History and scope of prosthodontics

This is helpful for the MDS 1st year student.

1. INSTITUTE OF DENTAL STUDIES & TECHNOLOGIES DEPT. OF PROSTHODONTICS CROWN AND BRIDGE HISTORY AND SCOPES OF PROSTHODONTICS PRESENTED BY DR SONU KUMAR MDS 1 ST yr student [email protected]

2. CONTENTS INTRODUCTION TO PROSTHODONTICS HISTORICAL REVIEW HISTORICAL DATES HISTORY OF COMPLETE DENTURES HISTORY OF FACEBOW HISTORY OF SURVEYOR

3. HISTORY OF RPD HISTORY OF FIXED PARTIAL DENTURES CROWN BRIDGES HISTORY OF IMPLANT HISTORY OF ARTICULATORS HISTORY OF DENTAL MATERIALS RECENT ADVANCMENT

4. INTRODUCTION Dentistry has a long history. Oral disease has been a problem since time beginning Modern dentistry method trace back to earliest culture. Prosthodontics is one of eight recognized specialties of dentistry. Prosthetic dentistry deals with the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients and clinical conditions associated with missing and deficient and/or oral and maxillofacial tissues using biocompatible substitutes.

5. HISTORICAL REVIEW 25,00:cro magnon year age shows evidence of tooth decay 5,000 B.C , “tooth worm” cause of dental decay 1700: “Barber surgeon” jack of all trades. Used to extract teeth and performed minor surgery and used to cut hair migration of dental practioners to American colonies and removed diseased tooth and inserted tooth. 1800’s : started extracting teeth with “turnkey ” cleaning teeth with scraper and removed cavities with hand instrument. Filling material: tin, gold foil, lead and silver Dentures were carved from ivory or fashioned from teeth of cattle.

6. HISTORICAL DATES 600B.C - Etruscans practice dental prosthetics using gold crowns and fixed bridgework.   1500 A.D - Ivory dentures comes into existence   1728 A.D - Faucherd proposes use of porcelain   1744 A.D - Duchateau makes First recorded porcelain denture 1864 A.D- Molding process of vulcanite dentures is patented by charles Goodyear 1855 A.D- Robert Arthur originates cohesive gold foil , allowing dentists to insert gold into cavity 1871 A.D -First Tooth coloured Silicate cement were introduced

7. 1901 A.D . Weston A. Price recommended the use of x-ray in root canal work . 1903 A.D . Four years course in dental colleges established . 1907 A.D. William H. Taggart demonstrates the cast gold inlay. 1907 A.D- William Taggart invents a Lost Wax Casting Machine, allowing dentists to make precision cast fillings. 1937A.D – Alvin Strock inserts the first Vitallium dental screw implant. 1949 A.D- Oskar Hagger , a Swiss chemist ,develops the first system of bonding acrylic resin to dentin & use of acrylics for dentures.

8. 1976 A.D – GIC invented by A Wilson 1978 A.D- Light activated composite appears in market 1983 A.D- Horn introduces resin bonded ceramic veneers 20 th century saw significant development in dentistry.

9. DENTURE FROM SIDON

10. HISTORY OF COMPLETE DENTURES  For years, dentures were fashioned from wood . BONE Replacement of decaying or lost tooth have been produced for thousand of years . denture were made as early as 700 BC using ivory & Bone . unfortunately, this level of technology was lost until about the 1800’s Bone was chosen due to its availability, reasonable cost and carvability . Fauchard fabricated dentures by measuring individual arches with a compass and cutting bone to fit the arches .It had better dimensional stability than wood, esthetic and hygienic concerns remained. Denture carved by Buddhist priest

11. IVORY They offered esthetic and hygienic advantage in comparison with denture bases carved from wood or bone. Carved ivory upper denture retained in the mouth by springs with natural human teeth cut off at the Neck and riveted at the base

12.   1794 John Greenwood began to swage gold bases for dentures. Made George Washington's dentures . George washington’s last dental prosthesis. The palate was swaged from a sheet of gold and ivory teeth riveted to it.The lower denture consists of a single carved block of ivory. The two dentures were held togther by steel Springs.

13. Human teeth were also used,pulled from the deceased or sold by poor people from their own mouths. G.Fonzi an italian dentist in Paris invented the Porcelain teeth for the construction Of dentures Picture shows partial denture of about 1830 ,porcelain teeth of fonzi’s design have been Soldered to a gold backing.

14. Could be tinted to simulate the colors of teeth and oral soft tissues. One piece porcelain upper denture crafted by Dr John Scarborough,Lambertville , New Jersey 1868.

15. In 1839 an important development took place CHARLES GOODYEAR discovered VULCANIZATION of natural rubber with sulphur (30%) and was patented by Hancock in england in 1843. NELSON GOODYEAR (brother of charles goodyear ) got the patent for vulcanite dentures in 1864 . A set of vulcanite dentures worn by Gen. John J. (Blackjack) Pershing, commander of the American Expeditionary Forces in France during the First World War Set of complete dentures having palate of swaged Gold and porcelain teeth set in vulcanite.

