1. Chapter 1 Dental Materials DAE/DHE 203
Introduction
Chapter 1
Dental Materials
DAE/DHE 203

2. Enthusiasm for the Subject!!
“What other topic could be so much to look forward to??”
Student BEFORE Dental Materials class…

3. Physical Reactions… Be careful…. this could happen to you!!
“I love Mental Materials!”
Student AFTER Dental Materials Class!!

4. Introduction The Science of Dental Materials
Its importance to our studies
History of Dental Materials
Characteristics of Ideal Dental Materials
Quality Assurance Programs
Identification of Restorations

5. The Science of Dental Materials:
Development & evaluation of materials
Characteristics of the material
Safety and Health
Effectiveness and Duration
Dynamic field in dentistry
The development and evaluation of dental materials:
How are these materials going to be used, manipulated?
What are the physical properties and characteristics of the materials?
Are these safe for the patient and provider?
Do they serve the purpose they are to serve?
Do they last a long time and continue to hold-up?
Dental Materials is the currently fastest changing aspect of dentistry. Dental seminars, journal articles, etc. are bombarded with new, improved techniques, applications of materials, technologies, etc. Many dentists are using very different dental materials than they were years ago.

6. The Science of Dental Materials:
“Why are we studying this field?”
Why are we studying this field? (ask students)
for the knowledge to make optimal selection of materials
To understand the behavior of the materials, use, handling, manipulation
Safety considerations of the materials
Patient education re. dental restoratives
Recognition of materials – proper tx and care of prosth/restorations (OH, prophys)
Understand the professional literature

7. History of Dental Materials:
Dating as early as 500 B.C. - present
Metals – gold
Plaster and wax models
Prosthetics of bone, ivory, wax, metals
Porcelains – late 1700’s
Amalgam – early 1800’s
Acrylics – 1940’s
Adhesive dentistry – 1970’s - present

8. The Oral Environment:
“What characteristics of the oral environment potentially challenge and place demands upon dental materials?”
What are the characteristics of the oral cavity that challenge dental materials?
Wet – saliva
Fluctuating pH – acidic/alkaline
Masticatory forces – up to 28,000 lb/psi
Gateway to digestive tract (ingestion)
Temperature fluctuations
Living tissue – tooth, oral mucosa, gingival fluids

9. Characteristics of Ideal Materials:
Biocompatible –
Non-toxic, non-irritating, non-allergenic
Mechanically stable & durable –
Strong, resistant to fracture
Resistant to Corrosion –
Does not deteriorate over time
Dimensionally Stable –
Little change by temperature & solvents

10. Characteristics of Ideal Materials:
Minimal conduction –
Insulates against thermal/electrical change
Esthetic –
Looks like oral tissue
Easy to manipulate –
Minimal/reasonable effort & time needed
Adheres to tissues –
Retains onto, and seals, tooth structure

11. Characteristics of Ideal Materials:
Tasteless and Odorless –
Not unpleasant to patient
Cleanable/Repairable –
Easily maintained or fixed
Cost-effective –
Affordability vs. benefits/disadvantages

12. Quality Assurance: Food & Drug Administration (FDA)
Ensures safety & efficacy of material/”device”
American Dental Association (ADA)
Council on Scientific Affairs establishes standards and specifications
ADA “seal of acceptance”
Clinical studies when there are no standards
International Standards Organization (ISO)
Clinical studies are required on dental materials that do not have written and accepted standards to demonstrate their safety and efficacy (producing desired effect).

