Cavity bases Flashcards

(33 cards)

1
Q

Define intermediate restorative materials (IRMs)

A

Materials applied to dentine to protect pulp prior to placing main restorative material

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2
Q

What is a varnish?

A

A very thin polymer seal to dentine surface

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3
Q

What is a cavity liner?

A

A layer of protective dentine sealer less than 500 um (0.5mm) thick

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4
Q

What is a cavity base?

A

A dentine replacement intended to eliminate undercuts or minimise bulk of main restorative material

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5
Q

What do IRMs do?

A

Most provide some form of protective function in addition to other functions to stop the pulp from getting damaged

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6
Q

What might adversely affect the pulp?

A

Physical: e.g. T or mechanical forces
Chemical: e.g. acids
may be related to:
-caries, microbial ingress or contamination
-miscellaneous (e.g. thermal or electrical stimuli)

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7
Q

Clinical need for IRMs

A

Intended to restore some of the protective barrier functions of enamel and dentine
-some direct restorative dental materials may themselves be irritant to the pulp

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8
Q

Properties of an ideal cavity base or liner

A
  • Safe and biocompatible
  • Forms effective dentine seal against chemicals, bacteria and other stimuli
  • Encourages reparative dentine
  • Chemically and mechanically compatible with other restorative materials
  • Tooth coloured, radiopaque and easy to place
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9
Q

What materials are used as IRMs?

A
Varnishes
Calcium hydroxide cements
Zinc oxide cements
GICs
Resin modified GICs
Visible light cured resins
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10
Q

What is a cavity varnish made out of?

A

Natural or synthetic polymer resins dissolved in a solvent

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11
Q

How do you apply cavity varnish?

A

Applied to cavity floor with brush or cotton

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12
Q

What happens after applying cavity varnish?

A

Solvent evaporates to leave thin layer of resin (process may be repeated)

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13
Q

What is the function of a cavity varnish?

A

Acts as barrier against chemical penetration of tooth tissue
May protect against microleakage and secondary caries

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14
Q

How are calcium hydroxide cements prepared?

A

Rigid self-setting material

Two pastes for mixing, chelation reaction forms zinc and calcium disalicyate and other compounds

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15
Q

What pH are calcium hydroxide cements? What does this do

A

Alkaline nature due to free Ca(OH)2

May promote secondary dentine as well as provide antibacterial properties

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16
Q

Calcium hydroxide cement properties

A

Low compressive strength (20MPa)
-sufficient to withstand condensation of amalgam
Initial pH > 11
-associated with tissue necrosis that may later mineralise –> reparative dentine

17
Q

What is the UK’s leading brand of calcium hydroxide cement?

A
Dycal
Mixing time 10s
Working time 2min20s
Setting time 2.5-3.5 mins
Radiopaque, ivory colour
Some say stimulation of secondary dentine
18
Q

How are ZOEs formed?

A

Generally by acid-base reaction between metal oxide and eugenol
Forms metal eugenolate chelate

19
Q

What are ZOEs used for?

A

Most commonly temporary restoration

Some developed for use as base/ liner

20
Q

Are ZOEs popular as bases or liners?

A

Increasingly unpopular
Risk of pulpal necrosis
Inhibition of composite resin polymerisation

21
Q

What is IRM (brand) used for?

A

Intermediate restoration designed to remain in place for up to 12 months
Or for use as base under non-resin restoration
ZOE

22
Q

Properties of GICs

A
Relatively durable (compressive strength >50 MPa)
Insoluble
Fluoride releasing
Aesthetic
Adhesion to mineralised tooth tissue
23
Q

What are GICs composed of?

A

Basic fluoroaluminosilicate glass
Polymeric acid
Water and
Tartaric acid

24
Q

How are GICs formed?

A

After mixing by acid-base reaction

Metal cations form salt bridges with ionised carboxylic acid gps on high molecular weight polyacids

25
Phases of GIC reaction
Dissolution (acidic attack of glass surface) | Gelation (early cross-linking by CA++) Hardening (substitution of Ca++ by Al +++)
26
Structure of a GIC
Composite biomaterial of acid-degraded glass particles set in a cross-linked hydrogel matrix
27
What is a resin-modified GIC?
Like GIC but with addition of water miscible monomer (HEMA) and a photoinitiator
28
How are RMGICs formed?
Acid-base reaction and photo-polymerisation | Shares chemical bond to untreated dentine
29
What are unfilled resins used for?
Increasingly popular to seal dentine surface in a cavity
30
How are unfilled resins formed?
Methacrylate monomers and photoinitiator to provide command set (via polymerisation) May be layered to increase the thickness of resin seal
31
Future trends for IRMs
Mineral trioxide aggregate increasingly considered for pulp capping -claims to stimulate reparative dentine with good preservation of pulp vitality
32
What is Biodentine from Septodont?
Portland cement which sets through complex dissolution and re-precipitation -used in pulp capping
33
What are the potential clinical benefits of Biodentine?
-Seal dentine = reduced microleakage = < sensitivity -Thermal insulation = < sensitivity Mechanical protection = better supported restoration -Maybe reparative dentine formation