16. 1868 John Hyatt, A US Printer, discovered the first plastic molding compound, called celluloid. He made it by dissolving nitrocellulose under pressure In 1909, another promising organic compound was found. This was phenol formaldehyde resin discovered by Dr. Leo Backeland Celluloid upper denture 1880,celluloid as a Substitute for vulcanite was unsuccessful as It absorbs stains and odors in the mouth, Gradually turns black and was flammable.

17. In 1937 Dr. Walter Wright gave dentistry its very useful resin. It was polymethyl methacrylate which proved to be much satisfactory material tested till now Denture made of polymethyl methacrylate

18. Ambrose Paré (1510-1590) - first to describe the use of artificial eyes to fit an eye socket. Made of gold and silver. Two types can be distinguished: ekblephara and hypoblephara , intended to be worn in front of or under the eyelids, respectively. A hypoblephara eye was designed to be used above an atrophic eye, as enucleation was not a common practice until the middle of the 1800s

19. Lauret hiester (1752)- glass eyes: Lauret hiester (1752)- glass eyes The town of Lausche , Germany, had a rich history in both decorative (doll eyes, Christmas ornaments) and prosthetic arts. In the 19th century, German craftsmen (later coined " ocularists ") began to tour the United States and other parts of the world, setting up for several days at a time in one city after another where they fabricated eyes and fit them to patients. Eyes were also fitted by mail order.

20. Stock eyes (or pre-made eyes) were also utilized. An "eye doctor" might keep hundreds of glass stock eyes in cabinets, and would fit patients with the best eye right out of the drawer

21. POST WORLD WAR II YEARS POST WORLD WAR II YEARS Methyl methacrylate supplanted vulcanite as denture material Prevulcanized latex introduced in 1939 - used for hollow and lightweight appliances Vinyl polymers, copolymers, and plastisols introduced around 1940 Polyurethane elastomer introduced in the 1970s.

22. Amatus lusitanus (1564) -Sponge Obturator with bent nail carrying the sponge. Ambroise pare (1510-1590 ), father of surgery-modified lusitanus ’ obturator by substituting nail with a functional clip Sponge obturator with screw closure and Special forceps.

23. HISTORY OF FACEBOW HISTORY OF FACEBOW 1889 - Richmond.S.Hayes - introduced first e.g of facebow like device. Named it-Articulating Caliper. But acc. To Prothero (1916)- Thomas.S.Gilmer - first to suggest principle of facebow Articulating caliper- Used to record the distance from patients condyle to a point along the midline of maxillary occlusal rim. 1894 -George.K.Bagby of Newburn obtained patent for Jaw Gauge. He took condyle as posterior reference point & alveolar border at symphysis as anterior reference point

24. 1899 -George B Snow –vital breakthrough-introduced first instrument & technique for recording anatomic relationship of maxilla to the condylar axis & transferring this to articulator. Wardswarth T attachment added a new dimension to facebows by providing a 3 rd point of reference to determine vertical position of occlusal plane.

25. 1866- Francis H Balkwill described maxillomandibular movement & relationship. He introduced an instrument an for measuring angle formed b/w planes of two lines drawn from articulating surface of condyles to the incisal point & occlusal plane - Balkwills angle. He also constructed Bite Frame- enabled to place lower in the same position relative to center of hinge. Charles.E.Luce -first to use mandibular facebow to reproduce movement of mandible……..used photographic method to record movements. 1896 - William.E.Walker invented Facial Clinometer-used to determine the individual relationships & movements of mandible.

26. HISTORY OF SURVEYOR HISTORY OF DENTAL SURVEYOR:- Paralleling device used long before the development of dental surveyor. Before visual surveying of cast was done. Dr. A.J.Fortunnati –first to demonstrate advantages of using mechanical device to map contours of abutment teeth.   Dr. Kennedy credited for coining the term –Height of Contour. Robinson suryeyor –First surveyor designed for RPD

27. 1917- Stanton-Hanau Dental Surveying Apparatus got patent . During 20 th century suryeyor marketed by Ney Dental International dominated market 1923 -weinstein & Roth developed commercially available surveyor Broken arm surveyor- significant modification…..allow surveyor to function as milling machine through adaptation Blockout instruments- surveyor used to blockout undercuts ,using a pendulum surveyor Milling machines – Developed for precision attachment fabrication. Nowadays, undercut areas are projected by a beam of laser light  

28. PARALLELOMETERS: •Used before surveyors. •Can be used intra orally as well as in labs. •Partially block undercuts. •Advanced parallelometer : Galloni isoparallelometer model 1020 •2000 Bechmann parallelometer : for the placement of precision attachment parallel to path of insertion.

29. TYPES OF DENTAL SURVEYOUR •NEY SURVEYOR •JELENKO SURVEYOR •WILLIAMS SURVEYOR •RETENTOSCOPE •STRESS-O-GRAPH •TICONIUM •BROKEN ARM CAST SURVEYOR •ELECTRICAL/ COMPUTERIZED •OPTICAL SURVEYOR •INTRA ORAL SURVEYOR •PARALLELOMETER

30. NEY SURVEYOR : •First model developed by Ney in 1923 •Original Ney surveyor featured a convenient palm rest on the top of the vertical arm. •First surveyor to be commercially available. •Ney designed in 1938 is the currently used surveyor.

