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 Amalgam
 Acrylic Resins
 Composite Resins
 Matrix Bands / Retainers
Amalgam & Resins
Wk. III / Day 1
Restorative Dentistry
 is focused on the general dental needs of the patient
 Restoration of teeth to their original form and shape
 Specific conditions that determine the need for
restorative dentistry include:
 Initial or recurring decay
 Replacement of a failed restoration
 Abrasion or wearing away of tooth structure
 Erosion of tooth structure
Esthetic / Cosmetic Dentistry
 Improving the appearance of teeth by repairing
imperfections (includes whitening)
 Specific conditions requiring esthetic dental treatment
 Discoloration (extrinsic or intrinsic staining)
 Anomalies (developmental disturbances)
= Peg lateral
 Abnormal spacing (DIASTEMA)
 Trauma
CAVITY PREPARATION
the process of removing diseased tooth structure while leaving
healthy tooth structure for the tooth to maintain a restoration
Amalgam
 Amalgam consists of several
different metals, with silver
being the predominant metal
 Metals  powder form then
mixed with mercury to form
a soft, pliable mixture
 Amalgam is a safe, affordable,
and durable material
 used predominantly to restore
premolars and molars
Composition of Dental Amalgam
Amalgam
alloy
powder
(57% to 46%)
Silver
(Strength)
Tin
(workability &
strength)
Copper
(strength and
corrosion resistance)
Zinc
(suppress
oxidation)
Mercury
(43% to 54%)
National Bureau of Standards
(Quality Control of Materials)
 Biting Force
 Temperature changes
 Bacteria
 Acidity
Amalgam Capsules
 Amalgam capsules are
measured by “ SPILLS ”
 1 spill = 1 surface filling
 2 spills = 1 large or 2 surface
fillings
 3-5 spills = 3 or more
surfaces, very large
restoration or multiple teeth
Amalgam Capsules (Cont)
 Triturates capsule to
mix alloy & mercury
together to form
amalgam
TRITURATION:
- Mechanical means of
combining the dental
alloy and mercury
Amalgamator
Metals Mixed to Form Dental
Amalgam
OVER TRITURATION
 Decreases setting time
 causes shrinkage
after the amalgam is
set. The filling will be
too small for the
tooth.
UNDER TRITURATION
 Increases setting time
 weakens the amalgam
causes increased
expansion of the
material when set.
 http://youtu.be/3SgOMCoDh0w
Amalgamator
•Causes brittleness
•Use rubber dam or cotton rolls
Patient Saliva
•Affects setting time & weakens
material
Unclean
instruments
•Prep must be dry otherwise it will
weaken the materialBlood in prep
Sources of Contamination
• Uses handpiece and burs, high-speed
(round bur initially, straight burs)
• Hand instruments-excavators,
chisels, etc.
• Slow handpiece to remove decay if
close to pulpal chamber .
• Excavator-Used to spoon out decay.
DDS/DMD -
Prepares
prep
Standard Amalgam Procedure:
Diagnosis, x-rays and anesthesia have been accomplished
•Use cotton rolls or
rubber dam
•Saliva ejector for
patient comfort
Isolate
Tooth
Standard Amalgam Procedure
continued
•Use calcium hydroxide
• Zinc oxide eugenol
•Cavity varnish (2 coats)
Medicate
Standard Amalgam Procedure
continued
•Amalgamator, amalgam
well & squeeze cloth
•Use carrier
•Condenser
Restore
with
amalgam
Standard Amalgam Procedure
continued
•Cleoid/discoid or frahm
for occlusal
•Hollenback for
interproximal
Carve
Standard Amalgam Procedure
continued
•Articulating paper
• Marks high spot with
color
•Re-carve if needed
Mark
Standard Amalgam Procedure
continued
Standard Amalgam Procedure
continued
• Burnish
• Floss, wet cotton roll
• 24-48 hours later
filling can be polished
Finish &
Smooth
Standard Amalgam Procedure
continued
https://youtu.be/q8-l5SBMpSc
Amalgam Tray Set-up
https://youtu.be/nz1OGqnOSLY
Amalgam Placement
 A matrix system provides a “temporary wall” for the
restoration process in Class II, III and IV preparations
 Universal retainer
 Also referred to as Tofflemire retainer
 A mechanical device that holds the matrix band snugly in
position
 Positioned most commonly from the buccal surface of
the tooth being restored
MATRIX Bands/ Retainers
Tofflemire/Matrix Retainer
Instrument book
Most Commonly Used Posterior
Matrix Bands
Anterior Matrix Systems
 A clear plastic matrix is used with
anterior composite resin or glass
ionomer materials
 The clear plastic matrix is also referred to
as the celluloid strip or Mylar strip
 Used for a Class III or IV restoration
when the proximal wall of an anterior
tooth is missing
 No retainer is needed to hold the matrix
in place, making this system an easier
application
 Assists the band in adapting to the tooth contour
(prevents overhang)
