Dental MaterialsDental Materials

Restorations, Luting and Pulp Restorations, Luting and Pulp TherapyTherapy

IntroductionIntroduction

RestorationsRestorations : :

A restoration is a material which A restoration is a material which substitutes substitutes

the missing tooth structure and the missing tooth structure and restores the restores the

form and function of the tooth form and function of the tooth

Types of Restorations Types of Restorations

TemporaryTemporary, , intermediate and intermediate and permanentpermanent

Direct and indirect Direct and indirect Esthetic and non-estheticEsthetic and non-esthetic

Temporary RestorationsTemporary Restorations

when ?when ? Time ?Time ? Treatment to the pulpTreatment to the pulp

Disadvantage:Disadvantage:

sensitivity sensitivity

microleakagemicroleakage

zinc oxide eugenol ( ZOE )zinc oxide eugenol ( ZOE )

Intermediate RestorationsIntermediate Restorations

particularly used in pedodontics particularly used in pedodontics Conventional zinc-eugenol Conventional zinc-eugenol

cements are deficient in cements are deficient in toughness. They have inadequate toughness. They have inadequate strength and abrasion resistance strength and abrasion resistance

. As a result, polymer reinforced . As a result, polymer reinforced cement (IRM) is used.cement (IRM) is used.

Requirements of a Temporary Filling Requirements of a Temporary Filling MaterialMaterial

1. Should have adequate strength to last 1. Should have adequate strength to last a few weeks, but weak enough to be a few weeks, but weak enough to be

dislodged easily. dislodged easily.

2. Should be easy to insert and remove.2. Should be easy to insert and remove.

3. Should have adequate seal. 3. Should have adequate seal.

4.Should have antibacterial properties. 4.Should have antibacterial properties.

5. Should have a beneficial effect (pain 5. Should have a beneficial effect (pain relief, healing, etc.) on the pulp. relief, healing, etc.) on the pulp.

6. Should have cariostatic properties. 6. Should have cariostatic properties.

Permanent RestorationPermanent Restoration

- any material that is expected to any material that is expected to last much longer than the last much longer than the temporary and inter mediate temporary and inter mediate restorations. restorations.

- Ex.: direct filling gold, amalgam , Ex.: direct filling gold, amalgam , composite resins, glass ionomer composite resins, glass ionomer cement, silicate cement , as well as cement, silicate cement , as well as porcelain, composite and cast porcelain, composite and cast metal inlays and onlays. metal inlays and onlays.

The length of time :The length of time :

Amalgam --------- composite Amalgam --------- composite

Direct and Indirect Direct and Indirect RestorationsRestorations

Esthetic and NonestheticEsthetic and Nonesthetic

An esthetic material is obviously An esthetic material is obviously something which is pleasing to an something which is pleasing to an individual. Gold !!individual. Gold !!

- Today an esthetic material implies - Today an esthetic material implies any material that is capable of any material that is capable of reproducing the color and reproducing the color and appearance of a natural tooth. appearance of a natural tooth.

LUTING ( Cementation )LUTING ( Cementation )

Cementation is the process by which Cementation is the process by which crowns, restorations and other crowns, restorations and other devices are fixed or attached to devices are fixed or attached to tooth structure using an tooth structure using an intermediate material called intermediate material called cement. cement.

Types Types Temporary cementation Temporary cementation Permanent cementation Permanent cementation

Temporary CementationTemporary Cementation

-Temporary bridges-Temporary bridges

- should have some soothing effect on - should have some soothing effect on the pulp of the freshly prepared vital the pulp of the freshly prepared vital tooth tooth

An example of such a temporary bonding An example of such a temporary bonding cement is a zinc oxide eugenol based cement is a zinc oxide eugenol based cement cement

Permanent CementationPermanent Cementation

a) strong b) insoluble in oral a) strong b) insoluble in oral fluids. c) be advantageous if it fluids. c) be advantageous if it had some chemical bonding to had some chemical bonding to the tooth structure. the tooth structure.

d) It should be fluid enough to d) It should be fluid enough to flow .flow .

Ex. zinc phosphate cement, glass Ex. zinc phosphate cement, glass ionomer cement, resin cement, ionomer cement, resin cement, polycarboxylate cement polycarboxylate cement

PULP CAPPINGPULP CAPPING

Pulp capping is a process of placing a Pulp capping is a process of placing a specialized agent in contact with or in specialized agent in contact with or in close proximity to the pulp with the close proximity to the pulp with the intention of encouraging formation of intention of encouraging formation of new dentin (secondary dentin) and new dentin (secondary dentin) and promote the healing of the pulp. promote the healing of the pulp.

Criteria for Pulp CappingCriteria for Pulp Capping

The pulp should be healthy and The pulp should be healthy and uninfected. uninfected.

The area of exposure should be no The area of exposure should be no more than 0.5 mm. more than 0.5 mm.

Following exposure the dentist should Following exposure the dentist should make all attempts to immediately make all attempts to immediately isolate the tooth and prevent isolate the tooth and prevent contamination. contamination.

Types of Pulp Capping : Types of Pulp Capping : 1)1) Direct pulp capping Direct pulp capping 2)2) Indirect pulp capping Indirect pulp capping

Direct Pulp CappingDirect Pulp Capping

Such a situation is often Such a situation is often encountered during :encountered during :

– deep carious lesions deep carious lesions – Traumatic fractures of the tooth Traumatic fractures of the tooth – Iatrogenic exposure during cavity Iatrogenic exposure during cavity

preparation preparation – Iatrogenic exposure during crown Iatrogenic exposure during crown

preparation. preparation.