31. JELENKO SURVEYOR: •It is also known as Will’s surveyor. •It was introduced in 1929 •It is used with different designs of cast holders.

32. WILLIAM SURVEYOR : •Table is adjusted to desired tilt. •Degree of inclination can be recorded for positioning the cast at any time. •Centre of rotation always remains constant.

33. RETENTOSCOPE: •It is produced by the saddle lock company. •It is a surveyor with undercut gauge. •The cast attached on the table can be raised and lowered vertically and eliminates the need for movement in vertical rod.

34. TICONIUM: STRESS O GRAPH: •One of the modern instrument •The marking point will make vertical line on the abutment tooth until depth has been reached. •Also produced by Ticonium company. •Consists of two vertical holders/ horizontal arms. •One for measuring undercut. •Second for measuring survey line.

35. BROKEN-ARM CAST SURVEYOR •Featuring the Gimbel stage table. •Can be adjusted in any tilt/ direction. •Spring loaded surveying arm. •Straight hand piece could easily be clamped with surveying arm.

36. ELECTRONIC/COMPUTERIZED SURVEYORS: •Surveyor with milling machine: built in motor and cross table •Micro analyzer: capable of measuring undercut electronically in mm. • Paratherm surveyor: blockout waxing instrument heats waxing tools electrically, surveying arm moves in 3 axis. • Austenal surveyor: modern electical surveyor.

37. OPTICAL SURVEYOR: •parallel light beams. •Light bulbs with dense filaments & condenser lenses. •Contained in a box. Advantages : •Changes in survey lines & undercut can be inspected easily. •Better visualization. Disadvantages: . •Requires dark room •Light beams reflecting from cast can pose problems in illumination

38. INTRA-ORAL SURVEYORS •For checking tooth preparation of abutment teeth for fixed/removable partial dentures. •Accurately indicates planned path of insertion •Visual guide during tooth preparation •Inexpensive, practical & readily available method.

39. HISTORY OF RPD Any prosthesis that replaces some teeth in a partially dentate arch. It can be removed from the mouth and replaced at will-(GPT ) 1770 - Alexis-made the partial denture-porcelain teeth & ivory base 1791 - first British patent granted to Nicholas Dubois De Chemant - for the purpose of making partial set of denture-attached by springs for affixing the same in a more easy & effectual manner. 1792 - he began to sell dentures 1808 - single tooth in porcelain were made 1950 -thermoplastisized materials introduced in dentistry

40. 1962 - Flexite company-introduces first flexite thermoplastic – flomopolymer (Teflon type of plastic)- used in fabrication of flexible dentures. 1986- Dental-D company introduced tooth coloured clasps using Acetal Resin. 20 th century-acrylic dentures

41. HISTORY OF FPD   1789 - first made by J. Greenwood –carved from hippopotamus ivory Denture contains real human teeth fixed in ivory by means of Brass Screws CROWNS ; 5 th century B.C-first constructed by Etruscans 1880 - Porcelain tooth soldered to gold backing- patented by Dr. Cassius 1884 - A crown constructed entirely of porcelain with a metal dowel incorporated inside- patented by Dr. Marshell 1888 – Charley Henry Land- patented a method of fashioning porcelain inlays 1901 - method of fusing porcelain at higher temperature has been perfected

42. 1903 – Land introduces the strong esthetic porcelain jacket crown 1992 - Fixed Partial Dentures replaces missing teeth

43. 1884 - A crown constructed entirely of porcelain with a metal dowel incorporated inside- patented by Dr. Marshell 1888 – Charley Henry Land- patented a method of fashioning porcelain inlays

44. 1901 - method of fusing porcelain at higher temperature has been perfected 1903 – Land introduces the strong esthetic porcelain jacket crown 1992 - Fixed Partial Dentures replaces missing teeth BRIDGES : Started 2600 yrs ago First use –comes from Etruscans Extravaganza –bridges-made for women-show their wealth.

45. HISTORY OF DENTAL IMPLANT 3000 yrs ago –first copper stud was nailed in an Egyptian mouth 1913- Endosseous crib of iridium- paladium introduced 1920 - Variation in orthopedic screw seen 1930- Development of chrome alloys-development of modern dental technology 1939 -Stock brothers of Boston introduces a solid screw 1940 -Dalh of Germany introduces intramucosal or button implants (maxilla) 1948- Subperiosteal implant- Vatallium -introduced by Goldberg & Gershkoff

46. 1953 - Sollier - Transosteal implant 1966- Linkow – Endosseous Blade-Vent implant 1970 - Ramus frame implant - Roberts & Roberts 1977 - Branemark – reported results of prospective clinical research trials of totally edentulous pts. Restored with dental implants-Revolutionized implant dentistry 1981 -Non submerged implant system introduced 1984 onwards several improvements –CT scan, sinus lift, nerve transposition, pterygoid implants

