EC dental science最新文献

Soaring gold prices have created an almost impossible void in the Dental Materials supply reserves for affordable patient posterior crowns. Fortunately, aerotech fiber-reinforced composite (FRC) materials in use for many diverse structural applications can be developed for dentistry to replace gold with computer-assisted design/computer-assisted manufacture (CAD/CAM) technology. Current dental ceramics or high-strength oxide ceramics like alumina and zirconia available for CAD/CAM have extremely poor fracture-toughness properties and can propagate microscopic cracks rapidly to sudden adverse brittle failure. As a highly promising alternative, exceptional FRC fracture toughness properties counteract brittle failure with high-strength fibers that act as major barriers to crack propagation. In addition, excellent rapid FRC CAD/CAM machining can offer one-patient appointments for single crowns. FRCs have high-strength fibers coupled into a polymer matrix with the ability to form strong covalent bonds with resin adhesives whereas ceramics do not bond well and oxide ceramics have non-reactive inert surfaces making resin bonding extremely difficult. Prominent adhesive free-radical covalent bonding by FRCs then provides a great opportunity to achieve a crown marginal reline directly on the patienťs clinical tooth for possible near zero-gap defect tolerances. To place crown gingival marginal defects in proper perspective, gaps between the tooth and crown expose luting cements that can wash out and provide space for microbial plaque growth. Bacterial toxins released from a crown-tooth interface can subsequently produce secondary decay, gingival inflammation and eventually under severe plaque environments breed periodontal disease with bone loss.

Newer dental fiber-reinforced composites can provide service with less wear than enamel. Further, fibers in bulk molding form pack oriented parallel to the occlusal-dentinal floor planes that wear by uniform thinning into micrometer-sized fiber remnants and subsequent flat plate-like particulate bond by compression back into the polymer matrix. The fiber wear-in process is accomplished by creating fine crystalline chemically resistant nanoparticulates that become an exceptional polishing agent. Resulting consolidation by the underlying fiber network squeezes plasticized polymer and partially hydrolyzed polymer chains along with residual monomer, pendant methacrylate groups and nano-sized particulate to the surface that surround larger exposed micrometer-sized particulate and smallest fiber remnants. Eventually consolidation of the polymer matrix overall squeezes up and engulfs the top particulate or fiber remnants forming a smooth polished hard polymer-matrix composite wear surface probably filled with small nanoparticulate. The final hardened polymer surface may show particulate from worn fibers, but displays no signs of the original fibers after an in vitro wear simulator test comparable to 3 years of clinical service. Nanoparticulates formed from the fibers that have broken down generally reconsolidate back in to the top surface for a polished toughened polymer surface or behave as a polishing agent. The underlying fiber-reinforced composite network supports wear loads to greatly reduce wear especially as fibers extend well beyond a critical length that prevents fiber debonding from the matrix. Further, fiber-reinforced composite consolidation can aid in cavity molding placement by applied pressure to squeeze monomer, resin and particulates from the fiber network toward collapsing or filling in voids and removing entrapped air.