Our lecture today is about reviewing dental materials in relation to complete denture construction : We will talk about the

clinical relevant of the materials , so if I talk about polymer , what does the polymer mean ? When I hear a ward polymer , I have to remember that polymer comes from what ? - Monomer , so we have a chemical reaction and the result is polymer . Dentures are important vehicles , a lot of people are edentulous , more people are alive for elderly age and acrylic is a very very common material used for all these application and for our case the denture base is the area where we used acrylic and the teeth , so its the base and the teeth . And we know the teeth and the base has another alternatives . For teeth we used plastic acrylic but there are some other materials used for dentures and they have advantages and disadvantages . We used acrylic for many things : 1. Relining materials . 2. Provisional partials . 3. Impression trays . 4. Record bases . 5. Occlusal splints . 6. Mouth guard . 7. Orthodontic retainers . 8. Provisional restorations . Polymer : multiple monomers going into each other that means that we have differences between polymerization reaction , we have addition and condensation type .
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What do you think the one that we are using in complete dentures ? - Additional type , there is no byproduct and we are only adding monomer to another monomer creating a large molecule called a polymer . Polymers are not the same , they arrange either linearly in a line or they become branching , that means : 1. linear: this type has one ability to bind from one side , one from one side and one from the other side . 2. Branching : this type has the ability to bind from more than one side and this is when we used more than one polymer in the reaction . 3. cross linked polymerization : these are monomers also have the ability to create chemicals bond and e they cross linked . where is this applied ? if you know that the linear is weak reaction and the branching is strong reaction and cross linked is even stronger . - heat cured is cross linked , teeth is more complex , its more cross linked , and this is because the way to create this is by pressure and temperature , ate in the lab during flasking you only can get up to 37 but in the manufacturers where they create the teeth , the teeth are compressed under heavier pressure and higher temperature . so the occlusal surfaces of the teeth is highly crossed linked to tolerate , we want it to tolerate the b . bite a question from student about if the material used in every type of polymerization are the same ? - yes , chemically the polymer that does cross linking is different from the polymer that only does a chain but the major of all acrylic has the same mer monomer but I add an addition to the mixture where a polymer that is able to do a cross linking and able to create branching . so we found that the pink acrylic that you process is cross linked , and the heat acrylic is even more cross linked because of the manufacturing environment they produced in .
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where is the linear go ? - relining material . - gingival third of the teeth . why ? remember that we want old acrylic (teeth) to bind to a new acrylic (pink acrylic) . what they do in the manufacturer ? they create the gingival third , the fitting surface that is going to sink in the pink acrylic , they make it of the linear type chains , that means in flasking and before backing we paint the teeth with a monomer after I remove only separating medium , this monomer infiltrates into the linear chains allowing the new pink acrylic to inter penetrate and begin the chains from inside the teeth out . so its a chemical reaction , inter penetrating polymerization . 4. coiled chains : are where we have impressions material , they are a polymers but they come in a coil shape . and this is why are flexible and resilient . There are even more stronger polymers , we are not going to talk about these . we could add around the polymers some material that makes them more flexible does we called them plasticizers . Where this apply ? - assume that we have an oily material around the hard pink acrylic that allows the chains to slip over each other , imagine that you have a big cup and you have rough rocks in it and try to remove the rocks around if they move ? they inter mingled with each other , they dont move easily . take some rocks and put some marbles in their and then shake it , the rock will begin moving around , so the glass marbles allowed more friction in movement of the solid polymers . where do we used that in dentistry ? - increase impact strength , some materials if they fall down they dont fracture easily like glass , but what else ? something familiar we add it to the denture after it become loose ? lining material that is rubbery in shape is a plasticizers .

plasticizers : there are a form of material usually oils or other types of small polymers , they become like marbles in between the polymers that have joined each other so it causes a sliding motion between those two solid material , this sliding motion gives us more flexibility . there a type of plasticizers what we call external plasticizers to the bead and there are something called internal plasticizers , they place these plasticizers in the balls of the polymer . now if I have a relining material that was rubbery and after one year it comes hard what happened ? the plasticizers had leaked out and thats why they change it from external to internal . when the material sets its exothermic and then after the polymerization it become contracting , sometimes its expand if it becomes in water and sometimes its expand if you heat the material , where this is apply clinically ? - the material are not stable dimensionally . - through the dough stage we have expansion . - when we preserve dentures in water because it will shrink if its stay dry . - during the setting the flask should be adapted to cast and thats why we apply pressure to preserve the dimensional stability . - its an exothermic reaction and thats why we place the flask in 37 because the actual temperature inside the flask in 95 because the reaction itself is exothermic and this temperature after the pressure we apply , allow more polymer to go into reaction and if that doesnt happen we will have many residual monomer and if we decrease the residual monomer we actually make the denture stronger , because more monomer go into the reaction , more polymerization , more cross linking . Now if I put it in a temperature more than 37 what will happen ? - We will have porosity because more than 37 we will have the monomer evaporate in its place , because its evaporate at 100.3 so I will have bubbles instead of monomers and thats is porosity .