47. HISTORY OF ARTICULATORS  It is a mechanical instrument that represents the temporomandibular joints and jaw membranes, to which maxillary and mandibular casts may be attached to simulate some or all mandibular movements

48. It may never be known when, where and from whose imagination the first mechanical hinge articulator emerged. Early articulators were hand made, constructed from material at hand. More common terms used were- Antagonizing frames , occluding frames. 1756 - first mechanical articulator- plaster articulator by PHILIP PFAFF

49. ARTICULATORS FROM 1700 To 18001 Philip Pfaff—plaster articulator (1756) The plaster articulator was first described by Phillip Pfaff in 1756. A plaster extension on the distal portion of the mandibular cast was grooved to serve as a guide for a plaster extension Of the maxillary cast. The extended casts together constituted the first articulator, commonly called a s lab articulator

50. ARTICULATORS FROM 1801 To 1900 • Barn Door Hinge articulator and adaptable Barn Door Hinge • JB Gariot’s first mechanical articulator (1805) • Howarth plaster articulator (1830) • Thomas W Evans—plain line articulator (1840) • Cameron’s articulator (1840) • Daniel T Evens articulator (1840) • Bonwill articulators (1858)

51. • ET Starr articulator (1868) • Antes­Lewis articulator (1895–1900) • Richmond Hayes articulator (1889) • Gysi­e Muller articulator (1896­1899) • William Earnest Walker—clinometer (1896) • Gritman’s articulator (1899)

52. ARTICULATORS FROM 1901 TO 1950 1. Huberty articulator (1901) 2. Kerr articulator (1902) 3. Christensen’s articulator (1905) 4. New century and modified new century articulator— George Snow (1906–1907) 5. The Acme articulator (1906) 6. Gysi adaptable articulator (1910) 7. Luce articulator (1911)

53. 8. Eltner articulator (1912) 9. 9. Gysi simplex articulator (1914) 10. Alligator- Rubert Hall (1915) 11. Hall’s anatomic articulator (1915) 12. Gysi Dreipunkt articulator (1917) 13. Monson-maxillomandibular instrument (1918) 14. Hagman balancer (1920) 15. Stephan articulator (1921)

54. 16. Hanau articulator (1921) 17. Hanau model M kinoscope (1923) 18. The Homer relator (1923) 19. Wadsworth articulator (1924) 20. Hanau model H110 articulator (1926) 21. Philips student articulator (Model C) or pantographic articulator (1926) 22. Hanau model H110 modified articulator (1927) 23. House articulator (1927)

55. 24. The Stansberry tripod instrument (1929) 25. Gysi Truebyte articulator (1930) 26. Terrell’s precision co-ordinator (1930) 27. Hanau crown and bridge articulator (1934) 28. The Phillips occlusoscope (1938) 29. The McCollum gnathoscope (1939) 30. Stephan articulator modified (1940) 31. Stephan articulator model P (1940)

56. 32. The Fournet articulator (1940) 33. Dentatus articulator ARH model (1944) 34. Johnson-Oglesby articulator (1950) 35. Moyer articulator (1950) 36. Coble articulator (1950) 37. Bergstorm articulator (1950) 38. The Galetti articulator (1950–1960)

57. THE BARN DOOR HINGE The "barn door', hinge, which long has been in use, is inexpensive and easy to obtain from any hardware or general store. This heavy-duty hinge is modified by bending each arm 90 degrees to form L-shaped upper and lower members.

58. THE ADAPTABLE BARN DOOR HINGE The adaptable "barn door" hinge is capable of opening and closing only in a hinge movement. It has an anterior Vertical stop, which is usually a carriage or machine bolt. Provided that the instrument is well manufactured and not flexible, lateral movement is held to a minimum.

59. GARIOT HINGE ARTICULATORS Gariot hinge joint articulator J B gariot designed the 1 st hinge articulator in 1805. Non adjustable.

60. Howarth Plaster Articulator In 1830, Howarth and Ladmore , produced a most common method for relating casts with the help of plaster index (also called as plaster articulators). It consisted of two nested metal boxes which were held in position and the hinge movement was controlled with elastics. The casts were secured in place, with twins or elastics.

61. Thomas W Evans—plain line articulator It is one of the earliest mechanical hinge articulators. Important feature was that vertical dimension could be preserved or altered as required.

62. BONWILL ARTICULATOR Bonwill articulator Design in 1858. Non adjustable. Imitates the movement of mandible in ecentric position.

63. THE KERR ARTICULATOR Several models of the Kerr articulator were on the market early in this century. It has a fixed protrusive and lateral movement. The hinge is located on approximately the same plane as the occlusal plane of the mounted cast. The concept of this design involved copying the center of mandibular rotation in the translatory opening movement.

64. The New Century articulator The New Century articulator has been credited to George B. Snow of the University of Buffalo. In 1906 he improved on the Gritman articulator of 1899 by converting the fixed condylar paths to adjustable condylar paths 1 and adding a tension spring, which allowed a greater range of movement without compromising the stability of the frame. The rotation centers were placed 4 inches apart in accordance with Bonwill's theory.

