2. SECTION TWO
Clinical Dental Materials
A wide variety of materials are used in the
Dentistry
Important how to handle
clinical application
failure of restorations
Understanding : composition
chemistry properties
Physical properties
mechanical properties
3. Amalgam composition
In 19th century, by mixing Mexican silver coin with mercury
Mercury +metals =amalgam
Selecting amalgam means selecting alloy
Alloy: silver+ tin+copper+zinc
amalgam manufacturers use vary composition and form
Ag+Sn=Ag3Sn(Ɣ) phase
Ɣ+mercury=amalgam
Copper=>strength, >6
4. The Alloy
Alloy is in powder, the size & shape of particle related to
handling & final property of amalgam
Not all particles are dissolved, final structure is core of Ɣ held
together by matrix
Lathe cut
Spherical
5. Setting Reaction
Ag Sn alloy mercury two new phases
solid at room temperature
final structure is one of a core of Ϫ
held together by matrix of predominantly Ϫ
1, Ϫ2
6. The copper in lathe cut in unreacted form, in discrete areas
In spherical alloy it spread uniformly
7. Mercury
mercury used in the preparation of
amalgam
needs to be very pure
surface layer of contaminant
interferes setting reaction
8. Properties of traditional amalgam
• Strength amalgam extremely important
(restoration able to withstand loads generated during mastication )
• final strength of amalgam function of the
properties individual phases
•
•Ϫ phase and the Ϫ I phase have a similar hardness
• Ϫ 2 phase is considerably softer
9. Properties of traditional amalgam
Strength: weak link within amalgam structure is Ɣ2
If this portion is minimized stronger amalgam would result
The amount of Ɣ1 and Ɣ2 that is formed depends on amount
of mercury
10. Strength
• The higher the mercury the weaker the
phases
• The final mercury contents depends on
condensation technique, size & shape of
particle
• In spherical alloy the ratio of mercury is
less than lathe cut due to easily
condensation
11. Strength
small particle size is contraindicated
more of alloy surface being exposed to mercury
more of the alloy will dissolve in the mercury
removal of excess mercury during the
placement of a restoration is Vitally important
12. Properties of traditional amalgam
Flow & Creep:
Excessive flow + occlusal force
Flattering of contact point
Overhanging margin
Protrusion of restoration from tooth surface at margin
And break down of restoration
major source of marginal breakdown
Creep: is flow caused by loads acting over long period
Creep is dependent upon both
The phase very prone to creep is Ɣ1 and Ɣ2
Yield strength
temperature
environment
13. Properties of traditional amalgam
Corrosion: could be advantage by sealing margins with corrosive
products
Is usually associated with Ɣ2 phase
The formation of oxide layer as protective coat
14. High copper content Amalgam
choice of the spherical particles was made
easier condensation
Increase in strength of traditional amalgam by eliminating Ɣ2
phase
By adding copper reaction as follows
No or very little Ɣ2 is present
Presently spherical alloy with high copper s available
Modification
important
changes
compressive
strength
rapid set to full
strength
reduction in
creep
reduced
susceptibility to
corrosion
15. Selection & using Amalgam
Two major factors:
Variable under control of manufacturer
composition
size, shape
Profound effect on amalgam properties
Handling property
Clinical performance
selection of alloy
operative procedure
16. Selection & using Amalgam
(Should I use a traditional or a copper-enriched amalgam alloy)?
Performance of high copper>traditional
Advantage of high Cu amalgam
○ Less creep
○ Less corrosion
○ No expansion, (no zinc)
○ Less marginal breakdown
○ Better clinical performance
1hr after placement high Cu is twice strong then traditional
Disadvantage of high Cu amalgam
More prone to tarnish than traditional
17. Selection & using Amalgam
Selecting particle size( handling characteristics , final composition)
Small particle size=>good polish, more mercury=>more Ɣ1 and Ɣ2
Large particles=> very hard to polish, not adhesion
Best choice? Medium particle
Lathe cut or spherical?
More of dentist choice
Spherical is easily condensed
18. Operator Variables
under the control of the dentist may
affect the final quality of the restoration
Proportioning()تناسب of the alloy and
mercury
Trituration (سازى )پودر amalgamation
condensation
carving and polishing
19. Selection & using Amalgam
Operators variable:
Proportion of alloy & mercury=>amalgam in capsule
Trituration : time is dependent to type of alloy, system of mixing
Spherical less time
(speed of 4000 rpm/ 5 seconds- speed of 2600rpm/20sec or more )
20. Condensation
Condensation=> excess mercury is
removed=>less porosity
Important component of condensing :
maximum force
suitably sized condensers in relation to cavity size
multiple and rapid thrusts
placement of small increment
Usage of force (30-40 N)& condensors
Speed of placing increments, big increments moreƔ1,2-
porosity
Cavity size
21. Carving & polishing
shape & size of particle
better initial surface spherical
polishing second visit is a matter
improves the aesthetics , remove mercury
recent studies on burnishing
increase surface hardness
improve marginal adaptation
reduce porosity
decrease corrosion
26. Limitation of Amalgam
Poor aesthetic :
polished finish is lost with time
due to tarnishing
Mercury toxicity :
mercury is a highly toxic
demands the greatest of care
sources of mercury exposure arise from:
accidental spills
poor mercury hygiene
direct contact with
mercury
amalgamators
placement of new and
removal of old restorations
27. Appropriate mercury
hygiene
Use of no-touch technique
Use of mechanical amalgamators with
good seals
Storage of mercury and old amalgams
under water
Unbreakable Tightly sealed containers
Cleaning up of spill
28. mercury intake into the body
World Health Organization
dental amalgam fillings is believed to be
well
below the threshold level of 30 Ųg/day
recommended
29. High Thermal Conductivity
pulpal sensitivity
hydrodynamic effect
pumping fluid (marginal gap )
suitable cavity preparation techniques
Galvanic Effects :
Two metallic restorations
Different degrees of electronegativity
Currents , strong metallic taste , corrosive breakdown
30. Lack of Adhesion
retentive cavity design
‘ extension for prevention‘
Lack of Strength and Toughness :
low tensile strength
material in bulk
margin angles need to be near 90°
small primary caries contraindicated
31. Limited Life Span of Dental Amalgam
Restorations
Hundreds of thousands of amalgams
are placed each year
half need replacement 4-5 years
destructive nature greatest concern
32. IMPROVING THE LONGEVITY OF AMALGAM
RESTORATIONS
reasons for replacement of amalgam restorations are
usually associated with:
tooth fracture
recurrent caries
gross amalgam fracture
marginal breakdown
Some of the failures are unavoidable properties
other can be avoided adopting appropriate technique
avoiding faults in cavity design
poor clinical technique
33. Tooth Fracture
Weakened Tooth Structure
more oral tissue that is removed
Undermined Enamel
Residual Caries
Recurrent Caries
Poor Matrix Techniques
Contamination ( blood or saliva ) poor adaptation
34. Poor Condensation
reduce the strength
Marginal adaptation will also be poor
marginal leakage
recurrent caries
Corrosion
Avoid dry amalgam mixing
36. Marginal Breakdown
Incorrect Cava-Surface Angles
Delayed Expansion H2O+ Zn ZnO+
H2
Over Filling, Underfilling and
Overcarving
37. Creep and Corrosion of the
Amalgam
limitations of mechanical, physical properties
avoidable if the previous factors observe
careful attention detail of cavity preparation,
handling
longer term, amalgams will eventually fail
creep or corrosion
has caused marginal breakdown
38. this material will continue to be one
of the most
convenient restorative materials for
posterior use