement.
The total surface area may include a passive area that does not participate
in load transfer.
Functional surface area also plays a major role in addressing the variable
implant to bone contact zones related to bone density.
D1 bone, is the densest bone found in the jaws is also the strongest bone
and provides an intimate contact with a threaded root form implant at initial
implant loading.
D4 bone has the weakest biomechanical strength and the lowest contact
area to dissipate the load at the implant to bone interface.
Thus an improved functional surface area per unit length of the implant is
needed to reduce the mechanical stress to this weak bone.
Implant macrogeometry and implant width are two important design
variables for optimizing surface area.
IMPLANT MACROGEOMETRY:
+ The macro design or shape of an implant has an important bearing on the
bone response.
+ Growing bone concentrates preferentially on protruding elements of the
implant surface, such as ridges, crests, teeth, ribs or the edge of threaded
surface.
+ The shape of the implant determines the surface area available for stress
transfer and governs the initial stability of the implant.
+ Smooth sided cylindrical implants provide ease in surgical placement,
however the bone to implant interface is subjected to significantly larger
shear conditions.
+ A smooth sided tapered implant allows for a component load to be delivered
to the bone implant interface, depending on the degree of taper, however
the greater the taper of smooth sided implant the less the overall surface
area of the implant body.
+ Threaded implants with circular cross sections provide for ease of surgical
placement and allow for greater functional surface area optimization to
transmit compressive loads to bone implant interface.
+ A smooth surface cylinder depends on a coating or microstructure for load
transfer to bone.
IMPLANT WIDTH:
+ An increase in implant width adequately increases the area over which
occlusal forces may be dissipated.
+ Wider root form designs exhibit a greater area of bone contact than narrow
implants of similar design because of an increase in circumferential bone
contact.
+ The larger the width of the implant the more it resembles the emergence
profile of the natural tooth.
+ The increased width of implants 6-12 mm also enhances the bending
fracture resistance. But the crestal bone anatomy most often constrains
implant width to less than 5.5mm.
THREAD GEOMETRY
Threads are designed to maximize initial contact enhance surface area and
facilitate dissipation of stresses at the bone- implant interface.
Functional surface area per unit length of the implant may be modified by
varying three thread geometry parameters
- thread pitch
- thread shape
- thread depth




THREAD PITCH:

+ Thread pitch is defined as the distance measured parallel with its axis
between adjacent thread forms or the number of threads per unit length in
the same axial plane or on the same side of the axis.
+ The smaller the pitch (finer) the more threads on the implant body for a
given unit length, and thus the greater surface area per unit length of the
implant body.
+ If force magnitude increase or bone density decreases one may decrease
the thread pitch to increase the functional surface area.
+ Some of the current popular designs which have different pitches.
+ The distance between pitches:
ITI Implant 1.5mm
Sterioss - 0.8mm
Nobel biocare,zimmer, 3i & life core 0.6mm
Biohorizons - 0.4mm
-the fewer the threads , the easier to bond or insert the implant.
THREAD SHAPE:

+ Thread shapes in implant geometry (dental implant designs include square,
Vshape and buttress.
+ The V shape thread design is called a fixture and is primarily used for
fixating metal parts together not load transfer.
+ The buttress thread shape was designed initially for and is optimized for
pullout loads.
+ The square or power threaded provides an optimized surface area for
intrusive, compressive load transmission.
+ The shear force on a V threaded face (typical of Zimmer, 3i and Nobel
biocare) is about 10 time greater than the shear force on a square thread.
THREAD DEPTH:
+ The threaded depth refers to the distance between the major and minor
diameter of the thread.
+ the greater the thread depth, the grater the surface area of the implant if all
the other factors are equal.
IMPLANT LENGTH:
+ As the length of an implant increases so does the overall total surface area.
+ D1 bone is the strongest and densest bone of the oral environment. The
strength of the bone and the intimate contact between the bone and
implant provide resistance to lateral loading. Bicortical stabilization is not
needed in D1 bone because it is already a homogenous cortical bone.
+ A long implant in D2 or D3 bone in the anterior mandible may cause
increased surgical risk, since attempting to engage the opposing cortical
plate and preparing a longer osteotomy may result in overloading of the
bone.
+ In poor quality D3 and D4 bone functional surface area must be maximized
to distribute occlusal loads optimally, the placement of longer implants in
posterior regions require surgical modifications like nerve repositioning,
placement of sinus grafts in maxillary posterior regions.
+ The shorter and smaller diameter implants had lower survival rates than
their longer or wider counter parts.
CREST MODULE CONSIDERATIONS:
Crest module of an implant body is the transosteal region from the implant
body and characterized as a region of highly concentrated mechanical
stress.
Slightly larger than outer diameter, thus the crest module seats fully over the
implant body osteotomy, providing a deterrent for the ingress of bacteria or
fibrous tissue.
The seal created by the larger crest module also provides for greater initial
stability of the implant following placement.
Polished collar (0.5 mm) perigingival area, provides for a desirable smooth
surface close to the perigingival area.
Longer polished collar shear loading crestal bone loss
Bone is often lost to first thread, because the first thread changes the shear
force of the crest module to a component of compressive force in which
bone is strongest.
APICAL DESIGN CONSIDERATIONS:
Round cross sectional implants do not resist torsional shear
forces when abutment screws are tightened hence anti rotational feature is
incorporated usually in the apical region of the implant body, with a hole or
vent. Bone can grow through the apical hole and resist torsional loads
applied to the implant. The apical hole region may increase the surface
area available to transmit compressive loads on the bone.
The disadvantage of the apical hole occurs when the implant
is placed through the sinus floor or becomes exposed through a cortical
plate. The apical hole may fill with mucous and become a source of
retrograde contamination. Another anti rotational feature of implant body
may be flat sides or grooves along the body or apical region of the implant
body.
The apical end of each implant should be flat rather than
pointed, this allows for the entire length of the implant to incorporate design
features that maximize desired strain profiles.
Progressive Loading
Misch (1980) proposed that
Gradual increase in occlusal load separated by a time interval to allow
bone to accommodate.
Softer the bone increase in progressive loading period.
Protocol Includes,
Time
Diet
Occlusal Contacts and occlusal material
Prosthesis Design


Time:
Two surgical appointments between initial implant placement and stage
II uncovery may vary on density.
D1 - 3 Months
D2 - 4 Months
D3 - 5 Months
D4 - 6 Months
Diet:
Limited to soft diet 10 pounds
Initial delivery of final prosthesis-21 pounds
Occlusal Material:
Initial step no occlusal material placed over implant
Provisional Acrylic lower impact force
Final - Metal / Porcelain
Occlusion:
Initial - No occlusal contact
Provisional - Out of occlusion
Final - At occlusion
Prosthesis Design:
First transititional No occlusal contact
No cantilever
Second transititional - Occlusal contact
With no cantilever
Final restoration - narrow occlusal table and cantilever with implant
protective occlusion guidelines.


SINGLE TOOTH IMPLANTS:
+ Single tooth implants require good bone support and control of harmful
effects of occlusal levers that are not parallel to the long axis of the implant.
+ The prosthesis must be designed to allow good oral hygiene, with easy
access to inter proximal surfaces and the retaining screw.
+ A molar can be replaced with two standard diameter implants or one wide
implant.
+ This type implant is contraindicated for larger spaces because the
masticatory and occlusal forces to the most distal or mesial portions will be
harmful.
+ To avoid excessive loads, the implant must be centered in the edentulous
space during placement.



ANTERIOR SINGLE TOOTH RESTORATIONS:
+ The anterior single tooth restoration is achieved using a standard diameter
implant, which is preferred over a narrow implant because it provides a
larger surface for osseo integration
+ Generally the use of wide implants in this area is not advocated because it
may compromise good esthetic results.
+ To avoid levers that may be produced during parafunction in centric and
eccentric positions, its recommended that the implant supported restoration
be left out of occlusion.
SHORT SPAN FIXED PARTIAL DENTURE:
The construction of a 3 unit particularly cantilever fixed
partial dentures require a posterior triangular zone of occlusal surface
between the supporting implants.
The chances of overloading the implants are far less and
this provides a better long term prognosis, because it offers a wider active
zone while also achieving good occlusal load in relationship to the axes of
the implants. the use of wide implants to support cantilever fixed partial
dentures improves the prognosis further, especially in those cases where
only two wide implants are needed compared to three of standard
diameter. wide implants allow for an increased occlusal surfaces in these
circumstances.
The proximity of anatomical features such as the
mandibular canal or the maxillary sinus limit the use of long implants. In the
presence of adequate bucco lingual bone width these limitations ca be
managed with the use of wide implants.
CANTILEVER FIXED PARTIAL DENTURE:
It results in greater torque with distal abutment as fulcrum.
May be compared with Class I lever arm.
May extend anterior than posterior to reduce the amount of force
It depends on stress factors
Parafunction
Crown height
Impact width
Implant Number
The design of cantilever fixed partial dentures is dependent on the occlusal
forces that can be elicited at the free end of the denture and the length and
width of the implants selected.
CASE 1:
+ A case with two implants placed for the lateral incisor and the canine with a
free end central incisor.
+ Two implants of adequate length are required.
+ The cantilever tooth should avoid contacts on the central incisors during
protrusion, lateral excursions and maximum intercuspation.




CASE II:
+ When the implants serve as support for the central and lateral incisors with
a free end canine, the occlusal configuration should provide group function
during lateral movements and avoids loading of canine.
+ If its not possible lateral guidance may be provided by the central and
lateral incisors avoiding any contact with the canine.

CASE III:
+ When two implants are placed unilaterally at the site of two maxillary
premolars, the free end canine must be left out of occlusion.
CASE IV:
+ Molar replacements achieve best results with a three Implant supported
fixed prosthesis providing premolar morphology to the restorations.
+ The length of the implants influences the outcome of treatment
+ Due to the enormous occlusal loads in the second molar area the use of a
free end fixed prosthesis is contra indicated.


BIOMECHANICS OF FRAMEWORKS AND MISFIT
Frameworks:
Metal framework for full arch prosthesis can fracture
More towards the cantilever section
Reasons:
1) Overload of cantilever
Unlikely to occur typical prosthetic alloy.
2) Metallurgic fatigue under cyclic loads
Prevention substantial cross sectional area
3-6 mm

TREATMENT PLANNING BASED ON BIOMECHANICAL RISK
FACTORS
Design of final prosthetic reconstruction
Anatomical limitation
Geometric risk factor
1) No. of implants less than no. of root support
One implant replacing a molar risk.
1 wide plat form implant / 2 regular implants
Two implants supporting 3 roots or more risk
2 wide platform implants
2) Wide platform implants
Risk if used in very dense bone
3) Implant connected to natural teeth
4) Implants placed in a tripod configuration
Desired counteract lateral loads
5) Presence of prosthetic extension
6) Implants placed offset to the center of the prosthesis in tripod
arrangement, offset is favorable.
7) Excessive height of the restoration

OCCLUSAL RISK FACTORS:
Force intensity and parafunctional habit
Presence of lateral occlusal contact
Centric contact in light occlusion
Lateral contact in heavy occlusion
Contact at central fossa
Low inclination of cusp
Reduced size of occlusal table
BONE IMPLANT RISK FACTORS
Dependence on newly formed bone
Absence of good initial stability
Smaller implant diameter
Proper healing time before loading
4 mm diameter minimum posteriors
Technological risk factors
Lack of prosthetic fit and cemented prostheses
Proven and standardized protocols
Premachined components
Instrument with stable and predefined tightening torque
WARNING SIGNS:
Repeated loosening of prosthetic / abutment screw
Repeated fracture of veneering material
Fracture of prosthetic / abutment screws
Bone resorption below the first thread

CONCLUSION:
Biomechanics is one of the most important
consideration affecting the design of the frame work for an implant bone
prosthesis. It must be analyzed during diagnosis and treatment planning as
it may influence the decision making process which ultimately reflect on the
implant supported prosthesis.

REFERENCES

1. Dental implant prosthetics Carl E. Misch
2. Principles and practice of implant dentistry Charles Weiss, Adam Weiss.
3. Tissue integrated prosthesis. Osseointegration in clinical dentistry
Branemark, zarb, Albrektsson
4. Oral rehabilitation with implant supported prosthesis -Vincente
5. ITI dental implants- Thomas G.Wilson
ALLOYS USED IN DENTISTRY


INTRODUCTION
Metals and alloys play an important role in dentistry. These form one of the four possible groups of
materials used in dentistry which include ceramics, composites and polymers. These are used in almost
all the aspects of dentistry including the dental laboratory, direct and indirect dental restorations and
instruments used to prepare and manipulate teeth. Although the latest trend is towards the metal free
dentistry, the metals remain the only clinically proven material for long term dental applications.

WORK ORIGIN / MEANING

Metal : Latin metallum = mine
Wrought : Old English worhte = to work beaten to shape
Eutectic : gr-eu=well, tectos = to melt, easily melted
Anneal : Old English-aelan = to burn, heat
Grain : Latin granum = seed
Alloy : Latin alligere = to bind
Dendrite : gr-dendron=tree
Element : Latin elementum = a first principle, a substance
that can not be resolved by chemical means into simpler substances
Crystal : Any substance having regular shape and flat
Surfaces
Lattice : fr-lattis=lath=bar=network of crossed bars
Space lattice = a geometrically regular, 3 dimensional arrangement of atoms in a space as it exits in a
crystalline material and studied in x-rays
Ingot = piece of cast metal sent to the work shop for rolling etc.
Base metal = metal which is easily oxidized when heated in air e.g. copper, lead, iron, zinc.


METALS :
Chemical elements in general can be classified as 1. Metals
2. Non-metals
3. Metalloids
Metalloids are those elements on the border line showing both metallic and non metallic properties,
e.g. carbon and silica. They do not form free positive ions but their conductive and electronic properties
make them important.
Metals constitute about 2/3
rd
of the periodic table published by DMITRI MEDELEYEVin 1868.
Of the 103 elements which are categorized in the periodic table according to the chemical properties, 81
are metals.
According to the metals hand book, they can be defined as AN OPAQUE LUSTROUS
CHEMICAL SUBSTANCE, THAT IS A GOOD CONDUCTOR OF HEAT AND
ELECTRICITY AND WHEN POLISHED IS A GOOD REFLECTOR OF LIGHT

HISTORY OF METALS
Metals have been used by man ever since he first discovered them. In ancient and pre-historic
times, only a few metals were known and accordingly these periods were called asCOPPER AGE,
BRONZE AGE and IRON AGE. Today more than 80 metallic elements and a large number of
alloys have been developed. Ore is a mineral containing one or more metals in a free or combined state.

PROPERTIES OF METALS :
All metals are solids except for mercury and gallium which are liquid at room temperature and
hydrogen which is a gas. The properties of metals can be listed out as follows :
1. They have a metallic luster and mirror like surface
2. They make a metallic sound when struck
3. Are hard, strong and dense
4. Ductile and malleable
5. Conduct heat and electricity
6. Have specific melting and boiling points
7. Form positive ions in solution and get deposited at the cathode during electrolysis. E.g. copper in copper
plating.

The outer most electrons of the atom are known as valence electrons. These are readily given
up and are responsible for most of the properties.
Metals are tough and this is due to the fact that the atoms of the metals are held together by
means of metallic bonds.
The chemical properties of metals are based upon the electromotive series which is a table of
metals arranged in decreasing order of their tendency to lose electrons. The higher an element is in the
series, the more metallic it is. This tendency of metals of lose electrons is known as oxidation potential.

CLASSIFICATION OF METALS :
They can be done in many ways like :
1. Pure metal and mixture of metals (alloys)
2. Noble metals and base metals :
Noble metal is one whose compounds are decomposable by heat alone, at a temperature not
exceeding that of redness. E.g. Au, Ag, and Pd.
Base metal is one whose compounds with oxygen are not decomposable by heat Alone, retaining oxygen
at high temperature. E.g. Zn, Fe, and Al
3. Case metal and wrought metal
Cast metal is any metal that is melted and poured into the mould
Wrought metal is a cast metal which has been worked upon in cold condition
4. Light metal e.g. Al and heavy metal e.g. Fe
5. High melting metal e.g. chromium and low melting metal e.g. tin
6. Highly malleable and ductile metal e.g. gold and silver

INTER ATOMIC BONDS :
The atoms are held together in place by atomic bonds or forces. They may be
1. Primary
2. Secondary

Primary bonds or inter atomic bonds :
These are very strong bonds and may be of either type :
a. Ionic - These are seen in ceramics
b. Covalent - They are seen in organic compounds
c. metallic bonds - They are seen in metals and are non
directional


Secondary bonds or inter molecular bonds :

These are weak forces and are otherwise known as Vander waals forces. The various types are :
a. Hydrogen bonds
b. Dipole bonds
c. Dispersion bonds
Of all these, the most important one is the metallic bond which was explained for the first time by
LORENTZ, a Dutch scientist in 1916. It can be explained by using the atomic and sub atomic structures.
The sub atomic structures
1. Protons positive charge
2. Neutrons neutral charge
3. Electrons negative charge


The center or the nucleus of an atom consists of proton and neutrons and are therefore positively
charged. This is balanced by the revolving electrons which are negatively charged and arranged in
concentric shells with progressively increasing energy. The electrons in the outer most shell are known
as VALENCE ELECTRONS.
These are loosely bound and are therefore readily given up by the atom to form positive ions. The
cations thus formed behave like hard spheres and the electron cloud formed by the freed valence
electrons roam about freely in the interstices formed by the arrangement of the solid spheres. The
electrons act like glue to hold all atoms together and are known as INTER ATOMIC
CEMENT. Because of this, the metals are strong, hard, malleable, ductile and good conductors of heat
and electricity.

MICROSCOPIC STRUCTURE OF METALS :
In the solid state, most metals have crystalline structure in which atoms are held together by
metallic bonds. This crystalline array extends for many repetition in 3 dimensions. In this array, the
atomic centers are occupied by nuclei and core electrons. The ionisable electrons float freely among the
atomic positions.
The space lattice is a 3 dimensional pattern of points in space and hence called as point
lattice. In this the simplest repeating unit is called as the UNIT CELL. The size and shape of the unit
cell are described by three vectors. They are a,b,c, and known as crystallographic axes. The length and
angle between them are known as LATTICE CONSTANTS AND LATTICE PARAMETERS.
When a molten metal is cooled the solicitation process is one of crystallization. These are
initiated at specific sites called nuclei. These in the molten metal are present as numerous unstable
atomic aggregates or clusters that tend to form crystal nuclei. These temporary nuclei are known
as EMBRYOS. These are generally formed from impurities within the molten metal. In the case of
pure metals, the crystals grow as dendrites which can be defined as a three dimensional network which is
branched like a tree. The critical radius is the minimal radius of the embryo at which the first permanent
solid space lattice is formed.
The crystals are otherwise known as grains since they seldom exhibit the customary geometric
forms due to interference from adjacent crystals during the change of state. The grains meet at grain
boundaries which are regions of transition between differently oriented crystals. These are regions of
importance as they are sites of:
1. Less resistance to corrosion
2. High internal energy and non crystalline
3. Collection of impurities
4. Barriers for dislocations
The nuclei can be homogeneous or heterogenous based upon whether they are developed from
the molten liquid or formed as a result of foreign bodies incorporated into the molten metal. When the
crystals meet at the grain boundaries they stop growing further. The grain boundaries are about 1-2
atomic distances thick. Grain boundaries can be high angles (>10-15 degrees) or low angled (< 10
degree).
The grain structure can be fine where in, it contains numerous nuclei as obtained during the rapid
cooling process (quenching) or refined when foreign bodies are added to obtain the fine grain structure.
EQUALIXED GRAINS
When cooling occurs and grains are formed, the grains start growing from the nuclei peripherally.
This takes the shape of a sphere and are equilaxed in structure meaning that they have the same
dimensions in any direction.
COLUMNAR AND RADIAL GRAINS
In a square mould, crystals grow from the edges towards the centre to form columnar grains
whereas in the cylindrical mould the grains grow perpendicular to the wall surface and form radial
grains. Columnar grains are weak due to interferences in the converging grains. Sharp margins have
columnar grains.


GRAIN SIZE :
The grain size can be altered by heating. When the metal is heated above the solidus temperature
to the molten state and rapidly quenched, small grains are formed whereas, when they are allowed to
cool slowly to room temperature the grains tend to grow due to atomic diffusion and this results in an
increased grain size and subsequent decrease in the number. The more fine the grain structure, the more
uniform and better are the properties.
ANISOTROPHY :
Alloys with uniform properties due to the presence of fine grain structure are said to be anisotropic.
METHODS OF FABRICATION OF METALS AND ALLOYS
1. CASTING : It is the best and most popular method.
2. WORKING ON THE METAL : They can be worked in the hot or cold conditions. They are known
as wrought metals. They can be pressed, rolled, forged or hammered.
3. EXTRUSION : A process in which a metal is forced through a die to form metal tubing.
4. POWDER METALLURGY : It involves the pressing of the powdered metal into the mould of
desirable shape and heating it to a high temperature to cause a solid mass.

SPACE LATTICES
The structure of the crystal can be determined using the BRAGGS LAW OF X-RAY
DIFFRACTION. There are 14 lattices known as BRAVIS LATTICES and these are grouped
under six families. These vary depending upon the crystallographic axes and lattice constants which are
the length of the vertices and the angle between them. The six families are :
1. Cubic
Simple
Body centered
Face centered
2. Triclinic
3. Tetragonal
Simple
Body centered
Rhombohedral
4. Orthorombic
5. Hexagonal
Simple
Body centered
Face centered
Base centered
6. Monoclinic
Simple
Base centered
















The arrangement of atoms in the crystal lattice depend on the atomic radius and charge distribution of
atoms.
The most commonly used metals in dentistry have one of the following space lattices : body centered
cubic, face centered cubic or hexagonal lattice.
SIMPLE CUBIC LATTICE
SYSTEM





LATTICE IMPERFECTIONS AND DISLOCATIONS
Crystallization from the nucleus does not occur in a regular fashion, lattice plane by lattice
plane. Instead, the growth is likely to be more random with some lattice positions left vacant and others
overcrowded with atoms being deposited interstitially. These are called defects and can be classified as :

A. POINT DEFECTS OR ZERO DIMENSIONAL DEFECTS
1. Vacancies or equilibrium defects :
Absences of an atom from its position. This can be :
Vacancy
Divacancy
Trivacancy
2. Interstitialcies :
Presence of extra atoms in the interstitial spaces.
3. Impurities
4. Electronic defects







Point defects are responsible for increased hardness, increased tensile strength, electrical
conductance, and phase transformations.

B. LINE DEFECTS OR SINGLE DIMENSIONAL DEFECTS :
These can be
1. Edge dislocation
2. Screw dislocation

The planes along which a dislocation moves is called as slip planes and when this occurs in
groups it is called as slip bands. The crystallographic direction in which the atomic planes move is called
as the slip direction and the combination of slip plane and slip direction is called as slip system.
These are responsible for ductility, malleability, strain hardening, fatigue, creep and brittle
fracture.
The face centered cubic consists of large number of slip systems and therefore is very
ductile. This is seen in gold.
The hexagonal closely packed system seen in zinc possesses relatively few slip systems and is
therefore very brittle.
In between these is the body centered cubic with intermediate properties.
The strain required to initiate movement is the elastic limit. The method of hardening of metals
and alloys is based on the impedance to the movement of dislocations.


















C.SURFACE DEFECTS OR PLANE DEFECTS OR TWO
DIMENSIONAL DEFECTS :
1. Grain boundaries
2. Twin boundaries :
These are seen in the NiTi wires responsible for transformation between the austenitic and
martensitic phases. These are important for the deformation of the titanium alloys. The atoms have a
mirror relationship.










3. Stacking fault
4. Tilt boundaries
D. VOLUME DEFECTS
These include cracks


ALLOTROPHY AND ISOMORPHOUS STATE :
ALLOTROPHY
This ability to exist in more than one stable crystalline form is called as allotrophy. The various
forms have the same composition but different crystal structure.
ISOMORPHOUS STATE
The ability to exist as a single crystal at any atomic composition of binary alloys is known as
iomorphous state e.g. Au-Ag, Au-Cu.