65. Snow developed a number of articulators; the modified version of the New Century instrument shown incorporates the incisal pin.

66. THE ACME ARTICULATOR The Acme articulator, which also was made by George B. Snow, is an elaboration of his 1906 New Century instrument. It includes three models of different widths that accommodate three ranges of intercondylar distance. The condylar paths are straight, and the condylar inclination is adjustable; the incisal pin rests on a changeable incisal guide. The Bennett movement is provided for arbitrarily. The guiding mechanisms are on the upper member.

67. GYSI ARTICULATOR Gysi simplex articulator Designed in 1908. Semi adjustable. Uses extraoral tracing. Advance instrument at that time.

68. GYSI SIMPLEX ADAPTABLE ARTICULATOR Gysi simplex adaptable articulator Designed by Alfred Gysi in 1914. Non adjustable and mean value articulator.

69. HAGEMAN ARTICULATOR Hageman Balancer Non adjustable which opens and closes on a hinge.

70. MONSON ARTICULATORS Monson articulator Designed by Monson in 1918. Based on spheric theory of occlusion. Non adjustable. Maxillomandibular instrument by Monson

71. STEPHAN ARTICULATOR MODEL P Stephan articulator Model P The stephan articulator as modified in 1940s is a simple hinge joint articulator that has a fixed condylar path Additional feature are an incisal pin and a vertical height adjustment.

72. GRITTMAN ARTICULATOR Grittman articulator Designed in 1899. Non adjustable. Condyles are on the lower member of the articulator Cast are mounted according to bonwill’s triangle

73. STEPHAN ARTICULATOR FIXED CONDYLAR GUIDE ARTICULATOR IN 1906.

74. Johnson - Oglesby articulator Developed around 1950. Has limited use and restorations produced. with it may required major adjustments intraorally. Moyer instrument is a mean value articulator and non adjustable .

75. THE HANAU MODEL H110 THE HANAU MODEL H110 The Hanau Model H110 T articulator evolved from the Model H115 that was manufactured in 1922 and 1923. It has individual condylar guidance adjustments in both the sagittal and the horizontal planes.

76. THE HANAU MODEL H110 MODIFIED THE HANAU MODEL H110 MODIFIED A modified Hanau Model H110 articulator appeared on the market in 1927 and introduced the incisal guide table. The original incisal guide cup with its fixed curvature could be moved only as a unit, and it did not have calibrations for resetting. The improved table appeared on Hanau articulators manufactured from 1927 to 1972 and allowed for adjustments in three dimensions through a considerable range.

77. THE PHILLIPS STUDENT ARTICULATOR THE PHILLIPS STUDENT ARTICULATOR Phillips demonstrated a prototype of the Student Articulator in 1926 before the National Society of Denture Prosthetists in Philadelphia. The articulator could reproduce mechanically the movements of the graphic recorder through the use of two vertical pins that follow the horizontal inclination of the glenoid fossa on adjustable horizontal planes and two horizontal pins that retraced the needlepoint tracing with the aid of two lateral controlling planes.

78. THE STANBERY TRIPOD INSTRUMENT THE STANBERY TRIPOD INSTRUMENT Before 1929, articulators could not accept all positional records; therefore the Stansbery Tripod articulator was designed without a hinge to facilitate the reproduction of any positional relationship.

79. THE HANAU CROWN AND BRIDGE ARTICULATOR THE HANAU CROWN AND BRIDGE ARTICULATOR The Hanau Crown and Bridge articulator is a small articulator, but unlike with other hinge articulators, a posterior pin-and-cam guidance mechanism can be set to simulate working and balancing side excursions of 15 degrees.

80. THE HANAU MODEL H2 SERIES THE HANAU MODEL H2 SERIES The principal feature of the Hanau Model 96H2 articulators was an increased distance between the upper and lower members from 95 mm to approximately 110 mm. In addition, the orbital indicator was added to the upper member. The H2-XPR had features identical to those of other models in this series, but in addition it had extendable condylar shafts and a retrusive protrusive adjustment in the condylar element. An adaptation of the Hanau Model H110 articulator, which uses a 0.75 inch lucite shim to increase the condylar post height, was described by Flinchbaugh

81. THE DENTATUS ARL ARTICULATOR THE DENTATUS ARL ARTICULATOR The Dentatus ARL articulator is a semiadjustable articulator that is a shaft type of instrument with a straight condylar path and a fixed intercondylar distance. In mechanical principle and design it is similar to the Hanau H2.1 An adjustable positioning mechanism on the upper member allows the use of a block that standardizes tile upper member to the lower member.

82. THE NEY ARTICULATOR THE NEY ARTICULATOR The Ney articulator is an arcon insirument with no locking device between the upper and lower members for centric position. The condylar elements can be set to varying intercondylar distances. These elements contain metal interchangeable condylar paths, and the elements are adjustable in all three planes to accept all positional records.

