1. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements, Bases, Liners, and Bonding Agents Chapter 33

2. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Introduction Materials generally divided and categorized according to functions ADA and FDA regulate dental materials

3. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Introduction ADA Council on Dental Materials, Instruments, and Equipment –Responsible for information and testing of dental materials

4. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Role of the Dental Assistant Depends on expanded functions of individual state practice acts Generally, assistant prepares and mixes materials Some states allow assistant to place materials in oral cavity

5. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Properties of Dental Materials Acidity Adhesion Biting forces –Tensile –Compressive –Shearing F F F F F F TensileCompressiveShear © Cengage Learning 2013

6. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Properties of Dental Materials Corrosion Dimensional Elasticity Flow Galvanism Hardness Courtesy of Dr. Gary Shellerud

7. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Properties of Dental Materials Microleakage Retention Bonding Solubility Enamel Dentin Salivary fluids Amalgam restoration Salivary fluids © Cengage Learning 2013

8. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Properties of Dental Materials Thermal properties –Conductivity –Expansion Viscosity Wettability

9. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check What term describes the ability of a material to flow? –Viscosity; the thicker the material, the less it flows

10. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Restorative Dental Materials Liners, bases, cements, and bonding agents Amalgam, composite, and glass isomers

11. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Variety of forms: –Powder/liquid –Two-paste system –Capsule –Dispensing syringe Self-curing Light-cured

12. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Terms Used in Conjunction with Dental Materials Luting Liner Base Sedative or palliative effect Varnish

13. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Zinc phosphate –Permanent cementation and insulating base –Composition –Properties –Manipulation considerations

14. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Zinc Phosphate Luting Consistency © Cengage Learning 2013

15. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Zinc Phosphate Base Consistency © Cengage Learning 2013

16. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Zinc oxide eugenol (ZOE) –Temporary cementation and restoration, low- strength base, periodontal dressing, and root canal sealer –Composition –Properties –Manipulation considerations

17. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. ZOE Luting Consistency © Cengage Learning 2013

18. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Reinforced zinc oxide eugenol –Permanent cementation, insulating base, and temporary restoration –Composition –Properties –Manipulation considerations

19. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Polycarboxylate cement –Permanent cementation and insulating base –Composition –Properties –Manipulation considerations

20. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cobwebs from Mixing Too Long © Cengage Learning 2013

21. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Glass ionomer –Permanent cementation, high-strength base, and low-strength liner; root canal sealer, restorative material, and core buildup material –Composition –Properties –Manipulation considerations

22. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Glass Ionomer © Cengage Learning 2013

23. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Resin-modified glass ionomer –Sensitive to light –Stronger –More water soluble –More adhesive –Releases fluoride –Comes in many forms

24. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Calcium hydroxide –Low-strength liner –Composition –Properties –Manipulation considerations

25. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Varnish –Thin liner –Composition –Properties –Manipulation considerations

26. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Resin cement –Permanent cementation –Composition –Properties –Manipulation considerations

27. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Compomer –Cements all types of dental restorations –Composition –Properties –Manipulation considerations

28. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Cements Etchants –Enhance retention/bonding qualities between tooth surface and dental materials –Used before bonding agents, restorative materials, dental cements, and sealants –Used on enamel and dentin surface

29. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Bonding Agents Also known as adhesives and bonding resins Improve retention between tooth structure and restoration –Enamel bonding –Dentin bonding

30. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check Which is more challenging: dentin or enamel bonding? –Dentin, due to higher water content, more organic than inorganic, proximity to pulp, and smear layer

31. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Restorative Dentistry Classification Cavity detection Caries detection Cavity cleaners/disinfectants Desensitizers Cavity preparation identification

32. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Restorative Dentistry Elements of cavity preparations –Outline form –Resistance form –Retention form –Convenience form –Finishing or refinement –Cleansing or debridement

33. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. M B D L Restorative Dentistry Pulpal floor or wall 1 2 6 8 5 3 7 4 1. Mesiobuccal line angle5. Buccopulpal line angle 2. Mesiolingual line angle 3. Distobuccal line angle 4. Distolingual line angle 6. Mesiopulpal line angle 7. Distopulpal line angle 8. Linguopulpal line angle © Cengage Learning 2013

34. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Advanced Chairside Functions Placing cements, bases, and liners Cavity preparation/pulpal involvement –Depends on amount of decay and types of materials used to restore tooth Treatment of cavity preparations –Varies with amount of enamel and dentin removed and how near prep is to pulp

35. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Advanced Chairside Functions Treatment of cavity preparation –Ideal Minimal dentin and enamel removed –Beyond ideal Dentin restored with base

36. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment of Cavity Preparations Near-exposure –Restoration occurs close to pulp Exposed pulp –Concerned about vitality of tooth

37. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cavity Liners Placed in deepest portion of cavity preparation Placed on axial or pulpal walls Form cement layers with minimum strength Protect pulp from chemical irritants Provide therapeutic affect to tooth

38. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cavity Varnish Used to seal dentin tubules –Prevents acids, saliva, and debris from reaching pulp Used under amalgam restorations –Prevents microleakage

39. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cavity Varnish Used under zinc phosphate –Prevents penetration of acids to pulp Placed after or on top of cavity liners or medicated bases

40. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cement Bases Thick putty placed under cavity preparation –Protects pulp and provides mechanical support for restoration Placed on floor of cavity –Raises floor level to ideal height