What are the problems of porosity ? - Weakness of the denture . - Brittle . - Stains . - Fungal infection . - Plaque accumulation . - Esthetically unacceptable , it become like milky powdery shape . Expansion on heat , where this applied clinically ? - When we instruct the patients when we gave them the denture not to put it in boiling water to disinfect it . but he will tell you about the hot tea that we drink ? you will tell him its ok because the denture is in your (the patient) mouth but if its outside and you boil it the shape of the denture will be changed . Acrylic resin types : we should have idea properties and its not always there , we have classifications of the acrylic according to the way we cure it . its either : - Chemically cured : cold cured , chemically initiator . - Heat cured : thermal initiator . - Light cured : photo initiator . How do we get it to cure in different conditions , simply by changing the initiator .
Heat cured resin : powder and liquid , we said that the resin will transfer to polymer why we need the powder ? - by adding powder to the reaction we reduce the shrinkage , we increase the strength , part of the powder we consider it as a filler , the powder is pre polymerized ( resin that has been polymerized ) and they polymerize it under heavy pressure , heavy temperature , which type is stronger ? - the powder it self , if we bring a block that are cured from monomer to polymer and another block that are cured from powder which is polymer and adding to it some monomer , which one is stronger ? - the powder because its already polymerized at the manufacturer .
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- and its faster , the setting time is reduced because most of it is already polymerized . - there are many things that we add to the monomer side specially cross linked agents , so the monomer can interpenetrate and begin the reaction from inside the bead (interpenetrating network reaction ) so these why we get polymer .
chemically cured resin : there are some differences in the molecular weight and the polymer beads and the way they reacted but who gives me a major property change in heat cured and chemical cured ? - heat cured : more gaseous porosity , stronger . - chemical cured : more shrinkage , small beads so we need more monomer and more shrinkage , amount of residual monomer more because we dont have enough pressure and enough heat and thats why we put it in hot water under pressure pot to make it stronger .

residual monomer : its a monomer that went into the interaction but did not actually turn into a polymer . glass transition temperature : its the temperature at which the denture turns from glassy amorphous properties to a rubbery properties and its at high temperatures . when we trim by using a bur from the base plate the edges become like rubber . it change from glassy stage to a rubbery stage . in heat cured dentures is usually high , in cold cured dentures its lower . thats means which denture will wrapage more , heat cured or chemically cured if we place it in hot water ? chemically cured , because it has lower glass transition temperature .
light activated material : this material although it doesnt has a lot residual monomer , its not very strong so its only used for base plates , record bases , trays and denture repair and plasticizers does this effect , lowering glass transition temperature .
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 high impact acrylic : its another type and it has lucitone in its component type and it make the denture stronger and doesnt brake easily . Back to the heat cured resin : this is the powder and liquid when we mix them , when we press the monomer on the polymer , its the sandy stage . and we call it like this because cal there is no reaction yet , the monomer is very liquid , the powder is very solid . but by time what happens when the monomer is in close contact with the powder ? - it begins dissolving the surface and penetrating to the inside . s What happens then ? - First is the sticky stage , its only the surface of the bead has been dissolved then it becomes dough stage when the whole of the bead has been interpenetrated by the monomer and finally the rubbery stage when the cross linking reaction begin . - The more heat and pressure the more reaction , the less residual monomer. - Residual stage : is the weak stage of the reaction . We have specific powder to liquid ratio , do you recommend to increase the setting reaction (decrease the time) to increase the liquid ? increase - No , because the property will change , the way we change settings reactions are all the ways other than changing the proportion , so we could decrease the setting time by changing the type of acrylic I am using , we could use accelerators such as water , alcohol or citrate but these doesnt change the properties . What will happen if we have more p/l? - Inadequate filling by monomer . - Weak material properties . - Porosity . Why we cure them in the dough stage ? - monomer penetrate the beads . - dissolves beads allows cross cross-linking agent to penetrate . - interpenetrating polymer network IPN .
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How we change the colour ? - By adding pigmentation . Why we add a separating media (sodium alginate , cold mold seal )before packing the acrylic ? - It easier to remove the denture and not to break it . but why it will break ? - because under pressure the flow of the material increases , it goes in the cast porosity so we want to take the denture out , the denture will be totally filled with gypsum on the fitting surface , its very difficult to remove. Its very important to put the denture under pressure why ? - Decrease porosity specially granular porosity . - Adapting to the cast even better . - Reducing setting time because the monomer is closer to the polymer under pressure . - Decrease the residual monomer . - Maintain the denture under pressure we squeeze extra material inside the flask and this extra material will compensate for polymerization shrinkage . - We also control the process strains , we dont open the flask because we might have crazing , wrapage , we might have distortion so also it reduces the warpage of distortion . Why do we heat and cool the denture in gradual way ? - We put the denture in the flask , then we do packing then we put it in a frame , that frame is held under pressure then we put it in a path and then we heat it . now we take it out and cool it . Do we do that suddenly ? - It should be kept to cool at room temperature or sometimes they instruct you to let it cool with the water itself . What will happen if I cool it quickly ? - The surface will shrink more and the core will still warm and that will make cracks or craze lines . Why we call them craze lines ? - Because they still some strings of the polymer com in between .
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Flasking steps : we do the wax up . then we create a flask which is a negative replica of the denture then we close the flask .