 Provides tooth separation
 Assist the band in containing the amalgam
Purpose of a Wedge
Plastic Wood
Types of Bands
1. Always remove the wedge first.
2. Remove tofflemire after loosening from the
band.
3. VERY carefully, remove the band – one side at
a time.
4. Be careful!!! You can damage the fresh
restoration while lifting off the band if you are
not gentle!
Matrix Removal
Placing Matrix Bands Video
https://youtu.be/RTfaz2YzSBs
END DAY 3
Provisional Restorative Materials
 Designed to cover the major
portion of a tooth or several teeth
Non-metal compounds
Acrylic Resins
Week 3 / Day 4
Example of Provisional Coverage
Materials
Acrylic Resin
From Hatrick CD, Eakle WS, Bird WF: Dental materials: clinical applications for dental assistants and dental hygienists, ed 2, St Louis, 2011, Saunders.
Monomer: Liquid portion of
the acrylic resin
Polymer: Powder portion of
the acrylic resin
POLYMERIZATION: Chemical
curing / hardening process of
the acrylic resin
Composition
Curing Types
Heat-Cured
Light-Cured
Self-Cured
Uses for Acrylic Resins
DENTURES
ORTHODONTIC APPLIANCEPIT & FISSURE SEALANT
BLEACHING TRAY
TEMPORARY
CROWNS/BRIDGE
CUSTOM TRAYS
Acrylic monomers should be stored
in cool, dark areas
Acrylic monomers destroy rubber
on contact
NEVER MIX IN RUBBER BOWL
Precautions
 http://youtu.be/GdSN2TafPFY
Acrylic crowns
Composite Resins
(Review)
ADVANTAGES
• Biting force is equal to amalgam
• Low solubility
• Excellent shading
• Minimal shrinking during and after setting
• Does not overly react to hot or cold temperatures
• Can be repaired-Bonds to itself
Cures fast with light
Cure in layers
Unlimited working time
Highly polishable
ADVANTAGES
Light Cure Composite
 Diagnose
(DDS/DMD)
 Prepare
 Isolate
 Medicate
 Etch
STEPS
 Bond
 Restore
 Trim Flash
 Bite Check
 Finish and
Smooth
 Must use amber shield or glasses to protect
eyes
Bands for Composite
 Mylar / Celluloid Strip /
Plastic Matrix
Used on anterior
teeth with composite
Class III / IV
48
END OF WEEK 3
49
UNIT 3 MOD – C REVIEW
1. Silver filling 2. Parts of tofflemire retainer
3. 7 Steps of amalgam
restoration
4. Quality control: National
Bureau of Standards
5. Purpose of Wedge 6. Sources of contamination in
amalgam restoration
7. Use of restorative dentistry
(Specific Condition)
8. Composition of Amalgam
9. Amalgamator - Function 10. Wedge – Use
11. Overhang 12. Black’s Cavity Classification:
Uses matrix system and type
13. Materials for building walls:
Class II restoration
14. Under trituration
15. Over Trituration 16. Esthetic / Cosmetic Dentistry
17. Amber Shield 18. Elements found in Amalgam
50
UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY)
1. Silver filling
Common name for amalgam
2. Parts of tofflemire retainer
1. Outer Knob : moves the spindle
2. Spindle: used to secure the band ends
3. Inner Knob: increases or decreases the
size of the loop to match the diameter
of the tooth.