83. THE HANAU MODEL 130-21 ARTICULATOR THE HANAU MODEL 130-21 ARTICULATOR The Hanau Model 130-21 articulators is one of a series (University series) of 24 models that vary from a basic equivalent model similar to the Hanau Model H to the more sophisticated Model130-21. This instrument has the condylar element in the upper member and is a split-axis instrument. It has a centric locking device and a mechanism to keep upper and lower members together. It is adjustable to varying intercondylar distances.

84. THE WHIP-MIX ARTICULATOR THE WHIP-MIX ARTICULATOR The Whip-Mix articulator is a simplified version of Stuart's fully adjustable articulator." It was designed for complete dentures, and was intended to be useful as a diagnostic instrument and as a teaching aid. This is a semiadjustable arcon articulator that has three intercondylar adjustments: small, medium, and large. These are selected by means of the accompanying Quick Mount face-bow that uses the external auditory meatus as a posterior landmark.

85. THE SIMULATOR THE SIMULATOR The Simulator evolved from the Granger Gnatholator . It is a fully adjustable articulator that can bc set from pantographic tracings, positional records, and other tracings. There are curved condylar paths, but the unique feature of the articulator is a condylar path that rotates inwardly, a broken axis, and a mechanical timing element that combine to reproduce mechanically the Bennett movement and Fischer's angle.

86. BERGSTROM ARTICULATOR Bergstrom articulator Designed in 1950. Semi adjustable similar to Hanau H.

87. THE DENAR MODEL D4A ARTICULATOR THE DENAR MODEL D4A ARTICULATOR The Denar D4A articulator (Fig. 90) is programmed from tracings made with a pneumatically controlled pantograph that was developed and introduced by the same company. The D4A articulator is a fully adjustable instrument that uses interchangeable condylar guidances that can be adjusted.

88. THE DENTATUS ARO ARTICULATOR THE DENTATUS ARO ARTICULATOR The Dentatus ARO articulator has all the features of the Dentatus ARL plus the unique feature of a movable arm that holds the mandibular cast. The universal joint and the locking device that attaches the movable arm to the base allow repositioning of the mandibular cast without remounting. The gauge block is used to center the lower member to the upper member, but once the mandibular cast has been repositioned the articulator or casts cannot be interchanged without the aid of centric relation records.

89. HISTORY OF DENTAL MATERIALS From ancient times to 1700s • Replacement of teeth • Gold • Dentistry mean esthetics not function • (a) Ivory, which was carved • (b) Porcelain, which was fired into tooth shapes • (c) Wax and gypsum, which were used for impressions and models • (d) Zinc oxide–eugenol and zinc phosphate,which evolved as fillings and cements to “glue” the restoration to the tooth

90. Dental materials in 1800s • Amalgam, a silver filling material, was widely accepted and frequently used. • Porcelain was also used for inlays and crowns. Source: clinical aspects of dental materials by Marcia Gladwin Michael Bagby .

91. Dental materials in 20th century • Casting techniques were esteblished • Alloys of gold, titanium, chromium with cobalt and with nickle were made • Cast metals were used for crowns bridges and partial dentures • Polymers and composites were also introduced

92. Dental materials and 21st century Dental materials and 21st century • New ceramic materials and technologies are coming day by day • PEEK (poly ether ether ketone) as new dental material • Basic concepts and uses are same, unchanged

93. HISTORY OF MATERIALS: HISTORY OF MATERIALS 18 th and 19 th century bees wax. 1782 William Rae – used wax with POP. 1842 Montgomery discovered GP. 1848 Colburn and Black- GP impression. 1925-28 Development of Hydrocolloids. 1930 – A W Ward and E B Kelly introduced ZOE

94. 1936-40 Alginate by S.William Wilding. 1950 introduction of elastomers. 1960 Introduction of polyether in Germany. 1988 Latest addition and light cured elastomers. 1990-2000 New auto devices and delivery systems. Research continues….

95. RECENT ADVANCEMENT IN PROSTHODONTICS RECENT ADVANCEMENT IN PROSTHODONTICS: 1.STEREOLITHOGRAPHY 2.LASER APPLICATION IN PROSTHETIC DENTISTRY 3. A CAD/CAM SYSTEM 4.IMPRESSION MATERIAL 5.ADHESIVES

96. 7.CERAMICS 8.CEMENTS 9. WAXES 10. GINGIVAL RETRACTION SYSTEMS 11. DENTAL DRILLS

97. OROFACIAL PROSTHESIS DESIGN AND FABRICATION USING STEREOLITHOGRAPHY OROFACIAL PROSTHESIS DESIGN AND FABRICATION USING STEREOLITHOGRAPHY The use of stereolithography for the manufacture of implantable prosthesis is relatively new aspects of this dentistry Data extracted from Computed Tomography (CT scan) can be used to produce computer models of three dimensional (3D) anatomical structures Using sterolithography , a rapid prototyping technique these computer models can be made into solid physical models.

98. LASER APPLICATION IN PROSTHETIC DENTISTRY LASER APPLICATION IN PROSTHETIC DENTISTRY The current use of Lasers in Reconstructive Dentistry encompases a wide variety of soft tissue procedures but the future may hold promise for hard tissue procedures too.