HEAT TREATMENT OR SOLID STATE REACTIONS
Heat treatment of meals (non-melting) in the solid state is known as solid state reactions. This is a
method to cause diffusion of atoms of the alloy by heating a solid metal to a certain temperature and for a
certain period of time. This will result in changes in the microscopic structure and physical properties.
Important criteria are :
1. Composition of the alloy
2. Temperature to which it is heated
3. Time of heating
4. Method of cooling slowly or quenching.
The purpose of heat treatment is :
1. Shaping and working on the appliance in the laboratory is made easy when the alloy is soft. This is the
first stage and called as softening heat treatment.
2. To harden the alloy to withstand high oral stresses, it is again heated and this is called hardening heat
treatment.


i. ANNEALING OR SOFTENING HEAT TREATMENT
This is done for structures that are cold worked. These cold worked structures are characterized by
:
1. Low ductility
2. Distorted and fibrous grains
When cold work is continued in these, they will eventually fracture. This is may :
1. Transgranular through the crystals and occur at room temperature
2. Intergranular in between the crystals and occurs at elevated temperature
These can be reversed by annealing. The various phase are :
1. Recovery
2. Recrystallization and
3. Grain growth
Technique:
The alloy is placed in an electric furnace at a temperature of 700 C for 10mins and then rapidly
quenched. Annealing temperature should be half that necessary to melt the metal in degrees Kelvin.
Recovery
During this phase, the cold work properties begin to disappear. There is a slight decrease in
tensile strength and no change in ductility. The tendency for warping decreases in this stage.
Recrystallization
There is a radical change in the microstructure. The old grains are replaced by a set of new
strain free grains. These nucleate in the most severely cold worked regions in the metal. The
temperature at which this occurs is the recrystallization temperature. During this the metal gets back to
the original soft and ductile nature.
Grain growth
If the fine grain structure in a crystallized alloy is further heated, the grains begin to grow. This is
essentially a process in which the larger grains consume the smaller grains. This process minimizes the
grain boundary energy. This does not progress until the formation of a coarse grain structure.









Properties of an annealed metal
1. There is an increase in ductility
2. Makes the metal tougher and less brittle

Stress relief annealing is a process which is done after cold working a metal to eliminate the
residual stress. This is done at relatively low temperatures with no change in the mechanical properties.


ii. HARDENING HEAT TREATMENT
This is done for cast removable partial dentures, saddles, bridges but not for inlays. This is done
for clasps after the try in stage so that adjustments can be carried out during the try in when the metal is
soft.

Technique
The appliance is heat soaked at a temperature between 200-450 C for 15-30 minutes and then
rapidly quenched. The results is :
1. Increased strength
2. Increased hardness
3. Increased proportional limit
4. Decreased ductility
Microscopic changes
Diffusion and rearrangement of atoms occur to form an ordered space lattice. Therefore this is
called as order hardening or precipitations hardening.

iii. SOLUTION HEAT TREATMENT OR SOLUTION HARDENING
When the alloy is soaked at 700C for 10 minutes and then rapidly quenched like that for a
softening treatment, any precipitation formed during the earlier heat treatment will become soluble in the
solvent metal.
iv. AGE HARDENING
This is a process in which following solution heat treatment ; the alloy is once again heated to bring
about further precipitation as a finally dispersed phase. This causes hardening of the alloy and it is
known as age hardening because the alloy will maintain the quality for many years. E.g. Duralium.

METHODS OF STRENGTHENING METALS AND ALLOYS :
All metals possess an inherent barrier to dislocations. This is relatively small and known aspearls
stress. This is imposed by the bonds associated with the arrangement of atoms in a given crystal
structure. Thus to improve the mechanical properties, other methods of hardening are used. These are :
1. GRAIN BOUNDARY HARDENING OR GRAIN REFINEMENT HARDENING
A poly crystalline metal contains numerous grains or crystals. These meet at the grain
boundaries. The grain boundary is non crystalline and contains impurities. These act as barriers to
dislocations as it moves by slip planes from one grain to another.
Finely grained structure contains large grain boundaries and hence the obstacle to motion of
dislocations is higher. therefore dislocation density rises rapidly due to plastic deformation. These
dislocations at the grain boundaries increase and therefore the stress necessary to continue the plastic
deformation also increases. Therefore, there is an increase in the yield strength and ultimate tensile
strength. The yield strength varies inversely with the square root of grain size (hall petch equation).
Grain refinement can be done by :
1. Heat treatment
2. Addition of grain refiners which act as nucleating agents.
Grains refiners are metals or foreign bodies of high melting temperature. They crystallize out at
high temperature and act as nuclei or seeds for further solidication. e.g. iridium, rhodium.
The best method to improve properties of alloys and metals is by the addition of grain
refiners. Finely reined grains structure contain grain size >70m.

2. SOLUTION HARDENING OR SOLID SOLUTION STRENGTHENING
An alloy is a solid solution ; it has a solute and a solvent. The atomic diameter of a solute and
solvent will never be the same.
The principle of solid solution hardening is by introducing either tensile or compressive strain
depending on whether the solute atom is smaller or larger than the solvent respectively and finally
distorting the grain structure. This solute can be either :
- Substitutional
- Interstitial

3. PRECIPITATION HARDENING
Another method of strengthening alloys is by means of this technique. In this, the alloy is heated
so that precipitates are formed as a second phase which blocks the movement of dislocations. The
effectiveness is greater if the precipitate is part of the normal crystal lattice which is known as coherent
precipitation.

4. DISPERSION STRENGTHENING
It is a means of strengthening a metal by adding finely divided hard insoluble particles in the soft
metal matrix as a result of which, the resistance to dislocations is increased. This increases hardness
and tensile strength.
The ideal properties are seen when the particles range from 2-15% by volume with spacing at 0.1
1.0m intervals and particle size from 0.01 0.1.
The ideal shape of the dispersed particle is a needle like LAMELLAR SHAPE which can
intersect with the slip planes. Powdered metallurgy makes use of this method for strengthening.

5. STRAIN HARDENING OR WORK HARDENING
This is seen in wrought metals. The metals are worked after casting to improve their mechanical
properties. They may be forged, hammered, drawn as wires, etc. All this is done below the re-
crystallization temperatures. This working causes vast number of deformations within the alloys or
metals. These interact with each other mutually, impeding the movements. The increased stress
required for further dislocation movement to achieve permanent deformation provides the basis for work
hardening. This result is distorted grain structure with the grains being fibrous.
ALLOYS

ALLOYS AS ALREADY SAID, MEAN IN LATIN = TO BIND
Alloys can be defined as
1. Alloy is a combination of two or more metals which are generally mutually soluble in the liquid condition.
2. Alloy is a metallic material formed by the intimate blending of two or more metals. Sometimes a non
metal may be added.
3. Alloy is a substance composed of two or more elements, at least one of which is a metal.

METHOD OF ALLOYING
1. By melting together the base metal and the alloying element, mixing them thoroughly and allowing them
to solidify. This is the common method.
2. Sintering or powder metallurgy : Metals are powdered, mixed and pressed to the desired shape and then
heated but not melted till the powders unite to form a solid mass.

OBJECTIVES OF ALLOYING
The subjects of alloying are :
1. To increase the hardness and strength
2. To lower the melting point
3. To increase the fluidity of the liquid metal
4. To increase the resistance to tarnish and corrosion
5. To make casting or working on metal easy
6. To change the microscopic structure of metal
7. To change the color of the metal
8. To provide special electrical and magnetic properties.

The alloying treatment may be present in the main or base element as a :
1. Substitutional type
2. Interstitial type
3. Chemically combined form


CLASSIFICATION OF ALLOYS
The alloys can be classified in many ways :
1. According to the uses - All metal inlays
- Crowns and bridges
- Metal ceramic restorations
- Removable partial dentures
- Implants

2. Major element present - Ferrous alloys : rich in iron
- Gold and silver alloys
- Babbit metals tin and lead
based alloys
- Nickel alloys

3. Nobility - High noble metals : noble metal - 60wt%
gold 40%
- noble metals : 25% wt%, no
stipulation for gold
- predominantly based metal : <25% of noble
metals

4. Principle three elements : - Au-Pd-Ag
- Pd-Ag-Sn
- Co-Cr-Mo
- Ti-Al-V

5. Based on yield strength and - Soft
elongation - Medium
- Hard
- Extra hard

6. Based on the dominant phase - Isomorphous
- Eutectic
- Peritectic
- Layered
- Intermetallic compound

7. Based on the method of - Cast metal
of fabrication
- Wrought metal

8. Based on the number of metals - Binary
- Ternary
- Quaternary
- Quinary


The composition of alloys can be defined by :
- Weight percentage of each element
- Atomic fraction or percentage of each element
Usually the alloy properties relate more directly to the atomic percentage rather than weight
percentage. The atomic % is not always equal to the weight %.
- In Au-Cu3, the wt% of Au is 51% of Au is 25%
- Beryllium is present in nickel alloys in a small amount of 1.8wt%, but by at % it constitutes about 10.7%.
SOLID SOLUTIONS OR ISOMORPHOUS STATE OR SINGLE PHASE :
Solid solution is nothing but solution in the solid state. The alloys of this type exist in a single
phase with two or more components. It consists of a solute and a solvent. These are completely miscible
in any proportion in both the solid and liquid state. Solvent is that metal whose space lattice persists and
solute is the other metal. By far these represent one of the simplest, most common and useful of all
combinations.
E.g. Au Ag
Au Cu
Au Pt
Au Pd
Ag Pd

The solid solution can be either :
1. SUBSTITUTIONAL SOLID SOLUTION
In this the solvent atoms are replaced by the solute.
This can be either :
- Regular or Ordered
- Random or Disordered
The ordered arrangement is one in which the atoms of solute are arranged in the solvent in an
ordered fashion so that they are not distinguishable from the solvent. E.g. Au-Cu3 obtained when 50.2
wt% of gold and 49.8wt% of copper is cooled to below 400C. This causes a distorted crystal structure
leading to keying it and increasing hardness. This ordered structure is called as super lattice.
The random arrangement contains solute that is randomly distributed in the solvent. E.g. Pd-Ag,
in which the silver atoms replace the palladium atoms randomly. This arrangements has higher energy.

2. INTERSTITIAL SOLID SOLUTION
In this, the solute atoms are present in positions between the solvent atoms. E.g. carbon is
distributed interstitially in iron to form steels. In this the atomic size of the solute atoms should be smaller
than the solvent atoms.










HOME ROTHERS RULE OF SOLID SOLUBILITY :
For substitution solid solutions, the solubility limit of solute in solvent depends on :
1. CRYSTAL STRUCTURE
Only metals with the same type of crystal lattice can form a series of solid solutions particularly if
the size factor is less than 8% most of the metals used for dental restorations are face centered cubic.
2. CHEMICAL AFFINITY
When two metals exhibit a high degree of chemical affinity, they tend to form an intermetallic
compound on solidification rather than a solid solution.
3. VALENCE :
Metals of the same valency and size are more likely to form extensive solid solutions than metals
of different valencies. If the valancies differ ; the metal with a higher valence may be soluble in a metal of
lower valence.
4. ATOM SIZE
If the sizes of the two metallic atoms differ by less than 15% they posses a favourable size factor
for solid solubility. If the size factor is greater than 15% multiple phases appear during solidification. For
good solubility the size difference should be less than 8%.

COOLING CURVE OF A SOLID SOLUTION
A cooling curve of a solid solution type of an
alloy is shown.








The temperature is found to drop as in the case of a pure metal from e to f by simple cooling of
the molten solution. At the temperature f, crystals of the solid start to form throughout the liquid. The
alloy is partly liquid and partly solid in the stage of cooling from f to g. During this time interval the
composition of the remaining liquid is changing slightly and the temperature continues to drop
slowly. The portion of the curve from f to g represents the solidification or freezing range during cooling
in contrast to the freezing point seen in pure metals. Portion g to h represented the cooling of the
solidified alloy.

PHASE DIAGRAM OF A SOLID SOLUTION ALLOY
The phase diagram of an alloy of
composition X (approximately 60% A and 40% B) is shown :








TmA and TmB represent the melting points of the pure metals A and B. This alloy is rendered
completely molten by heating it to a temperature above T1 which is the liquidus temperature for that
particular composition.
When the alloy is cooled from above T1, it remains molten until it reaches T1 where the first solid
begins to form. The composition of the first solid to form is given by drawing a horizontal line or TIE
LINE to intersect the solidus. In this case, drawing such a tie line reveals that the first solid to form has a
composition Z (approx 90% A/10%/B) As the alloy is further cooled, more crystallization occurs and
between temperatures T1 and T2 a mixture of solid and liquid exists.
Selecting one temperature Tsl within this region, the composition of both solid and liquid can be
predicted by noting where the tie line intersects both solidus and liquidus. Thus, at temperature Tsl, the
composition of the solid is Y (approx 80%A/ 20%B) and the composition of the remaining liquid is W
(approx75%B/ 25%A). On further cooling, the alloy becomes completely solid at temperature Ts. The
last liquid to crystallize has the composition V (approx 80%B/20%A). This confirms the previous
observation for the solid solution alloy, that a cored structure exists in which the first material to crystallize
is rich in the metal with the higher melting point (A), whilst the last material to solidify is rich in the other
metal (B).








PROPERTIES OF A SOLID SOLUTION ALLOY
The solid solution possesses:
1. Increased hardness
2. Increased strength
3. Increased proportional limit
4. Decreased ductility
5. Decreased resistance to corrosion due to coring
6. Melting range rather than a point
In general the microstructure of a solid solution resembles that of the parent metals with
properties that resemble an average of the two compounds. The properties keep increasing until the
concentration of each compound reaches 50%.

EUTECTIC ALLOYS
The eutectic alloy is one in which the components exhibit complete solubility in the liquid state but
limited solid solubility E.g. Ag-Cu. The term eutectic means lowest melting point. The eutectic alloy has
the lowest melting point than either of the constituent metals.
In silver copper system the temperature of silver is around 960.5C and that of copper is 1083
C. But that of the eutectic composition is 779.4 C. In this, an intimate but heretogeneous mixture of the
component metals exist when the alloy solidifies. E.g. a mixture of salt and ice although completely
soluble in each other in the liquid state solidifies as separate salt and ice crystal on solidification.
These in contrast to other alloys do not have a solidification range ; instead they have a
solidification point. When the eutectic alloy solidifies, the atoms of the constituent metals segregate to
form regions of nearly pure metals, which result in a layered structure.
It can be written as :
LIQUID = SOID SOLUTION + SOLID SOLUTION
It is referred to as invariant transformation because it occurs at a single temperature and
composition. The first formed grains of the above said equation are called as primary grains and they are
larger than that of the eutectic composition.
Partial eutectic is a system where in the metals exhibit solubility in liquid state and limited solubility
in the solid state.
COOLING CURVE OF A EUTECTIC ALLOY
The solidification of an alloy of eutectic
composition may present the same curve as that of a pure metal, except that the solidification
temperature is lower than that for either of the pure metals. The cooling curves of eutectic alloy, pure
metal and a composition between that of a metal and pure eutectic composition is given below :








During the cooling of such a mixture, the first break in the curve represents the separation of some
crystals of excess pure metal, resulting in a change in the shape of the cooling curve. As the metal
crystals separate, the composition of the remaining liquid alloy changes until the true eutectic composition
is reached. At this time, the freezing of the eutectic mixture occurs without further change in the
composition and at a constant temperature.
The cooling curve of an alloy of 50% tin and 50% lead through the temperature range from near
300C to about 120 C is shown. This composition does not represent the eutectic composition of lead
tin.
The cooling curve for this eutectic type of an alloy with excess lead present can be divided into five
distinct parts, each of which represents a change in condition, or liquidsoid phase equilibrium of the
system. These changes in the curve may be observed by simple inspection. The simple cooling of the
liquid alloy is represented from the starting temperature of about 270C to 210C. This section of the
curve is the same as that found in the uniform cooling of any liquid, and the temperature drop here
represents a simple function of the time of cooling.
The second portion of the curve from 210C to 176C represents the separation or freezing out of
pure lead from the molten mass. Within this range the whole mass is beginning to crystallize, but the
crystals that separate are pure lead floating in a liquid bath of lead and tin, which is continually becoming
richer in tin as a result of the lead separation. Lead continues to separate as a crystalline metal until a
temperature of 176C is reached.
At this point, the change in direction of the curve represents a rise in temperature from 176C to
183C, which is from the under cooled condition. This is due to the liberation of the latent heat of
fusion. The first irregularity of the curve at 210C was brought about by the liberation of the heat due to
crystallization of lead. The final solidified mass consists of a heterogeneous mass of lead crystals
surrounded by a matrix of lead tin alloy mixture of definite eutectic composition of 62% tin and 38%
lead. The matrix alloy has had its composition developed through the process of separation of 12% of
pure lead (50% minus 38%) during the cooling from 210 C to 183C. This final matrix alloy is called the
eutectic mixture.
Finally, from the temperature of 183C downward, the curve represents the simple cooling of the
solid alloy.

PHASE DIAGRAM OF A EUTECTIC ALLOY
The phase diagram is obtained as for the pure metal.
In this diagram, on the left is shown the melting point of lead (327C) and on the right the melting
temperature of tin (232C). The melting temperature (183C) of the eutectic alloy (62%) tin is shown to
be lower than that of either ingredient metal.














By connecting the portions of the cooling curves which represent the eutectic freezing
temperature and the portions of the cooling curves which represent the first separation of the excess
ingredient metal in different alloy compositions, a diagram is obtained.
From this it is evident that any alloy composition will be in the liquid phase when heated to a
temperature above that represented by the lines from 327C for pure lead, to 183C at 62% tin for the
eutectic, to 232C for pure tin. Below these lines, the excess metal will start to crystallize out when an
alloy of any composition is cooled, and the mass will entirely crystallized below the temperature of
183C. The composition of 62% tin and 38% lead represents the lowest melting mixture of tin and lead
and is described as the eutectic composition. At this composition no excess lead or tin separates, but
instead a homogenous mixture of lead and tin crystallizes simultaneously from the liquid state.
To the right of the eutectic composition, at 80% tin for example, the excess in separates during
the cooling from 200C to the eutectic melting temperature, at which time the eutectic mixture crystallizes
to surround the separated tin. In the lower right portion the solid alloy is described as solid eutectic and
tin.
In the left portion, on cooling, the excess lead in a composition of 60% lead and 40% tin will
separate before reaching 183C after which the eutectic will surround the lead crystals.
The phase diagram of the eutectic composition of Ag-Cu is given below :





This has a composition of 28.1% Cu and 71.9% Ag. It can be seen that a small amount of solid
solution exists at each end of the diagram, indicating, that silver is slightly soluble in copper and that
copper is slightly soluble in silver. The eutectic structure does not appear in alloys of less than 8.8%
copper. Only the solid exists with varying amount of solid solution depending on the temperature.
A photomicrograph of this alloy is interesting, since it indicates that silver and copper have
separated as mixtures rather than as homogeneous solutions of silver and copper. Such an appearance
is typical of eutectic alloys.


PROPERTIES OF EUTECTIC ALLOYS
Alloys with composition less than that of the eutectic are called as hypoeutectic and those with a
composition greater than that of the eutectic are known as hyper eutectic alloys. The primary crystals of
hypoeutectic are composed of solid solution and those of hyper eutectic are composed of solid
solution.
Therefore :
1. A linear variation between the composition and the physical properties cannot be expected.
2. Since there is a heterogeneous composition, they are susceptible to electrolytic corrosion.
3. They are brittle, because the present of insoluble phases inhibits slip.
4. They have a low melting point and therefore are important as solders.



PERITECTIC ALLOYS
Peritectic is a phase where there is limited solid solubility. They are not of much use in dentistry
except for silver tin system. Like the eutectic, this is also an invariant transformation since this occurs at a
particular temperature and composition. The reaction is written as :
Liquid + =
This type of reaction occurs when there is a big differences in the melting points of the
components. The peritectic phase diagram is given below.










The phase is a silver rich phase, the phase, a platinum rich, and + , a two phase region
resulting from limited solid solubility. The peritectic transformation occurs at the point P at which the
liquid, plus the platinum rich phase transforms into the silver rich phase. The substantial composition
change involved can lead to large amounts of coring if rapid cooling occurs. If the alloy has a
hypoperitectic composition, as does alloy 1 in the figure, cooling of the alloy through the peritectic
temperature results in the transformation.
LIQUID + = LIQUID +
Rapid cooling results in precipitation of phase around the grains before diffusion can
occur. The solid phase inhibits diffusion, and substantial coring occurs. The cored structure is more
brittle and has corrosion resistance inferior to that of the homogenous phase.
These alloys undergo phase reactions and transformations upon solidification because of partial
solubility of the constituent metals.


INTERMETALLIC COMPOUNDS
These are compounds that are soluble in the liquid state but unite and form a chemical compound
on solidification E.g. Ag3 Sn,
- Ag2 Hg3
- Sn7 Hg8
These are called as intermetallic compounds because ; the alloy is formed by a chemical reaction
between a metal and a metal. At space lattice level, the atoms of one metal, instead of appearing
randomly in the space lattice of another metal, occupy a definite position in every space lattice.







The phase diagram of an intermetallic
compounds is :










The most important feature in this diagram, from the stand point of silver tin amalgam alloy, is the fact that
when an alloy containing 26.85% tin is slowly cooled with a temperature of 480C, there is produced an
inter metallic compound, (Ag
3
-Sn) known also as gamma phase (). This silver tin compound is formed
only at the lower temperatures over a narrow composition range from about 25 to 27%. The silver
content for such an alloy would be 73.15% on the basis of the presence of 26.85% tin.
These diagrams are generally more complex than those for eutectic and solid solution alloys. Few
general effects can be predicted from alloys forming chemical compounds.


PROPERTIES OF INTER METALLIC COMPOUND
1. Very hard
2. Brittle
The properties do not resemble that of the pure metal.

LAYER TYPE SYSTEM
In this, the two metals are completely insoluble in both the liquid as well as the solid state. The two
metals appear to solidify at their individual freezing points into two separate distinct layers. The phase
diagram of this is shown below :











All this while, the discussion was on binary alloys and their phase diagrams. But the same can be
obtained for ternary alloys. The three pure metals may be represented as the vertices of an equilateral
triangle, with the temperature indicated by the length of the vertical line perpendicular to the plane of the
triangle. Ternary diagrams have not been developed to the extent of binary diagrams because of the
difficulty in their preparation and interpretation

DENTAL CASTING ALLOYS

Metal restorations can be made by a number of methods like direct compaction as in the case of
pure gold, swaging of metal foils, CAD-CAM process for pure titanium or titanium alloys, electroforming
and copy milling.
Thus, although a variety of methods are available, the best and the most popular method in use is
casting. In this, the impression of the prepared tooth is replicated in a refractory die, and a required
pattern is done using wax. This is then invested in an investment material and burned out. Now in the
mold available, the molten metal or alloy is casted under pressure using centrifugal force.

The major events in the history of dental casting alloys are given below :
Event Year
Introduction of lost wax technique 1907
Replacement of Co-Cr for Au in removable partial dentures 1933
Development of resin veneers for Au alloys 1950
Introduction of the porcelain fused to metal technique 1959
Palladium based alloys as alternatives to Au alloys 1968
Ni based alloys as alternatives to Au alloys 1971
Introduction of all ceramic technologies 1980
Au alloys as alternative to palladium based alloys 1999

The history of the dental casting alloys have been influenced by quite a number of factors which
involve the following :
1. The technological changes of dental prosthesis
2. Metallurgic advancements
3. Price changes of the noble metals

The fabrication of the cast inlay restoration which was presented by TAGGART in 1907 to the
New York Odontological group has been acknowledged as the first reported application of the lost wax
technique.