13. Identification of Restorations:
“Dental Restoration” –
Restores function & appearance of oral structure lost by pathology, injury, or is congenitally missing
Examples:
Pathology – caries: filling
Injury – broken tooth: crown
Congenitally Missing: prosthetic (i.e. bridge)

14. Identification of Restorations:
Direct Restoration –
A restoration that is created and placed directly into the prep site of the tooth
(i.e. amalgam filling, composite filling)
Indirect Restoration –
A restoration that is created outside of the mouth on a model of the prepped tooth and later fixed into the mouth
(i.e. gold crown, denture)

15. Direct Fillings:
Usually made of amalgam (“silver” metal) or composite (acrylic) materials
For caries of various degrees; anterior or posterior teeth
Posterior amalgam fillings

16. Direct Fillings: Anterior Composite Filling
Posterior Composite Filling

17. Crown:
Indirect restoration to replace missing crown of tooth, or protect remaining crown of tooth
Caries, fractures, teeth with RCT, esthetics
Made of porcelain, metals, or both
Porcelain-Fused-to-Metal (PFM) Crown

18. Bridge: An indirect restoration; to replace one or more missing teeth
“fixed” – not removable; cemented to existing teeth
Made of porcelain, metals, or both
Abutment – the existing tooth/teeth supporting the bridge
Pontic – the replacement tooth

19. Bridge:
Pontic
Missing tooth –
area to be restored
Abutments

20. Bridge: How many abutment teeth does the patient have?
Anterior bridge on model
In this anterior bridge (PFM), there are 2 missing teeth (#7, 10); there are four remaining “abutment” teeth (#6, 8, 9, 11).
These prosthetic pieces that are constructed in commercial dental labs are usually priced per “unit”. This bridge is a 6-unit bridge. If a dental office charges $700 per “unit”; the patient would probably be charged about $4200 for this restoration.
Anterior bridge before cementation
How many abutment teeth
does the patient have?

21. After bridge cementation
Before treatment
Note that the posterior left side of the pt’s mouth has also been restored. This is most likely a single bridge that is abutted to the 1st premolar & canine on the right, and goes around the arch to include the molar on the pt’s left.
After bridge cementation

22. FYI: Ancient Egyptian Bridge
Gold wire used to hold pontic crowns.

23. Indirect Restorations:
Inlay –
A fabricated restoration made of metal or porcelain that replaces missing tooth structure; does NOT include the restoration of any cusps
Onlay –
A fabricated restoration (as above) that DOES include the restoration of at least one cusp

24. Inlays vs. Onlays:
Porcelain Inlays
Gold Onlay

25. Veneers: All-porcelain or acrylic facing for tooth
Primarily used for esthetic reasons
Can alter shape & color of existing tooth
Veneers generally are made to cover the facial and incisal edges of anterior teeth.
Similar concept as a false fingernail being applied to the surface of a healthy nail.
These veneers are applied to tooth numbers #7-10.
They are bonded to tooth structure and generally cost the same or more than a PFM crown.

26. Denture:
The removable dental prosthetic used to replace all of the teeth in an arch; patient is edentulous.
Made of acrylic (teeth may be porcelain)
“Partial Denture” – replaces some teeth in the arch; patient is partially edentulous.
Made of acrylic usually with metal substructure and clasps

27. Denture: Full Upper and Lower Denture
The lower denture is always “horseshoe” shaped, to allow for the space that the tongue needs.
The upper denture is made to cover the palate to allow for a suction to be created to aid with retention.

28. Removable Partial Denture
metal clasp for retention

29. Endodontic Restorations:
“Endodontic” – “inside” the tooth; root canal treatment (RCT)
Gutta percha – used to fill the canal
Post and Core –
The post is a metal piece that is screwed into and cemented into the root canal
The core is built-up around the post to create more available tooth structure

30. Endodontic Restorations:
Post
(The core is built upon this post.)
Gutta Percha
(Silver Points used to be used in the canal as a filler.)

31. Endodontic Restorations:
amalgam
Build-up
unrestored pulp
Gutta percha
posts

32. Pediatric Restorations:
Stainless Steel Crown (SSC):
Prefabricated
Cemented

33. Pediatric Restorations:
Space Maintainer:
Holds space where primary tooth was prematurely lost
Stainless steel band/crown with loop
Fabricated outside of the mouth; cemented
(In class, show restorations from tray under Elmo projector)