99. LASER USE IN FIXED PROSTHESIS LASER USE IN FIXED PROSTHESIS Complete control of the oral environment at operative site is essential. Frequently cases are encountered in which gingival tissues need to be altered because of area of inflammation, previous subgingival restoration or subgingival caries. The finish line need to be placed near epithelial attachment making it impossible to retract the gingiva without stripping the attachment, bruising the periodontal ligament and creating uncontrolled bleeding. Sulcur gingivoplasty improves impression Technique and minimize gingival recession.

100. LASER USE IN IMPLANT DENTISTRY LASER USE IN IMPLANT DENTISTRY The importance of creating an environment for soft tissues around perimucosal portion of the implants cannot be over stated. All implants must pass through the submucosa and overlying stratified Squamous Epithelium.

101. A CAD/CAM SYSTEM FOR FABRICATION OF DENTURES A CAD/CAM SYSTEM FOR FABRICATION OF DENTURES So far the use of CAD/CAM has primarily being foccused on fixed restoration such as inlays crown because difficulty in recording soft tissue morphologies of edentulous areas, and interocclusal relationship. PROCEDURE: Involve three major steps (1) Impression procedure (2) Denture designing (3) Denture fabrication

102. IMPRESSION MATERIALS ALGINATE: ALGINATE Most commonly used impression material Advantages (1) Quick setting time (2) low cost (3) mild flavor Disadvantages (1) Poor dimensional stability (2) Messy (3) Hazardous dust (4) Repetitive hand mixing TYPES

103. DUSTLESS ALGINATE Contain high Algin content. Glycerin is incorporated on alginate particles Provides quality impression without the excessive flow. Provides more comfort then any other alginate impression material. Provides protection by reducing airborne particles , easier cleaning and healthy environment.

104. FLUORIDE CONTAINING ALGINATE: FLUORIDE CONTAINING ALGINATE Addition of NaF or SnF2 in an alginate impression. Can exert a considerable reduction in enamel solubility After fluoride addition, flexibility was 15.45–20.27%, and the recovery from deformation did not change.                                                                                

105. CHROMATIC ALGINATE: Advantages Colour changes seen while setting It is also more uniform, smoother and the compact surface enables a higher definition of detail. Three-phases of chromatic alginate: - Purple phase: mixing time – Orange phase: processing time – Yellow phase: insertion in the mouth

106. AUTO-MIX ALGINATE: it is time-saving, cost-effective alternative to traditional alginate. No hand mixing is required. Saves time and material Impressions remain stable. Tolerates disinfectants.

107. SILGIMIX : SILGIMIX An alginate Replacement Impression Material Developed from vinyl polysiloxane chemistry Addresses the shortcomings of alginate materials. Allows the user to delay pouring the model for several weeks Sultan’s Silgimix provides a simple alternative to messy, hazardous alginate materials .

108. RUBBER BASED IMPRESSION MATERIALS Non-aqueous impression materials Most widely used rubber based impression material is polyvinyl siloxane RUBBER BASED IMPRESSION MATERIALS HYDROPHYLIC POLYVINYL SILOXANE: HYDROPHYLIC POLYVINYL SILOXANE To improve hydrophilic properties surfactant and hydrophilic monomer are added whose result is a truly low contact angle. Additives also increase surface energy within the material. NANOFILLED POYVINYL SILOXANE: NANOFILLED POYVINYL SILOXANE Nan fillers are integrated in polyvinylsiloxane impression material It has improved hydrophilic properties Better flow Enhanced detail precision The newest class of elastomeric impression materials is a vinyl-polyether hybrid material called SENN

109. ADHESIVE NEW DEVELOPMENTS AND TRENDS ADHESIVE TYPES ( based on chemistry) Acrylic Epoxy Silicone Styrene block copolymer ADHESIVES ACRYLIC ADHESIVES: ACRYLIC ADHESIVES Includes the cyanoacrylate (CA)family Similar to super glues Traditional single component types cure primarily via reaction with atmospheric moisture. Newer formulations employ ultraviolet and visible light cure mechanism. cyanoacrylates are thermoplastics Recently, the introduction of truly flexible CAs promises to open new opportunities for these versatile adhesives. SILCONE ADHESIVES Strong biocompatible and have very high flexibility Can be cured by radiation , heat and moisture

110. RECENT ADVANCES IN CERAMIC MATERIALS RECENT ADVANCES IN CERAMIC MATERIALS Inceram Empress Techcerem Cad/Cam Procera system Captek system CERAMIC Inceram is supplied as one of the three core materials (1)In- ceram Spinell (2) In cerem Alumina (3)In- ceram Zirconia

111. EMPRESS: EMPRESS Hot pressed injection molded ceramics It utilizes the lost wax technique ( Wohlewend and Scharer ) Advantages 1) Lack of metal 2) Translucent ceramic core 3) High flexural strength 4) Excellent fit 5) Excellent esthetics TECHCEREM: TECHCEREM A thin ( 0.1 – 1.0 ) alumina core base layer is produced using thermal spray technique . thermal spray technique results in a density of 80 to 90%. Optimum strength and translucency are achieved by a sintering process at 1170°C