DESIRABLE PROPERTIES OF THE CASTING ALLOYS
The metals must exhibit
1. Biocompatibility
2. Ease of melting
3. Ease of casting, brazing, soldering, and polishing
4. Minimal reactivity with the mold material
5. Good wear resistance
6. High strength, stiffness and rigidity
7. Sag resistance
8. Excellent tarnish and corrosion resistance
9. Should be inert in the oral conditions
10. Should have fatigue resistance
11. Should be amenable to heat treatment
12. Little solidification shrinkage

CASTING SHRINKAGE
This includes both the solidification shrinkage and the thermal contraction from the solidification
temperature to room temperature. The shrinkage occurs in three stages :
1. The thermal contraction of the liquid metal between the temperature to which it is heated and the liquidus
temperature.
2. The contraction of the metal inherent in its change from the liquid to the solid state
3. The thermal contraction of the solid metal that occurs on further cooling to room temperature.
The first mentioned one is not of much consequence, because this is compensated by the molten
metal that flows into the mold.
In order to obtain accurately fitting prosthesis, it is necessary to obtain compensation for this
casting shrinkage. This can be achieved by either generating computer aided over sized dies or through
controlled expansion techniques, which include both setting or hygroscopic expansion and thermal
expansion.
Linear solidification shrinkage of casting alloys :
Alloy type Casting shrinkage (%)
Type I (Au based) 1.56
Type II (Au based) 1.37
Type III (Au based) 1.42
Type IV (Ni-Cr based) 2.30
Type V ( Co Cr based) 2.30
Generally type 2 and type 3 gold alloys represent the standards against which the performance of
other casting alloys are judged.
The classification of alloys for all metal, metal ceramic and frameworks for removable partial denture are
given below.

Classification of casting metals for full metal and metal ceramic prosthesis and partial dentures

Metal Type All-metal prostheses
Metal ceramic
prostheses
Partial denture
frameworks
High Noble (HN)
Au-Ag-Pd Pure Au (99.7%) Au-Ag-Cu-Pd
Au-Pd-Cu-Ag Au-Pt-Pd
HN metal ceramic
alloys
Au-Pd-Ag (5-12 wt
% Ag)
Au-Pd-Ag (>12 wt%
Ag)
Au-Pd
Noble (N)
Ag-Pd-Au-Cu Pd-Au
Ag-Pd Pd-Au-Ag
Noble metal ceramic
alloys
Pd-Ag
Pd-Cu-Ga
Pd-Ga-Ag
Predominantly Base
metal (PB)
CP Ti
Ti-Al-V
CP Ti
Ti-Al-V
CP Ti
Ti-Al-V
Ni-Cr-Mo-Be Ni-Cr-Mo-Be Ni-Cr-Mo-Be
Ni-Cr-Mo Ni-Cr-Mo Ni-Cr-Mo
Co-Cr-Mo Co-Cr-Mo Co-Cr-Mo
Co-Cr-W Co-Cr-W Co-Cr-W
Cu-Al


Solidus and liquidus temperature of the commonly used classes of alloys :

Alloy type ADA classification
Solidus temperature
(C)
Liquidus
temperature (C)
Au-Pt High Noble 1060 1140
Au-Pd High noble 1160 1260
Au-Cu-Ag-Pd High noble 905 960
Au-Cu-Ag-Pd Noble 880 1270
Pd-Cu Noble 1145 1230
Pd-Ag Noble 1185 1045
Ag-Pd Noble 990 1270
Ni-Cr-Be (Cr<20 wt
%)
base metal 1160 1270
Ni-Cr (Cr<20 wt %) base metal 1330 1390
Ni-Cr-Be (Cr<20 wt
%)
base metal 1250 1310
Co-Cr base metal 1215 1300




Different Metals Used In Dentistry
Gold (Au)

Gold provides a high level of corrosion and tarnish resistance
increases an alloy's melting range slightly.
Gold improves workability, burnish ability, and raises the density .
However, gold imparts a very pleasing yellow color to an alloy (if present in sufficient quantity).
Unfortunately, that yellow color is readily offset by the addition of "white" metals, such as palladium and
silver. Gold is a noble metal.

Palladium
Palladium is added to increase the strength, hardness (with copper), corrosion and tarnish resistance of
gold-based alloys.
Palladium will also elevate an alloy's melting range and improve its sag resistance.
It has a very strong whitening effect, so an alloy with 90% gold and only 10% palladium will appear
platinum-colored.
Palladium possesses a high affinity for hydrogen, oxygen, and carbon.
It lowers the density of the gold-based alloys slightly but has little similar effect on silver-based metals.
Palladium, a member of the platinum group, is a noble metal

Platinum
Platinum increases the strength, melting range, and hardness of gold-based alloys while improving their
corrosion, tarnish, and sag resistance.
It whitens an alloy and increases the density of non gold-based metals because of its high density.
Platinum is a member of the platinum group and is a noble metal

Iridium
serves as a grain refiner for gold- and palladium-based alloys to improve the mechanical properties as well
as the tarnish resistance.
Iridium is a member of the platinum group and is a noble metal.

Ruthenium (Ru)

Ruthenium acts as a grain refiner for gold- and palladium- based alloys to improve their mechanical
properties and tarnish resistance (like iridium).
Ruthenium is a member of the palladium group and is a noble metal.
Silver

Silver lowers the melting range, improves fluidity, and helps to control the coefficient of thermal expansion
in gold- and palladium-based alloys

Silver-containing porcelain alloys have been known to induce discoloration (yellow, brown, or green) with
some porcelains.

Silver possesses a high affinity for oxygen absorption, which can lead to casting porosity and/or gassing.

However, small amounts of zinc or indium added to gold- and silver-based alloys help to control silver's
absorption of oxygen.

Silver will also corrode and tarnish in the presence of sulfur. Although silver is a precious element, it is not
universally regarded as noble in the oral cavity .

Aluminium
Aluminum is added to lower the melting range of nickel-based alloys.
Aluminum is a hardening agent and influences oxide formation.
With the cobalt - chromium alloys used for metal ceramic restorations, aluminum is one of the elements
that is "etched" from the alloy's surface to create micromechanical retention for resin-bonded retainers
(Maryland Bridges).




Beryllium
Like aluminum, beryllium lowers the melting range of nickel-based alloys, improves castability, improves
polishability, is a hardener, and helps to control oxide formation.
The etching of nickel-chromium-beryllium alloys removes a Ni-Be phase to create the micro retention so
important to the etched metal resin-bonded retainer.
Questions have been raised as to potential health risks to both technicians and patients associated with
beryllium-containing alloys .

Boron
Boron is a deoxidizer.
For nickel-based alloys, it is a hardening agent and an element that reduces the surface tension of the
molten alloy to improve castability.
The nickel-chromium beryllium-free alloys that contain boron will pool on melting, as opposed to the Ni-Cr-
Be alloys that do not pool.
Boron also acts to reduce ductility and to increase hardness.

Chromium (Cr)
Chromium is a solid solution hardening agent that contributes to corrosion resistance by its passivating
nature in nickel- and cobalt-based alloys

Cobalt (Co)
Cobalt is an alternative to the nickel-based alloys, but the cobalt-based metals are more difficult to process.
Cobalt is included in some high-palladium alloys to increase the alloy's coefficient of thermal expansion
and to act as a strengthener

Copper (Cu)
Copper serves as a hardening and strengthening agent, can lower the melting range of an alloy, and
interacts with platinum, palladium, silver, and gold to provide a heat-treating capability in gold-, silver-,
and palladium-based alloys.
Copper helps to form an oxide for porcelain bonding, lowers the density slightly, and can enhance
passivity in the high palladium-copper alloys.

Gallium (Ga)
Gallium is added to silver-free porcelain alloys to compensate for the decreased coefficient of thermal
expansion created by the removal of silver. (Concerns over silver's potential to discolor dental porcelain
have greatly limited its use in systems other than palladium-silver )

Indium
Indium serves many functions in gold-based metal ceramic alloys.
It is a less volatile oxide-scavenging agent (to protect molten alloy);
lowers the alloy's melting range and density; improves fluidity;
Has a strengthening effect. Indium is added to non goldbased alloy systems to form an oxide layer for
porcelain bonding.
Alloys with a high silver content (eg, palladium-silver) rely on indium to enhance tarnish resistance.

Iron (Fe)
Iron is added to some gold-based porcelain systems for hardening and oxide production.
Iron is included in a few base metal alloys as well.

Manganese (Mn)
Manganese is an oxide scavenger and a hardening agent in nickel- and cobalt-based alloys.

Molybdenum (Mo)
Molybdenum improves corrosion resistance, influences oxide production, and is helpful in adjusting the
coefficient of thermal expansion of nickel-based alloys.

Nickel (Ni)
Nickel has been selected as a base for porcelain alloys because its coefficient of thermal expansion
approximates that of gold and it provides resistance to corrosion.
Unfortunately, nickel is a sensitizer and a known carcinogen.
Estimates of nickel sensitivity among women in the United States range from 9% to 31.9% and from 0.8%
to 20.7% among men .

Tin (Sn)
Tin is a hardening agent that acts to lower the melting range of an alloy. It also assists in oxide production
for porcelain bonding in gold- and palladium-based alloys. Tin is one of the key trace elements for
oxidation of the palladium-silver alloys.

Titanium (Ti)
Like aluminum and beryllium, titanium is added to lower the melting range and improve castability.
Titanium also acts as a hardener and influences oxide formation at high temperatures.

Zinc (Zn)
Zinc helps lower the melting range of an alloy and acts as a deoxidizer or scavenger to combine with other
oxides.

Zinc improves the castability of an alloy and contributes to hardness when combined with palladium.




ALLOYS FOR ALL METAL RESTORATION
As it can been seen from the table, the metals that can be used for all metal restoration can be
classified as highly noble, noble and base metal alloys.
Among the highly noble metals are Au-Ag-Cu-Pd and metal ceramic alloys. The metal ceramic
alloys are dealt under a separate section.
In the noble group are the Ag-Pd-Au-Pd and metal ceramics.
The base metal alloys that can be used for all metal restorations are those that are used for metal
ceramics and removable partial denture frameworks. Since they are used for the latter two purposes,
they are discussed under that.
It can be seen that all of the metal ceramics can be used for all metal restorations but it is not the
same vice versa. The principle reasons for this may be because the alloys of all metal restoration may
not be able to form metal oxides that is required for bonding to porcelain, their melting temperature may
be too low to resist sag deformation at porcelain firing temperatures, and their thermal co-efficient of
contraction may not be close enough to match that of porcelain.
Typical compositions of Casting Alloys for Full-Metal, Resin-Veneered and Metal- Ceramic
Prostheses
Alloy type Classification
Elemental composition (wt%)
Au Pd Ag Cu Ga, In, and Zn
I
High
Noble (Au-
based)
83 0.5 10 6 Balance
II
High
Noble (Au-
based)
77 1 14 7 Balance
III
High
Noble (Au-
based)
75 3.5 11 9 Balance
III
Noble (Ag-
based)
46 6 39 8 Balance
III
Noble
(Ag-based)
- 25 70 - Balance
IV
High
Noble (Au-
based)
56 4 25 14 Balance
IV
Noble
(Ag-based)
15 25 45 14 Balance
Metal
Ceramic
High
Noble (Au-
based)
52 38 - - Balance
Metal
Ceramic
Noble
(Ag-based)
- 60 30 - Balance
Metal
Ceramic
High
Noble (Au-
based)
88 7 1 - Balance
Metal
Ceramic
Noble
(Ag-based)
0-6 74-88 0-10 0-15 Balance
The alloys used for all metal restoration are described below :

GOLD AND GOLD BASED ALLOYS
Gold in the as cast condition is very soft and can be easily cold worked. The gold in the pure form
is used for direct restorations whereas the alloys of gold are used for casting purposes. The alloys of gold
are classified as :
Type Au% Ag% Cu% Pt/Pd% Zn%
I (soft) 85 11 3 - 1
II (Medium) 75 12 10 2 1
III (Hard) 70 14 10 5 1
IV (Extra hard) 65 13 15 6 1

It can be seen that the gold content or nobility of the alloys decreases on going from type I to type
IV. nobility of gold alloys is often indicated by either carat value of fineness. Carat value represents the
number of parts by weight of gold per 24 parts of gold. Fineness indicate the number of part per
thousand parts of gold. Thus the fineness rating is 10 times the gold percentage of the alloy. Fineness
is considered a more practical term than the carat value.
Their comparative properties, also are shown below

Type Hardness Proportional
limit
Strength Ductility Corrosion
resistance
I
II Increases Increases Increases Decreases Decreases
III Downwards Downwards Downwards Downwards Downwards
IV

Mechanical Property Requirements in ANSI/ADA Specification No.5 for Dental Casting Alloys
(1997)
Alloy type
Yield strength (0.2% offset) Elongation
Annealed Hardened Annealed Hardened
Minimum (MPa) Minimum (MPa) Minimum (MPa) Minimum (%) Minimum (%)
Type 1 80 180 - 18 -
Type 2 180 240 - 12 -
Type 3 240 - - 12 -
Type 4 300 - 450 10 3

hardness, strength and the proportional limit increases from type I to type IV whereas the ductility and the
corrosion resistance decreases from type I to type IV. This is due to the property of forming solid solution
by the alloying elements. The last two types can be further hardened be hardening heat treatments. The
corrosion resistance is due to the effects of platinum and palladium which form a cored structure on
solidification de to their high melting points. There is a consequent increase in the separation of the
liquidus and the solidus lines in the phase diagram.
USES
1. Type I : are sure for inlays which are well suppose and do not have to resist high masticatory
forces. The high ductility values allow them to be burnished thus improving the marginal fit.
2. Type 2 : are the most widely used metals for inlays. They have superior mechanical properties than
type I.
3. Type 3 : are used when there is less support from tooth structure and when the opposing stress are
high like for crowns, bridges.
4. Type 4 : are used exclusively for construction of components of partial dentures and for this reason are
referred to as partial denture casting alloys.
The functions of each of the ingredient metals in the casting alloy are :
1. Gold - Yellow color, ductility, resistance to tarnish
and corrosion.
2. Silver - Hardness and strength. Whiten the alloy thus
reducing the reddening effect of copper, but tarnishes the alloy.
3. Copper - Hardness and strength. Reddish color but
lowers tarnish resistance. Lowers fusion temperature. Reduces the density of the alloy.
4. Palladium - Increases resistance to tarnish and corrosion.
Whitens the alloy Cheap. Absorbs gases formed during casting, and thus reduces porosity. Increases
hardness.
5. Zinc - Acts as a scavenger and removes the oxides.
Makes the alloy more castable.
The classification based on the color of the allow :
1. Yellow gold Those with more than 60% Au
2. Low gold or economy gold With 42-55% Au, also has yellow color
3. White gold are those with gold more than 50%, but palladium gives the white color
4. Silver palladium with or without gold but mainly silver Has white color
5. Palladium silver with mainly palladium gives white color.
6. Japanese gold Also known as technique alloy used for training students in casting technology - has
yellow color. It has the composition of
Cu - 53%
Zn - 37%
Al - 7%
Others - 3%
The grain refined alloys are those that contain iridium or ruthenium in 100-150 parts per
million. By this the grain size is decreased to 150-50 microns. Therefore better physical properties can
be obtained since they depend on the smaller grain size for better properties.
The advantages of the refined alloys are :
High yield strength
High elongation
Homogenous casting
More resistance to corrosion

HEAT TREATMENT OF GOLD ALLOYS
The heat treatments are :
1. Softening heat treatment :
In this, the alloy is heated in an electric furnace at a temperature of above 700C for 10 min and
then quenched rapidly in water. The normal procedure is to leave the mould until the gold is no longer at
red heat which is visible in the sprues of the casting. This ensures that the internal metal temperature is
about 600 C after which it is quenched. This causes a fine grain structure. The ductility and the
corrosion resistance increase whereas the strength, hardness and the proportional limit decrease.
2. Homogenization heat treatment :
This is done when platinum and palladium are present, to remove coring. This involves heating
to 700C for ten minutes, followed by quenching.
3. Stress relief anneal :
This is done when any adjustments are done to the appliance to remove the stresses. This
involves heating in a low temperature to remove the stresses for a given period of time.
4. Hardening heat treatment :
This is done for type III and type IV alloys which contain sufficient amount of copper. This is due
to solid state transformations. The casting is heated to above 450 C and allowed to cool slowly until
200C, then quenching. This takes about 20 min. This causes an increase in the strength, hardness and
proportional limit with a decrease in corrosion resistance and ductility.

Hardening heat treatment (theoretical considerations):
The hardening process can be explained by the consideration of phase diagrams for silver copper
and gold copper systems.
Silver and copper are immiscible in each other. They form eutectic phase at a composition of
71.9% Ag and 28.1% Cu. Although they are not soluble in each other, they tend to form little amount of
solid solution at room temperature in the eutectic mixture. When the alloys are heated, the diffusion of
atoms become possible and copper tends to precipitate from the solid solution. This occurs of the
precipitation hardening procedure used for type III and type IV alloys.









Gold and copper form a continuous series of solid solution with face centered cubic lattices. The
copper is randomly substituted in the gold lattices. From the phase diagram it can be seen that the
solidus and the liquidus are close together and almost coincide at point M. Two other areas on the phase
diagram, at composition between 40% and 90% gold, indicate regions in which the alloys are capable of
forming an ordered state from a random one. This ordered lattice is known as super lattice.
This occurs by the rearrangement of atoms when their energy is increased to allow diffusion as
when heating to 200C 400C. The super lattice has a formula of Cu
3
-Au. This heat treatment is known
as ordered heat treatment. Similarly, when an alloy containing 75% gold is heated, an ordered tetragonal
structure of the formula Cu-Au is formed.














LOW GOLD CONTENT ALLOYS
These contain about 45% - 50% gold and was introduced due to rise in the price of gold. They have
a high palladium content which imparts a whitish color to them. The properties are similar to that of type
III and IV alloys, but the ductility is considerably lower. They have an elongation percent of only 2%
whereas, type III alloy has 20%.


SILVER PALLADIUM ALLOYS
These alloys, as the name suggest, contain predominantly silver in composition but have
substantial amounts of palladium (25%) that provide nobility and promote the Silver tarnish
resistance. They may or may not contain Copper or Gold. These contain small amounts of Zinc and
Indium. They are whitish in color.
These have casting temperatures in the range of yellow gold alloys. They have lower density than
the gold alloys and therefore, present difficulties in casting. Care must be paid to the casting temperature
and the mold temperature if no defects are to be expected. Alloys containing palladium have a propensity
to dissolve oxygen in the molten state which may lead to a porous casting.
The copper free Ag-Pd alloys contain 70% - 72% Ag and 25% Pd. These have properties of type
III Gold alloys. Other silver based alloys contain 60% Ag, 25% Pd and as much as 15% or more of
Cu. These have properties of type IV gold alloy. The major limitation of Ag-Pd alloys in general and Ag-
Pd Cu in particular is their greater potential for tarnish and corrosion.


ALUMINIUM BRONZE ALLOYS
This is the only alloy that is based on Copper as its main component and approved by the
ADA. Although, Bronze is defined as Copper rich Copper Tin phase, Bronze alloys containing no Tin
like Aluminium bronze (Cu-Al), Silicon bronze (Cu-Si), and Beryllium bronze the surface.
The aluminium bronze alloys contain 81-88wt% Cu, 7-11 wt% Ni and 1-4 wt% Fe. This has the
potential to react with Silver and form copper sulphide which tarnishes the surface.

ALLOYS FOR METAL CERAMIC RESTORATIONS
Because of the poor tensile and shear bond strength, All porcelain restorations are weak and
brittle. Therefore, they break easily. But porcelain is necessary for aesthetics. This problem is solved by,
making the restoration in metal and applying porcelain to labial and buccal areas of the appliance in thin
layers (veneers) for esthetics. Thus both strength and appearance are met.
Metal ceramic alloys are also referred to as porcelain-fused-to-metal or ceramometal alloys. But
the preferred term is metal-ceramic. Likewise the preferred acryonym is PFM rather than PBM
(porcelain bonded to metals) and PTM (porcelain to metal).
These are classified as high noble, noble and base metal, like in All Metal Restoration Alloys.
Properties of metal ceramic alloys :
1. High fusing temperature of the alloys. This should be 100C greater than the fusion temperature of
porcelain.
2. The contact angle between the ceramic and metal should be less than 60
3. They should form oxides on the surface for bonding to porcelain. For this purpose, base metals like Tin,
Indium and Iron are added.
4. They should have compatible co-efficient of thermal expansion. For, this is added Palladium which tends
to lower the co-efficient of thermal expansion. Although they should be equal theoretically, it is ideal to
have the co-efficient of thermal expansion of metal greater than that of the porcelain by 0.5 x 10
-
6
/C. Most metals have a coefficient of thermal expansion of 13.5 x 10
-6
/C and porcelains of about 13-
144 x 10
-6
/C.
5. Adequate stiffness and strength
6. High sag resistance
7. Accurate casting of the alloy even under high temperature. The bond between metals and porcelain is
that of chemisorption and the most common failure that occurs in metal ceramic is due to debonding of
the metal.















The high noble alloys used for PFM are :
1. Au-Pt-Pd alloys :
These have a gold cement ranging up to 88% with varying amounts of palladium, platinum, and
small amounts of base metals. These are yellow in color. They have a high melting range. The base
metals are tin, indium and iron, and these are added to form metal oxides for bonding to
porcelain. Rhenium is added as a grain refiner. The hardening that occurs in this is due to the precipitate
of Fe-Pt3. The heat treatment consists of heating the alloy for 30min at 550C. They have high stiffness,
hardness, strength and reasonable elongation but low sag resistance. Because of the yellow color,
producing esthetics is easier.
2. Au-Pd alloys :
They have a Pd content of 35% - 45% and Au content of 44% - 45%. These have remained
popular as metal ceramic alloys in spite of their relatively high cost. Due to the absence of silver, there is
freedom from porcelain greening and also decreased thermal coefficient of contraction. Since they do not
contain Pt or Fe there is no possibility for precipitation hardening to occur. Only solution hardening
occurs. Indium is added for bonding purposes and Gallium, for lowering of the fusion
temperature. Rhenium is the grain refiner and Ruthenium is added for improving castability. This
difficulty in casting is due to their low density. These are white in color and therefore esthetics is difficult
to obtain. They are harder, stiffer and stronger than Au-Pt-Pd. They are more ductile and easier to solder
but have higher casting temperatures.
3. Au-Pd-Ag Alloys :
These contain between 39% and 77% Au, up to 35% Pd and Silver levels as high as 22%. Silver
increases the thermal coefficient of contraction, but it has the tendency to discoloration porcelain. Indium
and Tin are used for bonding the Rhenium for grain refining. Ruthenium is used for improving the
castability. The hardening is by means of solution hardening and the properties are similar to that of Au-
Pd.
The noble metals used for metal ceramic restorations are :
1. Pd-Ag Alloys :
This was the first gold free noble metal to be marketed.
This contains about 53% - 61% Pd and 28% - 40% Ag. These have the lowest noblecontent of
the five noble metal alloys. These contain Tin and Indium for oxide formation for porcelain bonding, and to
increase the alloy hardness and Ruthenium for improving the castability, since they produce greening
effect. This is due to the escaping of the silver vapor to the surface of the alloys during the firing which
diffuses into the porcelain as silver ions and is reduced to colloidal metallic silver in the surface layer of
porcelain. This can be minimized by using ceramic coating agents or gold metal conditioners.
In some of these alloys there is the formation of internal oxides rather than an external
oxide. This produces nodules on the surface which causes a mechanical type of bond rather than a
chemical one. Because of the increased Pd content, there is a decrease in the coefficient of thermal
expansion but the increased silver content increases this and lowers the melting range.
2. Pd-Cu-Alloys :
These are recent introduction to the market and the cost is similar to that of the previous alloy
type.
These contain 74% to 80% Pd and 9% - 15% Cu. They may contain 2% Gold. These tend to
form dark brown or black oxides during porcelain firing. This should be eliminated by proper masking of
the oxide. It is necessary that a brown rather than a black oxide is formed. Otherwise poor adherence to
porcelain may occur. These are susceptible to sag deformation at elevated firing temperatures. Indium is
added for oxide formation and Gallium for improving casting qualities. It has high strength and hardness,
moderate modulus of elasticity and elongation.
3. Pd-Co Alloys :
This is comparable in cost to the above previous groups. They are often advertised as gold free,
nickel free, beryllium free and silver free alloys.
These are the most sag resistant of all noble metal alloys. These have fine grain size. These
tend to discolor porcelain in spite of the absence of the silver due to the formation of cobalt oxides. But
this is not considered as a significant problem and no metal coating agents are necessary to mask the
oxide layer. Like the above three alloys, they have a high coefficient of thermal expansion and can be
used with higher expansion porcelains.
4. Pd-Ga-Ag and Pd- Ga Ag-Au Alloys :
These are the most resistant of the noble alloys. These were introduced because of their
tendency to form lighter oxides than Pd-Cu or Pd-Co. They are compatible with lower expansion
porcelains like vita porcelain.