Indirect Pulp CappingIndirect Pulp Capping

Secondary dentin formation can be Secondary dentin formation can be induced even when the pulp is induced even when the pulp is not exposed but is near exposure. not exposed but is near exposure. When the calcium hydroxide is When the calcium hydroxide is placed in the region of the near placed in the region of the near exposure, it can still induce new exposure, it can still induce new dentin formation through the dentin formation through the remaining thin dentinal wall. remaining thin dentinal wall.

Indications of indirect pulp cappingIndications of indirect pulp capping: :

Deep carious lesions close to the Deep carious lesions close to the pulp. pulp.

During excessive crown During excessive crown preparation the pulp is often visible preparation the pulp is often visible through the remaining dentin as a through the remaining dentin as a pinkish or reddish spot or area. pinkish or reddish spot or area.

Similar near exposures may be Similar near exposures may be seen in cases of traumatic tooth seen in cases of traumatic tooth fracture. fracture.

CEMENT BASECEMENT BASE

is a layer of cement placed beneath a is a layer of cement placed beneath a permanent restoration to encourage permanent restoration to encourage recovery of the injured pulp and to recovery of the injured pulp and to protect it against numerous types of protect it against numerous types of insults .insults .

The type of insults depends upon the The type of insults depends upon the particular restorative material. It may be particular restorative material. It may be thermal or chemical. The base serves as thermal or chemical. The base serves as replacement or substitute for the replacement or substitute for the protective dentin, that has been protective dentin, that has been destroyed by caries or cavity preparation destroyed by caries or cavity preparation

A) High Strength Bases :A) High Strength Bases :These are These are used to provide thermal protection & used to provide thermal protection & mechanical support for the restoration. mechanical support for the restoration.

Ex.: zinc phosphate, zinc Ex.: zinc phosphate, zinc polycarboxylate, glass ionomer and polycarboxylate, glass ionomer and reinforced ZOE cements.reinforced ZOE cements.

B) Low Strength Bases :B) Low Strength Bases : have have

minimum strength and low rigidity. minimum strength and low rigidity. Their main function is to act as a barrier Their main function is to act as a barrier to irritating chemicals and to provide to irritating chemicals and to provide therapeutic benefit to the pulp. Ex: therapeutic benefit to the pulp. Ex: calcium hydroxide and zinc oxide calcium hydroxide and zinc oxide eugenol. eugenol.

Properties of Dental Properties of Dental CementsCements

Thermal PropertiesThermal Properties : :

important sp. When metallic R.important sp. When metallic R. Is used.Is used.

- Thickness- Thickness at least 0.75 mm at least 0.75 mm

Protection Against Chemical Protection Against Chemical InsultsInsults

Serve as barrier Serve as barrier Calcium hydroxide and zinc oxide-Calcium hydroxide and zinc oxide-

eugenol are most effective for this eugenol are most effective for this especially in deep (close to the especially in deep (close to the pulp) cavities. pulp) cavities.

Polycarboxylate and glass ionomer Polycarboxylate and glass ionomer bases are also used as chemical bases are also used as chemical barriers in more moderate cavities barriers in more moderate cavities

Therapeutic EffectTherapeutic Effect

Some bases are used for their Some bases are used for their therapeutic benefit to the pulp. therapeutic benefit to the pulp. For example, calcium hydroxide For example, calcium hydroxide acts as a pulp capping agent and acts as a pulp capping agent and promotes the formation of promotes the formation of secondary dentin. Zinc oxide-secondary dentin. Zinc oxide-eugenol has an sedative effect eugenol has an sedative effect on the pulp. on the pulp.

StrengthStrength: :

the cement base should develop the cement base should develop sufficient strength rapidly, in sufficient strength rapidly, in order to allow early condensation order to allow early condensation of amalgam. The minimum of amalgam. The minimum strength requirement of a base strength requirement of a base between 0.5 and 1.2 mPa. between 0.5 and 1.2 mPa.

The cement base must have The cement base must have sufficient strength tosufficient strength to : :

Withstand the forces of Withstand the forces of condensation .condensation .

Withstand fracture or distortion Withstand fracture or distortion under masticatory stresses .under masticatory stresses .

The base is selected according to:The base is selected according to: 1)Design of the cavity 1)Design of the cavity 2) Type of permanent restorative 2) Type of permanent restorative

material used.material used. 3) Proximity of the pulp to the 3) Proximity of the pulp to the

cavity walls .cavity walls .

Cavity LinerCavity Liner

Is a dentine sealer that is less Is a dentine sealer that is less than 0.5 mm thick and is able to than 0.5 mm thick and is able to promote the health of the pulp by promote the health of the pulp by adhesion to the tooth structure or adhesion to the tooth structure or by antibacterial action .by antibacterial action .

Liners And VarnishLiners And Varnish

Liners and varnishes are agents Liners and varnishes are agents in a volatile solvent which when in a volatile solvent which when applied to a surface evaporates applied to a surface evaporates leaving behind a thin film. This leaving behind a thin film. This film acts as a barrier which has film acts as a barrier which has different functions depending on different functions depending on the circumstance and the location the circumstance and the location where it is applied where it is applied