4. Diagonal Slot: Slides up and down on
spindle; open slots is facing towards the
gingiva
5. Guide Slot: straight slot, right and left
slot s for right and left quadrant
3. 7 Steps of amalgam
restoration
Prepare, Isolate, Medicate, Restore, Carve,
Check bite, Finish
4. Quality control: National
Bureau of Standards
1. Bacteria 2. Biting force
3. Temperature changes 4. Acidity
5. Purpose of Wedge
Assist the band in adapting to the tooth
contour
Assist the band in containing the amalgam
Provide tooth separation
6. Sources of contamination in
amalgam restoration
Unclean instruments
Patient’s saliva
Blood in the cavity prep
51
UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY)
7. Use of restorative dentistry
(Specific Condition)
Initial or recurring decay
Replacement of a failed restoration
Abrasion or wear of tooth structure
Erosion of tooth structure
8. Composition of Amalgam
alloy and mercury
9. Amalgamator - Function
Blend or mix alloy and mercury in capsule
form
10. Wedge – Use
Anytime a matrix is used
When the preparation involves a missing
tooth wall
To prevent overhang
11. Overhang
excess material escaping between the
tooth and the matrix band
12. Black’s Cavity Classification:
Uses matrix system and type
Class II: matrix band
Class III & IV: mylar strip
13. Materials for building walls:
Class II restoration
Tofflemire Retainer Matrix Band
Wooden Wedge
14. Under trituration
increases the setting time of the amalgam,
weakens the alloy and causes expansion
of the amalgam when set
52
UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY)
15. Over Trituration
Decreases setting time
causes shrinkage
16. Esthetic / Cosmetic Dentistry
Improving the appearance of teeth by
repairing imperfections which includes
discoloration and anomalies like peg
laterals
17. Amber Shield
Eye protection material when using the
curing light for composite restoration
18. Elements found in Amalgam
Tin, Silver, Copper, Zinc

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Module c week 3

  • 1.  Amalgam  Acrylic Resins  Composite Resins  Matrix Bands / Retainers Amalgam & Resins Wk. III / Day 1
  • 2. Restorative Dentistry  is focused on the general dental needs of the patient  Restoration of teeth to their original form and shape  Specific conditions that determine the need for restorative dentistry include:  Initial or recurring decay  Replacement of a failed restoration  Abrasion or wearing away of tooth structure  Erosion of tooth structure
  • 3. Esthetic / Cosmetic Dentistry  Improving the appearance of teeth by repairing imperfections (includes whitening)  Specific conditions requiring esthetic dental treatment  Discoloration (extrinsic or intrinsic staining)  Anomalies (developmental disturbances) = Peg lateral  Abnormal spacing (DIASTEMA)  Trauma
  • 4. CAVITY PREPARATION the process of removing diseased tooth structure while leaving healthy tooth structure for the tooth to maintain a restoration
  • 5.
  • 6. Amalgam  Amalgam consists of several different metals, with silver being the predominant metal  Metals  powder form then mixed with mercury to form a soft, pliable mixture  Amalgam is a safe, affordable, and durable material  used predominantly to restore premolars and molars
  • 7. Composition of Dental Amalgam Amalgam alloy powder (57% to 46%) Silver (Strength) Tin (workability & strength) Copper (strength and corrosion resistance) Zinc (suppress oxidation) Mercury (43% to 54%)
  • 8. National Bureau of Standards (Quality Control of Materials)  Biting Force  Temperature changes  Bacteria  Acidity
  • 10.  Amalgam capsules are measured by “ SPILLS ”  1 spill = 1 surface filling  2 spills = 1 large or 2 surface fillings  3-5 spills = 3 or more surfaces, very large restoration or multiple teeth Amalgam Capsules (Cont)
  • 11.  Triturates capsule to mix alloy & mercury together to form amalgam TRITURATION: - Mechanical means of combining the dental alloy and mercury Amalgamator
  • 12. Metals Mixed to Form Dental Amalgam
  • 13. OVER TRITURATION  Decreases setting time  causes shrinkage after the amalgam is set. The filling will be too small for the tooth. UNDER TRITURATION  Increases setting time  weakens the amalgam causes increased expansion of the material when set.
  • 15. •Causes brittleness •Use rubber dam or cotton rolls Patient Saliva •Affects setting time & weakens material Unclean instruments •Prep must be dry otherwise it will weaken the materialBlood in prep Sources of Contamination
  • 16.