PHYSICAL PROPERTIES OF HIGH NOBLE AND NOBLE METAL ALLOYS :
1. All are biocompatible
2. Good resistance to tarnish and corrosion
3. Melting temperature of around 1000C. The casting temperature is obtained by adding 75-150C to the
liquidus temperature.
4. Density of 15gm/cm
3
. This gives an idea of how many castings can be done from a unit weight of metal
and therefore the cost.
5. Hardness from soft to hard
6. Elongation which is a measure of ductility of about 20-39%
7. Linear coefficient of thermal expansion in the range of 14 18 x 10
-6
/C.
8. Yield strength in the range of 103 572 MPa.

BASE METAL ALLOYS USED FOR PFM :
Base metals were introduced to the field of dentistry as an alternative to the noble metals due to
rise in the price of gold. They were found to possess some good qualities which have made them a
commonly used material in dentistry. The two commonly used alloys are Co-Cr and Ni-Cr.
According to the ADA the following combinations are available :
1. Cobalt chromium
2. Nickel chromium
3. Nickel chromium beryllium
4. Nickel cobalt chromium
5. Titanium aluminium vanadium
Although Ni-Cr is used for PFM, and Co-Cr for partial dentures, these are described here
because of the similarity in certain properties.
i. Co-Cr Alloys :
These were introduced by the name stellites by Eldwood Haynes an automobile engineer in the
early 1900. They were so named because of their bright, lustrous, mirror like surface resembling starts at
night.
The first introduced Co-Cr alloy in dentistry was called as vitallium and it was introduced in
1928. It was nickel free. This closely resembled satellites. This has been in use since 1930s. The first
dental application of this alloy is recognized as having been made by R.W. Erdle and C.H.P range.
In 1943, a report appeared which described the properties of these alloys including other
products under various names like ticonium, niranium and lunorium.
TYPES
There are two types of alloys and they are :
a. Type I which is high fusing with fusion temperature greater than 2400F.
b. Type II which is low fusing with fusion temperature less than 2400F.
COMPOSITION
These alloys generally contain 35% - 65% Co, 20-35% Cr, 0-23 Ni and trace quantities of other
elements such as molybdenum, silicon, beryllium, boron and carbon.
Cobalt and nickel are strong metals and the purpose of the chromium is to further strengthen the
alloy by solution hardening and to impart corrosion resistance by the passivating effect. This is because
of the chromium oxide that is formed when exposed to air. The minimum percentage required to provide
this protective coat is 12%. Nickel increases the ductility.
The minor elements are added to improve the casting and handling characteristics and modify the
mechanical properties.
Molybdenum decreases the thermal co-efficient of expansion and strengthens the alloy while
Tungsten, when present also acts to strengthen it. Beryllium causes grain refinement and uniformity of
the properties. It also lowers the melting point and strengthens and harden the alloy. Ruthenium
improves the castability, since the alloys are low is density.
Carbon acts as a major strengthener and also affects the strength and hardness when present at
0.2%. When this increases to above 0.25% it causes brittleness in the alloy. This is due to the formation
of carbide core. This concentration not only depends on the manufacturer but also on the type of flame
used. When oxyacetylene flame is used there is possibility of introducing carbon inadvertently.
These are stronger than Ni-Cr and used mainly for partial denture frameworks rather than
PFM. They are stronger than noble alloys.
PROPERTIES
1. Melting point :
Is between 1250. Therefore, they cannot be melted using gas air torch. Only induction method
and oxyacetylene flame should be used. While using care should be taken not to incorporate carbon in
excess.
2. Yield Strength :
This is between 470-710 MPa which for gold is 320mpa. As a result high stresses are required
to deform the appliance. This is important in constructing clasps.
3. Modulus of elasticity :
This is greater than the gold alloys and determines the thickness and the thinness of the various
parts of the denture framework. High stiffness is an advantage since less undercut is involved but this
can also be damaging to the abutment tooth because of the excessive stresses introduced when the
clasp is taken out and inserted into the mouth.

4. Tensile strength :
This is 685 to 870 MPa
5. Hardness :
This is in between 264 432 VHN. For gold it is around 264 VHN. Because of this it is difficult to
grind, cut or polish. The polishing of these is carried out by sand blasting using aluminium oxide of size
50 microns or by electrolytic deposition. This is in contrast to electroplating.
6. Ductility :
This denotes the elongation percentage which is less than gold which has around the ductility of
these is around 1.6 and 3.8 this is related to the fracture of the clasp and how it occurs.
7. Specific gravity :
This is a measure of the weight of the appliance and is half of that of gold.
8. High resistance to tarnish and corrosion
9. Solidification shrinkage :
This is greater than that of gold and is about 2.3. Therefore, it is necessary that the investment
compensates this shrinkage. For the alloys, either silica or phosphate bonded investments are used.
10. Castability :
This does not produce very accurate castings because of the low density which decreases the
thrust of the molten metal during casting. This is improved by alloying beryllium with it.
11. Cost :
This is less than that of gold and therefore economical.

OTHER USES :
i. As part of the implant denture
ii. For making surgical screws and plates
iii. Orthopedic surgery
ii. Ni-Cr Alloys :
These are base metal alloys with a composition of nickel -70 to 90% and chromium of about 13-
20%. Other elements added are iron, aluminum, molybdenum, beryllium, silicon and copper. These are
mainly used for PFM. These were developed after Co-Cr gained wide spread popularity.
PROPERTIES
a. Higher modulus of elasticity
b. Increased hardness
c. High yield strength
d. Less density
e. Less costly
f. Superior sag resistance which is about 25 microns as compared to 225 microns for gold.
g. Ductility greater than that of Co-Cr.
MANIPULATION OF BASE METAL CASTINGS
Since the fusion temperatures of these are high, they cannot be casted as for gold alloys in gypsum
bonded investments. Instead they should be casted in silica or phosphate bonded investments. Melting
of these should be done only by electrical induction or by acetylene/oxygen flame.
These alloys have low density and therefore do not develop the necessary thrust required for filling
the mould. Therefore the casting machines should be capable of producing this extra thrust. Because of
the increased hardness, these materials should be polished by electrolytic method.
COMPARISON OF PROPERTIES OF THE VARIOUS TYPES OF BASE METAL ALLOYS
Property High noble alloy Co-Cr Ni-Cr-Be CPTi
Biocompatibility Excellent Excellent Fair Excellent
Density (g/cm
3
) 14 7.5 8.7 4.5
Elastic Modulus
(GPa)
90 145-220 207 103
Sag resistance Poor-excellent Excellent Excellent Good
Technique
sensitivity
Minimal Moderately High Moderately Extremely
Bond to
porcelain
Excellent Fair High High
Metal High Low
Good Excellent
Low
Fair
Low

COMPARISON WITH CASTING GOLD ALLOYS
The two main components of cast partial denture frameworks are the connectors and
clasps. The connectors should be rigid and should not be permanently deformed. Thus it can be inferred
from the above comparison that Co-Cr alloys meet the requirements.
For a clasp, a high value of proportional limit is required in order to prevent deformation. A lower
value of modulus of elasticity would enable the clasp to engage relatively deep undercuts due to its
increased flexibility. In addition the alloy used to construct clasps should be ductile so that adjustments
can be made to clasps without fracture. Therefore the gold alloys most closely match the requirements
for a clasp. But in practice, both are cast from Co-Cr alloys. When designing clasps from this, due
regard must be paid to the high modulus of elasticity and low ductility. Clasps should not be designed to
engage deep undercuts and alterations leading to fracture. A reduction in thickness decreases the force
necessary to push the clasp over the bulge of the tooth but leaves it exposed to the dangers of
deformation during handling of the denture. This can be overcome by reducing the undercut area and
also the thickness of the clasp.
COMPARISON OF THE PROPERTIES OF TYPE IV AND Co-Cr ALLOY :
Properties Co-Cr Type Gold IV Comments
Tensile Strength (Mpa) 850 750 Both acceptable
Density (gms / cu.cm) 8 15 More difficult to produce defect
the castings for CO-Cr but
dentures are lighter.
Hardness (Vickers) 420 (Hard than
enamel)
250 (Softer than
enamel)
More difficult to polish but retains
polish during services.
Stiffness Stiff More flexible
Ductility 2 15 (as cast)
8 (hardened)
Co-Cr clasps may fracture if
adjustments are made.
Modulus of elasticity
(GPa)
220 100 Co-Cr more rigid for the same
thickness
Proportional limit (MPa) 700 500 Both resist stresses without
deformation.
Melting temperature
(oC)
As high as 1500 Lower than 1000 Co-Cr require electrical induction
or oxyacetylene
Casting shrinkage 2.3 1.25 1.65
Heat treatment Tarnish
resistance price
Complicated
adequate
Reasonable
Simple adequate
high

The success of the crown and bridge alloys depends to a great extent on the accuracy of the
restorations. The gold alloys have a significant advantage from this point of view. The casting shrinkage
is less (approximately 1.5% when for base metal alloys it is around 2.3%). This is well compensated by
the mould whereas, for the base metals it is not so. But one advantage of the Ni-Cr alloys is that, the
margins are not destroyed during finishing and polishing procedure. These are rarely used for all-metal
but widely, for metal ceramic restorations.

COMPARISON OF PROPERTIES OF TYPE III AND Ni-Cr ALLOY
Density (gm/cu.cm) 8 15 More difficult to produce to produce
defect free castings for Ni-Cr alloys.
Fusion temperature
(oC)
as high as
1350
Lower than
1000
Ni-Cr alloys require electrical induction or
oxyacetylene flame. Both adequate
Tensile strength
(MPa)
230 290 Both high enough to prevent distortions
when used.
Modulus elasticity
(GPa)
220 85 Higher modulus of Ni-Cr advantage for
larger restorations.
Hardness (Vickers
Ductility)
300 upto
30%
20 (as cast)
10 (hardened)
Ni-Cr more difficult to polish but retains
polish during service. Burnishing is
possible but high forces are required.

BIOCOMPATIBILITY OF BASE METALS
The main disadvantage of base metal alloys in from the beryllium vapor. This is greatest for the
dental technicians who are exposed to the dust and vapor during the various processes of casting and
finishing. According to OSHA, the exposure to beryllium dust in air should be limited to particulate
beryllium concentration of 2g/cu.m determined from 8 hour time weighted coverage. The allowable
ceiling concentration is 5 g/cu.m not to be exceeded for a 15 minutes period. For a minimum duration of
30 minutes a maximum ceiling concentration of 2 g/cu.m is allowed. This vapor can be reduced
effectively by the use of exhaust fans.
Exposure to beryllium may result in acute or chronic forms of beryllium disease. The symptoms
may vary from contact dermatitis to severe chronic pneumonitis which can be fatal. The chronic disease is
characterized by symptoms of severe coughing, chest pain and general weakness to pulmonary
dysfunction.
To other disadvantage of these base metal alloys is the allergy of patients to nickel. This allergy
can be tested by a patch test using 25% nickel sulfate. Positive reactions were reported by 9.4% women
and. 79% of men.
The effects of nickel exposure to humans have included dermatitis, cancer of the lungs, cancer of
the nasal sinus and larynx, irritation and perforation of the nasal septum loss of smell, asthma like lung
disease, pulmonary irritation, pneumoconiosis, a decrease in lung function and death.
NIOSH has recommended OSHA to adopt a standard to limit employee exposure to inorganic
nickel in the laboratory office to 15g/cu.m of air determined as a time weighted average (TWA)
concentration for upto a 10 hr work shift (40 hr work week) the existing OSHA standard specifies an 8 hr
TWA concentration limit of 1000g/cu.m of air.
Thus it is better to follow certain methods like using high speed evacuation systems when
procedures are performed intra orally and using exhaust fans in the laboratory.
DISADVANTAGE OF THE BASE METALS
i. Difficult to grind and polish because of their hardness.
ii. They are technique sensitive
iii. Checking or delayed failure of porcelain due to difference in the thermal co efficient of contraction.
iv. The greatest disadvantage lies in the variability in the strength and quality of the brazed or pre soldered
connectors. These are susceptible to brittle fracture and this is due to the fact that the pre soldered parts
contain voids, flux inclusions and localized shrinkage porosity. This can be avoided using the cast joining
process.
iii. Titanium
Commercially pure titanium is an element rather than an alloy. But since it is also used, it is
discussed here.
It is a slight weight metal with a density of 4.51g/cm
3
. It has a low elastic modulus of 110 GPa,
which is about half that of the other base metal alloys. IT has a relatively high melting point of 1668C
and a low coefficient of thermal expansion of 8.4 x 10
-6
/C. This value is far below that of
porcelains. Therefore, low fusing porcelains should be used. IT has a good passivating property. IT has
a poor oxidation resistance above 650C. At room temperature, it exists as a low strength but a ductile
metal while heating to above 883C, it forms a hard, more brittle phase.
This is non toxic and found to be the most bio compatible of all metals.
This is being used for crowns and removable partial dentures. It is an excellent choice to patients
with known allergy to nickel.
Titanium alloys
The most common alloy used is Ti-Al-Va. This contains 90% Ti, 6% Al, 4% Va. The major
benefits of alloying are strengthening and stabilization of the alloy against the formation of and phases
seen in the pure metal. The former is formed by the addition of Aluminium and the latter due to Copper,
Palladium or Vanadium.


COBALT CHROMIUM NICKEL ALLOYS
These alloys which were first marketed for use in 1950s, were originally developed as watch
springs. They were known as elgiloy.
Composition
40% cobalt, 20% chromium, 15% nickel, 15.8% iron, 7% molybdenum, 2% manganese, 0.16%
carbon and 0.04% beryllium.
These exhibit excellent tarnish and corrosion resistance in the oral environment.
Types
It is available in four tempers (soft, ductile, semi resilient and resilient) which are color coded. The
soft variety is color blue and the most widely used. All can be heat treated.
Heat treatment
The softening heat treatment is at 1100C to 1200C followed by a rapid quench.
The age hardening temperature is 260C C to 650C for elgiloy it should be kept at 482C for 5
hours.
Heat treatment is 482C for 7 to 12 minutes.
These stress relief heat treatment is at 370C for 11 minutes. This treatment not only improves the
elastic properties but also decreases the corrosion.
Properties
These alloys should not be annealed, since the softening effect cannot be reversed by heat
treatment. The hardness, yield strength and the tensile strength are the same as the stainless steel
alloys. Ductility is greater than the stainless steels in the softened state whereas less in the hardened
state.
NICKEL-TITANIUM ALLOYS
It was introduced commercially during the 1970s following research by Andreason and his
colleagues. They were called as NITINOL and this name came from the two elements nickel and titanium
and the Naval Ordinance Laboratory where these alloys were developed first by duehler and associates.
Composition
These contain 54% nickel, 44%. Titanium and generally 2% or les of cobalt. This result in the 1:1
atomic ratio of the two major components.
As with the other systems this alloys can exist in various crystallographic forms. At high
temperature a BCC lattice referred to as austenitic phase is table. Whereas appropriate cooling can
induce the transformation HCP martenistic phase. This transformation can also be induced by the
application of stress. There is a volumetric change associated with the transition and an orientation
relation is developed between the phases. This phase transition results in two unique features. Shape
memory and super elasticity (Psuedoelasticity).
The cobalt is used to control the lower transition temperature which can be near mouth
temperature. The memory effect is achieved by establishing a shape at temperature near 482C and
cooling it followed by forming it into another shape. When this is heated through the lower transition
temperature the wire will return to its original shape.
Inducing the phase transition by stress can produce super elasticity. The strain developed due to
the stress is caused by a phase change that results from a change in the crystal structure. These alloys
have large working radius. They are difficult to form and have to be joined by mechanical crimps as they
can not be soldered or welded.












-TITANIUM ALLOYS
Pure titanium is polymorphic or allotrophic. At temperature above 880C, the HCP or the crystal
lattice is stable whereas at high temperatures the metal rearranged into a BCC or crystal
lattice. Certain elements like Al, C, O and N stabilize the HCP structure whereas other such as V, Mo and
Ta stabilize the BCC structure.
The Ti-Al-V alloy contains both these crystal structures.
The Ti60% Al 40% alloy is based on the HCP lattice. An alloy to the composition of Ti 79% Mo -
115 and Sn 4% is produced as TMA and is used for orthodontic purposes. These contain the crystal
structure. This can be cold worked and heat treated.
It can be joined by electrical resistance welding which need not be reinforced with solder. This is
the only orthodontic alloy which is considered to possess true weld ability.
Both the forms of Ti have excellent corrosion resistance and environmental stability. This is
because of the oxide. B Ti is the only major orthodontic alloy that is Ni free. These properties of Ti
stimulated its use in heart valves, hip implants and orthodontic wires.

RECENT ADVANCEMENTS
The recent advancement in the metal field is the development of SINTERED COMPOSITE
These composites consist of sintered high noble alloy sponge infiltrated with an almost pure gold
alloy. The result is a composite between the two gold alloys that is not cast, but fired onto a refractory
die. The porcelain does not bond through an oxide layer in these systems, but it bonds mechanically to a
micro rough surface.
The advantages of this that any stress concentration on the ceramic is relieved by the excellent
ductility of the metal.
It has been claimed that these systems support few periodontal pathogens around the restoration
have yet to be substantiated.
CONCLUSION
Thus a variety of metals and alloys are available. These possess the main advantage over resins
in that, they are able to transfer heat which is due to the thermal conductivity. This is gives a more
acceptable appliance. But the main disadvantages as we all know is the esthetics because of which the
metal free dentistry is gaining wide spread popularity.
But the use of all ceramic is not favored, since they require extensive tooth preparation. More over
they are susceptible to fracture because their brittleness. Therefore the vast majority of restorations are
metal ceramic.
Finally the guidelines for the selection of an alloy for a restoration should be based on :
1. A thorough understanding of the alloy
2. Avoid selecting an alloy based on its color unless all other factors are equal
3. Know the complete composition of alloys, and avoid elements that are allergic to the patient
4. Whenever possible use single phase alloys
5. Using clinically proven products from quality manufacturers
6. Use alloy that have been tested for elemental release and corrosion and have the lowest possible release
of elements.
7. Focus on long term clinical performance
8. Finally it is important for the dentist to remember and take up the responsibility of being responsible for
the safety and efficacy of any restoration.


REFERENCES
1. Andersons Applied Dental Materials John F.Mc. Cabe
2. Dental Materials Craig. OBrien Powers
3. Essentials of Dental Materials S.H. Soratur
4. Material and Metallurgical Science S.R.J. Shantha Kumar
5. Materials Science and Engineering V. Ragahavan
6. Phillips Science of Dental Materials (Eleventh Edition) Anusavice
7. Restorative Dental Materials (Eleventh Edition) Robert G. Craig and John. M. Powers
8. Restorative Dental Materials Floyd. A. Peyton
9. J.P.D. April 2002 Volume 87 No.4 Page 351 363.

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- online orthodontic training
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Saturday, August 3, 2013
Metals in prosthodontics

Metals in prosthodontics


Introduction :
Metals form a large part of the earth on which we live, nearly 80% of the known elements are
metals, in the earths crust, most of the metallic elements occur in compounds and not in the metallic
state. A few of the rare and least reactive metals may be found in the metallic state in the earths crust.
These metals include gold, copper, mercury and platinum. Scientists think the earths core in mainly made
up of nickel and iron in the metallic state.
Ancient people knew a used many native metals. Gold was used for ornaments, plates, jewellery and
utensils as early as 3500 BC, gold objects showing a high degree of culture have been excavated at the
ruins of the ancient city of ur in mesapotamia. Silver was used as early as 2400 BC. Native copper was
also used at an early date for making tools and utensils. Since about 1000 BC iron and steel have been
the chief metals of construction.
The earliest known use of dental materials can be traced to approximately 500 BC and the
Etruscans, who used gold to make first dental bridges.
Definition :
GPT 7 defines metal as any strong and relatively ductile substance that provides
electropositive ions to corrosive environment and that can be polished to a high lusture, characterized by
metallic atomic bonding.
In dentistry, metals present one of the four major classes of materials used for the reconstruction
of decayed, damaged or missing teeth.



General characteristics of metals
- A metal is an element that ionizes positively in solution
- Metal have certain typical and characteristic properties that distinguish them from non metallic elements.
The optical properties metallic luster and high opacity
Physical properties high ductility and
- high electrical and thermal conductivity.
The extensive use of metals and their alloys in mechanical and structural applications in a result
of good mechanical properties and workability of many products.
Metallic bonding is responsible fore the unique properties of the metals. Metals atoms have
valance electrons that are rather loosely held and these electron are free to more throughout the solid.
This diffuse nature is responsible for easy deformability of metals and their high thermal and electrical
conductivities.
They are opaque because the valance electron absorbs the high, and they are lustrous because
the electrons remit the high.

STRUCTURE AND PROPERTIES OF METALS
Crystal structure :
- Metals usually have crystalline structure in solid state
- The atoms joining the crystals have a unique packing arrangement in space that is characteristic of that
metal at equilibrium. The smallest division of the crystalline metal that defines the unique packing is called
the unit cell. when the unit cell is repeated in space, the repeating atomic position form the crystal lattice
structure of a crystalline solid.
- Six different crystal system have been recognized : cubic, tetragonal, orthorhombic, monoclinic, triclinic,
and hexagonal.
- Atoms can be arranged in the six crystal systems in only 14 different arrays.
- The most common arrays for metals used in dentistry are
Body centered cubic :
Here atoms are located at each corner, and one atom is located at the centre this is the unit cell
of iron and of many alloys that are used in dentistry.
Face centered cubic :
With the face centered cubic unit cell, atoms are located at each corner, but no atom is in the
centre, and the atoms are located in the center of each of the six faces of the cube, this structure is found
in most of the pure metals and alloys used in dentistry including, gold, palladium, cobalt and nickel alloys.
Hexagonal close packed :
A few metals used in dentistry have a more complex hexagonal close packed structure ; a notable
example is titanium.
Crystallization :
When a molten metal or alloy is cooled, the solidification process is one of crystallization and is
initiated at specific sites called nuclei. The nuclei are generally formed from impurities within the molten
mass of the metal.
Characteristically, a metal crystallize in a 3 dimensional tree branch pattern from a central
nucleus. Such crystal formations are called dendrites. The growth starts from the nuclei of crystallization
and the crystals grow towards each other. Two or more crystals collide in their growth, and the growth is
stopped. Finally, the entire space is filled with crystals. However, each crystal remains a unit in itself. The
metal is therefore made up of thousands of tiny crystals. Such a metal is said to be polycrystalline in
nature, and each crystal is known technically as a grain.

Grain size :
The size of the grain depends upon the number and location of the nuclei at the time of
solidification. It the nuclei are equally spaced with reference to each other, the grains will be
approximately equal in size. The solidification can be pictured as proceeding from the nuclei in all
directions at the same time in the form of a sphere that is constantly increasing in diameter when these
spheres meet, they are flattened along various surfaces. The grain tends to be the same diameter in all
dimensions such a grain is called equiaxed.

Control of grain size :
In general, the smaller the grain size of the metal, the better are the physical properties. The finer
grain size can raise the yield stress increase the ductility and raise the ultimate strength. For ex : the yield
strength of many types of materials has been found to vary inversely with the square root of the grain
size.
Because the grains crystallize from nuclei of crystallization, it follows logically that the number of
grains formed is directly related to the number of nuclei of crystallization present at the time of
solidification.
This factor can be controlled to a degree by the rate of cooling. In other words, the more rapidly the
liquid state can be changed to the solid state, the smaller or finer the grains will be.
Another factor of equal importance is the rate of crystallization. If the crystals form faster than do
the nuclei of crystallization, the grains will be larger than if the reverse condition prevails. Conversely, if
the nuclear formation occurs faster than the crystallization, a small grain size can be obtained.
Consequently, a slow cooling results in large grains. In a polycrystalline metal, the shape of the
grain may be influenced by the shape of the mold in which the metal solidifies.
Grain boundaries :
The orientation of the space lattice of the various grains is different. The grain boundary is
assumed to be a region of transition between the differently oriented crystal lattices of two neighbouring
grains.