then we melt the wax (dewaxing step). We place a separator then mixing the acrylic and leaving it under a glass lap why ? after we mix the powder and liquid we cover it by a glass because if we let it exposed to air it will shrink and the surface will dry and after it goes in dough stage these dry particles will show as a pinkish granules in the denture and we call this granular porosity .

Then w e pack it by our fingers around the teeth .

 Then we place more acrylic in the cast side then we close it and pack it under pressure . Do we pack the material slowly or fast ? - Very slowly . What will happen if we pack it quickly ? - The flowing of the material is embedded , its need time to flow around the teeth so if I pack quickly it will break the cast , pressure will accumulate and break the cast . then I cure . what is the temperature ? - I have fast cycle and slow cycle Fast cycle : - Cure at 71-72C for 30 72C 30-90 min . - 100C for 30 min . Slow cycle : - cure at 71-72c for 10 hrs . 72c - A slow cycle is better w larger amounts of material . with - Generally, slow cures result in better dimensional accuracy . Why we place stone around the teeth ? - The vertical dimension will change because under the pressure teeth might go into the plaster because its weak we need something more strong and thats why we use stone even in some books they tell you cover the layer of stone up to the occlusal surface of the teeth and then add a layer where stone is mixed with investment material (its stronger) so its not two layer plaster and stone , they are three layers plaster , stone up to the teeth level and then they add an extra layer over the teeth with investment stone . Why we add plaster on the cast side ? - To preserve the master cast . How is that ? - Because plaster is weaker so I can knocking it and the plaster will break first and thats called harvesting the denture .
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Give me reasons why the teeth fill off the denture ? - Not enough monomer . - There is separating media on teeth . - The amount of acrylic is not enough . - The flow of material didnt go well because of fast pressure . - More trimming to the teeth lead to lose the linear material so it not incorporate well in the new acrylic . - Contamination of the acrylic with plaster, when I open the flask after the dewaxing, some particles of plaster goes over the teeth and I didnt clean it. - Vaseline contamination . - Wax contamination , I dont do dewaxing correctly , there still some wax on the teeth . We can flask and put heat and pressure control to increase the conversion , no matter how much we do , no matter how much heat and pressure we apply , still not at all the monomer goes in and still we have 2% of the monomer not giving into the reaction . What will happen if that monomer comes out to the patient mouth ? - Irritation , the monomer is hugely irritant . How do we remove it before that ? - We put it in water , after we take out the denture from the flask its not delivered immediately to the patient , it should be soaked for 24 hours in water , because this 24 hours soaking replaces residual monomer , it leaks out and instead comes in water , so we get the final shape of denture . We have fast cycle and slow cycle of the temperature but no matter what we keep the temperature inside the flask below the temperature of boiling and evaporation of the monomer . There are so many manufacturers that tell you boil the water and put the flask while boiling then reduce the heat . How come , how do they tell us put it in boiling water ? - These systems use the property of poor thermal conductivity , lets talk about the long cycle (slow) , it takes 8 hours , sometimes we let the water boil and put the flask for 1.5 then let it cool down to 37 . 8 hours , 2 of
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them the heat is running slowly into the core of the flask because of the poor conductivity of the acrylic and the stone , now to save that time they let you put it in the boiling water and then they tell you to close the heat up to 37 . So this boiling water where dose the heat go ? - it dissipate into the flask once it reaches the core , the outside is already 37 so the setting time is reduced . one more time , some manufacturer allow you to put the denture in boiling water what property are they depending on ? - the poor conductivity of the flask thats mean instead of waiting two hours for the whole flask to become 37 which is a lot of time , I could put it in boiling water and then turn it down to 37 , I would save two to three hours by this because in half an hour the boiling water will dissipate the heat into the core , and once it reaches the core of dentures itself inside the flask , its already equalize with the outside which is now 37 . so make sure what ever you used of dental material , the major rule is follow the manufacturer instructions .

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