  • 17. • Uses handpiece and burs, high-speed (round bur initially, straight burs) • Hand instruments-excavators, chisels, etc. • Slow handpiece to remove decay if close to pulpal chamber . • Excavator-Used to spoon out decay. DDS/DMD - Prepares prep Standard Amalgam Procedure: Diagnosis, x-rays and anesthesia have been accomplished
  • 18. •Use cotton rolls or rubber dam •Saliva ejector for patient comfort Isolate Tooth Standard Amalgam Procedure continued
  • 19. •Use calcium hydroxide • Zinc oxide eugenol •Cavity varnish (2 coats) Medicate Standard Amalgam Procedure continued
  • 20. •Amalgamator, amalgam well & squeeze cloth •Use carrier •Condenser Restore with amalgam Standard Amalgam Procedure continued
  • 21. •Cleoid/discoid or frahm for occlusal •Hollenback for interproximal Carve Standard Amalgam Procedure continued
  • 22. •Articulating paper • Marks high spot with color •Re-carve if needed Mark Standard Amalgam Procedure continued
  • 24. • Burnish • Floss, wet cotton roll • 24-48 hours later filling can be polished Finish & Smooth Standard Amalgam Procedure continued
  • 26.  A matrix system provides a “temporary wall” for the restoration process in Class II, III and IV preparations  Universal retainer  Also referred to as Tofflemire retainer  A mechanical device that holds the matrix band snugly in position  Positioned most commonly from the buccal surface of the tooth being restored MATRIX Bands/ Retainers
  • 29.
  • 30. Most Commonly Used Posterior Matrix Bands
  • 31. Anterior Matrix Systems  A clear plastic matrix is used with anterior composite resin or glass ionomer materials  The clear plastic matrix is also referred to as the celluloid strip or Mylar strip  Used for a Class III or IV restoration when the proximal wall of an anterior tooth is missing  No retainer is needed to hold the matrix in place, making this system an easier application
  • 32.  Assists the band in adapting to the tooth contour (prevents overhang)  Provides tooth separation  Assist the band in containing the amalgam Purpose of a Wedge Plastic Wood
  • 34. 1. Always remove the wedge first. 2. Remove tofflemire after loosening from the band. 3. VERY carefully, remove the band – one side at a time. 4. Be careful!!! You can damage the fresh restoration while lifting off the band if you are not gentle! Matrix Removal
  • 35. Placing Matrix Bands Video https://youtu.be/RTfaz2YzSBs END DAY 3
  • 36. Provisional Restorative Materials  Designed to cover the major portion of a tooth or several teeth Non-metal compounds Acrylic Resins Week 3 / Day 4
  • 37. Example of Provisional Coverage Materials
  • 38. Acrylic Resin From Hatrick CD, Eakle WS, Bird WF: Dental materials: clinical applications for dental assistants and dental hygienists, ed 2, St Louis, 2011, Saunders.
  • 39. Monomer: Liquid portion of the acrylic resin Polymer: Powder portion of the acrylic resin POLYMERIZATION: Chemical curing / hardening process of the acrylic resin Composition
  • 41. Uses for Acrylic Resins DENTURES ORTHODONTIC APPLIANCEPIT & FISSURE SEALANT BLEACHING TRAY TEMPORARY CROWNS/BRIDGE CUSTOM TRAYS
  • 42. Acrylic monomers should be stored in cool, dark areas Acrylic monomers destroy rubber on contact NEVER MIX IN RUBBER BOWL Precautions
  • 44. Composite Resins (Review) ADVANTAGES • Biting force is equal to amalgam • Low solubility • Excellent shading • Minimal shrinking during and after setting • Does not overly react to hot or cold temperatures • Can be repaired-Bonds to itself
  • 45. Cures fast with light Cure in layers Unlimited working time Highly polishable ADVANTAGES Light Cure Composite
  • 46.  Diagnose (DDS/DMD)  Prepare  Isolate  Medicate  Etch STEPS  Bond  Restore  Trim Flash  Bite Check  Finish and Smooth  Must use amber shield or glasses to protect eyes
  • 47. Bands for Composite  Mylar / Celluloid Strip / Plastic Matrix Used on anterior teeth with composite Class III / IV
  • 49. 49 UNIT 3 MOD – C REVIEW 1. Silver filling 2. Parts of tofflemire retainer 3. 7 Steps of amalgam restoration 4. Quality control: National Bureau of Standards 5. Purpose of Wedge 6. Sources of contamination in amalgam restoration 7. Use of restorative dentistry (Specific Condition) 8. Composition of Amalgam 9. Amalgamator - Function 10. Wedge – Use 11. Overhang 12. Black’s Cavity Classification: Uses matrix system and type 13. Materials for building walls: Class II restoration 14. Under trituration 15. Over Trituration 16. Esthetic / Cosmetic Dentistry 17. Amber Shield 18. Elements found in Amalgam