DEFORMATION OF METALS
The atoms within each grain are arranged in a regular three-dimensional lattice. There are several
possible arrangements such as cubic, body-centred cubic and face-centred cubic etc.
The arrangement adopted by any one crystal depends on specific factors such as atomic radius
and charge distributions on the atoms. although there is a tendency towards a perfect crystal structure,
occasional defects occur, such defects are called dislocations and their occurrence has an effect on the
ductility of the metal or alloy. When the material is placed under a sufficiently high stress the dislocation is
able to more through the lattice until it reaches a grain boundary.
The plane along which the dislocation moves is called the slip plane and the stress required to
initiate moment is called the elastic limit.
Application of a stress greater than the elastic limit causes the material to be permanently
deformed as a result of movement of dislocations.
Grain boundaries form natural barriers to the movement of dislocation. The concentration of grain
boundaries increases as the grain size decrease metals have higher valves of elastic limit.
It is important to understand that any process that impedes dislocation movement tends to harden
a metal, raise its yield stress and often lower its ductility.
COLD WORKING / WORK HARDENING :
A process for hardening the metal. It is the permanent deformation that takes place on the
application of sufficiently high force at room temperature, due to the movements of dislocations along slip
planes.
Any plastic deformation of the metal by hammering, drawing, cold forging or bending processes,
produce many dislocations in the metal that cannot slip through each other as easily as the lattice
becomes more distorted.
Such cold working not only produces a change in microstructure, with dislocation becoming
concentrated at grain boundaries, but also a change in grain shape. The grain are no longer equiaxed but
take up a more fibrous structure.
The properties of the metal are altered. The surface hardness, strength, and proportional limit are
increased, where as ductility and resistance to corrosion are decreased by strain hardening.
In dentistry, cold working occurs when gold foil is compacted, a denture clasp is bent, an inlay
margin is burnished, or a deformed metal layer forms on a crown during finishing and polishing.
The temperature below which work hardening is possible is termed as recrystallizaiton temperature.
Since metals and alloys have finite values of ductility or malleability there is a limit to the amount of
cold working which can be carried out. Attempts to carry out further cold working beyond this limit may
result in fracture.


ANNEALING :
The effects associated with cold working such as strain hardening, lower ductility and distorted
grain can be reversed by simply heating the metal. The process is called annealing.
The more severe the cold working, the more readily does annealing occur.
Annealing in general comprises three stages :
Recovery, recrystallization and grain growth :
Annealing is a relative process ; the higher the melting point of the metal, the higher is the
temperature needed for annealing. A rule of thumb is to use a temperature approximately one half that is
necessary to melt the metal.
Recovery : It is considered the stage at which the cold work properties begin to disappear before any
significant visible changes are observed under the microscope.
During this period there is very slight decrease in tensile strength and no change in ductility.
Recrystallizaiton : When a severely cold worked metal is annealed, than recrystallization occurs after
some recovery. This involves a rather radical change in the microstructure. The old grains disappear
completely and are replaced by a new set of strain free grains. These recrystallization grains nucleate in
the most severally cold worked regions in the metal, usually at grain boundaries, or where the lattice
was most severely bent on deformation.
On the completion of recrystalization the material essentially attains its original soft and ductile
condition.
Grain growth : The recrystallized structure has a certain grain size, depending upon the number of nuclei.
The more severe the cold working, the greater are the number of such nuclei. Thus, the grain size for the
completely recrystallized material can range from rather fine to fairly coarse.
If now the fine grain form is further annealed, the grains begin to grow. This grain growth process is
simply a boundary energy minimizing process. the effect, the large grains consume the little grains. It
does not progress indefinitely to a single crystal. Rather, an ultimate coarse grain structure is reached,
and then for all practical purposes, the grain growth stops.
Excessive annealing can lead to large grains. It should be emphasized that the phenomenon
occurs only in wrought material

ALLOYS :
An alloy is a mixture of two or more metals mixture of two metals are called binary alloys, mixtures
of three metals ternary alloys.
The term alloy systems refers to all possible compositions of an alloy.
To form an alloy, two or more metals are heated to a homogenous liquid state. However, a few
combinations of metals are not miscible in the liquid state and will not form alloys.
When a combination of two metals is completely miscible in the liquid state, the two metals are
capable of forming an alloy. When such a combination is cooled, one of three microstructure may form.
a) A solid solution
b) A mixture of intermetallic compound
c) An eutectic mixture s
Solid solution : When two metals are completely miscible in a liquid state, and they remain completely
mixed on solidification, the alloy formed is called a solid solution.
When two metals are soluble in one another in the solid state, the solvent in that metal whose
space lattice persists, and the solute is the other metal. The solvent may be defined as the metal whose
atoms occupy more than one half the total number of positions in the space lattice.
Eg : The copper and gold combination crystallizes in such a manner that the atoms of copper are
scattered throughout the crystal structure (space lattice) of gold, resulting, in a single phase system. Such
a combination is called the solid solution because it is a solid but has the properties of a solution. The
configuration of the space lattice of solid solution may be of several types.
- Substitutional, interstitial and ordered.
In substitution type : The atoms of the solute occupy the space lattice positions that normally are
occupied by the solvent atoms in the pure metal.
In interstitial type : The solute atoms are present in positions between the solvent atoms.
In ordered type : The solute atoms occupy specific sites within a common crystal lattice.
The extent of solid solubility is determined by at least 4 factors.
1) Atomic size : It the sizes of the two metallic atoms differ by less than 15% they posses a favorable size
factor for solid solubility.
2) Valance : metals of the same valance and size are more likely to form extensive solid solutions than are
metals of different valancies.
3) Chemical affinity : When two metals exhibit a high degree of chemical affinity, they tend to form an
intermettalic compound on solidification rather than a solid solution.
4) lattice type : Only metals with the same type of crystal lattice can form a complete series of solid solutions




Physical properties of solid solution :
Whenever a solute atom displaces a solvent atom, the difference in the size of the solute atom
results in a localized distortion or strained condition of the lattice, and slip becomes more difficult. As a
consequence, the strength, proportional limit and surface hardness are increased. Where as the ductility
is usually decreased.
In other words, the alloying of metals may be a means of strengthening the metal.
The general theory of slip interference in alloys in same as in strain hardening, except that a
different type of lattice distortion is present initially to inhibit slip before the structure is stressed or worked.
In general, the hardness and strength of any metallic solvent are increased by the atoms of the
solute.

Intermettalic compounds :
If two metals show a particular affinity for one another they may form intermettalic compounds with
precise chemical formulation. Intermettalic compounds are also formed on cooling liquid metal solution, in
the liquid state they have a tendency to unite and form definite chemical compounds on solidifying. As far
as the space lattice is concerned, the atom of one metal, instead of appearing randomly in the space
lattice of another metal, occupy a definite position in every space lattice.
Eg : In an alloy of silver and tin containing 73.2% of Ag and 26.8% of Sn by weight is heated above
500
0
C, it is a single phase liquid system. When the alloy is cooled, it solidifies to a compound with the
formula Ag
3
Sn, with silver and tin atoms occupying a definite positions in the space lattice. Such alloy is
called intermetalic compound and is used in dental amalgam alloys.


Properties of intermetallic compounds :
The intermetallic compounds formed in some alloy systems are usually hard and brittle. Their
properties rarely resemble those of metals making up the alloy.
Eutectic mixture :
Eutectic mixture occurs when the metals are miscible in the liquid state but separate into two
phases in the solid state. The two phases usually precipitate as alternating very fine layers of one phase
over the other ; such a combination is called eutectic mixture. An example of such a combination is 72%
silver and 28% copper with this alloy the eutectic is composed of fine, alternating layers of high silver
and high copper phases.
Characteristics of eutectics:
- The temperature at which the eutectic occurs is lower than the fusion temperature of either silver or
copper, and is the lowest temperature at which any alloy composition of silver and copper is entirely
liquid.
- There is no solidification range for this composition. In other words, it solidifies at a constant temperature,
which is characteristic of the particular eutectic.
Liquid o - solid solution + | - solid solution
It is referred to as an invariant transformation, since it occurs at a single temperature and
composition.
Properties of eutectic alloys:
- Eutectic mixtures are usually harder and stronger than the metals used to form the alloy and are often
quite brittle.
- Eutectic mixtures have poor corrosion resistance. Galvanic action between the two phases at a
microscopic level can accelerate corrosion.

Peritectic alloys :
Limited solubility of two metals can bad to a transformation referred to as peritectic
- Peritectic systems are not common in dentistry
- An example being a silver tin alloy system
- Like the eutectic transformation, the peritectic reaction in an invariant reaction (ie it occurs at a particular
composition and temperature) the reaction can be written as
- liquid + | o

METALS CAN BE BROADLY CLASSIFIED AS:
a) Noble metals
Noble metals are elements with a good metallic surface that retain their surface in dry air. The term
noble identifies elements in terms of their chemical stability ie. they resist oxidation and are impervious to
acids.
Gold, platinum, palladium, rhodium, ruthenium, iridium, osmium and silver are the eight noble
metals. In the oral cavity silver is more reactive sand therefore not considered as a noble metal.
b) Precious metals
The term Precious merely indicates whether a metal has intrinsic value or in other words they are
higher cost metals. Eight noble metals are also precious metals, and are defined as such bymajor
metallurgical societies and the federal government agencies. All noble metals are procigus but all
precious metals are not noble.
c) Semiprecious metals
There is no accepted composition that delineates precious from semiprecious. Therefore, use of
the term semiprecious should be avoided.


d) Base metals :
Although these metals have frequently been reffered to as non precious, the preferred designation
is base metal. These are non noble elements. base metals remain invaluable components of dental
casting alloys because of their influence on physical properties, control of the amount and type of
oxidation, or their strengthening effects. Eg : chromium, cobalt, nickel, Iron copper etc.

DENTAL CASTING ALLOYS
The history of dental casting alloys has been influenced by three major factors
1) The technological changes of dental prostheses
2) Metallurgical advancements
3) Price changes of the precious metals since 1968 when the U.S government lifted its support on the price
of gold before then 95% of fixed dental prostheses were made by alloys containing a minimum of s75%
by weight gold and other noble metals. However, when the price of gold increased drastically, the
development of alternative alloys increased dramatically to reduce the cost of cast of cast dental
restorations. These alternative alloys that contained no noble metal. Today, alternative alloys compose
the majority of alloys used.
Uses :
1) Fabrications of inlays, onlays
2) Fabrication of crowns, conventional all metal bridges, metal ceramic bridges, resin bounded bridges.
3) Endodontic posts
4) Removable partial denture frameworks

Desirable properties :
1) Biocompatibility
2) Ease of melting
3) Ease of casting, brazing and polishing
4) Little solidification shrinkiage
5) Minimal reactivity with the mould material
6) Good wear resistance
7) High strength and sag resistance
8) Excellent tarinsto and corrosion resistance

NOBLE METAL CASTING ALLOYS :
Noble metal casting alloys contain mainly gold, palladium, and platinum and silver. They also
contain limited amounts of base metal elements such as copper, indium, iron, tin and zinc.
High gold alloys :
Traditional dental casting alloys contain 70% by weight or more of gold, palladium and platinum.
ADA specification no. 5 for dental casting gold alloy divides these alloys into four types based upon
mechanical properties.
Type I soft (VHN 60 to 90)
Type II Medium (VHN 90 to 120)
Type II Hard (VHN 120 to 150 )
Type IV Extra hard (VHN minimum 150)

Compositions Of Casting Gold Alloys
Type Au Ag % Cu % Pt / Pd % Zn %
I 85 11 3 - 1
II 75 12 10 2 1
III 70 14 10 5 1
IV 65 13 15 6 1

It can be seen that the gold content or nobility decreases on going from type 1 (soft) alloy to type IV
(extra hard) alloy.
The increase in hardness observed when nobility decreases is primarily due to the solution
hardening effect of the alloying metals which all form solid solutions with gold. Type III and Type IV can
be further hardened by heat treatments. Copper is the principal hardener ; palladium and platinum serve
to hardens the alloy but also whitens it.
Zinc is added primarily as a oxygen scavenger during casting.
Comparative properties of the four types of casting gold alloys
Ty
pe
Hardness Proportio
nal limit
Streng
th
Ductilit
y
Corrosi
on
resistan
ce
I


Increases


Increases


Increa
ses


Decrea
ses


Decrea
ses
II
III
IV

The variation in alloy properties with composition is reflected in the application for which the
material are choosen.
Type I (Soft) for inlay restorations subjected to very slight stress and which do not have to resist high
masticatory forces. The high values of ductility of these alloys enables them to be burnished a process
which improves the marginal fit of the inlay and increases the surface hardness.
Type II (Medium) are used for inlays subjected to moderate stress and are the most widely used alloys
for inlays. They have superior mechanical properties, though at the expense of ductility.
Type III (Hard) are used for inlays subjected to high stress; onlays; thin crowns, abutments, pontics,
full crowns, denture bases and short span fixed partial dentures.
Type IV (extra hard) are used for extremely high stress states like endodontic posts and cores, thin
veneer crowns, long span fixed partial denture and removable partial denture.

LOW GOLD-CONTENT ALLOYS :
Large increase in the price of gold have led to the development and increased use of alloys with
lower gold content. Some alloys contain as little as 10% gold, but more normally a gold content of around
45-50% is used. They have high palladium content which imparts a characteristic whitish colour to the
alloys.
The properties of low-gold alloys are broadly similar to those of the type III and type IV casting gold
alloys, with one main exception. The ductility of these alloys may be significantly lower than the
conventional gold alloys. The casting techniques and equipment used for low-gold alloys are similar to
those used for conventional gold alloys.
Silver-palladium alloys :
These alloys are white-colored and predominantly silver in composition but with substantial
amounts of palladium to provide mobility and promote the silver tarnish resistance. There is generally a
minimum of 25% of palladium along with small quantities of copper, zinc and indium, in addition to gold
which is present in small quantities. The silver-palladium alloys have significantly lower density than gold
alloys, a factor which may affect castability. For a given volume of casting, there is a lower force
generated by the molten alloy during casting. Attention must be paid to details such as casting
temperature and mould temperature. If the mould is to be adequately filled by the alloy.
The properties of silver-palladium alloys are similar to those of the type III and IV gold alloys with
exeption to their lower ductility. The corrosion resistance is not as good as gold alloys. These alloys are
suitable alternatives to gold alloys. They offer a considerable saving in cost when compared to gold
alloys.
BASE METAL CASTING ALLOYS :
According to the ADA classification of 1984, any alloy that contains less than 25
0
weight % of the
noble metals gold, platinum, and palladium is considered a predominantly base metal alloy. Alloys within
this category include Co-Ca, Ni-Cr, Ni-Cr-Be, Ni-Co-Cr and Ti-Al-V.
Base metal alloys are used extensively in dentistry and have been in used for the past 70 years.
The attractiveness of these materials stems from their corrosion resistance, high strength, modules of
elasticity (stiffness), low density and low cost.
Co-Cr and Ni-Cr have been used for many years for fabricating partial denture frameworks and
have replaced type IV gold alloys completely for this application.
Ni-Cr alloys are used in fabricating crowns and bridges
Ni-Cr and Co-Cr alloys are used in PFM restorations
Titanium and titanium alloys are used for RPDS crowns, and bridges and implants
COMPOSITION :
Cobalt chromium alloys
These alloys generally cotain 35-65% Co, 20-35% Cr, 0-30% Ni
Nickel chromium alloys
Generally contain 70-80% Ni, 10-25% Cr.
Both these alloys contain minor alloying elements such as carbon, molybdenum, beryllium,
aluminium, silicon etc.
The concentration of minor elements have a great effect on the physical properties of alloys.
Functions of Various alloying elements :
Cobalt and Nikel are hard and strong metals.
Chromium further hardens the alloy by solution hardening and responsible for tarnish and corrosion
resistance.
Carbon increases the hardness of the alloy. About 0.2% increase over the amount of the alloys
becomes too hard and too brittle. Conversely, 0.2% reduction would reduce the alloys ultimate and tensile
strength.
Molybdenum 3% to 6% molybdenum contributes to the strength of the alloys.
Aluminium Increases the ultimate and tensile strength of the nickel containing alloys.
Beryllium Refines the grain structure and reduces the fusion temperature of the alloys.
Silicon Imparts good casting properties and increases the ductility.
Microstructure :
Microstructure of any substance is the basic parameter that controls the properties. In other words,
a change in the physical properties of a material is a strong indication that there must have been some
alteration in its microstructure. The microstructure of Co-Cr alloys in the cast condition is inhomogeneous,
consisting of a austenitic matrix composed of a solid solution of cobalt and chromium in a cored dendritic
structure.
Many elements present in a cast base metal alloy, such as chromium, cobalt and molybdenum are
carbide forming elements depending on the composition of a cast base metal alloy and its manipulative
condition, it may form many types of carbides. During crystallization the carbides become precipitated in
the interdendritic regions which form the grain boundaries. If the precipitated carbides form a continuous
phase, the alloy becomes extremely hard and a brittle, as the carbide phase acts a barrier to slip. A
discontinuous carbide phase is preferable since it allows slip and reduces the brittleness.
Whether a continuous or discontinuous carbide phase is formed depends on the amount of carbon
present and on the casting technique.
High melting temperature during casting favour discontinuous carbide phases but there is a limit to
which this can be used to any advantage since the use of very high casting temperature can cause
interactions between the alloy and the mould.
Manipulation of base metal casting alloys :
The fusion temperature of Ni/Cr and Co/Cr alloys are generally in the range of 1200-1500
0
C. This is
considerably higher than for the casting gold alloys (950
0
C). Melting of gold alloys can readily be
achieved using a gas-air mixture. For base metal alloys, however, either an acetylene-oxygen flame or an
electric induction furnace is required.
Investment moulds for base metal alloys must be capable of maintaining their integrity at high
casting temperature used, Silica-bonded and phosphate bonded investments are favoured.
The density values of base metal alloys are approximately half those of the casting gold alloys,
therefore the thrust developed during casting may be somewhat lower, with the possibility that the casting
may not adequately fill the mould. Casting machines used for the base metal alloys must therefore be
capable of producing extra thrust which overcomes this deficiency.
Base metal alloys are very hard and consequently difficult to polish. After casting, to remove
surface roughness sandblasting and electrolytic polishing is carried out. Final polishing is carried out
using high-speed polishing buff.
Physical properties :
Melting temperature : Most base metal alloys melt at 1400
0
C to1500
0
C.
Density : Average density is between7 and 8gm/cm
3
which is approximately half that of gold alloys.
Mechanical properties :
Yield strength: They have yield strength greater than 600 Mpa. Dental alloys should have at least 415
Mpa to withstand permanent deformation when used as partial denture clasps.
Modulus of elasticity : Is 220 Gpa ie. Approximately Twice that of type IV gold alloys. The higher the
elastic modulus, the more rigid structure can be expected.
Hardness : VHN is about 400 i.e. they have a hardness one third greater than that a gold alloys.
Although it makes the polishing of the casting a difficult process, the final finished surface is very durable
and resistant to scratching.
Elongation : These alloys are quite brittle. Cobalt-chromium alloys exibit elongation values of 1% to 2%
whereas cobalt-chromium-nickel alloy, which contains lesser amounts of molybdenum and carbon than
other cobalt based materials, shows an elongation of 10%.



Chemical properties:
Co-Cr / Ni-Cr alloys have very good corrosion resistance by virtue of the passivating effect. The
alloys are covered with a tenacious layer of chromic oxide which protects the bulk of the alloy from attack.
Chromium containing alloys are attached vigourously by chlorine; household bleaches should not
be used for cleaning appliances made from chromium-type alloys.
Disadvantages:
Although certain physical and mechanical features of the chromium type alloys are superior to
those of partial denture golds, clinical application of these materials may be burdened by the following
occurrences.
1. Clasps cast from relatively nonductile base metal alloys can break in service, some break within a short
period of time.
2. Minor but necessary adjustments required upon the delivery of the base metal partial denture can be
made difficult by the alloys high hardness and strength, and accompanying low elongation.
3. High hardness of the alloy can cause excessive wear of restorations and natural teeth that they contact.

TITANIUM AND TITANIUM ALLOYS:
Titanium resistance to electrochemical degradation, the benign biological response that it elicits;
its relatively light weight and its low density, low modulus and high strength make titanium based
materials attractive for use in dentistry.
Ti is a very reactive metal, it form a very stable oxide layer with a thickness of the order of
angstroms and it repassivates in a time of the order of nanoseconds. This oxide formation in the basis for
the corrosion resistance and biocompatibility of Ti.
Commercially pure titanium (c.p.Ti) is used for dental implants, surface coatings and more
recently for crowns, partial and complete dentures and orthodontic wires. Several titanium alloys are also
used of these alloys, Ti-6AtGv is the most widely used.
Commercially pure titanium:
c.p.Ti is available in four grades, which vary according to the oxygen (0.18 to 0.40 wt %) and iron
(0.20 to 0.50 wt%) content. These apparently slight concentration differences have a substantial effect on
the physical and mechanical properties.
At room temperature c.p. Ti has a hexagonal close packed crystal lattice, which is denoted as
alpha (o) phase on heating, an allotrophic phase transformation occurs. At 883
0
C, a body centred cubic
(BCC) phase, which is denoted by beta (|) phase, forms. A component with a predominantly | phase is
strong but more brittle than a component with as o-phase microstructure. As with other metals, the
temperature and time of processing and heat treatment dictate the amount, ratio and distribution of
phases, overall composition and microstructure, and resulting properties.
Titanium alloys:
Alloying elements are added to stabilize either the o and | phase, by changing the |transformation
temperature for example, in Ti-6Al-4V, aluminium in an o stabilizes, which expands the o-phase field by
increasing the (o+|) to | transformation temperature. The elements oxygen, carbon and nitrogen stabilize
the o phase as well because of their increased solubility in HCP structure, whereas vandalium, copper,
palladium, iron are | stabilizers which expand the | phase field by decreasing the (o+|)
to | transformation temperature.



Ti-6Al-4V:
It is the most widely used alloy because of its desired proportion and predictable productivity at
room temperature Ti-6Al-4V is a two phase (o+|) alloy.
At approx 975
0
C an allotrophic phase transformation takes place, transforming the microstructure
to a single phase BCC | alloy.
Properties :
Titanium has a density of 4.5 g/cm
3
, which is half of the weight of other non precious metals used in
dentistry and one quarter that of gold. The low density of titanium is advantages because it allows
lightweight prostheses to be fabricated.
The protective passive oxide film of on titanium mainly TiO
2
, is stable over a wide range of pHs,
potentials and temperature.
Minimum yield strength of Ti ranges between 240 to 890 MPa. It has low modulus of elasticity 103
to 113 MPa.
And has favorable microhardness 210 VHN.
High melting point of 1700
0
C
Alloys have a slightly lower melting point
In theory, the light weight of titanium and its strength-to-weight ratio, high ductility and low thermal
conductivity would permit design modifications in Ti restorations and removable prosthesis.
Casting: because of high affinity of titanium has for hydrogen, oxygen and nitrogen, standard crucibles
and investment materials cannot be used.
Dental castings are made via pressure-vaccum or centrifugal casting methods. The metal is melted
using an electric plasma arc or inductive heating in melting chamber filled with inert gas or held in a
vacuum. The molten metal than is transferred to the refactory mould centrifngal or pressure vaccum.
Filling casting of titanium commonly are used to fabriate crowns, bridge frameworks, and full and partial
denture frameworks. The casting machines are very expensive. Investment material such as phosphate
bonded silica and phosphate investment materials with added trace elements are used.
Other alloys: Ti 15 V, Ti 20 Cu, Ti 30 pd, Ti Co, Ti Cu.
Disadvantages:
1) High melting point 2) High reactivity 3) low roasting efficiency 4) Inadequate expansion of investment.
5) casting porosity 6) Difficulty in finishing this metal 7)Difficult to weld and solder 8) Expensive
equipment.
Alloys for metal-ceramic restoration
All ceramic anterior restorations can appear very natural. Unfortunately, the ceramics used in these
restorations are brittle and subject to fracture from high tensile stresses. Conversely, all metal restoration
are strong and tough but, from an aesthetic point of view, acceptable only for posterior restoration.
Fortunately the esthetic qualities of ceramic materials can be combined with the strength and toughness
of metals to produce restorations that have both a natural tooth like appearance and very good
mechanical properties.
A cast metal coping provides a substrate on which a ceramic coating in fused. The ceramics used
for these restorations are porcelains.
The bond between the metal and ceramic is the result of chemisorption by diffusion between the
surface oxides on the alloy and in the ceramic. These oxides are formed during wetting of the alloy by the
ceramic and firing of the ceramic.
Noble metals, which are resistant to oxidizing, must have other, more easily oxidizing element
added such as indium and tin to form surface oxides. The common practice of degassing or preoxidizing
the metal coping before ceramic application creates surface oxides that improve bonding.
Base metal alloys contain elements, such as nickel, chromium, and beryllium which form oxides
easily during degassing.

