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Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
Da130 restorative materials
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Da130 restorative materials

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  • 1. RESTORATIVE MATERIALS DA 130 Dental Materials and Anatomy and Physiology
  • 2. HISTORY OF DENTAL AMALGAM  Has been in use for over 150 years in dentistry  “Amalgam” actually means a mixture of metals  Consists of Mercury: Alloy  Alloy made up of varying percentages of silver, tin, copper and zinc  Percentages of alloy and mercury were once mixed by the hand of the dental assistant  Research soon discovered that mercury was a hazardous material, so standards of handling were developed
  • 3. WHEN DO WE USE DENTAL AMALGAM?  Dental amalgam is still considered a safe and effective means to restore a tooth  Amalgam is often used for:  Primary and permanent teeth  For stress bearing areas of the mouth (usually posterior)  For areas where moisture contamination is not a concern  For cost purposes  When aesthetics is not a concern
  • 4. MERCURY HAZARDS?  Although dental amalgam contains mercury, when it is mixed with the alloy, the chemical composition changes, and it becomes harmless  Mercury on it’s own is liquid metal, and considered hazardous  Premeasured capsules prevent dental personnel from handling mercury in it’s liquid state
  • 5. HOW TO HANDLE DENTAL AMALGAM  There is still a risk to healthcare workers regarding dental amalgam; therefore:  We use PPE when handling  We use premeasured capsules  We make sure we close the door of the triturator when mixing amalgam  Always use the suction during application to prevent patient aspiration, which could lead to potential toxicity  Have a mercury spill kit handy if a spill should occur, do not vacuum up!  Have an amalgam scraps container to place excess amalgam, do not throw in garbage!
  • 6. TRITURATOR AKA AN AMALGAMATOR
  • 7. WHEN TO USE CAUTION WITH DENTAL AMALGAM:  When mixing the dental amalgam  Mercury vapors will be released  Keep door to triturator closed during mixing  When handling amalgam  Use a no-touch technique (even with gloves on)  Use instruments to pass material, never touch with bare hands!  When restoring a tooth with an existing amalgam restoration  Be sure to use your PPE, vapors are given off when handpiece is in use  When cleaning amalgam after completion of procedure  Place in a amalgam scraps container  A container with a tight lid and keep either dry or with a small amount of radiographic fixer
  • 8. ADDITIONAL PRECAUTIONS:  Do not sterilize extracted teeth with amalgam restorations  Waste haulers will remove for a fee  Replace amalgam traps at regular intervals  Use a mercury spill kit if you have scraps or loose mercury
  • 9. AMALGAM ARMAMENTARIUM  Basic set-up (mirror, explorer and college pliers)  Spoon excavator  Tofflemire and wedges (if needed)  Amalgam carrier  Amalgam well  Condenser or plugger  Carvers  Hollenback  Cleoid/Discoid  Burnishers  Acorn / Ball  Articulating paper forceps  Triturator
  • 10. PROCEDURE STEPS:  Patient is given local anesthesia  Tooth is prepared – with a high speed and low speed handpiece  Tofflemire is placed – if there is interproximal involvement)  Medicaments placed (if necessary) – bases or liners  Amalgam is mixed – with triturator  Amalgam is packed – into a carrier
  • 11. PROCEDURE STEPS:  Amalgam is transferred – into the tooth  Amalgam is condensed – using condenser  Anatomy is carved – into amalgam with hollenback and cleoid/discoid  Tofflemire is removed  Restoration is smoothed – using burnishers  Tooth height is checked – using articulating paper  Adjustments may be necessary – return back to carvers and burnishers  Give patient post-operative instructions
  • 12. COMPOSITE RESTORATIVE PROCEDURE:  Composite has been the restorative material of choice for some time now  The growing concern of the public in regards to the safety of dental amalgam created the demand for high strength, aesthetically pleasing composite resin
  • 13. COMPOSITION OF COMPOSITE RESINS:  Resin matrix:  Dimethacrylate aka BIS-GMA: a fluid monomer (liquid)  Fillers: quartz and silica (minerals and crystal compounds)  Macrofilled: larger particles found in resin, known for high strength  Microfilled: smaller particles in resin, known for aesthetic qualities and ability to polish  Hybrid: most commonly used today, provide high strength and aesthetically pleasing results  Flowable: used in a syringe, this variation of composite is used for it’s flowable consistency  Dentist’s will often use this to place on floor of preparation  Sealant composites: similar to flowable, but consistency is even thinner to allow flow into pits and fissures of occlusal surfaces
  • 14. THE RIGHT SHADE:  Critical to creating a cosmetic final result  Use a universal shade guide  Unless a lab provides the office with a separate one  Take shade in natural light  Turn dental light off  Use a hand mirror, and have patient approve shade prior to use  Documentation of approval and selected shade is also necessary
  • 15. TECHNIQUE SENSITIVE:  Composite is affected by a number of factors, many of which the dental assistant can control:  Moisture contamination  Saliva  Light sensitive  Composite will begin to set if exposed to any light  Considerations for use with other materials  Certain dental materials cannot be used with composite:  Eugenol based medicaments  Fluoride treatments  Dental sealers (varnish)
  • 16. MEANS OF ISOLATION:
  • 17. ETCH AND BONDING AGENTS  Composite fillings are not created with mechanical retention, chemical retention is necessary  Acid etch – phosphoric acid  Used to open enamel rods and dentin tubules  Similar to sandpaper on wood  Tooth should appear chalky white when properly done.  Primer is used to condition tooth and aids in bonding  Bonding agent unifies the tooth and material
  • 18. MICROSCOPIC IMAGES OF ENAMEL RODS  Before etching  After etching
  • 19. MICROSCOPIC IMAGES OF DENTIN TUBULES  Dentin and nerve tissue  Enamel and dentinal tissue
  • 20. ARMAMENTARIUM:  Basic set-up  Spoon excavator  Plastics instrument  Condenser  Burnisher  Articulating paper forceps  Matrix strips  Composite/dispensing unit  Acid etch  Prime and Bond system  Curing light
  • 21. PROCEDURE STEPS:  Dentist administer local anesthesia to the patient  Shade is taken  Always prior to preparation  Tooth is prepared – with dental handpieces  Tooth is isolated – meaning, protecting the tooth from moisture and contaminants  Cotton rolls, dri-angles and rubber dam are indicated  Acid-etch is placed – creates porosities on the tooth surface  Usually for 20-40 seconds  Thoroughly rinse for 20 seconds  Replace wet cotton rolls
  • 22. ETCH FIRST, THEN APPLY BONDING AGENTS
  • 23. PROCEDURE STEPS  Dry tooth  Place primer – conditions tooth to receive bond  Dry tooth  Place bonding agent – allows for unification of tooth and composite material  Cure  With light for 20 seconds  Place composite material  Flowable first on floor of prep  Hybrid placed in layers and cured in increments  Final details are created  Final cure – 40-60 seconds
  • 24. FINAL STEPS  After completion of the procedure, the dentist will check the occlusion (how the patient bites)  Once optimal occlusion is achieved, the dentist will polish the restoration

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