112. CAD/CAM: CAD/CAM CAD/CAM is being used in dental laboratory and general practice settings. Only one CAD/CAM system is currently available for in-office chair side use,CEREC ® 3D. PROCERA SYSTEMS These all-ceramic individual restorations comprise a densely sintered alumina core. It contains 99.9% alumina and it the hardest among ceramics used It can be used for anterior , posterior crowns ,veneers ,on lays and inlays CAPTEK SYSTEM: CAPTEK SYSTEM Captek is acronym for capillary casting technology An alternative methodology for elimination of the casting process from metal-bonded crowns and bridges

113. CEMENTS GLASS IONOMER CEMENT: GLASS IONOMER CEMENT GICs lack toughness GICs can be re-enforced physically Release less amount of fluorides than conventional GICs suggested as alternatives to amalgam or composites for posterior restorations. HYBRID IONOMER: HYBRID IONOMER It is resin modified GIC This material is intended to overcome the disadvantages of conventional GICs. Addition of Polymerizable functional groups. Improved translucency. Higher tensile strength than conventional GICs It exhibits higher bond strength to composites NEW CEMENTS COMPOMER: COMPOMER This unique material has dual properties. Fluoride release is less than conventional GICs It is mainly indicated for restoring low stress bearing areas These materials set via a free radical polymerization reaction.

114. WAXES: WAXES: WAXES Dental waxes are low molecular weight esters of fatty acids derived from natural and synthetic components such as petroleum derivatives that soften to plastic state at a relatively low temperature. These waxes eliminates duplicating techniques for the working models and saves time Used for all types of metal works , crowns , bridges , implants ADVANTAGES Easy to use Economic Cures quickly ,excellent strength and elasticity Odorless and stable

115. GINGIVAL RETRACTION SYSTEM EXPASYL: EXPASYL It is temporary gingival retraction system It is alternative to traditional gingival retraction procedures( gingival retraction cords ) It is a painless ,fast ,reliable ,high quality system for temporary opening of sulcus Expasyl is aluminum chloride in paste form Opening of sulcus does not cause bleeding GINGIVAL RETRACTION SYSTEM MAGIC FOAM CORD: MAGIC FOAM CORD Expanding PVS material Non- haemostatic gingival retraction system Designed for easy and fast retraction of the gingival sulcus . Syringed around the crown preparation margins and a cap ( Comprecap ) is placed. STAY PUT: STAY PUT Stay-put The revolutionary retraction cord Stay put is so pliable that it stays where you put it unique combination of softly braided retraction cord and an ultra fine copper filament. Does not lift out of the sulcus , do not unravel no overlapping required and impregnation.

116. DENTAL DRILLS DENTAL DRILL: DENTAL DRILL The dental drill is a tool used by dentists to bore through tooth enamel Drill technology steadily improved over time, resulting in faster and more efficient drills . Modern dental drills can rotate at over 800,000 rpm , and generally use hard metal alloy bits The most sophisticated dental drill has an internal cooling system, an epicyclic speed-increasing gearbox, and fiber optic illumination. A new method of treating cavities is known as " air- abrasive " technology Focus of research shifted to developing alternatives to conventional drills altogether. Another technology that may replace the dental drill is the laser. The major attractions of these alternative devices are increased precision and a reduction in sensations of pain and discomfort , often eliminating the need for anaesthesia .

117. SINGLE USE DISPOSABLE DIAMOND BURS : SINGLE USE DISPOSABLE DIAMOND BURS Fresh, fast cutting first time, every time Freedom from maintaining and putting up with dulling used diamonds Reasonable cost eliminates the need to recoup expense by reusing diamonds Effective patient-to-patient infection control

118. DENTURE BASE MATERIAL FLEXIBLE DENTURE BASE MATERIAL: FLEXIBLE DENTURE BASE MATERIAL Valplast is a flexible denture base resin that is ideal for partial dentures The resin is a biocompatible nylon thermoplastic DENTURE BASE RESINS ULTRA HIGH IMPACT HEAT-CURED DENTURE BASE : ULTRA HIGH IMPACT HEAT-CURED DENTURE BASE Ultra high impact to resist breakage Easily finished and polished Superior physical properties Accurate fit Convenient 2 hour heat cure

119. MICROWAVE CURED DENTURE BASE RESIN : MICROWAVE CURED DENTURE BASE RESIN It is handled just like conventional resins up to the point of curing. The microwave makes curing easier then conventional methods. Three minutes and a standard 500 watt microwave are need to cure higher quality and more precise dentures. FLUOROCORE: FLUOROCORE It is Fluoride Releasing Composite Core Build-Up Material FluoroCore Core Build-Up material uses a biocompatible urethane resin and is supplied in two shades, blue and tooth colored. The FluoroCore Core Build-Up Material is contraindicated for direct application to dental pulp TANSLUCENT ESTHETIC POSTS: TANSLUCENT ESTHETIC POSTS These have enhanced radio-opacity Superior esthetics Outstanding strength Ability to transmit polymerizable LIGHT