CLASSIFICATION OF ALLOYS USED FOR METAL CERAMIC RESTORATION
1) High noble - Gold Platinum Palladium (Au-pt-pd)
Gold Palladium Silver (Au-pd-Ag)
Gold Palladium (Au-Pd)
2) Noble Palladium Gold (Pd Au)
Palladium Gold Silver (Pd-Au-Ag)
Palladium Silver (Pd-Ag)
3) Base metal Pure Titanium
Titanium Aluminium Vanadium (Ti-Al-V)
Nikel Chromium Molybdenum (Ni-Cr-Mo)
Nikel Chromium Molybdenum Berillyum (Ni-Cr-Mo-Be)
Inspite of vastly different chemical compositions, all alloys share at least three common features
1) They have potential to bond to dental porcelain
2) They posses co-efficient of thermal contraction compatible with those of
dental porcelain.
3) Their solidus temperature is sufficiently high to permit the application of
low-fusing porcelains.
HIGH NOBLE ALLOYS:
The high noble alloys are composed principally of gold and platinum group metals with minor
additions of tin, indium, and iron added for strength and to promote a good porcelain bond to metal oxide.


Gold-platinum palladium alloys:
These have a gold content ranging upto 88% with varying amounts of Pd, Pt and small amount of
base metals alloys of this type are restricted to 3-unit spans, anterior cantilevers, or crowns.
Gold-palldium-silver alloys:
These gold based alloys contain between 39% and 77% gold and upto 35% palladium, and silver
levels as high as 22%. The silver increases the thermal contraction co-efficient, but it also has the
tendency to discolor some porcelains.
Gold-palladium alloys: -
A gold content ranging from 44% to 55% and palladium level of 35%
to 45% is present in these metal-ceramic alloys, which have remained
popular despite their relatively high costs. Yield strengths and hardness are
favourable and elastic modulus is increased significantly compared with
high gold alloys. Corrosion resistance is excellent because of high nobility.
The only recognizable disadvantage is the incompatible co-efficient of
thermal contraction with some of the porcelains with higher thermal
contractions co-efficient, due to the lack of silver though there is freedom
from silver discolouration. Alloys of this type must be used with porcelains
which have lower coefficient of thermal contraction to avoid the
development of axial and circumferential tensile stresses in porcelain
during the cooling part of the porcelain firing cycle.
NOBLE ALLOYS :
According to ADA classification of 1984, noble alloys must contain at
least 25% to 40% silver. Tin and indium are both usually added to increase
the alloys hardness and to promote oxide formation. These alloys were
developed. When the cost of Pd was considerably lower than Au ; those
conditions no longer exist. Some ceramics used with these high Ag alloys
resulted in a greenish-yellow discolouration termed as greening, due to
the silver vapour that escapes from the surface of these alloys during firing
of the porcelain, the silver vapour diffuses is ionic silver into the porcelain,
and is reduced to form colloidal metallic silver in the surface of porcelain.
Palladium-copper alloys:
First introduced to dental profession in 1982 ; they are comparable in cost to Pd-Ag alloys. They
are usually composed of 74-80% palladium and 2-15% copper. They cause none of the porcelain colour
problems associated with silver. High hardness value in some of the alloys are offset by a relatively low
elastic modulus, resulting in better working characteristics than would be expected with a high hardness
value. Strength is good, and in some alloys extremely high yield strengths are found. Some Pd-Cu alloys
have a rather heavy oxide that is difficult to cover with opaque porcelain. They are susceptible to creep
deformation at elevated firing temperatures, tending to contraindicate their use in large-span fixed partial
dentures.
Palladium-cobalt alloys:
These alloys contain around 88% palladium and 4-5% cobalt this groups is the most sag resistant
of the noble metal alloys. These alloys have good handling characteristics. They tend to have relatively
high thermal contraction coefficient and would be expected to be more compatible with higher-expansion
porcelain. However, the main disadvantage is the formation of a dark oxide that may be difficult to mask
at thin margins.
Palladium-gallium-silver and palladium-gallium-silver-gold alloys:
These alloys are the most recent of the noble metals. This group of alloys was introduced because
they tend to have a slightly lighter-coloured oxide than that of Pd-Cu or Pd-Co alloys, and they are
thermally compatible with lower expansion porcelains. The silver content is relatively low (5%) and is
inadequate to cause porcelain greening.

Physical properties of high noble and noble metal alloys:
1) The metal ceramic alloys must have a high melting range so that the metal is solid well above the
porcelain sintering temperature to minimize distortion of casting during porcelain application.
2) Must have considerably low fusing temperature
3) Good corrosion resistance
4) High modulus of elasticity
BASE METAL ALLOYS FOR METAL CERAMIC RESTORATION:
Developed in the 1970s, most of the base metal alloys are based on nickel and chromium, but a
few cobalt-chromium based alloys are also available.
Composition :
Ni Cr 61-81 wt / nickel
11-27% chromium
2-5% molybdenum
Co-Cr 53-67% cobalt
25-32% chromium
2-6% molybdenum
These alloys contain one or more of the following elements;
aluminum, beryllium, boron, carbon, cobalt, copper, cerium, gallium, iron,
manganese, niobium, silicon, tin, and zirconium.
Properties of Ni-Cr, Ni-Cr-Be and Co-Cr alloys:
The base metal alloys have different physical properties than the noble metal alloys. The most
significant are high hardness, high yield strength, and high elastic modulus. Elongations is about the
same as for the gold alloys but is negated by the high yield strength which makes it difficult to work the
metal.
The elastic modulus of base metal alloys in as much as two times
greater than the value of noble metal alloys which decreases the flexibility
to a significant degree. The flexibility of a FPD framework constructed of Ni-
Cr is less than half that of a framework of the same dimensions made from
a high-gold alloy. This property would enhance the application of base
metal alloys for long-span bridges. In a similar manner, the high modulus of
elasticity may be used to permit thinner castings.
- The creep resistance of nickel-based alloys at porcelain firing temperature
is considered to be for superior to the resistance of gold and palladium
based alloys under the similar conditions. It is particularly important in long
span bridges where the porcelain firing temperature may cause the
unsupported structure to deform permanently under controlled condition it
has been found that base metal alloy deforms less than 25 m, whereas a
noble metal alloy deforms 225 m.
- In general, the high hardness and high strength of base metal alloys
contribute to certain difficulties in clinical practice grinding and polishing of
fixed restorations to achieve proper occlusion occasionally require more
chair side time.
- They have high casting temperature and they have much lower densities
(7 to 8gm /C
3
) thus on the basis of the lower density and low intrinsic value
of the component metals, the cost difference between base metal and
noble metal alloys can be substantial. The disadvantage is adequate
casting compensation is at a times a problem, as in the fit of the coping.
- The addition of beryllium to some Ni-Cr alloys results in more favourable
properties. Beryllium increases the fluidity, and improves casting
performance. Be, also controls surface oxidation and results in more
reliable, less technique sensitive porcelain metal bonds.
DENTAL IMPLANT MATERIALS:
Most commonly, metals and alloys are used for dental implants. Initially, surgical grade stainless
steel and Co-Cr alloys were used because of their acceptable physical properties and relatively good
corrosion resistance and biocompatibility. However, it is currently more common to use implants made of
pure titanium or titanium alloys, because of the excellent biocompatibility of titanium.
Stainless steel:
Surgical austenitic steel is an iron-carbon (0.05%) alloy with approximately 18% chromium to impart
corrosion resistance and 8% nickel to stabilize the austenitic structure.
Because nickel is present, its use in patients allergic to nickel is
contraindicated.
The alloys is most frequently used in a wrought and heat-treated
condition. It has high strength and ductility, thus it is resistant to brittle
fracture.
Surface passivation is required to maximize corrosion- biocorrosion
resistance of all alloys, this one is the most subject to crevice and pitting
corrosion. Therefore, care must be taken to use and retain the passivated
(oxide) surface.
Cobalt-chromium-molybdenum alloy :
These alloys are most often used in an as cast or cast and annealed condition. This permits the
fabrication of custom designs, such as subperiosteal frames.
Their composition is approximately 63% cobalt, 30% chromium and 5% molybdenum and they
contain small concentrations of carbon, manganese and nickel.
Molybdenum stabilizes the structure
Carbon acts as a hardener
These alloys posses outstanding resistance to corrosion and they
have a high modulus.
However they are the least ductile of all the alloys systems and
bending must be avoided.
When proper quality control is ensured, this alloys group exists
excellent biocompatibility.
Because of the requirement of low cost and long-term clinical
success, but stainless steel and Co-Cr alloys have been used extensively
in many areas of surgery and dentistry.
Titanium and titanium-aluminium-vandalium (Ti-6A-4V) alloy :
Commercially pure titanium (Cp Ti) has become one of the materials of choice because of its
predictable interaction with the biologic environment.
Titanium is a highly reactive metal it oxidizes (passivates) on contact
with air or normal tissue fluids. This reactivity is favourable for implant
devices because it minimizes biocorrosion. An oxide layer 10 A
0
thick forms
on the cut surface of pure titanium within a millisecond. Thus any scratch or
nick in the oxide coating is essentially self healing.
Ti 6Al 4V alloy :
In its most common alloyed form it contains 90 wt % titanium, 9 wt % aluminium and 4 wt %
vanadium.
- Density : 4.5g/cm
3
, making it 40% lighter than steel.
- The metal posses a high strength : weight ratio
- Ti has modulus of elasticity approx. one half that of stainless steel or Co-Cr
alloys. However it is still 5-10 times higher than that of bone.
- Few titanium substructures are plasma sprayed or coated with a thin layer
of calcium phosphate ceramic.
The rationale for coating the implant with tricalcium phosphate or
hydroxyapatite, both rich in calcium and phosphorous into produce a
bioactive surface that promotes bone growth and induces a direct bond
between the implant and hard tissue.
The rationale of a plasma sprayed surface is to provide a roughened,
though biologically acceptable, surface for bone in growth to ensure
anchorage in the jaw.
Other metals and alloys:
Many other metals and alloys have been used for dental implant device fabrication. Early implants
extra made of gold, palladium, tantalum, platinum, iridium and alloys of these metals.
More recently, devices made from zirconium, hafnium and tungsten
have been evaluated.

BIOCOMPATIBILITY OF DENTAL CASTING METALS:
Dental casting alloys are widely used in applications that place them into contact with the oral
epithelium, connective tissue or bone for many years. Given these long-term roles, it is paramount that
the biocompatibility of the casting alloys be measured and understood.
Biologically relevant properties of casting alloys:
- Dental alloys are complex metallurgically, in dentistry alloys usually contain at least 4 and after 6 or more
metals.
- Dental alloys are commonly described by their composition. Compositions
are expressed in wt % or at %. Atomic percentage better predicts the
number of atoms available to be released and affect the body.
- Another way of describing the alloys is by its phase structure. Single phase
alloys have similar composition throughout the structure. Elements in
multiple phase alloys combine in such a way that some areas differ in
composition than the other areas.
- The phase structure of an alloy is critical to its corrosion properties and its
biocompatibility. The interaction between the biologic environment and the
phase structure is what determines which elements will be released and
therefore how the body will respond to the alloy.
Corrosion:
Corrosion of alloys occurs when elements in the alloy ionize corrosion of an alloys indicate that
some of the elements are available to affect the tissues around it.
Corrosion is measured by Observing the alloy surface
Electrochemical test
Spectroscopic methods
Corrosion of an alloy is of fundamental importance to its biocompatibility because the release of elements
from the alloys is necessary for adverse biological effects such as toxicity, allergy, or mutagenecity.
The biological response to the elements depends upon
Which elements is released
Quantity released
Duration of exposure to tissues
- An alloy does not necessarily release elements in proportion to its composition.
- Multiple phases will often increase the elemental release from alloys.
- Certain elements have a higher tendency to be released from dental alloys, regardless of alloy
composition. This tendency is called liability.
Cu, Ni, Ga are liable elements
Ca, Zn are relatively liable
Au, Pd, Pt have low liability
- Reduction in pH will increase elemental release from dental alloys.
Geis gerstofer (1991) measured the substance release from NI-Cr-Mo and Co-Cr-Mo alloys using a
solution of lactic acid and NaCl. Results reveals a considerable more rate of corrosion in NI-Ci-Mo alloy
than Co-Cr-Mo alloy and alloys with Be contents, showed extremely high ion release under the corrosive
conditions.
Yang Tai et al (1992) in a simulated 1 yr period of mastication, the results showed that nickel and
berythium metals were release both by dissolution and occlusal wear.
J. C. Wataha et al (1998) subjected high noble, noble, base metal alloys for 30min to a solution with pH
ranging from 1 to 7 and concluded saying that the transient exposure of casting alloys to an acidic oral
environment is likely to significantly increase elemental release from nickel based alloys, but not from
high noble and noble alloys.
F. Oscar et al (2000) evaluated corrosion of Ni-Cr and Cu-Al alloys by in vitro and invitro tests and found
almost no corrosion with Ni-Cr alloys but high corrosion of Cu-Al alloys was observed.
Systemic toxicity of casting alloys:
Elements that are released from alloys into the oral cavity may gain access to the inside of the
body through the epithelium in the gut, through the gingiva or other oral tissue. In contrast, elements that
are released from dental implants into the bony tissues around the implant.
The route by which an element gain access inside the body is critical to its biological effects. It is for
this reason that elemental release from implants in thought to be more critical biologically than elemental
release from dental alloys used for prosthetic restorations.
Once inside the body metal ions can be distributed to many tissue, each harbouring a characteristic
amount they are distributed by
- Diffusion through the tissues
- Lymphatic system
- Blood stream
Ultimately the body eliminates metals through the urine, feces or lungs
- There in little evidence that elements released from casting alloys contribute significantly to the systemic
presence of elements in the body.
- In most situations, the amounts of elements that are released from the dental alloys are far below those
taken in as a part of the diet.
Furthermore, no studies with dental casting alloys and implants have shown that systemic metal
levels are elevated from the use of dental crowns.
In summary, systemic toxicity from dental casting alloys has not been demonstrated.
Local toxicity:
A second major concern about the safety of dental casting alloys is whether elements released can
cause toxicity locally that is adjacent to the restoration.
The concentration that is required to have a local adverse effect may be much lower than
concentration necessary to cause systemic effects through oral route.
Dental crown often extends below the level of the gingiva. If the elements from the alloy are
released into the sulcus they may reach high concentration as they are not diluted by saliva.
Elements released towards the tissue side of the RPD framework may not be diluted by oral fluids
to the same extent as elements that are released from the opposite side of the framework consequently,
the metal ion concentration may be higher next to the tissue than in the saliva.
It is clear that if metal ions are present at high enough concentrations, they will other or totally
disable the cellular metabolism.
Toxicity of these metal ions is reported on the concentration to depress cellular activity by 50% or
total toxic concentration 50% (TC 50 value).
If the exposure time of a metal ion to cell is increased, the TC50 value will decrease. Thus alloys
that release elements over longer periods are more likely to cause local toxic effects.
Although the release of elements from dental casting alloys is well established, the local biologic
effect of these released elements is still a topic of debate.
Studies have clearly established that release of metallic ions is necessary for cellular damage but
does not guarantee that cellular damage will occur. Whether damage will occur depends on the elemental
species, the concentration released and the duration of exposure to the cells.
Lamster et al (1987) reviewed 2 cases who demonstrated significant loses of alveolar bone about the
nickel rich non precious alloy and porcelain crown. The loss of alv. bone occurred within 18 months after
placement of the restorations reason for this was thought that the electrolysis of metal leading to
corrosion and bioavailability of nickel.
John C. Wataha et al (2002) assessed the toxicity of 5 types of casting alloys commonly used after,
stimulated tooth brushing, in acidic environment and a toothpaste. Au-Pt, Au-Pd and Ni-Cr (without Be)
exhibited mitoxicity. A large increase in the toxicity was noted for Pd-Cu-Ga and Ni-Ca-Be alloys.
We know there is significant tolerance in vivo to low levels of elements released from dental
alloys over the short term questions of long-term responses to these low level of elements remain
unanswered.
Allergy: An element must be released from an alloy to cause allergy. Allergy and toxic reaction are often
difficult to difficult to distinguish. Classically, allergic responses are characterized by dose independence.
In reality the boundary between toxicity and allergy are not clear and the relationship is still an active area
of research.
Patch tests for metal hypersensitivity are controversial allergy to metal is assessed by either
applying the metal ion to the skin in a patch or injecting a small amount of ion below the skin, but the
metal salts are in some liquid vehicle, and the vehicle will affect the results whether it is water, oil or
petrolatum. Even the type of patch can influence the results.
The incidence of hypersensitivity to dental alloys appears to quiet low.
Studies indicate that about 15% of the general population is sensitive to nickel, 8% is sensitive to
cobalt, and 8% to chromium. Documented allergies have also been reported for mercury, copper, gold,
platinum, palladium, tin and zinc.
Timothy K. James (1986) stated that incidence to Ni hypersensitivity was more in women (10 times more
than men) the reason was attributed to high frequency of exposure to nickel jewellery, nickel plated
objects at work and at home.
There is probably a genetic component to the frequency of metal allergy as well.
It is possible for metals to have cross reactive allergy some studies have reported that patients who
are sensitive to palladium are nearly always also sensitive to nickel.

Mutagenicity and carcinogenicity:
Mutagenecity describes an alteration of the sequence of DNA.
Carcinogenecity means alternations in the DNA have caused a call to grow and divide inappropriately
carcinogenecity results from several mutations.
An alloys ability to cause mutagenesis of carcinogenesis is directly related to its corrosion.
There is little or no evidence from the dental literature that indicates the dental alloys are
carcinogenic. It is also imperative to realize that the form of the metal is critical to understanding its
mutagenic potential.
For example, the oxidation state of chromium is critical to understanding its mutagenic potential
Ca
3+
is not a mutagen but Cr
6+
is.
The molecular form of the metal is also important Nickel ions are weak mutagens but nickel
subsulfide (Ni
2
S
3
) is highly mutagenic.
Therefore, it is improper to state that a metal is mutagenic or carcinogenic per Se.
In dental laboratories, the vapour forms of elements such as beryllium are the most common
mutagenic threat. The vapours are created during the casting and finishing of the prosthesis. Exposure to
beryllium may result in acute and chronic forms of beryllium disease beryllosis. Symptoms range from
coughing, chest pain and general weakness to pulmonary dysfunction.
Overall, there is no evidence that dental alloys cause or contribute to neoplasia in the body.
However it may be prudent for the practitioner to avoid alloys containing elements such as cadmium,
cobalt and beryllium which are known carcinogen.
To minimize biological risks, dentists should select alloys that have the lowest release of elements
selection of an alloy should be made using corrosion and biological data from dental manufacturers.


CONCLUSION :
As a wide range of metals and alloys combination are now available, it is necessary for us to have
the knowledge about the composition, properties and biocompatibility of the constituent metals of the
alloys, to be able to choose them for the required applications. The decision is not an easy one, as it will
have financial, technical and patient satisfaction consequences. In may ways the decision is
philosophical, based on the drawbacks of using a particular alloy versus its known clinical benefits.
REFERENCES :

1) Science of Dental Materials Anusavice, 10
th
Edn.
2) Restorative Dental Materials Craig, 11
th
Edn.
3) Applied Dental Materials Mccabe, 7
th
Edn.
4) Dental Materials and their selection OBrien 2
nd
Edn.
5) JPD 2000; 83; 223-234
6) Quint. Int. 1996 ; 27 : 401 408
7) JADA ; 128 : 37 45
8) Dent. Metr 2001 ; 17 : 7 13
9) Dent. Metr. 2003 ; 19 : 174 181
10) JPD 2000; 84 : 575 82
11) JPD 2002 ; 87 : 94 98
12) J. Periodontal. 1987 ; 58 : 486 492
13) JPD 1998 ; 80 : 691 698
14) JADA 2003 ; 134 : 347 349
15) IJP 1991 ; 4 : 152 158
16) IJP 1995 ; 11 : 432 437
17) JPD 1992 ; 68 : 692 697
18) JPD 1983 ; 49 : 363 370.

METALS IN PROSTHODONTICS
- Introduction
- History of metals
- Definition
- General characteristics of metals
- Structure and properties of metals
- Deformation of metals
- Cold working
- Annealing
- Alloys
o Solid solutions
o Intermetallic compound
o Eutectic formation
o Perictectic formation
- Classification of metals
- Dental casting alloys
o Uses
o Desirable properties
- Noble metal casting alloys
- Base metal casting alloys
- Alloys for metal ceramic restoration
- Implant materials
- Biocompatibility of metals
- Conclusion
- References


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Wednesday, July 31, 2013
INDIAN DENTAL ACADEMY: Recent advances in Prosthetic Dentistry
INDIAN DENTAL ACADEMY: Recent advances in Prosthetic Dentistry: ADVANCES IN FIELD OF 1.
GENERAL 2. COMPLETE DENTURE PROTHESIS 3. FIXED PARTIAL DEN...
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Recent advances in Prosthetic Dentistry

ADVANCES IN FIELD OF
1. GENERAL

2. COMPLETE DENTURE PROTHESIS

3. FIXED PARTIAL DENTURE PROSTHESIS

4. REMOVABLE PARTIAL DENTURE PROSTHESIS

5. MAXILLO-FACIAL PROSTHESIS

6. ORAL IMPLANTOLOGY

7. MATERIALS AND INSTRUMENTATION























INTRODUCTION
The only thing in life that is constant is change, and developement and the developement is the
essence of any change - Human Society ever since its advant house undergone various changes
starting from discovery of wheels and fire to revolutionary invention of super computers and aircrafts
that defy all the laws of gravity.
Moreover, human beings have used and misused their power of knowledge in various ways both
for good as well as evil.
In one hand they have created nuclear weapons, gamma radiations of which is still giving birth to
a crippled child's, on the other hands they have also invented life saving drugs, a drug which made
hearts beat back to life and drug which restored priceless vision of blinds.
Indeed this world have progressed in leaps and bounds on the similar lines too, oral and dental
health's, like many aspects of human condition, are in the midst of major transition.
The scientific and technological basis of dentistry, are expanding rapidly in a world where
alternative changes in the managements and financing of health care, the demography of our nation,
and public expectations of better "quality of life".
Dentistry has come a long way from just replacing missing teeth to replacing lost alveolus
supporting facial structures, recreating esthetics, reestablishing phonetics and many other major
developments.
Most of all we can say that in prosthetics by using all the artificial materials as well as technologies
we can give a natural appearance of an individual at the best of mankind.


OROFACIAL PROSTHESIS DESIGN AND FABRICATION USING STEREOLITHOGRAPHY
Aust Dent Journal 2000 45:4
The use of stereolithography for the manufacture of implantable prosthesis is relatively new
aspects of this dentistry. Until now, its use with the regard to mandibular resection has been to produce
pre-operative models that allows more sophisticated planning of the contour and better preparation of
the metallic framework to be implanted. The framework rejoins the mandible restoring its function.
Data extracted from Computed Tomography (CT ) scan can be used to produce computer models
of three dimensional (3D) anatomical structures. Using sterolithography, a rapid prototyping technique
these computer models can be made into solid physical models.
The surface and internal structure of the anatomical site can be reproduced by polymerization of
UV light sensitive liquid resin using a laser beam.
The laser rays progressively polymerise photomonomer on the surface of the vat solution.
The model is built vertically step by step as the polymerized section submerged beneath the
surface of the solution.
These models are then used for diagnosis and treatment planning of various cases.