  • 50. 50 UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY) 1. Silver filling Common name for amalgam 2. Parts of tofflemire retainer 1. Outer Knob : moves the spindle 2. Spindle: used to secure the band ends 3. Inner Knob: increases or decreases the size of the loop to match the diameter of the tooth. 4. Diagonal Slot: Slides up and down on spindle; open slots is facing towards the gingiva 5. Guide Slot: straight slot, right and left slot s for right and left quadrant 3. 7 Steps of amalgam restoration Prepare, Isolate, Medicate, Restore, Carve, Check bite, Finish 4. Quality control: National Bureau of Standards 1. Bacteria 2. Biting force 3. Temperature changes 4. Acidity 5. Purpose of Wedge Assist the band in adapting to the tooth contour Assist the band in containing the amalgam Provide tooth separation 6. Sources of contamination in amalgam restoration Unclean instruments Patient’s saliva Blood in the cavity prep
  • 51. 51 UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY) 7. Use of restorative dentistry (Specific Condition) Initial or recurring decay Replacement of a failed restoration Abrasion or wear of tooth structure Erosion of tooth structure 8. Composition of Amalgam alloy and mercury 9. Amalgamator - Function Blend or mix alloy and mercury in capsule form 10. Wedge – Use Anytime a matrix is used When the preparation involves a missing tooth wall To prevent overhang 11. Overhang excess material escaping between the tooth and the matrix band 12. Black’s Cavity Classification: Uses matrix system and type Class II: matrix band Class III & IV: mylar strip 13. Materials for building walls: Class II restoration Tofflemire Retainer Matrix Band Wooden Wedge 14. Under trituration increases the setting time of the amalgam, weakens the alloy and causes expansion of the amalgam when set
  • 52. 52 UNIT 3 MOD – C REVIEW (INSTRUCTOR KEY) 15. Over Trituration Decreases setting time causes shrinkage 16. Esthetic / Cosmetic Dentistry Improving the appearance of teeth by repairing imperfections which includes discoloration and anomalies like peg laterals 17. Amber Shield Eye protection material when using the curing light for composite restoration 18. Elements found in Amalgam Tin, Silver, Copper, Zinc

Editor's Notes

  1. General dentistry is also called operative dentistry. What type of materials would be used for restorative dentistry? (Both direct and indirect restoration materials should be used.)
  2. What types of materials are used for esthetic dentistry? (Direct and indirect restoration materials, along with whitening materials)
  3. What are the steps of initial preparation? (Outline form, resistance form, retention form, and convenience form)
  4. This photo displays the mercury liquid and alloy powder, separated on the left, and at various stages of mixing to produce a final amalgam for placement. It is important to ensure that trituration is complete before amalgam is placed in a carrier for placement in the preparation. Different manufacturers call for different trituration times, depending on the components of their products. Other variables to keep in mind: Triturating machines sometimes malfunction, and stocked amalgam capsules may reach their expiration dates before being used.
  5. Amalgam set up pge 806 3dr edition steps are a dign off on lab:
  6. Top diagram: Universal band. Middle diagram: Extension band. Bands must be contoured to make proper contact with the adjacent teeth. What instrument is used to contour bands? (A burnisher)
  7. Metal bands are not used because the resin/composite material can be scratched or marked by the stainless steel. No retainers are used.
  8. Pg 831
  9. This figure shows only one example of what can be used as a provisional coverage material.
  10. At the bottom left are a liquid (dark bottle) and a powder (white bottle). The dropper is used to measure liquid into a dappen dish, to which the powder is gradually added to achieve the desired consistency. This photo displays a few of the dispensing methods for these materials, including an auto-mixing tip attached to a cartridge with two separate barrels, which is attached to a dispensing gun.