Lesson 2 -A wide variety of materials have been used as tooth crown and root replacements.

-The four groups of materials used in dentistry today are material Ideal Restorative Material (what can be the ideal properties?) Biocompatible Bond permanently to tooth structure or bone Match the natural appearance of tooth structure and other visible tissues Exhibit properties similar to tooth enamel, dentin and other tissues Be capable of initiating tissue repair or regeneration of missing or damaged tissues. How we classifiy dental materials? (follow the classification in Kenneth) - Preventive materials - Restorative materials - Auxiliary materials Preventive materials Pit and fissure sealants. Sealing agents that prevent leakage. Materials that are used primarily for their antibacterial effects. Liners, bases, cements and restorative materials that are used primarily because they release fluoride. (glass ionomer) (leakingdefinition in dental purpose?) Dental cement liner (picture) Fissure sealing (picture) Restorative materials Consis of all synthetic components that can be used to repair or replace tooth structure: Primers Bonding agents Liners Cement

Bases Amalgams Resin-based composites Compomers (material for restoratory) Hybrid ionomers Cast matals Metal-ceramics Ceramics Denture polymers

Dental amalgam (picture) Glass ionomer (picture) Gold inlay Composite tubes (R1, R2, R Ceramic bride (have different classification as well) Restorative materials (find the Direct restorative material Used intraorally to fabricate restorations or prosthetic devices directly on the teeth or tissues Indirect restorative material E.g. Gold inlay indirect, because . Bridge Almagam Auxiliary dental materials Substances that are used in the process of fabricating dental prostheses and appliances but that do not become part of these devices These include: Acid etching solutions Impression materials Casting investments Used extraorally Materials are formed indirectly on casts or other replicas of the teeth and other tissues

Gypsum cast and model materials Dental waxes Acrylic resins for impression and bleaching tray Acrylic resins for mouth guards and occlusion aids Finishing and polishing abrasives

(Is Alginate impression the auxiliary dental materials? Yes) Acide etching solution (picture) Alginate impression (picture) Historical use of restorative materials Phoenicians used dental bands and wires Etruscans carved ivory or bone for the construction of partial denture teeth that were fastened to natural teeth by means of gold wiles or bands. Egyptian tombstones indicate that tooth doctors were considered to be medical specialists; they are not known to have performed restorative dentistry. Mayans used implants consisting of seashell segments that were placed in anterior tooth sockets. Hammered gold inlays and stone or mineral inlys were placed for aesthetic purposes or traditional ornamentation by the Mayans and later by the Aztecs. Incas performed tooth mutilation using hammered gold, but the material was not placed for decorative purpose. Pare (1509-1590): surgeon to foul kings, used lead or cork for tooth fillings. (picture) Queen Elizabeth I (1533-1603) used cloth fragments to fill the cavities in her teeth (picture) Fauchard (1678-1761) most important The father of modern dentistry used tin foil or lead cylinders for filling tooth cavities. Modern dentistry began in 1728, when fauchard published a book describing many types of dental restorations, including a method for the construction of artificial dentures made form ivory. (denture made from IVORY picture) Pfaff gold foil to cap the pulp chamber

Bull beten gold in Connecticut for dental applications in 1812 Arculanus gold-leaf dental fillings in 1848 Sponge gold was introduced in 1853 in US, England to replace gold leaf Arthur promoted the use of cohesive gold in US Philbrook described the use of metal filling Taveau (1816) developed in France the first dental amalgam using filings from the silver coins mixed with mercury (father of Amalgam) Black 1895 proposed standardized cavity preparations and manufacturing. Gold shell crown Mouton in 1746, then patented till 1871 by Beers 1885, Logan 1756, Pfaff described a method of making impressions of the mouth in wax from which he constructed a model with plaster of Paris This method allowed dentists to make impressions of the patients edentulous jaws Duchateau and Chernant, designed a process in 1774 for producing hard, decay proofporcelain dentures. Porelain inlay was introduced in the early 1800s. (whats inlay?) Porcelain bonding to metals was not fully refined for metal ceramic 1808, fonzi developed an individual porcelain tooth that was held in place Evans (1836) refined the method of making accurate measurements in the mouth In 1839 that Charles Goodyear invented a lowcost vulcanized rubber that allowed dentures to be molded accurately and fit the mouth. This invention accelerated the demand for accuratedly fitting dentures at a reasonably low cost.

1893, denture bases have advanced in quality through the use of acrylic resin and cast metals 1935, polymerized aclylic resin was introduced as a dental material because of inadequate technology and lack of electricity, fillings were of poor quality and didnt fit well within the teeth. In 1907 Taggert developed a ore refned method for producing cast inlys.

How safe are Dental Restorative Materials? No dental device (indcluding restorative materials) is absolutely safe.

Safety is relative, and the selection and use of dental devices or materials are based on the assumption that the benefits of such use far outweigh the known biological risks.

The tow main biological effects are allergic and toxic reaction.

Father of modern toxicology Paracelsus (1493-1541) the major routes by which toxic agents enter the body are through the gastrointestinal tract (ingestion), lungs (inhalation), skin (topical) and parenteral routes. Exposure to toxic agents can be sub Crown is metal place to patient 3 days later rush appears (what happened? allergy -> 1. Acute (less than 24 hr) 2. Sub-acute (repeated, 1 mth or less) 3. Sub-chronic (1 to 3 mths) 4. Chronic (longer than 3 mths) Like toxicity, chemical allergy may also be dose- dependent, but it often results from low doses of chemical agents once sensitization has occurred. For a dental restorative material to produce an allergic reaction, most chemical agents combine with endogenous proteins to form antigen The synthesis of sufficient numbers of antibodies takes 2 to 2 weeks. A later exposure to the chemical agent can induce an antigen-antibody reaction and clinical signs and symptoms of allergy Munksgaard (1992) conclude that occupational risk in dentistry are low and that patient risk for side effects of dental treatment is extremely low. (important when anasthetics application via noodles) chemical combine with the protein in the body, that takes 2-3 weeks to produce antigen that able to combat)