LASER APPLICATION IN PROSTHETIC DENTISTRY
DCNA Vol 44 No 4, Oct 2000
The addition of laser surgery to reconstructive process can heighten the act and the science of this
multidisciplinary field.
The current use of Lasers in Reconstructive Dentistry encomposes a wide variety of soft tissue
procedures but the future may hold promise for hard tissue procedures too.

LASER USE IN FIXED PROSTHESIS
1. Complete control of the oral environment at operative site is essential.
2. Frequently cases are encountered in which gingival tissues need to be altered because of area of
inflammation, previous subgingival restoration or subgingival caries.
3. The finish line need to be placed near epithelial attachment making it impossible to retract the gingiva
without stripping the attachment, bruising the periodontal ligament and creating uncontrolled bleeding.
4. Recurrent Bleeding in gingival sulcus can make impression maki ng impossible.
5. In such cases SULCULAR LASER GINGIVOPLASTY can be used to develop a new, healthier
gingival sulcus, to control haemorrhage, and to remove just enough epithelial attachment and
periodontal ligament to facilitate the placement of Retraction cord.
6. Laser Sulcur gingivoplasty improves impression Technique and minimizes gingival recession.



LASER USE IN IMPLANT DENTISTRY
The importance of creating an environment for soft tissues around perimucosal portion of the
implants cannot be over stated.
All implants must pass through the submucosa and overlying stratified Squamous Epithelium.
Misch considered this the weak link between prosthetis attachment and predictable bony support of
the implant.
The gingival epithelium or biologic seal become an important factor in implant longevity.
If a biological seal is created from the begining of implant uncovering using laser technology vs.
conventional surgery, the attached gingiva would heal directly around the implant, forming an epithelial
cuff.
Implants may be uncovered protectively with laser energy.
Soft tissues > then 3mm thick should be reduced with laser to create an ideal pocket depth around
the implant.










EFFECT OF LOW ENERGY LASER APLICATION IN THE TREATMENT OF DENTURE - INDUCED
MUCOSAL LESION
The use of low-energy lasers has recently gained considerable attention. They are primarily used to
relieve pain, reduce inflammation and edema and accelerate healing. Studies on the biologic effects of
low energy lasers have been concerned with the ability of such light to increase blood circulation within
regenerated tissues to increase production of collagen by fibroblast and to promote a suppresive effect on
the immune system.
Furthermore, increased mitotic activity has been reported, which indicates the growth stimulation
occurs.
Recently, the bacteriocidal effect of light from a low energy laser was introduced as an alternative
approach to Antibiotics and Antiseptics in eliminiting cariogen and periodontopathogenic bacteria from
lesion.
The greatest benefit of using a low energy laser is its effects can be achieved without damaging host
tissues and with protection to the operator.
The effect of therapeutic laser treatment on both soft tissues and bone with subsequent
improvement of denture foundation after t/t of denture induced mucosal lesions.







A CAD/CAM SYSTEM FOR FABRICATION OF COMPLETE DENTURES
UP Vol 7 No 1 1994
This study investigate, the development of Computer Aided System for designing and Fabrication of
Complete Denture.
So far the use of CAD/CAM has primarily being foccused on fixed restoration such as inlays crown
because difficulty in recording soft tissue morphologies of edentulous areas, and interocclusal
relationship.
Methods of recording and measuring 3D morphology have been greatly improved with recent
advancement of optoelectronic measuring unit CAD software.
PROCEDURE:
Involve three major steps
(1) Impression procedure
(2) Denture designing
(3) Denture fabrication
(1) Impression procedure
1. As the first step, an impression of the load bearing area of the residual ridge and denture
borders was made for the maxillary and mandibular arches using a specially designed double impression
trays with Conventional Rubber Base or Silicone impression material.
2. Maxillary + Mandibular impressions are hold at specific V.H. and HR in patients mouth

3. The double impression trays are transfered and mounted on a 3D laser scanner that has a rod around
which both the impression can rotate to full 360. Two dimensional images are recorded by spread laser
beam and Four Charged-Couple device camera while the impression is made to move / mearly. Surface
images are obtained at three different angles time required - 15 to 20 mins.
2. Denture design, Arrangement of Artificial Teeth
Denture space data are transfered to an engeenering work station. Artificial teeth and denture surface
data from the database are overlaped and matched with those of the denture space.
Placement of Artificial Teeth is done to acchive proper stress distribution.
3. Denture Fabrication
Either a numerically controlled milling machine or 3-D laser lithography machine can be used.
Laser lithgraphy create 3D models of new products based on CAD design.

Therefore, only two outer shells (occlusal/polished part) and (tissue surface part) are photopolymerised.
Tooth shade acrylic resin composites are used to fill inside the occlusal portion and two surface are
connected using reference point.
Tissue coloured autopolymerizing resin composite is then placed into the space and excess removed,
and shells are polished using conventional manner.
STAFNE' S BONE CAVITY AND ITS UTILIZATION IN COMPLETE DENTURE RETENTION
J.P.C. MARCH 2002
In 1942 Stafne's described a series of Asymptomatic Radiolucent lesions located near the angle of the
mandible. Subsequent reports have shown that these condition represents a well-defined concavity of the
cortical bone on the lingual surface of the mandible.
The origin of this developmental depression is thought to be secondary to
a) Entrapment of Salivary Gland parenchyma during the developmental process of mandible.
b) Accentuation of the cavity.
c) Indentation along the lingual aspect of the mandible that contains an extension of the submandibular
gland.
Because of their location Stafen's Bone cavities have also been called lingual/ mandibular salivary gland
depression or lingual/cortical mandibular defect.
Although the defects are thought to be developemental, they do not appear to be present at Birth.
Occasionally the defects appears bilaterally.
They often appears radiographically as a round or ovoid, well circumscribed radioluscency. This
reported incidence based on panoromic radiographic observation. They should be differentially diagnosed
out from any Mandibular Cyst. Stafen's Bone Cavity ranges from 1 to 3 cm in diameter and they often
present below the inferior Alveolar cannal.
Engagement of a mandibular denture in bilateral Stafen's Bone cavity aid in retention and stability of
mandibular dentures.


MAGNETS IN PROSTHETIC DENTISTRY
J.P.D. AUG 2001 Vol 86 No 2.

Magnets have generated great interest within dentistry and their application are numerous.
The 2 main areas of their interest are in the field of orthodontics as well as Removable
Prosthodontics.
The reason for their popularity is related to their small size and strong attractive forces allow them to
be placed in prosthesis without being obtrusive within the mouth. Over the last century, significant
advances have been made in the development of magnetic materials which have been quickly transfered
into dental applications. The main magnetic materials used is the rare earth elements Neodynaim-Iron-
Boron (Nd, Fe, B).
Other materials used include RE Alloy, Samarium-Cobalt (Sm-Co). Samarium iron nitride is a
promising new candidate for permanent magnet application because of its high resistance to
demagnetisation high magnetism and better resistance than Nd Fe B to temperature and Corrossion to
oral fluids.
Another Advancement includes the Encapsulation of the pre-existing magnets within a relatively inert
alloys such as stainless steal or titanium.







SURFACE CONDITIONS AND VISCOELASTIC PROPERTIES OF DENTURE LINER PERMAFLEX
IJP Vol 8 No 3 1995
When patients suffer from fragile supporting mucosa, excessive residual ridge resorption, substantial
undercuts and/or Traumatic or pathologic tissue, less, the clinician may opt for the use of a soft lining
material between the intaglio surface of a prosthesis and the supporting tissues.
Soft tissue are useful to attenuate the discomfort result from the instability of improper adaptation of the
prosthesis.
The selected material must
a) minimize bone resorption
b) protect supporting gingival tissues
c) provides good surface condition that is can enable to clinical adjustment.
Materials include in this family of Denture liners are those in the family of Acrylic Resins.
a) Dentimex BV
b) Perform
c) Dimethyl polysiloxanes (DMPS-Flexor)
d) Ethylene Vinyl Acetate Copolymers
All of these materials behave visco-elastically, depending of their flexibility, which can be varied according
to the selected thickness.Therefore, clinical choice between these different families is determined by the
problems presented by the supporting tissues and the design of the prosthesis.
The denture bearing mucosa also exhibit viscoelastic properties.
Among the new denture liners is Benzene dimethyl polysiloxane materials permaflex establish the
efficiency of the material as a resilient denture liners.

CENTRIC RELATION A NEW CONCEPT
A new concept of Centric Relation is defined as "A clinically determined position of the mandible
both condyles into their anterior uppermost position.
This defination defines the old defination is the centric relation is the relationship of the mandible to
maxilla when the condyles are at the most posterior portion of the glenoid fossa.
Because some author belief that in Centric Relation all the load of the mandibular residual ridge are
transfered to the joint cavity pushing the head of the condyle against the avuscular disc and the cavity
wall. Recently it has been found
that there is evidence of nerve and blood vessels in this posterior aspect which can get compressed
causing pain to the individuals. But such pains are not noted in the patient thereby suspecting the actual
position of this condylar head in the joint cavity. So recently authors have suggested their position to be
anterior uppermost position of joint cavity.









DENTAL CERAMICS: WHATS NEW
Dental Update Jan/Feb 2002
Ceramic materials new have a firmly established role in many aspects of clinical dentistry.
The success of recently introduced ceramic materials and systems may be attributed to several
factors, including Technological advences and an increasing more towards the avoidence of use of metal
in the mouth and their replacement with tooth coloured materials whenever possible.
As for all Restorative materials, improvement in strength, clinical performance and longevity, continue
to drive the search for the ideal ceramic material.
To date, those ceramic materials which appear to have the strength for use in posterior teeth as full
and partial coverage restoration include
a) In ceram (Vita Zahnfabrik Germany) b) Procera (Nobel Biocare)
c) Empress (Invoclar Vivadent)
IN-CERAM
In ceram core material is primarily crystalline in nature, whereas other forms of ceramics used in
dentistry was largely compossed of glass matrix with a secondary crystalline phase.
In ceram is said to possess sufficient strength and toughness to be used for Ant and Post all ceramic
restoration and fixed partial denture bridgework.
The types of In ceram are based on alumina, spinal (a mix of alumina and magnesia) or zirconia,
which makes possible the fabrication of framework of different transluscency by use of different
processing technique.
Flexural Strength and # Toughness of In ceram alumina are 2.5 and 3.5 times greater than those of
conventional or high leucite ceramic.
PROCERA
Procera crowns (Nobel Biocare) combine the advantage of a metal coping with high precision
processing techniques. The substructure is fabricated from titanium (a metal used widely in detnal
implants and with a proven high degree of bio compatibility) using a combination of copy milling and spark
erosion.
The aesthetic porcelain that overlays the metal core is of a low fusing composition to minimize excess
oxdn of Titanium during firing.
PROCERA ALL-CERAM~
This comprises of high-strength, densely sintered alumina core veenered with porcelain. A die
constructed from an impression of a prepared tooth, is scanned to allow remote production of a densely
sintered alumina core which is returned to the original laboratory for porcelain build up of the final crown.
Fracture resistance of ceramic restoration is dependent not only on the intrinsic strength and
toughness of the material itself overall fitting accuracy also contribute to the ability of the restoration to
withstand biting force.
IPS EMPRESS 2 (INVOCLAR VIVADENT)
Hot-pressed leucite-reinforced ceramic were introduced serving to reinforce the glossy matrix and
prevant crack propogation.
With IPS Empress, 30-40% crystals content can be introduced before the aesthetic of the core and
resulting restoration are compromised.
In IPS Empress 2, controlled crystallization production of a lithium disilicate glass ceramic enables the
creation of a 60% crystal content by volume without loss of transluscency as the refractive index of the
crystals is similar to that of glass matrix.
Furthermore the strength of the resultant material is reported to be 3 times that of original Empress.
The lithium disilicate glass ceramic serves as the underlying framework for IPS Empress 2, and the
manufactures stated that the strength of the material is sufficient to withstand masticatory forces and to
support edentulous area upto 9 mm in premolar and 11 mm in anterior region.
Fluoroapatite crystals are formed through controlled crystalization and are reported to be similar in
shape and composition to those in natural teeth providing similar wear compatibility and optical
properties.
It is also claimed that the fine grain structure and high crystallinity of the glass ceramic reduces the
potential for wear of the opposing dentition.
There are definite clinical advantages of using Empress 2.
While 1.5mm of axial reduction is usually recomended for metal ceramics only I mm is needed for
IPS Empress 2.
CAD-CAM
COMPUTER AIDED DESIGN
COMPUTER AIDED MACHINE
The first chair side produced ceramic inlay based on a CAD CAM unit. (Cerec, Siemens Germany)
was placed in 1985 since when there have been seveal related developments including introdution of
second generation in 1994 and in 2000 Cerec3.
Cerec 3 comprises both an acquisition and a milling unit which enables concurrent designs and
production of restoration.
The softwares can be supplemented with Cerec 3 crown which contains a tooth library and is said to
be suitable for the manufacture of all posterior restoration and anterior crowns.
Another option is the Cerec 3 Veneer software for producing anterior partial crowns and veneers.
The Cerec 3 milling unit has been seperated from the acquisition unit to enable simultaneous design
and milling. The milling wheel had been replaced with tapered diamond bur reducing the machining
process time by 3-5 mins.
The milling element is designed to accomodate the future option of fabricatint three unit Bridges.
Another feature is the Cerec Scan option for productin of restoration by indirect approach, in which a
conventional model of the preparation and adjacent teeth is cast.
This is scanned with an integrated laser scanner, the model is then replaced with a ceramic block and
the milling procedure commences.
SHOULDER PORCELAIN
To correct the problem of rounding or slumping of conventional porcelain margins after firing as the
fusion temperature were identical, manufactures created special shoulder porcelain containing aluminous
porcelain that fuses at temperatures 30-80 higher than the dentin and enamel porcelain.
Advantages : Stability during firing cycles
Stronger in flexure than conventional porcelain making the margin more resistance to fracture.
OPALESCENT PORCELAIN
Opalescence in dental porcelains is a light scattering effect acchived with the minute concentrations of
high index refraction oxides in a size range near the wavelength of visible light.
CASTABLE CERAMIC
The best documented member of this group is Dicor System (Trubyte Dentsply) which is a micaceous
glass ceramic.
Restoration are produced with the lost wax technique and centrifual casting of heat-treated glass
ceramic. Dicor causes less wear of opposing dentition than that of reinforced conventional porcelain.

CEROMERS
Normal mastication puts enormous pressure on opposing dentition and when conventional porcelain
comes in contact with tooth enamel, serious wear damage can occur.
Thats why you need the delicacy of Ceromer that's short for a CERamia optimised Polymer.
Targis Ceromer System provides the beauty and aesthetic capabilities of ceramic with flexural strength
and shade control of resin.
This system protects and prevents the opposing tooth wear.
Targis ceramic polymer matrix can be heat cured or light cured to create. 1) Crowns
2) Inlays 3) Onlays 4) Implant superstructure (telescopic crown)
This materials can be directly applied over the cast as need of necessary restoration can be buid up to
form crowns, inlays, onlays and bridges after heat curing or light curing method.
A -7






LITHIUM ION STRENGTHENING OF DENTAL PORCELAIN
UP Vol 8 No 3 1995
Dental Ceramics can provide unsurpased aesthetic qualities when used to restore natural teeth.
However one of the inherent disadvantages of these materials is the low tensile strength when
unsupported and subjected to occlusal loading there is a tendency to fracture.
Many developments have been directed towards a strong less esthetic material metal or reinforced
ceramic core that can be overlaid by weaker tooth coloured porcelain.
Thermal tempering and ion exchange have been used to improve the mechanical properties of
existing dental porcelain. Thermal tempering produces a low thermal expansion surface layer that is
placed in compression on cooling, thus increses resistance to tensile strengths.
Ion exchange is a similar approach that involves the replacement of monovalent ions at the surface
of the glass with larger ions.
Compressive strength are generated in the surface layer and decrease the tendency towards crack
propagation.
The effect has been attributed to the inward diffusion of potassium ions replacing the smaller sodium
ions in the glass matrix.
Alternatively, sodium containing glasses have been strengthened by ion exchange with smaller
lithium ions.
More recently the strengthening effect of leucite-reinforced porcelain by double ion exchange has
generated considerable interest. Introduction of small lithium atoms followed by exchange with
Rubidium has been reported to give superior strengthening.
Dispersive X-ray Analysis revealed that the depth of ion exchange was most marked within 1Opm
below the surface, although it extend to atleast 100 m,
EVALUATION OF A NEW OPAQUE SYSTEM FOR METAL CERAMIC RESTORATION
UP Vol 8 No 2 1995
The technical and biophysical factors/involved in the fabrication of fixed restoration are of clinical
importance for the long term prognosis for prosthodontic patients. Technical failures include loss of
retention fracture of matal components and porclain veener fractures. Fractures through the porcelain or
at the metal metaloxide layer interface are the result of metal porcelain-bond that is stronger than strength
of porcelain-porcelain or metal-metal bond itself.
Adhesive failures occur when the bond between the metal and porcelain is inadequate. The
application of the porcelain opaque layer is a critical step in preventing adhesive failure. Additionally, the
opaque layer masks the metal, allowing appropiate shades to be obtained.
The traditional application of opaque porcelain begins with the mixing of porcelain powder with a liquid
binder that commonly consisted of distilled water, alcohol and glycerine. The creamy opaque paste is
applied to the metal substructure in a minimum of two layers. The first layer acts as a wetting layer and
the subsequent layers fill in the irregularities and mask the metal.
Vita VMK-Paint-On 88 opaque and Opaque P are two conventional opaque systems. Recently a new
opaque system called BIOPAQUE become commercially available. This opaque system can be directly
applied to metal surface without mining and condensing. It offers easy application and decrease WT.



Additionally, uniform thickness and excellent opacity can be attained with Biopaque.
Opaque porcelain contains crystals having a high refractive index that disperse and reflects light
masking the metal substructure and preventing it from influencing porcelain colour.
X-ray powder diffraction analysis of Biopaque demonstrate that only the base of this system is a newly
developed material.
Biopaque attained superior clinical results with regard to technical and biologic failures as compared to
the two other traditional opaque system.

















NONMETAL POST SYSTEMS
Dental Update - Sept 2001
The recent years, non metal alternatives for post system have been introduced.
(A) COMPOSITES POST SYSTEM
(B) CERAMIC POST SYSTEM
COMPOSITE POST SYSTEM
Composite materials are composed of fibres of carbon or silica surrounded by matrix of polymer resin.
The philosophy behind the use of these materials lies in the belief that a post
should mimic the dentin of the root in its physical properties, distribute the stresses impossed in the root
in most favourable ways to reduce chances of root #.
a. Carbon fibre Post
1. Composipost : Composed of 8mm pretensed (fibres arranged lingitudinally
within epoxy resins. The bundles are produced industrially and then machined into desired shape.
Radioopaque in characteristic.
2. Carbonite (1.2, 1.35, 1.5mm)
Differ from composipost in that bundles of fibres 6mm in dia braided together with epoxy matrix
Arrangement gives increase Resistance to bending and torsion compared with parallel fibre arrangement.
3. Mirafit Carbon : Identical to Carbonite.
b Silica Fibre Post : Carbon post do not lend them to utilise with all ceramic that alter
aesthetics.
1. Aesthetipost : Central core of carbonfibre surrounded by quartz fibres,
arranged longitudinally.
2. Aesthetiplus post : Consisting entirely of Quartz fibre. More recently this
company has produced a transluscent quartz fibre post designed to permit light curing unit materials to be
used for luiting.
3. Snow post (l.mm,1.2mm, 1.4mm)
Composed of 60% longitudinally arranged silica zirconium glass fibres in epoxy resins. The surface is t/t
with silane to enhance bonding with resin cements.
Cylindrical in shape with 3 tapper at apex.
4. Light transmiting post
Transluscent post have been introduced in order to allow the use of light cured luiting agent, facilitate
cement placement and evaluation of post seating prior to cement setting.
The original purpose of light transmitting post to provide a means of reconstituting roots with overly flared
cannals caused by caries or over excessive endodontic procedure, the aim being to achieve union
between remaining dentin and light cured composite, thereby restoring the lost bulk and original root
strength.





B. CERAMIC POST SYSTEM
The use of ceramic to provide a core and a post retention continues the idea of using a tough but
aesthetic material to support all ceramic units.
The introduction of zirconium oxide ceramics has provided a material with over twice the flexure
strength of Aluminus Ceramic System.
Building a core of ceramic directly onto the zirconia post has not been possible awing to ~ in coefficient
of thermal expansion of core and post material. Ceramic cores and thus to be fabricated indirectly and
then luted around the protuded end of post.
Cosmpost (1.4mm, 1.7mm) : Cylindrically shaped with a conical tip lvoclar/
Vivadent.
Posts have smooth surfaces and are subsequently t/t to roughen the surface which increased Bond
strength between post and core.













METAL-FREE INLAY-RETAINED FIXED PARTIAL DENTURE
Quintessence Int Daniel Edelhoff
Metal free restorative material are oppening doors to new preparation methods of fixed partial denture
prosthesis.
As the results of developement in past few years various metal free systems that can be used to fabricate
short span fixed partial Denture (FPD) are now available. Generally metal-reinforced systems are the
materials of choice for fabricating posterior fixed partial denture (FPD) because of their reliability and
durability, but this system facilitate the periodontal assessment and preserving the healthy tooth structure.

Basic disadvantages in metal alloy
_

1. Base metal components that form on the surface of the alloy during the metalceramic fusing
process may have a negetive effect on adjacent soft tissues.
2. Opaque darkish appearance caused by certain metal denture retainers in abutment seem to be
unesthetic. Consequently highly aesthetically acceptable materials - High strength pressed ceramic and
fibre reinforced composites (FRC) have achieved a certain degree of popularities.


Matel free inlay retained FPD fabricated with High strength pressed ceramic.



Following pre requisites must be met of successful results are to be achieved
a) Good Oral Hygine
b) Low Susceptibility to Caries
c) Parallel alignment of abutment teeth.
d) Minimum height of Abutment teth >5mm Coronogingivally.
c) Maximum mesiodistal extension of interdental gap of 9mm if pressed ceramic and 12mm of
Fibre reinforced composites are used.

RECOMENDATION FOR PREPARATION
a) 2mm occlusal preparation depth (floor of isthmus - central groove)
b) 1.5mm preparation depth of proximal box (shoulder with rounded internal angle).
c) Isthmus width of 1.5mm to 2mm in premolars and 2.5-3mm in molars. d) Proximal angle
of the internal cavity surface to the enamel surface 100-120.
c) Minimum dia of connectors 4mm x 5mm.
f) Divergence angle of cavity approx 6.









PRIMARY ANTERIOR TOOTH REPLACEMENT WITH A FIXED PROSTHESIS USING A PRECISIOIN
CONNECTION SYSTEM
Quintessence Int Vol 33 No 4 2002
Anterior primary tooth loss frequently occurs in young children (ages 6 to 36 months) despite all the
routine preventive measures used in paediatric dentistry. Particularly susceptible to this phenomenon is
Maxillary Central Incisors. Use of Removable Functional. Space Maintainers is recomended as a
therapeutic approach to treatment.
Fixed Space Maintainers of properly designed are less damaging to the oral tissues than removable
space maintainers.
A Resinbonded Prosthesis without rigid connectors permits normal physiologic premaxillary growth
because it does not provide a rigid connection between the pontics.
The use of fixed prosthesis in children in limited by the arch modification that results from the
developement of primary and mixed dentition occlusion. However a period of stability exists in which fixed
appliances may be used i. e. in age of 3-5.5 yrs in which primary arch is completed and the sagital and
transverse dimensions are unaltered.
The Crownless Bridge Works System (CBW Co) was developed in by Nijwegen University as an
advancement of Universal Dental Anchorage (UDA) Plus System.
With this system it is possible to replace both anterior and posterior teeth with a strong prosthesis of
single or multiple pontics and at the same time to preserve abutment teeth.






The CWB system combines techniques derived from the UDA prosthesis system with a system that
utilizes precision connectors attached to Abutment Teeth, with pins comented in proximal aspect.
The CBW system combine two retention techniques, the anchorage and adhesive system.
In addition to the aesthetic advancements provided by minimal need to alter support teeth, the system
offers following advantages
1. Minimally invasive abutment preparation.
2. Improved distribution of loads compared to that with adhesive prosthesis.
3. Few periodontal problems because of absence of margins.
4. Reversible and easily repairable system.
5. No alternation in occlusion.
6. Minimal stress to patients.






