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Da130 restorative materials

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Da130 restorative materials

  1. 1. RESTORATIVE MATERIALSDA 130 Dental Materials and Anatomy andPhysiology
  2. 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 oncemixed by the hand of the dental assistant Research soon discovered that mercury was ahazardous material, so standards of handling weredeveloped
  3. 3. WHEN DO WE USE DENTALAMALGAM? Dental amalgam is still considered a safe andeffective means to restore a tooth Amalgam is often used for: Primary and permanent teeth For stress bearing areas of the mouth (usuallyposterior) For areas where moisture contamination is not aconcern For cost purposes When aesthetics is not a concern
  4. 4. MERCURY HAZARDS? Although dental amalgam contains mercury,when it is mixed with the alloy, the chemicalcomposition changes, and it becomes harmless Mercury on it’s own is liquid metal, andconsidered hazardous Premeasured capsules prevent dental personnel fromhandling mercury in it’s liquid state
  5. 5. HOW TO HANDLE DENTALAMALGAM There is still a risk to healthcare workersregarding dental amalgam; therefore: We use PPE when handling We use premeasured capsules We make sure we close the door of the trituratorwhen mixing amalgam Always use the suction during application to preventpatient aspiration, which could lead to potentialtoxicity Have a mercury spill kit handy if a spill should occur,do not vacuum up! Have an amalgam scraps container to place excessamalgam, do not throw in garbage!
  6. 6. TRITURATOR AKA ANAMALGAMATOR
  7. 7. WHEN TO USE CAUTION WITHDENTAL 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 barehands! When restoring a tooth with an existing amalgamrestoration Be sure to use your PPE, vapors are given off whenhandpiece is in use When cleaning amalgam after completion ofprocedure Place in a amalgam scraps container A container with a tight lid and keep either dry or with a smallamount of radiographic fixer
  8. 8. ADDITIONAL PRECAUTIONS: Do not sterilize extracted teeth with amalgamrestorations Waste haulers will remove for a fee Replace amalgam traps at regular intervals Use a mercury spill kit if you have scraps or loosemercury
  9. 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. 10. PROCEDURE STEPS: Patient is given local anesthesia Tooth is prepared – with a high speed and lowspeed handpiece Tofflemire is placed – if there is interproximalinvolvement) Medicaments placed (if necessary) – bases orliners Amalgam is mixed – with triturator Amalgam is packed – into acarrier
  11. 11. PROCEDURE STEPS: Amalgam is transferred – into the tooth Amalgam is condensed – using condenser Anatomy is carved – into amalgam with hollenback andcleoid/discoid Tofflemire is removed Restoration is smoothed – using burnishers Tooth height is checked – using articulating paper Adjustments may benecessary – return back tocarvers and burnishers Give patient post-operativeinstructions
  12. 12. COMPOSITE RESTORATIVEPROCEDURE: Composite has been the restorative material ofchoice for some time now The growing concern of the public in regards tothe safety of dental amalgam created the demandfor high strength, aesthetically pleasingcomposite resin
  13. 13. COMPOSITION OF COMPOSITERESINS: Resin matrix: Dimethacrylate aka BIS-GMA: a fluid monomer (liquid) Fillers: quartz and silica (minerals and crystalcompounds) Macrofilled: larger particles found in resin, known for highstrength Microfilled: smaller particles in resin, known for aestheticqualities and ability to polish Hybrid: most commonly used today, provide high strength andaesthetically pleasing results Flowable: used in a syringe, this variation of composite is used forit’s flowable consistency Dentist’s will often use this to place on floor of preparation Sealant composites: similar to flowable, but consistency is eventhinner to allow flow into pits and fissures of occlusal surfaces
  14. 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 approveshade prior to use Documentation of approval and selected shade is alsonecessary
  15. 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. 16. MEANS OF ISOLATION:
  17. 17. ETCH AND BONDING AGENTS Composite fillings are not created withmechanical retention, chemical retention isnecessary Acid etch – phosphoric acid Used to open enamel rods and dentin tubules Similar to sandpaper on wood Tooth should appear chalky white when properlydone. Primer is used to condition tooth and aids inbonding Bonding agent unifies the tooth and material
  18. 18. MICROSCOPIC IMAGES OF ENAMELRODS Before etching  After etching
  19. 19. MICROSCOPIC IMAGES OF DENTINTUBULES Dentin and nervetissue Enamel and dentinaltissue
  20. 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. 21. PROCEDURE STEPS: Dentist administer local anesthesia to thepatient Shade is taken Always prior to preparation Tooth is prepared – with dental handpieces Tooth is isolated – meaning, protecting thetooth from moisture and contaminants Cotton rolls, dri-angles and rubber dam are indicated Acid-etch is placed – creates porosities on thetooth surface Usually for 20-40 seconds Thoroughly rinse for 20 seconds Replace wet cotton rolls
  22. 22. ETCH FIRST, THEN APPLY BONDINGAGENTS
  23. 23. PROCEDURE STEPS Dry tooth Place primer – conditions tooth to receive bond Dry tooth Place bonding agent – allows for unification of tooth andcomposite 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. 24. FINAL STEPS After completion of the procedure, the dentistwill check the occlusion (how the patient bites) Once optimal occlusion is achieved, the dentistwill polish the restoration

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