CHAIR SIDE PRE FABRICATED FIBRE REINFORCED RESIN COMPOSITE FIXED PARTIAL
DENTURE
The introduction of pre impregnated fibre reinforced resin composite has provided the dental profession
with the oppurtunity to fabricate and deliver adhesive, esthetic and metal free tooth replacement.
The introduction of preimpregnated fibre reinforced composite (FRC) has provided another options for
chairside fixed partial denture (FPD) fabrication.
Indications of this FRC FPD
l. Emergency replacement of Tooth lost due to Trauma.
2. Ant Tooth extracted due to failed Endodontic procedure.
3. Fixed space maintainer, after Orthodontic Treatment.
4. Prior to loading of Implants.

The wings are composed of a strip of unidirectional FRC sandiwiched between 2 woven Fibre Reinforced
Composite Strips.
Three unpolymerized FRC wings are covered with thin foil sheath to prevent contamination and/or
premature polymerization.
The model of the edentulous space is made from Alginate Impression.
The important pre-chairside steps include positioning of the prefabricated FPD on the model trimming the
wings to fit within the Abutments creating proximal retentive locks and forming intraoral putty positioning
index.
Prefabricated FRC FPD being caried to the position in the incisal intraoral positioning matrix. The
unpolymerized listing particulate resin composite is now polymerized, with FPD in that position.
EXPA SYL GINGIVAL TISSUE RETRACTION PASTE
Impression making for all fixed prosthesis requires access to the prosthetic margin white minimally
traumatizing the tissue, so that clinician can produce as much clinical information as possible to
laboratory.
Expa-syl is newly introduced unique paste system specifically designed for gingival retraction that
ensures seperation of the gingival margin and drying of the sulcus.
Expa-syl is injected into the sulcus left in space for approx 1 to 2 mins and then thoroughly rinsed with
air/water spray. The sulcus is left open and dry ready for impression making.
Expasyl composed mainly of two materials Kaolin and A12 Cl, act as an haemostatic agent, Kaolin is
a clay like material responsible for the body or rigidity of the material.
Expasyl is an water soluble paste so it should be used without salivary contamination.
Clinician should be aware of potential interaction between Expasyl and Impression material especially
Alginates and Polyether with A1
2
C1
3
Ideally Expasyl should be used with polyvinyl siloxane impression.












FLEXIBLE CAST FOR FABRICATION OF MULTIPLE POST COPING OVEROENTURE
RESTORATION
JPD March 1999 Vol 81 No 3
Post Coping Restoration can be fabricated using a direct, indirect or combination direct-indirect
method.
Traditionally working cast are mode of stone. Stone cast requires atleast 1 hr for setting. They also
sometimes # during seperation of the cast from the impression. The use of cast that is available
chairside within mins of impression making would save valuable chairside time and improve the
accuracy of coping margins.
In this procedure custom post is fabricated directly into the root cannal space with pattern resin
(Duralay). Core is also fabricated minimal Retentive grooves are placed in resin pattern core to look the
post into the impression material.

After placing the gingival retraction cord around the teeth to provide access to intracrevicular
margins, an impression is made with Polyether Elastomeric Impression Material.
Ensure for accurate reproduction of the margin and the retention of post within the impression.
Lightly lubricate the posts with petrolleum jelly and a flexible working cast is poured with Mach 2 die
system using 2 stage pouring Technique.
After 6mins the flexible cast is seperated and die is made new fabrication of coping is done on the
cast using an indirect method.
CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT
COLLAR
UP Vol 9 No 5 1996
Endosseous Dental Implants of seveal designs and materials have improved the prognosis for the
successful restoration of partially or completely edentulous patient. Implant survival is primarily dependent
upon the establishment of osseointegration, characterised by lack of an intervening soft tissue layer at the
interface of implant surface and supporting bone.
In patients with poor oral hygine around implant supported fixed restoration alveolar bone loss is
greater.
The types and abundance of micro organisms in dental plaque deposits vary with the degree of
implant surface toughness at transmucosal junction. Surface properties such as hydrophobicity of various
materials also appear to be an important to dental plaque adherence.
Despite the widespread used of polished titanium collars as transmucosal elements in implant
system, relatively few studies appear to have been carried out on dental plaque formation on these
surfaces.
This study compare the responses of the peri-implant soft tissues to titanium and ceramic coated
surfaces of removable Transmucosal Element (TME) of established IM2 implant system.
Conventional IM2 TME were modified in the laboratory by addition of dental ceramic coating.




CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT COLLAR
IJP Vol 9 No 5 1996
Endosseous Dental Implants of several designs and materials have improved the prognosis for the
successful restoration of partially and completely edentulous patient.
Implant survival is primarily dependent upon the establishment of osseointegration, characterized by lack
of an intervening soft tissue layer at the interface of implant surface and supporting bone.
In patients with poor oral hygiene around implant supported fixed restoration alveolar bone loss is greater.
The types and abundance of micro organisms in dental plaque deposits vary with the degree of implant
surface toughness at transmucosal junction. Surface properties such as hydrophobicity of various
materials also appear to be an important to dental plaque adherence.
Despite the widespread used of polished titanium collars as transmucosal elements in implant system,
relatively few studies appear to have been carried out on dental plaque formation on these surfaces.
This study compares the responses of the peri-implant soft tissues to titanium and ceramic coated
surfaces of removable Transmucosal Element (TME) of established IM2 implant system.
Conventional IM2 TME were modified in the laboratory by addition of dental ceramic coating.





CLINICAL ASSESSMENT OF A CERAMIC COATED TRANSMUCOSAL DENTAL IMPLANT
COLLAR (Contd.)
In a group of patients with two functional IM2 implants linked by a Dolder0type bar to support a
complete mandibular Removable prosthesis, existing THE were replaced by ceramic coated THE on one
side and a comentional TME on other side.
A range of clinical parameters was used to assess the responses of the soft tissue at intervals of 1, 4
and 12 weeks.
Results shows that
The scores of accumulation of plaque deposit on ceramic coated transmucosal element were significantly
lower than those recorded for titanium transmucosal elements.









PERI-IMPLANT TISSUE RESPONSE OF IMMEDIATELY LOADED, THREADED HA-
COATED IMPLANTS AND CONVENTIONAL IMPLANT
JPD Vol 87 No 2 FEB 2002
This study evaluate the implant success and periimplant tissue response of immediately loaded
threaded hydroxyapatite (HA) coated root form implants supporting mandibular bar over denture with
opposing conventional maxillary over denture. Osseointegrated Endosseous implants have been a
successful modalities for t/t completely or partially edentulous patient. To achieve this osseointegration
certain guidelines are to be followed
1. A complete aseptic and ......... surgical technique. 2. A complete soft tissue coverage.
3. An extended healing time during which no load should be given.
Periods of 3 to 4 moinths and 4 to 6 months have been recomended as healing times for
osseointegrated implants placed in the mandible and maxilla respectively. Faster osseous adaptation
has been demonstrated with Hydroxyapatite coated (HA) implants.
Johson reported complications associated with HA-coated implants and suggested that the HA coatings
are more succeptible to bacterial infection and rapid asseous breakdown.
Babbush et al described a technique of immediately loading 4 Titanium plasma sprayed (TPS) implants
placed in mandibular symphysis with an overdenture. The implants were rigidly splinted by metal bar
and the denture was relined within 2 to 3 days after surgery.
The final clip prosthesis were placed 2-3 weeks later.
The author reported a cumulative failure rate is more in the cases of HA coated threaded root form
implants than conventional root form implants.

PROSTHODONTIC CONSIDERATIONS WHEN USING IMPLANTS FOR ORTHODONTIC
ANCHORAGE
JPD Vol 77 1997
The use of Implants for orthodontic anchorage can produce superior preprosthetic tooth position.
Their use often requires a crown or prosthesis to be fabricated for use as a connection between the
orthodontic device and the implant.
Dental Implants because of their stability could serve as an ideal anchorage unit. Anchorage control is
fundamental to successful orthodontic treatment and Dentofacial Orthopedics.
Prosthodontic advantages of implant orthodontic anchorage
Implants have been found to produce superior preprosthetic tooth position in the following situations
1. Retruding and Realining the teeth
Proclined Anterior Teeth can present both esthetic and functional problems that may be compounded by
palatal soft tissue trauma from mandibular anteriors due to increase vertical overlap.
Strategically positioning posterior implant can be used as an anchorage to effect movements of the teeth.
2. Closing Edentulous space so prosthesis is not required
Retromolar pad implants fixation is particularly advantageous when abutment teeth use for Removable or
Fixed Denture prosthesis have large pulp unsuitable for abutment preparation.
They actually help in closing of the edentulous space by using Retromolar pad implants as an anchorage
units.
3. Correcting midline and Ant tooth spacing
Implants are particularly helpful when multiple posterior teeth are missing and the desired movement
requires teeth to be moved in only one direction around the arch circumference.
4. Reestablishing proper Anteroposterior and Mediolateral position for malposed molar
abutment
Implants facilitate acchieving positional goals when there are multiple missing posterior teeth and
particularly when the malaligned molar abutment is located at the end of an edentulous span.
5. Intruding and/or Extruding Teeth
It can be especially difficult to intrude one molar while extruding another particularly if posterior teeth are
missing.
Implant anchorage can definitely facilitate such movements.
6. Correcting a Reverse Occlusal Relationship
Correcting an anterior reverse occlusal relationship (cross bite) in class III patients can be challenging.
Retracting entire mandibular arch with ramus implants is possible. It is also possible to retract the
mandibular arch with ramus implants simultaneously protracting the maxillary arch by tuberosity implants.

A MODIFIED IMPLANT IMPRESSION TECHNIQUE
JPD Vol 87 No 3 March 2002

1. Impression copings on the implants are seated and secured them with guide pins.
2. Opening is prepared on the buccal side of the tray near the implants Holes are prepared in the
tray to allow head of the guide pins protruded without contracting the tray.
3. Light bodied Impression Material is used to record the area around the remaining teeth.
4. The tray is replaced in the mouth and ensures that guidepins are visible through the holes on
the top of the tray.
5. Injection type impression material (Kerr) is placved through the side opeing until the materials
flow from the holes at top of the tray.
6. After the impression get set impression containing the copings are removed.
RETRIEVAL TECHNIQUE FOR FRACTURED IMPLANT-SCREW
JPD Nov 2001 Vol 86 No 5 Russell, T. Williamson Fonda. G. Robinson
In implant prosthodontics abutment screws and prosthetic retaining screws both have the potential for 4.
Screw loosening and Retightening may lead to subsequent # of abutment screws or prosthetic retaining
screws.
If an abutment screw 4 above the head of the implant, haemostat may be useful to grasp the broken
screw but if the screw # below the head of the implant then other method is applicable.
After the prosthesis or abutment is removed the screw hole is vigourously flushed with an air/water spray
from a 3-way syringe.
An airstream is used to dry the screw hole.
A sharp 1/4th round bur in a high speed handpiece is activated, and lightly touched to the exposed site of
# screw.
The objective is to have spinning bur blades contract the metal surface of the screw so the screw will spin
out of the screw hole.

A TITANIUM AND VISIBLE LIGHT POLYMERIZED RESIN OBTURATOR
JPD APRIL 2002 Vol 87 No 4
BENITO RILO URBANA SANTANA
Patients with intraoral defects due to partial maxillectomy for neoplasm form a highly hetrogenous
group need the most appropriate protocol for rehabilatation.
The presence of absence of natural teeth together with the size of the resection and the extent of soft
tissue loss have major implication for prosthesis design.

When natural teeth are available as abutment, a metal frame work is indicated typically made up of
(Co-Cr).
But comercially pure titanium has been in use for more than a decade approx. weighs 40% lighter than
(Co-Cr) frame work.
Proposed approaches for reducing the weight of these components have included the use of alternative
materials.
Because the tissue surrounding the defect change rapidly after surgery as well as during or after
radiotherapy, repeated adjustment is necessary.
The use of visible light polymerized Resin (VLP) not only reduces the weight but also improves oral
hygine since these resins demonstrate a much lower porosities than conventional auto polymerized.
Advantages : 1. decrease weight
2. increase facilities in fabricatin
3. increase facilities in adjustment.
MAXILLOFACIAL MATERIAL
An ideal material for Maxillofacial Restoration is ideally yet to be achieved despite the research expended
in the post few years.
The formulative approach with chemical Acrylic analog had a brief period of product development for
maxillofacial prosthesis.
Series of Co-polymers for methylmethacrylate have been introduced. Another is Ter polymer for the use
as a synthetic acrylic latex to form a skin over elastomer scaffolding.
Polydimethylsiloxane and various proprietary silicones are premost in clinical usage, particularly where
flexible tissue anatomic reconstructing is needed.
There are two basic types
(A) RTV - Room Temperature Vulcanizing (B) HTV - Heat Vulcunizing.
Some new structural polymers
1. Silphenylene Elastomers
2. Chlorinated Polyethylene.
COMPARISON OF TITANIUM AND COBALTCHROMIUM REMOVABLE PARTIAL DENTURE CLASP
Despite some evidence of casting defects the flexibility and the long term retentive resiliency of the
clasps suggest that titanium and titanium alloys are suitable for Removable Partial dentures specially in
the cases of deep undercuts.
Titanium has modulus of elasticity that is lower than that of Cobalt Chromium (Co-Cr) which increase its
resilience.
This property allow them to place in deeper undercut areas.
Ti-6AL-4V clasps for a 0.75mm undercut showed the least amount of work hardening and permanent
deformation, as small change in retention these clasps was consistent through out the years of clinical
use.
SEM examination of cross sections of Ti-6AL-4V clasp revealed that cracking was confined to the
surface layer and thus not like to cause any permanent deformation.
OPTICAL SURVEYING OF CAST FOR REMOVABLE PARTIAL DENTURE

Surveyors are necessary to determine the path of insertion of RPD.
Basically surveyor consist of a mobile platform, on which cast is placed and titled in different directions
respect vertical marking red.
Because of this position the marker is always parallel to its previous position as it move from one part of
the cast to other.
Using same principle cast can be surveyed by parallel light beams instead of the vertical rod.
The cast is placed on a movable table and surveyed in a dark room using parallel light beams.
The survey line is the border of the light and dark zone.
The geometric location of a conventional lead marker survey line and the one created by light beams are
in the same location.
After securing most favourable path of insertion for design of RPD the table of the surveyor is fixed in
position and survey lines are marked with lead marker.
Advantages
Change of survey lines and undercuts can be easily inspected for different position of the cast.
Slight undercut that cannot be measured by lead marker can be observed by optical surveying.
IMPROVEMENTS IN ALGINATES
l. Flavour Added - Spearmint / Mango / Mint
2. Rapid Set - Hydrogum Normal Set - Neocolloid
3. Dust free - Aliginoplast
4. Chromatic Alginate - TRIALGIN / KROMALGIN
5. Paste form - (Catalyst + Base)
6. Alginate Containing Microbials
1) Chlorhexidine
2) Quantanary Aluminium (Components)
IMPRESSION MATERIAL MIXING INSTRUMENT
PENTAMIX 2

Faster dimension for perfect mixing. System for automatic mixing and dispensing.
Advantages : a) Top quality mix in less time b) More flexible mix
c) Homogenous void free mix
d) Direct filling of syringes and Trays
When changing impression materials cartridges have to be changed and change penta mixing tip.
Impregnum
TM
Penta
TM
Soft Heavy Body/Light Body Impression Material
With Impression materials, the better the detail, the more accurate the final restoration.
Introducing Impregnum
TM
and Penta
TM
Soft Heavy Body/Light Body Impression material, a precision
polyether impression material that is accurate and hydrophillic, resulting in cut standing details even in
moist environment, right from start of mixing.
The Soft Technology makes the material less rigid for easier removal from the mouth while improving the
taste for better patient's satisfaction.
Intrinsic presetting hydrophilicity helps capture and reproduce outstanding details.
INVESTING MATERIALS
CARBON FREE, PHOSPHATE BONDED INVESTMENT
(A) GC FUJIVEST SUPER
A carbon-free phosphate bonded investment for precision castings of precious semiprecous and Pd base
alloys for use in both quick heating and slow heating procedure.
Advantages : *a) With special attention to complicated implant casting
*b) Carbon free creamy consistency
c) High fluidity and wettebility
*d) Very smooth surface
*e) Controllable expansion
(B) GC FUJIVEST II
A carbon free phosphate bonded investment for precision crowns and bridge castings of all dental alloys
for use in both quick and slow heating process.
Advantages : a) Carbon free
b) High fluidity + Wettebility
*c) Controlled setting + Thermal Expansion
*d) Smooth surface
e) Detailed Reproduction
f) Ringless Technique possible in both slow and quick heating process.
(C) GC Stellavest
Same as GC FUJIVEST 11
BITE REGISTRATION MATERIAL
GC EXABITE
Polyvinyl siloxane silicone impression material with properties specially adjusted to the requirement of
Bite Registration.
Advantages
1. Fast reliable mixing and application directly from catridges.
2. Thixotropic properties with ideal balance between stability and fluidity. 3. Extremely
accurate reproduction of details.
RAMITEC PENTA
Polyether impression material for Bite registration for automatic mixing and dispensing in PENTAMIX
SYSTEM.
Advantages
1. Automatic mixing and dispensing with PENTAMIX unit.
Absolutely homogenous and void free mixing at the touch of a bulton.
DIMENSION BITE 60 seconds
Extremely foot setting Addition-cured silicone with high ultimate hardness.
Advantages
l. Extremely short ST of 60 secs.
2. Automatic mixing in new GARNAT 2 SYSTEM.
FLASKING STONE
GC ADVASTONE
Specially designed for flasking techniques in denture fabrication
Advantages : *a) Minimal S. Expansion
*b) Comfortable WT
*c) High compressive strength
*d) Yet diminished strength after setting for easy devesting
e) Excellent Accuracy
GC STONE GLAZE LIQUID
Stone Glaze liguid specifically designed for the surface t/t/ of GC Fujirock EP plaster/white
Advantages :
a) Better visibility of details
b) First class presentation of prosthesis
c) Bio compatible.
DISOLVING AGENT FOR DENTAL STONE AND PLASTER
Agent for dissolving dental stone and plaster residues by immersion
Advantages : High disolving capacity
Suitable for stone + Gypsum Bonded Investment
CEMENTS
RESIN REINFORCED GLASS-IONOMER LUITING CEMENT
GC FUJI PLUS
Due to complination of Resin + GIC this material provide wide varity of application possibilities.
Indicated for luiting all kinds of metal and Acrylic/Resin crowns, inlays, onlays and bridges as well as
luiting of Porcelain ceramic inlays.
Advantages : Easy mixing and handling like conventional cement.
Similar machanical properties to Resin cement.
*Elimination of complex and moisture sensitive bonding procedure.
*Good adhesion to metal, resin and silanated porcelain.
*No post operative sensitivity.
*Optimal Marginal Seal.
*Radiopacity.
GC FUJI PLUS EWT
Luiting of long span Bridges, Combination work and luiting of several restoration.
One step extended Working Time.
Advantages : Same as GC FUJI PLUS only l min extended Working
Time help in easy removal of excess material.
TWINLOOK
Light/Self curing luiting composite systems.
INDICATION
l. Inlays, Onlays and laminate veneers
2. Adhesive bridgework.
ADVANTAGE
Cures readily and thoroughly due to light and redox curing.
Easily and quickly polished.
iscosity is perfect for placing multiple surface inlays.
DISINFECTING SOLUTION
COEZYME
Dual enzymatic Detergent Concentrate.
Advantages
Co enzyme is highly concentrated dual enzymatic detergent.
The ionic surfactant in Coezyme help the powerful solution to access and clean hard-to-reach areas.
The synergistic enzymes dissolve and lift
proteins and the low sudsing neutral pH
detergent component remove the dissolve particulates.
DENTURE COMFORT WITH STERADENT
Steradent has launched Steradent Denture Comfort Fixative Cream.
As well as ensuring secure and comfortable hold of the Dentures, the cream includes camonite, claimed
to help prevent gum inflamation.
The current range of steradent products include.
Steradent Tripple action original and Fresh Cleaning Tablets Steradent Extra length.
GC Fit Checker
Easy flowing white condensation silicone material for location of pressure points of dentures and for
checking accuracy of Crown and Bridges.
Advantages : 1. Minimal film thickness
2. Easy to remove from metal and resin surfaces
3. Clearly visible colur contrast to denture resins and metals.
GC Fit Checker II
White Polyvinyl silicone Addition Silicone Material especially for checking pressure points and accuracy of
fit of Crown + Bridges.
Advantages :
Easy application with Thixotropic Consistency
Exact detail Reproduction
3. Optimised colour and Transparency.
GC METAL PRIMER II
This is an Adhesive for Bonding Dental Acrylic to Metal Simple bonding Technique producing a durabl e
bond between Composite Veneering materials and metal structures without a marginal gap.
Allow safe Adhesive bonding of resin cements to metal restorations of all dental Alloys.
Advantages : *1. Easy fast brush Technique
*2. Reliable Adhesion
*3. No leakage
*4. Resistant to Humidity
5. Can be used with all dental Alloys and Acrylic.
METALOR COMES OUT OF THE SHADE
Metalor unveiled their new digital shade system developed in collaboration with Dent Park Ltd and
Olympus Optical Company at recent FDI.
Metalor have secured the worldwide marketing rights to use software and Hardware developed by Dent
Park, bringing together an advanced olympus digital camera to address the complicated subjects of
shade selection and communication in dentistry.
The product is new generation of Hardware and Software which combine to accurately measure the
shade, shape and contour of natural tooth, transmitting the data electronically from dental office to dental
laboratory without compromising the shade information.
GC ACRON MC
GC Acron MC is an microwave curing Denture Resins in which polymerisation takes place in a microwave
at much shorter time.
This is supplied same as powder and liquid form. Advantages
* 1. 3 minutes polymerization time in a standard household microwave oven.
*2. Uniform polymerisation even in thick sections.
*3. Excellent Dimensional Stability.
*4. Excellent fit to the tissue surfaces.
* 5. High Surface Hardness.
*6. High Strength.
*7. Colour stability. GC PATTERN RESIN LS
GC Pattern Resin LS is a lose shrinkage modeling Resin use for modelling of metal casting plates,
telescopic and Konus crown, adhesive bridges palatal and lingual bars, connectors etc.
Specially developed on brud-on-Technique. Advantages
1. High precision
2. Minimum shrinkage during polymerisation 3. Dimension stable
4. High Hardness and strength 5. Short ST
6. Modelling directly on the working model.
COMPOSITE RESTORATIVE MATERIAL UNIFIL F
This is a new generation Composite Restorative Material having an unique property of Fluoride releasing
action.
Coming in shades of A2 and A3.5 Advantages
l. Unifil is a light curved, radiopaque fluoride releasing hybrid Composite for all anterior and
posterior restoration.
2. It is a non sticky, easy to place, sculpt and pack composite and is BISGMA free.
3. Consist of silans coated fluoaluminosilicote glass fillers.
4. Benefits from significant fluoride and stronium in release to strengthen, protect and remineralize
tooth structure.
I DENTAL DIAMOND BURS MADE WITH NEW TECHNOLOGY JPD JULY 1999 Vol 82 No 1 CFM
BORGES DR Med Dent Conventional Diamond Burs shows several limitations such as heterogenicity of
grain shape, the difficulty of automation during fabrication, the decrease of cutting effectiveness due to
repeated sterilization.
An additional short comming may be represented by the potential release of Niz+ ions from the metallic
binder into body fluids.
A new diamond rotative instrument made of continuous diamond rotative instrument mode of a
continuous diamond film obtained by Chemical Vapour Deposition (CVD).
Cutting Tests were followed by SEM examination and Electron microprobe analysis (EMA) to trace
mettalic residue both on the surface of the bur and the substrate.
EMA demonstrate that the metals of Ni, Cr, Si and Fe were present in the metallic binder matrix of
conventional bur and could be smeared on the surface of the substrate.
SEM showed that significant loss of diamond particles occured during cutting.
On other hand no discreate particles sheared off the CVD bur.
The new CVD burs not only proves to be more efficient in cutting, ability and longevity but also decrease
risk of metal contamination